Effects of heat in the properties of NaOCl alone and mixed with etidronate and alkaline tetrasodium EDTA

Sodium hypochlorite against Enterococcus faecalis biofilm in dentinal tubules: effect of concentration, temperature, and exposure time

This study aimed to evaluate the effectiveness of two sodium hypochlorite concentrations at different exposure times and temperatures against Enterococcus faecalis biofilms of varying ages in human dentinal tubules. Dentin blocks were infected with E. faecalis for either 3 days or 3 weeks of incubation. Subsequently, the samples were exposed to sterile water, 2%, and 5.25% sodium hypochlorite for 3 and 10 min at 20 °C and 60 °C . Viability staining and confocal laser scanning microscopy were used to assess the proportion of killed bacteria in the dentinal tubules after exposure. There are no significant differences in the efficacy of E. faecalis killing between 2% sodium hypochlorite at 60 °C for various exposure times and 5.25% sodium hypochlorite at different temperatures or exposure times (P > 0.05). When both solutions were compared at the same temperatures with a 10-min exposure time, no significant differences in the effectiveness of E. faecalis killing between 2% and 5.25% sodium hypochlorite were observed (P > 0.05). To optimize the effectiveness of sodium hypochlorite in killing E. faecalis while minimizing potential damage to root dentin and soft tissue, clinicians should prioritize increasing the temperature or exposure time of sodium hypochlorite, rather than raising its concentration.

Engineering a Microphysiological Model for Regenerative Endodontic Studies

Dental pulp infections are common buccal diseases. When this happens, endodontic treatments are needed to disinfect and prepare the root canal for subsequent procedures. However, the lack of suitable in vitro models representing the anatomy of an immature root canal hinders research on regenerative events crucial in endodontics, such as regenerative procedures. This study aimed to develop a 3D microphysiological system (MPS) to mimic an immature root canal and assess the cytotoxicity of various irrigating solutions on stem cells. Utilizing the Dental Stem Cells SV40 (DSCS) cell line derived from human apical papilla stem cells, we analyzed the effects of different irrigants, including etidronic acid. The results indicated that irrigating solutions diminished cell viability in 2D cultures and influenced cell adhesion within the microphysiological device. Notably, in our 3D studies in the MPS, 17% EDTA and 9% 1-hydroxyethylidene-1, 1-bisphosphonate (HEBP) irrigating solutions demonstrated superior outcomes in terms of DSCS viability and adherence compared to the control. This study highlights the utility of the developed MPS for translational studies in root canal treatments and suggests comparable efficacy between 9% HEBP and 17% EDTA irrigating solutions, offering potential alternatives for clinical applications.

Effects of traditional and novel proteolytic agents on tissue dissolution and dentine microhardness

The study aimed to evaluate the tissue-dissolving ability of papain and bromelain with respect to that of sodium hypochlorite (NaOCl) at the temperatures of 25°C and 60°C. The study also assessed the effects of these proteolytic agents on radicular dentine microhardness. Warming NaOCl, papain and bromelain solutions resulted in significant tissue dissolution at all time intervals (p < 0.001). At 60°C, bromelain showed significantly higher tissue weight loss at every time interval when compared to NaOCl (p < 0.001). All of the three organic tissue dissolvents reduced the microhardness at 1 hr when compared to their respective baseline values. The reduction in microhardness from the baseline reading was statistically significant only in the papain group at 30 min (p = 0.018) and at 60 min (p = 0.03) when compared to the control group. Hence it was concluded that bromelain exerted superior tissue dissolution action, especially when warmed, with minimal effect on dentine microhardness.

Assessment of the root surface temperature during the use of intracanal agitation systems: In vitro study

This study aimed to evaluate the temperature changes that the different methods of agitation of irrigants promote on the external dental root surface. Nine extracted human lower premolars were standardized by cone-beam computed tomography and used. The root canal was instrumented with a Reciproc 40.06 file. Temperature measurement was performed using K-type thermocouple sensors attached to the middle, cervical, and apical thirds of the teeth. The teeth had their roots immersed in distilled water at 37ºC, which were distributed into 3 experimental groups according to the mechanical agitation methods to be studied. US Group (n=3), Irrisonic Ultrasonic Tip activated through ultrasound; EC Group (n=3), Easyclean Tip coupled to a contra-angle low-speed handpiece; XP Group (n=3), XP-endo Finisher file coupled to an endodontic electrical motor. Temperature measurements were performed simultaneously with agitation and irrigation of intracanal irrigants. Statistical analysis was performed using SPSS software with a significance level of 5%. For multiple comparisons, the Tukey test was used. The association between mechanical agitation methods and root third was statistically significant. Regarding the temperatures recorded on the external surface of the roots, the ultrasonic tip was significantly higher than the XP-endo Finisher file and the Easyclean tip, which did not differ from each other. Regarding the ultrasonic tip, the external temperature in the middle third (39.46ºC) of the root was significantly lower than in the cervical (40.41ºC) and apical third (40.53ºC). None of the agitation methods of irrigants studied presented heating above 47ºC, and their use is safe for periodontal tissues.

