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Grazioli G, de León Cáceres E, Tessore R, Lund RG, Monjarás-Ávila AJ, Lukomska-Szymanska M, Hardan L, Bourgi R, Cuevas-Suárez CE. In Vitro Bond Strength of Dentin Treated with Sodium Hypochlorite: Effects of Antioxidant Solutions. Antioxidants (Basel) 2024; 13:1116. [PMID: 39334775 PMCID: PMC11428966 DOI: 10.3390/antiox13091116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2024] [Revised: 09/06/2024] [Accepted: 09/08/2024] [Indexed: 09/30/2024] Open
Abstract
This systematic review aims to evaluate whether the application of antioxidant solutions can enhance the bond strength of resin-based materials to sodium hypochlorite (NaOCl)-treated dentin. This study follows the PICOT strategy: population (sodium hypochlorite-treated dentin), intervention (application of antioxidants), control (distilled water), outcome (bond strength), and type of studies (in vitro studies). The systematic review and meta-analysis were conducted following PRISMA guidelines. Electronic databases were searched for in vitro studies evaluating the effects of antioxidants on bond strength to sodium hypochlorite-treated dentin. Two independent reviewers screened articles, extracted data, and assessed risk of bias. Meta-analyses were performed using a random-effects model to compare standardized mean differences in bond strength between antioxidant pretreatment and control groups. Inclusion criteria consisted of in vitro studies that examined the bond strength of resin-based materials to NaOCl-treated dentin with antioxidant application, while exclusion criteria included studies with incomplete data, those not using a control group, or those that did not directly measure bond strength. From 3041 initial records, 29 studies were included in the qualitative analysis and 25 in the meta-analysis. Ascorbic acid, sodium ascorbate, grape seed extract, green tea, and rosmarinic acid significantly improved bond strength to sodium hypochlorite-treated dentin (p < 0.05). The effectiveness of grape seed extract varied with adhesive system type. Hesperidin, p-toluene sulfonic acid, and sodium thiosulfate did not significantly improve bond strength. Most studies had a high risk of bias. This suggests that the conclusions drawn from these studies should be interpreted with caution, and further research with more robust methodologies may be needed to confirm the findings. In conclusion, this systematic review implies that certain antioxidants can improve bond strength to sodium hypochlorite-treated dentin, with efficacy depending on the specific agent and adhesive system used. Further standardized studies are needed to optimize protocols and confirm these findings.
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Affiliation(s)
- Guillermo Grazioli
- Department of Dental Materials, School of Dentistry, Universidad de la República, Av. General Las Heras 1925, Montevideo 11300, Uruguay; (G.G.); (E.d.L.C.); (R.T.)
| | - Elisa de León Cáceres
- Department of Dental Materials, School of Dentistry, Universidad de la República, Av. General Las Heras 1925, Montevideo 11300, Uruguay; (G.G.); (E.d.L.C.); (R.T.)
| | - Romina Tessore
- Department of Dental Materials, School of Dentistry, Universidad de la República, Av. General Las Heras 1925, Montevideo 11300, Uruguay; (G.G.); (E.d.L.C.); (R.T.)
