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Kim KH, Lévesque C, Malkhassian G, Basrani B. Efficacy of the GentleWave System in the removal of biofilm from the mesial roots of mandibular molars before and after minimal instrumentation: An ex vivo study. Int Endod J 2024; 57:922-932. [PMID: 38374488 DOI: 10.1111/iej.14044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 01/29/2024] [Indexed: 02/21/2024]
Abstract
AIM To compare the efficacy of Enterococcus faecalis biofilm removal using the GentleWave System (GWS) (Sonendo Inc, CA) on non-instrumented versus minimally instrumented root canal systems. METHODOLOGY Thirty-four mandibular molars were autoclaved and allocated to four groups: Negative control (n = 5); positive control (n = 5); Group 1: non-instrumentation + GWS (NI + GWS) (n = 12); and Group 2: minimal instrumentation + GWS (MI + GWS) (n = 12). Of 34 samples, 24 samples with Vertucci type 2 configuration within the mesial root of each sample were allocated to Groups 1 and 2 and then matched based on the working length and root canal configuration. After inoculation of samples with E. faecalis for 3 weeks, the GWS was used on Group 1 without any instrumentation and Group 2 after instrumentation of mesial canals until size 20/06v. CFU and SEM analysis were used. RESULTS Log10 (CFU/mL) from the positive control, and Group 1 and 2 were 7.41 ± 0.53, 3.41 ± 1.54, and 3.21 ± 1.54, respectively. Both groups showed a statistically significant difference in the reduction of viable E. faecalis cells compared to the positive control (Group 1 [p = .0001] and Group 2 [p < .0001]), whilst showing no significant difference between the two tested groups (p < .05). CONCLUSION The use of GWS on the non-instrumented root canal system could be an effective disinfection protocol in removing the biofilm without dentin debris formation.
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Affiliation(s)
- Kwang Ho Kim
- Endodontics, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
| | - Céline Lévesque
- Microbiology, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
| | - Gevik Malkhassian
- Endodontics, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
| | - Bettina Basrani
- Endodontics, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
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Nogueira APA, Grazziotin-Soares R, Leal AMM, Freitas Júnior SAG, Gonçalves BLL, Bauer J, Ferreira MC, Carvalho CN. Root Canal Dentin Microhardness after Contact with Antibiotic Medications: An In Vitro Study. Dent J (Basel) 2024; 12:201. [PMID: 39056988 PMCID: PMC11276266 DOI: 10.3390/dj12070201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 04/19/2024] [Accepted: 05/21/2024] [Indexed: 07/28/2024] Open
Abstract
Background: Antibiotic pastes used as intracanal medication in cases of revascularization therapy might cause negative effects on tooth properties, such as a reduction in dentin microhardness. This in vitro study investigated dentin microhardness in three different locations distancing from the canal lumen after 20 days of treatment with a tri-antibiotic paste (ciprofloxacin, metronidazole, and minocycline), and with a double-antibiotic paste (ciprofloxacin and metronidazole), with calcium hydroxide [Ca(OH)2] UltracalTM XS-treated dentin as comparison. Material and Methods: Human mandibular premolars (n = 48) had the root canals cleaned and shaped and were used to produce dentin slices. Dentin slices remained immersed in the medications for 20 days. The Knoop microhardness (KHN) test was performed before (baseline/Day-0) and after treatment (Day-20) with the medications. Indentations were made at 25 µm, 50 µm, and 100 µm distances from the root canal lumen. The KHN was compared intra-group using Wilcoxon's test. Independent groups were compared using Mann-Whitney's and Kruskal-Wallis' tests, at α = 5%. Results: The microhardness in all the tested groups was reduced at Day-20 in comparison with Day-0 (p < 0.001) (intra-group comparison/same distances). The Day-0 values were similar, and the Day-20 values were higher for the Ca(OH)2 group (p < 0.05) (comparison between groups/same distances). Conclusions: Calcium hydroxide for 20 days would be preferred rather than antibiotic pastes to minimize the expected reduction in dentin microhardness during regenerative procedures.
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Affiliation(s)
- Amanda Palmeira Arruda Nogueira
- School of Dentistry, CEUMA University, São Luís 65075-120, MA, Brazil; (A.P.A.N.); (A.M.M.L.); (S.A.G.F.J.); (B.L.L.G.); (M.C.F.)
| | - Renata Grazziotin-Soares
- Department of Oral Biological Medical Sciences, Faculty of Dentistry, University of British Columbia UBC, Vancouver, BC V6T 1Z4, Canada;
| | - Adriana Marques Mesquita Leal
- School of Dentistry, CEUMA University, São Luís 65075-120, MA, Brazil; (A.P.A.N.); (A.M.M.L.); (S.A.G.F.J.); (B.L.L.G.); (M.C.F.)
| | | | - Bruna Laís Lins Gonçalves
- School of Dentistry, CEUMA University, São Luís 65075-120, MA, Brazil; (A.P.A.N.); (A.M.M.L.); (S.A.G.F.J.); (B.L.L.G.); (M.C.F.)
| | - José Bauer
- Dental Materials Laboratory, School of Dentistry, University Federal of Maranhão (UFMA), São Luís 5085-582, MA, Brazil;
| | - Meire Coelho Ferreira
- School of Dentistry, CEUMA University, São Luís 65075-120, MA, Brazil; (A.P.A.N.); (A.M.M.L.); (S.A.G.F.J.); (B.L.L.G.); (M.C.F.)
| | - Ceci Nunes Carvalho
- School of Dentistry, CEUMA University, São Luís 65075-120, MA, Brazil; (A.P.A.N.); (A.M.M.L.); (S.A.G.F.J.); (B.L.L.G.); (M.C.F.)
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Pauletto G, Machry RV, Baumhardt T, de Freitas Daudt N, Pereira GKR, Bier CAS. Effect of radiotherapy, immediate dentin sealing and irrigation simulating single- or two-visits endodontic treatment on the bond strength to pulp chamber dentin: an in vitro study. Odontology 2024:10.1007/s10266-024-00971-9. [PMID: 38951300 DOI: 10.1007/s10266-024-00971-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Accepted: 06/19/2024] [Indexed: 07/03/2024]
Abstract
This study aimed to evaluate the influence of radiotherapy and different endodontic treatment protocols on the bond strength to pulp chamber dentin. Eighty mandibular molars were randomly divided into two groups (n = 40): non-irradiated and irradiated (60 Gy). The pulp chambers were sectioned, and each group was subdivided (n = 8), according to the endodontic treatment protocol: no treatment (Control); Single-visit; Two-visits; Immediate dentin sealing (IDS) + single-visit; and IDS + two-visits. Each endodontic treatment visit was simulated through irrigation with 2.5% NaOCl, 17% EDTA and distilled water. IDS was performed by actively applying two coats of a universal adhesive to the lateral walls of the pulp chamber. After, the pulp chambers were restored with resin composite and four sticks were obtained for microtensile test. In addition, the dentin of the pulp chamber roof was assessed for surface roughness, chemical composition, and topography after each treatment protocol. Two-way ANOVA, Tukey's post hoc, Mann-Whitney, Kruskal-Wallis and Dunn's post hoc were performed (α = 5%). The treatment protocol affected bond strength (p < 0.05), while the irradiation did not (p > 0.05). The control group presented the highest values (p < 0.05). The single-visit group demonstrated better performance compared to the other groups (p < 0.05), which did not differ from each other (p > 0.05) The use of IDS changed the surface roughness (p < 0.05), chemical composition (p < 0.05) and topography of the dentin. In conclusion, the treatment protocol influenced dentin adhesion, while irradiation did not.
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Affiliation(s)
- Guilherme Pauletto
- Post-Graduate Program in Oral Science, Faculty of Dentistry, Federal University of Santa Maria (UFSM), Roraima Avenue #1000, T Street, Building 26F, Room 2383, Santa Maria, Rio Grande do Sul, 97105-900, Brazil.
| | - Renan Vaz Machry
- Post-Graduate Program in Oral Science, Faculty of Dentistry, Federal University of Santa Maria (UFSM), Roraima Avenue #1000, T Street, Building 26F, Room 2383, Santa Maria, Rio Grande do Sul, 97105-900, Brazil
- Department of Restorative Dentistry, Faculty of Dentistry, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Tadeu Baumhardt
- Radiotherapy Sector, University Hospital of Santa Maria, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil
| | - Natália de Freitas Daudt
- Post-Graduate Program in Mechanical Engineering, Faculty of Mechanical Engineering, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil
| | - Gabriel Kalil Rocha Pereira
- Post-Graduate Program in Oral Science, Faculty of Dentistry, Federal University of Santa Maria (UFSM), Roraima Avenue #1000, T Street, Building 26F, Room 2383, Santa Maria, Rio Grande do Sul, 97105-900, Brazil
| | - Carlos Alexandre Souza Bier
- Post-Graduate Program in Oral Science, Faculty of Dentistry, Federal University of Santa Maria (UFSM), Roraima Avenue #1000, T Street, Building 26F, Room 2383, Santa Maria, Rio Grande do Sul, 97105-900, Brazil
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Ozel B, Ayhan T, Kaptan F, Sahin F, Karapınar-Kazandağ M. Dual- or single rinse? The tubular sealer penetration of endodontic chelating agents. PLoS One 2024; 19:e0303377. [PMID: 38875249 PMCID: PMC11178202 DOI: 10.1371/journal.pone.0303377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 04/23/2024] [Indexed: 06/16/2024] Open
Abstract
INTRODUCTION In this study, we aimed to compare the effectiveness of various chelating agents, ethilenediaminetetraacetic acid (EDTA), citric acid (CA), and etidronic acid (HEDP) mixed in two different forms, in removing the smear layer and promoting the penetration of an endodontic sealer into the dentinal tubules of extracted single-rooted teeth. METHODS The study used 75 teeth divided into five groups: 17% EDTA, 10% CA, 9% HEDP + NaOCl, 9% HEDP + distilled water (DW), and a control (DW) group. Scanning electron microscopy was used to assess smear layer removal and confocal laser microscopy was used to evaluate tubular sealer penetration at different depths from the apical tip. RESULTS Sealer penetration was highest with 17% EDTA and 10% CA as compared with the other agents (p<0.001). At the cervical third, the sealer penetration for EDTA, HEDP + NaOCl, and HEDP + DW groups were significantly different than those in DW (p = 0.020). For the middle third, EDTA, CA, and HEDP + NaOCl groups were significantly higher than those of the DW group (p<0.001). Cervical-level values were significantly higher than apical-level values for HEDP + NaOCl, HEDP + DW, and DW (p<0.001). Smear layer removal was lower with 9% HEDP + DW than with 17% EDTA and 10% CA at all depths (p<0.001). A significancy in smear layer removal was observed between 10% CA and control (p = 0.015) in middle depth. CONCLUSION Within the limitations of this study, highest values were seen in EDTA and CA in terms of sealer penetration and smear layer removal. In the light of these findings, the use of strong chelating agents highlights better clinical efficiency than dual-rinse or single HEDP irrigation.
