Effect of phytic acid as an endodontic chelator on resin adhesion to sodium hypochlorite-treated dentin

In Vitro Bond Strength of Dentin Treated with Sodium Hypochlorite: Effects of Antioxidant Solutions

This systematic review aims to evaluate whether the application of antioxidant solutions can enhance the bond strength of resin-based materials to sodium hypochlorite (NaOCl)-treated dentin. This study follows the PICOT strategy: population (sodium hypochlorite-treated dentin), intervention (application of antioxidants), control (distilled water), outcome (bond strength), and type of studies (in vitro studies). The systematic review and meta-analysis were conducted following PRISMA guidelines. Electronic databases were searched for in vitro studies evaluating the effects of antioxidants on bond strength to sodium hypochlorite-treated dentin. Two independent reviewers screened articles, extracted data, and assessed risk of bias. Meta-analyses were performed using a random-effects model to compare standardized mean differences in bond strength between antioxidant pretreatment and control groups. Inclusion criteria consisted of in vitro studies that examined the bond strength of resin-based materials to NaOCl-treated dentin with antioxidant application, while exclusion criteria included studies with incomplete data, those not using a control group, or those that did not directly measure bond strength. From 3041 initial records, 29 studies were included in the qualitative analysis and 25 in the meta-analysis. Ascorbic acid, sodium ascorbate, grape seed extract, green tea, and rosmarinic acid significantly improved bond strength to sodium hypochlorite-treated dentin (p < 0.05). The effectiveness of grape seed extract varied with adhesive system type. Hesperidin, p-toluene sulfonic acid, and sodium thiosulfate did not significantly improve bond strength. Most studies had a high risk of bias. This suggests that the conclusions drawn from these studies should be interpreted with caution, and further research with more robust methodologies may be needed to confirm the findings. In conclusion, this systematic review implies that certain antioxidants can improve bond strength to sodium hypochlorite-treated dentin, with efficacy depending on the specific agent and adhesive system used. Further standardized studies are needed to optimize protocols and confirm these findings.

Oracle of phytic acid in dental panacea - Insight into properties, therapeutic effect, regeneration, materials interaction and oral physiology

Phytic acid (inositol hexaphosphate/IP6) is a versatile chemical that is abundant in nature and is required for a variety of biological processes. It is harnessed in a wide range of fields, including drug discovery, daily supplies, chemical industries, medicine, and dentistry. IP6 is becoming increasingly popular in dentistry, with promising results. Several properties, such as cariostatic ability, beneficial impact on enamel disintegration, and anti-plaque, anti-tartar, and dental adhesive-forming properties, have been investigated thus far. Due to many constraints in the literature, there was a point in time when IP6 received less attention, which impacted knowledge in this field. Nevertheless, the positive outcomes of the flourishing of IP6 have recently been reconsidered from a number of papers that have improved our understanding of its modes of action in the aforementioned applications. The role of phytic acid in refining the properties and manoeuvring of dental resources is being investigated in novel endeavors in treating diseases of pulp and tissues supporting tooth structure, but to show its novel therapeutic potential, more precisely calibrated clinical trials are needed. This review examines and discusses the various uses proposed in the literature, as well as the applications of IP6 in dentistry.

Is a mix - A fix? "A microscopic analysis of depth of penetration of three combinations of irrigants"

Aims

The aim of the study is to evaluate the penetration depth of irrigants mixed with NaOCl into dentinal tubules at the apical third of the root canal using a confocal laser scanning microscope (CLSM).

Materials and Methods

Thirty-six single-rooted teeth were selected, decoronated, and straight-line access established. Then, the canal was enlarged with hand Protaper till size F3. The samples were divided randomly into three groups: Group 1 was irrigated with 3% NaOCl mixed with 1% phytic acid; Group 2 was irrigated with 3% NaOCl mixed with 18% etidronic acid; and Group 3 was irrigated with 3% NaOCl mixed with chitosan. The samples were subjected to CLSM evaluation. One-way analysis of variance with Tukey's post hoc was used for statistical analysis.

