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Tavangar MS, Shafiei F, Eslami Pirharati S, Bakhshandeh M, Ghahramani Y. Effect of crosslinking/antioxidant agents as final irrigant on the fracture resistance of endodontically treated root after radiotherapy. PLoS One 2024; 19:e0311132. [PMID: 39418277 PMCID: PMC11486412 DOI: 10.1371/journal.pone.0311132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 09/10/2024] [Indexed: 10/19/2024] Open
Abstract
AIM To investigate the effects of Epigallocatechin gallate (EGCG) and curcumin, as a final irrigant on the fracture resistance of irradiated root that obturated with an epoxy resin sealer. METHODOLOGY Eighty mandibular premolars were randomly divided into non-irradiated (NIR) and irradiated (IR) groups. The teeth were irradiated at 2 Gy per fraction, 5 times a week for a total dose of 60 Gy over 6 weeks. All specimens were decoronated, remaining 13±1 mm root length. Two groups were subdivided into four groups (n = 10): 1) non-instrumented; the intact root served as control. The other roots were instrumented with a pro-taper NiTi rotary system. The final irrigation used was 17% EDTA, followed by three irrigation solution groups; 2) 2.5% NaOCl, 3) 0.02% EGCG, and 4) 0.1% curcumin. Root canals were filled with gutta-percha and AH plus. All specimens were embedded in self-curing acrylic resin and loaded vertically at 1 mm/min until fracture occurred. Also, sealer penetration was assessed by confocal laser scanning microscopy (CLSM). The data were evaluated statistically using two-way ANOVA and Tukey test (α = 0.05). RESULTS In irradiated roots, fracture resistance of EGCG and curcumin groups did not differ from non-instrumented roots, but they were higher than the NaOCl group (P = 0.006). However, NaOCl, EGCG, and curcumin in irradiated roots had comparable strength that was higher than in the non-instrumented group (p<0.001). Difference between irradiated and non-irradiated roots was observed only for NaOCl and non-instrumented groups (P≤0.004). In irradiated roots, a higher sealer penetration was observed in EGCG and curcumin groups compared to NaOCl. CONCLUSION EGCG and curcumin could be promising final irrigants to reverse the adverse effect of radiotherapy on the strength of irradiated roots obturated with AH Plus sealer.
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Affiliation(s)
- Maryam S. Tavangar
- Department of Operative Dentistry, Oral and Dental Disease Research Center, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fereshteh Shafiei
- Department of Operative Dentistry, Oral and Dental Disease Research Center, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Mohsen Bakhshandeh
- Allied Medical Faculty, Radiology Technology Department, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Yasamin Ghahramani
- Department of Endodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
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Par M, Cheng L, Camilleri J, Lingström P. Applications of smart materials in minimally invasive dentistry - some research and clinical perspectives. Dent Mater 2024:S0109-5641(24)00287-2. [PMID: 39341720 DOI: 10.1016/j.dental.2024.09.017] [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: 04/09/2024] [Revised: 08/25/2024] [Accepted: 09/20/2024] [Indexed: 10/01/2024]
Abstract
OBJECTIVES Dental caries is one of the most prevalent bacteria-induced non-communicable diseases globally. It is known to be the top oral health burden in both developing and developed nations. There is substantial literature on the disease process and there is still debate on the extent of caries removal needed and the adequacy of the materials available to restore the lost tooth structure. The current review discusses the disease process together with the contemporary management of the carious lesion and also presents substantial evidence on novel materials and techniques that make minimally invasive dentistry predictable. METHODS The written work presented shows the most relevant literature for the management of dental caries focusing on novel materials used in minimally invasive dentistry. RESULTS There is still much to learn about specific antimicrobial and caries prevention mechanisms of novel materials. Materials that respond to a single or a few stimuli remain "weakly intelligent" in the face of the complex microenvironment in the oral cavity. Engineered systems that combine artificial intelligence and chemical engineering, are expected to possess higher intelligence, self-healing capabilities as well as environmental adaptability, and may be future promising research directions. SIGNIFICANCE The targeted approach in managing dental caries will hopefully have a better clinical outcome. The strategies discussed are alternatives to the contemporary approach and will improve the clinical management.
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Affiliation(s)
- M Par
- Department of Endodontics and Restorative Dentistry, University of Zagreb School of Dental Medicine, Zagreb, Croatia
| | - L Cheng
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China; Department of Operative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - J Camilleri
- Dentistry, School of Health Sciences, College of Medicine and Health, University fo Birmingham, Birmingham, United Kingdom.
| | - P Lingström
- Department of Cariology, Institute of Odontolog, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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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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Geogi CC, Dubey S, Singh P, Rajkumar B, Samant PS, Rawat A. A Comparative Evaluation of the Effect of Different Endodontic Irrigating Solutions on Microhardness of Root Canal Dentin: An in vitro Study. JOURNAL OF DENTISTRY (SHIRAZ, IRAN) 2024; 25:236-242. [PMID: 39371949 PMCID: PMC11452603 DOI: 10.30476/dentjods.2023.98298.2071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 08/21/2023] [Accepted: 09/21/2023] [Indexed: 10/08/2024]
Abstract
Statement of the Problem During endodontic therapy, irrigation solutions applied in the root canal may affect the physicochemical properties of the dentinal wall, thereby changing its microhardness. This may adversely affect the sealing ability and adhesion of dental materials. Therefore, many studies have focused on the search for an ideal root canal irrigant that has a minimal effect on dentinal microhardness. Purpose This in vitro study was conducted to determine the changes in dentin microhardness after root canal irrigation with different endodontic irrigants. Materials and Method Ninety-five freshly extracted maxillary central incisor teeth with straight single canals were selected. These teeth were sectioned transversely at the level of the cementoenamel junction. The working length of each tooth was determined, and canal space was prepared by the HyFlex CM rotary file system. During instrumentation, normal saline was used for irrigation. Then, teeth were split longitudinally into two segments. According to the irrigating solution employed, samples were divided into five groups (n=19): normal saline (Group A), 3% sodium hypochlorite (Group B), 2% chlorhexidine (Group C), 5% calcium hypochlorite (Group D), and 0.2% nanochitosan (Group E).3 mL of the corresponding irrigating solution was administered for total15 minutes in each prepared sample. The Vickers micro-hardness tester was then used to assess micro-hardness. The data was analyzed using one-way analysis of variance (ANOVA). Results All tested irrigating solutions decreased the dentinal microhardness. Samples irrigated with 5% calcium hypochlorite demonstrated dentinal microhardness of 42.43±1.62, which is the lowest among all the tested groups, followed by nano chitosan, sodium hypochlorite, and chlorhexidine. Samples treated with control group (saline) demonstrated the maximum microhardness of dentin in the present study. Conclusion Within the limitations of this research, it can be concluded that the tested novel irrigating solutions, 5% calcium hypochlorite and 0.2% nanochitosan, were more detrimental to radicular dentin microhardness when compared with conventional endodontic irrigants.
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Affiliation(s)
- Chris Cherian Geogi
- Dept. of Conservative Dentistry and Endodontics, Babu Banarasi Das College of Dental Sciences, Lucknow (U.P.), India
| | - Sandeep Dubey
- Dept. of Conservative Dentistry and Endodontics, Babu Banarasi Das College of Dental Sciences, Lucknow (U.P.), India
| | - Palak Singh
- Dept. of Conservative Dentistry and Endodontics, Babu Banarasi Das College of Dental Sciences, Lucknow (U.P.), India
| | - B Rajkumar
- Dept. of Conservative Dentistry and Endodontics, Babu Banarasi Das College of Dental Sciences, Lucknow (U.P.), India
| | - Praveen Singh Samant
- Dept. of Conservative Dentistry and Endodontics, Babu Banarasi Das College of Dental Sciences, Lucknow (U.P.), India
| | - Ananya Rawat
- Dept. of Conservative Dentistry and Endodontics, Babu Banarasi Das College of Dental Sciences, Lucknow (U.P.), India
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Mukundan D, Jeevanandan G. Cytotoxic Effect of Two Different Concentrations of Sodium Hypochlorite: An In-Vitro Study. Cureus 2024; 16:e66999. [PMID: 39280567 PMCID: PMC11402334 DOI: 10.7759/cureus.66999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2024] [Accepted: 08/16/2024] [Indexed: 09/18/2024] Open
Abstract
Introduction The endodontic treatment of primary teeth presents considerable complications due to their distinct anatomical properties. In order to achieve a successful endodontic treatment, certain factors must be assessed. These factors include a precise diagnosis, thorough cleaning, and a reliable disinfection protocol. Although sodium hypochlorite (NaOCl) has been effective as an irrigation agent in primary teeth, it is important to recognize that higher concentrations of NaOCl might possibly inflict toxic harm on the periapical environment if they penetrate the tooth's apical foramina. Since primary teeth are important, pediatric dentists must choose an appropriate NaOCl concentration for root canal irrigation, as higher concentrations can be toxic. Thus, the current investigation examined the cytotoxicity of two different NaOCl concentrations at various volumes. Methods To evaluate the cytotoxicity potential, a culture of nauplii (brine shrimp) was prepared and subjected to testing. For the test, 5, 10, 20, and 40 µL of 1% and 3% NaOCl were added to the brine shrimp culture at different concentrations, and saline was used as a control. After a span of 24 hours, the total number of alive nauplii was duly noted. Results After 24 hours, nauplii showed no mortality in the control group. For 1% NaOCl, mortality ranged from 10% to 20% across volumes, with no significant differences (p = 0.193). In contrast, 3% NaOCl caused significantly higher mortality: 20% at 5 µL, 30% at 10 and 20 µL, and 60% at 40 µL (p = 0.007). Tukey's analysis revealed no significant differences for 1% NaOCl (p > 0.05) but significant differences for 3% NaOCl at 40 µL (p < 0.05). Conclusion Based on the results of the present study, it was observed that a 1% NaOCl solution exhibited a lower level of toxicity in comparison to a 3% NaOCl solution. These findings highlight the importance of using lower concentrations of NaOCl for endodontic irrigation in pediatric dentistry to reduce the risk of tissue damage and ensure safer outcomes for young patients.
