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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] [MESH Headings] [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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Kottathil H, Zehnder M, Gubler A, Attin T, Narkedamalli R, Ballal NV. Compatibility of Dual Rinse HEDP with Sodium Hypochlorite Solutions Containing Proprietary Additives. J Endod 2024:S0099-2399(24)00402-3. [PMID: 39033801 DOI: 10.1016/j.joen.2024.07.007] [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: 04/05/2024] [Revised: 06/18/2024] [Accepted: 07/09/2024] [Indexed: 07/23/2024]
Abstract
INTRODUCTION A salt of 1-hydroxyethylidene-1,1-diphosphonic acid was commercialized some years ago. This so-called Dual Rinse HEDP has been tested for its combined actions and interactions with pure NaOCl solutions. The aim of this study was to assess Dual Rinse interactions with NaOCl solutions containing proprietary additives. METHODS Designated endodontic NaOCl solutions that come at 2 different strengths (2% and 5.25%), and without or with additives (Chloraxid and Chloraxid Extra, respectively) were tested. Some of their key chemical and physical properties were determined in the presence or absence of HEDP (9%) in the solution. In addition, soft tissue dissolution efficacy of test and control solutions was assessed in extracted teeth (n = 10 per group, 90 teeth in total). RESULTS The NaOCl content in the 2% Chloraxid solutions was slightly above, that in the 5.25% solutions below the labelled concentration. The additives in the Chloraxid Extra solutions neither altered their surface tension, nor their viscosity. The addition of HEDP to any of the tested NaOCl solutions reduced their pH, and increased their surface tension and viscosity. HEDP-induced available chlorine loss over the first hour was similar between all NaOCl solutions. Soft tissue dissolution in the root canals was affected by NaOCl concentration, but neither by any proprietary NaOCl additive in the Chloraxid solutions, nor the addition of Dual Rinse HEDP. CONCLUSIONS Proprietary additives had no influence on any of the tested parameters, including surface tension of the "Extra" solutions. The increased viscosity of combined NaOCl/HEDP solutions deserves further attention.
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Affiliation(s)
- H Kottathil
- Clinic of Conservative and Preventive Dentistry, University of Zurich, Zurich, Switzerland
| | - M Zehnder
- Clinic of Conservative and Preventive Dentistry, University of Zurich, Zurich, Switzerland.
| | - A Gubler
- Clinic of Conservative and Preventive Dentistry, University of Zurich, Zurich, Switzerland
| | - T Attin
- Clinic of Conservative and Preventive Dentistry, University of Zurich, Zurich, Switzerland
| | - R Narkedamalli
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - N V Ballal
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Ozel B, Ayhan T, Kaptan F, Sahin F, Karapınar-Kazandağ M. Dual- or single rinse? The tubular sealer penetration of endodontic chelating agents. PLoS One 2024; 19:e0303377. [PMID: 38875249 PMCID: PMC11178202 DOI: 10.1371/journal.pone.0303377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 04/23/2024] [Indexed: 06/16/2024] Open
Abstract
INTRODUCTION In this study, we aimed to compare the effectiveness of various chelating agents, ethilenediaminetetraacetic acid (EDTA), citric acid (CA), and etidronic acid (HEDP) mixed in two different forms, in removing the smear layer and promoting the penetration of an endodontic sealer into the dentinal tubules of extracted single-rooted teeth. METHODS The study used 75 teeth divided into five groups: 17% EDTA, 10% CA, 9% HEDP + NaOCl, 9% HEDP + distilled water (DW), and a control (DW) group. Scanning electron microscopy was used to assess smear layer removal and confocal laser microscopy was used to evaluate tubular sealer penetration at different depths from the apical tip. RESULTS Sealer penetration was highest with 17% EDTA and 10% CA as compared with the other agents (p<0.001). At the cervical third, the sealer penetration for EDTA, HEDP + NaOCl, and HEDP + DW groups were significantly different than those in DW (p = 0.020). For the middle third, EDTA, CA, and HEDP + NaOCl groups were significantly higher than those of the DW group (p<0.001). Cervical-level values were significantly higher than apical-level values for HEDP + NaOCl, HEDP + DW, and DW (p<0.001). Smear layer removal was lower with 9% HEDP + DW than with 17% EDTA and 10% CA at all depths (p<0.001). A significancy in smear layer removal was observed between 10% CA and control (p = 0.015) in middle depth. CONCLUSION Within the limitations of this study, highest values were seen in EDTA and CA in terms of sealer penetration and smear layer removal. In the light of these findings, the use of strong chelating agents highlights better clinical efficiency than dual-rinse or single HEDP irrigation.
