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Ballal NV, Ray AB, Narkedamalli R, Urala AS, Patel V, Harris M, Bergeron BE, Tay FR. Effect of continuous vs sequential chelation on the mechanical properties of root dentin: An ex vivo study. J Dent 2024; 148:105214. [PMID: 38950767 DOI: 10.1016/j.jdent.2024.105214] [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: 05/13/2024] [Revised: 06/24/2024] [Accepted: 06/26/2024] [Indexed: 07/03/2024] Open
Abstract
OBJECTIVES To evaluate the mechanical properties of root canal dentin treated with sodium hypochlorite (NaOCl) in combination with hydroxyethylidene diphosphonic acid (HEDP) or ethylenediaminetetraacetic acid (EDTA). METHODS For testing fracture resistance, 45 single-rooted teeth were instrumented and irrigated with NaOCl/HEDP, NaOCl/EDTA, or distilled water. Fifteen untreated teeth served as control. After obturation, specimens from the experimental groups were thermocycled, dynamically-loaded, and then statically-loaded in a universal testing machine until failure. For flexural strength analysis, 15 teeth were instrumented and irrigated with NaOCl/HEDP or NaOCl/EDTA. Root segments were sectioned into dentin bars and tested for flexural strength using a universal testing machine. For microhardness evaluation, 20 teeth were instrumented and irrigated with NaOCl/HEDP or NaOCl/EDTA. Dentin disks from the coronal-third of each root segment were prepared, one before and one after irrigation, for microhardness testing with a Knoop hardness tester. RESULTS The highest fracture resistance was recorded in the untreated group, and the lowest in the EDTA group. Although the HEDP group had higher fracture resistance than the EDTA group, the distilled water group demonstrated even greater fracture resistance than the HEDP group. Specimens treated with HEDP had significantly higher flexural strength and microhardness values when compared with those treated with EDTA. CONCLUSION The fracture resistance, flexural strength, and microhardness of root canal dentin were higher when root canals were irrigated with NaOCl/HEDP, when compared with NaOCl/EDTA. CLINICAL SIGNIFICANCE Irrigating root canals with NaOCl combined with HEDP significantly improves the mechanical integrity of root canal dentin compared to the use of NaOCl with EDTA.
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Affiliation(s)
- Nidambur Vasudev Ballal
- Department of Conservative Dentistry & Endodontics, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India.
| | - Ayan Bhadra Ray
- Department of Conservative Dentistry & Endodontics, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Rajkumar Narkedamalli
- Department of Conservative Dentistry & Endodontics, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Arun S Urala
- Department of Orthodontics and Dentofacial Orthopaedics, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Vineet Patel
- Department of Endodontics, Dental College of Georgia, Augusta University, Augusta, GA, USA
| | - Mark Harris
- Department of Endodontics, Dental College of Georgia, Augusta University, Augusta, GA, USA
| | - Brian E Bergeron
- Department of Endodontics, Dental College of Georgia, Augusta University, Augusta, GA, USA
| | - Franklin R Tay
- Department of Endodontics, Dental College of Georgia, Augusta University, Augusta, GA, USA.
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Par M, Steffen T, Dogan S, Walser N, Tauböck TT. Effect of sodium hypochlorite, ethylenediaminetetraacetic acid, and dual-rinse irrigation on dentin adhesion using an etch-and-rinse or self-etch approach. Sci Rep 2024; 14:6315. [PMID: 38491076 PMCID: PMC10943220 DOI: 10.1038/s41598-024-57009-x] [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: 01/05/2024] [Accepted: 03/13/2024] [Indexed: 03/18/2024] Open
Abstract
The aim was to investigate the influence of endodontic irrigation solutions and protocols on the micro-tensile bond strength (μTBS) to dentin using an etch-and-rinse (ER) or self-etch (SE) adhesive approach. Eighty extracted human molars were ground to dentin. After pretreating for 27 min (21 min-3 min-3 min) with five different endodontic irrigation protocols (Group 1: NaOCl-EDTA-NaOCl; Group 2: NaOCl-NaOCl-EDTA; Group 3: NaOCl-NaCl-NaOCl; Group 4: Dual Rinse-Dual Rinse-Dual Rinse; Group 5: NaCl-NaCl-NaCl), an ER (Optibond FL, Kerr) or a SE (Clearfil SE Bond, Kuraray) adhesive system was applied. After light-curing, composite build-ups were made and cut into dentin-composite sticks. μTBS and failure modes were analyzed. Nonparametric statistical analyses (α = 0.05) were performed for comparison of the five groups within each type of adhesive as well as between the two adhesive systems used. The use of an ER instead of a SE adhesive system resulted in significantly higher μTBS for all irrigation protocols except for group 1 (NaOCl-EDTA-NaOCl) and 2 (NaOCl-NaOCl-EDTA). A statistical difference between the five different endodontic irrigation protocols was only found within the SE adhesive group, where group 1 (NaOCl-EDTA-NaOCl) achieved highest values. The use of an ER adhesive system cancels out the effect of the endodontic irrigation solution. The highest μTBS was achieved when using a NaOCl-EDTA-NaOCl-irrigation protocol in combination with Clearfil SE Bond, which shows that the selection of the endodontic irrigation should match the corresponding SE adhesive system.
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Affiliation(s)
- Matej Par
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Gunduliceva 5, 10000, Zagreb, Croatia.
| | | | - Selinay Dogan
- Department of Conservative and Preventive Dentistry, Center for Dental Medicine, University of Zurich, 8032, Zurich, Switzerland
| | - Noah Walser
- Department of Conservative and Preventive Dentistry, Center for Dental Medicine, University of Zurich, 8032, Zurich, Switzerland
| | - Tobias T Tauböck
- Department of Conservative and Preventive Dentistry, Center for Dental Medicine, University of Zurich, 8032, Zurich, Switzerland
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Novozhilova N, Babina K, Polyakova M, Sokhova I, Sherstneva V, Zaytsev A, Makeeva I, Mikheikina A. The Effect of Different Compositions and Concentrations of Etidronate-Containing Irrigants on the Antibacterial Activity of Sodium Hypochlorite against Enterococcus faecalis and Candida albicans. Dent J (Basel) 2024; 12:46. [PMID: 38534270 DOI: 10.3390/dj12030046] [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: 01/23/2024] [Revised: 02/12/2024] [Accepted: 02/19/2024] [Indexed: 03/28/2024] Open
Abstract
We assessed the effect of different compositions and concentrations of two etidronate-containing irrigants on the antibacterial activity of sodium hypochlorite (SH) against Enterococcus faecalis and Candida albicans in vitro. Pure cultures of C. albicans and E. faecalis were isolated from root canal samples. The disc diffusion method was used to compare the antibacterial effect of pure SH and SH mixed with 9%, 15%, and 18% etidronate of two manufactures (dual rinse (DR); IsraDent (ID)) and EDTA. The pH and temperature of the solutions were measured immediately after mixing and within 40 min. The ANOVA revealed a significant influence of the type of irrigating solution on the C. albicans and E. faecalis inhibition zone diameters that ranged from 6.6 to 51.6 mm and from 6.4 to 12.4 mm, respectively. SH with DR 9% exhibited the highest effect against C. albicans. The antifungal activity of the other irrigants was SH = SH + DR15% = SH + DR18% = SH + ID9% > SH + EDTA > SH + ID15% > SH + ID18%. No significant differences in the anti-E. faecalis effect were revealed between the tested solutions except for the mixtures of SH and 15% and 18% ID, which exhibited no antiseptic effect. There was a strong positive correlation between antiseptic activity against both microorganisms and the pH values of the tested solutions. In conclusion, most etidronate formulations did not significantly hamper sodium hypochlorite activity against C. albicans and E. faecalis. The effect was concentration- and manufacturer-dependent.
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Affiliation(s)
- Nina Novozhilova
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Ksenia Babina
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Maria Polyakova
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Inna Sokhova
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Valeria Sherstneva
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Alexandr Zaytsev
- Institute of Linguistics and Intercultural Communication, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Irina Makeeva
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Anna Mikheikina
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
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Kumar M, Shahi S, Agarwal LK, El-Shamy FMM, Gupta K, Aggarwal N. Evaluation of Dissolution of Pulp by Sodium Hypochlorite when Mixed with Tetrasodic Etidronate and Disodic Ethylenediamine Tetraacetate under Controlled Flow. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2024; 16:S684-S686. [PMID: 38595430 PMCID: PMC11001124 DOI: 10.4103/jpbs.jpbs_940_23] [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: 09/24/2023] [Revised: 10/02/2023] [Accepted: 10/03/2023] [Indexed: 04/11/2024] Open
Abstract
Background Sodium hypochlorite serves as the most efficient root canal irrigating fluid. Objectives This study's goal was to assess the replenished NaOCl's capacity to dissolve the tissue of pulp when combined with 9% tetrasodic etidronate (Na4HEBP), 18% tetrasodic etidronate (Na4HEBP), and 17% disodic ethylenediaminetetraacetate (Na2EDTA) under continuous controlled administration. Materials and Methods Hundred and twenty complete undamaged teeth of the anterior mandible extracted due to periodontal problems within forty-eight hours were taken as a source of the pulp tissue. Results It was found that there was a decrease in the weight of pulp tissue in all groups except negative control. Conclusion NaOCl's potential to dissolve tissue with chelating agents like EDTA and HEBP inside the root canal was unaffected when there was controlled administration of EDTA and HEBP.
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Affiliation(s)
- Mukesh Kumar
- Department of Conservative Dentistry and Endodontics, Patna Dental College and Hospital, Patna, Bihar, India
| | - Siddharth Shahi
- Department of Conservative Dentistry and Endodontics, Sarjug Dental College, Laheriasarai, Darbhanga, Bihar, India
| | - Lalit Kumar Agarwal
- Department of Conservative Dentistry and Endodontics, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India
| | | | - Khushboo Gupta
- Department of Conservative Dentistry and Endodontics, Chandra Dental College and Hospital, Lucknow, Uttar Pradesh, India
| | - Nidhi Aggarwal
- Department of Conservative Dentistry and Endodontics, MMCDSR, Mullana, Haryana, India
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Ulusoy Öİ, Ballal NV, Narkedamalli R, Ulusoy N, Shetty KP, Luke AM. Dislodgement resistance and structural changes of tricalcium silicate-based cements after exposure to different chelating agents. PLoS One 2024; 19:e0296647. [PMID: 38232127 DOI: 10.1371/journal.pone.0296647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 12/18/2023] [Indexed: 01/19/2024] Open
Abstract
This study aimed to evaluate the dislodgement resistance and structural changes of different mineral trioxide aggregate cements (MTA) like Pro-Root MTA, Ortho MTA, and Retro MTA after exposure to sodium hypochlorite (NaOCl), NaOCl-Ethylenediaminetetraacetic acid (EDTA), 1-hydroxyethylidene-1, 1-bisphosphonate (Dual Rinse HEDP), and NaOCl-Maleic acid (MA). The root canal spaces of 150 dentine slices were obturated using tricalcium silicate cements and divided into 3 groups (n = 50): Group1: ProRoot MTA, Group2: Retro MTA, and Group3: Ortho MTA. The samples in each group were further subdivided into four experimental (n = 10) and one control groups (n = 10): 2.5% NaOCl-17% EDTA, Dual Rinse HEDP, 2.5% NaOCl-7% Maleic acid, 2.5% NaOCl, distilled water (control). The dislodgement resistance and structural changes of cements were measured. Use of DR HEDP resulted in higher dislodgement resistance compared to17% EDTA and 7% MA in the samples obturated with Ortho MTA and Pro-Root MTA (p<0.001). In Retro MTA group, samples treated with DR HEDP and 17% EDTA had higher dislodgment resistance compared to 7% MA (p<0.001). On microstructural and elemental analysis of all the three MTA cements, samples treated with 17% EDTA and 7% MA were more amorphous and granular when compared to DR HEDP, which was pettle shaped. Calcium level was decreased more in samples treated with 17% EDTA and 7% MA when compared to DR HEDP.
