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Irusa K, Alrahaem IA, Ngoc CN, Donovan T. Tooth whitening procedures: A narrative review. DENTISTRY REVIEW 2022; 2:100055. [DOI: 10.1016/j.dentre.2022.100055] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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Boutsioukis C, Arias-Moliz MT. Present status and future directions - irrigants and irrigation methods. Int Endod J 2022; 55 Suppl 3:588-612. [PMID: 35338652 PMCID: PMC9321999 DOI: 10.1111/iej.13739] [Citation(s) in RCA: 66] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 03/21/2022] [Indexed: 11/30/2022]
Abstract
Irrigation is considered the primary means of cleaning and disinfection of the root canal system. The purpose of this review was to set the framework for the obstacles that irrigation needs to overcome, to critically appraise currently used irrigants and irrigation methods, to highlight knowledge gaps and methodological limitations in the available studies and to provide directions for future developments. Organization of bacteria in biofilms located in anatomic intricacies of the root canal system and the difficulty to eliminate them is the main challenge for irrigants. Sodium hypochlorite remains the primary irrigant of choice, but it needs to be supplemented by a chelator. Delivery of the irrigants using a syringe and needle and activation by an ultrasonic file are the most popular irrigation methods. There is no evidence that any adjunct irrigation method, including ultrasonic activation, can improve the long‐term outcome of root canal treatment beyond what can be achieved by instrumentation and syringe irrigation. It is necessary to redefine the research priorities in this field and investigate in greater depth the penetration of the irrigants, their effect on the biofilm and the long‐term treatment outcome. New studies must also focus on clinically relevant comparisons, avoid methodological flaws and have sufficiently large sample sizes to reach reliable conclusions. Future multidisciplinary efforts combining the knowledge from basic sciences such as Chemistry, Microbiology and Fluid Dynamics may lead to more effective antimicrobials and improved activation methods to bring them closer to the residual biofilm in the root canal system.
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Affiliation(s)
- C Boutsioukis
- Department of Endodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - M T Arias-Moliz
- Department of Microbiology, Faculty of Dentistry, University of Granada, Granada, Spain
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Athanassiadis B, Abbott PV, Walsh LJ. A critical analysis of research methods and experimental models to study tooth discolouration from endodontic materials. Int Endod J 2022; 55 Suppl 2:370-383. [PMID: 35165907 DOI: 10.1111/iej.13708] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Accepted: 02/08/2022] [Indexed: 11/27/2022]
Abstract
As a range of materials used in endodontics may cause tooth discolouration, exploration of factors responsible for the darkening of the tooth crown or root is warranted. This narrative review paper discusses the range of technical factors that apply in laboratory studies that assess endodontic discolouration. As an example of how these factors operate, particular examples relating to discolouration caused by endodontic medicaments containing tetracycline antibiotics are used. Following the PRILE 2021 guidelines approach, a summary of key variables to be addressed in the methodology for laboratory studies is presented, to inform future work.
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Affiliation(s)
| | - Paul V Abbott
- UWA Dental School, The University of Western Australia
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Ozkan HB, Cobankara FK, Sayin Z, Ozer F. Evaluation of the Antibacterial Effects of Single and Combined use of Different Irrigation Solutions Against Intracanal Enterococcus Faecalis. Acta Stomatol Croat 2020; 54:250-262. [PMID: 33132388 PMCID: PMC7586900 DOI: 10.15644/asc54/3/3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Objectives This study assessed the antibacterial activity of both separate and combined uses of 5.25% sodium hypochlorite (NaOCl), 2% chlorhexidine (CHX), 17% ethylenediaminetetraacetic acid (EDTA), 3% hydrogen peroxide (H2O2), MTAD, SmearClear (SC) and 13.8% chlorine dioxide (ClO2) irrigation solutions against Enterococcus faecalis. Materials and Methods Two hundred eighty single rooted human premolars were randomly grouped into 26 test and 2 control (negative and positive) groups and were incubated for 24 h with E. faecalis, except for the negative control group. The tested solutions were as follow: NaOCl; CHX; ClO2; MTAD; SC; EDTA; H2O2; NaOCl + CHX; NaOCl + MTAD; SC + NaOCl; EDTA + NaOCl; H2O2 + NaOCl; ClO2 + CHX; CHX + MTAD; SC + CHX; EDTA + CHX; CHX + H2O2; ClO2 + MTAD; SC + ClO2; EDTA + ClO2; ClO2 + H2O2; SC+MTAD; EDTA+MTAD; MTAD + H2O2; SC + H2O2; and EDTA + H2O2. Optic density values were recorded at 0, 6, 12, 18, 24, 30, 36, 42 and 48 h and bacterial growth curve created for each solution. Results The CHX, MTAD and ClO2 showed a high potential for the elimination of E. faecalis, both alone and in all combinations. The EDTA, H2O2, H2O2+ EDTA, H2O2 + NaOCl and SC + NaOCl groups showed less antibacterial activity than the other groups. The SC + CHX group showed the best antibacterial effect against E. faecalis. Conclusion The SC + CHX combination can be recommended as the most effective irrigation regimen against E. faecalis in persistent endodontic infections.