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Affiliation(s)
- Beliz Ozel
- Department of Endodontics, Yeditepe University Faculty of Dentistry, Yeditepe University, Istanbul, Turkey
| | - Tuba Ayhan
- Department of Endodontics, Yeditepe University Faculty of Dentistry, Yeditepe University, Istanbul, Turkey
| | - Figen Kaptan
- Department of Endodontics, Yeditepe University Faculty of Dentistry, Yeditepe University, Istanbul, Turkey
| | - Fikrettin Sahin
- Department of Genetics and Bioengineering, Faculty of Engineering, Yeditepe University, Istanbul, Turkey
| | - Meriç Karapınar-Kazandağ
- Department of Endodontics, Yeditepe University Faculty of Dentistry, Yeditepe University, Istanbul, Turkey
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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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Awati AS, Dhaded NS, Mokal S, Doddwad PK. Analysis of the depth of penetration of an epoxy resin-based sealer following a final rinse of irrigants and use of activation systems: An in vitro study. JOURNAL OF CONSERVATIVE DENTISTRY AND ENDODONTICS 2024; 27:87-94. [PMID: 38389742 PMCID: PMC10880483 DOI: 10.4103/jcde.jcde_221_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: 10/12/2023] [Revised: 11/02/2023] [Accepted: 11/06/2023] [Indexed: 02/24/2024]
Abstract
Objective The objective of the study was to compare and evaluate the depth of penetration of an epoxy resin-based sealer following a final rinse of 17% ethylenediaminetetraacetic acid (EDTA) and 18% 1-hydroxyethylidene 1, 1-diphosphonate (HEDP), with diode laser and passive ultrasonic activation (PUI): an in vitro confocal laser scanning microscopy study. Materials and Methods Fifty-two extracted human mandibular premolar teeth with single root and single canal were selected. They were disinfected in 0.1% thymol solution, cleaned of calculus and soft tissues, and stored in 0.1% thymol solution till use. All teeth were radiographed and selected as per the inclusion and exclusion criteria. The teeth were decoronated using a diamond disk under copious water spray to acquire a standardized root length of 14 mm. Working length was established by inserting a size 10-K file into each root canal until it is visible at the apical foramen and by subtracting 1 mm from the recorded length. Instrumentation of the root canal was done till master apical file size of F3 using ProTaper universal, rotary instruments. The canals were irrigated with 2 mL of 3% sodium hypochlorite between successive files. Teeth were randomly divided into four subgroups n = 12 according to the intervention. Passive ultrasonic irrigation and diode laser were used to activate the irrigants. Final irrigation was performed with distilled water. These specimens were examined using confocal laser scanning microscope (OLYMPUS FLUOVIEW FV 3000) for dentinal tubule penetration of the sealer. Two-way ANOVA test and Tukey's multiple post hoc test were used for statistical analysis. Results Highly significant difference was seen between the groups with EDTA and HEDP, with HEDP demonstrating the highest penetration. Among the activation techniques used in this study, PUI showed the highest penetration of the sealer. The least penetration was seen with diode laser activation and EDTA. Conclusions The irrigation activation techniques significantly influence the penetration of sealer into root dentinal tubules. When penetration of sealer with different irrigation techniques and irrigants was evaluated, significant greater level of sealer penetration was attained with PUI activation of HEDP.