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Affiliation(s)
- Özgür İlke Ulusoy
- Faculty of Dentistry, Department of Endodontics, Gazi University, Ankara, Turkey
| | - Nidambur Vasudev Ballal
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Karnataka, India
| | - Rajkumar Narkedamalli
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Karnataka, India
| | - Nuran Ulusoy
- Faculty of Dentistry, Department of Restorative Dentistry, Near East University, Nicosia, Northern Cyprus
| | - Krishna Prasad Shetty
- Department of Clinical Science, College of Dentistry, Ajman University, Ajman, United Arab Emirates
- Centre for Medical and Bio-Allied Health Sciences Research, Ajman University, Al-Jruf, Ajman, United Arab Emirates
| | - Alexander Maniangat Luke
- Department of Clinical Science, College of Dentistry, Ajman University, Ajman, United Arab Emirates
- Centre for Medical and Bio-Allied Health Sciences Research, Ajman University, Al-Jruf, Ajman, United Arab Emirates
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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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Deepa VL, Vanga HR, Kadali N, Divve S, Sravya V, Kapa RS. Effect of prewarming and continuous warming on tissue dissolving ability of Triton™ versus Twin Kleen™: An in vitro study. JOURNAL OF CONSERVATIVE DENTISTRY AND ENDODONTICS 2024; 27:100-104. [PMID: 38389751 PMCID: PMC10880472 DOI: 10.4103/jcde.jcde_201_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 11/15/2023] [Accepted: 12/06/2023] [Indexed: 02/24/2024]
Abstract
Context TwinKleen™ and Triton™ are newer all-in-one irrigants that have simultaneous action on both organic and inorganic contents. Studies comparing their tissue dissolving ability (TDA) either at room temperature (RT) or on prewarming (PW) and continuous warming (CW) are not yet reported. Aims To evaluate and compare the effect of 3% sodium hypochlorite (NaOCl), Twin Kleen™, and Triton™, on the bovine TDA. Materials and Methods One hundred and twenty tissue specimens (size 4 mm × 4 mm × 2 mm and weight 37 ± 3 mg) were divided into Group 1, normal saline (negative control); Group 2, 3% NaOCl (positive control); Group 3, Twin Kleen™; and Group 4, Triton™ (n = 30) Each group is further divided into three subgroups with ten samples each as sub group a - at room temperature (RT), sub group b - on pre warming (PW) and sub group c- on continuous warming (CW), Tissue specimens were immersed in test tubes with 5 ml of respective irrigants replenished thrice every 15 min. The percentage difference in tissue weights was calculated after 5, 10, and 15 min. Statistical Analysis Used Multiple intergroup comparisons were done using Tukey's multiple-comparison test, using SPSS software version 23.0. Results Both Triton™ and 3% NaOCl showed significantly higher dissolution than normal saline and Twin Kleen™ on CW followed by PW than at RT. Twin Kleen™ showed significantly less dissolution at all the tested temperatures. Conclusions Heating enhances the TDA of Triton™ and 3% NaOCl but not Twin Kleen™. CW showed significantly higher dissolution than PW.
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Affiliation(s)
- Velagala Lakshmi Deepa
- Department of Conservative Dentistry and Endodontics, Lenora Institute of Dental Sciences, Rajanagaram, Andhra Pradesh, India
| | - Himasai Reddy Vanga
- Department of Conservative Dentistry and Endodontics, Lenora Institute of Dental Sciences, Rajanagaram, Andhra Pradesh, India
| | - Naveena Kadali
- Department of Conservative Dentistry and Endodontics, Lenora Institute of Dental Sciences, Rajanagaram, Andhra Pradesh, India
| | - Sravyasai Divve
- Department of Conservative Dentistry and Endodontics, Lenora Institute of Dental Sciences, Rajanagaram, Andhra Pradesh, India
| | - Vemana Sravya
- Department of Conservative Dentistry and Endodontics, Lenora Institute of Dental Sciences, Rajanagaram, Andhra Pradesh, India
| | - Roopa Sravya Kapa
- Department of Conservative Dentistry and Endodontics, Lenora Institute of Dental Sciences, Rajanagaram, Andhra Pradesh, India
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Tartari T, Wilchenski BS, de Souza Lima LA, Vivan RR, Ballal V, Duarte MAH. The use of sodium hypochlorite mixed with etidronic acid during canal preparation increases debris extrusion. AUST ENDOD J 2023; 49:584-591. [PMID: 37571801 DOI: 10.1111/aej.12788] [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: 03/31/2023] [Revised: 07/28/2023] [Accepted: 07/31/2023] [Indexed: 08/13/2023]
Abstract
The purpose of this study was to compare the impact of different irrigation protocols on debris extrusion. Single-rooted teeth were distributed into groups based on the irrigation protocols (n = 40): 2.5% NaOCl (biomechanical preparation: 20 mL and final irrigation: 5 mL); 2.5% NaOCl (biomechanical preparation: 20 mL) + 17% EDTA (final irrigation: 2 mL) + 2.5% NaOCl (final irrigation: 3 mL); and a mixture of 5% NaOCl +18% HEDP (biomechanical preparation: 20 mL and final irrigation: 5 mL). The canals were prepared using a reciprocating instrument size 40/0.06. For final irrigation, the groups were reassigned based on the agitation methods (n = 10): (a) no agitation; (b) ultrasonic; (c) sonic; and (d) continuous rotation. The control group (n = 10) received saline solution without agitation. The amount of debris extruded was measured by weight and analysed using One-way ANOVA (α < 0.05). The subgroups treated with NaOCl + HEDP mixture showed a significantly higher amount of extruded debris (p < 0.05), while there was no difference among agitation methods in all groups (p > 0.05).
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Affiliation(s)
- Talita Tartari
- Department of Restorative Dentistry, Piracicaba School of Dentistry, State University of Campinas, Piracicaba, Brazil
- Department of Operative Dentistry, Endodontics, and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Brenda Stefhany Wilchenski
- Department of Operative Dentistry, Endodontics, and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Luana Arantes de Souza Lima
- Department of Operative Dentistry, Endodontics, and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Rodrigo Ricci Vivan
- Department of Operative Dentistry, Endodontics, and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Vasudev Ballal
- Department of Conservative Dentistry & Endodontics, Manipal College of Dental Sciences, Manipal, Karnataka, India
| | - Marco Antonio Hungaro Duarte
- Department of Operative Dentistry, Endodontics, and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
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Mikheikina A, Novozhilova N, Polyakova M, Sokhova I, Mun A, Zaytsev A, Babina K, Makeeva I. Knowledge, Attitude, and Practice towards Chelating Agents in Endodontic Treatment among Dental Practitioners. Dent J (Basel) 2023; 11:156. [PMID: 37504222 PMCID: PMC10378705 DOI: 10.3390/dj11070156] [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: 05/04/2023] [Revised: 06/16/2023] [Accepted: 06/20/2023] [Indexed: 07/29/2023] Open
Abstract
The use of chelating agents (CAs) in the endodontic irrigation protocol is required to dissolve the inorganic components of the smear layer. We aimed to assess the knowledge, attitude, and practice of dental professionals regarding the use of CAs during root canal treatment. A cross-sectional anonymous online survey was conducted among specialized endodontists and general dentists who routinely perform endodontic treatment and work in government-funded or private clinics in Moscow. The 8 min survey consisted of four parts: basic demographic data, knowledge (five items), attitude (four items), and practice (five items). We collected 376 completed questionnaires; a majority of the respondents were general dentists (87.5%) and worked in private clinics (77.4%). Most respondents (83.5%) showed a fair knowledge of the CAs used in endodontics, while 16.5% showed a poor knowledge of the topic. Small yet significant differences were found between endodontists and general practitioners and between dentists employed by private and government-funded clinics. A majority of dental practitioners (83%) demonstrated a positive attitude towards the use of CAs in endodontic treatment, and there were no differences among the study subgroups. Almost a third of the respondents always used chelating solutions during endodontic treatment, while 17% of the respondents did not use them at all. There were significant differences in this parameter between dentists working in private and government-funded clinics. Practice significantly correlated with attitude towards chelating agents and with knowledge of the topic. In conclusion, dental practitioners demonstrated a fair knowledge of CAs. Despite a positive attitude, 71% of the respondents did not use CAs for all endodontic patients.
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Affiliation(s)
- Anna Mikheikina
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Nina Novozhilova
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Maria Polyakova
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Inna Sokhova
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Anastasia Mun
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Alexandr Zaytsev
- Institute of Linguistics and Intercultural Communication, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Ksenia Babina
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Irina Makeeva
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
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Navarrete N, Almansa JM, de la Macorra JC, Arias-Moliz MT, Arias A. Effect of the Controlled Delivery of Chelating Agents on the Pulp Tissue Dissolution Ability of Fresh Sodium Hypochlorite Solutions. J Endod 2023; 49:307-312. [PMID: 36574829 DOI: 10.1016/j.joen.2022.12.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 12/15/2022] [Accepted: 12/19/2022] [Indexed: 12/25/2022]
Abstract
INTRODUCTION The purpose of this study was to evaluate pulp tissue dissolution ability of sodium hypochlorite (NaOCl) when mixed with tetrasodic etidronate (Na4HEBP) and disodic ethylenediaminetetraacetate (Na2EDTA) under controlled flow. METHODS Bovine pulp tissue was extracted from the lower incisors of 10 bovine jaws. Pulp specimens were standardized in size (1 × 3 × 10 mm), blotted dry, and weighed (initial weight [T0]: mean (SD) = 31.98 (1.18) mg). Specimens from the same jaw were randomly assigned to 2 control (n = 3 each) and 4 experimental groups (n = 10 each): NC (negative control/distilled water), PC (positive control/6%NaOCl), G1 (3%NaOCl), G2 (3%NaOCl-17% Na2EDTA), G3 (3%NaOCl-18% Na4HEBP), and G4 (3%NaOCl-9% Na4HEBP). Distilled water and NaOCl were provided using a delivery pump under a continuous controlled rate (1 mL/min). A second pump alternately delivered either Na2EDTA or Na4HEBP at the same rate with a 30-second programmed interval. Percentage of tissue weight loss was calculated at 2, 5, and 10 minutes (T2, T5, and T10) and compared among groups with analysis of variance. Free available chlorine and pH were controlled at T0 and T10. RESULTS No tissue remained in PC at T5. No dissolution occurred in NC. There were no significant differences in the percentage of weight loss among experimental groups at any point of time. Some remnant tissue was found in G3 (1.4% ± 2.4) and G4 (1.6% ± 2.3) at T10, whereas nothing was left in G1 and G2. CONCLUSIONS The controlled delivery of Na2EDTA and Na4HEBP did not alter tissue dissolution ability of NaOCl when fresh solutions were mixed in the root canal.