Advances in the Role of Sodium Hypochlorite Irrigant in Chemical Preparation of Root Canal Treatment

Irrigation of root canal system is of great significance to the success of endodontic treatment, where sodium hypochlorite (NaOCl) is the most widely used irrigant in chemical preparation. NaOCl functions by eliminating bacterial biofilms and dissolving organic tissue, which may vary according to several factors such as the microbiology of root canal infection and the concentration of the irrigant. It has been proposed that the effectiveness of NaOCl could be enhanced via several methods, including heating the irrigant, applying in conjunction with certain reagents, or activating by agitation techniques. Despite its antibacterial and tissue-dissolving capacities, NaOCl should be used with caution to avoid detrimental effect due to its cytotoxicity and negative effect on dentin properties. In this narrative review, we discussed the factors that affect the properties of NaOCl, the methods to improve its efficacy, and the side effects that might occur in clinical practice.

The Efficacy of Selected Sodium Hypochlorite Heating Methods for Increasing and Maintaining Its Intracanal Temperature—An Ex Vivo Study

Background: Enhancement of the temperature of sodium hypochlorite (NaOCl) solution would increase its cleaning potential and decontamination of the root canal system. Therefore, the aim of the present in vitro investigation was to compare the efficacy of different methods of NaOCl heating by evaluating the temperature profiles developed at different levels of the root canal system. Methods: Five thermocouples were applied at different levels of the root canal system of extracted human premolars. NaOCl solution was heated according to two methods: extraoral heating (50 °C, 60 °C, and 70 °C) using a magnetic hotplate heater and intracanal heating by F-06, XF-30/04, and ML-12 pluggers at 100 °C, 150 °C, and 180 °C. Results: The extraoral heating method was ineffective to produce a significant temperature increase at the root apex. Comparable results were obtained using the intracanal heating method through the ML-12 plugger that showed slightly better results only when set at 180 °C. On the other hand, negligible differences were observed in terms of temperature maintenance at several levels of the root between the F-06 and XF-30/04 pluggers, even though the time intervals were higher in case of XF-30/04. Conclusions: The intracanal heating method provided a better temperature persistence in the middle third of the root canal system. Conversely, extraoral heating was ineffective to produce a significant temperature increase at the apex of the root. Comparable results were obtained even using the ML-12 plugger.

Effects of chlorine disinfectants on the microbial community structure and the performance of anaerobic digestion of swine manure

The residual chlorine disinfectants (CDs) in swine slurry could negatively impact the anaerobic digestion (AD). The objective of this study was to investigate the effects of CDs on mesophilic and thermophilic AD. The results indicated that CDs exerted inhibition effects on methanogenesis at the initial stage of mesophilic AD, leading to the extension of lag time from 0.62 days for control to 0.85, 1.9, 3.8, and 5.5 days with the increasing CDs concentrations of 50, 100, 200, and 400 mg/L, respectively. Under thermophilic condition, the inhibition effects reduced significantly at the initial stage but a decrease of CMP_u at later stage was observed. The microbial analysis revealed that CDs resulted in the enrichment of chlorine-resistant bacteria (Clostridum_sensu_stricto_1) and archaea (Methanosarcina). Addition of activated carbon (AC), zero-valent iron (ZVI) and biochar (BC) was evaluated for alleviating the inhibitions of CDs and proved to be feasible strategies to alleviate the inhibited AD.

Efficacy of preheated chelating agents on calcium ion removal from instrumented root canals

Background

The heating of chelating agents such as EDTA increases dentin wettability by decreasing surface tension. However, the calcium ion release effect of preheated chelating agents in instrumented root canals has not yet been mentioned. In this study, it was aimed to evaluate the number of calcium ions removed by the pre-heated chelating agents from the root canals.

Material and Methods

After 51 bovine teeth were instrumented, three of them were separated as negative controls and the remaining teeth were divided into six groups according to the temperature of the solution (at 22 or 37ºC): EDTA-22, CITRIC-22, QMix-22, EDTA-37, CITRIC-37 and QMix-37. Following irrigation, calcium ion levels were determined by atomic absorption spectrophotometer in chelating agents collected from the root canals.

Results

QMix solution eliminated significantly more calcium ions than other chelating agents at different temperatures (p< 0.05). Regardless of the heating, QMix and 17% EDTA were significantly superior to 40% Citric acid (p< 0.05) while no significant difference was detected between QMix and 17% EDTA groups (p< 0.05). Heating all chelating agents did not significantly increase their ability to remove calcium ions from pre-instrumented root canals (P< 0.05). In the SEM examination, it was observed that the smear layer was removed from the middle third of the roots, except for the negative control group.

Conclusions

Temperature changes have shown that these agents do not increase the ability of the smear layer to dissolve the inorganic structure. QMix at different temperatures may be recommended to use as the final chelating agent.

Key words:EDTA, citric acid, QMix, calcium ions, temperature.