Results

Group 3 (NaOCl with chitosan) showed a greater depth of penetration in comparison to Groups 1 and 2.

Conclusion

Within limitations, it can be concluded that chitosan, in combination with NaOCl can be used as an alternative to the current irrigation protocol.

Application of Inositol Hexaphosphate and Inositol in Dental Medicine: An Overview

Phosphorylated inositol hexaphosphate (IP6) is a naturally occurring carbohydrate, and its parent compound, myoinositol (Ins), is abundantly present in plants, particularly in certain high-fiber diets, but also in mammalian cells, where they regulate essential cellular functions. IP6 has profound modulation effects on macrophages, which warrants further research on the therapeutic benefits of IP6 for inflammatory diseases. Here, we review IP6 as a promising compound that has the potential to be used in various areas of dentistry, including endodontics, restorative dentistry, implantology, and oral hygiene products, due to its unique structure and characteristic properties. Available as a dietary supplement, IP6 + Ins has been shown to enhance the anti-inflammatory effect associated with preventing and suppressing the progression of chronic dental inflammatory diseases. IP6 in dentistry is now substantial, and this narrative review presents and discusses the different applications proposed in the literature and gives insights into future use of IP6 in the fields of orthodontics, periodontics, implants, and pediatric dentistry.

Effect of phytic acid on dentinal collagen solubilization and its binding and debinding potentials to dentin

OBJECTIVES

To study phytic acid (IP6) effect on collagen solubilization by assessing hydroxyproline (HYP) release, evaluate its binding to demineralized (DD) and mineralized dentin (MD) and determine the effect of different media on debinding of IP6.

METHODS

Demineralized dentin beams were incubated in 1%, 2% or 3% IP6 and HYP release was evaluated at 1 or 3 weeks and compared to those obtained in untreated control or phosphoric acid (PA)-treated beams. DD or MD powder was treated with 1%, 2% or 3% IP6 and the decrease in IP6 amount was quantitated by ultraviolet-visible spectroscopy. IP6-treated samples were re-suspended in distilled water, ethanol, urea or sodium chloride and the amount of IP6 displaced was determined.

RESULTS

At 1 week, the control group and IP6 showed lower HYP release when compared to PA (P < 0.05). There was no difference among PA, IP6 and control at 3 weeks (P = 0.22). IP6 binding was concentration dependent. 1% IP6 had higher binding potential with MD compared to DD while 2% IP6 showed the opposite result (P<0.05). 3% IP6 had similar binding values between DD and MD (P = 0.53). The highest debinding in MD occurred with urea for 2%, 3% and 1% IP6 in descending manner. Within each concentration of IP6 in DD, the highest debinding effect was reported with ethanol.

CONCLUSIONS

IP6 bound to DD and MD in a concentration-dependent manner. IP6 was debound from DD mostly by the action of ethanol, while in MD, urea caused the most displacement. Collagen solubilization of IP6-treated DD was comparable to untreated DD.

CLINICAL SIGNIFICANCE

These findings add to the potential use of IP6 as an alternative to PA for dentin etching which possibly results in long-term stability of resin-dentin adhesion.

Ex-vivo study about antimicrobial effectiveness of phytic acid against Enterococcus faecalis into root canals

BACKGROUND

Endodontic failure is due to the persistence of microorganisms, especially Enterococcus faecalis, which have become resistant to disinfection measures. Sodium hypochlorite has been traditionally used, whereas phytic acid, a natural irrigant, needs to be further investigated.

METHODS

This ex-vivo study compared the antibacterial effectiveness of 0.9% saline solution, 5% sodium hypochlorite and 5% phytic acid against Enterococcus faecalis ATCC 29212 into the apical root canal third of 96 single-rooted extracted teeth, after 1-minute push-and-pull irrigation - a basic irrigation technique. Survived microorganisms were evaluated both through a traditional colony-forming-unit count and introducing the viability PCR, which precisely detects only DNA from intact cells: dead and damaged cells were excluded thanks to a propidium monoazide dye.

