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Grundmann J, Golde J, Steuer S, Tetschke F, Kirsten L, Walther J, Koch E, Hannig C. Visualization of carious lesions with polarized and depolarized light microscopy. BIOMEDICAL OPTICS EXPRESS 2024; 15:3018-3036. [PMID: 38855694 PMCID: PMC11161379 DOI: 10.1364/boe.514904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 02/28/2024] [Accepted: 03/06/2024] [Indexed: 06/11/2024]
Abstract
Polarized light microscopy (PLM) is an established method in dental histology for investigating the ultrastructure and carious process of teeth. This study introduces a novel approach for measuring the degree of polarization (DOP) in a modified PLM setup and uses the DOP to assess the changes of the optical properties of enamel and dentin due to caries. The validation is provided by a comparison with complementary imaging methods, i.e. standard PLM and µCT. The results show that demineralization is reliably displayed by the DOP in accordance with the common imaging methods, and that this quantitative analysis of depolarization allows the characterization of the different pathohistological zones of caries.
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Affiliation(s)
- Julia Grundmann
- TU Dresden, Faculty of Medicine Carl Gustav Carus, Policlinic of Operative Dentistry, Periodontology and Pediatric Dentistry, Fetscherstrasse 74, 01307 Dresden, Germany
- TU Dresden, Faculty of Medicine Carl Gustav Carus, Medical Physics and Biomedical Engineering, Fetscherstrasse 74, 01307 Dresden, Germany
| | - Jonas Golde
- TU Dresden, Faculty of Medicine Carl Gustav Carus, Medical Physics and Biomedical Engineering, Fetscherstrasse 74, 01307 Dresden, Germany
- TU Dresden, Faculty of Medicine Carl Gustav Carus, Anesthesiology and Intensive Care Medicine, Clinical Sensoring and Monitoring, Fetscherstrasse 74, 01307 Dresden, Germany
- Fraunhofer Institute for Material and Beam Technology IWS, Winterbergstrasse 28, 01277 Dresden, Germany
| | - Svea Steuer
- TU Dresden, Faculty of Medicine Carl Gustav Carus, Anesthesiology and Intensive Care Medicine, Clinical Sensoring and Monitoring, Fetscherstrasse 74, 01307 Dresden, Germany
| | - Florian Tetschke
- TU Dresden, Faculty of Medicine Carl Gustav Carus, Policlinic of Operative Dentistry, Periodontology and Pediatric Dentistry, Fetscherstrasse 74, 01307 Dresden, Germany
- TU Dresden, Faculty of Medicine Carl Gustav Carus, Anesthesiology and Intensive Care Medicine, Clinical Sensoring and Monitoring, Fetscherstrasse 74, 01307 Dresden, Germany
- Current address: Sonovum GmbH, Deutscher Platz 4, 04103 Leipzig, Germany
| | - Lars Kirsten
- TU Dresden, Faculty of Medicine Carl Gustav Carus, Medical Physics and Biomedical Engineering, Fetscherstrasse 74, 01307 Dresden, Germany
| | - Julia Walther
- TU Dresden, Faculty of Medicine Carl Gustav Carus, Medical Physics and Biomedical Engineering, Fetscherstrasse 74, 01307 Dresden, Germany
| | - Edmund Koch
- TU Dresden, Faculty of Medicine Carl Gustav Carus, Anesthesiology and Intensive Care Medicine, Clinical Sensoring and Monitoring, Fetscherstrasse 74, 01307 Dresden, Germany
| | - Christian Hannig
- TU Dresden, Faculty of Medicine Carl Gustav Carus, Policlinic of Operative Dentistry, Periodontology and Pediatric Dentistry, Fetscherstrasse 74, 01307 Dresden, Germany
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Gómez-Delgado M, Camps-Font O, Luz L, Sanz D, Mercade M. Update on citric acid use in endodontic treatment: a systematic review. Odontology 2023; 111:1-19. [PMID: 36220913 DOI: 10.1007/s10266-022-00744-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 09/02/2022] [Indexed: 01/06/2023]
Abstract
This systematic review aims to analyse the available evidence concerning the use of citric acid (CA) in endodontics treatment and to assess its results in terms of different considerations: effect on smear layer removal, influence on sealer bond strength, activation effect by means of sonic or ultrasonic devices, effects on dentine surface, antibacterial activity, and effectiveness boost for regenerative procedures, releasing growth factors from dentin. To evaluate the results of CA as a final irrigant and compare them to other chelating agents. This review followed the PRISMA checklist. An electronic search was conducted in MEDLINE (OVID), Scopus (Elsevier) and the Web of Science (Thomson Reuters) databases. Risk of bias of included studies was evaluated using the modified CONSORT checklist and the PRIRATE checklist 2020 guidelines. 39 studies fulfilled the eligibility criteria to be included in this review: 27 in vitro studies using extracted human teeth, 10 in vitro studies using human dentin disks, and 2 RCT. Citric acid has proven to be effective in smear layer removal, showing better results in coronal and middle root thirds, improving its effect when combined with manual dynamic activation. There is no agreement regarding citric acid effect on sealer adhesion and adaptation to root canal walls due to heterogeneity within studies. Citric acid irrigation can decrease dentine microhardness and cause decalcification and erosion, especially when used before NaOCl. Citric acid has proven to be beneficial in regenerative endodontic procedures due to higher TGF-β1 release.Trial registration: Prospero database CRD42021267055.