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Affiliation(s)
- Aishwarya Sanjay Awati
- Department of Conservative Dentistry and Endodontics, KLE VK Institute of Dental Sciences, Belagavi, Karnataka, India
| | - Neha S. Dhaded
- Department of Conservative Dentistry and Endodontics, KLE VK Institute of Dental Sciences, Belagavi, Karnataka, India
| | - Siddhesh Mokal
- Department of Conservative Dentistry and Endodontics, KLE VK Institute of Dental Sciences, Belagavi, Karnataka, India
| | - Preeti Kore Doddwad
- Department of Conservative Dentistry and Endodontics, KLE VK Institute of Dental Sciences, Belagavi, Karnataka, India
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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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Zarean P, Göllner M, Zarean P, Neuhaus KW. 2D and 3D Erosion Landscape Analysis of Endodontic-Treated Teeth Using EDTA and HEDP as Chelating Agents: A High-Resolution Micro-Computed Tomographic Study. Dent J (Basel) 2023; 11:286. [PMID: 38132424 PMCID: PMC10742433 DOI: 10.3390/dj11120286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 11/28/2023] [Accepted: 12/07/2023] [Indexed: 12/23/2023] Open
Abstract
This study aimed to assess the amount of erosion during activated endodontic irrigation with either HEDP or EDTA via high-resolution micro-computed tomography. Two root canals of twenty premolars were prepared with ProTaper Next and irrigated with sodium hypochlorite. Palatal canals, which served as control groups, were sealed, while buccal canals were further irrigated with either EDTA (n = 10) or HEDP (n = 10), which served as test groups. Micro-CT was performed to measure erosion depth. For 2D and 3D measurements, non-parametric repeated ANOVA measurements and post hoc tests were performed. 2D analysis showed highly significant differences between the case groups at each position of the root (p ≤ 0.01). The cervical and apical positions showed significant differences in the EDTA group (p = 0.03). The 3D analysis also showed significant differences between both chelating agents (p < 0.01) and the case and control groups (p = 0.01). The mean erosion depths in the cervical, middle, and apical thirds of the EDTA group were 45.75, 41.79, and 32.25 µm, and for the HEDP group were 20.25, 16.40, and 15.96 µm, respectively. HEDP seems to have a significantly less erosive effect. Different irrigation protocols with harsher conditions, as might be the case during endodontic retreatment, could be assessed with micro-CT.
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Affiliation(s)
- Parichehr Zarean
- Department of General Pediatric and Adolescent Dentistry, University Center for Dental Medicine Basel UZB, University of Basel, Mattenstrasse 40, 4058 Basel, Switzerland; (P.Z.); (P.Z.)
| | - Michael Göllner
- F. Hoffmann-La Roche Ltd., Grenzacherstrasse 124, 4070 Basel, Switzerland;
| | - Paridokht Zarean
- Department of General Pediatric and Adolescent Dentistry, University Center for Dental Medicine Basel UZB, University of Basel, Mattenstrasse 40, 4058 Basel, Switzerland; (P.Z.); (P.Z.)
| | - Klaus W. Neuhaus
- Department of General Pediatric and Adolescent Dentistry, University Center for Dental Medicine Basel UZB, University of Basel, Mattenstrasse 40, 4058 Basel, Switzerland; (P.Z.); (P.Z.)
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010 Bern, Switzerland
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Hassan R, Roshdy NN. Effect of continuous chelation on the dentinal tubule penetration of a calcium silicate-based root canal sealer: a confocal laser microscopy study. BMC Oral Health 2023; 23:377. [PMID: 37296374 PMCID: PMC10257323 DOI: 10.1186/s12903-023-02995-z] [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: 02/23/2023] [Accepted: 04/27/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND This study aimed to evaluate the effect of various irrigation protocols on the penetration depth of a calcium silicate-based sealer into dentinal tubules using confocal laser scanning microscopy (CLSM). METHODS Twenty single-rooted mandibular premolars were endodontically prepared and divided into the following two groups according to the irrigation protocol used (n = 10): Group I: NaOCl + EDTA and Group II: continuous chelation (NaOCl/Dual Rinse). Obturation was performed with the warm vertical compaction technique using TotalFill HiFlow bioceramic sealer mixed with a fluorophore dye. Samples were observed using CLSM at 10× to measure the percentage of sealer penetration and its maximum depth into the dentinal tubules. Data were analysed using one-way ANOVA followed by Tukey's post-hoc test. The significance level was set at p < 0.05 within all tests. RESULTS Comparing the overall results of all sections tested, no statistically significant differences existed between the groups regarding the percentage of sealer penetration (p = 0.612) and maximum depth of penetration (p > 0.05). CONCLUSIONS With both types of irrigation used, dentinal tubule penetration was higher in the coronal section than in the apical section. Continuous chelation using NaOCl/Dual Rinse HEDP performed better in the coronal segments, while irrigation using NaOCl + EDTA promoted a higher percentage of sealer penetration in the apical segment.
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Affiliation(s)
- Reham Hassan
- Egyptian Russian University, Badr city, Egypt.
- Faculty of Dentistry, Minia University, Minia, Egypt.
