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Iandolo A, Pisano M, Buonavoglia A, Giordano F, Amato A, Abdellatif D. Traditional and Recent Root Canal Irrigation Methods and Their Effectiveness: A Review. Clin Pract 2023; 13:1059-1072. [PMID: 37736930 PMCID: PMC10514886 DOI: 10.3390/clinpract13050094] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 08/25/2023] [Accepted: 08/25/2023] [Indexed: 09/23/2023] Open
Abstract
According to contemporary dental standards, the primary goal of endodontic therapy is the chemo-mechanical cleaning of the complex root canal system. Watering root canals with approved solutions and activating them are essential parts of this operation. This review outlines various irrigant activation methods for root canal therapy. Specifically, a comparison among the methods of manual dynamic activation, sonics (subsonic, sonic, and ultrasonic), internal heating, and lasers, was conducted. The results in this work were gathered using Scopus, Web of Science, Google Scholar, and PubMed databases by searching the following keywords: sodium hypochlorite, cleaning, activation, and irrigation methods. The present work concluded that the use of irrigant activation has a greater benefit than its absence. Regardless, it is impossible to point to a single effective activation method.
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Affiliation(s)
- Alfredo Iandolo
- Department of Medicine and Surgery, School of Dentistry, University of Salerno, 84081 Salerno, Italy; (M.P.); (F.G.); (A.A.)
| | - Massimo Pisano
- Department of Medicine and Surgery, School of Dentistry, University of Salerno, 84081 Salerno, Italy; (M.P.); (F.G.); (A.A.)
| | - Alessio Buonavoglia
- Department of Biomedical and Neuromotor Sciences, School of Dentistry, University of Bologna, 40125 Bologna, Italy;
| | - Francesco Giordano
- Department of Medicine and Surgery, School of Dentistry, University of Salerno, 84081 Salerno, Italy; (M.P.); (F.G.); (A.A.)
| | - Alessandra Amato
- Department of Medicine and Surgery, School of Dentistry, University of Salerno, 84081 Salerno, Italy; (M.P.); (F.G.); (A.A.)
| | - Dina Abdellatif
- Department of Endodontics, Faculty of Dentistry, University of Alexandria, Alexandria 21531, Egypt;
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2
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Vohra F, Alsaif R, Alsayed H, AlSaeed MM, Mourad AME. Decontamination of lithium disilicate ceramics using various photosensitizers, herbal and chemical disinfectants, and the effect of surface conditioners on bond strength values. Photodiagnosis Photodyn Ther 2023:103619. [PMID: 37209762 DOI: 10.1016/j.pdpdt.2023.103619] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 05/11/2023] [Accepted: 05/15/2023] [Indexed: 05/22/2023]
Abstract
AIM To assess and compare the antimicrobial efficacy of disinfectants on lithium disilicate ceramic (LDC) used in dental applications and shear bond strength (SBS) of LDC after using different conditioners hydrofluoric acid (HF), self-etching ceramic primers (SECP) and Neodymium-doped yttrium orthovanadate (Nd: YVO4). MATERIALS AND METHODS One hundred and twenty LDC discs were fabricated by auto-polymerizing acrylic resin using the lost wax technique. S. aureus, S. mutans, and C. albican were inoculated on thirty discs (n=30 each). Each group was further divided into three subgroups based on different disinfecting agents used (n=30) Group 1: Garlic extract, Group 2: Rose Bengal (RB) activated by PDT, and Group 3: Sodium hypochlorite (NaOCl). An assessment of the survival rate of microorganisms was performed. The remaining thirty samples were surface treated using three different LDC surface conditioners (n=10) Group 1: HF + Silane (S), group 2: SECP, and Group 3: Nd: YVO4 laser+S. SBS and failure mode analysis were performed using a universal testing machine and stereomicroscope at 40x magnification, The statistical analysis was conducted using one-way ANOVA and Post Hoc Tukey test. RESULTS Garlic extract, RB, and 2% NaOCl sample displayed comparable outcomes of antimicrobial potency against C. albicans, S aureus, and S. mutans (p>0.05). Furthermore, SBS analysis showed HF+S, SECP, and Nd: YVO4+S exhibited comparable outcomes of bond strength (p>0.05). CONCLUSION Garlic extract and Rose bengal activated by PDT can be contemplated as alternatives to the chemical agent NaOCl used for LDC disinfection. Similarly, SECP and Nd: YVO4 possess the potential to be used for the surface conditioning of LDC to improve the bond integrity with resin cement.
