Abstract
AIM AND BACKGROUND: The aim of the present study was to compare the efficacy of a caries control reagent [silver diamine fluoride (SDF)] and chemomechanical reagent (Papacarie gel) on smear layer removal under scanning electron microscopy (SEM) on root canal dentin of young permanent teeth. METHODOLOGY: Therapeutically extracted young premolars (n = 30) were randomly divided into three groups of 10 teeth each. Group I, control group [5.25% NaOCl + 17% ethylenediaminetetraacetic acid (EDTA)], group II, Papacarie duo gel, and group III, 3.8% SDF solution. Root canals were prepared by rotary files, and an identical irrigation protocol was followed for the three groups. Teeth were bisected longitudinally and evaluated for smear layer removal under SEM. Images analyzed were scored using criteria given by Torabinejad. All the numerical scores were subjected to statistical analysis by the Chi-square test and Kruskal-Wallis test, and results were drawn. RESULTS: Scanning electron microscopy analysis revealed the presence of residual heavy smear layer on the entire root length in group III (100%) and minimal smear layer in group II (40%), which was statistically significant. On comparison at different root levels, a statistically significant difference was reported in the middle and apical thirds among all three groups (p ≤ 0.05). CONCLUSION: Papacarie gel removed the smear layer as efficiently as the control group, besides being less detrimental to the immature dentin. Though 3.8% SDF inadequately removed the smear layer upon irrigation as compared to Papacarie and the control group, it effectively occluded the dentinal tubules. Both Papacarie and 3.8% SDF solution can be considered as adjunct root canal irrigants in young permanent teeth with wider dentinal tubules. CLINICAL RELEVANCE: The smear layer acts as a substrate for bacteria and obstructs the canal walls. Its removal has been advocated, without damaging the dentinal microhardness of the root. In search of a biologically safe irrigation solution, Papacarie and SDF were considered, and statistically significant results were obtained. HOW TO CITE THIS ARTICLE: Mythreyi G, Sharada J, Shaik H, et al. Evaluation of the Efficacy of 3.8% Silver Diamine Fluoride and Papacarie as Root Canal Irrigants in Smear Layer Removal in Young Permanent Teeth: An In Vitro Study. Int J Clin Pediatr Dent 2025;18(12):1413-1417.