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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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Gawdat SI, Bedier MM. Influence of dual rinse irrigation on dentinal penetration of a bioceramic root canal sealer: A Conofocal microscopic Analysis. AUST ENDOD J 2022; 48:481-486. [PMID: 34919319 DOI: 10.1111/aej.12599] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 10/14/2021] [Accepted: 12/05/2021] [Indexed: 12/14/2022]
Abstract
To evaluate the sealer penetration after applying dual rinse irrigant in comparison with sodium hypochlorite and 17% EDTA. Mandibular premolars were prepared by ProTaper Next and irrigated with NaOCl, NaOCl/Dual Rinse or NaOCl/EDTA and then obturated with a single-cone technique and bioceramic-based. Samples were observed using confocal laser microscopy, and the maximum depth of penetration was measured, as well as the percentage of sealer coating the canal wall and the penetration area of the sealer. One-way anova was used, followed by Tukey post hoc test. Sealer penetration area displayed a statistically significant difference between the tested groups (P < 0.05), and the highest percentage of sealer coating the canal wall and the greatest depth of sealer penetration were found in Group (NaOCl/Dual Rinse). Group (NaOCl/Dual Rinse) displayed better sealer penetration inside the dentinal tubules than Group (NaOCl/EDTA), while Group (NaOCl) showed the lowest sealer penetration.
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Enhancing the intracanal antibacterial effects of sodium hypochlorite with etidronic acid or citric acid. J Endod 2022; 48:1161-1168. [PMID: 35750221 DOI: 10.1016/j.joen.2022.06.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 06/10/2022] [Accepted: 06/11/2022] [Indexed: 11/20/2022]
Abstract
INTRODUCTION This study evaluated the bacterial reduction promoted by root canal preparation using irrigation with sodium hypochlorite (NaOCl) alone, associated with etidronic acid (HEDP) or alternated with citric acid, and after a supplementary agitation step. METHODS Extracted mandibular premolars were selected and distributed into 3 groups based on anatomically paired micro-computed tomographic analyses. The canals were contaminated with Enterococcus faecalis for 30 days and then subjected to chemomechanical preparation with a reciprocating instrument under irrigation with NaOCl alone, mixed with HEDP (NaOCl/HEDP), or alternated with citric acid (NaOCl/CA). A supplementary agitation step with the XP-endo Finisher was performed in all groups. Intracanal bacteriological samples were taken before (S1) and after preparation (S2), and after the supplementary approach (S3). DNA was extracted from the samples and subjected to quantitative real-time polymerase chain reaction. RESULTS Intragroup analyses revealed a substantial bacterial reduction from S1 to S2 or S3 in all groups (p<0.01). The supplementary agitation resulted in S2-to-S3 bacterial reduction of 6%, 68%, and 80% in the NaOCl, NaOCl/HEDP, and NaOCl/CA groups, respectively. Irrigation with NaOCl alone resulted in 53% and 47% of samples negative for bacteria in S2 and S3, respectively. Corresponding figures for NaOCl/HEDP were 75% and 85%, and 44% and 72% for NaOCl/CA. Intergroup analyses of S2 samples showed that NaOCl/HEDP was significantly more effective than the other two in reducing the bacterial levels (p<0.05). After the supplementary approach, both NaOCl/HEDP and NaOCl/CA were significantly more effective than NaOCl alone (p<0.05), with no significant differences between them (p>0.05). CONCLUSION Both the freshly combined NaOCl/HEDP solution and the alternate use of NaOCl and citric acid followed by XP-endo Finisher agitation resulted in significantly higher intracanal bacterial reduction than NaOCl alone.