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Affiliation(s)
- Hatice Buyukozer Ozkan
- Department of Endodontics, Faculty of Dentistry, Alanya Alaaddin Keykubat University, Alanya, Antalya, Turkey
| | - Funda Kont Cobankara
- Department of Endodontics, Faculty of Dentistry, Selcuk University, Konya, Turkey
| | - Zafer Sayin
- Department of Microbiology, Faculty of Veterinary Medicine, Selcuk University, Konya, Turkey
| | - Fusun Ozer
- Department of Preventive and Restorative Sciences, School of Dental Medicine University of Pennsylvania, Philadelphia, Pennsylvania
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Mechanisms of Staining with Demeclocycline and Doxycycline Root Canal Medicaments. Eur Endod J 2018; 3:66-72. [PMID: 32161858 PMCID: PMC7006570 DOI: 10.14744/eej.2018.47966] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 02/15/2018] [Accepted: 02/12/2018] [Indexed: 11/20/2022] Open
Abstract
Tetracyclines are a unique class of antibiotics which also have additional effects including anti-inflammatory, anti-resorptive and substantive within the root canal. There has been a long-held view that tetracycline medicaments discolour teeth and should be avoided. The evidence base around this topic was explored, including a review of the methodology used in laboratory studies. A search of PubMed, Medline and Scopus databases was conducted to identify studies of demeclocycline and doxycycline medicaments used in root canal therapy. An analysis of the methodology used in these studies was performed to determine if these replicate current clinical practice. The related literature on mechanisms of tetracycline stability and the effects of light, oxidation, moisture and chemical interactions was examined. Studies investigating the effects of Ledermix paste on segments of bovine dentine and avulsed or reimplanted teeth as well as combinations with other antibiotics were excluded from this review. Even though demeclocycline medicament pastes were introduced in 1962, the first laboratory studies of discolouration were not done until 2000. All later studies followed a similar approach, which included exposure to sodium hypochlorite for up to 30 minutes and storage in moist conditions with 100% humidity. Staining during dark storage and enhanced staining on exposure to light were reported, indicating multiple pathways of degradation of demeclocycline and its reaction products. Light, moisture and oxidation are the key factors which drive discolouration from demeclocycline. Clinical issues from tooth staining can be prevented by removal of medicament pastes from the access cavity, and placement of a sound interim restoration. Use of a doxycycline paste obviates concerns of staining. Laboratory assessments of the potential for staining should replicate in vivo conditions.
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Alkaline Sodium Hypochlorite Irrigant and Its Chemical Interactions. MATERIALS 2017; 10:ma10101147. [PMID: 28961175 PMCID: PMC5666953 DOI: 10.3390/ma10101147] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 09/23/2017] [Accepted: 09/24/2017] [Indexed: 11/18/2022]
Abstract
Endodontic irrigating solutions may interact chemically with one another. This is important, because even when solutions are not admixed, they will come into contact with one another during an alternating irrigation technique, forming unwanted by-products, which may be toxic or irritant. Mixing or alternating irrigants can also reduce their ability to clean and disinfect the root canal system of teeth by changing their chemical structure with subsequent loss of the active agent, or by inducing precipitate formation in the root canal system. Precipitates occlude dental tubules, resulting in less penetration of antimicrobials and a loss of disinfection efficacy. Sodium hypochlorite is not only a very reactive oxidizing agent, but is also the most commonly used endodontic irrigant. As such, many interactions occurring between it and other irrigants, chelators and other antimicrobials, may occur. Of particular interest is the interaction between sodium hypochlorite and the chelators EDTA, citric acid and etidronate and between sodium hypochlorite and the antimicrobials chlorhexidine, alexidine, MTAD and octenisept.
