1
|
Savaris JM, Isoton JC, Fluck BF, Tedesco M, Bortoluzzi EA, da Fonseca Roberti Garcia L, da Silveira Teixeira C. Comparative Analysis of AH Plus Bond Strength to Root Canal Dentin and Adhesive Interface Quality after Calcium Hydroxide Removal using Different Irrigation Protocols. J Endod 2024; 50:659-666. [PMID: 38431198 DOI: 10.1016/j.joen.2024.02.019] [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: 07/25/2023] [Revised: 02/23/2024] [Accepted: 02/23/2024] [Indexed: 03/05/2024]
Abstract
INTRODUCTION To evaluate the push-out bond strength (POBS) of AH Plus sealer to root dentin and the adhesive interface quality after calcium hydroxide (Ca(OH)2) intracanal dressing removal with different final irrigation protocols. METHOD After root canal instrumentation and irrigation, 40 root canals were filled with Ca(OH)2 and sealed. After 14 days, the specimens were randomly distributed according to the irrigation protocols for Ca(OH)2 removal (n = 10): GH2O (control) - distilled water; GNaOCl - 1% NaOCl; GEDTA - 17% EDTA; GEDTA + NaOCl - 17% EDTA + 1% NaOCl. The root canals were filled with AH Plus sealer and gutta-percha. After 7 days, the roots were sectioned into dentin slices and submitted to POBS test and analysis of the adhesive interface under scanning electron microscope. The POBS data were statistically evaluated (analysis of variance and Tukey test). The Kruskal-Wallis and Mann-Whitney tests were used to analyze the adhesive interface (α = 0.05). RESULTS GH2O, GNaOCl, and GEDTA + NaOCl had similar POBS values, with higher values on the apical third, in comparison with other thirds (P < .05). A homogeneous and free-of-gaps adhesive interface was observed for GH2O, GNaOCl, and GEDTA + NaOCl, with difference between GH2O and GEDTA (P < .05). GH2O and GEDTA + NaOCl presented higher sealer tags formation (P < .05). CONCLUSION The final rinse with EDTA for Ca(OH)2 dressing removal had a negative effect on the POBS of the filling material to root dentin. The use of EDTA followed by NaOCl had results similar to the distilled water, providing uniform and free-of-gaps adhesive interface, and a higher number of sealer tags.
Collapse
Affiliation(s)
- Julia Menezes Savaris
- Postgraduate Program in Dentistry, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Jakson Carlos Isoton
- Postgraduate Program in Dentistry, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Bruna Fiorine Fluck
- Postgraduate Program in Dentistry, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Maybell Tedesco
- Postgraduate Program in Dentistry, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Eduardo Antunes Bortoluzzi
- Division of Endodontics, Department of Diagnosis and Oral Health, University of Louisville, Louisville, Kentucky
| | | | | |
Collapse
|
2
|
Düzgün S, Topçuoğlu HS, Kahraman Ö, Eminsoy AT. Efficacy of different irrigation agitation systems in the removal of root canal sealers from artificial standardised grooves. AUST ENDOD J 2023; 49 Suppl 1:339-344. [PMID: 36810934 DOI: 10.1111/aej.12741] [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: 09/10/2022] [Revised: 01/25/2023] [Accepted: 02/05/2023] [Indexed: 02/24/2023]
Abstract
The present study aims to assess the efficacy of different irrigation agitation systems in removing calcium silicate-based sealers from artificial standardised apical grooves. After the root canal instrumentation of 96 teeth, artificial apical grooves were created in half of each root. The samples were divided into two main groups according to the sealer type (AH Plus Jet [APJ] and Sure-Seal Root™ [SSR]) (n = 48). The root halves were then reassembled and divided into four experimental groups based on the final irrigation technique used: Conventional Syringe Irrigation (CSI), Ultrasonic Irrigant Agitation (UIA), Sonic Agitation (SA) and Manual Dynamic Agitation (MDA). The roots were then dissembled to assess the amount of root canal sealer. UIA significantly removed more of SSR sealer than CSI, MDA and SA while there was no statistical difference between CSI, MDA, SA and UIA groups in the APJ group. None of the irrigation agitation systems used had completely removed the APJ and SSR sealers. However, UIA was more effective in removing SSR sealer from the standardised apical groove than were CSI, MDA and SA.