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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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Wong J, Manoil D, Näsman P, Belibasakis GN, Neelakantan P. Microbiological Aspects of Root Canal Infections and Disinfection Strategies: An Update Review on the Current Knowledge and Challenges. FRONTIERS IN ORAL HEALTH 2022; 2:672887. [PMID: 35048015 PMCID: PMC8757850 DOI: 10.3389/froh.2021.672887] [Citation(s) in RCA: 63] [Impact Index Per Article: 31.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 05/17/2021] [Indexed: 02/06/2023] Open
Abstract
The oral cavity is the habitat of several hundreds of microbial taxa that have evolved to coexist in multispecies communities in this unique ecosystem. By contrast, the internal tissue of the tooth, i.e., the dental pulp, is a physiologically sterile connective tissue in which any microbial invasion is a pathological sign. It results in inflammation of the pulp tissue and eventually to pulp death and spread of inflammation/infection to the periradicular tissues. Over the past few decades, substantial emphasis has been placed on understanding the pathobiology of root canal infections, including the microbial composition, biofilm biology and host responses to infections. To develop clinically effective treatment regimens as well as preventive therapies, such extensive understanding is necessary. Rather surprisingly, despite the definitive realization that root canal infections are biofilm mediated, clinical strategies have been focused more on preparing canals to radiographically impeccable levels, while much is left desired on the debridement of these complex root canal systems. Hence, solely focusing on "canal shaping" largely misses the point of endodontic treatment as the current understanding of the microbial aetiopathogenesis of apical periodontitis calls for the emphasis to be placed on "canal cleaning" and chemo-mechanical disinfection. In this review, we dissect in great detail, the current knowledge on the root canal microbiome, both in terms of its composition and functional characteristics. We also describe the challenges in root canal disinfection and the novel strategies that attempt to address this challenge. Finally, we provide some critical pointers for areas of future research, which will serve as an important area for consideration in Frontiers in Oral Health.
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Affiliation(s)
- Jasmine Wong
- Discipline of Endodontology, Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - Daniel Manoil
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institute, Huddinge, Sweden
| | - Peggy Näsman
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institute, Huddinge, Sweden
| | - Georgios N Belibasakis
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institute, Huddinge, Sweden
| | - Prasanna Neelakantan
- Discipline of Endodontology, Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
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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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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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Ballal NV, Ivica A, Meneses P, Narkedamalli RK, Attin T, Zehnder M. Influence of 1-Hydroxyethylidene-1,1-Diphosphonic Acid on the Soft Tissue-Dissolving and Gelatinolytic Effect of Ultrasonically Activated Sodium Hypochlorite in Simulated Endodontic Environments. MATERIALS (BASEL, SWITZERLAND) 2021; 14:2531. [PMID: 34068094 PMCID: PMC8152752 DOI: 10.3390/ma14102531] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 05/11/2021] [Accepted: 05/12/2021] [Indexed: 11/24/2022]
Abstract
The addition of Dual Rinse HEDP, an etidronate powder, to a sodium hypochlorite (NaOCl) solution can create a combined single endodontic irrigant with a soft tissue-dissolving and a decalcifying effect, which can replace traditional alternating irrigation with chemically non-compatible solutions. While the short-term compatibility between NaOCl and 1-hydroxyethylidene-1,1-diphosphonic acid (HEDP) has been shown, it remains unclear whether ultrasonic activation of a combined NaOCl & HEDP solution immediately reduces the available chlorine and/or renders the NaOCl ineffective in dissolving organic tissue remnants. This was tested in three experiments: (1) direct activation in test tubes in an ultrasonic bath and then the activation by an ultrasonically oscillating tip (IrriSafe) in (2) an epoxy resin model containing a simulated isthmus filled with gelatin, and (3) extracted teeth with simulated resorption cavities filled with soft tissue. The control solutions were physiological saline and 2.5% NaOCl without HEDP. In (1), available chlorine after 30 s of ultrasonic activation (37 kHz) of test and control solution was assessed, as well as shrimp tissue weight loss in direct exposure. In (2) and (3), the ultrasonic tip was driven at 1/3 of full power using the respective unit, and areas of removed gelatin from the isthmus and tissue weight loss were used as the outcomes, respectively. Experiment (1) revealed no negative impact by HEDP on available chlorine (1), while all three experiments showed a highly significant (p > 0.001) synergistic effect, which was not hampered by HEDP, between NaOCl and ultrasonic activation regarding tissue weight loss (1, 3) and dissolution of gelatin (2).