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Affiliation(s)
- M Gómez-Delgado
- Department of Dentistry, Universitat de Barcelona, Barcelona, Spain
| | - O Camps-Font
- Department of Dentistry, Universitat de Barcelona, Barcelona, Spain
| | - L Luz
- Postgraduate Program in Endodontics, University of Rio Grande Do Sul, Porto Alegre, Brazil
| | - D Sanz
- Department of Dentistry, Universitat de Barcelona, Barcelona, Spain
| | - M Mercade
- Department of Dentistry, Universitat de Barcelona, Barcelona, Spain. .,IDIBELL Institute, C/Feixa Llarga S/N, Hospitalet de Llobregat, 08907, Barcelona, Spain.
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Briseño-Marroquín B, Callaway A, Shalamzari NG, Wolf TG. Antibacterial efficacy of peracetic acid in comparison with sodium hypochlorite or chlorhexidine against Enterococcus faecalis and Parvimonas micra. BMC Oral Health 2022; 22:119. [PMID: 35397605 PMCID: PMC8994351 DOI: 10.1186/s12903-022-02148-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 03/25/2022] [Indexed: 11/29/2022] Open
Abstract
Background The main goal of an endodontic treatment is a complete debridement of the root canal system; however, currently mechanical shaping and chemical cleaning procedures for this purpose have deemed non-satisfactory.
Methods The efficacy of peracetic acid (PAA; 0.5, 1.0, 2.0%), as a root canal irrigation solution, against Enterococcus faecalis (DSM 20478) and Parvimonas micra (DSM 20468) when compared with the one of sodium hypochlorite (NaOCI; 1.0, 3.0, 5.0%), chlorhexidine digluconate (CHX; 0.12, 0.2, 2.0%) and 0.9% NaCI (as a control solution) was in vitro investigated with the agar diffusion and direct contact methods. The inhibition zone diameters observed with the agar diffusion test were determined. The viable bacterial counts (CFU/ml) were calculated with the direct method. Results The agar diffusion test showed that all three root canal irrigation solutions had an efficacy against E. faecalis at all concentrations. The largest inhibition zone diameters against E. faecalis were observed with 5.0% NaOCI. At all three concentrations of PAA, NaOCI, and CHX, the inhibition zone diameter increased with increase in concentration. For P. micra, PAA had a similar inhibition zone diameter despite a concentration increase. In contrast, for NaOCI and CHX, the inhibition zone diameter increased with increasing concentration. 2.0% CHX produced the largest inhibition zone diameter against P. micra. For E. faecalis, only the comparison between 2.0% PAA and 5.0% NaOCI showed statistical significance (p = 0.004). For P. micra the efficacy comparison between the lowest, middle, and highest concentrations of each solution, a statistical significance (p < 0.05) was found for all three solutions. After direct contact with PAA, NaOCI and CHX, no viable bacteria could be determined for either P. micra or E. faecalis. Conclusions PAA had a similar antibacterial efficacy as the one of NaOCl and CHX when in direct contact with E. faecalis and P. micra. In the agar diffusion test, PAA showed a similar antibacterial efficacy as the one of CHX and a lower one as the one of NaOCl for E. faecalis.
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Rath PP, Yiu CKY, Matinlinna JP, Kishen A, Neelakantan P. The effect of root canal irrigants on dentin: a focused review. Restor Dent Endod 2020; 45:e39. [PMID: 32839720 PMCID: PMC7431934 DOI: 10.5395/rde.2020.45.e39] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 06/03/2020] [Accepted: 06/09/2020] [Indexed: 11/15/2022] Open
Abstract
Despite the vast literature on the effects of root canal irrigants on the dentin characteristics, the precise effects of clinically relevant irrigation sequences remain unclear. In this review, we systematically dissect the role of different sequential irrigation approaches that are used in clinical endodontics. Using a systematic search strategy, we attempt to answer the question: ‘Which irrigating sequence has the most deleterious effects on dentin structure and properties?’ The effect of irrigants on the dentin composition and mechanical properties have been reviewed. A wide variety of concentrations, duration and techniques have been employed to characterize the effects of chemicals on dentin properties, thus making it impossible to draw guidelines or recommendations of irrigant sequences to be followed clinically. It was apparent that all the studied irrigation sequences potentially result in some deleterious effects on dentin such as decrease in the flexural strength, microhardness, modulus of elasticity and inorganic content and organic-inorganic ratio of the dentin. However, the literature still lacks comprehensive investigations to compare the deleterious effect of different irrigation sequences, using a wide variety of qualitative and quantitative methods. Such investigations are essential to make clinical recommendations and strategize efforts to minimize chemically-induced damage to dentin characteristics.
