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Drews DJ, Nguyen AD, Diederich A, Gernhardt CR. The Interaction of Two Widely Used Endodontic Irrigants, Chlorhexidine and Sodium Hypochlorite, and Its Impact on the Disinfection Protocol during Root Canal Treatment. Antibiotics (Basel) 2023; 12:antibiotics12030589. [PMID: 36978457 PMCID: PMC10044599 DOI: 10.3390/antibiotics12030589] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 03/09/2023] [Accepted: 03/09/2023] [Indexed: 03/18/2023] Open
Abstract
In recent years, sodium hypochlorite and chlorhexidine digluconate have been the gold standard of irrigation solutions utilized within the disinfection protocol during root canal treatments. Nowadays, it is known that, during chemical disinfection of the root canal, consecutive application of sodium hypochlorite and chlorhexidine digluconate leads to the formation of an orange-brown precipitate. This precipitate is described as being chemically similar to para-chloroaniline, which is suspected to have cytotoxic and carcinogenic effects. Concerns also exist regarding its influence on the leakage of root canal fillings, coronal restorations, and tooth discoloration. The purpose of this article is to review the literature on the interaction of sodium hypochlorite and chlorhexidine digluconate on the tooth and its surrounding tissues, and to discuss the effect of the precipitate formed during root canal treatment. We further address options to avoid the formation of the precipitate and describe alternative irrigation solutions that should not interact with sodium hypochlorite or chlorhexidine digluconate.
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Affiliation(s)
- Dirk-Joachim Drews
- Private Dental Practice, 69469 Weinheim, Germany
- University Outpatient Clinic for Conservative Dentistry and Periodontology, Martin-Luther-University Halle-Wittenberg, 06112 Halle, Germany
| | - Anh Duc Nguyen
- University Outpatient Clinic for Conservative Dentistry and Periodontology, Martin-Luther-University Halle-Wittenberg, 06112 Halle, Germany
| | - Antje Diederich
- University Outpatient Clinic for Conservative Dentistry and Periodontology, Martin-Luther-University Halle-Wittenberg, 06112 Halle, Germany
| | - Christian Ralf Gernhardt
- University Outpatient Clinic for Conservative Dentistry and Periodontology, Martin-Luther-University Halle-Wittenberg, 06112 Halle, Germany
- Correspondence: ; Tel.: +49-345-557-3741
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Effect of Endodontic Irrigating Solutions on Radicular Dentine Structure and Matrix Metalloproteinases-A Comprehensive Review. Dent J (Basel) 2022; 10:dj10120219. [PMID: 36547035 PMCID: PMC9776432 DOI: 10.3390/dj10120219] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 11/17/2022] [Accepted: 11/21/2022] [Indexed: 11/24/2022] Open
Abstract
Irrigating solutions play an important role in the eradication of intracanal microbes and debris dissolution during endodontic treatment. Different combinations of solutions and protocols have been advocated, with sodium hypochlorite (NaOCl), ethylenediamine tetra acetic acid (EDTA), and chlorhexidine (CHX) remaining the most widely used ones by many clinicians. Although these solutions provide efficient inorganic dissolution and antimicrobial capacity, their use has also been reported to cause undesired effects on root dentin composition and mechanical and biomechanical properties, such as microhardness, surface roughness, bond strength, and matrix metalloproteinase (MMP) activity. Several corroborating studies attribute these changes in mechanical properties of dentine to the use of irrigating solutions, and there are limited reports on how the solutions affect the expression of MMPs, which may be a correlating link to understanding the role of these enzymes in dentin collagen and changes in the mechanical properties of dentin. Hence, using the basis of several studies from the literature, the objective is to comprehensively review the influence of individual and combined irrigating solutions on root dentine structure and the activity of the MMPs.
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Hachem CE, Chedid JCA, Nehme W, Kaloustian MK, Ghosn N, Sahnouni H, Mancino D, Haikel Y, Kharouf N. Physicochemical and Antibacterial Properties of Conventional and Two Premixed Root Canal Filling Materials in Primary Teeth. J Funct Biomater 2022; 13:jfb13040177. [PMID: 36278646 PMCID: PMC9589963 DOI: 10.3390/jfb13040177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 09/30/2022] [Accepted: 09/30/2022] [Indexed: 10/31/2022] Open
Abstract
In this study, some physicochemical and antibacterial properties of three root canal filling materials for primary teeth, Calplus “CP” (Prevest DenPro, Lewes, DE, USA), Bio-C Pulpecto “Bio-CP” (Angelus, Basil, Londrina, Paraná, Brazil), and Zinc Oxide and Eugenol “ZOE” (Prevest DenPro, Lewes, DE, USA) were compared. For each material, the pH, solubility, contact angle, and crystalline microstructure under SEM were evaluated. Their antibacterial activity against Enterococcus faecalis was determined through direct tests. The Kruskal−Wallis test was used to analyze the results using a one-way analysis of variance on ranks. All the materials had an alkaline pH at 3, 24, and 72 h, with CalPlus having the highest (p < 0.05). Bio-CP was more soluble during the evaluation period (24 h) than ZOE and CalPlus (p < 0.05). Bio-CP and ZOE demonstrated the creation of crystallite structures on their surfaces after immersion in PBS at 37 °C, whereas CalPlus showed none. The lowest contact angle was observed for Bio-CP (53 ± 1.5°); contact angles of (86 ± 4°) and (96 ± 1°), respectively, were observed after 10 s of the deposition of the water drop for CalPlus and ZOE. In conclusion, according to this study, there is still a need to develop new filling materials for primary teeth. ZOE, CalPlus and Bio-CP demonstrated different physicochemical and antibacterial properties, but none of the materials had optimal properties and could be considered the most suitable filling material for primary teeth pulpectomy. Bioceramics in their current state are not an alternative. The physicochemical and antibacterial properties still need improvement to fit the intricate anatomy of primary teeth.