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Affiliation(s)
- Natalia Navarrete
- Department of Clinical Dentistry, Universidad Europea de Madrid, Faculty of Biomedical and Health Sciences
| | - Juan M Almansa
- Department of Conservative and Prosthetic Dentistry, School of Dentistry, Complutense University, Madrid, Spain
| | - José C de la Macorra
- Department of Conservative and Prosthetic Dentistry, School of Dentistry, Complutense University, Madrid, Spain
| | | | - Ana Arias
- Department of Conservative and Prosthetic Dentistry, School of Dentistry, Complutense University, Madrid, Spain.
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11
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Sfeir G, Bukiet F, Hage W, El Hachem R, Zogheib C. Impact of Final Irrigation Protocol on the Push-Out Bond Strength of Two Types of Endodontic Sealers. MATERIALS (BASEL, SWITZERLAND) 2023; 16:1761. [PMID: 36902876 PMCID: PMC10004703 DOI: 10.3390/ma16051761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 02/10/2023] [Accepted: 02/12/2023] [Indexed: 06/18/2023]
Abstract
Aim: The aim of this study was to assess the impact of the final irrigation protocol on the push-out bond strength of calcium silicate-based sealers when compared to an epoxy resin-based sealer. Materials and Methods: Eighty-four single-rooted mandibular human premolars were shaped using the R25® instrument (Reciproc, VDW, Munich, Germany) and then divided into three subgroups of 28 roots each depending on the final irrigation protocol: EDTA (ethylene diamine tetra acetic acid) and NaOCl activation, Dual Rinse® HEDP (1-hydroxyethane 1,1-diphosphonate) activation or sodium hypochlorite (NaOCl) activation. Then, each subgroup was divided into two groups (14 each) according to the sealer used (AH Plus Jet® or Total Fill BC Sealer®) for single-cone obturation. Dislodgement resistance using a universal testing machine, samples' push-out bond strength and failure mode under magnification were determined. Results: EDTA/Total Fill BC Sealer® showed significantly greater values of push-out bond strength compared with HEDP/Total Fill BC Sealer® and NaOCl/AH Plus Jet®, with no statistical difference with EDTA/AH Plus Jet®, HEDP/AH Plus Jet® and NaOCl/Total Fill BC Sealer®, whereas HEDP/Total Fill BC Sealer® showed significantly lower values of push-out bond strength. The apical third demonstrated higher means of push-out bond strength compared with middle and apical thirds. The most common failure mode was cohesive but showed no statistical difference compared to other types. Conclusions: Irrigation solution and final irrigation protocol affect the adhesion of calcium silicate-based sealers.
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Affiliation(s)
- Germain Sfeir
- Department of Endodontics, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut 17-5208, Lebanon
| | - Frédéric Bukiet
- Assistance Publique des Hôpitaux de Marseille, 13005 France; Aix Marseille Univ, CNRS, ISM, Inst. Movement Sci, 13288 Marseille, France
| | - Wajih Hage
- Department of Endodontics, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut 17-5208, Lebanon
| | - Roula El Hachem
- Department of Endodontics, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut 17-5208, Lebanon
| | - Carla Zogheib
- Department of Endodontics, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut 17-5208, Lebanon
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12
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Sobrino M, Foschi F, Estévez R, Loroño G, Conde Villar A, Pérez-Alfayate R. Effects of continuous chelation on the instrumentation of curved canals with a martensitic NiTi file system: an ex vivo micro-CT evaluation. Odontology 2023; 111:123-131. [PMID: 35798914 DOI: 10.1007/s10266-022-00727-3] [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: 04/05/2022] [Accepted: 06/23/2022] [Indexed: 01/06/2023]
Abstract
This study aimed to evaluate the influence of continuous chelation on apical transportation and centrality in shaped curved canals prepared with a martensitic file system and evaluated by micro-CT. Twenty-four lower molar canals with a curvature of 25º-40º were scanned pre-operatively with micro-CT and divided into 2 groups according to two different irrigation regimens (n = 12). Group 1 was irrigated with NaOCl, group 2 with Dual Rinse. All canals were prepared with VDW.ROTATE system. The samples were scanned post-operatively and evaluated at 1, 3 and 5 mm from the apex to determine apical transportation and canal centrality using VG Studio software. Statistical analysis was performed with SPSS software using the non-parametric Mann-Whitney test. No statistically significant differences were found between the two groups for both apical transportation and canal centrality at any of the levels studied (p < 05). The use of continuous chelation during the instrumentation of the canals with martensitic alloy files does not produce greater transportation and does not generate changes in centralization compared to NaOCl-only irrigation. Combined chelation and disinfection while shaping with martensitic NiTi can simplify the irrigation regimen without inducing iatrogenic aberrations.
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Affiliation(s)
- M Sobrino
- Department of Dentistry, Postgraduate Program in Endodontics, Universidad Europea de Madrid, Madrid, Spain
| | - F Foschi
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, Guy's Hospital, Tower Wing, Floor 22, London, SE1 9RT, UK. .,Peninsula Dental School, University of Plymouth, The John Bull Building, Plymouth Science Park, Plymouth, PL6 8BU, Devon, UK.
| | - R Estévez
- Department of Dentistry, Postgraduate Program in Endodontics, Universidad Europea de Madrid, Madrid, Spain
| | - G Loroño
- Department of Dentistry, Postgraduate Program in Endodontics, Universidad Europea de Madrid, Madrid, Spain
| | - A Conde Villar
- Department of Dentistry, Postgraduate Program in Endodontics, Universidad Europea de Madrid, Madrid, Spain
| | - R Pérez-Alfayate
- Department of Dentistry, Postgraduate Program in Endodontics, Universidad Europea de Madrid, Madrid, Spain
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13
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Borges MMB, Dijkstra RJB, Andrade FB, Duarte MAH, Versluis M, van der Sluis LWM, Petridis X. The response of dual-species bacterial biofilm to 2% and 5% NaOCl mixed with etidronic acid: a laboratory real-time evaluation using optical coherence tomography. Int Endod J 2022; 55:758-771. [PMID: 35470434 PMCID: PMC9325035 DOI: 10.1111/iej.13754] [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: 12/31/2021] [Revised: 04/19/2022] [Accepted: 04/20/2022] [Indexed: 11/29/2022]
Abstract
Aim The addition of etidronic acid (HEDP) to sodium hypochlorite (NaOCl) could increase the antibiofilm potency of the irrigant, whilst maintaining the benefits of continuous chelation. Studies conducted so far have shown that mixing HEDP with NaOCl solutions of relatively low concentration does not compromise the antibiofilm efficacy of the irrigant. However, the working lifespan of NaOCl may decrease resulting in a reduction of its antibiofilm efficacy over time (efficiency). In this regard, continuous irrigant replenishment needs to be examined. This study investigated the response of a dual‐species biofilm when challenged with 2% and 5% NaOCl mixed with HEDP for a prolonged timespan and under steady laminar flow. Methodology Dual‐species biofilms comprised of Streptococcus oralis J22 and Actinomyces naeslundii T14V‐J1 were grown on human dentine discs in a constant depth film fermenter (CDFF) for 96 h. Biofilms were treated with 2% and 5% NaOCl, alone or mixed with HEDP. Irrigants were applied under steady laminar flow for 8 min. Biofilm response was evaluated by means of optical coherence tomography (OCT). Biofilm removal, biofilm disruption, rate of biofilm loss and disruption as well as bubble formation were assessed. One‐way anova, Wilcoxon's signed‐rank test and Kruskal–Wallis H test were performed for statistical analysis of the data. The level of significance was set at a ≤.05. Results Increasing NaOCl concentration resulted in increased biofilm removal and disruption, higher rate of biofilm loss and disruption and increased bubble formation. Mixing HEDP with NaOCl caused a delay in the antibiofilm action of the latter, without compromising its antibiofilm efficacy. Conclusions NaOCl concentration dictates the biofilm response irrespective of the presence of HEDP. The addition of HEDP resulted in a delay in the antibiofilm action of NaOCl. This delay affects the efficiency, but not the efficacy of the irrigant over time.
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Affiliation(s)
- M M B Borges
- Department of Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - R J B Dijkstra
- Department of Conservative Dentistry, Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - F B Andrade
- Department of Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - M A H Duarte
- Department of Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - M Versluis
- Physics of Fluids group, Technical Medical (TechMed) Center and MESA+ Institute for Nanotechnology, University of Twente, Enschede
| | - L W M van der Sluis
- Department of Conservative Dentistry, Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - X Petridis
- Department of Conservative Dentistry, Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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14
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Boutsioukis C, Arias-Moliz MT. Present status and future directions - irrigants and irrigation methods. Int Endod J 2022; 55 Suppl 3:588-612. [PMID: 35338652 PMCID: PMC9321999 DOI: 10.1111/iej.13739] [Citation(s) in RCA: 79] [Impact Index Per Article: 39.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 03/21/2022] [Indexed: 11/30/2022]
Abstract
Irrigation is considered the primary means of cleaning and disinfection of the root canal system. The purpose of this review was to set the framework for the obstacles that irrigation needs to overcome, to critically appraise currently used irrigants and irrigation methods, to highlight knowledge gaps and methodological limitations in the available studies and to provide directions for future developments. Organization of bacteria in biofilms located in anatomic intricacies of the root canal system and the difficulty to eliminate them is the main challenge for irrigants. Sodium hypochlorite remains the primary irrigant of choice, but it needs to be supplemented by a chelator. Delivery of the irrigants using a syringe and needle and activation by an ultrasonic file are the most popular irrigation methods. There is no evidence that any adjunct irrigation method, including ultrasonic activation, can improve the long‐term outcome of root canal treatment beyond what can be achieved by instrumentation and syringe irrigation. It is necessary to redefine the research priorities in this field and investigate in greater depth the penetration of the irrigants, their effect on the biofilm and the long‐term treatment outcome. New studies must also focus on clinically relevant comparisons, avoid methodological flaws and have sufficiently large sample sizes to reach reliable conclusions. Future multidisciplinary efforts combining the knowledge from basic sciences such as Chemistry, Microbiology and Fluid Dynamics may lead to more effective antimicrobials and improved activation methods to bring them closer to the residual biofilm in the root canal system.