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Affiliation(s)
- Divya Mukundan
- Pediatric and Preventive Dentistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Ganesh Jeevanandan
- Pediatric and Preventive Dentisty, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
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Abdul Hadi Ahmed R, Mohammed Ali Hussein B. Effect of Laser Treatment of Root Dentine on Retention of Dental Fiber Post in Endodontically Treated Teeth: An In Vitro Study. J Lasers Med Sci 2024; 15:e28. [PMID: 39188935 PMCID: PMC11345800 DOI: 10.34172/jlms.2024.28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Accepted: 05/19/2024] [Indexed: 08/28/2024]
Abstract
Introduction: The most common causes of fiber post-failure are inadequate restorations and dislodgement. This study aimed to evaluate fiber post-bond strength to dentin following Er,Cr:YSGG laser irradiation. Methods: A total of 65 human mandibular premolars with single roots were included. The 14 mm root length was instrumented with the rotary system using the crown-down technique. Gutta-percha was used for obturation, followed by conventional post space preparation. The samples were divided into two major groups: control (A) and Er,Cr:YSGG (2780 nm) laser group (B). The laser group was subdivided into (B1) 1.25 W, (B2) 1.5 W, and (B3) 1.75 W. All laser groups were set at 20 Hz, 10% and 30% water/air ratio. Fiber posts were cemented with selfadhesive cement. Each sample was divided horizontally into two slices, coronal and apical. The universal testing equipment was used to conduct a push-out test. All groups were examined by SEM and temperature changes. The statistical analysis was performed by using one-way ANOVA and Tukey HSD tests. Results: SEM images of all laser groups revealed the elimination of the smear layer and opened dentinal tubules, which was particularly noticeable in the apical region with no thermal risk to the periodontal tissue. In the push-out test, all laser groups had highly significant (P<0.001) increases in the bond strength of fiber post to dentin. The failure mode of the control group was a predominantly adhesive failure, whereas the laser groups were a predominantly mixed type. Conclusion: The three laser protocols can be used safely in the surface treatment of the fiber post space of endodontically treated teeth. Laser help to increase the bond strength of fiber post to dentin, especially in the apical area.
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Khoury RD, de Carvalho LS, do Nascimento MFR, Alhussain F, Abu Hasna A. Endodontic irrigants from a comprehensive perspective. World J Clin Cases 2024; 12:4460-4468. [PMID: 39070803 PMCID: PMC11235474 DOI: 10.12998/wjcc.v12.i21.4460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 05/06/2024] [Accepted: 06/03/2024] [Indexed: 06/30/2024] Open
Abstract
This review article explores the fundamental principles of modern endodontics with a focus on root canal cleaning and shaping. It reviews commonly used endodontic irrigant, namely sodium hypochlorite (NaOCl), herbal extracts, chlorhexidine (CHX), and chelating agents, highlighting their properties, applications, and potential drawbacks. NaOCl, a key antimicrobial agent, demonstrates effectiveness against various microorganisms but poses challenges such as high cytotoxicity. Herbal extracts, gaining recognition in endodontics, present an alternative with potential advantages in preserving dentin integrity. CHX, known for its broad-spectrum antimicrobial activity, is discussed in both liquid and gel formulations, emphasizing its role in reducing smear layer formation and preserving hybrid layer durability. Chelating agents, specifically ethylenediaminetetraacetic acid and citric acid, play a vital role in removing the smear layer, enhancing dentin permeability, and facilitating the penetration of antimicrobial agents. The review article underscores the importance of careful application and consideration of each irrigant's properties to ensure safe and effective endodontic procedures. It serves as a valuable guide for clinicians in selecting appropriate irrigants based on specific treatment requirements.
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Affiliation(s)
- Rayana Duarte Khoury
- Department of Restorative Dentistry, Endodontics Division, Institute of Science and Technology, São Paulo State University, São José dos Campos 12245000, SP, Brazil
| | - Lara Steffany de Carvalho
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University, São José dos Campos 12245000, SP, Brazil
| | - Mauro Felipe Rios do Nascimento
- School of Dentistry, The National Institute of Higher Education and Postgraduate Studies Padre Gervásio-INAPÓS, Pouso Alegre 37550-121, MG, Brazil
| | - Fadi Alhussain
- School of Dentistry, Syrian Private University, Al Kiswah 877C+P2, Damascus, Syria
| | - Amjad Abu Hasna
- Department of Restorative Dentistry, Endodontics Division, Institute of Science and Technology, São Paulo State University, São José dos Campos 12245000, SP, Brazil
- School of Dentistry, Universidad Espíritu Santo, Samborondón 092301, Ecuador
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Kong X, Vishwanath V, Neelakantan P, Ye Z. Harnessing antimicrobial peptides in endodontics. Int Endod J 2024; 57:815-840. [PMID: 38441321 DOI: 10.1111/iej.14043] [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: 10/25/2023] [Revised: 01/27/2024] [Accepted: 01/29/2024] [Indexed: 06/13/2024]
Abstract
Endodontic therapy includes various procedures such as vital pulp therapy, root canal treatment and retreatment, surgical endodontic treatment and regenerative endodontic procedures. Disinfection and tissue repair are crucial for the success of these therapies, necessitating the development of therapeutics that can effectively target microbiota, eliminate biofilms, modulate inflammation and promote tissue repair. However, no current endodontic agents can achieve these goals. Antimicrobial peptides (AMPs), which are sequences of amino acids, have gained attention due to their unique advantages, including reduced susceptibility to drug resistance, broad-spectrum antibacterial properties and the ability to modulate the immune response of the organism effectively. This review systematically discusses the structure, mechanisms of action, novel designs and limitations of AMPs. Additionally, it highlights the efforts made by researchers to overcome peptide shortcomings and emphasizes the potential applications of AMPs in endodontic treatments.
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Affiliation(s)
- Xinzi Kong
- Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong S.A.R., China
| | - Vijetha Vishwanath
- Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong S.A.R., China
| | - Prasanna Neelakantan
- Department of Endodontics, University of the Pacific Arthur A. Dugoni School of Dentistry, San Francisco, California, USA
| | - Zhou Ye
- Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong S.A.R., China
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Nogueira APA, Grazziotin-Soares R, Leal AMM, Freitas Júnior SAG, Gonçalves BLL, Bauer J, Ferreira MC, Carvalho CN. Root Canal Dentin Microhardness after Contact with Antibiotic Medications: An In Vitro Study. Dent J (Basel) 2024; 12:201. [PMID: 39056988 PMCID: PMC11276266 DOI: 10.3390/dj12070201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 04/19/2024] [Accepted: 05/21/2024] [Indexed: 07/28/2024] Open
Abstract
Background: Antibiotic pastes used as intracanal medication in cases of revascularization therapy might cause negative effects on tooth properties, such as a reduction in dentin microhardness. This in vitro study investigated dentin microhardness in three different locations distancing from the canal lumen after 20 days of treatment with a tri-antibiotic paste (ciprofloxacin, metronidazole, and minocycline), and with a double-antibiotic paste (ciprofloxacin and metronidazole), with calcium hydroxide [Ca(OH)2] UltracalTM XS-treated dentin as comparison. Material and Methods: Human mandibular premolars (n = 48) had the root canals cleaned and shaped and were used to produce dentin slices. Dentin slices remained immersed in the medications for 20 days. The Knoop microhardness (KHN) test was performed before (baseline/Day-0) and after treatment (Day-20) with the medications. Indentations were made at 25 µm, 50 µm, and 100 µm distances from the root canal lumen. The KHN was compared intra-group using Wilcoxon's test. Independent groups were compared using Mann-Whitney's and Kruskal-Wallis' tests, at α = 5%. Results: The microhardness in all the tested groups was reduced at Day-20 in comparison with Day-0 (p < 0.001) (intra-group comparison/same distances). The Day-0 values were similar, and the Day-20 values were higher for the Ca(OH)2 group (p < 0.05) (comparison between groups/same distances). Conclusions: Calcium hydroxide for 20 days would be preferred rather than antibiotic pastes to minimize the expected reduction in dentin microhardness during regenerative procedures.