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Affiliation(s)
- Priti Pragati Rath
- Discipline of Endodontology, Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR
| | - Cynthia Kar Yung Yiu
- Discipline of Pediatric Dentistry, Division of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR
| | - Jukka Pekka Matinlinna
- Dental Materials Science, Division of Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR
| | - Anil Kishen
- Faculty of Dentistry, The University of Toronto, Toronto, ON, Canada.,Dentistry, Mount Sinai Hospital, Toronto, ON, Canada
| | - Prasanna Neelakantan
- Discipline of Endodontology, Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR
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Chia MSY, Parolia A, Lim BSH, Jayaraman J, Porto ICCDM. Effect of QMix irrigant in removal of smear layer in root canal system: a systematic review of in vitro studies. Restor Dent Endod 2020; 45:e28. [PMID: 32839709 PMCID: PMC7431937 DOI: 10.5395/rde.2020.45.e28] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Revised: 01/13/2020] [Accepted: 01/18/2020] [Indexed: 11/11/2022] Open
Abstract
Objectives To evaluate the outcome of in vitro studies comparing the effectiveness of QMix irrigant in removing the smear layer in the root canal system compared with other irrigants. Materials and Methods The research question was developed by using Population, Intervention, Comparison, Outcome and Study design framework. Literature search was performed using 3 electronic databases PubMed, Scopus, and EBSCOhost until October 2019. Two reviewers were independently involved in the selection of the articles and data extraction process. Risk of bias of the studies was independently appraised using revised Cochrane Risk of Bias tool (RoB 2.0) based on 5 domains. Results Thirteen studies fulfilled the selection criteria. The overall risk of bias was moderate. QMix was found to have better smear layer removal ability than mixture of tetracycline isonomer, an acid and a detergent (MTAD), sodium hypochlorite (NaOCl), and phytic acid. The efficacy was less effective than 7% maleic acid and 10% citric acid. No conclusive results could be drawn between QMix and 17% ethylenediaminetetraacetic acid due to conflicting results. QMix was more effective when used for 3 minutes than 1 minute. Conclusions QMix has better smear layer removal ability compared to MTAD, NaOCl, Tubulicid Plus, and Phytic acid. In order to remove the smear layer more effectively with QMix, it is recommended to use it for a longer duration.
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Affiliation(s)
| | - Abhishek Parolia
- Division of Clinical Dentistry, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
| | | | - Jayakumar Jayaraman
- Department of Developmental Dentistry, University of Texas Health School of Dentistry, San Antonio, TX, USA
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Glycolic acid: Characterization of a new final irrigant and effects on flexural strength and structural integrity of dentin. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2020; 106:110283. [DOI: 10.1016/j.msec.2019.110283] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 09/03/2019] [Accepted: 10/05/2019] [Indexed: 11/22/2022]
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Cardoso LR, Baldasso FER, Delai D, Montagner F, Kopper PMP. Effect of EDTA, sodium, and calcium hypochlorite on the inorganic component of root canal dentin: A SEM analysis. Microsc Res Tech 2018; 82:128-133. [PMID: 30582246 DOI: 10.1002/jemt.23151] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 09/13/2018] [Accepted: 09/19/2018] [Indexed: 11/11/2022]
Abstract
This study evaluated the influence of canal irrigation protocols with 5.25% calcium hypochlorite [Ca(OCl)2 ], 5.25% sodium hypochlorite (NaOCl) and 17% EDTA solution on the inorganic component of root canal dentin. Sixty roots were randomly divided into six groups (n = 10): Saline solution (SS) (control); Saline solution (SSE) +17% EDTA; CH - 5.25% Ca(OCl)2 ; CHE - 5.25% Ca(OCl)2 + 17% EDTA; SH - 5.25% NaOCl; SHE - 5.25% NaOCl +17% EDTA. After canal irrigation, the specimens were longitudinally split and analyzed by scanning electron microscopy (SEM). Dentinal tubules were observed in transverse (middle and apical thirds) direction. The images were classified in scores, according to smear layer removal and peritubular dentin alteration, and data were analyzed by Kruskal-Wallis's test, followed by Dunn's test (α = 0.05). In the middle third, all groups with EDTA presented better removal of the smear layer with higher peritubular dentin alteration (p < .05). In the apical third, this happened only in SHE (p < .05). Ca(OCl)2 and NaOCl exhibit similar performance to remove smear layer and alteration of the inorganic component in the middle third. In the apical third, NaOCl associated with EDTA showed better performance in smear layer removal.
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Affiliation(s)
- Luana Roleto Cardoso
- Graduate Program in Dentistry, Federal University of Rio Grande do Sul, UFRGS, Porto Alegre, RS, Brazil
| | | | - Débora Delai
- Graduate Program in Dentistry, Federal University of Rio Grande do Sul, UFRGS, Porto Alegre, RS, Brazil
| | - Francisco Montagner
- Graduate Program in Dentistry, Federal University of Rio Grande do Sul, UFRGS, Porto Alegre, RS, Brazil
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