Influence of Propolis, Ozone and Photodynamic therapy in root canal disinfection on resin bond strength to radicular dentin

Remineralizing pretreatment using casein phosphopeptide-amorphous calcium phosphate fluoride, self-assembling peptide, and nanohydroxyapatite gel activation via invisible infrared light on the dentin microhardness and micro shear bond strength to the composite restoration

AIM

Different remineralizing pretreatments Casein phosphopeptide-amorphous calcium phosphate fluoride (CPP-ACPF), tricalcium phosphate fluoride (TCP-F), self-assembling peptide (SAP) P11-4 and 10 % Nanohydroxyapatite (nHA) gel activation via invisible infrared light on the dentin microhardness (MH) and micro shear bond strength (µSBS) of composite restoration.

METHODS

Seventy-five human molar teeth were collected and the dentinal surface of all the samples was exposed to different demineralizing solutions. (n = 15) Group 1 (demineralized dentin), Group 2 (CPP ACP), Group 3 (TCP-F), Group 4 (SAP P11-4), Group 5 (nHA gel activation via invisible infrared light). MH assessment was performed using Vickers hardness. Each group of 10 samples was subjected to composite restoration buildup and µSBS were tested. The debonded samples were then observed under a stereo-microscope for failure analysis. ANOVA was conducted, along with Tukey's post hoc analysis, to examine the µSBS of composite and MH of the remineralized surface.

RESULTS

nHA gel activation via invisible infrared light pretreated specimens showed the maximum outcomes of surface hardness (331.2 ± 77.3) and bond strength (10.38 ± 2.77). However, Group 4 (SAP P11-4) (148.3 ± 29.2) remineralized dentin displayed minimum scores of MH and µSBS (5.88 ± 1.01).

CONCLUSION

Remineralizing pretreatment nHA gel activation via invisible infrared light and casein phosphopeptide-amorphous calcium phosphate fluoride seem to improve the dentin MH and µSBS of the composite restoration.

Pretreatment of Root Dentin Using Photon-Induced Photoacoustic Streaming, Photodynamic Therapy, and Riboflavin with EDTA as a Final Irrigant to Improve Bond Integrity of Glass Fiber Post

Objective: To evaluate the outcome of post space disinfection using Er,Cr:YSGG laser (ECYL), riboflavin photosensitizer (RFP), and photon-induced photoacoustic streaming (PIPS) along with ethylene diamine tetra acetic acid (EDTA) as final irrigant on the bond values of glass fiber post (GFP) to the canal wall. Materials and methods: Forty human mandibular premolars were subjected to root canal treatment after decoronation till the cementoenamel junction. Post space was prepared using a Gates-Glidden drill leaving 4 mm of gutta perch at the apical third of the root section. Random allocation of samples was performed into four groups based on the post space disinfection (n = 10 each): Group 1: 1% RFP and 17% EDTA, group 2: 5.25% sodium hypochlorite (NaOCl) and 17% EDTA (control), group 3: PIPS and 17% EDTA, and group 4: ECYL and 17% EDTA. GFP was luted using Rely X Unicem. A universal testing machine and stereomicroscope were used to assess the push-out bond strength (PBS) and failure mode, respectively. Analysis of variance determined the PBS amid different experimental groups at three root levels. Multiple group comparison using means of tested groups was identified using post hoc Tukey. Results: The coronal third of group 2 (5.25% NaOCl +17% EDTA) demonstrated the highest PBS (8.83 ± 0.11 MPa). However, the lowest bond integrity (4.15 ± 0.52 MPa) was displayed in an apical third of group 1 (RFP +17% EDTA). The intergroup comparison revealed that 5.25% NaOCl +17% EDTA at all three levels demonstrated comparable outcomes of PBS with PIPS +17% EDTA and ECYL +17% EDTA specimens (p > 0.05). However, riboflavin +17% EDTA demonstrated the lowest bond strength (p < 0.05). Conclusions: Er,Cr: YSGG and PIPS in combination with 17% EDTA demonstrated comparable outcomes of bond score with those of conventional gold standard irrigation regime 5.25% NaOCl.

Effectiveness of final cavity disinfectant Terminalia chebula, Malachite, and Indocyanine green, against E. faecalis and on the bond interface of fiber post to radicular dentin

AIMS

Evaluation of antimicrobial efficacy of contemporary disinfection Malachite green (MG), Terminalia chebula (T. chebula), and Indocyanine green (ICG)) against E. faecalis and their effect on push-out bond strength (PBS) of glass fiber post (GFP) bonded to root dentin in comparison to conventional irrigation used (Sodium hypochlorite (NaOCl) + Ethylene diamine tetraacetic acid (17% EDTA).