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Affiliation(s)
- C Boutsioukis
- Department of Endodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - M T Arias-Moliz
- Department of Microbiology, Faculty of Dentistry, University of Granada, Granada, Spain
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15
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Boutsioukis C, Arias-Moliz MT, Chávez de Paz LE. A critical analysis of research methods and experimental models to study irrigants and irrigation systems. Int Endod J 2022; 55 Suppl 2:295-329. [PMID: 35171506 PMCID: PMC9314845 DOI: 10.1111/iej.13710] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 02/07/2022] [Accepted: 02/08/2022] [Indexed: 11/28/2022]
Abstract
Irrigation plays an essential role in root canal treatment. The purpose of this narrative review was to critically appraise the experimental methods and models used to study irrigants and irrigation systems and to provide directions for future research. Studies on the antimicrobial effect of irrigants should use mature multispecies biofilms grown on dentine or inside root canals and should combine at least two complementary evaluation methods. Dissolution of pulp tissue remnants should be examined in the presence of dentine and, preferably, inside human root canals. Micro-omputed tomography is currently the method of choice for the assessment of accumulated dentine debris and their removal. A combination of experiments in transparent root canals and numerical modeling is needed to address irrigant penetration. Finally, models to evaluate irrigant extrusion through the apical foramen should simulate the periapical tissues and provide quantitative data on the amount of extruded irrigant. Mimicking the in vivo conditions as close as possible and standardization of the specimens and experimental protocols are universal requirements irrespective of the surrogate endpoint studied. Obsolete and unrealistic models must be abandoned in favour of more appropriate and valid ones that have more direct application and translation to clinical Endodontics.
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Affiliation(s)
- C Boutsioukis
- Department of Endodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - M T Arias-Moliz
- Department of Microbiology, Faculty of Dentistry, University of Granada, Granada, Spain
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16
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Rebolloso de Barrio E, Pérez-Higueras JJ, García-Barbero E, Gancedo-Caravia L. Effect of exposure to etidronic acid on the bond strength of calcium silicate-based cements after 1 and 21 days: an in vitro study. BMC Oral Health 2021; 21:591. [PMID: 34798880 PMCID: PMC8603527 DOI: 10.1186/s12903-021-01959-5] [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: 06/21/2021] [Accepted: 11/09/2021] [Indexed: 11/30/2022] Open
Abstract
Background After reparation of root perforations with calcium silicate-based cements (CSBC), the surface of the material is expected to be exposed to root canal irrigants (RCI) while resuming the root canal treatment. Methods The aim of this study was to compare the effect of exposure to a mixture of sodium hypochlorite (NaOCl) and etidronic acid (HEBP) or other irrigants on the Push Out Bond Strength (POBS) of CSBC after two different setting times. 240 root slices 1 mm thick were obtained from single-rooted human teeth. A 1.4 mm diameter perforation was performed on each slice and filled with Biodentine (BD) or ProRoot MTA (PMTA). After 1 or 21 days they were exposed to 17% ethylenediaminetetraacetic acid, 5.25% NaOCl, a mixture of 5.25% NaOCl and 9% HEBP (NaOCl + HEBP) or saline (n = 15) and submitted to a push-out test. POBS results were analysed with ANOVA and Tukey tests. Results BD showed higher POBS than PMTA after 1 day (p < .05). After 21 days no differences were found between materials. After 1 day exposure to NaOCl + HEBP resulted in higher POBS, compared to the other irrigants (p < .05). Conclusion POBS results are influenced by the cement, the setting time and the exposure to irrigants.
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Affiliation(s)
- Elena Rebolloso de Barrio
- Department of Conservative and Prosthetic Dentistry, School of Dentistry, Complutense University, Pza. Ramon y Cajal, s/n. Ciudad Universitaria, 28040, Madrid, Spain
| | - Juan José Pérez-Higueras
- Department of Conservative and Prosthetic Dentistry, School of Dentistry, Complutense University, Pza. Ramon y Cajal, s/n. Ciudad Universitaria, 28040, Madrid, Spain.
| | - Ernesto García-Barbero
- Department of Conservative and Prosthetic Dentistry, School of Dentistry, Complutense University, Pza. Ramon y Cajal, s/n. Ciudad Universitaria, 28040, Madrid, Spain
| | - Lucía Gancedo-Caravia
- Department of Conservative and Prosthetic Dentistry, School of Dentistry, Complutense University, Pza. Ramon y Cajal, s/n. Ciudad Universitaria, 28040, Madrid, Spain
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17
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Jaiswal S, Gupta S, Nikhil V, Bhadoria A, Raj S. Effect of intracanal and extracanal heating on pulp dissolution property of continuous chelation irrigant. J Conserv Dent 2021; 24:544-548. [PMID: 35558661 PMCID: PMC9089773 DOI: 10.4103/jcd.jcd_230_21] [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: 05/03/2021] [Revised: 08/25/2021] [Accepted: 10/21/2021] [Indexed: 11/12/2022] Open
Abstract
Context Extracanal and intracanal heating of sodium hypochlorite (NaOCl) improve its pulp dissolution, but limited literature is available on its effect as a combined single irrigant with etidronate. Aim The aim of this study is to compare the effect of temperature on the effectiveness of NaOCl and continuous chelation protocol on the time required for the dissolution of vital and necrotic pulp. Materials and Methods Dissolution time of 120 standardized bovine (buffalo) pulp fragments, divided into 12 subgroups based on tissue type (vital/necrotic), irrigant (NaOCl/continuous chelation), and temperature (extracanal, intracanal, and nonheated irrigant), was noted. Conical glass tips mimicking the root canal were considered specimen containers. About 0.2 ml of irrigant corresponding to the irrigation protocol was taken in them and then pulp samples were added to it. Samples were observed using loupes under 2.5 X magnification. Dissolution time was recorded using a stopwatch. The study was approved by the Institutional Ethical Committee (SDC/2019/591). Statistical Analysis Used Two-way analysis of variance; statistical product and service solutions version 25. The level of significance was set at P < 0.05. Results Time for pulp dissolution by continuous chelation mixture was significantly more as compared to NaOCl alone in all subgroups. Pulp tissue dissolution for both vital and necrotic pulp was improved by the increase in temperature of both irrigants and dissolution time was more for necrotic than vital tissue. Pulp tissue dissolution was significantly better by intracanal heating as compared to extracanal heating. Conclusion Although intracanal heating of continuous chelation mixture improves its pulp dissolution capacity significantly as compared to extracanal heating and nonheating protocol but pulpal dissolution capacity of nonheated 5% NaOCl still remains significantly better as compared to intracanal and extracanal heated continuous chelation mixture.
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Affiliation(s)
- Shikha Jaiswal
- Department of Conservative Dentistry and Endodontics, Subharti Dental College and Hospital, Meerut, Uttar Pradesh, India
| | - Sachin Gupta
- Department of Conservative Dentistry and Endodontics, Subharti Dental College and Hospital, Meerut, Uttar Pradesh, India
| | - Vineeta Nikhil
- Department of Conservative Dentistry and Endodontics, Subharti Dental College and Hospital, Meerut, Uttar Pradesh, India
| | - Anupriya Bhadoria
- Department of Conservative Dentistry and Endodontics, Subharti Dental College and Hospital, Meerut, Uttar Pradesh, India
| | - Shalya Raj
- Department of Conservative Dentistry and Endodontics, Subharti Dental College and Hospital, Meerut, Uttar Pradesh, India
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18
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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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19
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Cusicanqui Méndez DA, Cardenas Cuéllar MR, Feliz Pedrinha V, Velásquez Espedilla EG, Bombarda de Andrade F, Rodrigues PDA, Cruvinel T. Effects of curcumin-mediated antimicrobial photodynamic therapy associated to different chelators against Enterococcus faecalis biofilms. Photodiagnosis Photodyn Ther 2021; 35:102464. [PMID: 34320428 DOI: 10.1016/j.pdpdt.2021.102464] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 07/18/2021] [Accepted: 07/22/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND The aim of this study was to evaluate curcumin-mediated antimicrobial photodynamic therapy (aPDT) action combined or not with ethylenediaminetetraacetic acid (EDTA) and hydroxyethylidene bisphosphonate (HEBP) on Enterococcus faecalis biofilms. METHODS Enterococcus faecalis biofilms were grown on dentin bovine discs in brain heart infusion (BHI) medium with 1% glucose, in aerobic conditions at 37°C for 7 days. Then, they were randomly distributed to one of experimental conditions, as follows: control, 75 J.cm-2 LED, 600 μmol.L-1 curcumin, 17% EDTA, 18% HEBP, 600 μmol.L-1 curcumin plus 75 J.cm-2 LED, 600 μmol.L-1 curcumin plus 17% EDTA, 600 μmol.L-1 curcumin plus 18% HEBP, 600 μmol.L-1 curcumin plus 17% EDTA and 75 J.cm-2 LED or 600 μmol.L-1 curcumin plus 18% HEBP and 75 J.cm-2 LED. The viability of microorganisms and the vitality of biofilms were determined by colony forming unit counts and confocal scanning laser microscopy (CSLM), respectively. Statistical analysis was conducted by Kruskal Wallis and Dunn's post-hoc tests (α = 0.05). RESULTS The results showed that all combinations of aPDT with chelators significantly reduced the viability of microbial cells and the vitality of biofilms in comparison to control, even when considering deeper layers of biofilms. CONCLUSION The combination of curcumin with EDTA and HEBP similarly improved the effect of aPDT on E. faecalis biofilms.
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Affiliation(s)
| | - Maricel Rosario Cardenas Cuéllar
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, SP, Brazil
| | - Victor Feliz Pedrinha
- Laboratory of Dental Materials, Graduate Program in Dentistry, School of Dentistry, Federal University of Pará, Pará, Brazil
| | | | - Flaviana Bombarda de Andrade
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, SP, Brazil
| | - Patrícia de Almeida Rodrigues
- Laboratory of Dental Materials, Graduate Program in Dentistry, School of Dentistry, Federal University of Pará, Pará, Brazil
| | - Thiago Cruvinel
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, SP, Brazil.
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20
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Sedghizadeh PP, Sun S, Jones AC, Sodagar E, Cherian P, Chen C, Junka AF, Neighbors JD, McKenna CE, Russell RGG, Ebetino FH. Bisphosphonates in dentistry: Historical perspectives, adverse effects, and novel applications. Bone 2021; 147:115933. [PMID: 33757899 PMCID: PMC8076070 DOI: 10.1016/j.bone.2021.115933] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 03/11/2021] [Accepted: 03/16/2021] [Indexed: 02/08/2023]
Abstract
Studies of the potential role of bisphosphonates in dentistry date back to physical chemical research in the 1960s, and the genesis of the discovery of bisphosphonate pharmacology in part can be linked to some of this work. Since that time, parallel research on the effects of bisphosphonates on bone metabolism continued, while efforts in the dental field included studies of bisphosphonate effects on dental calculus, caries, and alveolar bone loss. While some utility of this drug class in the dental field was identified, leading to their experimental use in various dentrifice formulations and in some dental applications clinically, adverse effects of bisphosphonates in the jaws have also received attention. Most recently, certain bisphosphonates, particularly those with strong bone targeting properties, but limited biochemical effects (low potency bisphosphonates), are being studied as a local remedy for the concerns of adverse effects associated with other more potent members of this drug class. Additionally, low potency bisphosphonate analogs are under study as vectors to target active drugs to the mineral surfaces of the jawbones. These latter efforts have been devised for the prevention and treatment of oral problems, such as infections associated with oral surgery and implants. Advances in the utility and mechanistic understanding of the bisphosphonate class may enable additional oral therapeutic options for the management of multiple aspects of dental health.