Collapse
Affiliation(s)
- Salih Düzgün
- Department of Endodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
| | | | - Ömür Kahraman
- Department of Endodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
| | - Ayşe Tuğba Eminsoy
- Department of Endodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
| |
Collapse
|
3
|
Pelozo LL, Souza-Gabriel AE, Alves Dos Santos GN, Camargo RV, Lopes-Olhê FC, Sousa-Neto MD, Mazzi-Chaves JF. Canal Drying Protocols to Use with Calcium Silicate-based Sealer: Effect on Bond Strength and Adhesive Interface. J Endod 2023; 49:1154-1160. [PMID: 37516237 DOI: 10.1016/j.joen.2023.07.015] [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: 05/12/2023] [Revised: 07/07/2023] [Accepted: 07/17/2023] [Indexed: 07/31/2023]
Abstract
INTRODUCTION The aim of this study was to evaluate the influence on bond strength and interface quality of different canal drying protocols in roots filled with Bio-C Sealer (BCS; Angelus, Londrina, Paraná, Brazil). METHODS Ninety-six roots of upper canines were prepared with an R50 file (Reciproc; VDW GmbH, Munich, Germany) and irrigated with 2.5% sodium hypochlorite and 17% EDTA under ultrasonic agitation. Roots were divided according to the drying protocol as follows: dry, the White Mac tip (Ultradent, Indaiatuba, SP, Brazil) for 5 seconds followed by aspiration with a capillary tip for 5 seconds and paper points; slightly moist, the White Mac tip followed by capillary aspiration without paper points; wet, the White Mac tip followed by a single paper point. The roots were filled with BCS or AH Plus (AHP; Dentsply Maillefer, Ballaigues, Switzerland) (n = 16) and sectioned for the push-out test after 3 months. Failure modes were assessed, and the interface morphology was analyzed under scanning electron microscopy. After 6 months, the other half of the roots were evaluated. Data were analyzed by analysis of variance/Tukey test at 5%. The chi-square test was used in the failure analysis and the Kruskal-Wallis/Dwass-Steel-Critchlow-Fligner for interface analysis. RESULTS The AHP-filled roots had the highest bond strength when the canal was dried (P < .05). No difference was found for periods (P > .05). For BCS, the highest bond strength was found in the slightly moist canals (P < .05). A predominance of adhesive failures was observed. The dried canals filled with AHP had the highest percentage of good adaptation, whereas BCS had no difference. CONCLUSIONS The best drying protocol for AHP is using the White Mac tip followed by capillary tip aspiration and paper points until complete dryness, and for BCS, it is using the White Mac tip followed by capillary aspiration without paper points.