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Affiliation(s)
- Fahim Vohra
- Prosthetic dental sciences, college of dentistry, King Saud university.
| | - Rawan Alsaif
- Prosthetic dental sciences, college of dentistry, King Saud university.
| | - Hussain Alsayed
- Prosthetic dental sciences, college of dentistry, King Saud university.
| | - Mojahid M AlSaeed
- University Dental Hospital King Saud University P.O Box 60169, Riyadh 11545, Saudi Arabia.
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3
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Advances in the Role of Sodium Hypochlorite Irrigant in Chemical Preparation of Root Canal Treatment. BIOMED RESEARCH INTERNATIONAL 2023; 2023:8858283. [PMID: 36685672 PMCID: PMC9859704 DOI: 10.1155/2023/8858283] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 01/06/2023] [Accepted: 01/07/2023] [Indexed: 01/15/2023]
Abstract
Irrigation of root canal system is of great significance to the success of endodontic treatment, where sodium hypochlorite (NaOCl) is the most widely used irrigant in chemical preparation. NaOCl functions by eliminating bacterial biofilms and dissolving organic tissue, which may vary according to several factors such as the microbiology of root canal infection and the concentration of the irrigant. It has been proposed that the effectiveness of NaOCl could be enhanced via several methods, including heating the irrigant, applying in conjunction with certain reagents, or activating by agitation techniques. Despite its antibacterial and tissue-dissolving capacities, NaOCl should be used with caution to avoid detrimental effect due to its cytotoxicity and negative effect on dentin properties. In this narrative review, we discussed the factors that affect the properties of NaOCl, the methods to improve its efficacy, and the side effects that might occur in clinical practice.
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Kumari U, Zafar T, Shafqat S, Askary SH, Qasim M, Kamran MA, Baig EA, Shaikh AC, Qureshi A. Caries-affected dentin disinfection using Triphala, Indocyanine green, and Potassium Titanyl Phosphate laser and their effect on adhesive bond strength. Photodiagnosis Photodyn Ther 2022; 41:103257. [PMID: 36592785 DOI: 10.1016/j.pdpdt.2022.103257] [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: 12/13/2022] [Revised: 12/23/2022] [Accepted: 12/28/2022] [Indexed: 12/31/2022]
Abstract
AIM To assess the impact of new cavity sterilization types using ozone water (OW), Potassium Titanyl Phosphate laser (KTPL), Triphala, and indocyanine green photosensitizer (ICGP) on adhesive bond strength. MATERIALS AND METHODS Fifty human permanent molars were included based on the criteria of International Caries Detection and Assessment System (ICDAS) scores 4 and 5 visual examinations, surface hardness valuation, staining by a caries detector solution, and radiographs. Caries-affected dentin (CAD) samples were randomly distributed into groups based on methods of disinfection (n = 10). Group 1: chlorhexidine, group 2: ow, group 3: KTPL, group 4: Triphala, and group 5: ICGP. Following disinfection, specimens were applied with Adper prime and bond NT and then restored with resin composite. All specimens were positioned in a jig of the universal testing machine for shear bond strength (SBS). The debonded samples were analyzed under a stereomicroscope at 40x magnification to determine the type of failure. Analysis of variance (ANOVA) and Tukey HSD tests were used keeping the level of significance p < 0.05. RESULTS The highest bond of adhesive resin was displayed by group 2 specimens cleaned using OW (16.71 ± 0.19 MPa). Whereas, the lowest bond integrity was observed by group 5 specimens disinfected using ICGP (11.21 ± 0.16 MPa). It was observed samples disinfected with OW (16.71 ± 0.19 MPa) in group 2 and samples in group 4 (16.09 ± 0.26 MPa) treated with Triphala displayed comparable outcomes of bond strength (p > 0.05). It was observed that group 2 (70%) and 4 (80%) treated specimens accounted mostly for cohesive failure. However, groups 1 (80%), 3 (60%), and 5 (70%) displayed an adhesive failure pattern. CONCLUSION OW and Triphala displayed better bond integrity of adhesive resin to CAD and therefore have the potential to be used as a cavity disinfectant in clinical settings. However, ICGP and KTPL displayed weak bonds of adhesive to CAD. More work is needed to extrapolate the findings of the present study.