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Affiliation(s)
- Claire El Hachem
- Department of Pediatric Dentistry, Faculty of Dentistry, Saint Joseph University, Beirut 1107 2180, Lebanon
| | - Jean Claude Abou Chedid
- Department of Pediatric Dentistry, Faculty of Dentistry, Saint Joseph University, Beirut 1107 2180, Lebanon
| | - Walid Nehme
- Department of Endodontics, Arthur A. Dugoni School of Dentistry, University of the Pacific, 155 5th Street, San Francisco, CA 94103, USA
| | - Marc Krikor Kaloustian
- Department of Endodontics, Faculty of Dentistry, Saint Joseph University, Beirut 1107 2180, Lebanon
| | - Nabil Ghosn
- Craniofacial Research Laboratory, Faculty of Dental Medicine, Saint Joseph University, Beirut 1107 2180, Lebanon
| | - Hafsa Sahnouni
- Department of Biomaterials and Bioengineering, INSERM UMR_S 1121, Biomaterials and Bioengineering, 67000 Strasbourg, France
| | - Davide Mancino
- Department of Biomaterials and Bioengineering, INSERM UMR_S 1121, Biomaterials and Bioengineering, 67000 Strasbourg, France
- Department of Endodontics, Faculty of Dental Medicine, Strasbourg University, 67000 Strasbourg, France
- Pôle de Médecine et Chirurgie Bucco-Dentaire, Hôpital Civil, Hôpitaux Universitaire de Strasbourg, 67000 Strasbourg, France
| | - Youssef Haikel
- Department of Biomaterials and Bioengineering, INSERM UMR_S 1121, Biomaterials and Bioengineering, 67000 Strasbourg, France
- Department of Endodontics, Faculty of Dental Medicine, Strasbourg University, 67000 Strasbourg, France
- Pôle de Médecine et Chirurgie Bucco-Dentaire, Hôpital Civil, Hôpitaux Universitaire de Strasbourg, 67000 Strasbourg, France
| | - Naji Kharouf
- Department of Biomaterials and Bioengineering, INSERM UMR_S 1121, Biomaterials and Bioengineering, 67000 Strasbourg, France
- Department of Endodontics, Faculty of Dental Medicine, Strasbourg University, 67000 Strasbourg, France
- Correspondence: ; Tel.: +33-667522841
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Lindblad RM, Lassila LVJ, Vallittu PK, Tjäderhane L. The effect of chlorhexidine and dimethyl sulfoxide on long-term sealing ability of two calcium silicate cements in root canal. Dent Mater 2020; 37:328-335. [PMID: 33341245 DOI: 10.1016/j.dental.2020.11.031] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 11/24/2020] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To evaluate the long-term effect of chlorhexidine (CHX) and dimethyl sulfoxide (DMSO) on the sealing ability and biomineralization of two different calcium silicate cements (CSC) in root canal. METHODS Sixty human third molar root canals were obturated with ProRoot MTA or Biodentine. Before obturation the canals were irrigated with saline (control), 2% CHX or 5% DMSO. Microleakage was tested after three days and after six months. After additional six months (12 months after root filling) the roots were cut into 2 mm thick dentine discs. The discs were stored in artificial saliva for one year. The bond strength was measured with the push-out method, and the failure mode was evaluated with a stereomicroscope. The most apical disc of each tooth was used for Vickers hardness test. RESULTS No significant differences between the groups was found in initial microleakage. The leakage increased significantly during the 6-month storage in all groups except in Biodentine-CHX group and Biodentine-DMSO group. CHX and DMSO irrigation significantly increased the leakage with ProRoot MTA with time, but there was no statistically significant difference compared to the ProRoot MTA-control group at six months' time point. CHX significantly reduced the push-out bond strength of ProRoot MTA. With Biodentine irrigation with CHX or DMSO resulted with significantly higher push-out strength compared to the Biodentine control group. Fracture analysis showed statistically significant difference in the distribution of the fractures between the groups, but neither CHX nor DMSO change the fracture pattern statistically significantly. With Vickers hardness test ProRoot MTA with and without DMSO as the final irrigant showed significantly higher dentin hardness than any Biodentine-group. SIGNIFICANCE Considering that aging increased the leakage in all groups except with Biodentine-DMSO and the differences in the push-out strength and surface microhardness data, it appears that the time-related biomineralizing effect of MTA and Biodentine does not improve sealing to dentin. CHX significantly reduced ProRoot MTA bond strength and increased pure adhesive failures with both cements.