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Affiliation(s)
- Beliz Ozel
- Department of Endodontics, Yeditepe University Faculty of Dentistry, Yeditepe University, Istanbul, Turkey
| | - Tuba Ayhan
- Department of Endodontics, Yeditepe University Faculty of Dentistry, Yeditepe University, Istanbul, Turkey
| | - Figen Kaptan
- Department of Endodontics, Yeditepe University Faculty of Dentistry, Yeditepe University, Istanbul, Turkey
| | - Fikrettin Sahin
- Department of Genetics and Bioengineering, Faculty of Engineering, Yeditepe University, Istanbul, Turkey
| | - Meriç Karapınar-Kazandağ
- Department of Endodontics, Yeditepe University Faculty of Dentistry, Yeditepe University, Istanbul, Turkey
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Katunarić A, Grgac SF, Gabrić D, Pavelić B, Bago I. Effect of sodium hypochlorite and ethylenediaminotetraacetic acid activated by laser and ultrasonic energy on surface morphology and chemical composition of intracanal dentin. Microsc Res Tech 2024; 87:818-831. [PMID: 38100184 DOI: 10.1002/jemt.24474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 11/03/2023] [Accepted: 12/05/2023] [Indexed: 03/02/2024]
Abstract
The aim of the study was to evaluate the structural and chemical changes in intracanal dentin after root canal irrigation with sodium hypochlorite (NaOCl) and ethylenediaminetetraacetic acid (EDTA) using additional activation with a novel Er:YAG Shock Wave-Enhanced Emission Photoacoustic Streaming (SWEEPS), ultrasonic irrigation (UI), and Nd:YAG irradiation. Root canals of extracted human premolars were instrumented with distilled water and distributed into groups according to the irrigation protocol used: Group 1: conventional needle irrigation (CI) with 3% NaOCl; group 2: CI with 15% EDTA; and group 3: CI with NaOCl+EDTA. In group 4, root canals were irrigated with NaOCl+EDTA+NaOCl using the following techniques: CI (group 4A), SWEEPS (group 4B), UI (group 4C). In group 4D, root canals were finally irradiated with Nd:YAG laser. After the irrigation, the intracanal dentin sample was collected and analyzed using spectroscope with a Fourier transformation of infrared spectrum in Attenuated total reflection technique (FTIR-ATR) to calculate apatite/collagen ratio. Scanning electron microscopy (SEM) and energy dispersive x-ray spectrometry (EDS) were used to determine its chemical composition. FTIR-ATR showed no significant difference in the phosphate/amid I ratio between the control and the experimental groups (p > 0.05). SWEEPS and UI of NaOCl+EDTA+NaOCl caused the most pronounced decrease of Ca and P (p < 0.05) value compared to CI and control group, and canal wall erosion. SWEEPS and UI of NaOCl+EDTA+NaOCl caused the most pronounced decrease of Ca and P value and significant canal wall erosion. However, no difference in phosphate/amide ratio was reported among groups. RESEARCH HIGHLIGHTS: SWEEPS and UI of NaOCl+EDTA+NaOCl caused the most pronounced decrease of Ca and P values and significant canal wall erosion. There was no difference in phosphate/amide ratio among the irrigation protocols.
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Affiliation(s)
- Adriana Katunarić
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | | | - Dragana Gabrić
- Department of Oral Surgery, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Božidar Pavelić
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Ivona Bago
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
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Usta SN, Erdem BA, Gündoğar M. Comparison of the removal of intracanal medicaments used in regenerative endodontics from root canal system using needle, ultrasonic, sonic, and laser-activated irrigation systems. Lasers Med Sci 2024; 39:27. [PMID: 38214804 PMCID: PMC10786972 DOI: 10.1007/s10103-024-03980-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 01/04/2024] [Indexed: 01/13/2024]
Abstract
This study aimed to compare the syringe-needle irrigation (SNI), passive ultrasonic irrigation (PUI), EDDY, and shock wave-enhanced emission photoacoustic streaming (SWEEPS) techniques regarding calcium hydroxide and double antibiotic paste removal from the root canal in regenerative endodontic treatments. Eighty single-rooted human teeth were decoronated and enlarged up to #100 to stimulate the immature tooth model. Root canals were irrigated with 1.5% sodium hypochlorite followed by saline solution according to the regenerative endodontic treatment protocol. Dressed teeth were divided into 2 main groups regarding the used intracanal medicaments. Calcium hydroxide and double antibiotic paste were introduced to the canals, and teeth were stored for 3 weeks. Each medicament group was divided into 4 subgroups according to the activation techniques. Medicaments were removed using a 17% EDTA solution. Teeth were split longitudinally into two parts. The remaining medicaments were evaluated under a stereo microscope with a scoring system. Data were analyzed with the Kruskal-Wallis and Mann-Whitney U tests. Regardless of the used irrigation activation systems, there was no statistically significant difference between the removal of the CH and DAP from the root canal (P>0.05). While SWEEPS had the highest ability regarding the removal of intracanal medicaments, syringe-needle irrigation had the lowest (P<0.05). There was no statistically significant difference between PUI and EDDY (P>0.05). Complete removal of intracanal medicaments could not be achieved with any techniques. SWEEPS technology was more effective in removing intracanal medicaments in regenerative endodontic treatments compared to the sonic and ultrasonic irrigation activation systems.
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Affiliation(s)
- Sıla Nur Usta
- Department of Endodontics, Gulhane Faculty of Dentistry, University of Health Sciences, Ankara, Turkey.
| | - Berat Akın Erdem
- Department of Endodontics, Gulhane Faculty of Dentistry, University of Health Sciences, Ankara, Turkey
| | - Mustafa Gündoğar
- Department of Endodontics, Faculty of Dentistry, University of Medipol, Istanbul, Turkey
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7
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La Rosa GRM, Plotino G, Nagendrababu V, Pedullà E. Effectiveness of continuous chelation irrigation protocol in endodontics: a scoping review of laboratory studies. Odontology 2024; 112:1-18. [PMID: 37433927 PMCID: PMC10776731 DOI: 10.1007/s10266-023-00835-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 06/27/2023] [Indexed: 07/13/2023]
Abstract
This scoping review aimed to synthesize and explore the current boundaries and limitations of laboratory research on the effectiveness of continuous chelation irrigation protocol in endodontics. This scoping review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Extension for Scoping Reviews. Literature search was conducted on Pubmed and Scopus to identify all laboratory studies evaluating smear layer and hard-tissue debris removal or, antimicrobial efficacy, or dentine erosion induced by continuous chelation. Two independent reviewers performed the all review steps and the relevant items were recorded. Seventy-seven potentially relevant studies were identified. Finally, 23 laboratory studies met the eligibility criteria for qualitative synthesis. Seven studies focused on the smear layer/debris removal outcome, 10 on antimicrobial activity, and 10 on dentine erosion. In general, the continuous chelation protocol was equally or more effective in the cleanliness of root canals and antimicrobial activity compared with traditional sequential protocol. In addition, etidronate solutions seemed to be milder chelating agents compared to those with EDTA, thus resulting in reduced or no dentine erosion and roughness modification. Yet, the methodological differences among the included studies limit the results' generalizability. The continuous chelation seems to be equally or more effective in all investigated outcomes when compared with the traditional sequential protocol. The methodological variability among the studies and shortcomings in the methods employed limit the generalizability and clinical relevance of the results. Standardized laboratory conditions combined with reliable three-dimensional investigation approaches are necessary to obtain clinically informative findings.
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Affiliation(s)
- Giusy Rita Maria La Rosa
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy.
| | | | - Venkateshbabu Nagendrababu
- Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, UAE
| | - Eugenio Pedullà
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
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Zarean P, Göllner M, Zarean P, Neuhaus KW. 2D and 3D Erosion Landscape Analysis of Endodontic-Treated Teeth Using EDTA and HEDP as Chelating Agents: A High-Resolution Micro-Computed Tomographic Study. Dent J (Basel) 2023; 11:286. [PMID: 38132424 PMCID: PMC10742433 DOI: 10.3390/dj11120286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 11/28/2023] [Accepted: 12/07/2023] [Indexed: 12/23/2023] Open
Abstract
This study aimed to assess the amount of erosion during activated endodontic irrigation with either HEDP or EDTA via high-resolution micro-computed tomography. Two root canals of twenty premolars were prepared with ProTaper Next and irrigated with sodium hypochlorite. Palatal canals, which served as control groups, were sealed, while buccal canals were further irrigated with either EDTA (n = 10) or HEDP (n = 10), which served as test groups. Micro-CT was performed to measure erosion depth. For 2D and 3D measurements, non-parametric repeated ANOVA measurements and post hoc tests were performed. 2D analysis showed highly significant differences between the case groups at each position of the root (p ≤ 0.01). The cervical and apical positions showed significant differences in the EDTA group (p = 0.03). The 3D analysis also showed significant differences between both chelating agents (p < 0.01) and the case and control groups (p = 0.01). The mean erosion depths in the cervical, middle, and apical thirds of the EDTA group were 45.75, 41.79, and 32.25 µm, and for the HEDP group were 20.25, 16.40, and 15.96 µm, respectively. HEDP seems to have a significantly less erosive effect. Different irrigation protocols with harsher conditions, as might be the case during endodontic retreatment, could be assessed with micro-CT.