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Affiliation(s)
- Ujala Kumari
- Dental Clinician, Private Dental Clinic, Karachi, Pakistan
| | | | | | - Syed Hussain Askary
- Department of Community Dentistry, Fatima Jinnah Dental College, Karachi, Pakistan
| | - Muhammad Qasim
- Department of Operative Dentistry and Endodontics King Khalid University, Abha, Saudi Arabia
| | - Muhammad Abdullah Kamran
- Department of Pedodontics and Orthodontics Sciences, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Eisha Abrar Baig
- Department of Operative Dentistry, Dow International Dental College, Karachi, Pakistan
| | - Amynah C Shaikh
- Department of Oral Biology, College of Dentistry, Dow International Dental College, Karachi, Pakistan
| | - Ambrina Qureshi
- Department of Community and Preventive Dentistry, Dow University of Health Sciences, Karachi, Pakistan.
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Gelio MB, Ramos ATPR, Zaniboni JF, Escalante-Otárola WG, Besegato JF, Kuga MC. Effect of irrigation protocols on chemical smear layer formation over the post-space dentin. Microsc Res Tech 2022; 85:3005-3013. [PMID: 35535716 DOI: 10.1002/jemt.24149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 04/10/2022] [Accepted: 05/01/2022] [Indexed: 11/12/2022]
Abstract
This study evaluated the effect of irrigation protocols using 95% ethanol (ET) or 1% peracetic acid (PA) prior the use of 2% chlorhexidine (CHX) compared to distilled water (DW) on the chemical smear layer (CSL) formation and incidence of open dentin tubules at the apical, medium, and cervical third of the post-space dentin. Scanning electron microscopy (SEM) and electron dispersive spectroscopy (EDS) images were used. Forty bovine roots were endodontically treated. After, post-space preparation was performed and the roots were randomized in four groups (n = 10) according to the irrigation protocol: DW, CHX, CHX-ET and CHX-PA. The chemical composition of CSL and the incidence of open dentin tubules at the post-space thirds were evaluated by EDS (500× magnification) and SEM (2000× magnification) images, respectively. Data from chemical composition of CSL were descriptively analyzed, while the incidence of open dentin tubules was evaluated by scores and submitted to Kruskal-Wallis and Dunn test (p = .05). Cl, Bi, and Si were the chemical elements most found over the dentin after the irrigation with CHX and CHX-ET. Moreover, CHX and CHX-ET showed the highest incidence of CSL (p < .05), but without difference between them (p > .05), regardless of the post-space third. DW and CHX-PA showed similar incidence of CSL (p > .05). No difference on the incidence of open dentin tubules was found for any irrigation protocol and post-space third (p > .05). The use of 1% PA prior the post-space irrigation with CHX decrease the incidence of CSL. RESEARCH HIGHLIGHTS: The post-space irrigation with chlorhexidine results in the formation of chemical smear layer. Ethanol is not capable to remove the chemical smear layer. Peracetic acid is more effective to remove the chemical smear layer.
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Affiliation(s)
- Mariana Bena Gelio
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University, Araraquara, São Paulo, Brazil
| | | | - Joissi Ferrari Zaniboni
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University, Araraquara, São Paulo, Brazil
| | | | - João Felipe Besegato
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University, Araraquara, São Paulo, Brazil
| | - Milton Carlos Kuga
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University, Araraquara, São Paulo, Brazil
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Orhan EO, Irmak Ö, Hür D. What does not form after accidental sodium hypochlorite contact with chlorhexidine? Int Endod J 2022; 55:685-688. [PMID: 35511028 DOI: 10.1111/iej.13729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 02/23/2022] [Accepted: 03/18/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Ekim Onur Orhan
- Translational Medicine Research and Clinical Center, Eskisehir Osmangazi University, Eskisehir, Turkey.,Department of Endodontics, Faculty of Dentistry, Eskişehir Osmangazi University, Eskişehir, Turkey
| | - Özgür Irmak
- Department of Restorative Dentistry, Faculty of Dentistry, Near East University, Nicosia, Cyprus
| | - Deniz Hür
- Department of Chemistry, Faculty of Science, Eskişehir Technical University, Eskisehir, Turkey
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Elsayed M. Multiparameter image analysis to evaluate dentinal tubules patency after using different irrigation protocols. SCIENTIFIC DENTAL JOURNAL 2022. [DOI: 10.4103/sdj.sdj_109_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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Eren SK, Örs SA, Aksel H, Canay Ş, Karasan D. Effect of irrigants on the color stability, solubility, and surface characteristics of calcium-silicate based cements. Restor Dent Endod 2022; 47:e10. [PMID: 35284325 PMCID: PMC8891465 DOI: 10.5395/rde.2022.47.e10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 03/30/2021] [Accepted: 04/12/2021] [Indexed: 11/11/2022] Open