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Affiliation(s)
- Amanda Palmeira Arruda Nogueira
- School of Dentistry, CEUMA University, São Luís 65075-120, MA, Brazil; (A.P.A.N.); (A.M.M.L.); (S.A.G.F.J.); (B.L.L.G.); (M.C.F.)
| | - Renata Grazziotin-Soares
- Department of Oral Biological Medical Sciences, Faculty of Dentistry, University of British Columbia UBC, Vancouver, BC V6T 1Z4, Canada;
| | - Adriana Marques Mesquita Leal
- School of Dentistry, CEUMA University, São Luís 65075-120, MA, Brazil; (A.P.A.N.); (A.M.M.L.); (S.A.G.F.J.); (B.L.L.G.); (M.C.F.)
| | | | - Bruna Laís Lins Gonçalves
- School of Dentistry, CEUMA University, São Luís 65075-120, MA, Brazil; (A.P.A.N.); (A.M.M.L.); (S.A.G.F.J.); (B.L.L.G.); (M.C.F.)
| | - José Bauer
- Dental Materials Laboratory, School of Dentistry, University Federal of Maranhão (UFMA), São Luís 5085-582, MA, Brazil;
| | - Meire Coelho Ferreira
- School of Dentistry, CEUMA University, São Luís 65075-120, MA, Brazil; (A.P.A.N.); (A.M.M.L.); (S.A.G.F.J.); (B.L.L.G.); (M.C.F.)
| | - Ceci Nunes Carvalho
- School of Dentistry, CEUMA University, São Luís 65075-120, MA, Brazil; (A.P.A.N.); (A.M.M.L.); (S.A.G.F.J.); (B.L.L.G.); (M.C.F.)
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Steier L, Albino Souza M, Poli de Figueiredo JA. NaOCl alternative options. Br Dent J 2024; 236:859. [PMID: 38877233 DOI: 10.1038/s41415-024-7513-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Accepted: 05/15/2024] [Indexed: 06/16/2024]
Affiliation(s)
- L Steier
- University of Pennsylvania, School of Dental Medicine, Philadelphia, USA.
| | - M Albino Souza
- University of Passo Fundo, Dental School, Passo Fundo, Rio Grande do Sul, Brazil.
| | - J A Poli de Figueiredo
- Federal University of Rio Grande do Sul, Department of Morphological Sciences, Porto Alegre, Rio Grande do Sul, Brazil.
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N S, D K, Gowda A, Nagaraja S, Mathew RS, G A N, R V. A Comparative Evaluation of Contact Angle and Depth of Penetration of Sodium Hypochlorite With Various Surfactants: An In Vitro Study. Cureus 2024; 16:e62480. [PMID: 39022486 PMCID: PMC11251930 DOI: 10.7759/cureus.62480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2024] [Accepted: 06/13/2024] [Indexed: 07/20/2024] Open
Abstract
OBJECTIVE Sodium hypochlorite (NaOCl) is regarded as the most frequently used root canal irrigant. Its high surface tension prevents its penetration into complex canal anatomies. The present study assesses the contact angle and penetration depth of 2.5% NaOCl with 0.2% cetrimide and propylene glycol. MATERIAL AND METHODS Sixty recently extracted mandibular premolars with a single root were obtained. Thirty were sectioned longitudinally, and the remaining 30 teeth were sectioned transversely. Acrylic blocks were used to mount the parts, and 5 µL of each of the following solutions was placed on the dentin surface: Group 1: 2.5% NaOCl (control), Group 2: 0.2% cetrimide + 2.5% NaOCl, and Group 3: propylene glycol + 2.5% NaOCl. Following this, contact angle analysis was made using a contact angle goniometer. We prepared and instrumented access cavities in 30 teeth to work up to the size of the ProTaper Gold F2 (Dentsply Tulsa Dental Specialties, Tulsa, OK). Samples were allocated to the three groups, and irrigation was done accordingly. They were sectioned at the coronal, middle, and apical thirds and then subjected to confocal laser scanning microscopy. The data were analyzed using a one-way ANOVA and a Tukey multiple comparison test. RESULTS Group 2 had the least contact angle (35.20°) and the highest depth of penetration (DOP; 752.409 µm) when compared to Groups 1 and 3. The DOP decreased significantly from the coronal, middle, and apical thirds. No discernible variation in the contact angle was found between the radicular and coronal portions. CONCLUSION 0.2% cetrimide improved the efficiency of 2.5% NaOCl as an irrigant by lowering its contact angle and increasing its DOP.
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Affiliation(s)
- Shubhashini N
- Department of Conservative Dentistry and Endodontics, Rajarajeswari Dental College and Hospital, Bengaluru, IND
| | - Krithika D
- Department of Conservative Dentistry and Endodontics, Rajarajeswari Dental College and Hospital, Bengaluru, IND
| | - Akhilesh Gowda
- Department of Conservative Dentistry and Endodontics, Rajarajeswari Dental College and Hospital, Bengaluru, IND
| | - Shruthi Nagaraja
- Department of Conservative Dentistry and Endodontics, Faculty of Dental Sciences, Ramaiah University of Applied Sciences, Bengaluru, IND
| | - Rhea S Mathew
- Department of Conservative Dentistry and Endodontics, Faculty of Dental Sciences, Ramaiah University of Applied Sciences, Bengaluru, IND
| | - Nivaskumar G A
- Department of Conservative Dentistry and Endodontics, Faculty of Dental Sciences, Ramaiah University of Applied Sciences, Bengaluru, IND
| | - Vinaychandra R
- Department of Conservative Dentistry and Endodontics, Rajarajeswari Dental College and Hospital, Bengaluru, IND
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Souza MA, Steier L, Vanin GN, Zanella ML, Pizzi CM, Ferreira ER, Dallepiane FG, Piccolo NM, da Silva Koch J, Souza KR, Costa UMD, Dos Santos VV, Palatynska-Ulatowska A, de Figueiredo JAP. Antimicrobial action, cytotoxicity and erosive potential of hypochlorous acid obtained from an electrolytic device compared with sodium hypochlorite. Clin Oral Investig 2024; 28:282. [PMID: 38683234 DOI: 10.1007/s00784-024-05675-6] [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: 02/16/2024] [Accepted: 04/21/2024] [Indexed: 05/01/2024]
Abstract
OBJECTIVES This study aimed to compare the antimicrobial action, cytotoxicity, cleaning ability, and erosion of dentine of hypochlorous acid (HClO) obtained from an electrolytic device at two different concentrations (Dentaqua) and three concentrations of sodium hypochlorite (NaOCl). METHODS Microbiological test-The root canals of sixty single-rooted extracted human teeth were inoculated with Enterococcus faecalis and divided into 6 groups (n = 10), according to decontamination protocol: DW (control); 1% NaOCl; 2.5% NaOCl; 5.25% NaOCl; 250 ppm HClO and 500 ppm HClO. The colony-forming units were counted to evaluate the decontamination potential of each group, calculating the reduction in bacterial percentage. Cytotoxicity test-Cytotoxicity was evaluated after inoculation of the same tested protocols in fibroblastic cells for 3 min, calculating the cell viability percentages. Specifical statistical analysis was performed (α = 5%). Cleaning ability and erosion-Fifty-six single-rooted bovine lower incisors were divided into seven groups of 8 roots each, being the test groups 1% NaOCl; 2.5% NaOCl; 5,25% NaOCl; 250 ppm HClO and 500 ppm HClO, and a negative and positive control. Negative control was not contaminated, and the other groups were inoculated with Enterococcus faecalis. SEM images were ranked as from the cleanest to the least clean. Erosion was also assessed, being ranked from the least to the most eroded dentine. RESULTS The highest bacterial reduction was observed in experimental groups, with no statistical differences between them (p > 0.05). The highest number of viable cells was observed in control group, followed by 250 ppm HClO and 500 ppm HClO groups, with statistical differences between them (p < 0.05). 1% NaOCl; 2.5% NaOCl; 5.25% NaOCl and 500 ppm HClO displayed the cleanest areas. All sodium hypochlorite groups displayed erosion with higher ranks with greater concentration, while hypochlorous acid did not display any erosion regardless the concentration. CONCLUSIONS It is possible to conclude that HClO obtained from an electrolytic device presented high antimicrobial activity and low cytotoxicity in both tested concentrations. 500 ppm HClO did not display erosion and showed great cleaning ability. CLINICAL RELEVANCE The use of 500 ppm hypochlorous acid may reduce unfavorable behavior of sodium hypochlorite whilst maintaining its antimicrobial action.