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Affiliation(s)
- Parichehr Zarean
- Department of General Pediatric and Adolescent Dentistry, University Center for Dental Medicine Basel UZB, University of Basel, Mattenstrasse 40, 4058 Basel, Switzerland; (P.Z.); (P.Z.)
| | - Michael Göllner
- F. Hoffmann-La Roche Ltd., Grenzacherstrasse 124, 4070 Basel, Switzerland;
| | - Paridokht Zarean
- Department of General Pediatric and Adolescent Dentistry, University Center for Dental Medicine Basel UZB, University of Basel, Mattenstrasse 40, 4058 Basel, Switzerland; (P.Z.); (P.Z.)
| | - Klaus W. Neuhaus
- Department of General Pediatric and Adolescent Dentistry, University Center for Dental Medicine Basel UZB, University of Basel, Mattenstrasse 40, 4058 Basel, Switzerland; (P.Z.); (P.Z.)
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010 Bern, Switzerland
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Karatas E, Hadis M, Palin WM, Milward MR, Kuehne SA, Camilleri J. Minimally invasive management of vital teeth requiring root canal therapy. Sci Rep 2023; 13:20389. [PMID: 37990070 PMCID: PMC10663499 DOI: 10.1038/s41598-023-47682-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 11/16/2023] [Indexed: 11/23/2023] Open
Abstract
The present study aimed to investigate the possible use of a non-instrumentation technique including blue light irradiation for root canal cleaning. Extracted human single rooted teeth were selected. Nine different groups included distilled water, NaOCl, intra-canal heated NaOCl, and NaOCl + EDTA irrigation after either instrumentation or non-instrumentation, and a laser application group following non-instrumentation technique. The chemical assessment of the root canal dentine was evaluated using energy dispersive spectroscopy (EDS) and Fourier transform infrared (FT-IR) spectroscopy. Surface microstructural analyses were performed by using scanning electron microscopy (SEM). The antimicrobial efficacy of different preparation techniques was evaluated using microbial tests. Light application didn't change the calcium/phosphorus, carbonate/phosphate and amide I/phosphate ratios of the root canal dentin. The root canal dentin preserved its original chemistry and microstructure after light application. The instrumentation decreased the carbonate/phosphate and amide I/phosphate ratios of the root canal dentin regardless of the irrigation solution or technique (p < 0.05). The application of light could not provide antibacterial efficacy to match the NaOCl irrigation. The NaOCl irrigation both in the non-instrumentation and instrumentation groups significantly reduced the number of bacteria (p < 0.05). The use of minimally invasive root canal preparation techniques where the root canal is not instrumented and is disinfected by light followed by obturation with a hydraulic cement sealer reduced the microbial load and preserved the dentin thus may be an attractive treatment option for management of vital teeth needing root canal therapy.
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Affiliation(s)
- E Karatas
- Ataturk University, Erzurum, Turkey
- School of Dentistry, Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, 5, Mill Pool Way Edgbaston, Birmingham, B5 7EG, UK
| | - M Hadis
- School of Dentistry, Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, 5, Mill Pool Way Edgbaston, Birmingham, B5 7EG, UK
| | - W M Palin
- School of Dentistry, Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, 5, Mill Pool Way Edgbaston, Birmingham, B5 7EG, UK
| | - M R Milward
- School of Dentistry, Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, 5, Mill Pool Way Edgbaston, Birmingham, B5 7EG, UK
| | - S A Kuehne
- School of Dentistry, Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, 5, Mill Pool Way Edgbaston, Birmingham, B5 7EG, UK
- School of Science and Technology, Nottingham Trent University, Nottingham, UK
| | - J Camilleri
- School of Dentistry, Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, 5, Mill Pool Way Edgbaston, Birmingham, B5 7EG, UK.
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Atalay I, Erişen FR. Evaluation of the effects of different chelation agents on root dentin roughness. AUST ENDOD J 2023; 49 Suppl 1:71-78. [PMID: 36116094 DOI: 10.1111/aej.12691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 08/07/2022] [Accepted: 09/09/2022] [Indexed: 09/17/2023]
Abstract
Successful root canal treatment requires effective irrigation of the entire root canal system. While chelating agents support irrigation, they can also alter physicochemical properties of the root dentin structure. The aim of this study is to evaluate the effect of different chelation agents on root dentin roughness. Twenty-five extracted maxillary incisors were used in this study. Samples were separated longitudinally and divided into five groups: distilled water, NaOCl, ethylenediaminetetraacetic acid (EDTA), phytic acid and citric acid (CA). Atomic force microscope and energy dispersive X-ray spectroscopy analyses were used for analysing. One-way analysis of variance and Turkey tests were used in the statistical analysis of the study. EDTA, CA and phytic acid solutions increased the roughness and phytic acid and CA solutions decreased the Ca/P ratio in dentin tissue. No statistical difference was observed in the other groups. The decrease of Ca/P ratio should be taken under consideration during irrigation. The increase in surface roughness may provide clinical benefit by supporting the adhesion of the root canal filling materials to the dentin surface.
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Affiliation(s)
- Işınsu Atalay
- Department of Endodontics, Faculty of Dentistry, Istanbul University, Istanbul, Turkey
| | - Fehmi Raif Erişen
- Department of Endodontics, Faculty of Dentistry, Istanbul University, Istanbul, Turkey
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11
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Kawanishi Y, Maezono H, Shimaoka T, Kitatani T, Naito K, Sotozono M, Klanliang K, Takahashi Y, Hayashi M. Morphological Analyses of Effects of Endodontic Irrigant Solutions Using a Root Canal Model and an Immersion Model. Int J Dent 2023; 2023:3938522. [PMID: 37547814 PMCID: PMC10397496 DOI: 10.1155/2023/3938522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 05/23/2023] [Accepted: 06/24/2023] [Indexed: 08/08/2023] Open
Abstract
Objective This study aimed to compare an experimental model simulating clinical root canal irrigation (root canal model) with a conventional experimental model immersing dentin sample to irrigants (immersion model) to evaluate removal of the smear layer and decalcification of the root canal dentin using sodium hypochlorite (NaOCl) and two different concentrations of ethylenediaminetetraacetic acid (EDTA) solution. Materials and Methods Forty-five single-rooted extracted human teeth were prepared using a Ni-Ti rotary file. EDTA, NaOCl, and citric acid were used in the root canal models and the immersion models. After the irrigation protocol, root canal surfaces were observed under scanning electron microscopy. Residual smear and decalcification of the root canal dentin were evaluated objectively by measuring the percentage of the area occupied by visible dentin tubules, the number of visible dentin tubules, and the mean area of a visible single dentin tubule. Results Root canal and immersion models with the same irrigation protocol showed significantly different results for smear residues and decalcification of root canal dentin. In the root canal model, neither different EDTA concentrations nor the order of EDTA and NaOCl applications significantly impacted smear residues or decalcification of root canal dentin. Furthermore, no erosion of the root canal dentin surface was observed in any experimental groups in the root canal model using EDTA and NaOCl compared to intact dentin. Conclusions Experimental design affected results for residual smear layer and decalcification of root canal dentin. The order of EDTA and NaOCl use and the concentration of EDTA did not affect results. EDTA and NaOCl irrigation did not cause erosion in the root canal model in this study.
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Affiliation(s)
- Yuzo Kawanishi
- Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, 1-8 Yamada-Oka Suita, Osaka 565-0871, Japan
| | - Hazuki Maezono
- Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, 1-8 Yamada-Oka Suita, Osaka 565-0871, Japan
| | - Tsuyoshi Shimaoka
- Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, 1-8 Yamada-Oka Suita, Osaka 565-0871, Japan
| | - Takumi Kitatani
- Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, 1-8 Yamada-Oka Suita, Osaka 565-0871, Japan
| | - Katsuaki Naito
- Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, 1-8 Yamada-Oka Suita, Osaka 565-0871, Japan
| | - Maki Sotozono
- Division of Cariology, Operative Dentistry and Endodontics, Department of Oral Health Science, Niigata University Graduate School of Medical and Dental Sciences, 2-5274 Gakkocho-Dori Chuo-Ku, Niigata 951-8514, Japan
| | - Kittipit Klanliang
- Division of Endodontics, Department of Restorative Dentistry and Periodontology, Faculty of Dentistry, Chiang Mai University, Suthep Road Tambon Suthep Amphur Mueang Chiang Mai, Chiang Mai 50200, Thailand
| | - Yusuke Takahashi
- Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, 1-8 Yamada-Oka Suita, Osaka 565-0871, Japan
| | - Mikako Hayashi
- Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, 1-8 Yamada-Oka Suita, Osaka 565-0871, Japan
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12
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Ghandi M, Jadidi S. Endodontic management of type IIIb dens invaginatus in central incisor: A case report. Clin Case Rep 2023; 11:e7679. [PMID: 37465240 PMCID: PMC10350666 DOI: 10.1002/ccr3.7679] [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: 05/02/2023] [Revised: 06/17/2023] [Accepted: 06/20/2023] [Indexed: 07/20/2023] Open
Abstract
We described a type IIIb dens invaginatus, its root canal treatment, and results on 3- and 12-month visits. Despite its significant challenges, proper endodontic therapy in such cases can cause positive prognosis and successful outcome.
