1
|
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 2024:105214. [PMID: 38950767 DOI: 10.1016/j.jdent.2024.105214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Revised: 06/24/2024] [Accepted: 06/26/2024] [Indexed: 07/03/2024] Open
Abstract
OBJECTIVES To evaluate the mechanical properties of root canal dentin treated with sodium hypochlorite (NaOCl) in combination with hydroxyethylidene diphosphonic acid (HEDP) or ethylenediaminetetraacetic acid (EDTA). METHODS For testing fracture resistance, 45 single-rooted teeth were instrumented and irrigated with NaOCl/HEDP, NaOCl/EDTA, or distilled water. Fifteen untreated teeth served as control. After obturation, specimens from the experimental groups were thermocycled, dynamically-loaded, and then statically-loaded in a universal testing machine until failure. For flexural strength analysis, 15 teeth were instrumented and irrigated with NaOCl/HEDP or NaOCl/EDTA. Root segments were sectioned into dentin bars and tested for flexural strength using a universal testing machine. For microhardness evaluation, 20 teeth were instrumented and irrigated with NaOCl/HEDP or NaOCl/EDTA. Dentin disks from the coronal-third of each root segment were prepared, one before and one after irrigation, for microhardness testing with a Knoop hardness tester. RESULTS The highest fracture resistance was recorded in the untreated group, and the lowest in the EDTA group. Although the HEDP group had higher fracture resistance than the EDTA group, the distilled water group demonstrated even greater fracture resistance than the HEDP group. Specimens treated with HEDP had significantly higher flexural strength and microhardness values when compared with those treated with EDTA. CONCLUSION The fracture resistance, flexural strength, and microhardness of root canal dentin were higher when root canals were irrigated with NaOCl/HEDP, when compared with NaOCl/EDTA. CLINICAL SIGNIFICANCE Irrigating root canals with NaOCl combined with HEDP significantly improves the mechanical integrity of root canal dentin compared to the use of NaOCl with EDTA.
Collapse
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.
| |
Collapse
|
2
|
Mumcu AK, Kurnaz S, Kiraz G, Gündüz MK. Comparative effects of 17% ethylenediaminetetraacetic acid and 9% etidronic acid applied with different irrigant activation techniques on the release of growth factors from dentin: in vitro study. BMC Oral Health 2024; 24:612. [PMID: 38802852 PMCID: PMC11131224 DOI: 10.1186/s12903-024-04336-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 05/06/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND Growth factors embedded in the extracellular matrix of the dentin play an important role in the migration, proliferation, and differentiation of dental pulp stem cells in regenerative endodontics. In regenerative endodontic treatments, the type of irrigation solution used is crucial for the release of growth factors (GFs) from the dentin matrix. This study evaluated the effectiveness of different irrigant activation techniques (IAT) using two different chelating agents, 17% ethylenediaminetetraacetic acid (EDTA) and 9% etidronic acid (HEDP), in terms of their GF release. METHODS Seventy-two mandibular premolar teeth were prepared to simulate an open apex. The root fragments were irrigated with 20 ml of 1.5% sodium hypochlorite and 20 ml of saline solution. Eight root fragments were randomly separated for the control group, and the remaining 64 fragments were randomly separated into eight groups based on two different chelating agents (17% EDTA and 9% HEDP) and four different IAT ((conventional needle irrigation (CNI), passive ultrasonic irrigation (PUI), sonic activation with EDDY, and XP-endo Finisher (XPF)). TGF-β1, VEGF-A, BMP-7 and IGF-1 release levels were determined using an ELISA, and statistical analysis was performed using the Kolmogorov-Smirnov test, ANOVA, and the Tukey test (p < .05). RESULTS Compared to the control group, the experimental groups showed significantly higher GF release when using EDTA or HEDP. Among the activation groups, the EDDY group triggered the highest GF release, and the CNI group triggered the lowest. CONCLUSIONS IAT with EDTA and HEDP can increase GF release, with EDDY being the most effective IAT method. Using chelating agents with IAT may be beneficial in regenerative endodontic treatments.
