Ultrasonic agitation reduces the time of calcium hydroxide antimicrobial effect and enhances its penetrability

OBJECTIVES

The objective of the present work was to evaluate the ultrasonic agitation, time and vehicle (propylene glycol or distilled water) on the antimicrobial potential and penetrability of calcium hydroxide pastes on infected dentin by means of Confocal Laser Scanning Microscopy (CLSM) and microbiological culture (MC).

MATERIALS AND METHODS

Dentin specimens were infected with Enterococcus faecalis using a new contamination protocol of 5 days. The specimens were divided into eight groups and dressed with the pastes for 7 or 15 days: G1) calcium hydroxide (CH) + propylene glycol (prop)/7 days (d), G2) CH + prop/7d + ultrasonic agitation (U), G3) CH + distilled water (dw)/7d, G4) CH + dw/7d + U, G5) CH + prop/15d, G6) CH + prop/15d + U, G7) CH + dw/15d, G8) CH + dw/15d + U. The ultrasonic activation was made for 1 min in both directions with a plain point insert. After medications removal, the images obtained by CLSM showed the viable (green) and dead (red) bacteria with Live and Dead dye. By the MC, the dentinal wall debris obtained by burs were collected for colony counts. For the penetration test, the Rodamine B dye was added to the CH pastes and analyzed by CLSM.

RESULTS

The 7 and 15-days CH + prop+U pastes performed better antimicrobial efficacy, followed by the CH + dw+U/15d paste.

CONCLUSIONS

All pastes demonstrated better penetration and antimicrobial activity against E. faecalis when agitated with ultrasound, even in periods of up to seven days. The propylene glycol vehicle showed better results.

CLINICAL RELEVANCE

Agitation of the dressing that remains for less time inside the root canal can optimize the decontamination of endodontic treatment.

Penetration of hypochlorites with lowered surface tension into dentine tubules

BACKGROUND

The purpose of the present study was to assess the effect of concentration and temperature of sodium hypochlorite (NaOCl) with added surfactants and time of exposure on its penetration into human dentine.

METHODS

Seventy-five extracted permanent maxillary anterior teeth with single canals were shaped by using ProTaper SX hand-operated instruments. Then teeth were sectioned perpendicular to their long axis. The crowns and apical thirds of all the teeth were removed. The remaining roots were processed into 4-mm-long blocks and stained overnight in crystal violet. One hundred fifty stained blocks were further split into halves and treated by six NaOCl-based solutions from different brands: three solutions added with surfactants (Hypoclean, H6, Chlor-Xtra) and their regular counterparts (5.25%, 6%, <%6NaOCl). The dentine blocks were exposed to the solutions for 2, 5, and 20 minutes at 20° C, 37° C, and 45° C, respectively. The depth of penetration of NaOCl was determined by bleaching of the stain and measured by light microscopy at magnifications of 20x and 40x. Statistical analysis was made by using two way ANOVA and by comparing groups two by two with t-test.

RESULTS

The shortest penetration (130.80±1.92μm) was measured after incubation with 5.25%NaOCl for 2 minutes at 20° C; the highest penetration (375.40±3.05μm) was obtained with Chlor-Xtra for 20 minutes at 45° C. Temperature and exposure time had a significant direct relationship with penetration of sodium hypochlorites with lowered surface tension into dentinal tubules.

CONCLUSIONS

The exposure time and temperature of sodium hypochlorite as well as the addition of surfactants may influence the penetration depth of irrigants into dentinal tubules.

Effect of dentin treatment time with tetraclean on its residual antibacterial activity

The goal of this study was to evaluate the effect of dentin treatment duration (10 minutes, 24 hours, and seven days) with Tetraclean on its residual antibacterial activity in bovine root dentin. Results showed that the number of colony-forming units in all three experimental groups was zero at the first culture. Furthermore, the 10-minute group and seven-day group demonstrated the highest and the lowest number of colony-forming units, respectively.

Apical Diffusion of Calcium Hydroxide in an in vitro Model

An in vitro agar model was developed to study the effect of intracanal medicaments on periapical tissues and was used to study the diffusion of three calcium hydroxide (Ca(OH)2) medicaments of varying viscosity through simulated root canals with various sizes of apical foramina. Experimental medicaments were added to pipette tips used to represent tooth roots, which were fixed in syringes containing brain heart infusion agar and calcium-reactive dye. OH and Ca concentrations were measured in the agar at 30 minutes and 24 hours. Ca concentration and pH increased with larger aperture sizes, and higher pH and Ca diffusion was produced by a 10% Ca(OH)2 solution than was produced by Pulpdent or a Ca(OH)2 paste. The results suggest that the properties of the Ca(OH)2-containing vehicle could affect the action of the medicament in the periapical tissues.