| | - Rafael Guerra Lund
- Department of Restorative Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas 96010-610, Brazil;
| | - Ana Josefina Monjarás-Ávila
- Dental Materials Laboratory, Academic Area of Dentistry, Autonomous University of Hidalgo State, San Agustín Tlaxiaca 42160, Mexico;
| | | | - Louis Hardan
- Department of Restorative Dentistry, School of Dentistry, Saint-Joseph University, Beirut 1107 2180, Lebanon;
- Department of Digital Dentistry, AI and Evolving Technologies, Saint-Joseph University, Beirut 1107 2180, Lebanon
| | - Rim Bourgi
- Department of Restorative Dentistry, School of Dentistry, Saint-Joseph University, Beirut 1107 2180, Lebanon;
- Department of Biomaterials and Bioengineering, INSERM UMR_S 1121, University of Strasbourg, 67000 Strasbourg, France
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Jonker CH, L'Abbé EN, van der Vyver PJ, Zahra D, Oettlé AC. A micro-computed tomographic evaluation of maxillary first molar root canal morphology in Black South Africans. J Oral Sci 2024; 66:151-156. [PMID: 38853002 DOI: 10.2334/josnusd.24-0074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2024]
Abstract
PURPOSE This study was conducted to investigate the root canal anatomy of maxillary first molars in Black South Africans. METHODS Micro-computed tomography was used to investigate 101 maxillary first molars (53 teeth from the right, 48 from the left; 50 male and 51 female teeth). The number of root canals in each tooth was determined, and the relationship between side, sex and age was analyzed using chi-squared test. To determine intra- and inter-observer reliability, Cohen's kappa coefficients were calculated. RESULTS Intra- and inter-rater agreements of 96.92% and 98.08% were achieved, respectively. Most teeth contained either three or four canals, but a second, third and fourth mesio-buccal canal was found in 60.39%, 5.94% and 0.99% of teeth, respectively. The disto-buccal and palatal roots contained predominantly single canals, but additional canals were noted in 2.97% and 1.98% of teeth. Four canals were common in females and teeth on the right side often contained a second mesio-buccal canal. However, the prevalence of a third mesio-buccal canal was higher in males than in females. CONCLUSION The teeth studied showed diversity and variations between sexes and arch sides. These findings will aid clinicians in endodontic treatment and will be applicable for educational purposes.
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Affiliation(s)
- Casper H Jonker
- Faculty of Health, Peninsula Dental School, University of Plymouth, Truro Dental Education Facility, Knowledge Spa, Royal Cornwall Hospital
- Department of Anatomy, Forensic Anthropology Research Centre, Faculty of Health Sciences, University of Pretoria
| | - Ericka N L'Abbé
- Department of Anatomy, Forensic Anthropology Research Centre, Faculty of Health Sciences, University of Pretoria
| | | | - Daniel Zahra
- Peninsula Medical and Dental Schools, Faculty of Health, University of Plymouth
| | - Anna C Oettlé
- Anatomy and Histology Department, School of Medicine, Sefako Makgatho Health Sciences University
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Patel SR, Jarad F, Moawad E, Boland A, Greenhalgh J, Liu M, Maden M. The tooth survival of non-surgical root-filled posterior teeth and the associated prognostic tooth-related factors: A systematic review and meta-analysis. Int Endod J 2024. [PMID: 38949036 DOI: 10.1111/iej.14116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 05/28/2024] [Accepted: 06/18/2024] [Indexed: 07/02/2024]
Abstract
BACKGROUND Analysis of the survival of root-filled posterior teeth and the associated prognostic tooth-related factors will enable clinicians to predict the outcome of root canal treatment. OBJECTIVES To investigate (i) the survival of root-filled posterior teeth and (ii) the tooth-related factors that may affect their survival. METHODS Randomized controlled trials, comparative studies and observational studies assessing survival rates of root-filled posterior teeth with a minimum 4-year follow-up period were identified through an electronic search of the following databases up to January 2023: The Cochrane Central Register of Controlled Trials, Medline via PubMed, the Cochrane Database of Systematic Reviews, Embase, Web of Science and NIHR centre for reviews and dissemination. Two reviewers (SP and ML) independently selected the final studies based on pre-defined inclusion criteria. The Newcastle Ottawa Scale and the Cochrane Risk of Bias Tool for Randomized Trials were used to assess the risk of bias. Pooled weighted survival rates were analysed using a random effects meta-analysis model using DerSimonean and Laird methods. Descriptive analysis of studies describing any prognostic tooth-related factors was conducted. RESULTS Of the 72 studies identified, data from 20 studies were included in the survival meta-analysis, and data from 13 of these studies were included in the descriptive analysis of tooth-related factors; 12 studies were retrospective, 7 were prospective, and one was a randomized control trial. The pooled survival rates at 4-7 years and 8-20 years of root-filled posterior teeth regardless of tooth type was 91% (95% CI, 0.85; 0.95) and 87% (95% CI, 0.77; 0.93), respectively. The prognostic tooth-related factors mentioned in the included studies were (i) remaining coronal tooth structure, (ii) ferrule, (iii) crown-to-root ratio (iv) tooth type and location (v) periodontal disease (vi) proximal contacts and (vii) cracks. CONCLUSIONS The meta-analysis suggests that root canal treatment has a high medium to long term survival outcome. The narrative summary identified 7 factors that affect tooth survival. However, there is a paucity of evidence, and more research is needed in this area. REGISTRATION PROSPERO Registration: CRD42021227213.