Collapse
Affiliation(s)
- Arzu Kaya Mumcu
- Department of Endodontics, Faculty of Dentistry, Kutahya Health Sciences University, Kutahya, Türkiye.
| | - Safa Kurnaz
- Department of Endodontics, Faculty of Dentistry, Kutahya Health Sciences University, Kutahya, Türkiye
| | - Gülsen Kiraz
- Department of Endodontics, Faculty of Dentistry, Kutahya Health Sciences University, Kutahya, Türkiye
| | - Meliha Koldemir Gündüz
- Department of Basic Sciences of Engineering, Faculty of Engineering and Natural Sciences, Kutahya Health Sciences University, Kutahya, Türkiye
| |
Collapse
|
3
|
Novozhilova N, Babina K, Polyakova M, Sokhova I, Sherstneva V, Zaytsev A, Makeeva I, Mikheikina A. The Effect of Different Compositions and Concentrations of Etidronate-Containing Irrigants on the Antibacterial Activity of Sodium Hypochlorite against Enterococcus faecalis and Candida albicans. Dent J (Basel) 2024; 12:46. [PMID: 38534270 DOI: 10.3390/dj12030046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 02/12/2024] [Accepted: 02/19/2024] [Indexed: 03/28/2024] Open
Abstract
We assessed the effect of different compositions and concentrations of two etidronate-containing irrigants on the antibacterial activity of sodium hypochlorite (SH) against Enterococcus faecalis and Candida albicans in vitro. Pure cultures of C. albicans and E. faecalis were isolated from root canal samples. The disc diffusion method was used to compare the antibacterial effect of pure SH and SH mixed with 9%, 15%, and 18% etidronate of two manufactures (dual rinse (DR); IsraDent (ID)) and EDTA. The pH and temperature of the solutions were measured immediately after mixing and within 40 min. The ANOVA revealed a significant influence of the type of irrigating solution on the C. albicans and E. faecalis inhibition zone diameters that ranged from 6.6 to 51.6 mm and from 6.4 to 12.4 mm, respectively. SH with DR 9% exhibited the highest effect against C. albicans. The antifungal activity of the other irrigants was SH = SH + DR15% = SH + DR18% = SH + ID9% > SH + EDTA > SH + ID15% > SH + ID18%. No significant differences in the anti-E. faecalis effect were revealed between the tested solutions except for the mixtures of SH and 15% and 18% ID, which exhibited no antiseptic effect. There was a strong positive correlation between antiseptic activity against both microorganisms and the pH values of the tested solutions. In conclusion, most etidronate formulations did not significantly hamper sodium hypochlorite activity against C. albicans and E. faecalis. The effect was concentration- and manufacturer-dependent.
Collapse
Affiliation(s)
- Nina Novozhilova
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Ksenia Babina
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Maria Polyakova
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Inna Sokhova
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Valeria Sherstneva
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Alexandr Zaytsev
- Institute of Linguistics and Intercultural Communication, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Irina Makeeva
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Anna Mikheikina
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| |
Collapse
|
4
|
Radioimaging in the Evaluation of the Therapeutic Effect of the Vegetable Extract Obtained from Epilobium Parviflorum Schreb. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12030998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
For years, apical microleakage has been considered the main factor in endodontic failure therapy. Sealing abilities and antibacterial properties of root canal sealers and intracanal medicaments between appointments have been recognized as important factors for the success of endodontic treatment. Background: Apical periodontitis (AP) is an inflammatory disease around the apex of a tooth root. The microorganisms reach the pulp by dentinal tubules especially when there is an open cavity after a coronal fracture and the pulp is in contact with the septic oral environment. The aim of the study was to evaluate the dynamics of healing by recording periapical index (PAI), after two appointment endodontic procedure with commercial or experimental intracanal medicament. Methods: A total of 40 patients with primary chronic apical periodontitis requiring root canal treatment were assigned randomly into four groups according to the teeth medicated with dehydrated plant extract, calcium hydroxide, calcium hydroxide mixed with chlorhexidine (CHX) gel 2%, Walkhoff paste and obturated on a second visit, 7 days later. Patients were recalled at intervals of 3, 6, and 12 months to evaluate the treated teeth both clinically and radiographically for periapical healing. A 5-score scale PAI was used to evaluate stages of the periapical healing on a periapical radiography using a Kodak Dental imaging software provided by the radio-imagistic center. Results: Radiological evaluation revealed that the experimental intracanal medicament had a cumulative positive healing capacity by reducing the PAI as well as all resorbable pastes used in endodontic conventional therapy. Conclusions: The results suggest that the vegetable dry extract obtained from Epilobium parviflorum Schreb can be used as an inter-appointment medication among with the root canal filling for the positive effect on apical healing quantified by reducing the PAI.