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Affiliation(s)
- Parish P Sedghizadeh
- Division of Periodontology, Diagnostic Sciences & Dental Hygiene, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, California, United States of America.
| | - Shuting Sun
- BioVinc LLC, Pasadena, California, United States of America
| | - Allan C Jones
- General Dental Practice; Torrance, California, United States
| | - Esmat Sodagar
- Division of Periodontology, Diagnostic Sciences & Dental Hygiene, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, California, United States of America
| | - Philip Cherian
- BioVinc LLC, Pasadena, California, United States of America
| | - Casey Chen
- Division of Periodontology, Diagnostic Sciences & Dental Hygiene, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, California, United States of America
| | - Adam F Junka
- Department of Pharmaceutical Microbiology and Parasitology, Medical University of Wroclaw; Wroclaw Research Centre EIT, Wroclaw, Poland
| | - Jeffrey D Neighbors
- BioVinc LLC, Pasadena, California, United States of America; Department of Pharmacology and Medicine, Pennsylvania State University College of Medicine, Hershey, PA, United States of America
| | - Charles E McKenna
- Department of Chemistry, University of Southern California, Los Angeles, CA, United States of America
| | - R Graham G Russell
- The Botnar Research Centre, Nuffield Department of Orthopaedics, Rheumatology & Musculoskeletal Sciences, University of Oxford, United Kingdom; The Mellanby Centre for Musculoskeletal Research, Department of Oncology and Metabolism, University of Sheffield, United Kingdom
| | - Frank H Ebetino
- BioVinc LLC, Pasadena, California, United States of America.
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21
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Álvarez-Sagües A, Herce N, Amador U, Llinares-Pinel F, Nistal-Villan E, Presa J, Álvarez L, Azabal M. Efficacy of EDTA and HEDP Chelators in the Removal of Mature Biofilm of Enterococcus faecalis by PUI and XPF File Activation. Dent J (Basel) 2021; 9:41. [PMID: 33918842 PMCID: PMC8068811 DOI: 10.3390/dj9040041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 04/01/2021] [Accepted: 04/06/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Biofilm removal from the root canal during endodontic treatment is necessary to prevent further complications. Irrigation is essential to success. Several irrigants have been proposed without a proper comparison. The aim of the study is to compare the antibacterial capacity of different activated irrigants using passive ultrasonic activation (PUI) or XP-Endo finisher (XPF). METHODS A total of 100 instrumented teeth were incubated in an Eppendorf tube containing 0.5 McFarland of Enterococcus faecalis and incubated for 2 weeks at 37 °C. Roots were divided into 5 groups (n = 20) according to the irrigant type: ethylenediaminetetraacetic acid (EDTA) (17%), ethydronic acid (HEDP) (9%) mixed with 5.25% sodium hypochlorite (NaOCl), EDTA (17%) mixed with 5.25% NaOCl, PBS, and a control group. Each group was divided into two subgroups (n = 10): PUI and XPF. RESULTS As compared to the untreated control group, the irrigators included in the study had a significant effect in bacteria reduction. The obtained results show HEDP to be the most effective irrigant, since no bacteria were recovered after treatment of this group, followed by EDTA mixed with NaOCl and, finally, the EDTA-irrigated group. CONCLUSIONS HEDP is the best irrigating agent in combination with XPF or PUI file activation to eliminate bacteria in our experimental model.
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Affiliation(s)
- Alejandro Álvarez-Sagües
- Dentistry Department, Faculty of Medicine, San Pablo CEU University, 28668 Madrid, Spain; (N.H.); (M.A.)
| | - Nerea Herce
- Dentistry Department, Faculty of Medicine, San Pablo CEU University, 28668 Madrid, Spain; (N.H.); (M.A.)
| | - Ulises Amador
- Departamento de Química y Bioquímica, Facultad de Farmacia, Universidad San Pablo-CEU, Urbanización Montepríncipe, Boadilla del Monte, 28668 Madrid, Spain;
| | - Francisco Llinares-Pinel
- Microbiology Section, Departamento CC, Farmacéuticas y de la Salud, Facultad de Farmacia, Universidad CEU San Pablo, Boadilla del Monte, 28668 Madrid, Spain; (F.L.-P.); (E.N.-V.)
| | - Estanislao Nistal-Villan
- Microbiology Section, Departamento CC, Farmacéuticas y de la Salud, Facultad de Farmacia, Universidad CEU San Pablo, Boadilla del Monte, 28668 Madrid, Spain; (F.L.-P.); (E.N.-V.)
| | - Jesús Presa
- Independent Researcher, 28668 Madrid, Spain;
| | - Laura Álvarez
- Dentistry Department, Faculty of Medicine, San Pablo CEU University, 28668 Madrid, Spain; (N.H.); (M.A.)
| | - Magdalena Azabal
- Dentistry Department, Faculty of Medicine, San Pablo CEU University, 28668 Madrid, Spain; (N.H.); (M.A.)
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Tartari T, Borges MMB, de Araújo LBB, Vivan RR, Bonjardim LR, Duarte MAH. Effects of heat in the properties of NaOCl alone and mixed with etidronate and alkaline tetrasodium EDTA. Int Endod J 2021; 54:616-627. [PMID: 33219520 DOI: 10.1111/iej.13450] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 11/02/2020] [Accepted: 11/17/2020] [Indexed: 01/15/2023]
Abstract
AIM To assess the free available chlorine concentration (FAC), organic tissue dissolution and smear layer removal capacity of sodium hypochlorite (NaOCl) alone and when mixtured with etidronate (HEDP) and tetrasodium EDTA (Na4 EDTA), and heated to different temperatures. METHODOLOGY Mixtures at 1 : 1 ratio of 5% NaOCl with distilled water (considered NaOCl alone), 18% HEDP or 10% Na4 EDTA were heated to 25 °C, 37 °C, 48 °C and 60 °C. The FAC in the mixtures was assessed at 5, 10, 20, 30, 60 and 120 min. Samples of bovine muscle tissue (n = 10) were prepared with similar size and weighed before and after 5, 10 and 15 min of immersion in the mixtures heated to the different temperatures to verify organic matter dissolution. The intergroup results were compared statistically using one-way analysis of variance (anova) and intragroup by two-way analysis of variance (anova), both followed by Tukey's multiple-comparison test (α < 0.01). Bovine dentine blocks (n = 10) were analysed by scanning electron microscopy before and after immersion in the mixtures, and the time taken to remove the smear layer from the surfaces of the samples was determined. The Friedman test was used to compare the scores of the same group (α < 0.01), and the Kruskal-Wallis test with Dunn's post hoc was used to compare the different groups (α < 0.01). Saline solution was used as a control in the experiments of tissue dissolution and smear layer removal, RESULTS: Heating NaOCl alone did not affect its FAC. The higher the temperature of the mixtures with the chelators, the lower the FAC. Organic tissue dissolution was improved by increases in temperature of NaOCl alone and its mixture with HEDP (P < 0.01); however, the mixture with Na4 EDTA had no improvement (P > 0.01). Smear layer removal by NaOCl alone was enhanced by heating resulting in lower scores in some samples and became more rapid in the mixtures with the chelators. The saline solution did not promote tissue dissolution nor smear layer removal (P > 0.01). CONCLUSION In this laboratory study, heating NaOCl alone or when mixed with HEDP improved its capacity to dissolve organic matter and remove the smear layer. However, the mixture with HEDP required frequent refreshment to retain these effects when heated. Due to the acceleration in the reaction between the irrigants, very rapid reductions in the free available chlorine in the mixtures with Na4 EDTA heated to the different temperatures occurred.
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Affiliation(s)
- T Tartari
- Department of Operative Dentistry, Endodontics, and Dental Materials, University of São Paulo, Bauru, Brazil
| | - M M B Borges
- Department of Operative Dentistry, Endodontics, and Dental Materials, University of São Paulo, Bauru, Brazil
| | - L B B de Araújo
- Department of Operative Dentistry, Endodontics, and Dental Materials, University of São Paulo, Bauru, Brazil
| | - R R Vivan
- Department of Operative Dentistry, Endodontics, and Dental Materials, University of São Paulo, Bauru, Brazil
| | - L R Bonjardim
- Department of Biological Science, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - M A H Duarte
- Department of Operative Dentistry, Endodontics, and Dental Materials, University of São Paulo, Bauru, Brazil
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Ulusoy Öİ, Genç Şen Ö, Zeyrek S, Kaya M, Paltun YN. Effect of final irrigation protocols on the fracture resistance of roots with varying dentine thickness. Eur J Oral Sci 2021; 129:e12769. [PMID: 33667031 DOI: 10.1111/eos.12769] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 01/09/2021] [Accepted: 01/12/2021] [Indexed: 11/27/2022]
Abstract
This study evaluated the effects of 9% etidronic acid (HEBP) and 17% ethylenediaminetetraacetic acid (EDTA) used either with conventional syringe irrigation (CSI) or passive ultrasonic irrigation (PUI) on the fracture resistance of roots with different dentine thickness. The root canals of 120 extracted teeth were widened, leaving dentinal walls with different thicknesses of either 0.75 mm, 1.50 mm, or 2.25 mm with 40 teeth in each group. Within each of these groups, four subgroups (n = 10) were formed according to the final irrigation regimens applied: 2.5% NaOCl-17% EDTA with CSI; 2.5% NaOCl-17% EDTA with PUI; 2.5% NaOCl + 9% HEBP with CSI; 2.5% NaOCl + 9% HEBP with PUI. The irrigated root canals were obturated with AH Plus sealer and gutta-percha cones. A compressive vertical loading was applied to the samples and the force at fracture was recorded. Data were statistically analysed using a multiple linear regression analysis. The most influencing factor for the fracture strength of roots was the remaining dentine thickness, followed by the irrigation method, and then the irrigation solution. The samples irrigated using PUI were statistically significantly more resistant to fracture than those using CSI (mean difference = 116.3 N; 95% CI = [53.9, 178.6] N). The application of HEBP was associated with higher resistance to fracture than the application of EDTA (mean difference = 71.0 N; 95% CI = [8.6, 133.3] N).