MATERIALS AND METHODS

Root canal treatment was initiated on sixty human single-rooted premolars and working length was established. The canals were enlarged using ProTaper universal system till F3. The prepared canals were obturated with Gutta-percha (GP) and AH Plus sealer followed by post-space preparation. Twenty canals contained a standard strain of E. faecalis (n=5 in each group) cultured overnight at 37 °C in BHI broth. All the samples were randomly allocated into four groups based on post-space irrigation. (n = 10) Group 1: 5.25% NaOCl+17% EDTA (Control), Group 2: 5.25% NaOCl + ICG, Group 3: 5.25% NaOCl + MG and Group 4: 5.25% NaOCl + T. chebula. Survival rates of E. faecalis were evaluated on the twenty specimens. GFP was placed on the remaining samples using self-etch dual-cure pastes and sectioning was performed in 1 mm thick slices. PBS and failure mode were analyzed using a universal testing machine and stereomicroscope. One-way analysis of variance (ANOVA) and Tukey multiple comparison t-tests were used for data analysis. (p = 0.05).

RESULTS

5.25% NaOCl+17% EDTA demonstrated (0.11±0.01 CFU/mL) the lowest survival rate of E. faecalis. However, Group 2 (5.25% NaOCl + ICG) exhibited the highest survival rate (0.52 ± 0.10). Furthermore, the coronal third of group 4 (5.25% NaOCl + T. chebula) (8.71±0.25 MPa) specimens demonstrated the highest PBS of GFP. However, an apical section of group 2 samples (5.25% NaOCl + ICG) (1.21±0.71 MPa) displayed the lowest outcome of bond integrity.

CONCLUSION

Terminalia chebula when used as a final canal disinfectant seems to be promising in improving canal sterility and the bond strength of GFP to the root dentin.

Influence of antimicrobial photodynamic therapy on the bond strength of endodontic sealers to intraradicular dentin: A systematic review and meta-analysis

BACKGROUND

The objective of this systematic review and meta-analysis (SRMA) was to investigate the influence of antimicrobial photodynamic therapy (aPDT) on the bond strength of endodontic sealers to intraradicular dentin.

METHODS

This SRMA followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and was registered in the International Prospective Registry of Systematic Reviews (PROSPERO) (CRD42022319856). A population, intervention, control, and outcome (PICO) question was formulated: "Does antimicrobial photodynamic therapy decrease the bond strength of root canal sealers?". A literature search was performed in PubMed/MEDLINE, Embase, Web of Science, Scopus, Cochrane Library, and ProQuest databases until July 2022. Joanna Briggs Institute Critical Assessment Guidelines for Quasi-Experimental Studies were used for quality assessment. The meta-analysis was based on the inverse variance (IV) method (p<0.05).

RESULTS

Out of an initial 345 articles, 8 in vitro studies were included, published between 2013 and 2022. The studies were qualitatively analyzed; two studies showed a positive effect, two studies a negative effect, and the other studies showed no effect on bond strength of endodontic sealers to intraradicular dentin. Seven of the studies were included in the SRMA, which indicated that there was no significant difference in bond strength when using aPDT (P = 0.90; MD: -0.03; 95% CI: -0.46 to -0.41). There was a high level of evidence for each meta-analysis outcome.

CONCLUSION

It can be concluded that the use of aPDT as a method of root canal disinfection does not negatively influence the bond strength of endodontic sealers in the root canal.

Caries-affected dentin disinfection using Triphala, Indocyanine green, and Potassium Titanyl Phosphate laser and their effect on adhesive bond strength

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.

Adjunctive use of Er, Cr: YSGG laser, Potassium titanyl Phosphate laser, and photosensitizer on extrusion bond strength of radicular dentin to bioceramic sealers

AIM

To assess the impact of adjunctive final root canal disinfection regime curcumin photosensitizer (CP) activated by Photodynamic therapy (PDT), Er, Cr: YSGG laser (ECL), and Potassium titanyl Phosphate (KTP) laser on the bond integrity of two endodontic Bioceramic (BC) sealers.