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Affiliation(s)
- R M Lindblad
- City of Helsinki Health Centre, University Dental Clinic, Helsinki, Finland
| | - L V J Lassila
- Department of Biomaterials Science and Turku Clinical Biomaterials Centre-TCBC, Institute of Dentistry, University of Turku, Turku, Finland
| | - P K Vallittu
- Department of Biomaterials Science and Turku Clinical Biomaterials Centre-TCBC, Institute of Dentistry, University of Turku, Turku, Finland; City of Turku, Welfare Division, Turku, Finland
| | - L Tjäderhane
- Department of Oral and Maxillofacial Diseases, University of Helsinki, and Helsinki University Hospital, Helsinki, Finland, Research Unit of Oral Health Sciences, and Medical Research Center Oulu (MRC Oulu), Oulu University Hospital and University of Oulu, Oulu, Finland.
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The Effect of Chlorhexidine and Dimethyl Sulfoxide on Long-Term Microleakage of Two Different Sealers in Root Canals. Eur Endod J 2019; 4:38-44. [PMID: 32161885 PMCID: PMC7006554 DOI: 10.14744/eej.2018.02886] [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: 12/01/2018] [Revised: 12/14/2018] [Accepted: 12/14/2018] [Indexed: 01/04/2023] Open
Abstract
Objective The aim of root canal obturation is to prevent leakage and inhibit microbial invasion. This study aimed to determine the effect of chlorhexidine (CHX) and dimethyl sulfoxide (DMSO) as final irrigants on microleakage of root filling immediately and after 18 months. The hypothesis was that either CHX or DMSO would not affect the immediate or long-term microleakage. Methods A total of 120 human third molar root canals were obturated with RealSeal SE or Topseal and gutta percha. Before obturation, the canals were irrigated with saline (control), 2% CHX or 5% DMSO. Microleakage of half of each groups (n=10) was measured after 3 days, and of the other half was measured after 18 months with fluid filtration method. Results In immediate measurements, RealSeal SE performed significantly better in CHX-irrigated group (p=0.035; Mann-Whitney test). For both sealers, DMSO had the lowest mean microleakage values, which were also statistically significantly lower than with CHX irrigation within sealers (p<0.009 for Topseal and p=0.04 for RealSeal SE; Mann-Whitney test). With RealSeal SE, the microleakage with CHX was significantly higher than that in controls (p=0.022; Mann-Whitney test). Conclusion Neither final irrigant showed statistically significant differences in the immediate microleakage within the two sealers. Irrigation with DMSO caused significantly less microleakage than CHX for both sealers after 18 months.
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Esteban Florez FL, Hiers RD, Larson P, Johnson M, O'Rear E, Rondinone AJ, Khajotia SS. Antibacterial dental adhesive resins containing nitrogen-doped titanium dioxide nanoparticles. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2018; 93:931-943. [PMID: 30274130 DOI: 10.1016/j.msec.2018.08.060] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Revised: 04/25/2018] [Accepted: 08/29/2018] [Indexed: 10/28/2022]
Abstract
The development of dental adhesive resins with long-lasting antibacterial properties is a possible solution to overcome the problem of secondary caries in modern adhesive dentistry. OBJECTIVES (i) Synthesis and characterization of nitrogen-doped titanium dioxide nanoparticles (N_TiO2), (ii) topographical, compositional and wettability characterization of thin-films (unaltered and experimental) and, (iii) antibacterial efficacy of N_TiO2-containing dental adhesives against Streptococcus mutans biofilms. MATERIALS AND METHODS Nanoparticles were synthesized and characterized using different techniques. Specimens (diameter = 12 mm, thickness ≅ 15 μm) of OptiBond Solo Plus (Kerr Corp., USA) and experimental adhesives [50, 67 and 80% (v/v)] were fabricated, photopolymerized (1000 mW/cm2, 1 min) and UV-sterilized (254 nm, 800,000 μJ/cm2) for microscopy, spectroscopy, wettability and antibacterial testing. Wettability was assessed with a contact angle goniometer by dispensing water droplets (2 μL) onto four random locations of each specimen (16 drops/group). Drop profiles were recorded (1 min, 25 frames/s, 37 °C) and contact angles were calculated at time = 0 s (θINITIAL) and time = 59 s (θFINAL). Antibacterial testing was performed by growing S. mutans (UA159-ldh, JM10) biofilms for either 3 or 24 h (anaerobic conditions, 37 °C) with or without continuous light irradiation (410 ± 10 nm, 3 h = 38.75 J/cm2, 24 h = 310.07 J/cm2) against the surfaces of sterile specimens. RESULTS N_TiO2 was successfully prepared using solvothermal methods. Doped-nanoparticles displayed higher light absorption levels when compared to undoped titania. Experimental adhesives demonstrated superior antibacterial efficacy in dark conditions. CONCLUSIONS The findings presented herein suggest that N_TiO2 is a feasible antibacterial agent against cariogenic biofilms.