Collapse
|
5
|
Ballal NV, Ivica A, Meneses P, Narkedamalli RK, Attin T, Zehnder M. Influence of 1-Hydroxyethylidene-1,1-Diphosphonic Acid on the Soft Tissue-Dissolving and Gelatinolytic Effect of Ultrasonically Activated Sodium Hypochlorite in Simulated Endodontic Environments. MATERIALS 2021; 14:ma14102531. [PMID: 34068094 PMCID: PMC8152752 DOI: 10.3390/ma14102531] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 05/11/2021] [Accepted: 05/12/2021] [Indexed: 11/24/2022]
Abstract
The addition of Dual Rinse HEDP, an etidronate powder, to a sodium hypochlorite (NaOCl) solution can create a combined single endodontic irrigant with a soft tissue-dissolving and a decalcifying effect, which can replace traditional alternating irrigation with chemically non-compatible solutions. While the short-term compatibility between NaOCl and 1-hydroxyethylidene-1,1-diphosphonic acid (HEDP) has been shown, it remains unclear whether ultrasonic activation of a combined NaOCl & HEDP solution immediately reduces the available chlorine and/or renders the NaOCl ineffective in dissolving organic tissue remnants. This was tested in three experiments: (1) direct activation in test tubes in an ultrasonic bath and then the activation by an ultrasonically oscillating tip (IrriSafe) in (2) an epoxy resin model containing a simulated isthmus filled with gelatin, and (3) extracted teeth with simulated resorption cavities filled with soft tissue. The control solutions were physiological saline and 2.5% NaOCl without HEDP. In (1), available chlorine after 30 s of ultrasonic activation (37 kHz) of test and control solution was assessed, as well as shrimp tissue weight loss in direct exposure. In (2) and (3), the ultrasonic tip was driven at 1/3 of full power using the respective unit, and areas of removed gelatin from the isthmus and tissue weight loss were used as the outcomes, respectively. Experiment (1) revealed no negative impact by HEDP on available chlorine (1), while all three experiments showed a highly significant (p > 0.001) synergistic effect, which was not hampered by HEDP, between NaOCl and ultrasonic activation regarding tissue weight loss (1, 3) and dissolution of gelatin (2).
Collapse
Affiliation(s)
- Nidambur Vasudev Ballal
- Department of Conservative Dentistry and Endodontics, Manipal Academy of Higher Education, Manipal College of Dental Sciences, Manipal, Karnataka 576104, India; (N.V.B.); (R.K.N.)
| | - Anja Ivica
- Clinic of Conservative and Preventive Dentistry, University of Zurich, 8032 Zurich, Switzerland; (A.I.); (P.M.); (T.A.)
| | - Pamela Meneses
- Clinic of Conservative and Preventive Dentistry, University of Zurich, 8032 Zurich, Switzerland; (A.I.); (P.M.); (T.A.)
| | - Raj Kumar Narkedamalli
- Department of Conservative Dentistry and Endodontics, Manipal Academy of Higher Education, Manipal College of Dental Sciences, Manipal, Karnataka 576104, India; (N.V.B.); (R.K.N.)
| | - Thomas Attin
- Clinic of Conservative and Preventive Dentistry, University of Zurich, 8032 Zurich, Switzerland; (A.I.); (P.M.); (T.A.)
| | - Matthias Zehnder
- Clinic of Conservative and Preventive Dentistry, University of Zurich, 8032 Zurich, Switzerland; (A.I.); (P.M.); (T.A.)
- Correspondence:
| |
Collapse
|