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Affiliation(s)
- Matheus Albino Souza
- School of Dentistry, Graduate Program in Dentistry, University of Passo Fundo - UPF. BR 285/São José, Prédio A7, Apto 2, Passo Fundo, RS, CEP: 9052-900, Brazil
| | - Liviu Steier
- School of Dental Medicine, University of Pennsylvania - UPENN, 240 South 40Th Street (40Th & Locust St.), Philadelphia, PA, ZIP19104, USA
| | - Gabriele Nichetti Vanin
- School of Dentistry, Graduate Program in Dentistry, University of Passo Fundo - UPF. BR 285/São José, Prédio A7, Apto 2, Passo Fundo, RS, CEP: 9052-900, Brazil
| | - Mylena Lazareti Zanella
- School of Dentistry, Graduate Program in Dentistry, University of Passo Fundo - UPF. BR 285/São José, Prédio A7, Apto 2, Passo Fundo, RS, CEP: 9052-900, Brazil
| | - Camila Monteiro Pizzi
- School of Dentistry, Graduate Program in Dentistry, University of Passo Fundo - UPF. BR 285/São José, Prédio A7, Apto 2, Passo Fundo, RS, CEP: 9052-900, Brazil
| | - Eduarda Rizzon Ferreira
- School of Dentistry, Graduate Program in Dentistry, University of Passo Fundo - UPF. BR 285/São José, Prédio A7, Apto 2, Passo Fundo, RS, CEP: 9052-900, Brazil
| | - Felipe Gomes Dallepiane
- School of Dentistry, Graduate Program in Dentistry, University of Passo Fundo - UPF. BR 285/São José, Prédio A7, Apto 2, Passo Fundo, RS, CEP: 9052-900, Brazil
| | - Nathan Mateus Piccolo
- School of Dentistry, Graduate Program in Dentistry, University of Passo Fundo - UPF. BR 285/São José, Prédio A7, Apto 2, Passo Fundo, RS, CEP: 9052-900, Brazil
| | - Jordana da Silva Koch
- Graduate Program in Dentistry, Oral Biology Lab, Federal University of Rio Grande do Sul - UFRGS, Rua Sarmento Leite 500 Sala 134, Porto Alegre, RS, CEP90050-170, Brazil
| | - Kellyn Rocca Souza
- Graduate Program in Dentistry, Oral Biology Lab, Federal University of Rio Grande do Sul - UFRGS, Rua Sarmento Leite 500 Sala 134, Porto Alegre, RS, CEP90050-170, Brazil
| | - Ubirajara Maciel da Costa
- School of Veterinary Medicine, State University of Santa Catarina - UDESC, Av. Luiz de Camões, 2090, Conta Dinheiro, Lages, SC, CEP: 88.520-000, Brazil
| | - Vanessa Valgas Dos Santos
- School of Medicine, University of Planalto Catarinense - UNIPLAC, Av. Mal. Castelo Branco 170, Lages, SC, CEP 88526-075, Brazil
| | - Aleksandra Palatynska-Ulatowska
- Department of Endodontics, Medical Faculty, Division of Dentistry, Medical University of Lödz, 251 Pomorska Street, Lödz, 92-213, Poland
| | - José Antônio Poli de Figueiredo
- Graduate Program in Dentistry, Oral Biology Lab, Federal University of Rio Grande do Sul - UFRGS, Rua Sarmento Leite 500 Sala 134, Porto Alegre, RS, CEP90050-170, Brazil.
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13
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Şengül SN, Ozturk S, Ulubayram K, Pekel Bayramgil N, Kucukkaya Eren S. Effect of final irrigation protocols with chitosan nanoparticle and genipin on dentine against collagenase degradation: An ex-vivo study. Int Endod J 2024; 57:477-489. [PMID: 38240378 DOI: 10.1111/iej.14027] [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: 06/16/2023] [Revised: 12/03/2023] [Accepted: 01/10/2024] [Indexed: 03/07/2024]
Abstract
AIM Endodontic irrigants may affect the mechanical and chemical properties of dentine. This study evaluated the effects of various final irrigation protocols including the use of chitosan nanoparticle (CSnp) and cross-linking with genipin on the (1) mechanical and (2) chemical properties of dentine against enzymatic degradation. METHODOLOGY CSnp was synthesized and characterized considering physiochemical parameters and stability. The root canals of 90 single-rooted teeth were prepared and irrigated with NaOCl. Dentine discs were obtained and divided into groups according to the following irrigation protocols: Group NaOCl+EDTA, Group NaOCl+CSnp, Group NaOCl+EDTA+CSnp, Group NaOCl+CSnp+Genipin, Group NaOCl+EDTA+CSnp+Genipin and Group distilled water. (1) Mechanical changes were determined by microhardness analysis using Vickers-tester. (2) Chemical changes were determined by evaluating molecular and elemental compositions of dentine using Fourier transform infrared spectroscopy (FTIR) analysis and scanning electron microscope (SEM)/energy dispersive X-ray spectroscopy (EDS) analysis, respectively. All analyses were repeated after the discs were kept in collagenase for 24 h. Data were analysed with repeated measures analysis of variance and Bonferroni correction for microhardness analysis, and Kruskal-Wallis and Wilcoxon tests for FTIR and SEM/EDS analyses (p = .05). RESULTS (1) Collagenase application did not have a negative effect on microhardness only in Group NaOCl+EDTA+CSnp+Genipin when compared with the post-irrigation values (p > .05). Post-collagenase microhardness of Group NaOCl+EDTA+CSnp and Group NaOCl+CSnp+Genipin was similar to the initial microhardness (p > .05). (2) After collagenase, Amide III/PO 4 3 - ratio presented no change in Group NaOCl+EDTA+CSnp, Group NaOCl+CSnp+Genipin and Group NaOCl+EDTA+CSnp+Genipin (p > .05), while decreased in other groups (p < .05). Collagenase did not affectCO 3 2 - /PO 4 3 - ratio in the groups (p > .05). There were no changes in the groups in terms of elemental level before and after collagenase application (p > .05). CONCLUSIONS CSnp and genipin positively affected the microhardness and molecular composition of dentine. This effect was more pronounced when CSnp was used after EDTA.
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Affiliation(s)
- S N Şengül
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - S Ozturk
- Department of Basic Pharmaceutical Sciences, Faculty of Pharmacy, Hacettepe University, Ankara, Turkey
| | - K Ulubayram
- Department of Basic Pharmaceutical Sciences, Faculty of Pharmacy, Hacettepe University, Ankara, Turkey
| | - N Pekel Bayramgil
- Department of Chemistry, Faculty of Science, Hacettepe University, Ankara, Turkey
| | - S Kucukkaya Eren
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
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Acharya S, Sahoo D, Singh B, Gurunathan D. Revascularization Revisited with Modified Triple Antibiotic Paste and NeoPutty MTA®. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2024; 16:S1871-S1874. [PMID: 38882759 PMCID: PMC11174228 DOI: 10.4103/jpbs.jpbs_1212_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 12/23/2023] [Accepted: 12/23/2023] [Indexed: 06/18/2024] Open
Abstract
Introduction and Aim Performing endodontic treatment in an immature permanent tooth that has experienced trauma or carious exposure can pose challenges. The root canals in these teeth are typically open and fragile, making instrumentation and obturation difficult. Traditional apexification, which involves placing calcium hydroxide paste in the root canal for a specified period to induce the formation of a calcified barrier, has been a long-standing approach. While it is a widely used method, leaving the paste in the root for extended periods can weaken it due to the paste's hygroscopic properties and the proteolytic activities of calcium hydroxide. As a result, researchers have been exploring alternative treatments that allow for the full development of immature teeth. Revascularization has emerged as one such alternative, with a variety of treatment protocols documented in scientific literature. Description of the Case This case report, for the first time, describes the use of NeoPutty MTA® and triple antibiotics paste for revascularization in a young female child on a carious, exposed lateral incisor with opex apex with success. Conclusion The revascularization process attempted on the infected tooth met with success and closure of apex was noticed in a short period of time.