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Affiliation(s)
- S R Patel
- Department of Endodontics, University of Liverpool School of Dentistry, Liverpool, UK
| | - F Jarad
- Department of Endodontics, University of Liverpool School of Dentistry, Liverpool, UK
| | - E Moawad
- Department of Endodontics, University of Liverpool School of Dentistry, Liverpool, UK
| | - A Boland
- Liverpool Reviews and Implementation Group (LRiG), University of Liverpool, Liverpool, UK
| | - J Greenhalgh
- Liverpool Reviews and Implementation Group (LRiG), University of Liverpool, Liverpool, UK
| | - Maria Liu
- Department of Endodontics, University of Liverpool School of Dentistry, Liverpool, UK
| | - Michelle Maden
- Liverpool Reviews and Implementation Group (LRiG), University of Liverpool, Liverpool, UK
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de Pellegrin SF, Pauletto G, Carlotto IB, Garcia Mendes AL, de Azevedo Mello P, Souza Bier CA. Interactions between calcium hypochlorite and irrigants commonly used in endodontic practice: a chemical analysis. J Endod 2023:S0099-2399(23)00245-5. [PMID: 37178758 DOI: 10.1016/j.joen.2023.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 04/27/2023] [Accepted: 05/02/2023] [Indexed: 05/15/2023]
Abstract
INTRODUCTION This study aimed to identify possible products resulting from chemical interactions between calcium hypochlorite [Ca(OCl)2] and other irrigants for endodontic use using electrospray ionization quadrupole time-of-flight mass spectrometry (ESI-QTOF-MS). METHODS The 5.25% Ca(OCl)2 was associated with either 70% ethanol solution, distilled water, saline solution (0.9% sodium chloride), 5% sodium thiosulfate, 10% citric acid, 17% EDTA, or 2% chlorhexidine (CHX). The reaction ratio was 1:1 and the products obtained were analyzed by ESI-QTOF-MS. RESULTS The interactions between Ca(OCl)2 and CHX generated an orange-brown precipitate, without identification of para-chloroaniline (PCA), and between Ca(OCl)2 and sodium thiosulfate a milky-white precipitate. Furthermore, when the oxidizing agent was associated with EDTA and citric acid, chlorine gas was released. As for the other associations, 70% ethanol, distilled water, and saline solution, no precipitation or gas release occurred. CONCLUSION The orange-brown precipitate occurs due to the chlorination of guanidine nitrogens, and the milky-white precipitate is due to the partial neutralization of the oxidizing agent. The release of chlorine gas occurs due to the low pH of the mixture, which results in the rapid formation and decomposition of chlorine. In this context, an intermediate rinsed with distilled water, saline solution and ethanol between Ca(OCl)2 and CHX, citric acid and EDTA seems to be appropriate to prevent the formation of by-products when these irrigants need to be used in the canal. Furthermore, if it is necessary to use sodium thiosulfate, a larger volume of the solution must be used than that used for the oxidizing solution.
