Comparative evaluation of different irrigation solutions used in dentistry: A scanning electron microscope and energy dispersive X-ray analysis study.

CONTEXT

BACKGROUND

Effective irrigation is essential for successful pulpectomy in primary teeth. Sodium hypochlorite (NaOCl), although widely used, has cytotoxic and demineralizing effects. Bioactive alternatives such as silver diamine fluoride (SDF) and fluoridated mouthwash require evaluation.

AIMS: This study aimed to compare the effects of NaOCl, SDF, and fluoridated mouthwash on dentinal surface morphology and elemental composition using scanning electron microscopy (SEM) and energy dispersive X-ray (EDX) spectroscopy analysis.

SETTINGS AND

DESIGN

In vitro experimental study conducted in a tertiary dental institution. Materials and

Methods

Thirty-six extracted primary maxillary incisors were randomly divided into three groups ( n = 12): 1% NaOCl, 3.8% SDF, and 0.05% fluoridated mouthwash. Standardized access preparation and irrigation were performed. SEM assessed smear layer removal, and EDX evaluated elemental composition (Ca, P, Ag, F).

STATISTICAL ANALYSIS USED: One-way ANOVA and Kruskal-Wallis tests were used with significance set at P < 0.05.

RESULTS

NaOCl demonstrated complete smear layer removal (Score 0) across all root thirds with significantly reduced calcium and phosphorus content and no silver or fluoride deposition. SDF showed effective smear layer removal with dentinal tubule occlusion, significant silver (4.97%) and fluoride deposition, and preserved mineral content compared to NaOCl. Fluoridated mouthwash exhibited the highest calcium preservation with minimal residual smear layer and moderate fluoride uptake, with all intergroup differences being statistically significant ( P < 0.05).

CONCLUSIONS

SDF and fluoridated mouthwash are effective bioactive alternatives to NaOCl, offering smear layer removal while preserving dentinal integrity and enhancing mineral deposition.