Abstract
Objectives Materials and Methods Results Conclusions
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Affiliation(s)
- Selen Küçükkaya Eren
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Sevinc Askerbeyli Örs
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Hacer Aksel
- Department of Periodontics and Endodontics, School of Dental Medicine, University at Buffalo, Buffalo, NY, USA
| | - Şenay Canay
- Department of Prosthodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Duygu Karasan
- Division of Prosthodontics, Clinique Universitaire de Médecine Dentaire (CUMD), University of Geneva, Geneva, Switzerland
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Effect of Sodium Hypochlorite Concentration in Continuous Chelation on Dislodgement Resistance of an Epoxy Resin and Hydraulic Calcium Silicate Sealer. Polymers (Basel) 2021; 13:polym13203482. [PMID: 34685241 PMCID: PMC8537795 DOI: 10.3390/polym13203482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 10/05/2021] [Accepted: 10/07/2021] [Indexed: 11/17/2022] Open
Abstract
The conditioning of the root canal wall during chemo-mechanical root canal treatment differentially affects the adhesion of root canal sealers. This investigation evaluated the impact of sodium hypochlorite (NaOCl) concentration as used in a root canal irrigation concept called continuous chelation, with 1-hydroxyethylidene-1,1-diphosphonic acid (HEDP) contained in the NaOCl solution that is applied. Fourier-transform infrared spectra of the dentinal wall were gathered. The consequential effects on push-out bond strength of an epoxy resin (AH Plus) versus a hydraulic CaSi sealer (BioRoot RCS) were assessed. Single-rooted extracted human teeth were used and irrigated with pure NaOCl at a concentration of 0% (physiological saline), 2.5%, or 5.25%. Dual Rinse HEDP (9%) was added to the solutions, or not added for further control. Pure NaOCl solutions caused a decrease in the amide III: phosphate ratios, which was counter-acted by the addition of HEDP. It was observed that the adhesion of the epoxy resin sealer under investigation was negatively affected by this NaOCl deproteinization of the canal wall in a dose-dependent manner, while the opposite was observed with the CaSi sealer. HEDP when used in conjunction with NaOCl was beneficial for the adhesion of both sealers.
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10
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Alkahtany MF, Almadi KH, Sohail M, Alzahrani KM, Vohra F, Abduljabbar T. Influence of adjunctive photodynamic therapy (curcumin) on the extrusion bond strength of radicular dentin to contemporary root canal sealers. Photodiagnosis Photodyn Ther 2021; 34:102341. [PMID: 33992812 DOI: 10.1016/j.pdpdt.2021.102341] [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: 04/19/2021] [Revised: 05/04/2021] [Accepted: 05/10/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The aim was to compare Photodynamic therapy (PDT) as an adjunct to NaOCl and EDTA on the extrusion bond strength (EBS) of AH Plus (AH), Sealapex (SA) and MTA Fillapex (MF) root canal sealers. MATERIALS AND METHOD Root canal treatment for human teeth (n = 60) using protaper universal system was performed followed by irrigation with NaOCl/ EDTA. Samples were divided (n = 30) based on disinfection technique, NaOCl/EDTA and NaOCl/EDTA with PDT (Curcumin-PS-CP) as an adjunct. Specimens were divided in three subgroups (n = 10) based on sealers used (Gp 1-Na-E-AH, Gp 2-Na-E-PDT-AH, Gp 3-Na-E-SA, Gp 4-Na-E-PDT-SA, Gp 5-Na-E-MF & Gp 6-Na-E-PDT-MF). Canals were dried and obturated followed by sectioning at coronal and middle third. EBS testing was performed using a universal testing machine (UTM) and modes of failure were assessed. Analysis of variance (ANOVA) and Tukey multiple comparison tests were used to compare the means of EBS. (p < 0.05). RESULTS Sealers showed a significant influence on EBS, as Gp 1 (Co: 9.21 ± 0.62, Mid: 8.54 ± 0.55) and Gp 2 (Co: 7.11 ± 0.68, Mid: 7.30 ± 0.37) showed higher EBS than Gp 3 (Co: 5.21 ± 0.63, Mid: 4.36 ± 0.83) and Gp 4 (Co: 5.39 ± 0.72, Mid: 4.46 ± 0.74). Gp 5 (Co: 9.04 ± 0.13, Mid: 8.14 ± 0.91) and Gp 6 (Co: 8.67 ± 0.42, Mid: 8.07 ± 0.07) exhibited higher EBS than Gp 3 and Gp 4 specimens. Adjunctive use of PDT for AH sealer (Gp 2) showed decreased EBS compared to Gp 1 specimens. EBS remained comparable for both MTA-Fillapex and Sealapex with and without PDT. CONCLUSION AH Plus (Gp 1 and 2) and MTA-Fillapex (Gp 5 and 6) sealers displayed better EBS compared to Sealapex (Group 3 and 4). Adjunctive Application of PDT (CP) did not show a significant improvement in bond strength of sealers to root dentin.