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Affiliation(s)
- Özgür İlke Ulusoy
- Department of Endodontics, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - Özgür Genç Şen
- Department of Endodontics, Faculty of Dentistry, Yüzüncü Yıl University, Van, Turkey
| | - Salev Zeyrek
- Department of Endodontics, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - Melih Kaya
- Department of Endodontics, Faculty of Dentistry, Yüzüncü Yıl University, Van, Turkey
| | - Yelda Nayır Paltun
- Department of Endodontics, Faculty of Dentistry, Gazi University, Ankara, Turkey
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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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Villalta-Briones N, Baca P, Bravo M, Solana C, Aguado-Pérez B, Ruiz-Linares M, Arias-Moliz MT. A laboratory study of root canal and isthmus disinfection in extracted teeth using various activation methods with a mixture of sodium hypochlorite and etidronic acid. Int Endod J 2020; 54:268-278. [PMID: 32970865 DOI: 10.1111/iej.13417] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 09/10/2020] [Accepted: 09/17/2020] [Indexed: 12/29/2022]
Abstract
AIM To evaluate in a laboratory setting the antibiofilm activity of several irrigating protocols including conventional irrigation, ultrasonic activation and XP-endo Finisher, with a mixture of sodium hypochlorite and etidronic acid in infected isthmuses and root canals of extracted human mandibular molar teeth. METHODOLOGY Fifty-six mesial roots of mandibular molars, half of them with a continuous isthmus from the cervical to the apical third between the two root canals (type 1), and the other half with a continuous isthmus from the cervical to the middle third and one canal in the apical third (type 2), were included. The root canals were contaminated for 7 days with an Enterococcus faecalis suspension. There were three experimental groups plus a control group (n = 7 per type of root canal anatomy). All the root canals, except for the control group that was not treated, were chemomechanically prepared and then assigned to one of the experimental groups according to the final adjunctive procedure: conventional irrigation, ultrasonic activation or XP-endo Finisher activation. The irrigating solution used was a combination of 2.5% sodium hypochlorite and 9% etidronic acid, and the final protocols were applied for three cycles of 30 s with a 3 mL volume. The antibiofilm activity was evaluated at each location (root canal and isthmus) and third (cervical, middle and apical) using confocal laser scanning microscopy and the live/dead technique. Statistical analysis was performed using SPSS (descriptive statistics) and SUDAAN (P-value calculations). RESULTS Root canals had significantly lower biovolume values than the isthmuses (P < 0.05). The biovolume in the root canals was significantly reduced in all the experimental groups in all the thirds except for conventional irrigation in the apical third (P > 0.05). In the cervical and middle thirds, ultrasonic activation was associated with the lowest biovolumes (P < 0.05), followed by XP-endo Finisher. In the isthmus, disinfection was similar in all the thirds for all the protocols. Conventional irrigation was associated with intermediate values with no significant differences from the control group or from the activated protocols (P > 0.05), although the latter were significantly different from the control group (P < 0.05). No differences were found between ultrasonic activation and XP-endo Finisher in the middle and apical thirds (P > 0.05) in the isthmuses. CONCLUSIONS In this laboratory study on extracted teeth, the isthmus was more difficult to disinfect than root canals. In the root canals, ultrasonic activation and XP-endo Finisher had a greater effectiveness than conventional irrigation. In the isthmuses, no differences were observed between the two activation techniques and conventional irrigation.
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Affiliation(s)
- N Villalta-Briones
- Department of Stomatology, School of Dentistry, University of Granada, Granada, Spain
| | - P Baca
- Department of Stomatology, School of Dentistry, University of Granada, Granada, Spain
| | - M Bravo
- Department of Stomatology, School of Dentistry, University of Granada, Granada, Spain
| | - C Solana
- Department of Stomatology, School of Dentistry, University of Granada, Granada, Spain
| | - B Aguado-Pérez
- Department of Stomatology, School of Dentistry, University of Granada, Granada, Spain
| | - M Ruiz-Linares
- Department of Stomatology, School of Dentistry, University of Granada, Granada, Spain
| | - M T Arias-Moliz
- Department of Microbiology, School of Dentistry, University of Granada, Granada, Spain
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26
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Evaluation of different irrigation solutions and activation methods on removing calcium hydroxide. J Dent Sci 2020; 16:700-705. [PMID: 33854721 PMCID: PMC8025183 DOI: 10.1016/j.jds.2020.09.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 09/07/2020] [Indexed: 11/23/2022] Open
Abstract
Background/purpose Dual Rinse HEDP is a soft chelator which can be used simultaneously with sodium hypochlorite (NaOCl). The aim of this study is to evaluate the efficacy of Dual Rinse HEDP with different irrigation systems on removing calcium hydroxide [Ca(OH)2]. Materials and methods Eighty maxillary central incisor teeth were shaped and a standard groove on the apical third of the root canal surface was prepared. The root canals were filled with Ca(OH)2. Samples were divided into two groups according to the solution and these two groups were divided into three subgroups based on the activation technique. In group 1 (n = 10) Ca(OH)2 was removed using conventional irrigation with NaOCl whereas in group 2 (n = 10) conventional irrigation with NaOCl - Dual Rinse HEDP mixture was used. Group 3 (n = 15) and group 4 (n = 15) received sonic activation with the same irrigants as groups 1 and 2 respectively. In group 5 (n = 15) passive ultrasonic irrigation (PUI) was used with NaOCl while in group 6 (n = 15) the irrigant was the mixture. The amount of remaining Ca(OH)2 in the artificial grooves were evaluated under a light microscope. Results None of the procedures managed to completely remove the Ca(OH)2 from artificial grooves. There was no significant difference between the groups (p = 0.053). The scores were significantly lower in PUI group compared to the other techniques between NaOCl groups (p = 0.021). Conclusion Dual Rinse HEDP does not make a difference on elimination of Ca(OH)2. PUI is more efficient than both methods when NaOCl solution is used.
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Wright PP, Kahler B, Walsh LJ. The effect of temperature on the stability of sodium hypochlorite in a continuous chelation mixture containing the chelator clodronate. AUST ENDOD J 2020; 46:244-248. [DOI: 10.1111/aej.12399] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/09/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Patricia P. Wright
- School of Dentistry University of Queensland Herston Queensland Australia
| | - Bill Kahler
- School of Dentistry University of Queensland Herston Queensland Australia
| | - Laurence J. Walsh
- School of Dentistry University of Queensland Herston Queensland Australia
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Antimicrobial effectiveness of etidronate powder (Dual Rinse ® HEDP) and two EDTA preparations against Enterococcus faecalis: a preliminary laboratory study. Odontology 2020; 108:396-405. [PMID: 32112364 DOI: 10.1007/s10266-020-00499-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 11/24/2019] [Indexed: 01/30/2023]
Abstract
This study aimed to evaluate the antimicrobial and antibiofilm activity of two chelating agents: ethylenediaminetetraacetic acid (EDTA) combined or not with detergents, and etidronic acid combined with sterile saline. The bacterial inhibitory and bactericidal concentrations (MIC and MBC, respectively) were determined on Enterococcus faecalis ATCC 4083 strain. Antimicrobial tests were performed on a biofilm model after treatment with the chelating agents at different times (1, 3, and 5 min) using a biofilm eradication concentration (MBEC) and confocal laser scanning microscope (CLSM) assays. Quantification of cell biomass and percentage of live and dead cells in the biomass was assessed for each group. The normality of the distributions for each variable was assessed using the D'Agostino and Pearson's omnibus normality test. The comparison of bacterial viability among groups and between any two groups was performed using the non-parametric Kruskal-Wallis one-way analysis of variance and the Dunn's test, respectively. No significant between-group difference was observed regarding biomass reduction. On the other hand, EDTA combined with detergents displayed a substantial increase of the dead bacteria ranging between 35 and 43%; whereas, the number of cells killed in the control group and in the other treated groups always ranged between 1 and 6%, at all experimental times. The addition of detergents to EDTA can improve its anti-biofilm activity by reducing EPS production and enhancing the killing of sessile bacterial cells. Clinical relevance EDTA presents a relevant antimicrobial activity when combined with surface-active agents.
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Wright PP, Scott S, Kahler B, Walsh LJ. Organic Tissue Dissolution in Clodronate and Etidronate Mixtures with Sodium Hypochlorite. J Endod 2020; 46:289-294. [DOI: 10.1016/j.joen.2019.10.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 10/13/2019] [Accepted: 10/27/2019] [Indexed: 10/25/2022]
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30
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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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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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Dual Rinse® HEDP increases the surface tension of NaOCl but may increase its dentin disinfection efficacy. Odontology 2019; 107:521-529. [DOI: 10.1007/s10266-019-00436-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 04/08/2019] [Indexed: 01/06/2023]
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Ballal NV, Das S, Rao BSS, Zehnder M, Mohn D. Chemical, cytotoxic and genotoxic analysis of etidronate in sodium hypochlorite solution. Int Endod J 2019; 52:1228-1234. [PMID: 30848496 DOI: 10.1111/iej.13110] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 03/05/2019] [Indexed: 10/27/2022]
Abstract
AIM To test whether the incorporation of a chelation powder, etidronate, marketed for root canal irrigation (Dual Rinse HEDP) into a sodium hypochlorite (NaOCl) solution induced additional cytotoxic and genotoxic effects not observed with NaOCl alone. METHODOLOGY Fresh and 24-h-old mixtures of 0.9 g of etidronate in 10 mL of 2.5% NaOCl were assessed for their basic chemical features including pH and the ability to chelate Ca2+ from hydroxylapatite. Pure NaOCl and phosphate-buffered saline (PBS) with/without etidronate served as control solutions. Cytotoxic and genotoxic effects of diluted solutions (1:10, 1:100, and 1:1000) were assessed on Chinese hamster lung fibroblast (V79) using the MTT, clonogenic and micronucleus assays, respectively. One-way ANOVA and Tukey's HSD test were applied with an alpha-type error of 5% (P < 0.05). RESULTS In mixtures of NaOCl and etidronate, the free available chlorine was lost completely after 24 h, and the pH dropped by more than 3 units. However, the ability of the etidronate to chelate Ca2+ was maintained. The fresh mixtures of NaOCl and etidronate were not more toxic than NaOCl alone (P > 0.05), whilst the 24-h-old mixtures were less toxic (P < 0.05) and statistically similar to pure etidronate. Etidronate per se showed little cytotoxicity and no genotoxicity at the tested dilutions. CONCLUSIONS The ability of the used etidronate, Dual Rinse HEDP, to chelate calcium is not affected by NaOCl. Cytotoxicity and genotoxicity of mixed solutions is dictated by the presence of free available chlorine therein.