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Affiliation(s)
- Sonu Acharya
- Department of Pediatric and Preventive Dentistry, Institute of Dental Sciences, Siksha 'O' Anusandhan (Deemed to be) University, Bhubaneswar, Odisha, India
| | - Dipmalla Sahoo
- Department of Pediatric and Preventive Dentistry, Institute of Dental Sciences, Siksha 'O' Anusandhan (Deemed to be) University, Bhubaneswar, Odisha, India
| | - Bismay Singh
- Department of Pediatric and Preventive Dentistry, Institute of Dental Sciences, Siksha 'O' Anusandhan (Deemed to be) University, Bhubaneswar, Odisha, India
| | - Deepa Gurunathan
- Department of Pediatric and Preventive Dentistry, Saveetha Dental College and Hospitals, SIMATS, Chennai, Tamil Nadu, India
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Marques JA, Falacho RI, Santos JM, Ramos JC, Palma PJ. Effects of endodontic irrigation solutions on structural, chemical, and mechanical properties of coronal dentin: A scoping review. J ESTHET RESTOR DENT 2024; 36:606-619. [PMID: 37698359 DOI: 10.1111/jerd.13135] [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: 05/15/2023] [Revised: 08/29/2023] [Accepted: 08/30/2023] [Indexed: 09/13/2023]
Abstract
OBJECTIVE This review aims to assess structural, chemical, and mechanical properties of coronal dentin after endodontic irrigation. MATERIALS AND METHODS Reporting followed the PRISMA extension for scoping reviews. An electronic search was carried out in PubMed, Embase, and Cochrane Library. Records filtered by language and published up to November 4, 2022 were independently screened by two researchers. Studies evaluating structural, chemical, or mechanical properties of human permanent coronal dentin after irrigation within the scope of nonsurgical root canal treatment were included. Data were extracted regarding study type, sample description and size, experimental groups, outcome, evaluation method, and main findings. RESULTS From the initial 1916 studies, and by adding 2 cross-references, 11 in vitro studies were included. Seven studies provide ultrastructural and/or chemical characterization, and six assessed microhardness and/or flexural strength. One percent to 8% sodium hypochlorite (NaOCl) and 1%-17% ethylenediaminetetraacetic acid (EDTA) were the most commonly tested solutions, with contact times of 2-240 min (NaOCl) and 1-1440 min (EDTA) being evaluated. CONCLUSIONS Overall, the literature is consensual regarding the inevitable impact of NaOCl and chelating agents on coronal dentin, with both deproteinizing and decalcifying effects being concentration- and time-dependent. The alteration of mechanical parameters further confirmed the surface and subsurface ultrastructural and chemical changes. CLINICAL SIGNIFICANCE Endodontic treatment success highly depends on restorative sealing. Understanding the result of exposing coronal dentin, the main substrate for bonding, to irrigants' action is crucial. The deproteinizing and decalcifying effects of NaOCl and chelating agents are both concentration- and time-dependent, causing surface and subsurface ultrastructural, chemical, and mechanical alterations.
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Affiliation(s)
- Joana A Marques
- Institute of Endodontics, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Center for Innovation and Research in Oral Sciences (CIROS), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Rui I Falacho
- Center for Innovation and Research in Oral Sciences (CIROS), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Institute of Oral Implantology and Prosthodontics, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - João Miguel Santos
- Institute of Endodontics, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Center for Innovation and Research in Oral Sciences (CIROS), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Coimbra Institute for Clinical and Biomedical Research (iCBR) and Center of Investigation on Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine and Clinical Academic Center of Coimbra (CACC), Coimbra, Portugal
| | - João Carlos Ramos
- Center for Innovation and Research in Oral Sciences (CIROS), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Institute of Operative Dentistry, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Paulo J Palma
- Institute of Endodontics, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Center for Innovation and Research in Oral Sciences (CIROS), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
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16
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Liu H, Nio S, Shen Y. Sodium hypochlorite against Enterococcus faecalis biofilm in dentinal tubules: effect of concentration, temperature, and exposure time. Odontology 2024; 112:390-398. [PMID: 37646916 DOI: 10.1007/s10266-023-00850-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 08/18/2023] [Indexed: 09/01/2023]
Abstract
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.
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Affiliation(s)
- He Liu
- Division of Endodontics, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, 2199 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Stefanie Nio
- Division of Endodontics, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, 2199 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Ya Shen
- Division of Endodontics, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, 2199 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada.
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Shaji D, Krishnamma S, Attuvalappil Rajan D, Narayanankutty SK, George J, Ramakrishnan C. Comparative Evaluation of a New Tricalcium Silicate Cement With Calcium Hydroxide as Direct Pulp Capping Agents: A Clinical Study. Cureus 2024; 16:e56508. [PMID: 38646305 PMCID: PMC11026997 DOI: 10.7759/cureus.56508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 03/18/2024] [Indexed: 04/23/2024] Open
Abstract
Background and objectives Direct pulp capping (dPC) is a therapeutic process that involves the application of a protective chemical to an exposed pulp with the intent to facilitate the restoration and preservation of its vitality and function. Despite numerous proposed solutions, researchers have yet to find a dependable, non-absorbable bioactive pulp capping substance that constantly activates cellular healing processes, consequently preserving pulpal vitality over an extended period of time. The objective of this study was to assess and contrast the efficacy of a novel tricalcium silicate cement and calcium hydroxide in preserving the long-term health of the dental pulp following dPC using clinical and radiographic observations. Materials and methods A total of 60 individuals with symptoms of reversible pulpitis associated with deep carious lesions were chosen for dPC in the study. Two groups comprising 30 patients each underwent dPC using the novel tricalcium silicate cement (experimental group) and calcium hydroxide (control group) out of the total number of patients. A thin protective covering of self-curing glass ionomer base was applied on top of the capping material. The dentist provided instant permanent restoration employing direct posterior composite resin. Follow-up examinations were conducted three, six, nine, and 12 months after the procedure, during which assessments were performed using clinical and radiographic parameters. Results The minimum age of the study group was 16, and its maximum age was 34 (22.35 ± 2.3 years). The control group consisted of 12 males and 18 females, while the Biodentine group consisted of 13 males and 17 females. The age and gender distribution were determined to have insignificant statistical differences across the groups. The pain score exhibited statistical significance at both the three-month and six-month follow-up visits (p < 0.05). The pain score at the 12-month follow-up was 0.38 ± 0.52 in the case group and 0.42 ± 0.61 in the control group (p = 0.79). The average Periapical Index (PAI) score for the Dycal and Biodentin groups after the 12-month follow-up was 1.38 ± 0.97 and 1 ± 0.3, respectively. This difference was found to be statistically significant (p = 0.044). In addition, there was a statistically significant difference in the PAI score at the three-month, six-month, and nine-month follow-ups (p < 0.01). During the entirety of the follow-up duration, one individual in the Biodentine group had tenderness upon percussion, a negative reaction for pulp vitality, pulpal changes, and a widening of the periodontal space. Statistically significant differences were observed in pulpal changes and tenderness on percussion during the nine-month and 12-month follow-up periods (p < 0.05). After 12 months, the rate of success in the group treated with Dycal was 91.3%, while the success percentage in the group treated with Biodentine was 98.55%. This difference in outcomes was determined to be statistically significant (λ2 = 5.46; p = 0.019). Conclusion The study findings indicate that Biodentine, a novel tricalcium silicate cement, outperforms calcium hydroxide in preserving pulp vitality over the long term following dPC. The Biodentine group attained an overall success rate of 98.55%, whereas the Dycal group had a success rate of 91.3% following 12 months of subsequent follow-up visits.
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Affiliation(s)
- Dhanya Shaji
- Department of Conservative Dentistry and Endodontics, Government Dental College, Thrissur, IND
| | - Sobha Krishnamma
- Department of Conservative Dentistry and Endodontics, Government Dental College, Kottayam, IND
| | | | | | - Jinu George
- Department of Conservative Dentistry and Endodontics, Government Dental College, Thrissur, IND
| | - Christalin Ramakrishnan
- Department of Conservative Dentistry and Endodontics, Government Dental College, Thrissur, IND
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Barakat RM, Almohareb RA, Alsuwaidan M, Faqehi E, Alaidarous E, Algahtani FN. Effect of sodium hypochlorite temperature and concentration on the fracture resistance of root dentin. BMC Oral Health 2024; 24:233. [PMID: 38350980 PMCID: PMC10865544 DOI: 10.1186/s12903-024-03954-y] [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: 08/14/2023] [Accepted: 01/29/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Sodium hypochlorite (NaOCl) is the most efficient root canal irrigant to date. The aim of this study was to compare the effect of NaOCl used at different temperatures and concentrations on the compressive strength of root dentin. MATERIALS AND METHODS Seventy-two extracted human single-canaled straight roots of comparable size and length were selected and randomly divided into six groups (n = 12): Group (A) served as a control with unprepared canals. The other groups were instrumented with rotary ProTaper Universal files up to size F3. Group (B) was irrigated with 1% NaOCl at room temperature, Group (C) with 1% NaOCl heated to 70 °C, Group (D) with 5.25% NaOCl at room temperature, and Group (E) with 5.25% NaOCl heated to 70 °C. Saline was used in Group (F). The roots were sectioned into 2-mm-thick disks that underwent compression testing using a universal testing machine. Data were analyzed using one-way ANOVA and post hoc Tukey tests. The significance level was set at p ≤ 0.05. RESULTS A total of 255 disks were tested. The control group showed the highest compressive strength (p = 0.0112). However, this did not differ significantly from that of heated (p = 0.259) or unheated (p = 0.548) 1% NaOCl. There were no statistically significant differences between the groups of instrumented teeth. CONCLUSION Within the conditions of this study, irrigation with NaOCl at different concentrations and temperatures during root canal preparation did not affect the compressive strength of root dentin. CLINICAL RELEVANCE This study demonstrates that the use of NaOCl as a root canal irrigant is not associated with a clinically relevant decrease in root compressive strength, especially when compared to saline.