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Affiliation(s)
- Mostafa Ghandi
- Department of Endodontics, School of DentistryArak University of Medical SciencesArakIran
| | - Soheila Jadidi
- School of DentistryArak University of Medical SciencesArakIran
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13
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Huang CS, Hsiao CH, Chang YC, Chang CH, Yang JC, Gutmann JL, Chang HC, Huang HM, Hsieh SC. A Novel Endodontic Approach in Removing Smear Layer Using Nano and Submicron Diamonds with Intracanal Oscillation Irrigation. NANOMATERIALS (BASEL, SWITZERLAND) 2023; 13:nano13101646. [PMID: 37242062 DOI: 10.3390/nano13101646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 05/11/2023] [Accepted: 05/12/2023] [Indexed: 05/28/2023]
Abstract
Sodium hypochlorite (NaOCl) and ethylenediaminetetraacetic acid (EDTA) are commonly recommended for effectively removing organic and inorganic components in the smear layer. This layer is found on root canal walls after root canal instrumentation. However, high-concentration EDTA reduces the strength of dentin and the dissolution efficacy of organic substances in NaOCl solution. The objective of this study was to investigate the efficacy of applying nano and submicron diamonds in irrigation solutions with sonic and ultrasonic oscillation for removing the smear layer during endodontic treatment. Extracted single-rooted human teeth were instrumented with ProTaper® Gold (Dentsply Sirona) nickel-titanium rotary instruments. Subsequently, each canal was irrigated with 3% NaOCl, 17% EDTA, distilled water, and 10-1000 nm-sized nano and submicron diamond irrigation solutions, respectively. Sonic and ultrasonic instruments were compared for oscillating the irrigation solutions. The teeth were processed for scanning electron microscopy to observe the efficiency of smear layer removal on the canal walls. Our results indicated that diamond sizes of 50 nm and above irrigation solutions showed significant effectiveness in removing the smear layer following the oscillation of sonic instruments for 10 s. Ultrasonic assisted 500 nm and 1000 nm diamond solutions significantly differed from the other diamond-sized solution in their ability to remove the smear layer. These results suggest that sonic and ultrasonic oscillation with specific sizes of nano and submicron diamond irrigation solution can be used as an alternative approach to removing the smear layer during endodontic treatment. The potential clinical application of root canal treatments can be expected.
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Affiliation(s)
- Ching-Shuan Huang
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 11031, Taiwan
- Department of Dentistry, Taipei Medical University Hospital, Taipei 11031, Taiwan
| | - Chih-Hsun Hsiao
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 11031, Taiwan
- Department of Endodontology, Taipei Municipal Wan-Fang Hospital, Taipei 11696, Taiwan
| | - Yu-Chia Chang
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 11031, Taiwan
- Department of Endodontology, Taipei Municipal Wan-Fang Hospital, Taipei 11696, Taiwan
| | - Chih-Hsiang Chang
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 11031, Taiwan
| | - Jen-Chang Yang
- Graduate Institute of Nanomedicine and Medical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei 11031, Taiwan
| | - James L Gutmann
- College of Dentistry, Texas A&M University, Dallas, TX 77843, USA
| | - Huan-Cheng Chang
- Institute of Atomic and Molecular Sciences, Academia Sinica Taiwan, Taipei 11529, Taiwan
| | - Haw-Ming Huang
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 11031, Taiwan
| | - Sung-Chih Hsieh
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 11031, Taiwan
- Department of Endodontology, Taipei Municipal Wan-Fang Hospital, Taipei 11696, Taiwan
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14
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Widbiller M, Rosendahl A, Schlichting R, Schuller C, Lingl B, Hiller KA, Buchalla W, Galler KM. Impact of Endodontic Irrigant Activation on Smear Layer Removal and Surface Disintegration of Root Canal Dentine In Vitro. Healthcare (Basel) 2023; 11:healthcare11030376. [PMID: 36766951 PMCID: PMC9914448 DOI: 10.3390/healthcare11030376] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 01/22/2023] [Accepted: 01/23/2023] [Indexed: 01/31/2023] Open
Abstract
The objective of this study was to compare the ability of different endodontic irrigation activation methods to enable irrigant penetration, remove the smear layer from root canal walls after preparation, and investigate surface effects on dentine. Root canals of 90 single-rooted teeth were prepared and irrigated with EDTA (17%) and sodium hypochlorite (5%), where both irrigants or sodium hypochlorite only were activated as follows: conventional needle irrigation, ultrasonic activation, sonic activation (EDDY), or laser-based activation (photon-induced photoacoustic streaming/PIPS). For the evaluation of irrigant penetration into dentinal tubules, methylene blue was injected and activated as well. Subsequently, teeth were sectioned horizontally, and dye penetration depths were measured. Alternating sections were split in halves and randomly selected for scanning electron microscopic analysis. Root canal dentine was assessed for smear layer removal and surface disintegration according to a defined scoring system. The data were analyzed statistically with nonparametric and chi-squared tests for whole teeth and separately for coronal, middle, and apical thirds. All the tested activation methods removed a thicker smear layer than needle irrigation only. Additional activation of EDTA improved penetration depths of the irrigants, but not the smear layer removal. Surface disintegration of root canal dentine was observed with the additional activation of EDTA and particularly after laser-based techniques. Additional activation of EDTA does not seem to offer any convincing advantages in terms of irrigant penetration or smear layer removal but disrupts the dentine surface. Especially laser-based activation resulted in undesirable destruction of root canal wall dentine.
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Affiliation(s)
- Matthias Widbiller
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, 93053 Regensburg, Germany
- Correspondence:
| | - Andreas Rosendahl
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, 93053 Regensburg, Germany
| | | | - Christine Schuller
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, 93053 Regensburg, Germany
| | - Benedikt Lingl
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, 93053 Regensburg, Germany
| | - Karl-Anton Hiller
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, 93053 Regensburg, Germany
| | - Wolfgang Buchalla
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, 93053 Regensburg, Germany
| | - Kerstin M. Galler
- Department of Operative Dentistry and Periodontology, Friedrich-Alexander-University Erlangen-Nuernberg, 91054 Erlangen, Germany
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15
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Radwanski M, Leski M, Puszkarz AK, Sokolowski J, Hardan L, Bourgi R, Sauro S, Lukomska-Szymanska M. A Micro-CT Analysis of Initial and Long-Term Pores Volume and Porosity of Bioactive Endodontic Sealers. Biomedicines 2022; 10:2403. [PMID: 36289666 PMCID: PMC9599172 DOI: 10.3390/biomedicines10102403] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 09/19/2022] [Accepted: 09/23/2022] [Indexed: 11/21/2022] Open
Abstract
The evaluation of the porosities within the interface of root canals obturated with endodontics materials is extremely important for the long-term success of endodontic treatments. The aim of this study was to compare initial and long-term volume of pores (total, open, closed) and porosity (total, regional) of three bioactive endodontic sealers: GuttaFlow Bioseal, Total Fill BC Sealer, and BioRoot RCS. Root canals were obturated with three “bioactive” sealers using the single-cone technique. The volume of open and closed pores and porosity were calculated using a micro-computed tomography (MCT) method. The measurements were performed after 7 days (initial) and after 6 months (long-term) of incubation. Statistical significance was considered at p < 0.05. The total volume of pores remained unchanged after the 6-month storage. GuttaFlow Bioseal exhibited significantly higher long-term volume in open pores than Total Fill BC Sealer. The total porosity in all the tested sealers presented no statistically significant change after the 6-month storage, except for BioRoot RCS. The total porosity values of this latter material significantly increased after long-term incubation, especially in the apical region. In conclusion, the use of bioactive sealers with excessive tendency to create porosities both in shorth- and long-term periods of storage may compromise the long-term success of endodontic treatments.