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Affiliation(s)
- N V Ballal
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - S Das
- Department of Radiation Biology and Toxicology, School of Life Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - B S S Rao
- Department of Radiation Biology and Toxicology, School of Life Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - M Zehnder
- Department of Preventive Dentistry, Periodontology and Cariology, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - D Mohn
- Department of Preventive Dentistry, Periodontology and Cariology, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.,Institute for Chemical and Bioengineering, Department of Chemistry and Applied Biosciences, ETH Zurich, Zurich, Switzerland
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Morago A, Ruiz‐Linares M, Ferrer‐Luque CM, Baca P, Rodríguez Archilla A, Arias‐Moliz MT. Dentine tubule disinfection by different irrigation protocols. Microsc Res Tech 2019; 82:558-563. [DOI: 10.1002/jemt.23200] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 11/09/2018] [Accepted: 12/03/2018] [Indexed: 11/10/2022]
Affiliation(s)
- Ana Morago
- Department of Microbiology, Faculty of DentistryUniversity of Granada Granada Spain
| | - Matilde Ruiz‐Linares
- Department of Stomatology, Faculty of DentistryUniversity of Granada Granada Spain
| | | | - Pilar Baca
- Department of Stomatology, Faculty of DentistryUniversity of Granada Granada Spain
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Wright PP, Kahler B, Walsh LJ. The Effect of Heating to Intracanal Temperature on the Stability of Sodium Hypochlorite Admixed with Etidronate or EDTA for Continuous Chelation. J Endod 2019; 45:57-61. [DOI: 10.1016/j.joen.2018.09.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 09/06/2018] [Accepted: 09/23/2018] [Indexed: 11/16/2022]
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Effects of etidronate, NaOCl, EDTA irrigation solutions and their combinations on cyclic fatigue resistance of nickel–titanium single-file rotary and reciprocating instruments at body temperature. Odontology 2018; 107:190-195. [DOI: 10.1007/s10266-018-0388-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 09/03/2018] [Indexed: 10/28/2022]
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Tejada S, Baca P, Ferrer-Luque CM, Ruiz-Linares M, Valderrama MJ, Arias-Moliz MT. Influence of dentine debris and organic tissue on the properties of sodium hypochlorite solutions. Int Endod J 2018; 52:114-122. [DOI: 10.1111/iej.12986] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Accepted: 07/13/2018] [Indexed: 11/29/2022]
Affiliation(s)
- S. Tejada
- Department of Microbiology; University of Granada; Granada Spain
| | - P. Baca
- Department of Stomatology; School of Dentistry; University of Granada; Granada Spain
| | - C. M. Ferrer-Luque
- Department of Stomatology; School of Dentistry; University of Granada; Granada Spain
| | - M. Ruiz-Linares
- Department of Stomatology; School of Dentistry; University of Granada; Granada Spain
| | - M. J. Valderrama
- Department of Statistics and Operations Research; School of Pharmacy; University of Granada; Granada Spain
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Effect of Root Dentin Conditioning on the Pushout Bond Strength of Biodentine. J Endod 2018; 44:1186-1190. [PMID: 29861064 DOI: 10.1016/j.joen.2018.04.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 03/19/2018] [Accepted: 04/08/2018] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Sodium hypochlorite (NaOCl) is the main irrigant to clean root canals. Decalcifying agents are advocated as additional means to condition the root dentin. The aim of this study was to evaluate the effect of alternating (EDTA) or continuous 1-hydroxyethane 1,1-diphosphonic (HEDP) chelation in conjunction with NaOCl irrigation on the pushout bond strength of Biodentine (Septodont, Saint Maur des Fosses, France). METHODS Single root canals of 50 extracted, mature human teeth were divided into 5 groups (n = 10) and enlarged using rotary instruments. Canals were irrigated with 5 mL irrigant after each instrument and then with 5 mL after mechanical preparation as follows: 2.5% NaOCl during and then 2.5% NaOCl, 17% EDTA, or 17% EDTA followed by 2.5% NaOCl after preparation. Continuous chelation with 2.5% NaOCl/9% Dual Rinse HEDP (Medcem GmbH, Weinfelden, Switzerland) during and after preparation. The control group was irrigated with water during and after preparation. Canals were then filled with Biodentine. A horizontal section of 1.5-mm thickness was taken from the middle root third, and a pushout bond test was performed. Data were statistically analyzed using 1-way analysis of variance/Tukey honest significant different test. RESULTS The pushout bond strength of Biodentine was significantly higher when the root canal was irrigated with 2.5% NaOCl/9% Dual Rinse HEDP (19.6 ± 2.3 MPa) than with NaOCl alone (15.5 ± 1.5 MPa) or the NaOCl/EDTA sequences (15.7 ± 2.2 MPa and 16.9 ± 2.9 MPa) (P < .05), which did not differ among each other (P > .05). The lowest pushout bond strength values were found with water irrigation (11.5 ± 0.5 MPa) (P < .05 to all other groups). CONCLUSIONS Irrigation with 2.5% NaOCl/9% Dual Rinse HEDP significantly improved the pushout bond strength of Biodentine to the root canal dentin.
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Lima Nogueira BM, da Costa Pereira TI, Pedrinha VF, de Almeida Rodrigues P. Effects of Different Irrigation Solutions and Protocols on Mineral Content and Ultrastructure of Root Canal Dentine. IRANIAN ENDODONTIC JOURNAL 2018; 13:209-215. [PMID: 29707017 PMCID: PMC5911296 DOI: 10.22037/iej.v13i2.19287] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Introduction The aim of this study was to evaluate the effect of different irrigating solutions and irrigation protocols on the chemical and physical structure of root dentin. Materials and Methods Thirty extracted single-rooted human teeth were selected and then distributed into the following treatment groups (n=10): G1, saline solution (0.9% NaCl); G2, 2.5% NaOCl + 17% EDTA + 2.5% NaOCl; G3, 2.5% NaOCl + 9% Etidronate (HEBP) + 2.5% NaOCl; G4, mixture of 5% NaOCl + 18% HEBP; G5, 2.5% NaOCl + 17% EDTA + 0.9% NaCl, and G6, 2.5% NaOCl + 9% HEBP + 0.9% NaCl. The ultrastructure of dentin was characterized through scanning electron microscopy (SEM) and energy dispersive x-ray spectrometry (EDS) determined the chemical composition in terms of the calcium (Ca), phosphorus (P), magnesium (Mg) and potassium (K) content and the Ca/P ratio; and the crystalline phase was analyzed by x-ray diffraction (XRD). A descriptive analysis was performed on the ultrastructure and the crystallography data of dentin. Data analysis included a chemical composition analysis of variance (one-way ANOVA) and a subsequent multiple comparison test (Tukey's test). Results Except for the control group, all groups showed morphological changes upon visualization with SEM. For EDS, G2 and G5 showed significant mineral loss and changes in the Ca/P ratio (P<0.05); the highest values of Ca and P were observed in G3, G4 and G6. Conclusion All the irrigating solutions and irrigation protocols tested promoted changes in the morphology and physical and chemical composition of the dentin. However, no significant differences were observed crystallographically.
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Ulusoy ÖI, Savur IG, Alaçam T, Çelik B. The effectiveness of various irrigation protocols on organic tissue removal from simulated internal resorption defects. Int Endod J 2018; 51:1030-1036. [PMID: 29505173 DOI: 10.1111/iej.12919] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Accepted: 02/27/2018] [Indexed: 11/28/2022]
Abstract
AIM To evaluate the effectiveness of NaOCl, NaOCl-EDTA and NaOCl + HEBP activated by ultrasonics and XP-endo Finisher on organic tissue removal from simulated internal root resorption cavities. METHODOLOGY The root canals of 144 single-rooted teeth were instrumented. The teeth were split longitudinally, and semicircular cavities were prepared in the canal walls on each half of the roots. Samples obtained from ground bovine muscle tissue were weighed and adapted into the semicircular cavities. The root fragments were reassembled and cemented to create a circular simulated resorption cavity within the canal. Teeth were divided into twelve groups (n = 12) according to the irrigation protocols: group 1: NaOCl, no activation; group 2: NaOCl, passive ultrasonic irrigation (PUI); group 3: NaOCl, XP-endo Finisher; group 4: NaOCl-EDTA, no activation; group 5: NaOCl-EDTA, PUI; group 6: NaOCl-EDTA, XP-endo Finisher; group 7: NaOCl + HEBP, no activation; group 8: NaOCl + HEBP, PUI; group 9: NaOCl + HEBP, XP-endo Finisher; group 10: distilled water, no activation; group 11: distilled water, PUI; and group 12: distilled water, XP-endo Finisher. The teeth were disassembled, and the tissue remaining inside the resorption cavities were weighed. The data were analysed statistically using two-way anova and Fisher's LSD tests with a significance level of 0.05. RESULTS The use of XP-endo Finisher with the experimental solutions resulted in the greatest tissue weight loss compared to the other activation protocols (P < 0.001). There was no significant difference between NaOCl and NaOCl + HEBP in terms of tissue removal. CONCLUSION The use of a NaOCl + HEBP mixture activated with XP-endo Finisher was an effective irrigation regimen for removing simulated organic tissues from artificial internal root resorption cavities in the straight root canals of single-rooted teeth.
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Affiliation(s)
- Ö I Ulusoy
- Department of Endodontics, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - I G Savur
- Department of Endodontics, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - T Alaçam
- Department of Endodontics, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - B Çelik
- Department of Statistics, Faculty of Science, Gazi University, Ankara, Turkey
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Patil PH, Gulve MN, Kolhe SJ, Samuel RM, Aher GB. Efficacy of new irrigating solution on smear layer removal in apical third of root canal: A scanning electron microscope study. J Conserv Dent 2018; 21:190-193. [PMID: 29674823 PMCID: PMC5890411 DOI: 10.4103/jcd.jcd_155_17] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Aims The aim of this in vitro study is to evaluate and compare the smear layer removal efficacy of etidronic acid-based irrigating solution with others in the apical third of the root canal. Materials and Methods Forty human single-rooted mandibular premolar teeth were taken and decoronated to standardize the canal length. After biomechanical preparation, teeth were randomly divided into four groups (n = 10) and the final irrigation was carried out with tested irrigants. Group I: normal saline (negative control); Group II: 5.25% sodium hypochlorite (NaOCl) with surfactant and 17% ethylenediaminetetraacetic acid (EDTA) with surfactant; Group III: freshly mixed BioPure MTAD; and Group IV: freshly mixed Chloroquick solution. The teeth were split into two halves and observed under a scanning electron microscope to analyze the amount of smear layer present. Statistical Analysis Data were analyzed using the Kruskal-Wallis test and Mann-Whitney test. Results Group II (5.25% NaOCl with surfactant followed by 17% EDTA with surfactant) showed least smear layer scores (1.1 ± 0.3162). This was followed by Group III (MTAD) (2.2 ± 0.4216) and then Group IV (Chloroquick) (2.4 ± 0.5164). Conclusion Sequential use of 5.25% NaOCl with surfactant and 17% EDTA with surfactant was found to be the most efficient than MTAD and Chloroquick in the removal of smear layer in the apical third of root canal.