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Affiliation(s)
- Fernando Luis Esteban Florez
- The University of Oklahoma Health Sciences Center, Department of Restorative Sciences, Division of Dental Biomaterials College of Dentistry, 1201 North Stonewall Avenue, Room 146, Oklahoma City, OK 73117, USA.
| | - Rochelle Denise Hiers
- The University of Oklahoma Health Sciences Center, Department of Restorative Sciences, Division of Dental Biomaterials College of Dentistry, 1201 North Stonewall Avenue, Room 146, Oklahoma City, OK 73117, USA.
| | - Preston Larson
- The University of Oklahoma, Samuel Roberts Noble Microscopy Laboratory, 770 Van Vleet Oval, Norman, OK 73019, USA.
| | - Matthew Johnson
- The University of Oklahoma, Department of Physics and Astronomy, 440 West Brooks Street, Room 129, Norman, OK 73019, USA
| | - Edgar O'Rear
- The University of Oklahoma, School of Chemical, Biological and Materials Engineering, 100 East Boyd, T-301, Sarkeys Energy Center, Norman, OK 73019, USA.
| | - Adam J Rondinone
- Oak Ridge National Laboratory, Center for Nanophase Materials Sciences, Oak Ridge, TN 37831, USA.
| | - Sharukh Soli Khajotia
- The University of Oklahoma Health Sciences Center, Department of Restorative Sciences, Division of Dental Biomaterials College of Dentistry, 1201 North Stonewall Avenue, Room 146, Oklahoma City, OK 73117, USA.
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Tartari T, Wichnieski C, Bachmann L, Jafelicci M, Silva RM, Letra A, van der Hoeven R, Duarte MAH, Bramante CM. Effect of the combination of several irrigants on dentine surface properties, adsorption of chlorhexidine and adhesion of microorganisms to dentine. Int Endod J 2018; 51:1420-1433. [DOI: 10.1111/iej.12960] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Accepted: 05/30/2018] [Indexed: 11/28/2022]
Affiliation(s)
- T. Tartari
- Department of Operative Dentistry, Endodontics, and Dental Materials; Bauru School of Dentistry; University of São Paulo; Bauru SP Brazil
| | - C. Wichnieski
- Department of Endodontics; Pontifical Catholic University of Paraná; Curitiba PR Brazil
| | - L. Bachmann
- Department of Physics; Faculty of Philosophy, Science and Literature of Ribeirão Preto; University of São Paulo; Ribeirão Preto SP Brazil
| | - M. Jafelicci
- Department of Physical Chemistry; Institute of Chemistry; São Paulo State University; Araraquara SP Brazil
| | - R. M. Silva
- Department of Endodontics; School of Dentistry; University of Texas Health Science Center at Houston; Houston TX USA
| | - A. Letra
- Department of Endodontics; School of Dentistry; University of Texas Health Science Center at Houston; Houston TX USA
- Department of Diagnostic and Biomedical Sciences; School of Dentistry; University of Texas Health Science Center at Houston; Houston TX USA
| | - R. van der Hoeven
- Department of Diagnostic and Biomedical Sciences; School of Dentistry; University of Texas Health Science Center at Houston; Houston TX USA
| | - M. A. H. Duarte
- Department of Operative Dentistry, Endodontics, and Dental Materials; Bauru School of Dentistry; University of São Paulo; Bauru SP Brazil
| | - C. M. Bramante
- Department of Operative Dentistry, Endodontics, and Dental Materials; Bauru School of Dentistry; University of São Paulo; Bauru SP Brazil
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Saeed M, Koller G, Niazi S, Patel S, Mannocci F, Bruce K, Foschi F. Bacterial Contamination of Endodontic Materials before and after Clinical Storage. J Endod 2017; 43:1852-1856. [DOI: 10.1016/j.joen.2017.06.036] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 06/29/2017] [Accepted: 06/29/2017] [Indexed: 12/31/2022]
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Prado M, Menezes MSDO, Gomes BPFDA, Barbosa CADM, Athias L, Simão RA. Surface modification of gutta-percha cones by non-thermal plasma. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2016; 68:343-349. [DOI: 10.1016/j.msec.2016.05.062] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Revised: 05/08/2016] [Accepted: 05/15/2016] [Indexed: 10/21/2022]
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Turk T, Kaval ME, Sarikanat M, Hülsmann M. Effect of final irrigation procedures on fracture resistance of root filled teeth: an ex vivo study. Int Endod J 2016; 50:799-804. [PMID: 27464713 DOI: 10.1111/iej.12680] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Accepted: 07/26/2016] [Indexed: 10/21/2022]
Abstract
AIM To evaluate the effect of chlorhexidine (CHX) on fracture resistance of roots treated with different concentrations of ethylenediaminetetraacetic acid (EDTA). METHODOLOGY One hundred and twenty intact single-rooted premolar teeth were sectioned below the cementum-enamel junction to standardize the length of the teeth to 12 mm. The canals of one hundred specimens were instrumented with ProTaper Universal rotary instruments up to size F4 and were randomly divided into five groups (n = 20) according to the final irrigating solutions: Group 1: distilled water (DW); Group 2: 5% EDTA and 2.5% NaOCl; Group 3: 17% EDTA and 2.5% NaOCl; Group 4: 5% EDTA, 2.5% NaOCl, DW and 2% CHX; Group 5: 17% EDTA and 2.5% NaOCl, DW and 2% CHX. Root canals were filled with gutta-percha and epoxy resin-based root canal sealer using a single-cone technique. Twenty teeth served as negative controls and were not instrumented nor root filled (Group 6). All specimens were embedded in self-curing acrylic resin and loaded vertically at 0.5 mm min-1 until fracture occurred. The data were evaluated statistically using one-way anova test followed by Holm-Sidak's multiple comparison test (P < 0.05). RESULTS Group 1 (only DW) had the lowest vertical fracture strength, followed by Group 3 (17% EDTA and 2.5% NaOCl; P < 0.05). Group 6 (negative control group) had the highest fracture resistance. Final irrigation with CHX following irrigation with 17% EDTA or 5% EDTA and 2.5% NaOCl (groups 4 and 5) significantly increased the fracture resistance of roots (P < 0.05). However, the difference between Group 4 and Group 5 was not significant (P > 0.05). CONCLUSIONS Intracanal CHX rinse of EDTA/NaOCl-treated root dentine enhanced the fracture resistance of roots filled with AH Plus.