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Affiliation(s)
- Mateusz Radwanski
- Department of Endodontics, Medical University of Lodz, 251 Pomorska Str., 92-213 Lodz, Poland
| | - Michal Leski
- Department of Endodontics, Medical University of Lodz, 251 Pomorska Str., 92-213 Lodz, Poland
| | - Adam K. Puszkarz
- Institute of Material Science of Textiles and Polymer Composites, Faculty of Material Technologies and Textile Design, Lodz University of Technology, 116 Żeromskiego Street, 90-924 Lodz, Poland
| | - Jerzy Sokolowski
- Department of General Dentistry, Medical University of Lodz, 251 Pomorska Str., 92-213 Lodz, Poland
| | - Louis Hardan
- Department of Restorative Dentistry, School of Dentistry, Saint-Joseph University, Beirut 1107 2180, Lebanon
| | - Rim Bourgi
- Department of Restorative Dentistry, School of Dentistry, Saint-Joseph University, Beirut 1107 2180, Lebanon
| | - Salvatore Sauro
- Dental Biomaterials and Minimally Invasive Dentistry, Departamento de Odontología, Facultad de Ciencias de la Salud, Universidad CEU-Cardenal Herrera C/Del Pozo ss/n, Alfara del Patriarca, 46115 Valencia, Spain
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University, 119146 Moscow, Russia
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16
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Retana-Lobo C, Ramírez-Mora T, Murillo-Gómez F, Maria Guerreiro-Tanomaru J, Tanomaru-Filho M, Reyes-Carmona J. Final irrigation protocols affect radicular dentin DMP1-CT expression, microhardness, and biochemical composition. Clin Oral Investig 2022; 26:5491-5501. [PMID: 35499657 DOI: 10.1007/s00784-022-04516-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 04/24/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To evaluate the effect of several final irrigation protocols on radicular dentin microhardness, biochemical composition, and DMP1-CT expression. MATERIALS AND METHODS A total of 140 single-rooted human teeth were prepared with WaveOne Gold files and randomly distributed into 7 groups (n = 20) according to the final irrigation protocol: distilled water (DW); sodium hypochlorite-EDTA (NaOCl-EDTA); EDTA (EDTA); EDTA-NaOCl (EDTA-NaOCl); EDTA-chlorhexidine (EDTA-CHX); passive ultrasonic irrigation (PUI:NaOCl-EDTA); and PUI:NaOCl-EDTA-NaOCl. Dentin microhardness (n = 10) was evaluated in the root canal lumen using Vickers hardness tester. Immunohistochemical analysis (n = 5) was used to evaluate DMP1-CT expression. Dentin ultrastructure and biochemical composition were evaluated by using Raman and energy dispersive X-ray analysis (EDAX) (n = 5) with a scanning electron microscope (SEM). Analysis of variance (ANOVA) and Tukey test were performed (p˂0.05). RESULTS Raman spectra of the organic content and DMP1-CT expression were lower at the lumen canal in EDTA-NaOCl, PUI:NaOCl-EDTA, and PUI:NaOCl-EDTA-NaOCl when compared to control (p < 0.05). EDAX showed reduced values for calcium and phosphorus in EDTA-NaOCl, PUI:NaOCl-EDTA, and PUI:NaOCl-EDTA-NaOCl. SEM microphotography's showed completely cleaned dentin, permeable tubules, and dentin erosion, mainly when PUI was used. NaOCl-EDTA presented significantly higher microhardness values than PUI:NaOCl-EDTA-NaOCl (p < 0.05). PUI:NaOCl-EDTA-NaOCl exhibited the lowest Vickers hardness values of all groups. CONCLUSION The final irrigation protocols that used a final rinse with NaOCl and PUI showed a detrimental effect on radicular dentin DMP1-CT expression, biochemical composition, and microhardness. CLINICAL RELEVANCE The adequate irrigation protocol could be advantageous to preserve the radicular dentin ultrastructure, promote adequate adhesion, and sustain favorable conditions for biomineralization and regeneration.
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Affiliation(s)
- Cristina Retana-Lobo
- Department of Endodontics, Faculty of Dentistry, LICIFO, University of Costa Rica, SJO, Sabanilla, San José, 11502, Costa Rica
| | - Tatiana Ramírez-Mora
- Department of Endodontics, Faculty of Dentistry, LICIFO, University of Costa Rica, SJO, Sabanilla, San José, 11502, Costa Rica
| | - Fabian Murillo-Gómez
- Dental Materials Research Laboratory, School of Dentistry, University of Costa Rica, SJO, Sabanilla, San José, 11502, Costa Rica
| | | | - Mario Tanomaru-Filho
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP), Araraquara, SP, Brazil
| | - Jessie Reyes-Carmona
- Department of Endodontics, Faculty of Dentistry, LICIFO, University of Costa Rica, SJO, Sabanilla, San José, 11502, Costa Rica.
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17
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Likhyani L, Choudhary M, Khandelwal S, Chacko Y. Management of an anomalous maxillary lateral incisor fused with a supernumerary tooth and a coronal dens invaginatus. ENDODONTOLOGY 2022. [DOI: 10.4103/endo.endo_197_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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18
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Coaguila-Llerena H, Gaeta E, Faria G. Outcomes of the GentleWave system on root canal treatment: a narrative review. Restor Dent Endod 2022; 47:e11. [PMID: 35284323 PMCID: PMC8891464 DOI: 10.5395/rde.2022.47.e11] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 08/03/2021] [Accepted: 08/17/2021] [Indexed: 11/11/2022] Open
Affiliation(s)
- Hernán Coaguila-Llerena
- Department of Restorative Dentistry, Araraquara School of Dentistry, São Paulo State University - UNESP, Araraquara, SP, Brazil
| | - Eduarda Gaeta
- Department of Restorative Dentistry, Araraquara School of Dentistry, São Paulo State University - UNESP, Araraquara, SP, Brazil
| | - Gisele Faria
- Department of Restorative Dentistry, Araraquara School of Dentistry, São Paulo State University - UNESP, Araraquara, SP, Brazil
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19
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Retana-Lobo C, Guerreiro-Tanomaru JM, Tanomaru-Filho M, Mendes de Souza BD, Reyes-Carmona J. Sodium Hypochlorite and Chlorhexidine Downregulate MMP Expression on Radicular Dentin. Med Princ Pract 2021; 30:470-476. [PMID: 34153965 PMCID: PMC8562034 DOI: 10.1159/000517887] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 06/15/2021] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Matrix metalloproteinases (MMPs) are present in radicular dentin and can convert structural matrix proteins into signaling molecules; thus, these enzymes play an essential role in dentin biomineralization and tissue regeneration therapies. Their expression on radicular dentin may be affected by the irrigation solutions used during root canal treatments. This study aimed to evaluate the effects of the most common irrigants on radicular dentin MMP expression. MATERIALS AND METHODS The experimental solutions were distilled water (control), 5% sodium hypochlorite (NaOCl), 18% ethylenediaminetetraacetic acid (EDTA), and 2% chlorhexidine (CHX). Samples were prepared from extracted human teeth. For zymography analysis, root sections were powderized, and dentin proteins were extracted to observe gelatinolytic activity. Root dentin slices were treated with the experimental solutions for immunohistochemical analysis using anti-MMP-2 and anti-MMP-9 antibodies. ANOVA and the Tukey test were performed. RESULTS Zymograms revealed the presence of MMP-2, MMP-8, and MMP-20 in the control group and the EDTA-treated group. Immunohistochemistry confirmed the presence of MMP-2 and MMP-9 mainly associated with the dentinal tubule lumens and occasionally with intertubular dentin. NaOCl- and CHX-treated groups showed lower expression of MMPs than the control group. Immuno-staining for both proteinases in the EDTA-treated group showed higher expression compared to the other experimental groups. CONCLUSION Our results showed that most common irrigants affect MMP expression on radicular dentin. Treatment with NaOCl and chlorhexidine resulted in lower expression of MMPs, while EDTA increased their expression in root canal dentin.
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Affiliation(s)
| | | | - Mario Tanomaru-Filho
- Department of Restorative Dentistry, São Paulo State University (UNESP), Araraquara, Brazil
| | | | - Jessie Reyes-Carmona
- Department of Endodontics, University of Costa Rica, San Jose, Costa Rica
- *Jessie Reyes-Carmona,
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20
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Effects of different irrigation protocols on dentin surfaces as revealed through quantitative 3D surface texture analysis. Sci Rep 2020; 10:22073. [PMID: 33328515 PMCID: PMC7744534 DOI: 10.1038/s41598-020-79003-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 11/24/2020] [Indexed: 11/20/2022] Open
Abstract
The combination of ethylenediaminetetraacetic acid (EDTA) and sodium hypochlorite (NaOCl) has been advocated as an effective irrigation methodology to remove organic and inorganic matter in root canal therapy. Yet, it was suggested that both solutions might lead to structural changes of the dentinal wall surface, depending on the order of application which might affect sealer mechanical retention. This study aims to evaluate the effect of different irrigating protocols on dentin surface roughness using quantitative 3D surface texture analysis. Data stems from 150 human root dentin sections, divided into five groups, each prepared according to one of the following protocols: Negative control; 17% EDTA; 17% EDTA followed by 5.25% NaOCl; 5.25% NaOCl; and 5.25% NaOCl followed by 17% EDTA. Each dentin sample was examined for its three-dimensional surface texture using a high-resolution confocal disc-scanning measuring system. EDTA 17% and the combined EDTA 17% with NaOCl 5.25% showed considerably higher roughness properties compared to the control and to NaOCl 5.25% alone. However, the irrigation sequence did not affect the dentin roughness properties. Therefore, mechanical retention is probably not dependent upon the selection of irrigation protocol sequence.
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21
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Rath PP, Yiu CKY, Matinlinna JP, Kishen A, Neelakantan P. The effects of sequential and continuous chelation on dentin. Dent Mater 2020; 36:1655-1665. [PMID: 33162115 DOI: 10.1016/j.dental.2020.10.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 06/26/2020] [Accepted: 10/14/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Proteolytic and demineralizing agents have a profound influence on the dentin ultrastructure, which plays a key role in the mechanical integrity of the tooth and integrity of dentin-biomaterial interfaces. In-depth characterization of dentin treated with a novel root canal irrigation protocol comprising sodium hypochlorite (NaOCl) and etidronate (HEDP) is lacking. This study comprehensively characterized and compared the effects of the continuous chelation (NaOCl/HEDP) and sequential chelation (NaOCl/EDTA) protocols on dentin. METHODS Dentin blocks, dentin powder and root canals of mandibular premolars were distributed into Group 1, Saline (control); Group 2, NaOCl/EDTA; and Group 3, NaOCl/HEDP. Ultrastructural characteristics of the treated dentin were investigated using electron microscopy and light microscopy, while the surface roughness was analyzed using atomic force microscopy. Chemical compositional changes were characterized using Fourier transform infrared spectroscopy (FTIR) and energy-dispersive-X-ray spectroscopy (EDS), while collagen degradation was determined using ninhydrin assay. Data were statistically analyzed using multiple-factor one-way ANOVA and Tukey HSD tests (P = 0.05). RESULTS NaOCl/HEDP resulted in partially degraded, yet mineralized collagen fibers, with minimal alteration to the subsurface matrix. Conversely, NaOCl/EDTA dissolved the hydroxyapaptite encapsulation, exposing collagen fibre bundles. There was no significant difference in the surface roughness between the two protocols (P > 0.05). NaOCl/HEDP resulted in homogenous distribution of organic and inorganic components on the treated surface. SIGNIFICANCE This study highlighted that continuous chelation (NaOCl/HEDP) resulted in a frail surface collagen layer while sequential chelation (NaOCl/EDTA) exposed bare collagen fibres. These surface and sub-surface effects potentially contribute to structural failures of dentin and/or dentin-biomaterial interfacial failures.