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Affiliation(s)
- Mazen F Alkahtany
- Department of Restorative Dental Science, Division of Endodontics, College of Dentistry, King Saud University, Riyadh, Saudi Arabia.
| | - Khalid H Almadi
- Department of Restorative Dental Science, Division of Endodontics, College of Dentistry, King Saud University, Riyadh, Saudi Arabia.
| | - Maham Sohail
- Department Of Operative Dentistry, Dow International Dental College, Karachi, Pakistan.
| | - Khaled M Alzahrani
- Department of Prosthetic Dental Sciences, College of Dentistry, Prince Sattam Bin AbdulAziz University, 11942, Alkharj, Saudi Arabia.
| | - Fahim Vohra
- Department of Prosthetic Dental Science, College of Dentistry, King Saud University, Research Chair for Biological Research in Dental Health, College of Dentistry, Riyadh, 11545, Saudi Arabia.
| | - Tariq Abduljabbar
- Department of Prosthetic Dental Science, College of Dentistry, King Saud University, Research Chair for Biological Research in Dental Health, College of Dentistry, Riyadh, 11545, Saudi Arabia.
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Influence of Lignocaine Hydrochloride with Adrenaline on Free Active Chlorine Content of Sodium Hypochlorite Solution Admixed in Various Proportions. Eur Endod J 2021; 6:117-121. [PMID: 33531450 PMCID: PMC8056803 DOI: 10.14744/eej.2020.52523] [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] [Indexed: 11/20/2022] Open
Abstract
Objective: Local anaesthetic solution that is commonly employed for supplemental intrapulpal injection (IPI) may routinely come in contact with subsequently used sodium hypochlorite (NaOCl) during endodontic treatment of symptomatic irreversible pulpitis cases. This in vitro study investigated the available free active chlorine (FAC) content of 3% NaOCl after mixing with 2% lignocaine hydrochloride with adrenaline (LA) solution in three different proportions using iodometric titration analysis. Methods: Aliquots of 3% NaOCl (control) in different measures (30 mL, 27 mL, 21 mL and 15 mL) served as the effective concentrate of various proportions of NaOCl admixed with the test solutions, i.e., demineralised water (DM) and LA. The mixed aliquots containing NaOCl-DM and NaOCl-LA combination solutions admixed in various proportions (9:1, 7:3 and 1:1 w/v) respectively served as the experimental groups. Iodometric titration was performed to determine the FAC of each independent solution.The results were then evaluated using one-way ANOVA and Tukey’s post hoc analysis to determine the differences between various groups and amongst the individual admixtures. The level of significance was set at P<0.05. Results: Inter-group comparisons revealed statistically significant differences (P<0.05) between all the test groups. An intra-group analysis revealed significant differences (P<0.05) in group 2, whereas no differences (P>0.05) were observed in group 3. Further, there was a dose dependent reduction in FAC content in both the experimental groups with lowest FAC values were observed in 1:1 solution admixtures followed by 7:3 and 9:1 proportions. Conclusion: There was a significant reduction in NaOCl FAC content when admixed with lignocaine HCl even in small proportions. Hence, adequate measures should be taken to remove the residual LA from the pulpal space, before the use of NaOCl after IPI administration.