Collapse
Affiliation(s)
- Lais Lima Pelozo
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | | | | | - Rafael Verardino Camargo
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Fabiane Carneiro Lopes-Olhê
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Manoel Damião Sousa-Neto
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Jardel Francisco Mazzi-Chaves
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
| |
Collapse
|
4
|
Santos ASD, de Sá MAB, Duarte MAH, Horta MCR, Silveira FF, Nunes E. Endodontic cement penetration after removal of calcium hydroxide dressing using XP-endo finisher. Braz Oral Res 2022; 36:e068. [PMID: 36507755 DOI: 10.1590/1807-3107bor-2022.vol36.0068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 02/02/2022] [Indexed: 12/15/2022] Open
Abstract
We aimed to evaluate the penetration of endodontic cement following the removal of calcium hydroxide (Ca(OH)2) dressing using the XP-endo Finisher in association with different irrigating solutions. Sixty premolars were instrumented and applied with a Ca(OH)2 dressing. To remove Ca(OH)2, the teeth were divided into six groups, each with a different volume of sodium hypochlorite (NaOCl) and ethylenediaminetetraacetic acid (EDTA), as well as solution stirring time with XP-endo Finisher (0, 30, and 60 sec). Root canals were filled using the lateral condensation technique. Fluorescein dye was added to the cement for microscopic laser scanning analysis. In the generated images, linear measurements were taken in micrometers, and their averages were calculated. To analyze the perimeter penetration ratio of the cement, the total perimeter of the canal and the segment of the total perimeter of the canal where the endodontic cement penetrated into the dentinal tubules were measured in micrometers. We found that using an XP-endo Finisher in irrigation was more effective than using a needle and syringe during the extension and penetration of endodontic cement. Shaking with XP-endo Finisher with 17% EDTA increased the extent and perimeter of the penetration of the endodontic cement into the dentinal tubules. However, using the XP-endo Finisher with EDTA only was more efficient than using the instrument interchangeably in NaOCl and EDTA. Although XP-endo Finisher contributes to the removal of Ca(OH)2, none of the protocols or instruments used removed all Ca(OH)2 from the root system.
Collapse
Affiliation(s)
- Alyssa Sales Dos Santos
- Pontifícia Universidade Católica de Minas Gerais - PUC-MG, Graduate Program in Dentistry, Department of Dentistry, Belo Horizonte, MG, Brazil
| | - Maria Aparecida Barbosa de Sá
- Pontifícia Universidade Católica de Minas Gerais - PUC-MG, Graduate Program in Dentistry, Department of Dentistry, Belo Horizonte, MG, Brazil
| | - Marco Antônio Húngaro Duarte
- Universidade de São Paulo - USP, School of Dentistry of Bauru, Department of Operative Dentistry, Endodontics and Dental Materials, Bauru, SP, Brazil
| | - Martinho Campolina Rebello Horta
- Pontifícia Universidade Católica de Minas Gerais - PUC-MG, Graduate Program in Dentistry, Department of Dentistry, Belo Horizonte, MG, Brazil
| | - Frank Ferreira Silveira
- Pontifícia Universidade Católica de Minas Gerais - PUC-MG, Graduate Program in Dentistry, Department of Dentistry, Belo Horizonte, MG, Brazil
| | - Eduardo Nunes
- Pontifícia Universidade Católica de Minas Gerais - PUC-MG, Graduate Program in Dentistry, Department of Dentistry, Belo Horizonte, MG, Brazil
| |
Collapse
|
5
|
Shi L, Wu S, Yang Y, Wan J. Efficacy of five irrigation techniques in removing calcium hydroxide from simulated S-shaped root canals. J Dent Sci 2022; 17:128-134. [PMID: 35028030 PMCID: PMC8739234 DOI: 10.1016/j.jds.2021.05.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 05/26/2021] [Indexed: 11/27/2022] Open
Abstract
Background/purpose Calcium hydroxide [Ca(OH)2], a wildly used intracanal medicament, should be completely removed from the root canal before obturation to avoid negative effects on the treatment. This study evaluated the effectiveness of conventional needle irrigation (CNI), passive ultrasonic activation (PUI), photon-induced photoacoustic streaming (PIPS), XP-endo Finisher (XP) and EDDY for the removal of Ca(OH)2 from S-shaped root canal. Materials and methods Eighty-four S-shaped root canals in resin blocks were prepared using Protaper Gold up to size #25/0.08 and filled with Ca(OH)2. Five groups were established according to the removal techniques (n = 16): CNI, PUI, PIPS, XP and EDDY group. The positive and negative control group (n = 2) were also established. Sodium hypochlorite 3% was used as the irrigant. Digital radiographs were used to measure the remaining Ca(OH)2. Statistical analysis of the data was performed by using the Kruskal–Wallis test, followed by Dunn's post hoc test with Bonferroni correction (α = 0.05). Results All the tested techniques completely removed Ca(OH)2 from the straight portion and coronal curve of the S-shaped root canal in 100% of cases. Regarding the apical curve, PUI, EDDY, PIPS and XP removed significantly more Ca(OH)2 than CNI (P < 0.05), with no significant differences among these four groups (P > 0.05). The complete clearance of Ca(OH)2 from the apical curve was observed in 75%, 62.5%, 56.3%, 43.8% and 0% of cases of PUI, EDDY, PIPS, XP and CNI group, respectively. Conclusion Irrigant activation enhanced Ca(OH)2 removal from the apical region of the S-shaped root canal. CNI was significantly less effective than all activation techniques.