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Affiliation(s)
- Priti P Rath
- Discipline of Endodontology, Department of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region
| | - Cynthia K Y Yiu
- Discipline of Pediatric Dentistry, Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region
| | - Jukka P Matinlinna
- Dental Materials Science, Department of Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region
| | - Anil Kishen
- Faculty of Dentistry, The University of Toronto, Dentistry; Mount Sinai Hospital, Toronto, ON, Canada
| | - Prasanna Neelakantan
- Discipline of Endodontology, Department of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region.
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22
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Voegeli G, Bella ED, Mekki M, Machtou P, Bouillaguet S. Effect of a Modified Irrigation Protocol on the Cleanliness of Moderately Curved Canals. Eur J Dent 2020; 15:90-95. [PMID: 33003241 PMCID: PMC7902106 DOI: 10.1055/s-0040-1715985] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Objectives
This study tested the hypothesis that modifying the sequence of sodium hypochlorite (NaOCl)/ethylene diamine tetra-acetic acid (EDTA) irrigation during root canal shaping would improve apical cleanliness in moderately curved canals.
Materials and Methods
Forty-five root canals were prepared using Protaper Gold with three irrigation protocols. Standard irrigation (SI) used 0.5 mL 3% NaOCl between each instrument, followed by 5 mL 17% EDTA manually agitated for 30 seconds. Reverse irrigation (RI) used 0.5 mL of 17% EDTA between each instrument, then 5 mL of 3% NaOCl, manually agitated for 30 seconds. Reverse irrigation plus (RI+) was similar to RI, except NaOCl (5 mL), used as a final rinse, was allowed to interact for 3 minutes with dentin before manual agitation (30 seconds).
Root canal cleanliness was evaluated under the scanning electron microscope (SEM) (Hulsmann score); the chemical composition of dentin after irrigation was analyzed by energy dispersive X-ray (EDX). Statistical Analysis
Results were compared using Kruskal–Wallis ANOVA by ranks and Wilcoxon matched paired posthoc tests. A Chi-square test assessed whether the best cleanliness would demonstrate a significant association with one irrigation protocol; odds ratio calculation was performed using score “1” versus score “2 or more” (2+) (
p
< 0.05).
Results
In the apical region, cleanliness was better in RI+ than SI and both significantly better than RI. Odd ratios indicate that the cleanliness in RI+ was significantly better than RI and SI groups (
p
< 0.000 and 0.003, respectively). Independently of the irrigation protocol, EDX analyses showed no chemical alteration of root dentin.
Conclusions
Using 17% EDTA during shaping, followed by 3% NaOCl rinse for 3 minutes, improved apical cleanliness without inducing erosion of dentin.
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Affiliation(s)
- Garance Voegeli
- University Clinics of Dental Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Enrico Di Bella
- Department of Economics and Business Studies, Faculty of Economics, University of Genoa, Genoa, Italy
| | - Mustapha Mekki
- Biomaterials Unit, Section of Dental Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | | | - Serge Bouillaguet
- University Clinics of Dental Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
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Wright PP, Scott S, Shetty S, Kahler B, Walsh LJ. Resistance to compressive force in continuous chelation. AUST ENDOD J 2020; 47:150-156. [PMID: 32902070 DOI: 10.1111/aej.12440] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 07/13/2020] [Accepted: 08/07/2020] [Indexed: 11/28/2022]
Abstract
Continuous chelation involves the simultaneous use of sodium hypochlorite and a chelating agent. Given the combination of a proteolytic agent and a demineralising chelator, this study aimed to investigate whether mixtures containing the weak chelators etidronate or clodronate and sodium hypochlorite could adversely affect the mechanical strength of teeth compared to the sequence sodium hypochlorite/EDTA/sodium hypochlorite. Matching pairs of bovine teeth were tested on a universal testing machine, and the compressive load at fracture was recorded. One root from each pair was prepared with the sequence, and the matching tooth was prepared with either water, the clodronate mixture or the etidronate mixture. No differences in load at fracture were seen between either mixture and the sequence. However, loads were higher in the teeth irrigated with water compared to the sequence. The results indicated that the continuous chelation mixtures did not alter tooth mechanical properties compared to the standard sequence.
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Affiliation(s)
- Patricia P Wright
- School of Dentistry, University of Queensland, Herston, QLD, Australia
| | - Suzanne Scott
- Australian e-Health Research Centre, CSIRO, North Ryde, NSW, Australia
| | - Sowmya Shetty
- School of Dentistry, University of Queensland, Herston, QLD, Australia
| | - Bill Kahler
- School of Dentistry, University of Queensland, Herston, QLD, Australia
| | - Laurence J Walsh
- School of Dentistry, University of Queensland, Herston, QLD, Australia
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24
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Rath PP, Yiu CKY, Matinlinna JP, Kishen A, Neelakantan P. The effect of root canal irrigants on dentin: a focused review. Restor Dent Endod 2020; 45:e39. [PMID: 32839720 PMCID: PMC7431934 DOI: 10.5395/rde.2020.45.e39] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 06/03/2020] [Accepted: 06/09/2020] [Indexed: 11/15/2022] Open
Abstract
Despite the vast literature on the effects of root canal irrigants on the dentin characteristics, the precise effects of clinically relevant irrigation sequences remain unclear. In this review, we systematically dissect the role of different sequential irrigation approaches that are used in clinical endodontics. Using a systematic search strategy, we attempt to answer the question: ‘Which irrigating sequence has the most deleterious effects on dentin structure and properties?’ The effect of irrigants on the dentin composition and mechanical properties have been reviewed. A wide variety of concentrations, duration and techniques have been employed to characterize the effects of chemicals on dentin properties, thus making it impossible to draw guidelines or recommendations of irrigant sequences to be followed clinically. It was apparent that all the studied irrigation sequences potentially result in some deleterious effects on dentin such as decrease in the flexural strength, microhardness, modulus of elasticity and inorganic content and organic-inorganic ratio of the dentin. However, the literature still lacks comprehensive investigations to compare the deleterious effect of different irrigation sequences, using a wide variety of qualitative and quantitative methods. Such investigations are essential to make clinical recommendations and strategize efforts to minimize chemically-induced damage to dentin characteristics.
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Affiliation(s)
- Priti Pragati Rath
- Discipline of Endodontology, Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR
| | - Cynthia Kar Yung Yiu
- Discipline of Pediatric Dentistry, Division of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR
| | - Jukka Pekka Matinlinna
- Dental Materials Science, Division of Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR
| | - Anil Kishen
- Faculty of Dentistry, The University of Toronto, Toronto, ON, Canada.,Dentistry, Mount Sinai Hospital, Toronto, ON, Canada
| | - Prasanna Neelakantan
- Discipline of Endodontology, Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR
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25
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Bosaid F, Aksel H, Makowka S, Azim AA. Surface and structural changes in root dentine by various chelating solutions used in regenerative endodontics. Int Endod J 2020; 53:1438-1445. [PMID: 32619296 DOI: 10.1111/iej.13354] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 06/25/2020] [Accepted: 06/26/2020] [Indexed: 01/16/2023]
Abstract
AIM To evaluate the effects of the prolonged use of various irrigant solutions used during regenerative endodontic procedures on the physical and chemical structure of root canal dentine in extracted human teeth. METHODOLOGY Sixtyroot dentine samples from extracted, single-rooted, human teeth were assigned to 10 groups. Eight groups were irrigated with 1.5% NaOCl for 5 min, followed by 3%, 10%, 17% EDTA or 10% citric acid (CA) for 5 or 10 min. One group received only NaOCl irrigation, and samples with only distilled water irrigation were used as a control group. The changes in microhardness and flexural strength were determined using Vickers and 3-point flexural tester, respectively. Molecular and elemental compositions were recorded using FTIR and EDS spectroscopy. Data were analysed using one-way anova, Kruskal-Wallis and Mann-Whitney U tests. RESULTS The application of 1.5% NaOCl for 5 min did not affect the mineral content or microhardness of dentine (P > 0.05). However, it significantly decreased the dentine collagen peak values (P < 0.05), which was similar to the control group after the use of chelating agents (EDTA and 10% of CA) (P > 0.05). The effect of EDTA on the inorganic content was not concentration and time dependent (P > 0.05). CA resulted in a significantly greater reduction in the inorganic contents compared with the control and EDTA groups (P < 0.05). Regardless of the time, EDTA and CA significantly decreased dentine microhardness compared to the control (P < 0.05) with the greatest reduction in the CA groups (P < 0.05). NaOCl alone was associated with the lowest flexural strength, while none of the other irrigation regimens significantly decreased the flexural strength compared to the control group (P> 0.05). CONCLUSIONS Use of 1.5% NaOCl for 5 min decreased the collagen content of samples of human dentine from extracted teeth while EDTA and 10% citric acid mostly affected the inorganic content and microhardness of dentine surfaces. None of the irrigant solutions significantly decreased the mechanical properties of the entire dentine specimen.