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Erİk CE, Kaya BÜ, Maden M, Orhan EO. Influence of sodium hypochlorite/etidronic acid combination and SmearOFF on push-out bond strength of fiber posts to root dentin. Dent Mater J 2020; 39:554-562. [PMID: 32161238 DOI: 10.4012/dmj.2019-055] [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] [Indexed: 11/23/2022]
Abstract
The aim was to evaluate the effects of different irrigation protocols on the bonding ability of fiber posts on root canal dentin through push-out test and the dentin tubule penetration of luting cement by confocal laser scanning microscope (CLSM). Forty-eight single-rooted premolars were divided into six groups (n=8) based on post space irrigation protocols: Saline 0.85%; Etidronate 18% (HEBP); EDTA 17%; NaOCl 5.25%+EDTA 17%; NaOCl 2.5%/HEBP 9% combination; SmearOFF. Two specimens per group were assessed with CLSM. The push-out test and the failure analysis were performed. Whilst EDTA had the highest bond strength at the coronal and middle thirds, it was not statistically significant compared to saline, HEBP, and NaOCl/HEBP at the middle third (p>0.05). Cement/dentin adhesive failures were predominant (41.9%) and the intratubular fluorescence intensity was significant among the groups (p<0.05). EDTA resulted in highest bond strength values and dentinal penetration.
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Affiliation(s)
- Cevat Emre Erİk
- Department of Endodontics, Faculty of Dentistry, Suleyman Demirel University
| | - Bulem Üreyen Kaya
- Department of Endodontics, Faculty of Dentistry, Suleyman Demirel University
| | - Murat Maden
- Department of Endodontics, Faculty of Dentistry, Suleyman Demirel University
| | - Ekim Onur Orhan
- Department of Endodontics, Faculty of Dentistry, Osmangazi University
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13
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Mobaraki B, Yeşildal Yeter K. Quantitative analysis of SmearOFF and different irrigation activation techniques on removal of smear layer: A scanning electron microscope study. Microsc Res Tech 2020; 83:1480-1486. [PMID: 32671904 DOI: 10.1002/jemt.23541] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 06/11/2020] [Accepted: 06/16/2020] [Indexed: 11/09/2022]
Abstract
The aim of this study was to evaluate the effectiveness of SmearOFF solution on smear layer removal by using different irrigation activation techniques. One hundred and twenty mandibular premolars were decoronated, and instrumented with Reciproc up to size 50. Then, the specimens were divided into 6 groups according to the final irrigation activation technique: Group 1: SmearOFF + Conventional syringe irrigation (CSI); Group 2: SmearOFF + Sonic activation (SA); Group 3: SmearOFF + Passive ultrasonic activation (PUA); Group 4:17% EDTA + CSI; Group 5:17% EDTA + SA, and Group 6:17% EDTA + PUA. Teeth were split longitudinally, and specimens were observed under scanning electron microscope. Images were taken from the coronal, middle, and apical thirds of the teeth with 1,000× magnification and analyzed using ImageJ program to calculate total open dentinal tubule areas. Three-way ANOVA test was applied to reveal any significant differences among solutions, activation techniques and root thirds. There was no statistically significant difference among the groups in terms of irrigation solutions (p > .05). There was a statistically significant difference between PUA and CSI groups (p < .05). However, no significant difference was observed between PUA and SA, or between SA and CSI (p > .05). All experimental procedures were most effective in the middle region of the root, followed by cervical and apical thirds (p < .05). PUA showed higher efficacy in smear layer removal compared with CSI. SmearOFF and 17% EDTA showed similar results. The best results in removing smear layer were obtained in the middle region of the root.
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Affiliation(s)
- Babak Mobaraki
- Department of Endodontics, Eskişehir Osmangazi University, Faculty of Dentistry, Eskişehir, Turkey
| | - Kübra Yeşildal Yeter
- Department of Endodontics, Eskişehir Osmangazi University, Faculty of Dentistry, Eskişehir, Turkey
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Coaguila-Llerena H, Rodrigues EM, Santos CS, Ramos SG, Medeiros MC, Chavez-Andrade GM, Guerreiro-Tanomaru JM, Tanomaru-Filho M, Faria G. Effects of octenidine applied alone or mixed with sodium hypochlorite on eukaryotic cells. Int Endod J 2020; 53:1264-1274. [PMID: 32535966 DOI: 10.1111/iej.13347] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 06/05/2020] [Accepted: 06/08/2020] [Indexed: 11/30/2022]
Abstract