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Affiliation(s)
- Reem M Barakat
- Dental Clinics Department, King Abdullah bin Abdulaziz University Hospital, Princess Nourah Bint Abdulrahman University, Box 84428, Riyadh, 11671, Saudi Arabia
| | - Rahaf A Almohareb
- Department of Clinical Dental Sciences, College of Dentistry, Princess Nourah Bint Abdulrahman University, P.O. Box 84428, Riyadh, 11671, Saudi Arabia.
| | - Munirah Alsuwaidan
- Dental Intern, College of Dentistry, Princess Nourah Bint Abdulrahman University, P.O. Box 84428, Riyadh, 1167, Saudi Arabia
| | - Ebtihal Faqehi
- Dental Intern, College of Dentistry, Princess Nourah Bint Abdulrahman University, P.O. Box 84428, Riyadh, 1167, Saudi Arabia
| | - Enas Alaidarous
- Dental Intern, College of Dentistry, Princess Nourah Bint Abdulrahman University, P.O. Box 84428, Riyadh, 1167, Saudi Arabia
| | - Fahda N Algahtani
- Department of Clinical Dental Sciences, College of Dentistry, Princess Nourah Bint Abdulrahman University, P.O. Box 84428, Riyadh, 11671, Saudi Arabia
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Kameri A, Dragidella A, Haziri A, Hashani Z, Kurteshi K, Kurti A. Antifungal and genotoxic effects of Thymus serpyllum as a root canal irrigant. Clin Exp Dent Res 2024; 10:e837. [PMID: 38345516 PMCID: PMC10847709 DOI: 10.1002/cre2.837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 11/13/2023] [Accepted: 12/21/2023] [Indexed: 02/15/2024] Open
Abstract
OBJECTIVES The aim of this study was the assessment of the efficiency of the ethyl acetate (EthOAc) extract of Thymus serpyllum against Candida albicans and to compare it with sodium hypochlorite (NaOCl) and chlorhexidine (CHX), as well as their genotoxic effect. MATERIAL AND METHODS The antifungal effectiveness of the EthOAc extract of Thymus serpyllum was determined using the agar disk diffusion method. The inhibition zones induced by the EthOAc extract were compared after 5 min, 60 min, and 24 h to those induced by standard solutions (2% CHX and 2% NaOCl). An in vitro genotoxicity assay was performed in cultured lymphocytes from the blood of human volunteers to observe micronuclei formation. Statistical analysis of the results was performed using the Kruskal-Wallis test and one-way analysis of variance. RESULTS The inhibition zone of combination of CHX with EthOAc extract of Thymus serpyllum against C. albicans was 29.7 mm after 5 min, 28.3 mm after 60 min, and 29 mm after 24 h. The inhibition zone of NaOCl in combination with EthOAc extract of Thymus serpyllum against C. albicans was 0 mm. The EthOAc extract of Thymus serpyllum did not show a genotoxic effect on lymphocyte cells. CONCLUSIONS The EthOAc extract of Thymus serpyllum in combination with CHX may be a useful root canal disinfection in endodontic therapy.
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Affiliation(s)
- Ariana Kameri
- Department of Dental Pathology and Endodontics, Faculty of MedicineUniversity of Prishtina “Hasan Prishtina”PrishtinaKosova
| | - Agime Dragidella
- Department of Dental Pathology and Endodontics, Faculty of MedicineUniversity of Prishtina “Hasan Prishtina”PrishtinaKosova
| | - Arben Haziri
- Department of Chemistry, Natural Science FacultyUniversity of Prishtina “Hasan Prishtina”PrishtinaKosova
| | - Zeqir Hashani
- Faculty of EducationUniversity “Fehmi Agani”GjakoveKosova
| | - Kemajl Kurteshi
- Department of Biology, Natural Science FacultyUniversity of Prishtina “Hasan Prishtina”PrishtinaKosova
| | - Arsim Kurti
- Department of Microbiology, Medical FacultyUniversity of Prishtina “Hasan Prishtina”PrishtinaKosova
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20
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Zeng C, Hu P, Egan CP, Bergeron BE, Tay F, Ma J. Bacteria debridement efficacy of two sonic root canal irrigant activation systems. J Dent 2024; 140:104770. [PMID: 37923053 DOI: 10.1016/j.jdent.2023.104770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 10/30/2023] [Accepted: 11/01/2023] [Indexed: 11/07/2023] Open
Abstract
OBJECTIVE To evaluate the bacteria debridement efficacy of two generations of sonic root canal irrigant activation systems: EndoActivator (Dentsply Sirona), the first generation, and SmartLite Pro EndoActivator, the second generation. METHODS Instrumented, autoclaved, single-rooted human premolars were inoculated with Enterococcus faecalis (ATCC-29212) for 21 days. The bacteria biofilm-containing teeth were randomly divided into 5 groups (N=8): Group 1: Syringe-side-vented needle (S-N) delivery of saline for 1 min; Group 2: S-N delivery of 2% NaOCl for 1 min; Group 3: S-N delivery of 2% NaOCl for 5 min; Group 4: EndoActivator activation of 2% NaOCl for 1 min; Group 5: SmartLite Pro EndoActivator activation of 2% NaOCl for 1 min. The teeth were evaluated for bacterial reduction using CFU counts, and the percentages of dead bacteria within the dentinal tubules using confocal laser scanning microscopy. RESULTS Activation of NaOCl with EndoActivator or SmartLite Pro EndoActivator significantly reduced the overall intracanal bacterial load, compared with S-N irrigant delivery (P<0.05), with no significant difference between the two agitation devices (P>0.05). Nevertheless, S-N delivery of 2% NaOCl for 5 min produced better bacteria debridement than either sonic agitation system. Different degrees of bacteria kill were identified in the coronal-middle portions and apical portion of the canal space. CONCLUSION Delivery time of NaOCl affects the efficacy of bacteria disinfection. Activation for 1 min with the EndoActivator or SmartLite Pro EndoActivator demonstrated comparable canal wall biofilm and intracanal bacteria reduction efficacy when 2% NaOCl was used as irrigant for disinfecting E. faecalis in single-rooted teeth. CLINICAL SIGNIFICANCE Although the sonic root canal irrigant activation devices investigated do not completely eliminate live bacteria biofilms from the canal space, they help reduce bacteria load during irrigant activation.
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Affiliation(s)
- Chang Zeng
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Pei Hu
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Colin P Egan
- The Dental College of Georgia, Augusta University, Augusta, GA, USA
| | - Brian E Bergeron
- The Dental College of Georgia, Augusta University, Augusta, GA, USA
| | - Franklin Tay
- The Dental College of Georgia, Augusta University, Augusta, GA, USA.
| | - Jingzhi Ma
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
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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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22
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Uçar AY, Kölüş T, Bozkurt DA, Neelakantan P, Ali IAA, Belli S. A laboratory investigation on the effect of biguanide- and pyridine-derived antiseptics on the adhesion of resin composites to dentin. AUST ENDOD J 2023; 49:599-605. [PMID: 37602727 DOI: 10.1111/aej.12791] [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: 02/25/2023] [Revised: 08/06/2023] [Accepted: 08/13/2023] [Indexed: 08/22/2023]
Abstract
Optimal bonding of adhesive restorations to dentin is crucial to prevent microleakage and enhance the survival of root-filled teeth. The aim of this study was to investigate the effect of chlorhexidine (CHX), alexidine (ALX) and octenidine dihydrochloride (OCT) on the bond strength of resin composites to coronal dentin. Human coronal dentin specimens were treated with 2% CHX, 0.1% ALX, 0.1% OCT or saline then restored with traditional or bulk-fill resin composites. The adhesion strength between the resin and dentin was measured using the microtensile bond strength and failure mode was determined using a stereomicroscope. Treatment with ALX and OCT resulted in significantly greater μTBS compared with CHX and saline, irrespective of the resin composite used. Alexidine treatment predominantly resulted in mixed failure, while adhesive failures were frequently observed in CHX and saline-treated dentin. In conclusion, final irrigation with ALX or OCT improved the bonding of resin composites to dentin.