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Affiliation(s)
- F Bosaid
- Division of Endodontics, University at Buffalo, School of Dental Medicine, Buffalo, NY, USA
| | - H Aksel
- Division of Endodontics, University at Buffalo, School of Dental Medicine, Buffalo, NY, USA
| | - S Makowka
- Dental Materials Research Laboratory, University at Buffalo, School of Dental Medicine, Buffalo, NY, USA
| | - A A Azim
- Division of Endodontics, University at Buffalo, School of Dental Medicine, Buffalo, NY, USA
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26
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Barón M, Morales V, Fuentes MV, Linares M, Escribano N, Ceballos L. The influence of irrigation solutions in the inorganic and organic radicular dentine composition. AUST ENDOD J 2020; 46:217-225. [PMID: 31984636 DOI: 10.1111/aej.12395] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/27/2019] [Indexed: 11/29/2022]
Abstract
The aim of this study was to analyse changes in radicular dentine composition after different irrigation regimes using attenuated total reflectance Fourier-transform infrared spectroscopy (ATR-FTIR). Dentine slices from human single-root teeth were immersed in: (i) 5.25% sodium hypochlorite (NaOCl) for 1, 5 and 20 min; (ii) 17% EDTA for 1 min; and (iii) 5.25% NaOCl for 20 min, and 17% EDTA and 5.25% NaOCl, both for 1 min. Carbonate/mineral, Amide I/mineral and Amide III/CH2 ratios were determined using ATR-FTIR before and after immersion in the irrigation solutions tested. Results showed that 5.25% NaOCl significantly decreased carbonate/mineral, Amide I/mineral and Amide III/CH2 ratios (P < 0.05). Application of 17% EDTA produced no change in carbonate/mineral ratio (P = 0.120), while an increase in Amide I/mineral in apical third (P = 0.002) and Amide III/CH2 (P < 0.001) was observed. The combination of NaOCl, EDTA and NaOCl increased carbonate/mineral ratio in coronal third (P = 0.037), and Amide I/mineral (P = 0.003) and Amide III/CH2 (P = 0.001) ratios. In conclusion, irrigation solutions tested significantly affected radicular dentine composition.
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Affiliation(s)
- Marta Barón
- Faculty of Health Sciences, IDIBO Research Group, Rey Juan Carlos University, Madrid, Spain
| | - Victoria Morales
- Group of Chemical and Environmental Engineering, School of Experimental Sciences and Technology, Rey Juan Carlos University, Madrid, Spain
| | - Mª Victoria Fuentes
- Faculty of Health Sciences, IDIBO Research Group, Rey Juan Carlos University, Madrid, Spain
| | - María Linares
- Group of Chemical and Environmental Engineering, School of Experimental Sciences and Technology, Rey Juan Carlos University, Madrid, Spain
| | - Nuria Escribano
- Faculty of Health Sciences, IDIBO Research Group, Rey Juan Carlos University, Madrid, Spain
| | - Laura Ceballos
- Faculty of Health Sciences, IDIBO Research Group, Rey Juan Carlos University, Madrid, Spain
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27
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Keine KC, Kuga MC, Coaguila-Llerena H, Palma-Dibb RG, Faria G. Peracetic acid as a single endodontic irrigant: effects on microhardness, roughness and erosion of root canal dentin. Microsc Res Tech 2019; 83:375-380. [PMID: 31833180 DOI: 10.1002/jemt.23424] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 11/06/2019] [Accepted: 11/27/2019] [Indexed: 11/06/2022]
Abstract
The aim was to assess the effects of 1% peracetic acid (PAA) as a single endodontic irrigant on microhardness, roughness, and erosion of root canal dentin, compared with 2.5% sodium hypochlorite (NaOCl) and with 2.5% NaOCl combined with 17% EDTA. Forty human, single-rooted tooth hemisections were submitted to Knoop microhardness test, before and after the following irrigation protocols: PAA = 1% PAA; NaOCl = 2.5% NaOCl; NaOCl-EDTA-NaOCl = 2.5% NaOCl +17% EDTA +2.5% NaOCl; and SS = saline. Another 40 roots were instrumented, irrigated with the same protocols, and sectioned longitudinally. The roughness analysis was performed on the mesial section using a confocal laser scanning microscope, whereas erosion was analyzed on each third of the distal section, using a scanning electron microscope. The data were analyzed using ANOVA and Tukey post-tests, and Kruskal-Wallis and Dunn post-tests (α = .05). The PAA and NaOCl-EDTA-NaOCl groups showed no significant differences (p > .05); both promoted reduction in microhardness and increase in roughness, compared with the NaOCl and SS groups (p < .05). NaOCl-EDTA-NaOCl promoted higher erosion in the cervical and middle thirds than the other groups (p < .05); there was no difference among PAA, NaOCl, and SS (p > .05). There was also no difference among the groups regarding the apical third (p > .05). PAA used as a single endodontic irrigant caused reduction in root canal dentin microhardness and increase in roughness in a similar way to NaOCl-EDTA-NaOCl; however, PAA caused less erosion than NaOCl-EDTA-NaOCl.
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Affiliation(s)
- Kátia C Keine
- Department of Restorative Dentistry, Araraquara School of Dentistry, São Paulo State University - UNESP, Araraquara, São Paulo, Brazil
| | - Milton C Kuga
- Department of Restorative Dentistry, Araraquara School of Dentistry, São Paulo State University - UNESP, Araraquara, São Paulo, Brazil
| | - Hernán Coaguila-Llerena
- Department of Restorative Dentistry, Araraquara School of Dentistry, São Paulo State University - UNESP, Araraquara, São Paulo, Brazil
| | - Regina G Palma-Dibb
- Department of Restorative Dentistry, Ribeirão Preto School of Dentistry, São Paulo University - USP, Ribeirão Preto, São Paulo, Brazil
| | - Gisele Faria
- Department of Restorative Dentistry, Araraquara School of Dentistry, São Paulo State University - UNESP, Araraquara, São Paulo, Brazil
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28
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Wright PP, Cooper C, Kahler B, Walsh LJ. From an assessment of multiple chelators, clodronate has potential for use in continuous chelation. Int Endod J 2019; 53:122-134. [DOI: 10.1111/iej.13213] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 08/28/2019] [Indexed: 11/29/2022]
Affiliation(s)
- P. P. Wright
- The School of Dentistry The University of Queensland Herston QldAustralia
| | - C. Cooper
- Central Analytical Research Facility (CARF) Institute for Future Environments Queensland University of Technology Brisbane Qld Australia
| | - B. Kahler
- The School of Dentistry The University of Queensland Herston QldAustralia
| | - L. J. Walsh
- The School of Dentistry The University of Queensland Herston QldAustralia
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29
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Xin Y, Yang J, Song KY. [In vitro evaluation of the effectiveness of XP-endo Finisher file on smear layer removal after root canal instrumentation]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2019; 37:48-52. [PMID: 30854818 DOI: 10.7518/hxkq.2019.01.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJECTIVE This study aimed to evaluate the effectiveness of XP-endo Finisher (XPF) file and passive ultrasonic irrigation (PUI) in the smear layer removal of the root canal. METHODS A total of 60 human single-rooted premolars were selected and decoronated to standardize their canal length to 16 mm. Tooth samples were prepared using a S3 rotary system to prepare root canal with the file size of 3S and then randomly divided into 6 groups according to the final irrigation protocol, as follows: XPF 3 mL of 3% NaOCl for 1 min (group A); XPF 3 mL of 3% NaOCl for 1 min, followed by 4 mL of 17% ethylene diamine tetraacetic acid (EDTA) for 1 min (group B); PUI of 3 mL of 3% NaOCl for 1 min (group C); PUI of 3 mL of 3% NaOCl for 1 min, followed by 4 mL of 17% EDTA for 1 min (group D); 3 mL of 3% NaOCl for 1 min by using a syringe and a 30 G side-vented needle (group E); and 3 mL of 3% NaOCl for 1 min by using a syringe and a 30 G side-vented needle, followed by 4 mL of 17% EDTA for 1 min (group F). After the completion of the root canal preparation, the teeth were split into two longitudinally. The mean numbers of the visible open dentinal tubules in the apical and middle thirds of the root canals were evaluated via scanning electron microscope. RESULTS The whole surfaces of the root canals in groups A, C, and E were covered by a smear layer. Groups A and C possessed significantly higher number of visible open dentinal tubules than in group E (P<0.05), with statistically insignificant difference between groups A and C (P>0.05). The apical third of the samples in groups B and D and in the middle thirds of canals in group F exhibited a small amount of smear layer, and the dentinal tubules were open or semi-open. The root canal surfaces in the apical third of the samples in group F were covered by a smear layer, and the dentinal tubules were sealed or semisealed. The smear layers in the middle third of the samples in groups B and D were removed, and the dentinal tubules were more visibly open than those of the four other groups (P<0.05). The difference between groups B and D were statistically insignificant (P>0.05). CONCLUSIONS The difference between XPF and PUI in terms of the smear layer removal of the root canals was insignificant. Hence, XPF, as a new irrigation agitation technique, can aid in improving smear layer removal.