MATERIALS AND METHOD

Decoration of eighty human single-rooted teeth was performed up to a cementoenamel junction. After instrumentation, all samples were irrigated with 2.25% NaOCl solution followed by 17% EDTA. The specimens were divided arbitrarily into 8 groups (n = 10) based on the adjunctive final irrigation method used. Group 1 and 5 (Control): No adjunctive regime, cleaned using 2.25% NaOCl + 17% EDTA, group 2 and group 6: CP activated by PDT, Group 3 and Group 7 using ECL, Group 4 and Group 8: KTP laser. Following disinfection samples in groups 1, 2, 3, and 4 were obturated using Sankin apatite root canal sealer (SARS). Specimens in groups 5, 6, 7, and 8 were obturated using Pro-root endo sealer (PRES). Sectioning of samples was performed. The sectioned specimens were subjected to a compressive loading exerted via a steel plunger moving at a 0.5 mm/min crosshead speed till debonding. Means and standard deviations (SD) of EBS of BC sealer with the root canal dentin were assessed using one-way analysis of variance (ANOVA) and Post Hoc Tukey multiple comparison tests. The level of significance was measured at p = 0.05.

RESULTS

The coronal section of samples in group 5 (Na-E-PRES) exhibited the highest bond value. The lowest PBS was displayed by the middle third of specimens in group 6. Group 1 (Na-E-SARS), group 3 (Na-E-ECL-SARS), group 5 (Na-E-PRES), and group 7 (Na-E-ECL-PRES) exhibited comparable bond values (p>0.05). Whereas, group 2 (Na-E-PDT-SARS) and group 4 (Na-E-PTPL-SARS), group 6 (Na-E-PDT-PRES), and group 8 (Na-E-PTPL-PRES) were found to be comparable (p>0.05).

CONCLUSION

Adjunctive use of Er, Cr: YSGG laser displayed better extrusion bond strength with BC root canal sealer compared to CP activated by PDT and KTP laser. Bond strength is influenced by the type of irrigation.

Extrusion bond strength of glass fiber post to radicular dentin after final irrigation using MTAD, EDTA, Pineapple peel extract, and riboflavin

INTRODUCTION

The present study aims to determine the effect of different post-space final irrigants ethylenediaminetetraacetic acid (EDTA), a mixture of Doxycycline citric acid and detergent (MTAD), Riboflavin (RF) and Pineapple peel extract (PPE) on the bond integrity of GFPs bonded to radicular dentin.

MATERIALS AND METHODS

Crowns of forty human mandibular premolars teeth were sectioned up to cementoenamel junction CEJ. Root canal treatment was performed. Gates Glidden drills were used to retrieve gutta-percha from the canal. All the specimens were randomly divided into four groups based on the final irrigant used. Group 1 (NaOCl with EDTA), group 2 NaOCl+ MTAD, group 3 NaOCl+RF and group 4 NaOCl+PPE. Cementation of glass fiber posts (GFPs) was performed using self-etch dual-cure resin cement. Sectioning was performed using a slow-speed saw from the coronal, middle, and apical third under constant water irrigation. A universal testing machine was used to assess push-out bond strength (PBS) and failure mode was evaluated using a Stereomicroscope at 40x magnification. One-way analysis of variance (ANOVA) and Tukey multiple comparison tests were used for statistical analysis (p=0.05).

RESULTS

Group 4 (2.5% NaOCl+ PPE) displayed the highest PBS at all three root levels (Cervical: 11.22±0.74 MPa, Middle: 8.99±0.97MPa, and Apical: 6.00±0.88 MPa). However, Group 1 (2.5% NaOCl+17% EDTA) demonstrated the lowest EBS (Cervical: 9.25±0.17 MPa, Middle: 7.01±1.84 MPa, and Apical: 4.41±0.17 MPa). Inter-group comparison displayed that PBS to be comparable between group 1 and group 3 (2.5% NaOCl+ Riboflavin) (Cervical: 9.74±0.41 MPa, Middle: 7.44±1.18 MPa, and Apical: 4.21±0.05 MPa) (p > 0.05). Whereas, group 2 (1.3% NaOCl+ MTAD) (Cervical: 9.32±1.36 MPa, Middle: 7.17±1.75 MPa, and Apical: 4.85±0.19 MPa) and group 4 demonstrated comparable values of PBS (p >0.05).

CONCLUSION

Pineapple peel extract and a mixture of Doxycycline citric acid and a detergent when used as a final irrigant demonstrated better bond integrity of GFPs to radicular dentin at all three levels coronal, middle and apical.

Noncarious cervical lesion pretreated using antimicrobial photodynamic therapy and diode laser in reducing dentin hypersensitivity bonded to different restorative material: Valuation of bond values and invitro dye leakage

AIM

The present study aimed to appraise the effect of Diode laser (DL), riboflavin, and curcumin on the bond strength of adhesive restorative material and the effects of pretreatment on microleakage scores.