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Affiliation(s)
- T Turk
- Department of Endodontology, School of Dentistry, Ege University, Izmir, Turkey
| | - M E Kaval
- Department of Endodontology, School of Dentistry, Ege University, Izmir, Turkey
| | - M Sarikanat
- Department of Mechanical Engineering, School of Engineering, Ege University, Izmir, Turkey
| | - M Hülsmann
- Department of Operative Dentistry, Periodontology and Cariology, School of Dentistry, University of Göttingen, Göttingen, Germany
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Comparison between gutta-percha and resin-coated gutta-percha using different obturation techniques. J Appl Biomater Funct Mater 2016; 14:e307-13. [PMID: 27149939 DOI: 10.5301/jabfm.5000273] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2016] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The aim of this study was to evaluate and compare the obturation quality between canals obturated with gutta-percha/AH Plus sealer (GP group) and resin-coated GP/EndoREZ® sealer (ER group). METHODS A total sample of 90 mandibular premolar teeth was divided into 2 groups (2 × 45 canals): the GP group and ER group. Each group was further divided into 3 subgroups (n = 15): cold lateral compaction (CLC), warm lateral compaction (WLC) and single cone (SC). The teeth were subsequently embedded in resin and sectioned horizontally at 1, 3, 6 and 9 mm. All sections were then viewed with a stereomicroscope at ×40 magnification. The area occupied by core filling materials was determined using Cell^D software. RESULTS With CLC, the percentage of core filling materials in the ER group was significantly higher than in the GP group at the 1- and 3-mm levels. Similarly, with WLC, the percentage of core filling material in the ER group was significantly higher than in the GP group at the 1-, 3- and 9-mm levels. With SC, the percentage of core filling materials in the ER group was significantly higher than in the GP group at all levels. CONCLUSIONS It can be concluded that the resin-coated GP/EndoREZ® sealer is superior to the gutta-percha/AH Plus in the percentage of core filling material.
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Razmi H, Bolhari B, Karamzadeh Dashti N, Fazlyab M. The Effect of Canal Dryness on Bond Strength of Bioceramic and Epoxy-resin Sealers after Irrigation with Sodium Hypochlorite or Chlorhexidine. IRANIAN ENDODONTIC JOURNAL 2016; 11:129-33. [PMID: 27141222 PMCID: PMC4841349 DOI: 10.7508/iej.2016.02.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/19/2015] [Revised: 01/21/2016] [Accepted: 02/08/2016] [Indexed: 11/30/2022]
Abstract
Introduction: The aim of this in vitro study was to evaluate the effect of canal dryness on the push-out bond strength of two resin sealers (AH-Plus and Adseal) and a bioceramic sealer (Endosequence BC sealer) after canal irrigation with sodium hypochlorite (NaOCl) and chlorhexidine (CHX). Methods and Materials: A total of 18 extracted human premolars were used. Canals were prepared and were divided to two groups based on irrigation solution (either NaOCl or CHX). The samples were again divided based on pre-obturation canal condition (wet, half-wet and dry). The samples were sub-divided into 3 groups based on the sealer type; the teeth were obturated with gutta-percha and test sealers (Adseal, AH-Plus or BC sealer). A total number of 18 groups were available to be cut into dentine disks (12 disks in each group). The type of bond failure was also assessed in each group. Data were analyzed using the 3-way ANOVA, post hoc Tukey’s tests, t-test and the Fisher’s exact test. The level of significance was set at 0.05. Results: The bond strength of Adseal was not affected by the canal condition or irrigation with either NaOCl or CHX. Although the bond strength of AH-Plus was not affected by the irrigant type, the highest bond strength was seen in dry canals. For Endosequence BC sealer, the canal conditions did not affect the bond strength; however, CHX reduced the bond strength. Conclusion: Bond strength of resin sealers was not affected by irrigation solution; however, canal moisture negatively affected the bond strength of AH-Plus. CHX reduced the bond strength of BC sealer.