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Porter MLA, Münchow EA, Albuquerque MTP, Spolnik KJ, Hara AT, Bottino MC. Effects of Novel 3-dimensional Antibiotic-containing Electrospun Scaffolds on Dentin Discoloration. J Endod 2015; 42:106-12. [PMID: 26602451 DOI: 10.1016/j.joen.2015.09.013] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 09/17/2015] [Accepted: 09/19/2015] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Although intracanal application of the triple antibiotic paste (TAP) may offer advantages (eg, disinfection), this practice has been associated with significant drawbacks, including tooth discoloration. In this study, the color change of dentin was monitored during treatment with distinct TAP pastes and novel tubular-shaped 3-dimensional electrospun scaffolds containing minocycline (MINO) or doxycycline (DOX). METHODS Two TAP pastes (TAPMINO [MINO, metronidazole, and ciprofloxacin] and TAPDOX [DOX, metronidazole, and ciprofloxacin]), 4 scaffold-based groups containing MINO or DOX at distinct concentrations, 1 antibiotic-free scaffold, and 1 untreated group (control) were investigated. Human canines were sectioned at the cementoenamel junction and tubular-shaped scaffolds or paste were placed into the root canals and sealed. Color measurements (CIEL(*)a(*)b(*) parameters) were performed at baseline and after 1, 3, 7, 14, 21, and 28 days. Color changes were expressed as ΔE(*) values. In addition, scanning electron microscopy and energy-dispersive X-ray spectroscopy were also performed on the specimens after treatment. Data were analyzed using repeated measures analysis of variance (alpha = 0.05). RESULTS All antibiotic-containing groups led to greater discoloration than the antibiotic-free groups. A severe discoloration occurred after 1 day. At the end of the experiment, antibiotic-treated samples exhibited crusts/agglomerates over the dentin surface, which totally or partially obliterated the dentinal tubules. The presence of MINO resulted in a greater color change than DOX. CONCLUSIONS Scaffolds containing MINO or DOX produced similar color change to dentin when compared with their respective TAP systems, although DOX-related discoloration was less pronounced.
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Affiliation(s)
- Margaret Louise A Porter
- Department of Biomedical and Applied Sciences, Indiana University School of Dentistry, Indianapolis, Indiana; Department of Restorative Dentistry, Indiana University School of Dentistry, Indianapolis, Indiana
| | - Eliseu A Münchow
- Department of Biomedical and Applied Sciences, Indiana University School of Dentistry, Indianapolis, Indiana; Department of Operative Dentistry, Federal University of Pelotas, School of Dentistry, Pelotas, Rio Grande do Sul, Brazil
| | - Maria T P Albuquerque
- Department of Biomedical and Applied Sciences, Indiana University School of Dentistry, Indianapolis, Indiana; Universidade Estadual Paulista, São José dos Campos Dental School, São José dos Campos, São Paulo, Brazil
| | - Kenneth J Spolnik
- Department of Endodontics, Indiana University School of Dentistry, Indianapolis, Indiana
| | - Anderson T Hara
- Department of Cariology, Operative Dentistry and Dental Public Health, Indiana University School of Dentistry, Indianapolis, Indiana
| | - Marco C Bottino
- Department of Biomedical and Applied Sciences, Indiana University School of Dentistry, Indianapolis, Indiana.
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Giardino L, Estrela C, Generali L, Mohammadi Z, Asgary S. The in vitro Effect of Irrigants with Low Surface Tension on Enterococcus faecalis. IRANIAN ENDODONTIC JOURNAL 2015; 10:174-8. [PMID: 26229541 PMCID: PMC4509125 DOI: 10.7508/iej.2015.03.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2014] [Revised: 04/25/2015] [Accepted: 05/10/2015] [Indexed: 11/30/2022]
Abstract
Introduction: Due to the complex anatomy of the root canal system and high surface tension of common root canal irrigants (RCI), conducting an investigation on RCIs containing surfactants is a priority. The aim of this in vitro study was to verify the antibacterial potential of RCI with low surface tension in root canals infected with Enterococcus faecalis (E. faecalis). Methods and Materials: Thirty-five extracted human maxillary anterior teeth were prepared and inoculated with E. faecalis for 60 days. After root canal preparation, the teeth were randomly divided to one positive and one negative control groups and 5 experimental groups: Hypoclean/Tetraclean NA, Hypoclean, Tetraclean, NaOCl/Tetraclean and NaOCl. Bacterial growth was observed by turbidity of culture medium and then measured using a UV spectrophotometer. Data were analyzed in three time intervals (pre-instrumentation and, 20 min and 72 h after canal preparation) using the ANOVA and post hoc Tukey’s tests. The level of significance was set at 0.05. Results: The results indicated the presence of E. faecalis in all post-irrigation samples irrespective of the RCI. However, the optical densities in both post-irrigation periods showed bacterial reduction and significant differences between groups. Conclusion: RCI with low surface tension showed antibacterial potential in E. faecalis infected roots.