MATERIAL AND METHODS

Ninety caries-free human permanent premolars were obtained and disinfected. All specimens were mounted till CEJ. To provide standardization, a 2 × 2 mm flat non-carious cervical lesion (NCCL) dentin surface was exposed. This was followed by dentin surface roughening/cervical groove preparation with a round bur. After tooth surface preparation, ninety specimens were divided arbitrarily into three groups. Group 1: NCCL exposed to DL; group 2: NCCL pretreated with riboflavin photosensitizer (RFP) and group 3 pretreated with curcumin photosensitizer (CP). All the three groups were further divided into two subgroups A1, A2, B1, B2, C1, and C2 based on the restorative material used (n=15). Subgroup A1, B1, and C1 were restored with composite resin (CR). Subgroup A2, B2, and C2 were restored with RMGIC. Ten samples from each subgroup were evaluated for shear bond strength (SBS) testing under a universal testing machine (UTM). Five from each subgroup were evaluated for microleakage assessment. Bond strength and microleakage analysis were performed using analysis of variance (ANOVA) with a Post-hoc test (Tukey's post hoc test) at a significance level (p=0.05).

RESULTS

The group A1, DL-CR shows the highest SBS (16.41± 0.4 MPa). However, CP-RMGIC groups demonstrated the lowest bond integrity. RFP-CR and the DL-CR group displayed comparable outcomes of SBS (p>0.05). The highest microleakage was observed with CP-RMGIC. The least microleakage was displayed by DL-CR.

CONCLUSION

Noncarious cervical lesions pretreated with diode laser and riboflavin photosensitizer showed better shear bond strength and reduced microleakage when bonded to composite resin than non-carious cervical lesions pretreated with curcumin.

Resin Modified Glass Ionomer bonded to Caries affected dentin disinfected with Carbon dioxide laser, Diode lasers, Bee glue and Photosensitizing agents: An estimation of bond strength

AIM

The present in vitro study was carried out to evaluate the effect of different cavity disinfectants chlorhexidine (CHX), riboflavin (RF), diode laser (DL), carbon dioxide laser (CO₂), and Propolis on the bond values of resin-modified glass ionomer cement (RMGIC) restoration bonded to caries affected dentin (CAD) MATERIALS AND METHODS: : Forty multi-rooted mandibular molars were adapted in self-cure acrylic resin blocks up to the level of the cementoenamel junction so that only the crown portion of the tooth remained visible. Silicon carbide discs of 1200 and 600 grits were then used to remove infected dentin. However, CAD was left behind to use as a substrate for restoration. All samples were randomly divided into five groups based on the method of disinfection. group 1: Propolis, group 2: CHX, group 3:RF activated by PDT, group 4: CO₂ laser, and group 5: DL. RMGIC restoration was then placed on these disinfected samples. Samples were kept in an incubator keeping humidity at 100 % and temperature at 37 °C for about 24 hrs. All samples were then placed in a Universal testing machine to measure SBS. Failure modes were identified using a stereomicroscope. ANOVA test was used to analyze intergroup comparison. Tukey HSD test was used to evaluate multiple group comparisons. The level of significance was set at a p < 0.05 value.

RESULTS

Group 2 specimens disinfected with CHX established the highest SBS value (17.85±1.09 MPa). Whereas, Group 5 specimens in which CAD was disinfected with DL demonstrated the lowest SBS (10.36±0.33MPa).

CONCLUSION

CO₂ has the potential to be used alternate to CHX for caries-affected dentin disinfection. However, Riboflavin activated by photodynamic therapy; Diode laser, and Propolis as cavity disinfectant prior bond to resin-modified glass ionomer is not recommended and needs further probing.

Caries effected dentin disinfection using Ozone, methylthioninium chloride and turmeric activated by photodynamic therapy on bond integrity of resin-modified glass ionomer cement

AIM

To evaluate the shear bond strength (SBS) of caries effected dentin (CAD) bonded to resin-modified glass ionomer cement (RMGIC) after being disinfected with different methods their effect on microleakage scores.