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Affiliation(s)
- Arzu Yağmur Uçar
- Department of Endodontics, Faculty of Dentistry, Selçuk University, Konya, Turkey
| | - Türkay Kölüş
- Department of Restorative Dentistry, Faculty of Dentistry, Karamanoğlu Mehmetbey University Ahmet Keleşoğlu, Karaman, Turkey
| | - D Alperen Bozkurt
- Department of Endodontics, Faculty of Dentistry, Necmettin Erbakan University, Konya, Turkey
| | - Prasanna Neelakantan
- Divison of Restorative Dental Sciences, Discipline of Endodontology, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, Hong Kong
| | - Islam A A Ali
- School of Dentistry, Oregon Health & Science University, Portland, Oregon, USA
| | - Sema Belli
- Department of Endodontics, Faculty of Dentistry, Selçuk University, Konya, Turkey
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23
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Pascale C, Geaman J, Mendoza C, Gao F, Kaminski A, Cuevas-Nunez M, Darvishan B, Mitchell JC, Carrilho MR, Sigar I. In vitro assessment of antimicrobial potential of low molecular weight chitosan and its ability to mechanically reinforce and control endogenous proteolytic activity of dentine. Int Endod J 2023; 56:1337-1349. [PMID: 37584496 DOI: 10.1111/iej.13962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 07/25/2023] [Accepted: 07/28/2023] [Indexed: 08/17/2023]
Abstract
AIMS Chitosan-based biomaterials exhibit several properties of biological interest for endodontic treatment. Herein, a low molecular weight chitosan (CH) solution was tested for its antimicrobial activity against Enterococcus faecalis (E. faecalis) and effects on dentine structure. METHODOLOGY The root canal of 27 extracted uniradicular teeth were biomechanically prepared, inoculated with a suspension of E. faecalis and randomly assigned to be irrigated with either 5.25% sodium hypochlorite (NaClO), 0.2% CH or sterile ultrapure water (W). Bacteriologic samples were collected from root canals and quantified for of E. faecalis colony-forming units (CFUs). The effectiveness of CH over E. faecalis biofilms was further measured using the MBEC Assay®. Additionally, dentine beams and dentine powder were obtained, respectively, from crowns and roots of 20 extracted third molars. Dentine samples were treated or not with 17% EDTA and immersed in either CH or W for 1 min. The effects of CH on dentine structure were evaluated by assessment of the modulus of elasticity, endogenous proteolytic activity and biochemical modifications. RESULTS The number of E. faecalis CFUs was significantly lower for samples irrigated with CH and NaClO. No significant differences were found between CH and NaClO treatments. Higher modulus of elasticity and lower proteolytic activity were reported for dentine CH-treated specimens. Chemical interaction between CH and dentine was observed for samples treated or not with EDTA. CONCLUSIONS Present findings suggest that CH could be used as an irrigant during root canal treatment with the triple benefit of reducing bacterial activity, mechanically reinforcing dentine and inhibiting dentine proteolytic activity.
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Affiliation(s)
- Christina Pascale
- College of Dental Medicine Illinois, Midwestern University, Downers Grove, Illinois, USA
| | - Jay Geaman
- College of Dental Medicine Illinois, Midwestern University, Downers Grove, Illinois, USA
| | - Christine Mendoza
- College of Dental Medicine Illinois, Midwestern University, Downers Grove, Illinois, USA
| | - Feng Gao
- College of Dental Medicine Illinois, Midwestern University, Downers Grove, Illinois, USA
| | - Amber Kaminski
- College of Graduate Studies, Midwestern University, Downers Grove, Illinois, USA
| | - Maria Cuevas-Nunez
- College of Dental Medicine Illinois, Midwestern University, Downers Grove, Illinois, USA
| | - Behnam Darvishan
- College of Dental Medicine Illinois, Midwestern University, Downers Grove, Illinois, USA
| | - John C Mitchell
- College of Dental Medicine Illinois, Midwestern University, Downers Grove, Illinois, USA
- College of Dental Medicine Arizona, Midwestern University, Downers Grove, Illinois, USA
| | - Marcela R Carrilho
- College of Dental Medicine Illinois, Midwestern University, Downers Grove, Illinois, USA
| | - Ira Sigar
- College of Graduate Studies, Midwestern University, Downers Grove, Illinois, USA
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Kalyoncuoğlu ÜT, Ayyıldız S, Odabasi Tezer E. The impact of print orientation on the fracture resistance and failure patterns of additively manufactured cobalt-chromium post and cores. J Prosthodont 2023; 32:714-720. [PMID: 37664889 DOI: 10.1111/jopr.13762] [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: 10/30/2022] [Revised: 08/23/2023] [Accepted: 08/29/2023] [Indexed: 09/05/2023] Open
Abstract
PURPOSE The aim of this study was to evaluate the impact of the print orientation of direct metal laser sintering (DMLS) posts and cores on the fracture resistance and failure patterns of endodontically treated mandibular premolar teeth. MATERIALS AND METHODS Sixty intact human mandibular premolars were endodontically treated. The teeth were then randomly divided into four groups (n = 15). Cobalt-chromium (Co-Cr) metal posts were fabricated by traditional casting (Group C), and DMLS method in 0-, 45-, and 90-degree print orientations (Group DMLS 0, Group DMLS 45, and Group DMLS 90). The posts and cores were cemented with composite resin cement and subjected to compression test at a crosshead speed of 1 mm/min. Data was analyzed by using one-way analysis of variance ANOVA and multiple comparison post hoc Tukey tests (α = 0.05). Specimens were viewed under a stereo microscope with x20 magnification to evaluate the fracture types. RESULTS No significant differences were found among the groups tested in terms of fracture resistance (p > 0.05). Group C and Group DMLS 0 group exhibited similar fracture patterns. CONCLUSIONS It is possible to produce post and core restorations with the DMLS technique and use them clinically. Print orientation did not influence the fracture resistance. However, fracture patterns were different. Group C outperformed all DMLS groups in terms of fracture patterns.
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Affiliation(s)
- Ülkü Tuğba Kalyoncuoğlu
- Department of Prosthodontics, Faculty of Gülhane Dentistry, University of Health Sciences Turkey, Ankara, Turkey
| | - Simel Ayyıldız
- Department of Prosthodontics, Faculty of Gülhane Dentistry, University of Health Sciences Turkey, Ankara, Turkey
- University of Health Sciences Turkey, Medical Design Manufacturing Center, Ankara, Turkey
| | - Emine Odabasi Tezer
- Department of Endodontics, Faculty of Dentistry, Ankara University, Ankara, Turkey
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Nanda Z, Singh R, Kamble PP, Deshmukh G, Patil N, Patil AB, Banerjee S. Efficacy of Different Root Canal Irrigating Solutions in Removing Smear Layer: A Scanning Electron Microscopic Study. Cureus 2023; 15:e44618. [PMID: 37799225 PMCID: PMC10548495 DOI: 10.7759/cureus.44618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2023] [Indexed: 10/07/2023] Open
Abstract
Background The aim of the present investigation was to evaluate and compare the efficacy of frequently used chemical agents in terms of their capacity to eliminate the smear layer after instrumentation, as observed via scanning electron microscopy (SEM). Materials and methods Sixty extracted single-rooted mandibular premolar teeth, each with roots 15 mm in length, were used in this study. The teeth were divided into one control group and four study groups, each containing 12 teeth. In Control Group 0, teeth were irrigated with 3 ml of saline only. In Group 1, teeth were irrigated initially with 3% sodium hypochlorite (NaOCl) and then given a final rinse with 3 ml of 17% ethylenediaminetetraacetic acid (EDTA) for one minute. In Group 2, teeth were irrigated with 3% NaOCl and given a final rinse with 3 ml of a mixture of tetracycline, acid, and detergent (MTAD, BIOPURE) for one minute. In Group 3, teeth were irrigated with saline and given a final rinse with 3 ml of 17% EDTA for one minute. In Group 4, teeth were irrigated with saline and given a final rinse with 3 ml of MTAD for one minute. One-half of each tooth was chosen and prepared for scanning electron microscopic (SEM) examination at the cervical, middle, and apical thirds. These were observed at magnifications of up to 1,000 times to check for the presence or absence of a smear layer. The data were analyzed using the Kruskal-Wallis test and post-hoc Dunn's test. Results All of the root canal irrigation protocols exhibited superior efficacy compared to the control group in the elimination of the smear layer. Group 2 (3% NaOCl with MTAD) showed the lowest mean scores, compared to all the groups, followed by Group 1 (3% NaOCl with 17% EDTA). MTAD was more effective than EDTA. The smear layer was effectively removed from the apical third, followed by the middle and coronal thirds of the root. Conclusion Initial irrigation with 3% NaOCl and one-minute final irrigation with 3 ml MTAD was the most effective root irrigant, and particularly indicated in teeth with infection of the apical third.