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Affiliation(s)
| | - Carlos Estrela
- Department of Stomatological Sciences, Dental School, UFG-Federal University of Goiás, Goiânia, GO, Brazil
| | - Luigi Generali
- Dipartimento Chirurgico, Medico, Odontoiatrico e di Scienze Morfologiche con Interesse Trapiantologico, Oncologico e di Medicina Rigenerativa, Università di Modena e Reggio Emilia, Modena, Italy
| | - Zahed Mohammadi
- Iranian Center for Endodontic Research (ICER), Research Institute of Dental Sciences, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saeed Asgary
- Iranian Center for Endodontic Research (ICER), Research Institute of Dental Sciences, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Iskander M, Elkassas D, Mohsen MA. Effect of Two Matrix Metalloproteinase Inhibitors on the Color Stability of a Nanofilled Resin Composite. Oper Dent 2015; 40:E11-20. [DOI: 10.2341/12-428-l] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SUMMARY
Objectives
This in vitro study evaluated the effect of two matrix metalloproteinase (MMP) inhibitors on the color stability of two shades of a nanofilled resin composite.
Methods and Materials
A total of 60 sound human molars were used in this study. Flat dentin surfaces were obtained by wet grinding the occlusal surfaces. Following acid etching, the molars were divided into three equal groups according to the MMP inhibitor used: Group 1: no inhibitor (control group), group 2: chlorhexidine digluconate based (CHX; Consepsis, Ultradent, South Jordan, UT, USA); group 3: doxycycline based (MTAD; Biopure, Dentsply TulsaDental, Johnson, TN, USA). Adper Single Bond 2 Adhesive (3M ESPE, St Paul, MN, USA) was applied to the treated dentin surfaces. Each group was then subdivided into two equal subgroups of 10 molars each, according to the shade of the resin composite (Filtek Z350 XT, 3M ESPE) used, either B1 or A3. The color was assessed for each subgroup at three times: baseline (after 24 hours); after aging using a total energy of 600 kJ/m2 (Weather-Ometer Ci35A, Atlas Electronic Devices Company, Chicago, IL, USA); and then after a second period of aging, for a total energy of 1200 kJ/m2. Color assessment was carried out using a spectrophotometer. Color change (ΔE) was calculated according to the Commission Internationale de l'Eclairage L*a* b* color scale, comparing each aging period with the baseline color measurement. Data were analyzed using repeated measures analysis of variance and Tukey post hoc test.
Results
All tested subgroups showed greater discoloration than the clinically acceptable level (3.3). MTAD induced the highest statistically significant color change, followed by CHX, whereas the control groups showed the lowest statistical ΔE values with both tested shades. Shade B1 subgroups showed higher ΔE values when compared with shade A3 subgroups.
Conclusion
Accelerated aging caused color change in a nanofilled resin composite regardless of MMP inhibitor used. Furthermore, lighter shades showed less color stability when compared with darker shades.
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Affiliation(s)
- M Iskander
- Mireille Hany Iskander, DMD, Operative Dentistry, Misr International University, Cairo, Egypt
| | - D Elkassas
- Dina W Elkassas, BDS, MSc, PhD, associate professor, Operative Dentistry Department, Faculty of Oral and Dental Medicine, Misr International University, Cairo, Egypt
| | - MA Mohsen
- Mohamed Abdel Mohsen, BDS, MSc, PhD, professor, Operative Dentistry Department, Faculty of Oral and Dental Medicine, Cairo University, Cairo, Egypt
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Koursoumis AD, Kerezoudis NP, Kakaboura A. In vitro assessment of tooth color alteration by two different types of endodontic irrigants. J Contemp Dent Pract 2014; 15:529-33. [PMID: 25707821 DOI: 10.5005/jp-journals-10024-1574] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIM The purpose of this study was to assess in vitro the tooth color alterations associated with two commonly used endodontic irrigants, the chlorhexidine gluconate (CHX) and the sodium hypochlorite (NaOCl) up to 15 days post-treatment. Additionally, the possible influence of endodontic access preparation on tooth color was investigated. MATERIALS AND METHODS Thirty intact human anterior teeth were used. Black adhesive tape with a 4 mm diameter window was used to standardize the enamel surface intended for color analysis. After the access cavity, preparation and the initial root canal negotiation with stainless steel hand files, the root canal shaping was completed with rotary nickel-titanium files. The teeth were divided into three groups (n = 10). Conventional syringe irrigation was performed with one irrigant for each group. The enamel surfaces were colorimetrically evaluated before access cavity, after cavity preparation and at 1, 3, 7 and 15 days post-treatment. The CIE color parameters (L*, a*, b*) were recorded and averaged for each material and the corresponding color differences (ΔE) were calculated and statistically analyzed. RESULTS The most significant factor in tooth color alteration, during the endodontic treatment, was the access preparation. CHX and NaOCl caused tooth color changes comparable with the saline. CHX and NaOCl did not increase the tooth color changes relative to the values induced by the access preparation. CONCLUSION The two endodontic irrigants were not able to induce tooth color alteration to a greater extent than the access preparation. CLINICAL SIGNIFICANCE Chlorhexidine and NaOCl cannot be considered as discoloring endodontic materials. The most contributing factor in tooth color alteration during endodontic treatment in the anterior teeth is access preparation.