RESULTS

The culture methods showed that 5% sodium hypochlorite (median: 0 CFU/mL) has a significant greater antibacterial effectiveness (P<0.001) compared both to 0.9% saline solution (median: 4.76 CFU/mL) and 5% phytic acid (median: 0.25 CFU/mL). However, 5% phytic acid proved to be significantly more effective (P<0.001) than 0.9% saline solution. The viability PCR did not reveal a significant difference between 5% sodium hypochlorite (median: 4.12×10⁴ survived bacteria) and 0.9% saline solution (median: 8.45×10⁴ survived bacteria). Five percent phytic acid (median: 0.83×10⁴ survived bacteria) was significantly more effective than both 0.9% saline solution (P<0.001) and 5% sodium hypochlorite (P<0.001).

CONCLUSIONS

The findings suggest that 5% phytic acid works against root canal bacteria even with a basic irrigation technique and viability PCR seems to lead to more reliable and sensitive data rather than the culture methods.

Effect of phytic acid on bond strength and interfacial integrity of universal adhesive to deep dentin

Abstract This study investigated the effect of phytic acid (IP6) in different concentrations and application times on microtensile bond strength (µTBS) and interfacial integrity of universal adhesive to deep dentin. Flat deep dentin surfaces of 48 human molars were either etched with 37% phosphoric acid (PA) for 15 sec (control); or received no acid treatment and universal adhesive was applied directly in a self-etch mode (SE); or divided according to IP6 concentration (C) into two main groups: C1, 0.5%, and C2, 1%. Specimens of IP6 groups were further subdivided into three subgroups according to application time of IP6 (T) where; T1, 15 sec; T2, 30 sec and T3, 60 sec. Single Bond Universal Adhesive was then applied and resin composite blocks were built-up. Forty Specimens were then sectioned to produce resin/dentin beams that were used for µTBS testing using a universal testing machine. The remaining eight specimens were sectioned into slabs that were immersed into ammonical silver nitrate solution and nanoleakage was observed using a field emission scanning electron microscope (FE-SEM). The results showed that the application of IP6 in 0.5% and 1% produced significantly higher µTBS and less nanoleakage compared to PA and SE groups. Also, the application of IP6 for 60 sec recorded the highest µTBS and the lowest nanoleakage followed by 30 sec, and 15 sec respectively. Therefore, conditioning of deep dentin with IP6 enhances µTBS and interfacial integrity of universal adhesive to deep dentin in comparison to PA etching or using the universal adhesive in SE mode.

Postspace pretreatment with 17% ethylenediamine tetraacetic acid, 7% maleic acid, and 1% phytic acid on bond strength of fiber posts luted with a self-adhesive resin cement

Context:

Pretreatment of radicular dentin with chelating agents improves the bond strength of fiber-posts luted with a self-adhesive resin cement.

Aims:

The aim of this study was to assess the effects of the three chelating agents as final rinse of the postspace on bond strength of fiber posts luted with a self-adhesive resin cement.

Settings and Design:

This is an in vitro laboratory study.

Materials and Methods:

Forty-five mandibular premolars were prepared using MTwo rotary system and irrigation was done with 2.5% sodium hypochlorite. Three groups of teeth samples were considered for postspace preparation and irrigated with different solutions: Group 1: 17% ethylenediamine tetraacetic acid (EDTA); Group 2: 7% Maleic acid; Group 3: 1% Phytic acid. This was followed by the luting the posts with RelyX U200. After a week, from each sample, 2 mm thick slices were obtained from each third of the root and subjected to push-out bond strength testing.

Statistical Analysis Used:

One-way analysis of variance and Bonferroni's Post hoc analysis was used for assessing the results. The statistical significance level was set at P < 0.05.

Results:

Bond strength values were improved with maleic acid and phytic acid pretreatment with slight or no significant difference between these groups. A final rinse of postspace with EDTA significantly reduced the bond strength.

Conclusions:

Maleic acid (7%) pretreatment of postspace improved the adhesion of fiber posts luted with a self-adhesive resin cement.