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Affiliation(s)
- Hasan Razmi
- Department of Endodontics, Dental School, Dental Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Behnam Bolhari
- Department of Endodontics, Dental School, Dental Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Mahta Fazlyab
- Iranian Center for Endodontic Research, Research Institute of Dental Sciences, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran and Department of Endodontics, Dental Branch, Islamic Azad University, Tehran, Iran
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Uzunoglu E, Yilmaz Z, Erdogan O, Görduysus M. Final Irrigation Regimens Affect Fracture Resistance Values of Root-filled Teeth. J Endod 2016; 42:493-5. [DOI: 10.1016/j.joen.2015.12.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Revised: 11/24/2015] [Accepted: 12/05/2015] [Indexed: 11/27/2022]
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14
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Prado MD, Roizenblit RN, Pacheco LV, Barbosa CADM, Lima COD, Simão RA. Effect of Argon Plasma on Root Dentin after Use of 6% NaOCl. Braz Dent J 2016; 27:41-5. [DOI: 10.1590/0103-6440201600486] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Accepted: 12/10/2015] [Indexed: 11/21/2022] Open
Abstract
Abstract The aim of this study was to evaluate the effect of argon plasma on dentin surface after use of 6% NaOCl. Sixty bovine incisors had their crowns removed, the roots split, and the segments planed. One hundred twenty segments of the cervical third were used. The samples were divided in two groups (n=60): Control group: immersed in 6% NaOCl, washed, dried and then immersed in 17% EDTA, washed and dried and Argon group: after treatment described for the Control group, non-thermal argon plasma was applied for 30 s. Ten samples were evaluated by scanning electron microscopy in each group. Other ten samples were analyzed by Fourier transform infrared spectroscopy (FTIR). Thirty samples were analyzed with a goniometer to measure the contact angle between the dentin surfaces and solutions, to determine the surface free energy. The last ten samples were used to evaluate the wettability of AH Plus sealer. Data were statistically analyzed using Kruskal Wallis and Mann-Whitney tests (p<0.05). The results of this study showed that argon plasma did not modify the surface topography. FTIR analysis showed chemical modifications after plasma treatment. Argon plasma increased the surface free energy of dentin and AH Plus wettability. In conclusion, argon plasma treatment modified chemically the dentin surface. This treatment increased the surface free energy and wettability of an epoxy resin root canal sealer, favoring its bonding to dentin surfaces.
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Hamza MOB, Gufran K, Baroudi K. Assessment of the Potential of CFC (Calcium hydroxide Flagyl Ciprofloxacin) for the Rapid Disinfection of Resilon and Gutta-Percha. J Clin Diagn Res 2015; 9:ZC40-3. [PMID: 26557614 DOI: 10.7860/jcdr/2015/13442.6619] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Accepted: 08/20/2015] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Obturating materials exposed to the dental operating environment has been shown to be contaminated, making rapid chair side disinfection mandatory to ensure the sterility of the root canals. OBJECTIVE The purpose of this study was to investigate the effectiveness of CFC (combination of Calcium hydroxide, Flagyl and Ciprofloxacin) for the rapid disinfection of Gutta-percha and Resilon cones. MATERIALS AND METHODS Seventy new Gutta-percha and Resilon cones were randomly selected, contaminated with Enterococcus faecalis and divided into 4 group according to the irrigant used for disinfection {Group I: 5.25% Sodium Hypochlorite (NaOCl), Group II: MTAD, Group III: 2% Chlorhexidine (CHX), Group IV: CFC (a combination of Calcium hydroxide, Flagyl and Ciprofloxacin)}. All the samples were placed in a centrifuge tube with BHI broth after being washed with sterile water. The samples were then incubated for 7 days at 37(o)C. Samples were randomly plated on Mac Conkey agar plate and the colony count was recorded and the observations were drawn. RESULTS A 5.25% NaOCl required 1 minute exposure for effective disinfection of all the samples. MTAD could eliminate E.faecalis from gutta-percha samples in 30 seconds whereas it required 1 minute of exposure for Resilon cones. Both 2% CHX and CFC could not disinfect the samples with 1 minute exposure and a minimum of 5 minute exposure was required. CONCLUSION A 5.25% NaOCl and Biopure MTAD required less chair side time to disinfect all the samples effectively when compared with 2% CHX and CFC.
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Affiliation(s)
- Mariam Omer Bin Hamza
- Lecturer, Department of Restorative Dental Sciences, Al-Farabi Colleges , Riyadh, Saudi Arabia
| | - Khalid Gufran
- Lecturer, Department of Preventive Dental Sciences, College of Dentistry, Salman Bin Abdul Aziz University , Al-Kharj, Saudi Arabia
| | - Kusai Baroudi
- Assistant Professor, Department of Preventive Dental Sciences, Al-Farabi Colleges , Riyadh, Saudi Arabia
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Comparison of Different Irrigants in the Removal of Endotoxins and Cultivable Microorganisms from Infected Root Canals. ScientificWorldJournal 2015; 2015:125636. [PMID: 26346574 PMCID: PMC4546762 DOI: 10.1155/2015/125636] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Revised: 07/13/2015] [Accepted: 07/15/2015] [Indexed: 11/18/2022] Open
Abstract
This study was conducted to compare the effectiveness of different irrigants used to remove endotoxins and cultivable microorganisms during endodontic therapy. Forty root canals were contaminated and divided into groups according to the irrigant: 2% NaOCl + surfactant, 2% CHX, 2.5% NaOCl, and pyrogen-free saline solution (control). Samples were collected after root canal contamination (S1), after instrumentation (S2), and 7 days after instrumentation (S3). Microorganisms and endotoxins were recovered from 100% of the contaminated root canals (S1). At S2, 2% NaOCl + surfactant, 2% CHX, and 2.5% NaOCl were able to completely eliminate cultivable microorganisms. At S3, both 2% CHX and 2.5% NaOCl were effective in preventing C. albicans and E. coli regrowth, but E. faecalis was still detected. No microorganism species was recovered from root canals instrumented with 2% NaOCl + surfactant. At S2, a higher percentage value of endotoxin reduction was found for 2% NaOCl + surfactant (99.3%) compared to 2% CHX (98.9%) and 2.5% NaOCl (97.18%) (p < 0.05). Moreover, at S3, 2% NaOCl + surfactant (100%) was the most effective irrigant against endotoxins. All irrigants tested were effective in reducing microorganisms and endotoxins from root canals. Moreover, 2% NaOCl + surfactant was the most effective irrigant against endotoxins and regrowth of microorganisms.