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Affiliation(s)
| | - Nikolaos P Kerezoudis
- Department of School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Afrodite Kakaboura
- Department of School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
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Abstract
Tooth discoloration is a common problem for which patients seek dental care. Various medications can directly or indirectly result in tooth discoloration. As clinicians, it is our responsibility to know these therapeutic drugs which can cause tooth discoloration and educate our fellow colleagues to take necessary precautions when prescribing these medications. Therefore, the objective of this paper is to give an overview of the various medications that can be linked to tooth discoloration and to suggest the precautionary measures that can be taken to avoid or minimize it. Clinical Relevance: Dental discoloration potential of medications always needs to be considered before prescribing them.
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Barber A, King P. Management of the single discoloured tooth. Part 1: Aetiology, prevention and minimally invasive restorative options. ACTA ACUST UNITED AC 2014; 41:98-100, 102-4, 106-8 passim. [PMID: 24783878 DOI: 10.12968/denu.2014.41.2.98] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
UNLABELLED The single discoloured tooth is commonly encountered in general practice. This is the first of two articles covering the broad range of management options for the single discoloured tooth. This first part outlines the common causes of discoloration and possible methods of prevention. Minimally invasive techniques are covered. Clinical procedures are outlined and clinical cases used to demonstrate outcomes that can be achieved. CLINICAL RELEVANCE The single discoloured tooth is a commonly encountered clinical problem in general dental practice. A wide variety of management options exist and any one in particular may be most appropriate given the clinical scenario. It is therefore essential that general dental practitioners are familiar with the range of options that exist, as well as their indications, and consider adopting minimally invasive techniques in the first instance before moving to more invasive therapies.
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Hülsmann M. Effects of mechanical instrumentation and chemical irrigation on the root canal dentin and surrounding tissues. ACTA ACUST UNITED AC 2013. [DOI: 10.1111/etp.12047] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Venkataram V, Gokhale ST, Kenchappa M, Nagarajappa R. Effectiveness of chamomile (Matricaria recutita L.), MTAD and sodium hypochlorite irrigants on smear layer. Eur Arch Paediatr Dent 2013; 14:247-52. [DOI: 10.1007/s40368-013-0062-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2012] [Accepted: 12/05/2012] [Indexed: 11/25/2022]
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Bodrumlu E, Avsar A, Hazar Bodrumlu E, Cicek E. The effects of calcium hydroxide removal methods on bond strength of Epiphany SE with two irrigation protocols. Acta Odontol Scand 2013; 71:989-93. [PMID: 23167907 DOI: 10.3109/00016357.2012.741698] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The purpose of this study was to compare the effects of five calcium hydroxide removal methods on the bond strength of Epiphany SE sealer after canal irrigation with NaOCl+EDTA or NaOCl+MTAD. MATERIALS AND METHODS The 120 roots were instrumented by using the ProTaper rotary system under irrigation with 2.5% sodium hypochlorite and randomly divided into two major groups according to the final irrigation: 1.3% NaOCl + MTAD and 5% NaOCl + 17% EDTA. For controls, 10 roots from each of the final irrigations with NaOCl + MTAD and NaOCl + EDTA (20 roots) were not filled with Ca(OH)2. The intra-canal paste, Ca(OH)2 was applied to each of the 100 remaining roots and stored at 37°C for 7 days. Each group was sub-divided into five sub-groups (n = 10) according to the removal technique for the intra-canal dressing: Group-1: recapitulation with size 30 K file + 3 ml of saline solution, Group-2: recapitulation with size 30 K file + 3 ml of 5% NaOCl, Group-3: using 5% NaOCl + 17% EDTA, Group-4: using 5%NaOCl + 15% citric acid, and Group-5: using 1.3% NaOCl + 5 ml MTAD. The root canals were filled with Resilon and Epiphany SE sealer. The bond strength was measured. RESULTS The mean bond strength of Epiphany SE to root dentine irrigated with NaOCl + MTAD was lower than that of NaOCl + EDTA. The highest bond strengths were 3.31 ± 0.057 and 2.60 ± 0.054 in the NaOCl + citric acid group when Ca(OH)2 was applied to roots treated with NaOCl + EDTA and NaOCl + MTAD, respectively (p < 0.05). CONCLUSION For root canals treated with NaOCl + EDTA or NaOCl + MTAD, the use of NaOCl + chelating agent for Ca(OH)2 removal does not adversely affect the bond strength of Epiphany SE to dentin.
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Affiliation(s)
- E Bodrumlu
- Endodontics Department, Ondokuz Mayis University. Samsun, Turkey.