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Affiliation(s)
- Yue Xin
- Dept. of Conservative Dentistry and Endodontics, The Affiliated Stomatological Hospital of Nanchang University, The Key Laboratory of Oral Biomedicine of Jiangxi Province, Nanchang 330006, China
| | - Jian Yang
- Dept. of Conservative Dentistry and Endodontics, The Affiliated Stomatological Hospital of Nanchang University, The Key Laboratory of Oral Biomedicine of Jiangxi Province, Nanchang 330006, China
| | - Kuang-Yu Song
- Dept. of Microbiology, Jiangxi Medical College, Nanchang University, Nanchang 330006, China
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30
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Nogo‐Živanović D, Kanjevac T, Bjelović L, Ristić V, Tanasković I. The effect of final irrigation with MTAD, QMix, and EDTA on smear layer removal and mineral content of root canal dentin. Microsc Res Tech 2019; 82:923-930. [DOI: 10.1002/jemt.23239] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Revised: 01/14/2019] [Accepted: 01/31/2019] [Indexed: 11/09/2022]
Affiliation(s)
- Dajana Nogo‐Živanović
- Department for Restorative Dentistry and Endodontics, Faculty of MedicineUniversity of East Sarajevo Foca Bosnia and Herzegovina
| | - Tatjana Kanjevac
- Department of Dentistry, Faculty of Medical SciencesUniversity of Kragujevac Kragujevac Serbia
| | - Ljiljana Bjelović
- Department for Restorative Dentistry and Endodontics, Faculty of MedicineUniversity of East Sarajevo Foca Bosnia and Herzegovina
| | - Vladimir Ristić
- Department of Dentistry, Faculty of Medical SciencesUniversity of Kragujevac Kragujevac Serbia
| | - Irena Tanasković
- Department of Histology and Embryology, Faculty of Medical SciencesUniversity of Kragujevac Kragujevac Serbia
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31
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Wang D, Shen Y, Hancock REW, Ma J, Haapasalo M. Antimicrobial Effect of Peptide DJK-5 Used Alone or Mixed with EDTA on Mono- and Multispecies Biofilms in Dentin Canals. J Endod 2018; 44:1709-1713. [PMID: 30243660 DOI: 10.1016/j.joen.2018.07.018] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Revised: 07/11/2018] [Accepted: 07/19/2018] [Indexed: 12/31/2022]
Abstract
INTRODUCTION The present study aimed to evaluate the antibacterial effect of a new peptide, DJK-5, used alone or mixed together with EDTA on mono- and multispecies biofilms in dentin canals covered by a smear layer with or without preceding sodium hypochlorite (NaOCl) irrigation. METHODS One hundred twelve dentin blocks (224 final specimens) were prepared and divided into 56 groups, and Enterococcus faecalis or multispecies bacteria were introduced into dentinal tubules by centrifugation. After 1 week of cultivation, a uniform smear layer was created on the surface of the dentin blocks, and the samples were exposed to sterile water, 17% EDTA, 2% or 6% NaOCl, 10 μg/mL DJK-5, or a mixture of 8.5% EDTA +10 μg/mL DJK-5 or were combined treated with the solution in the following sequence: 2% or 6% NaOCl +10 μg/mL DJK-5, 2% or 6% NaOCl + 8.5% EDTA +10 μg/mL DJK-5, 2% or 6% NaOCl + 8.5% EDTA + 10 μg/mL DJK-5. Specimens without a smear layer treated by 6% NaOCl or 10 μg/mL DJK-5 served as the positive control. The irrigant exposure time was 3 or 10 minutes. The antibacterial efficacy was determined by live/dead staining and confocal laser scanning microscopy. RESULTS The smear layer reduced the antibacterial capacity of 6% NaOCl and 10 μg/mL DJK-5. The efficacy of 2% or 6% NaOCl followed by 10 μg/mL DJK-5 was superior to 10 μg/mL DJK-5 alone (P < .05) but inferior to 2% or 6% NaOCl + 8.5% EDTA + 10 μg/mL DJK-5 and 2% or 6% NaOCl + 8.5% EDTA + 10 μg/mL DJK-5 (P < .05). The mixture of 8.5% EDTA and 10 μg/mL DJK-5 had the same disinfection effectiveness as 10 μg/mL DJK-5 used alone (P < .05). Using 2% or 6% NaOCl before EDTA + peptide always resulted in the highest killing (P < .05). CONCLUSIONS The smear layer inhibits the disinfectant effect in dentin. Peptide DJK-5 showed a strong antibacterial effect against mono- and multispecies biofilms in dentin canals. The highest killing was measured when 6% NaOCl was followed by a mixture of EDTA and peptide DJK-5.
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Affiliation(s)
- Dan Wang
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Faculty of Dentistry, Division of Endodontics, Department of Oral Biological and Medical Sciences, University of British Columbia, Vancouver, Canada
| | - Ya Shen
- Faculty of Dentistry, Division of Endodontics, Department of Oral Biological and Medical Sciences, University of British Columbia, Vancouver, Canada
| | - Robert E W Hancock
- Centre for Microbial Diseases and Immunity Research, Department of Microbiology and Immunology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jingzhi Ma
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Markus Haapasalo
- Faculty of Dentistry, Division of Endodontics, Department of Oral Biological and Medical Sciences, University of British Columbia, Vancouver, Canada.
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Morgan AD, Ng YL, Odlyha M, Gulabivala K, Bozec L. Proof-of-concept study to establish an in situ method to determine the nature and depth of collagen changes in dentine using Fourier Transform Infra-Red spectroscopy after sodium hypochlorite irrigation. Int Endod J 2018; 52:359-370. [PMID: 30144371 DOI: 10.1111/iej.13004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 08/22/2018] [Indexed: 11/28/2022]
Abstract
AIM To establish a method using Fourier Transform Infra-Red spectroscopy (FTIR) to characterize the nature and depth of changes in dentinal collagen following exposure to sodium hypochlorite (NaOCl) during root canal irrigation in an ex vivo model. METHODOLOGY Fourier Transform Infra-Red spectroscopy was used to assess the changes in dentinal collagen when the root canal was exposed to NaOCl. The changes in dentinal collagen caused by NaOCl irrigation of root canals in transverse sections of roots, at 0.5 mm from the canal wall and 0.5 mm from the external root surface, were assessed by FTIR. The data were analysed using paired t-test with 5% significance level. RESULTS Fourier Transform Infra-Red spectroscopy confirmed that NaOCl exposure caused alterations in the chemistry and structure of collagen in dentine. FTIR spectra obtained from dentine surfaces and dentine adjacent to root canals exposed to NaOCl, all consistently showed degradation and conformational change of the collagen structure. FTIR data from the ex vivo model showed that the depth of effect of NaOCl extended to at least 0.5 mm from the canal wall. CONCLUSION In extracted human teeth, NaOCl caused changes in dentinal collagen that were measurable by FTIR. In an ex vivo model, the depth of effect into dentine extended at least 0.5 mm from the canal wall.
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Affiliation(s)
- A D Morgan
- Unit of Endodontology, Division of Restorative Dental Science, UCL Eastman Dental Institute, London, UK
| | - Y-L Ng
- Unit of Endodontology, Division of Restorative Dental Science, UCL Eastman Dental Institute, London, UK
| | - M Odlyha
- Department of Biological Sciences, Birkbeck, University of London, London, UK
| | - K Gulabivala
- Unit of Endodontology, Division of Restorative Dental Science, UCL Eastman Dental Institute, London, UK
| | - L Bozec
- Division of Biomaterials & Tissue Engineering, UCL Eastman Dental Institute, London, UK
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33
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Wang Z, Shen Y, Haapasalo M. Root Canal Wall Dentin Structure in Uninstrumented but Cleaned Human Premolars: A Scanning Electron Microscopic Study. J Endod 2018; 44:842-848. [DOI: 10.1016/j.joen.2018.01.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 01/27/2018] [Accepted: 01/29/2018] [Indexed: 10/17/2022]
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34
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Sigurdsson A, Garland RW, Le KT, Rassoulian SA. Healing of Periapical Lesions after Endodontic Treatment with the GentleWave Procedure: A Prospective Multicenter Clinical Study. J Endod 2018; 44:510-517. [DOI: 10.1016/j.joen.2017.12.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 11/25/2017] [Accepted: 12/01/2017] [Indexed: 11/26/2022]
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35
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Wang D, Shen Y, Ma J, Hancock RE, Haapasalo M. Antibiofilm Effect of D-enantiomeric Peptide Alone and Combined with EDTA In Vitro. J Endod 2017; 43:1862-1867. [DOI: 10.1016/j.joen.2017.06.037] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 06/24/2017] [Accepted: 06/29/2017] [Indexed: 10/18/2022]
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36
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DiVito EE, Le KT. Maxillary molar healing after treatment of an uninstrumented canal with a novel root canal procedure: a case report. Clin Case Rep 2017; 5:1676-1681. [PMID: 29026571 PMCID: PMC5628211 DOI: 10.1002/ccr3.1165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 07/14/2017] [Accepted: 08/07/2017] [Indexed: 11/08/2022] Open
Abstract
A major cause for endodontic failure is the inability to treat all anatomy. Studies report endodontic retreatments contain 42% missed canals. This case illustrates dentin preservation of a molar with an uninstrumented mesiobuccal‐3 canal revealed post‐GentleWave Procedure. Efficient cleaning and disinfection with maintained healing to 18 months is demonstrated.
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Tartari T, Bachmann L, Zancan RF, Vivan RR, Duarte MAH, Bramante CM. Analysis of the effects of several decalcifying agents alone and in combination with sodium hypochlorite on the chemical composition of dentine. Int Endod J 2017; 51 Suppl 1:e42-e54. [DOI: 10.1111/iej.12764] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2016] [Accepted: 03/13/2017] [Indexed: 11/27/2022]
Affiliation(s)
- T. Tartari
- Department of Operative Dentistry, Endodontics and Dental Materials; Bauru School of Dentistry; University of São Paulo; Bauru SP Brazil
| | - L. Bachmann
- Department of Physics; Faculty of Philosophy, Science and Literature of Ribeirão Preto; University of São Paulo; Ribeirão Preto SP, Brazil
| | - R. F. Zancan
- Department of Operative Dentistry, Endodontics and Dental Materials; Bauru School of Dentistry; University of São Paulo; Bauru SP Brazil
| | - R. R. Vivan
- Department of Operative Dentistry, Endodontics and Dental Materials; Bauru School of Dentistry; University of São Paulo; Bauru SP Brazil
| | - 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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