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Affiliation(s)
- Zinnie Nanda
- Conservative Dentistry and Endodontics, Jawahar Medical Foundation's (JMF) Annasaheb Chudaman Patil Memorial (ACPM) Dental College, Dhule, IND
| | - Romalpreet Singh
- Conservative Dentistry and Endodontics, Desh Bhagat Dental College, Malout, IND
| | - Priyanka P Kamble
- Oral Pathology and Microbiology, Jawahar Medical Foundation's (JMF) Annasaheb Chudaman Patil Memorial (ACPM) Dental College, Dhule, IND
| | - Gargi Deshmukh
- Dental Surgery, Chhatrapati Shahu Maharaj Shikshan Sanstha's (CSMSS) Dental College and Hospital, Aurangabad, IND
| | - Nileshrao Patil
- Conservative Dentistry and Endodontics, Jawahar Medical Foundation's (JMF) Annasaheb Chudaman Patil Memorial (ACPM) Dental College, Dhule, IND
| | - Anshuman B Patil
- Conservative Dentistry and Endodontics, Jawahar Medical Foundation's (JMF) Annasaheb Chudaman Patil Memorial (ACPM) Dental College, Dhule, IND
| | - Satyabrat Banerjee
- Conservative Dentistry and Endodontics, Jawahar Medical Foundation's (JMF) Annasaheb Chudaman Patil Memorial (ACPM) Dental College, Dhule, IND
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Dave AG, Mallya PL, Ballal NV, Shenoy R. Effect of ethylenediaminetetraacetic acid, maleic acid, and fumaric acid on postendodontic treatment root fracture toughness - An in vitro study. JOURNAL OF CONSERVATIVE DENTISTRY AND ENDODONTICS 2023; 26:453-457. [PMID: 37705546 PMCID: PMC10497077 DOI: 10.4103/jcd.jcd_252_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 05/29/2023] [Accepted: 06/02/2023] [Indexed: 09/15/2023]
Abstract
Aim The aim of this study was to evaluate the effectiveness of ultrasonic activation of ethylenediaminetetraacetic acid (EDTA), maleic acid (MA), and fumaric acid (FA) in combination with sodium hypochlorite (NaOCl) on postendodontic treatment root fracture toughness. Materials and Methods Forty single-rooted mandibular premolars were sectioned below the cementoenamel junction and were kept on average 14 mm long. With the exception of eight randomly selected teeth acting as a negative control group (Group I/nonprepared), the rest were prepared till F3. Thirty-two specimens were randomly placed into four groups equally and then irrigated using the final irrigation protocols. Saline and NaOCl were used to irrigate Group II, 17% EDTA and NaOCl were used to irrigate Group III, 7% MA and NaOCl were used to irrigate Group IV, and 0.7% FA and NaOCl were used to irrigate Group V. The irrigants were ultrasonically activated in every group. The root canals were obturated with gutta-percha and AH Plus sealer. The roots were embedded along the long axis in the self-curing acrylic blocks along with polyvinyl siloxane, leaving the coronal 2 mm of the root exposed. The specimens were tested using a universal testing machine. Statistical Analysis The Post hoc Tamhane's and one-way ANOVA tests were applied to examine the data. Results The result of the study revealed that 0.7% FA (598.09 N) provided better root fracture resistance than EDTA (428.07 N) and MA (511.87 N). Conclusion The conclusion derived from the study was that 0.7% FA provided better fracture resistance of endodontically treated teeth when compared to 17% EDTA and 7% MA.
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Affiliation(s)
- Aabha Gautam Dave
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Affiliated to Manipal Academy of Higher Education, Mangalore, India
| | - P. Laxmish Mallya
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Affiliated to Manipal Academy of Higher Education, Mangalore, India
| | - N. Vasudev Ballal
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Affiliated to Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Ramya Shenoy
- Public Health Dentistry, Manipal College of Dental Sciences, Affiliated to Manipal Academy of Higher Education, Mangalore, India
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Ahmed YE, Ahmed GM, Ghoneim AG. Evaluation of postoperative pain and healing following regenerative endodontics using platelet-rich plasma versus conventional endodontic treatment in necrotic mature mandibular molars with chronic periapical periodontitis. A randomized clinical trial. Int Endod J 2023; 56:404-418. [PMID: 36565044 DOI: 10.1111/iej.13886] [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: 06/24/2022] [Revised: 12/20/2022] [Accepted: 12/21/2022] [Indexed: 12/25/2022]
Abstract
AIM To evaluate the post-operative pain and the healing of necrotic mature permanent mandibular molar teeth with peri-apical periodontitis after conventional endodontic treatment versus after platelet-rich plasma (PRP) revascularization. METHODOLOGY The protocol of this randomized clinical trial was registered at www. CLINICALTRIALS gov with identification number NCT03350841. Twenty-eight patients were included in the study after confirming the diagnosis clinically and radiographically. In the first visit, mandibular molar teeth of both groups were mechanically prepared. Double antibiotic paste was prepared and injected then the cavity that was sealed with glass ionomer. At the second visit, the patients were randomized either to control group where standard endodontic treatment was completed by lateral condensation technique or assigned to intervention group where PRP revascularization technique. The degree of spontaneous pain was assessed using numerical rating scale (NRS) pre-operatively, then post-operatively after 6, 12 h and daily for 5 days. Patients were given a placebo to be administrated in case of pain. An analgesic (ibuprofen 400mg) was prescribed in case of persistent pain. Clinical and radiographic healing was assessed after 6 and 12 months. All demographic, baseline and outcome data were collected and statistically analysed. RESULTS Regarding the post revascularization/obturation pain, there was no statistically significant difference between severity of pain in the two groups at all time intervals except after 12 h, revascularization group showed statistically significantly higher prevalence of no pain than endodontic treatment group. Regarding the healing; the periapical lesions decrease in size significantly from the pre-operative lesion size in both groups without significant difference between the both groups. CONCLUSION Within the limitation of this study, PRP revascularization could be an alternative treatment to root canal treatment but further randomized clinical trials with standardized techniques and long follow up periods are recommended for more reliable results.
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Effect of Endodontic Irrigating Solutions on Radicular Dentine Structure and Matrix Metalloproteinases-A Comprehensive Review. Dent J (Basel) 2022; 10:dj10120219. [PMID: 36547035 PMCID: PMC9776432 DOI: 10.3390/dj10120219] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 11/17/2022] [Accepted: 11/21/2022] [Indexed: 11/24/2022] Open
Abstract
Irrigating solutions play an important role in the eradication of intracanal microbes and debris dissolution during endodontic treatment. Different combinations of solutions and protocols have been advocated, with sodium hypochlorite (NaOCl), ethylenediamine tetra acetic acid (EDTA), and chlorhexidine (CHX) remaining the most widely used ones by many clinicians. Although these solutions provide efficient inorganic dissolution and antimicrobial capacity, their use has also been reported to cause undesired effects on root dentin composition and mechanical and biomechanical properties, such as microhardness, surface roughness, bond strength, and matrix metalloproteinase (MMP) activity. Several corroborating studies attribute these changes in mechanical properties of dentine to the use of irrigating solutions, and there are limited reports on how the solutions affect the expression of MMPs, which may be a correlating link to understanding the role of these enzymes in dentin collagen and changes in the mechanical properties of dentin. Hence, using the basis of several studies from the literature, the objective is to comprehensively review the influence of individual and combined irrigating solutions on root dentine structure and the activity of the MMPs.
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The Potential of Phenothiazines against Endodontic Pathogens: A Focus on Enterococcus-Candida Dual-Species Biofilm. Antibiotics (Basel) 2022; 11:antibiotics11111562. [PMID: 36358217 PMCID: PMC9686549 DOI: 10.3390/antibiotics11111562] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 11/01/2022] [Accepted: 11/03/2022] [Indexed: 11/09/2022] Open
Abstract
Persistent apical periodontitis occurs when the endodontic treatment fails to eradicate the intraradicular infection, and is mainly caused by Gram-positive bacteria and yeasts, such as Enterococcus faecalis and Candida albicans, respectively. Phenothiazines have been described as potential antimicrobials against bacteria and fungi. This study aimed to investigate the antimicrobial potential of promethazine (PMZ) and chlorpromazine (CPZ) against E. faecalis and C. albicans dual-species biofilms. The susceptibility of planktonic cells to phenothiazines, chlorhexidine (CHX) and sodium hypochlorite (NaOCl) was initially analyzed by broth microdilution. Interaction between phenothiazines and CHX was examined by chequerboard assay. The effect of NaOCl, PMZ, CPZ, CHX, PMZ + CHX, and CPZ + CHX on biofilms was investigated by susceptibility assays, biochemical and morphological analyses. Results were evaluated through one-way ANOVA and Tukey’s multiple comparison post-test. PMZ, alone or in combination with irrigants, was the most efficient phenothiazine, capable of reducing cell counts, biomass, biovolume, carbohydrate and protein contents of dual-species biofilms. Neither PMZ nor CPZ increased the antimicrobial activity of CHX. Further investigations of the properties of phenothiazines should be performed to encourage their use in endodontic clinical practice.
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