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Prado MD, Assis DFD, Simão RA. Efeito de diferentes soluções utilizadas como irrigante final na superfície dentinária: análise de rugosidade. REVISTA DE ODONTOLOGIA DA UNESP 2014. [DOI: 10.1590/s1807-25772014000100006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUÇÃO: O uso de irrigantes pode gerar alterações microestruturais na superfície dentinária, entre as quais alterações na rugosidade. Essas alterações podem influenciar o processo de união dos materiais obturadores à dentina. OBJETIVO: O objetivo do presente trabalho foi avaliar o efeito das soluções de EDTA, hipoclorito de sódio (NaOCl) e clorexidina, como irrigante final, na rugosidade da superfície dentinária. MATERIAL E MÉTODO: Foram utilizadas raízes distais de seis terceiros molares inferiores, que foram planificadas com o auxílio de disco de lixa e cortadas em segmentos, totalizando 18 amostras. A análise inicial foi realizada utilizando-se o perfilômetro Dektak. Foram realizadas cinco varreduras por amostra. Em seguida, as amostras foram irrigadas com NaOCl para simular o preparo químico-mecânico e lavadas com água destilada. Foram então divididas em seis grupos de acordo com o protocolo de irrigação final: Água destilada; NaOCl 5,25%; clorexidina 2%; EDTA17%; EDTA 17% + NaOCl 5,25%, e EDTA 17% + clorexidina 2%. Novamente, em cada amostra, foram realizadas cinco varreduras, totalizando 15 varreduras por grupo. Os dados foram analisados estatisticamente pelos testes de Kruskal-Wallis e Mann-Whitney (p<0,05). RESULTADO: Foi encontrada alteração significativa da rugosidade somente no grupo em que houve a combinação do agente quelante com o NaOCl. CONCLUSÃO: Os protocolos de irrigação final apresentam diferentes efeitos na rugosidade da superfície dentinária.
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Bohn S, Ilie N. Wetting behaviour of silicone- and resin-based root canal sealers. Int Endod J 2013; 47:542-9. [DOI: 10.1111/iej.12184] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2013] [Accepted: 08/14/2013] [Indexed: 11/30/2022]
Affiliation(s)
- S. Bohn
- Department of Restorative Dentistry; Dental School Ludwig-Maximilians-University; Munich Germany
| | - N. Ilie
- Department of Restorative Dentistry; Dental School Ludwig-Maximilians-University; Munich Germany
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Lotfi M, Ghasemi N, Rahimi S, Vosoughhosseini S, Saghiri MA, Shahidi A. Resilon: a comprehensive literature review. J Dent Res Dent Clin Dent Prospects 2013; 7:119-30. [PMID: 24082982 PMCID: PMC3779370 DOI: 10.5681/joddd.2013.020] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2012] [Accepted: 03/23/2013] [Indexed: 11/17/2022] Open
Abstract
Background and aims. An ideal root canal filling material should completely seal the entire root canal space and block communication between the root canal system and its surrounding tissues; it should also be nontoxic, noncarcinogenic, non-genotoxic, biocompatible, insoluble in tissue fluids and dimensionally stable. Bonding to dentin is a promising property, which can prevent leakage and improve the sealing ability of root canal filling materials. Resilon was developed and rec-ommended initially because the existing rootcanal filling materials did not bond to root canal dentin. Since its introduction in 2004, numerous reports have been published regarding various aspects of this material. The aim of this literature review is to present investigations regarding Resilon's physical and chemical properties and leakage studies. Materials and methods. A review of the literature was performed by using electronic and hand searching methods for Resilon from May 2004 to April 2012. Results. There are many published reports regarding Resilon. The searchshowed that Resilon is composed of a parent polymer, polycaprolactone or Tone, which is a biodegradable aliphatic polyester, with filler particles consisting of bioactive glass, bismuth oxychloride and barium sulfate. It possesses some antibacterial and antifungal properties. It is a promising material for root canal filling. Despite the presence of numerous case reports and case series regarding these applications, there are few designed research studies on clinical applications of this material. Resilon has some drawbacks such as high cost. Conclusion. Resilon seals well and is a biocompatible material. However, more clinical studies are needed to confirm its efficacy compared with other materials.