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Affiliation(s)
- Nidambur Vasudev Ballal
- Department of Conservative Dentistry and Endodontics, Manipal Academy of Higher Education, Manipal College of Dental Sciences, Manipal, Karnataka 576104, India; (N.V.B.); (R.K.N.)
| | - Anja Ivica
- Clinic of Conservative and Preventive Dentistry, University of Zurich, 8032 Zurich, Switzerland; (A.I.); (P.M.); (T.A.)
| | - Pamela Meneses
- Clinic of Conservative and Preventive Dentistry, University of Zurich, 8032 Zurich, Switzerland; (A.I.); (P.M.); (T.A.)
| | - Raj Kumar Narkedamalli
- Department of Conservative Dentistry and Endodontics, Manipal Academy of Higher Education, Manipal College of Dental Sciences, Manipal, Karnataka 576104, India; (N.V.B.); (R.K.N.)
| | - Thomas Attin
- Clinic of Conservative and Preventive Dentistry, University of Zurich, 8032 Zurich, Switzerland; (A.I.); (P.M.); (T.A.)
| | - Matthias Zehnder
- Clinic of Conservative and Preventive Dentistry, University of Zurich, 8032 Zurich, Switzerland; (A.I.); (P.M.); (T.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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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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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, Scott S, Shetty S, Kahler B, Walsh LJ. Resistance to compressive force in continuous chelation. AUST ENDOD J 2020; 47:150-156. [PMID: 32902070 DOI: 10.1111/aej.12440] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 07/13/2020] [Accepted: 08/07/2020] [Indexed: 11/28/2022]
Abstract
Continuous chelation involves the simultaneous use of sodium hypochlorite and a chelating agent. Given the combination of a proteolytic agent and a demineralising chelator, this study aimed to investigate whether mixtures containing the weak chelators etidronate or clodronate and sodium hypochlorite could adversely affect the mechanical strength of teeth compared to the sequence sodium hypochlorite/EDTA/sodium hypochlorite. Matching pairs of bovine teeth were tested on a universal testing machine, and the compressive load at fracture was recorded. One root from each pair was prepared with the sequence, and the matching tooth was prepared with either water, the clodronate mixture or the etidronate mixture. No differences in load at fracture were seen between either mixture and the sequence. However, loads were higher in the teeth irrigated with water compared to the sequence. The results indicated that the continuous chelation mixtures did not alter tooth mechanical properties compared to the standard sequence.
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Affiliation(s)
- Patricia P Wright
- School of Dentistry, University of Queensland, Herston, QLD, Australia
| | - Suzanne Scott
- Australian e-Health Research Centre, CSIRO, North Ryde, NSW, Australia
| | - Sowmya Shetty
- School of Dentistry, University of Queensland, Herston, QLD, Australia
| | - Bill Kahler
- School of Dentistry, University of Queensland, Herston, QLD, Australia
| | - Laurence J Walsh
- School of Dentistry, University of Queensland, Herston, QLD, Australia
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Erİk CE, Kaya BÜ, Maden M, Orhan EO. Influence of sodium hypochlorite/etidronic acid combination and SmearOFF on push-out bond strength of fiber posts to root dentin. Dent Mater J 2020; 39:554-562. [PMID: 32161238 DOI: 10.4012/dmj.2019-055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The aim was to evaluate the effects of different irrigation protocols on the bonding ability of fiber posts on root canal dentin through push-out test and the dentin tubule penetration of luting cement by confocal laser scanning microscope (CLSM). Forty-eight single-rooted premolars were divided into six groups (n=8) based on post space irrigation protocols: Saline 0.85%; Etidronate 18% (HEBP); EDTA 17%; NaOCl 5.25%+EDTA 17%; NaOCl 2.5%/HEBP 9% combination; SmearOFF. Two specimens per group were assessed with CLSM. The push-out test and the failure analysis were performed. Whilst EDTA had the highest bond strength at the coronal and middle thirds, it was not statistically significant compared to saline, HEBP, and NaOCl/HEBP at the middle third (p>0.05). Cement/dentin adhesive failures were predominant (41.9%) and the intratubular fluorescence intensity was significant among the groups (p<0.05). EDTA resulted in highest bond strength values and dentinal penetration.