AIM To assess the effects of octenidine dihydrochloride (OCT) on eukaryotic cells and the cytotoxicity of OCT associated with sodium hypochlorite - NaOCl (NaOCl/OCT). METHODOLOGY L929 fibroblasts and human osteoblast-like cells (Saos-2) were exposed to 0.1% OCT, 2% CHX, 2.5% NaOCl, 5.25% NaOCl and mixtures of 5.25% NaOCl and 0.1% OCT (NaOCl/OCT) at 90 : 10, 80 : 20 and 50 : 50 ratios. Cell viability was assessed by methyl-thiazol-tetrazolium (MTT) and neutral red (NR) assays; type of cell death, by flow cytometry; cytoskeleton, by actin and α-tubulin fluorescence; and alkaline phosphatase (ALP) activity, by thymolphthalein release. The data were analysed by two-way ANOVA and Bonferroni tests (α = 0.05). RESULTS MTT and NR assays revealed that 0.1% OCT had the lowest cytotoxicity (P < 0.05), followed by 2% CHX (P < 0.05). The 2.5% NaOCl, NaOCl/OCT 80 : 20 and NaOCl/OCT 50 : 50 solutions had intermediate cytotoxicity. NaOCl 5.25% and NaOCl/OCT 90 : 10 had the highest cytotoxicity (P < 0.05). The OCT group had a higher percentage of viable cells than the NaOCl and CHX groups (P < 0.05), and induced apoptosis at higher doses. The cytoskeleton alterations were observed at 0.12%, 0.6% and 2.02% for the NaOCl, CHX and OCT groups, respectively. The solutions did not induce ALP activity. CONCLUSION Octenidine dihydrochloride was less cytotoxic, induced apoptosis at higher doses, caused few changes in the cytoskeleton and did not induce alkaline phosphatase activity. In addition, octenidine dihydrochloride reduced the cytotoxicity of 5.25% NaOCl when combined at 20 and 50%.
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Affiliation(s)
- H Coaguila-Llerena
- Department of Restorative Dentistry, Araraquara School of Dentistry, São Paulo State University - UNESP, Araraquara, Brazil
| | - E M Rodrigues
- Department of Restorative Dentistry, Araraquara School of Dentistry, São Paulo State University - UNESP, Araraquara, Brazil
| | - C S Santos
- Department of Restorative Dentistry, Araraquara School of Dentistry, São Paulo State University - UNESP, Araraquara, Brazil
| | - S G Ramos
- Department of Pathology, Ribeirão Preto Medical School, University of São Paulo - USP, Ribeirão Preto, Brazil
| | - M C Medeiros
- Department of Oral Diagnosis and Surgery, Araraquara School of Dentistry, São Paulo State University - UNESP, Araraquara, Brazil
| | - G M Chavez-Andrade
- Department of Restorative Dentistry, Araraquara School of Dentistry, São Paulo State University - UNESP, Araraquara, Brazil
| | - J M Guerreiro-Tanomaru
- Department of Restorative Dentistry, Araraquara School of Dentistry, São Paulo State University - UNESP, Araraquara, Brazil
| | - M Tanomaru-Filho
- Department of Restorative Dentistry, Araraquara School of Dentistry, São Paulo State University - UNESP, Araraquara, Brazil
| | - G Faria
- Department of Restorative Dentistry, Araraquara School of Dentistry, São Paulo State University - UNESP, Araraquara, Brazil
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Ioannidis K, Batty C, Turner C, Smith D, Deb S, Mannocci F. Ex vivo detection and quantification of apically extruded volatile compounds and disinfection by-products by SIFT-MS, during chemomechanical preparation of infected root canals. Dent Mater 2020; 36:257-269. [DOI: 10.1016/j.dental.2019.11.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 10/09/2019] [Accepted: 11/15/2019] [Indexed: 10/25/2022]
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Anggraini E, Suwartini T, Amin M, Roeslan B. The effectiveness of mixtures of tetracycline, acid and detergent, and mixtures of chlorhexidine and ethylenediaminetetraacetic acid in preventing the growth of Enterococcus faecalis: An Ex vivo study. SCIENTIFIC DENTAL JOURNAL 2020. [DOI: 10.4103/sdj.sdj_42_19] [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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17
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Emre Erik C, Onur Orhan E, Maden M. Qualitative analysis of smear layer treated with different etidronate concentrations: A scanning electron microscopy study. Microsc Res Tech 2019; 82:1535-1541. [PMID: 31187914 DOI: 10.1002/jemt.23318] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 04/02/2019] [Accepted: 05/29/2019] [Indexed: 11/10/2022]
Abstract
The aim of this study was to examine the smear layer removal capacity of various etidronate treatments. Seventy-eight roots were instrumented up to apical size X4 and randomly divided into five treatment groups and a positive control group (n = 13). Groups were as follows: irrigation with 5 ml of sterile saline (control) for 3 min, 5 ml of 17% ethylenediaminetetraacetic acid (EDTA) for 3 min, 5 ml of 9% A1-hydroxyethylidene-1,1-bisphosphonate (HEBP) for 3 min, 5 ml of 18% HEBP for 3 min, irrigation with 5 ml of 1% sodium hypochlorite (NaOCl) + 9% HEBP for 3 min, and 5 ml of 2% NaOCl + 18% HEBP for 3 min. The roots were examined using a scanning electron microscope. The smear layer scores in the 2% NaOCl + 18% HEBP group were lower than those in the other treatment groups and the control group (p < .05). There were no significant differences among the treatment groups in the smear layer scores of the coronal and middle thirds. However, the smear layer scores in the 2% NaOCl + 18% HEBP treatment group were lower those in the 9% HEBP and 18% HEBP treatment groups in the apical third (p < .05). In the clinical setting, the recommended concentration of HEBP is 18%, and it should be used with an oxidizing agent to ensure optimum smear layer removal.