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Affiliation(s)
- Mehrdad Lotfi
- Professor, Department of Endodontic, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Negin Ghasemi
- Postgraduate Student, Department of Endodontic, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Saeed Rahimi
- Professor, Department of Endodontic, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
- Dental and Periodontal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sepideh Vosoughhosseini
- Associate Professor, Department of Oral and Maxillofacial Pathology, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Ali Saghiri
- Research Associated, Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public health, Madison, WI, USA
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Efficacy of peracetic acid in rapid disinfection of Resilon and gutta-percha cones compared with sodium hypochlorite, chlorhexidine, and povidone-iodine. J Endod 2013; 39:1261-4. [PMID: 24041388 DOI: 10.1016/j.joen.2013.06.022] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2013] [Revised: 05/13/2013] [Accepted: 06/29/2013] [Indexed: 02/05/2023]
Abstract
BACKGROUND The aim of this investigation was to compare the effectiveness of 3% sodium hypochlorite (NaOCl), 2% chlorhexidine, 1% peracetic acid, and 10% povidone-iodine in the rapid disinfection of Resilon (Pentron Clinical Technologies, LLC, Wallingford, CT) and gutta-percha cones contaminated with Enterococcus faecalis and Bacillus subtilis. METHODS Two hundred fifty-six samples consisting of 128 gutta-percha cones and 128 Resilon cones were used in this study. The materials were tested for disinfection according to the type of solution (3% NaOCl, 2% chlorhexidine, 1% peracetic acid, or 10% povidone-iodine), the time of exposure to each solution (1 or 5 minutes), and the type of microorganisms (E. faecalis or B. subtilis). Subsequent to the disinfection, samples were placed in test tubes containing 10 mL Mueller-Hinton broth and incubated at 37°C for 7 days. All test tubes were observed at 24-hour intervals and visually checked for turbidity, signifying microbial growth. RESULTS In this study, 1% peracetic acid showed the best results for both 1 minute and 5 minutes of disinfection, 2% chlorhexidine showed the second best results although it was statistically at par with peracetic acid, and 3% hypochlorite ranked third in disinfection; this was statistically significant when compared with peracetic acid and chlorhexidine. Disinfection by povidone-iodine was the least within all the groups for both contact times although disinfection for 5 minutes showed better results than disinfection for 1 minute for gutta-percha. CONCLUSIONS The outcome of this study confirmed the efficacy of 1% peracetic acid and 2% chlorhexidine in the rapid disinfection of both Resilon and gutta-percha.
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Ballal NV, Tweeny A, Khechen K, Prabhu KN, Tay FR. Wettability of root canal sealers on intraradicular dentine treated with different irrigating solutions. J Dent 2013; 41:556-60. [PMID: 23603234 DOI: 10.1016/j.jdent.2013.04.005] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2012] [Revised: 03/23/2013] [Accepted: 04/10/2013] [Indexed: 11/30/2022] Open
Affiliation(s)
- Nidambur Vasudev Ballal
- Department of Conservative Dentistry & Endodontics, Manipal College of Dental Sciences, Manipal, Manipal University, Karnataka, India
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Gomes BP, Vianna ME, Zaia AA, Almeida JFA, Souza-Filho FJ, Ferraz CCR. Chlorhexidine in Endodontics. Braz Dent J 2013; 24:89-102. [DOI: 10.1590/0103-6440201302188] [Citation(s) in RCA: 135] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2013] [Accepted: 04/02/2013] [Indexed: 11/21/2022] Open
Abstract
Chemical auxiliary substances (CAS) are essential for a successful disinfection and cleanness of the root canals, being used during the instrumentation and if necessary, as antimicrobial intracanal medicaments. Different CAS have been proposed and used, among which sodium hypochlorite (NaOCl), chlorhexidine (CHX), 17% EDTA, citric acid, MTAD and 37% phosphoric acid solution. CHX has been used in Endodontics as an irrigating substance or intracanal medicament, as it possesses a wide range of antimicrobial activity, substantivity (residual antimicrobial activity), lower cytotoxicity than NaOCl whilst demonstrating efficient clinical performance, lubricating properties, rheological action (present in the gel presentation, keeping the debris in suspension); it inhibits metalloproteinase, is chemically stable, does not stain cloths, it is odorless, water soluble, among other properties. CHX has been recommended as an alternative to NaOCl, especially in cases of open apex, root resorption, foramen enlargement and root perforation, due to its biocompatibility, or in cases of allergy related to bleaching solutions. The aim of this paper is to review CHX's general use in the medical field and in dentistry; its chemical structure, presentation form and storage; mechanism of action; antimicrobial activity including substantivity, effects on biofilms and endotoxins, effects on coronal and apical microbial microleakage; tissue dissolution ability; interaction with endodontic irrigants; effects on dentin bonding, metalloproteinases and collagen fibrils; its use as intracanal medicament and diffusion into the dentinal tubules; its use as disinfectant agent of obturation cones; other uses in the endodontic therapy; and possible adverse effects, cytotoxicity and genotoxicity.
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Effect of Disinfection Solutions on the Adhesion Force of Root Canal Filling Materials. J Endod 2012; 38:853-5. [DOI: 10.1016/j.joen.2012.01.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2011] [Revised: 01/04/2012] [Accepted: 01/08/2012] [Indexed: 11/24/2022]
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Costa Dantas MC, do Prado M, Costa VS, Gaiotte MG, Simão RA, Bastian FL. Comparison between the Effect of Plasma and Chemical Treatments on Fiber Post Surface. J Endod 2012; 38:215-8. [DOI: 10.1016/j.joen.2011.10.020] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2011] [Revised: 10/19/2011] [Accepted: 10/26/2011] [Indexed: 11/16/2022]
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Prado M, Gusman H, Gomes BP, Simão RA. Effect of disinfectant solutions on gutta-percha and resilon cones. Microsc Res Tech 2012; 75:791-5. [DOI: 10.1002/jemt.21126] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2011] [Accepted: 10/17/2011] [Indexed: 11/08/2022]
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Evaluation of the Interaction between Endodontic Sealers and Dentin Treated with Different Irrigant Solutions. J Endod 2011; 37:1550-2. [DOI: 10.1016/j.joen.2011.08.014] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2011] [Revised: 08/09/2011] [Accepted: 08/09/2011] [Indexed: 11/21/2022]
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