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Affiliation(s)
- Cevat Emre Erİk
- Department of Endodontics, Faculty of Dentistry, Suleyman Demirel University
| | - Bulem Üreyen Kaya
- Department of Endodontics, Faculty of Dentistry, Suleyman Demirel University
| | - Murat Maden
- Department of Endodontics, Faculty of Dentistry, Suleyman Demirel University
| | - Ekim Onur Orhan
- Department of Endodontics, Faculty of Dentistry, Osmangazi University
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Cleanliness and erosion of root canal walls after irrigation with a new HEDP-based solution vs. traditional sodium hypochlorite followed by EDTA. A scanning electron microscope study. Clin Oral Investig 2020; 24:3699-3706. [DOI: 10.1007/s00784-020-03249-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 02/19/2020] [Indexed: 10/24/2022]
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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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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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Ballal NV, Ulusoy Öİ, Rao S, Gandhi P. The efficacy of different irrigation protocols in removing tricalcium silicate-based sealers from simulated root canal irregularities. Microsc Res Tech 2019; 82:1862-1868. [PMID: 31368166 DOI: 10.1002/jemt.23353] [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: 03/18/2019] [Revised: 05/11/2019] [Accepted: 07/16/2019] [Indexed: 11/10/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the efficacy of different irrigation protocols in removing two tricalcium silicate-based sealers from simulated root canal irregularities and root canal walls. MATERIAL AND METHODS Root canals of 140 single-rooted teeth were instrumented. In one-half of each root, an apical groove was created. The samples were divided into two main groups (n = 70) based on the sealer used. In group 1, the grooves were filled with MTA Fillapex; in group 2, BioRoot RCS. The reassembled root halves were divided into six experimental and one control groups: 2.5% NaOCl-17% EDTA (Passive ultrasonic irrigation [PUI]), 5% NaOCl/9% DualRinse HEDP (PUI), 2.5% NaOCl-7% Maleic acid (PUI), 2.5% NaOCl-17% EDTA (Er:YAG laser activated irrigation [LAI]), 2.5% NaOCl/9% DualRinse HEDP (LAI), 2.5% NaOCl-7% Maleic acid (LAI), Distilled water (Control). Specimens were scored using SEM. The data were analysed using Kruskal-Wallis and Mann Whitney U tests. RESULTS Maleic acid and DualRinse HEDP removed higher amounts of MTA Fillapex from the grooves compared to EDTA, when used with both activation methods (p < .001). CONCLUSIONS Ultrasonically activated maleic acid or DualRinse HEDP can be an effective irrigation regimen in removing tricalcium silicate-based sealers.
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Affiliation(s)
- Nidambur Vasudev Ballal
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Karnataka, India
| | - Özgür İlke Ulusoy
- Department of Endodontics, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - Sheetal Rao
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Karnataka, India
| | - Poornika Gandhi
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Karnataka, India
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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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Zollinger A, Attin T, Mohn D, Zehnder M. Effects of endodontic irrigants on blood and blood-stained dentin. Heliyon 2019; 5:e01794. [PMID: 31193548 PMCID: PMC6536424 DOI: 10.1016/j.heliyon.2019.e01794] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 03/13/2019] [Accepted: 05/20/2019] [Indexed: 11/17/2022] Open
Abstract
Objectives This study aimed to investigate bleaching effects of common endodontic irrigants on human whole blood and blood-stained dentin. Specifically, it was assessed whether sodium hypochlorite at a clinically recommended concentration (2.5% NaOCl) would bleach with similar efficacy as a peroxide-based irrigant at higher molarity (5% H2O2). Furthermore, the effects of a NaOCl-compatible chelator with a high affinity to iron (Dual Rinse HEDP) were investigated. Methods Human whole blood was mixed at a 1:20 ratio with either phosphate-buffered saline, 9% HEDP, 2.5% NaOCl, 2.5% NaOCl containing 9% HEDP, or 5% H2O2. Effects were assessed spectrometrically and photographically. Human dentin specimens were prepared with a methacrylate reservoir for liquids and a polished assessment side over 1 mm dentin thickness. Dentin was stained using human whole blood for 3 weeks and subsequently exposed to the irrigants for 60 min. Measurements were performed in the CIELAB color space. Results were compared using parametric tests with the alpha-type error set to 5%. Results When directly exposed, the solutions containing NaOCl completely discolored the blood, while the 5% H2O2 exerted a bleaching effect without complete dissolution of dissolved matter, and the pure 9% HEDP had no effect at all. The NaOCl solutions bleached blood-stained dentin more efficiently than H2O2 (p < 0.05). Conclusions Under the current conditions, the 2.5% NaOCl solution had a stronger bleaching effect on blood and blood-stained dentin than 5% H2O2. HEDP did not have any direct impact on blood color or NaOCl-derived bleaching.