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Affiliation(s)
- Sidnei Flores de Pellegrin
- Graduate Program in Dentistry, Faculty of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande do Sul State, Brazil
| | - Guilherme Pauletto
- MSciD and PhD Post-Graduate Program in Oral Science, Faculty of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande do Sul State, Brazil
| | - Israel Bangel Carlotto
- MSciD and PhD Post-Graduate Program in Oral Science, Faculty of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande do Sul State, Brazil
| | - Ana Luiza Garcia Mendes
- MSciD and PhD Post-Graduate Program in Chemistry, Faculty of Chemistry, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande do Sul State, Brazil
| | - Paola de Azevedo Mello
- MSciD and PhD Post-Graduate Program in Chemistry, Faculty of Chemistry, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande do Sul State, Brazil
| | - Carlos Alexandre Souza Bier
- MSciD and PhD Post-Graduate Program in Oral Science, Faculty of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande do Sul State, Brazil
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Sivieri-Araujo G, Strazzi-Sahyon HB, Jacomassi DP, Dos Santos PH, Cintra LTA, Kurachi C, Bagnato VS. Effects of methylene blue and curcumin photosensitizers on the color stability of endodontically treated intraradicular dentin. Photodiagnosis Photodyn Ther 2021; 37:102650. [PMID: 34838697 DOI: 10.1016/j.pdpdt.2021.102650] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 11/02/2021] [Accepted: 11/22/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Photodynamic therapy with photosensitizers can reduce the microbial load. However, few studies have evaluated the effects of photosensitizers on the color stability of endodontically treated intraradicular dentin. This in vitro study investigated the effects of methylene blue and curcumin photosensitizers used in photodynamic therapy on the color stability of intraradicular dentin. METHODS Sixty human incisors were divided into three experimental groups according to the photosensitizer solutions used and their concentrations: methylene blue (25 mg/L), curcumin (1000 mg/L), and curcumin (1500 mg/L). The color stability of endodontically treated intraradicular dentin was evaluated using a portable reflectance spectrophotometer before and after the samples been storage in 2 mL of the photosensitizer solutions during 5 min (n = 20). Color stability data were subjected to a normality test, and statistical analysis was performed using the one-way analysis of variance and Tukey least significant difference test (α = 0.05). RESULTS Samples treated with 25 mg/L methylene blue photosensitizer showed a higher level of color alteration than those stored in 1000 mg/L curcumin (p = .03322). However, there was no significant difference in the color alteration profiles between the samples treated with 25 mg/L methylene blue and 1500 mg/L curcumin (p = .36428). Furthermore, there was no difference in the color alteration profiles between the dentin samples immersed in 1000 mg/L and 1500 mg/L curcumin photosensitizer solutions (p = .45321). CONCLUSIONS Methylene blue and curcumin photosensitizers influenced the color stability of endodontically treated intraradicular dentin, and this color alteration exceeded the clinical acceptability threshold. Samples treated with 25 mg/L methylene blue showed the highest level of color alteration.
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Affiliation(s)
- Gustavo Sivieri-Araujo
- Department of Preventive and Restorative Dentistry, Discipline of Endodontics, Araçatuba School of Dentistry, São Paulo State University - UNESP, Araçatuba, SP, Brazil.
| | - Henrico Badaoui Strazzi-Sahyon
- Department of Dental Materials and Prosthodontics, Araçatuba School of Dentistry, São Paulo State University - UNESP, Araçatuba, SP, Brazil.
| | - Denis Pablo Jacomassi
- Optic Group, Physics Institute of São Carlos - IFSC, University of São Paulo - USP, São Carlos, SP, Brazil.
| | - Paulo Henrique Dos Santos
- Department of Dental Materials and Prosthodontics, Araçatuba School of Dentistry, São Paulo State University - UNESP, Araçatuba, SP, Brazil.
| | - Luciano Tavares Angelo Cintra
- Department of Preventive and Restorative Dentistry, Discipline of Endodontics, Araçatuba School of Dentistry, São Paulo State University - UNESP, Araçatuba, SP, Brazil.
| | - Cristina Kurachi
- Optic Group, Physics Institute of São Carlos - IFSC, University of São Paulo - USP, São Carlos, SP, Brazil.
| | - Vanderlei Salvador Bagnato
- Optic Group, Physics Institute of São Carlos - IFSC, University of São Paulo - USP, São Carlos, SP, Brazil.
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