MATERIAL AND METHODS

Based on criteria of ICDAS seventy-five teeth were selected and disinfected. All samples were grounded and a cavity prepared followed by random allocation of samples into different disinfection groups i.e., methylene blue photosensitizer (MBP), Silver diamine fluoride (SDF), Ozone (O₃); curcumin photosensitizer (CP) and chlorhexidine (CHX) (n = 15). All samples were restored with resin modified glass ionomer (RMGIC) incrementally. Ten specimens from each group were placed in universal testing machine (UTM) to calculate bond failure and failure type. Five samples from each group were evaluated for microleakage scores. SBS and microleakage scores was examined using analysis of variance (ANOVA) with a Post-hoc test. For all tests p-value, less than 0.5 was considered statistically significant.

RESULTS

The highest SBS was observed in CAD disinfected with CP bonded to RMGIC (16.42 ± 1.10 MPa). Similarly, the lowest bond values were demonstrated by CAD disinfected with MBP (9.21 ± 0.22 MPa) bonded to RMGIC respectively. CAD disinfected with CHX (Control) bonded to RMGIC demonstrated the lowest microleakage scores and showed a significant difference compared to other experimental groups (p< 0.05).

CONCLUSION

Curcumin along with O₃ has the potential to be used as a disinfectant in CAD as it improves SBS to RMGIC. CHX demonstrates low microleakage scores with decrease of bond integrity.

Photodynamic therapy and gaseous ozone versus conventional post space treatment methods on the push-out bond strength of fiber posts luting with different resin cements

BACKGROUND

The aim of this study was to compare the push-out bond strength of fiber posts by using two different resin cement after the treatments of post space with photodynamic therapy, gaseous ozone and conventional disinfection solution.

METHODS

The root canal treatments of one hundred maxillary incisors were performed. The roots were randomly distributed into 5 groups (n = 20). NaOCl of 2.5% + EDTA of 17% in group 1, CHX of 2% in group 2, toluidine blue + diode laser as the photodynamic therapy (PDT) in group 3 and ozone in group 4 were applied to the post spaces. Group 5 was washed with distilled water as control group. Each group was divided into two subgroups according to the adhesive types and the posts were bonded by using RelyX and LinkForce. The bond strength was calculated using the push-out test method. Resin tag formations were photographed with SEM. The push-out bond strength was analyzed by ANOVA and Tukey tests (p = .05).

RESULTS

The PDT group, which showed the highest PBS among the groups bonded with LinkForce at all levels, was significantly higher than Ozone and DW groups (p<.05). NaOCl and ozone treatments provided the highest PBS among the groups bonded with RelyX for all levels and this difference was significant according to the DW group (p < .05).

CONCLUSION

Post space treatments improved the bond strength of the fiber post ​​in both types of resin cement.

Role of Riboflavin; Curcumin photosensitizers and Ozone when used as canal disinfectant on Push-out bond strength of glass fibre post to radicular dentin

AIM

To assess the efficacy of photosensitizers (CP, riboflavin) and gaseous ozone in comparison to the conventional radicular dentin disinfectant (NaOCl) on push-out bond strength (PBS) of PFRC post cemented to radicular dentin MATERIAL AND METHOD: Human single-rooted teeth were collected, steriled implanted in polyvinyl pipes up to a cement-o-enamel junction and de coronated. Cleaning and shaping of the canal were performed using the crown down technique followed by obturation of the canal space. Canal space was prepared using peso reamers and samples were divided into four groups based on types of canal disinfectant protocols. Group 1: Riboflavin+ 17%EDTA; group 2: Curcumin Photosensitizer + 17% EDTA; group 3: Gaseous Ozone disinfection (O3) +17% EDTA and group 4 control 2.5% NaOCl +17% EDTA. Within the canal space, fiber post was cemented and cured, and thermocycled. PBS was evaluated using a Universal testing machine (UTM) and failure modes using a stereomicroscope at 40x magnification. One-way analysis of variance (ANOVA) was used to determine the mean and standard deviation of push-out bond strength (PBS). The Tukey multiple comparison tests (p = 0.05) was used to compare the means of PBS RESULTS: The highest PBS was displayed in group 2 CP+ 17% EDTA at all three root levels, coronal (8.81±0.61), middle (7.77±0.55), and apical (5.25±0.61). The lowest PBS was revealed in group 4, disinfected with 2.5% NaOCl +17% EDTA (control) at coronal (6.12±0.54), middle (5.46±0.84), and apical (3.00±1.88) levels. The most prevailed fracture mode was an adhesive failure (cement-dentin interface).

CONCLUSION

Radicular dentin disinfected with PDT using CP, riboflavin, and O3 displayed similar PBS at all root segments. NaOCl is a convenient, traditional, and commonly used disinfectant, and it's effects on PBS is still controversial.