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Affiliation(s)
- Adrian Zollinger
- Clinic of Preventive Dentistry, Periodontology and Cariology, University of Zurich, Center of Dental Medicine, Switzerland
| | - Thomas Attin
- Clinic of Preventive Dentistry, Periodontology and Cariology, University of Zurich, Center of Dental Medicine, Switzerland
| | - Dirk Mohn
- Clinic of Preventive Dentistry, Periodontology and Cariology, University of Zurich, Center of Dental Medicine, Switzerland
- Institute for Chemical and Bioengineering, Department of Chemistry and Applied Biosciences, ETH Zurich, Switzerland
| | - Matthias Zehnder
- Clinic of Preventive Dentistry, Periodontology and Cariology, University of Zurich, Center of Dental Medicine, Switzerland
- Corresponding author.
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Ballal NV, Gandhi P, Shenoy PA, Shenoy Belle V, Bhat V, Rechenberg D, Zehnder M. Safety assessment of an etidronate in a sodium hypochlorite solution: randomized double‐blind trial. Int Endod J 2019; 52:1274-1282. [DOI: 10.1111/iej.13129] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 04/12/2019] [Indexed: 11/28/2022]
Affiliation(s)
- N. V. Ballal
- Department of Conservative Dentistry and Endodontics Manipal College of Dental Sciences Manipal Academy of Higher Education Manipal Karnataka India
| | - P. Gandhi
- Department of Conservative Dentistry and Endodontics Manipal College of Dental Sciences Manipal Academy of Higher Education Manipal Karnataka India
| | - P. A. Shenoy
- Department of Microbiology Kasturba Medical College Manipal, Manipal Academy of Higher Education Manipal Karnataka India
| | - V. Shenoy Belle
- Department of Biochemistry Kasturba Medical College Manipal, Manipal Academy of Higher Education Manipal Karnataka India
| | - V. Bhat
- Department of Biochemistry Kasturba Medical College Manipal, Manipal Academy of Higher Education Manipal Karnataka India
| | - D.‐K. Rechenberg
- Department of Preventive Dentistry, Periodontology and Cariology University of Zürich Zürich Switzerland
| | - M. Zehnder
- Department of Preventive Dentistry, Periodontology and Cariology University of Zürich Zürich Switzerland
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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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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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Deari S, Mohn D, Zehnder M. Dentine decalcification and smear layer removal by different ethylenediaminetetraacetic acid and 1-hydroxyethane-1,1-diphosphonic acid species. Int Endod J 2018; 52:237-243. [PMID: 30030844 DOI: 10.1111/iej.12987] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Accepted: 07/18/2018] [Indexed: 12/01/2022]
Abstract
AIM To compare solutions of di- and tetrasodium ethylenediaminetetraacetic acid (EDTA) and 1-hydroxyethane-1,1-diphosphonic acid (HEDP) regarding their ability to solubilize calcium from dentine and remove smear layer. METHODOLOGY Solutions with a molarity corresponding to that of 17% Na2 EDTA (pH adjusted to 8.5) were prepared by dissolving Na2 and Na4 salts of HEDP (etidronate), or Na4 EDTA in deionized water. Standardized root dentine discs covered by a smear layer were prepared from human third molars. These discs (n = 10 per group) were immersed in test solutions or phosphate-buffered saline for 1 min. The dissolved Ca2+ was determined by atomic absorption spectroscopy, apparently opened dentinal tubules by laser scanning microscopy and automated image analysis. Ca2+ values were compared between groups by parametric, tubular areas by nonparametric methods, α = 0.05. RESULTS Solutions prepared from the tetrasodium salts were alkaline (pH 11.3-11.4), whilst counterparts made from the disodium salts were acidic. The EDTA solutions dissolved more calcium than the HEDP counterparts (P < 0.05); solutions prepared with the disodium salts dissolved more calcium than those made from the tetrasodium salts (P < 0.05). There was a high correlation between dissolved calcium and the apparently opened tubular areas (Spearman's ρ = 0.81). Differences between groups regarding opened tubules were similar to those observed regarding the Ca2+ values, with a slightly reduced discerning power due to high variance. CONCLUSION Calcium chelation and thus smear layer removal by EDTA and HEDP are influenced by pH.
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Affiliation(s)
- S Deari
- Clinic of Preventive Dentistry, Periodontology and Cariology, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - D Mohn
- Clinic of Preventive Dentistry, Periodontology and Cariology, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.,Department of Chemistry and Applied Biosciences, Institute for Chemical and Bioengineering, ETH Zurich, Zurich, Switzerland
| | - M Zehnder
- Clinic of Preventive Dentistry, Periodontology and Cariology, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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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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