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Affiliation(s)
- Priyanka Himmatrao Patil
- Department of Conservative Dentistry and Endodontics, M. G. V's KBH Dental College and Hospital, Nashik, Maharashtra, India
| | - Meenal Nitin Gulve
- Department of Conservative Dentistry and Endodontics, M. G. V's KBH Dental College and Hospital, Nashik, Maharashtra, India
| | - Swapnil Janardan Kolhe
- Department of Conservative Dentistry and Endodontics, M. G. V's KBH Dental College and Hospital, Nashik, Maharashtra, India
| | - Roshan Mathew Samuel
- Department of Conservative Dentistry and Endodontics, M. G. V's KBH Dental College and Hospital, Nashik, Maharashtra, India
| | - Gayatri Balasaheb Aher
- Department of Conservative Dentistry and Endodontics, M. G. V's KBH Dental College and Hospital, Nashik, Maharashtra, India
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Solana C, Ruiz-Linares M, Baca P, Valderrama MJ, Arias-Moliz MT, Ferrer-Luque CM. Antibiofilm Activity of Sodium Hypochlorite and Alkaline Tetrasodium EDTA Solutions. J Endod 2017; 43:2093-2096. [DOI: 10.1016/j.joen.2017.06.038] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Revised: 06/28/2017] [Accepted: 06/29/2017] [Indexed: 12/17/2022]
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Holland R, Gomes JE, Cintra LTA, Queiroz ÍODA, Estrela C. Factors affecting the periapical healing process of endodontically treated teeth. J Appl Oral Sci 2017; 25:465-476. [PMID: 29069143 PMCID: PMC5804382 DOI: 10.1590/1678-7757-2016-0464] [Citation(s) in RCA: 88] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 03/11/2017] [Indexed: 12/20/2022] Open
Abstract
Tissue repair is an essential process that reestablishes tissue integrity and regular function. Nevertheless, different therapeutic factors and clinical conditions may interfere in this process of periapical healing. This review aims to discuss the important therapeutic factors associated with the clinical protocol used during root canal treatment and to highlight the systemic conditions associated with the periapical healing process of endodontically treated teeth. The antibacterial strategies indicated in the conventional treatment of an inflamed and infected pulp and the modulation of the host's immune response may assist in tissue repair, if wound healing has been hindered by infection. Systemic conditions, such as diabetes mellitus and hypertension, can also inhibit wound healing. The success of root canal treatment is affected by the correct choice of clinical protocol. These factors are dependent on the sanitization process (instrumentation, irrigant solution, irrigating strategies, and intracanal dressing), the apical limit of the root canal preparation and obturation, and the quality of the sealer. The challenges affecting the healing process of endodontically treated teeth include control of the inflammation of pulp or infectious processes and simultaneous neutralization of unpredictable provocations to the periapical tissue. Along with these factors, one must understand the local and general clinical conditions (systemic health of the patient) that affect the outcome of root canal treatment prediction.
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Affiliation(s)
- Roberto Holland
- Universidade Estadual Paulista, Faculdade de Odontologia de Araçatuba, Departamento de Odontologia Restauradora, Araçatuba, SP, Brasil
| | - João Eduardo Gomes
- Universidade Estadual Paulista, Faculdade de Odontologia de Araçatuba, Departamento de Odontologia Restauradora, Araçatuba, SP, Brasil
| | - Luciano Tavares Angelo Cintra
- Universidade Estadual Paulista, Faculdade de Odontologia de Araçatuba, Departamento de Odontologia Restauradora, Araçatuba, SP, Brasil
| | - Índia Olinta de Azevedo Queiroz
- Universidade Estadual Paulista, Faculdade de Odontologia de Araçatuba, Departamento de Odontologia Restauradora, Araçatuba, SP, Brasil
| | - Carlos Estrela
- Universidade Federal de Goiás, Faculdade de Odontologia, Departamento de Ciências Estomatológicas, Goiânia, GO, Brasil
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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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Guneser MB, Akbulut MB, Eldeniz AU. Antibacterial effect of chlorhexidine-cetrimide combination, Salvia officinalis plant extract and octenidine in comparison with conventional endodontic irrigants. Dent Mater J 2017; 35:736-741. [PMID: 27725511 DOI: 10.4012/dmj.2015-159] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The aim of the present study was to compare the antimicrobial effect of sodium hypochlorite (NaOCl), 2% chlorhexidine (CHX), a CHX/cetrimide solution (CHX+CTR), octenidine hydrochloride (OCT) and Salvia officinalis plant extract against Enterococcus faecalis. Seventy decoronated single-rooted human teeth were infected and divided into 6 test (n=10) and 2 control groups (n=5) (negative, sterile samples and positive, infected samples). Following irrigants were then applied to test groups: 2.5% NaOCl, 5.25% NaOCl, CHX, CHX+CTR, S. officinalis extract and OCT. The dentin chips were obtained from inner root canal walls and analyzed by counting the number of colony forming units (CFU). The 2.5% NaOCl, 5.25% NaOCl, CHX and OCT groups presented no bacterial growth (CFU=0). S. officinalis and CHX+CTR groups reduced the number of E. faecalis cells but could not eliminate all. OCT may have potential as an endodontic irrigant in treatment of infected root canals.
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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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Biel P, Mohn D, Attin T, Zehnder M. Interactions between the Tetrasodium Salts of EDTA and 1-Hydroxyethane 1,1-Diphosphonic Acid with Sodium Hypochlorite Irrigants. J Endod 2017; 43:657-661. [DOI: 10.1016/j.joen.2016.12.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 11/23/2016] [Accepted: 12/01/2016] [Indexed: 10/19/2022]
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Tartari T, Bachmann L, Maliza AGA, Andrade FB, Duarte MAH, Bramante CM. Tissue dissolution and modifications in dentin composition by different sodium hypochlorite concentrations. J Appl Oral Sci 2016; 24:291-8. [PMID: 27383711 PMCID: PMC5022212 DOI: 10.1590/1678-775720150524] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Accepted: 02/15/2016] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES To determine the organic matter dissolution and changes in dentin chemical composition promoted by different concentrations of NaOCl over time. MATERIAL AND METHODS Fragments of bovine muscle tissue were weighed before and after 5, 10, and 15 min of immersion in the groups (n=10): G1- 0.9% saline solution; G2- 1% NaOCl; G3- 2.5% NaOCl; and G4- 5% NaOCl. Bovine dentin fragments were subjected to the same irrigants and absorption spectra were collected by Attenuated Total Reflectance of Fourier Transform Infrared Spectroscopy (ATR-FTIR) before and after 0,5, 1, 2, 3, 5, 8, and 10 min of immersion in the solutions. The ratios of the amide III/phosphate and carbonate/phosphate absorption bands were determined. The tissue dissolution and carbonate/phosphate ratios were submitted to the two-way analysis of variance (ANOVA) with Tukey's multiple-comparison test (α<0.05) and to the one-way analysis of variance with Tukey's (α<0.05). The amide III/phosphate ratio was analyzed by Friedman test (α<0.05) and the Kruskal-Wallis test with Dunn's post-hoc (α<0.05). RESULTS The increase in NaOCl concentration and contact time intensified the dissolution of organic matter and dentin collagen with reduction in the amide III/phosphate ratio. Significant differences between all groups (p<0.05) were observed in the dissolution of organic matter at 10 min and in the amide III/phosphate ratio between the saline solution and 5% NaOCl at 5 min. The carbonate/phosphate ratio decreased significantly in G2, G3, and G4 after 0,5 min of immersion (p<0.05), but more alterations did not occur in the subsequent periods (p>0.05). Intergroup differences were not observed in this ratio (p>0.05). CONCLUSIONS The increase in the exposure time and in the concentration of NaOCl solution lead to an increase in the tissue dissolution and dentin collagen deproteination. Furthermore, some carbonate ions are removed from the dentin inorganic phase by the NaOCl.
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Affiliation(s)
- Talita Tartari
- - Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Dentística, Endodontia e Materiais Odontológicos, Bauru, SP, Brasil
| | - Luciano Bachmann
- - Universidade de São Paulo, Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Departamento de Física, Ribeirão Preto, SP, Brasil
| | - Amanda Garcia Alves Maliza
- - Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Dentística, Endodontia e Materiais Odontológicos, Bauru, SP, Brasil
| | - Flaviana Bombarda Andrade
- - Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Dentística, Endodontia e Materiais Odontológicos, Bauru, SP, Brasil
| | - Marco Antonio Hungaro Duarte
- - Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Dentística, Endodontia e Materiais Odontológicos, Bauru, SP, Brasil
| | - Clovis Monteiro Bramante
- - Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Dentística, Endodontia e Materiais Odontológicos, Bauru, SP, Brasil
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Morago A, Ordinola-Zapata R, Ferrer-Luque CM, Baca P, Ruiz-Linares M, Arias-Moliz MT. Influence of Smear Layer on the Antimicrobial Activity of a Sodium Hypochlorite/Etidronic Acid Irrigating Solution in Infected Dentin. J Endod 2016; 42:1647-1650. [DOI: 10.1016/j.joen.2016.07.023] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Revised: 07/29/2016] [Accepted: 07/29/2016] [Indexed: 10/21/2022]
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Arias-Moliz MT, Morago A, Ordinola-Zapata R, Ferrer-Luque CM, Ruiz-Linares M, Baca P. Effects of Dentin Debris on the Antimicrobial Properties of Sodium Hypochlorite and Etidronic Acid. J Endod 2016; 42:771-5. [PMID: 26951957 DOI: 10.1016/j.joen.2016.01.021] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2015] [Revised: 12/28/2015] [Accepted: 01/11/2016] [Indexed: 10/22/2022]
Abstract
INTRODUCTION The purpose of this study was to determine the influence of dentin powder on the concentration, pH, and antimicrobial activity of sodium hypochlorite (NaOCl) alone and combined with etidronic acid (HEBP). METHODS Biofilms of Enterococcus faecalis were grown on the surface of dentin blocks for 5 days and then exposed to 1% and 2.5% NaOCl alone or combined with 9% HEBP for 3 minutes in the absence and presence of dentin powder. The biovolumes of the biofilm were measured using confocal microscopy and the live/dead technique. The available chlorine and pH of the solutions were also measured. Nonparametric tests were used to determine statistical differences (P < .05). RESULTS The presence of dentin powder resulted in a reduction of the free available chlorine and pH in all the irrigating solutions; 1% NaOCl lost its antimicrobial activity completely in the presence of dentin powder. The antimicrobial activity was significantly reduced in the 2.5% NaOCl and 1% NaOCl/HEBP groups, and it was not affected in the 2.5% NaOCl/HEBP group. CONCLUSIONS The presence of dentin powder significantly decreased the available chlorine and antimicrobial activity of 1% NaOCl, 2.5% NaOCl, and 1% NaOCl/HEBP irrigating solutions. The antimicrobial activity of 2.5% NaOCl/HEBP was not affected by the dentin powder after a 3-minute contact time against E. faecalis biofilms.
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Affiliation(s)
| | - Ana Morago
- Department of Microbiology, School of Dentistry, University of Granada, Spain
| | - Ronald Ordinola-Zapata
- Department of Endodontics, Bauru Dental School, University of São Paulo, São Paulo, Brazil
| | | | | | - Pilar Baca
- Department of Stomatology, School of Dentistry, University of Granada, Spain
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