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Gupta H, Kandaswamy D, Manchanda SK, Shourie S. Evaluation of the sealing ability of two sealers after using chlorhexidine as a final irrigant: An in vitro study. J Conserv Dent 2013; 16:75-8. [PMID: 23349582 PMCID: PMC3548352 DOI: 10.4103/0972-0707.105304] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2012] [Revised: 07/30/2012] [Accepted: 08/11/2012] [Indexed: 11/27/2022] Open
Abstract
Aims and Objectives: The aim of this study was to evaluate the effect of the precipitate formed by using sodium hypochlorite and chlorhexidine as a root canal irrigant on the sealing ability of different root canal sealers, using a push-out bond strength test. Materials and Methods: Twenty single rooted premolars were used for this study. The teeth were divided into two groups (Groups I and II) of ten teeth each, according to the obturation done with AH Plus with GuttaPercha and Resilon with epiphany, respectively. The groups were in turn divided into two subgroups of five teeth each (Subgroups A and B) according to the irrigation protocol, and were evaluated using a micro push-out bond strength, with the help of a universal testing machine. Statistical analysis was done using the paired t test. Results: The mean value of the AH Plus GuttaPercha group with precipitate formation (17.66 ± 0.56) showed the highest mean value for the bond strength, which was statistically higher (P < 0.05) than the rest of the groups. In the Resilon Epiphany group, the samples with precipitate formation showed (13.28 ± 1.35) the least bond strength, which was statistically lower than all the groups, except the Resilon samples without precipitate (13.99 ± 0.48). Conclusion: The precipitate formed by a combination of sodium hypochlorite and chlorhexidine tends to affect the bond strength of the sealers used for obturation.
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Affiliation(s)
- Hitesh Gupta
- Department of Conservative Dentistry and Endodontics, Himachal Institute of Dental Sciences, Paonta Sahib, Himachal Pradesh, India
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Srikumar GPV, Sekhar KS, Nischith KG. Mixture tetracycline citric acid and detergent - A root canal irrigant. A review. J Oral Biol Craniofac Res 2013; 3:31-5. [PMID: 25737877 DOI: 10.1016/j.jobcr.2012.09.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2012] [Accepted: 09/09/2012] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND Root canal irrigants play an indispensable role for the complete disinfection of the root canal system, in particular those areas of the root canal that are not accessible for instrumentation. Sodium hypochlorite, ethylene diamine tetra acetic acid, hydrogen peroxide and chlorhexidine are the most commonly used root canal irrigants in endodontic practice, but they do not satisfy all the properties of an ideal root canal irrigant. Mixture tetracycline, citric acid and detergent, a root canal irrigant, is commercially available as BioPure MTAD (Dentsply, Tulsa Dental, Tulsa, OK). METHODOLOGY The literature was searched for root canal irrigants used in the last 3 decades in PubMed. Data showed 83 relevant articles, of which 24 were found most suitable on the basis of description of properties, advantages and disadvantages of MTAD, hence were included. The aim of this study was to evaluate the properties of MTAD for its antibacterial efficiency, biocompatibility, chelating action with removal of endodontic smear layer and compare it with other commonly used root canal irrigants like sodium hypochlorite, ethylene diamine tetra acetic acid, hydrogen peroxide, chlorhexidine. RESULTS MTAD was found to be highly effective intracanal irrigant compared to other commonly used root canal irrigants with excellent disinfection of the entire root canal system. CONCLUSION MTAD is biocompatible with superior antimicrobial efficiency compared to other commonly used root canal irrigants.
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Affiliation(s)
- G P V Srikumar
- Senior Lecturer, Department of Conservative Dentistry & Endodontics, Purvanchal Institute of Dental Sciences, GIDA, Gorakhpur, Uttar Pradesh, India
| | - K S Sekhar
- Principal and HOD, Department of Conservative Dentistry & Endodontics, Purvanchal Institute of Dental Sciences, GIDA, Gorakhpur, Uttar Pradesh, India
| | - K G Nischith
- Professor & HOD, Department of Conservative Dentistry & Endodontics, Malabar Dental College, Kuttippuram, Kerala, India
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SHRESTHA D, WU WC, HE QY, WEI X, LING JQ. Effect of sodium ascorbate on degree of conversion and bond strength of RealSeal SE to sodium hypochlorite treated root dentin. Dent Mater J 2013; 32:96-100. [DOI: 10.4012/dmj.2012-125] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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19
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Good M, El KIA, Hussey DL. Endodontic 'solutions' part 1: a literature review on the use of endodontic lubricants, irrigants and medicaments. ACTA ACUST UNITED AC 2012; 39:239-40, 242-4, 246. [PMID: 22774686 DOI: 10.12968/denu.2012.39.4.239] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Endodontic lubricants, irrigants and medicaments help prepare and disinfect root canal systems (RCS) but primary and secondary cases involve different microbes and therefore it is unlikely that one protocol will be effective for both case types. Each individual 'solution' or sequence of'solutions' could play a significant role in each case type, but there are no detailed published guidelines in existence. To help inform clinical practice it was decided to undertake a literature review followed by a UK and Republic of Ireland wide audit on current endodontic'solution' usage within dental schools. The literature review was undertaken under the following headings: pre-op oral rinse; file lubricants; root canal irrigants and intracanal medicaments and provides an evidence base for protocol development for both primary and retreatment cases.The audit project and the protocols developed from the findings of both the literature review and audit will be presented in Part 2.