Collapse
Affiliation(s)
- Lu Shi
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People's Republic of China
| | - Shuang Wu
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People's Republic of China
| | - Yunfei Yang
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People's Republic of China
| | - Jie Wan
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People's Republic of China
| |
Collapse
|
6
|
Escobar PM, Lopes FC, Carvalho K, Fretes V, Hadid GG, Mazzi-Chaves JF, Sousa-Neto MD. Influence of different calcium hydroxide removal protocols on the bond strength of epoxy resin-based sealer in long oval root canals. Microsc Res Tech 2021; 85:781-788. [PMID: 34564917 DOI: 10.1002/jemt.23949] [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: 04/22/2021] [Revised: 08/25/2021] [Accepted: 09/16/2021] [Indexed: 11/06/2022]
Abstract
This study evaluated the effect of different protocols for Ca(OH)2 removal on the bond strength (BS) of epoxy resin-based sealer in long oval root canals. Forty-eight mandibular incisors with long oval root canals were selected by CBCT. Biomechanical preparation was performed, the samples were filled with Ca(OH)2 paste and distributed in four groups (n = 12): G-without Ca(OH)2 paste (C); G2-syringe/needle (SN); G3-SN + XP-Endo® Finisher (XPF); G4-SN + passive ultrasonic irrigation (PUI). After 7 days, Ca(OH)2 was removed and teeth were filled using AHPlus and guttapercha. In four samples from each group, the sealer was manipulated with 0.1% rhodamine to assess sealer penetration by fluorescent laser confocal microscopy (FLCM). Samples were sectioned in slices for BS, scanning electron microscopy, and FLCM analysis. The BS data were analyzed by ANOVA and Tukey tests (α = 0.05). The lowest BS values were found for the SN group (12.89 ± 4.36) compared to C (35.55 ± 10.05), while PUI group presented intermediate values (28.57 ± 9.35) and the XPF group (31.34 ± 9.8) showed values that were sometimes similar to C group and sometimes similar to PUI group (p > .05). The analysis of the adhesive interface showed evident gaps, with the presence of residues between the dentin and the filling material for the SN group, and for C, XPF and PUI groups juxtaposed adhesive interface. FLCM images showed sealer penetration in the dentinal tubules along the entire perimeter for C, XPF, and PUI groups. Ca(OH)2 removal with XPF and PUI from long oval root canals resulted in higher bond strength values compared to SN, besides better sealer penetration on dentinal tubules and juxtaposed adhesive interface.
Collapse
Affiliation(s)
- Patrícia Maria Escobar
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo-USP, Ribeirão Preto, Brazil
| | - Fabiane Carneiro Lopes
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo-USP, Ribeirão Preto, Brazil
| | - Kleber Carvalho
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo-USP, Ribeirão Preto, Brazil
| | - Vicente Fretes
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo-USP, Ribeirão Preto, Brazil
| | - Gabriela Gavilán Hadid
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo-USP, Ribeirão Preto, Brazil
| | - Jardel Francisco Mazzi-Chaves
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo-USP, Ribeirão Preto, Brazil
| | - Manoel Damião Sousa-Neto
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo-USP, Ribeirão Preto, Brazil
| |
Collapse
|