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Affiliation(s)
- C Emre Erik
- Department of Endodontics, Faculty of Dentistry, Suleyman Demirel University, Isparta, Turkey
| | - E Onur Orhan
- Department of Endodontics, Faculty of Dentistry, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Murat Maden
- Department of Endodontics, Faculty of Dentistry, Suleyman Demirel University, Isparta, Turkey
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Piperidou M, Sodhi RNS, Kolosowski KP, Basrani BR. Effects of Final Irrigation with SmearOFF on the Surface of Dentin Using Surface Analytical Methods. J Endod 2018; 44:1714-1719. [PMID: 30266468 DOI: 10.1016/j.joen.2018.07.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 07/14/2018] [Accepted: 07/26/2018] [Indexed: 11/19/2022]
Abstract
INTRODUCTION SmearOFF (Vista Dental Products, Racine, WI) is an irrigation solution containing chlorhexidine (CHX), EDTA, and a surfactant. This study examined the chemical interaction of SmearOFF with sodium hypochlorite (NaOCl) on the dentin surface, specifically the formation of precipitate and/or parachloroanaline (PCA). METHODS Dentin blocks prepared from human maxillary molars were mounted in resin. Dentinal tubules were exposed in a perpendicular orientation using an ultracryomicrotome. The blocks were divided into 2 groups: the CHX group, irrigation with 6% NaOCl, 17% EDTA, 6% NaOCl, and 2% CHX, and the SmearOFF group, irrigation with 6% NaOCl and SmearOFF. The dentin surface was analyzed with time-of-flight secondary ion mass spectrometry and X-ray photoelectron spectroscopy to determine the formation of precipitate or/and PCA on the surface of dentin. RESULTS Precipitation with PCA and occlusion of the dentinal tubules were noted on the dentin surface in the CHX group. No precipitate and no PCA were detected on the surface of dentin in the SmearOFF group. CONCLUSIONS Interaction of SmearOFF with NaOCl on the dentin surface did not result in the formation of precipitate or PCA.
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Affiliation(s)
- Myrto Piperidou
- MSc Endodontic Program, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
| | - Rana N S Sodhi
- Department of Chemical Engineering and Applied Chemistry, University of Toronto, Toronto, Ontario, Canada
| | - Kamil P Kolosowski
- MSc Endodontic Program, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
| | - Bettina R Basrani
- MSc Endodontic Program, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada.
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Alkaline Sodium Hypochlorite Irrigant and Its Chemical Interactions. MATERIALS 2017; 10:ma10101147. [PMID: 28961175 PMCID: PMC5666953 DOI: 10.3390/ma10101147] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 09/23/2017] [Accepted: 09/24/2017] [Indexed: 11/18/2022]
Abstract
Endodontic irrigating solutions may interact chemically with one another. This is important, because even when solutions are not admixed, they will come into contact with one another during an alternating irrigation technique, forming unwanted by-products, which may be toxic or irritant. Mixing or alternating irrigants can also reduce their ability to clean and disinfect the root canal system of teeth by changing their chemical structure with subsequent loss of the active agent, or by inducing precipitate formation in the root canal system. Precipitates occlude dental tubules, resulting in less penetration of antimicrobials and a loss of disinfection efficacy. Sodium hypochlorite is not only a very reactive oxidizing agent, but is also the most commonly used endodontic irrigant. As such, many interactions occurring between it and other irrigants, chelators and other antimicrobials, may occur. Of particular interest is the interaction between sodium hypochlorite and the chelators EDTA, citric acid and etidronate and between sodium hypochlorite and the antimicrobials chlorhexidine, alexidine, MTAD and octenisept.
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