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Affiliation(s)
- Melissa Good
- Department of Restorative Dentistry, The Royal Hospitals, Belfast Health and Social Care Trust, Belfast, BT12 6BP, Northern Ireland, UK
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20
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Ahmed HMA, Abbott PV. Discolouration potential of endodontic procedures and materials: a review. Int Endod J 2012; 45:883-97. [PMID: 22621247 DOI: 10.1111/j.1365-2591.2012.02071.x] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Advances in endodontic materials and techniques are at the forefront of endodontic research. Despite continuous improvements, tooth discolouration, especially in anterior teeth, is considered an undesirable consequence following endodontic treatment as it creates a range of aesthetic problems. This article aims to discuss the intrinsic and internalized tooth discolouration caused by endodontic procedures, and to address the discolouration potential of materials used during root canal treatment, including root canal irrigants, intra-canal medicaments, endodontic and post-endodontic filling materials. In addition, the discolouration patterns caused by combined endodontic and nonendodontic aetiological factors are discussed. The recommended guidelines that should be followed by dental practitioners to prevent and manage tooth discolouration are also outlined.
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Affiliation(s)
- H M A Ahmed
- Department of Restorative Dentistry, School of Dental Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.
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21
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Stojicic S, Shen Y, Qian W, Johnson B, Haapasalo M. Antibacterial and smear layer removal ability of a novel irrigant, QMiX. Int Endod J 2011; 45:363-71. [DOI: 10.1111/j.1365-2591.2011.01985.x] [Citation(s) in RCA: 146] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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22
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Kandaswamy D, Venkateshbabu N, Arathi G, Roohi R, Anand S. Effects of various final irrigants on the shear bond strength of resin-based sealer to dentin. J Conserv Dent 2011; 14:40-2. [PMID: 21691504 PMCID: PMC3099112 DOI: 10.4103/0972-0707.80737] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2010] [Revised: 06/21/2010] [Accepted: 07/03/2010] [Indexed: 11/30/2022] Open
Abstract
Aim: This study has been designed to evaluate the effect of strong (MTAD) or soft (1- hydroxyethylidene – 1, 1-bisphosphonate (HEBP) final irrigating solution on the shear bond strength of AH plus sealer to coronal dentin. 17% EDTA was used as the reference. Materials and Methods: Forty freshly extracted human maxillary first premolars were prepared using different irrigation protocols (n=10). All the test groups had 1.3% NaOCl as initial rinse and followed by specific final rinse for each group: G1 – distilled water(control), G2 – 17% EDTA, G3- 18% HEBP and G4 – MTAD. Sections of polyethylene tubes that are 3mm long were filled with freshly mixed sealer and placed on the dentin surfaces. The bonding between the sealer and dentine surface was evaluated using shear bond testing. The values were statistically evaluated using one-way ANOVA followed by Tukey's test. Result: Significant difference was found among the irrigating regimes. EDTA showed highest bond strength followed by HEBP and MTAD
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Affiliation(s)
- Deivanayagam Kandaswamy
- Department of Conservative Dentistry and Endodontics, Sri Ramachandra University, Chennai, Tamilnadu, India
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23
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Tay FR. Reply to Drs Pai and Thomas. J Endod 2011. [DOI: 10.1016/j.joen.2011.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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24
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Gopikrishna V, Venkateshbabu N, Krithikadatta J, Kandaswamy D. Evaluation of the effect of MTAD in comparison with EDTA when employed as the final rinse on the shear bond strength of three endodontic sealers to dentine. AUST ENDOD J 2010; 37:12-7. [PMID: 21418409 DOI: 10.1111/j.1747-4477.2010.00261.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The purpose of the study was to evaluate the effect of MTAD in comparison with EDTA as a final rinse on the shear bond strength of Kerr, Apexit and AH plus. Dentine surfaces of 135 extracted human non-carious maxillary premolars were divided into three groups (n = 45). Groups I and II were conditioned with 1.3% NaOCl for 20 min, followed by a final rinse of 17% EDTA for 1 min and MTAD for 5 min respectively. Group III was treated with distilled water. Each group was further divided into three subgroups (n = 15). Subgroup 1: Kerr, Subgroup 2: Apexit and Subgroup 3: AH plus. Three-millimetre-long sections of polyethylene tubes were filled with freshly mixed sealer and placed on the dentine surfaces. The bonding between the sealer and dentine surface was evaluated using shear bond testing. The values were statistically evaluated using one way anova followed by Tukey's test. Significant difference was found among the bond strength of the sealers and irrigating regimes. AH plus showed superior bond strength among the tested sealers, when EDTA was employed as the final rinse (P < 0.05). MTAD as a final rinse affected the bond strength of AH plus and Apexit, which were significantly lower than the control group.