Photochemical oxidation of p-chlorophenol by UV/H2O2 and photo-Fenton process. A comparative study

In this study, photochemical advanced oxidation processes (AOPs) utilizing the combinations of UV/H2O2 and the photo-Fenton reaction (UV + classical Fenton reaction) were investigated in lab-scale experiments for the degradation of p-chlorophenol. The study showed that the photo-Fenton process, (a mixture of hydrogen peroxide and ferrous or ferric ion), was the most effective treatment process under acidic conditions and produced a higher rate of degradation of p-chlorophenol at a very short radiation time. It accelerated the oxidation rate by 5-9 times the rate for the UV/H2O2 process. The reaction was found to follow the first order, the reaction was influenced by the pH, the input concentration of H2O2 and the amount of the iron catalyst and the type of iron salt. The experimental results showed that the optimum conditions were obtained at a pH value of 3, with 0.03 mol/l H2O2, and 1 mmol/l Fe(II) for the UV/H2O2/Fe(II) system and 0.01 mol/l H2O2 and, 0.4 mmol/l Fe(III) for the UV/H2O2/Fe(III) system. The reactions were accompanied by the generation of Cl- which reached its maximum value at a short reaction time when using the photo-Fenton process. Finally a rough comparison of the specific energy consumption shows that photo-Fenton process reduced the energy consumption by at least 73 to 83% compared with the UV/H2O2 process.

pH changes and calcium ion diffusion from calcium hydroxide dressing materials through root dentin

The purpose of this study was to evaluate Ca2+ and OH- diffusion properties through root dentin by using different calcium hydroxide (CH) dressing materials. Twenty-eight single-rooted teeth were instrumented and external defects were created on the root surface. 17% EDTA was used to eliminate the smear layer. All surfaces except the external defects were sealed, and the teeth were placed in normal saline. Ca2+ concentrations and the pH in the saline were determined for 3 days as the control period. After removing the teeth from normal saline, they were filled with: (i) DT Temporary Dressing CH; (ii) CH powder and normal saline; (iii) TempCanal; and (iv) CH points. The teeth were then placed in normal saline, and Ca2+ concentrations and pH values were measured at 1, 3, 7, 14, and 28 days. Nonsetting CH pastes gradually released Ca2+, whereas this increase was absent from CH points. None of the test materials induced a pH increase in the media during the observation period. This study demonstrated that, when nonsetting CH pastes are applied to the root canal, diffusion of Ca2+ without an increase in pH to the surrounding media occurs. This implies that these type of material are more suitable than CH points for treatment of external root resorption.

pH changes in root dentin over a 4-week period following root canal dressing with calcium hydroxide

Root canals in extracted human teeth were cleaned and shaped and subsequently dressed with a calcium hydroxide root canal dressing. pH Changes in the root dentin were measured over a 4-wk period with microelectrodes in small cavities at apical and cervical levels in inner and outer dentin. The pH increased within hours in the inner dentin, peaking at pH 10.8 cervically and 9.7 apically. However, 1 to 7 days elapsed before the pH began to rise in the outer root dentin, reaching peak levels of pH 9.3 cervically and 9.0 apically after 2 to 3 wk. The results show that hydroxyl ions derived from a calcium hydroxide dressing do diffuse through root dentin. They diffuse faster and reach higher levels cervically than apically. Surface pH measurements showed that hydroxyl ions do not diffuse in more than a minor way through the intact root surface.

Systemic release of corticosteroids following intra-dental use

Concern has been expressed in the past that the use of corticosteroids within root canal medicaments or pulp capping agents may lead to deleterious systemic effects. Calculations of the highest possible amounts that could be used, plus an analysis of the release and diffusion characteristics, and comparisons with known endogenous levels of corticosteroids, reveal that the intradental use of Ledermix paste and Ledermix cement is unlikely to result in any systemic side-effects.

Diffusion of medicaments within root canal dentin. A scanning electron microscopic study

Root canals of 21 maxillary human teeth were enlarged with reamers and flushed alternatively with sodium hypochlorite and hydrogen peroxide. After its mechanical preparation, root canals were dressed with camphorated paramonochloropherol and/or formocresol delivered by paper points. All three medicaments crystallize both on dentin walls and inside dentinal tubules. The clinical implications of these findings are discussed.

Electrochemical engineering approach to the irrigation of tooth canals under the influence of a vibrating file

Doubt exists concerning the irrigation of secondary tooth canals when the vibration of a file introduced into the main root canal is superimposed on flow-through irrigation of the main canal. Depending on the type of commercial equipment used, the vibrations of the file are sonic or ultrasonic. We use the methodology of an electrochemical engineering approach in a study of the intensity of the irrigation of the secondary canals under the influence of sonic and ultrasonic vibrations of a file located at various heights in the main canal. The tooth canals are simulated by small electrochemical cells containing electrodes located at the end of cavities simulating the secondary canals. An electrochemical method is used to measure the mass transfer coefficients at these electrodes, a classical method in electrochemical engineering laboratories. The values of the mass transfer coefficients are representative of the importance of the irrigation of the electrodes. Thus they give a quantitative idea of the vibrations on the irrigation of secondary tooth canals. The work demonstrates the usefulness of the electrochemical engineering approach in contributing to the solution of a biomedical problem.