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Affiliation(s)
- Velayutham Gopikrishna
- Department of Conservative Dentistry and Endodontics, Meenakshi Ammal Dental College, Chennai, India.
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Abstract
The success of endodontic treatment depends on the eradication of microbes from the root-canal system and prevention of reinfection. The root canal is shaped with hand and rotary instruments under constant irrigation to remove the inflamed and necrotic tissue, microbes/biofilms, and other debris from the root-canal space. Irrigants have traditionally been delivered into the root-canal space using syringes and metal needles of different size and tip design. Clinical experience and research have shown, however, that this classic approach typically results in ineffective irrigation. Many of the compounds used for irrigation have been chemically modified and several mechanical devices have been developed to improve the penetration and effectiveness of irrigation. This article summarizes the chemistry, biology, and procedures for safe and efficient irrigation and provides cutting-edge information on the most recent developments.
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Affiliation(s)
- Markus Haapasalo
- Division of Endodontics, Department of Oral Biological & Medical Sciences, UBC Faculty of Dentistry, The University of British Columbia, 2199 Wesbrook Mall, Vancouver, BC, Canada V6T 1Z3.
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Rasimick BJ, Nekich M, Hladek MM, Musikant BL, Deutsch AS. Interaction between Chlorhexidine Digluconate and EDTA. J Endod 2008; 34:1521-3. [DOI: 10.1016/j.joen.2008.08.039] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2008] [Revised: 08/19/2008] [Accepted: 08/24/2008] [Indexed: 10/21/2022]
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Abstract
This article presents a review of materials currently used in the practice of endodontics. Current endodontic materials include those that have been thoroughly tested by scientific investigation, clinical usage, and time, as well as others that are the result of new knowledge in the field of dental materials. Article sections are devoted to obturation materials, sealers, irrigation materials, smear layer removal, root-end filling materials, and intracanal medicaments. Knowing the particular qualities of materials can aid the clinician in choosing those that are appropriate for a given situation. Properties, components, and rationale for the materials' use are presented to aid the clinician in choosing materials for a particular need.
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Affiliation(s)
- R Scott Gatewood
- Department of Endodontics, University of Mississippi School of Dentistry, 2500 North State Street, Jackson, MS 39216, USA.
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HÜLSMANN MICHAEL, RÖDIG TINA, NORDMEYER SABINE. Complications during root canal irrigation. ACTA ACUST UNITED AC 2007. [DOI: 10.1111/j.1601-1546.2009.00237.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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29
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Tay FR, Hiraishi N, Schuster GS, Pashley DH, Loushine RJ, Ounsi HF, Grandini S, Yau JYY, Mazzoni A, Donnelly A, King NM. Reduction in Antimicrobial Substantivity of MTAD After Initial Sodium Hypochlorite Irrigation. J Endod 2006; 32:970-5. [PMID: 16982276 DOI: 10.1016/j.joen.2006.03.016] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2006] [Revised: 03/17/2006] [Accepted: 03/17/2006] [Indexed: 10/24/2022]
Abstract
Potential intrinsic tetracycline staining of intraradicular dentin has been observed when BioPure MTAD was employed as the final irrigant after initial rinsing with NaOCl. This study examined the effect of NaOCl-MTAD interaction on the antimicrobial substantivity of MTAD in dentin. Dentin cores previously irrigated with either MTAD, or in conjunction with 1.3% NaOCl as an initial irrigant were placed on blood agar plates inoculated with Escherichia faecalis at 10(5) cfu/ml. Dentin cores irrigated with 1.3% NaOCl only, and autoclaved dentin disks were used as the respective positive and negative controls. After anaerobic incubation, the mean diameter of bacterial inhibition zones formed around the MTAD group was significantly larger than the NaOCl/MTAD group, which, in turn, was not significantly different from the NaOCl positive control. Oxidation of MTAD by NaOCl resulted in the partial loss of antimicrobial substantivity in a manner similar to the peroxidation of tetracycline by reactive oxygen species.
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Affiliation(s)
- Franklin R Tay
- Department of Oral Biology and Maxillofacial Pathology, Medical College of Georgia, Augusta, Georgia 30912-1129, USA.
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