Accidental injection of ethylenediaminetetraacetic acid (EDTA) instead of an anaesthetic solution: a case report

The accidental use of drugs is an unacceptable mistake in medicine, but the misuse of different agents has been reported frequently in the literature. While performing local anesthesia before starting dental treatment, the injection of a wrong agent, as a result of confusing the liquid in the syringe may cause local and systemic complications. Sudden swelling, intense pain, and severe allergic reactions may develop in the patient. A complication causing soft tissue necrosis is presented in this case report in which Ethylenediaminetetraacetic acid (EDTA) was accidentally injected instead of an anesthetic solution. This case report is unique because it is the first to report an inadvertent injection of EDTA in dentistry.

Time-Dependent Effect of Various Irrigants for Root Canal on Smear Layer Removal

Background:

Existence of smear layer in root canals caused by instrumentation is believed to prevent penetration of irrigating agents, thereby resulting in endodontic treatment.

Aims and Objectives:

To compare and evaluate the effectiveness of two irrigants: 17% ethylenediaminetetraacetic acid (EDTA) and mixture of tetracycline isomer, an acid, and a detergent (MTAD) as final agents for eliminating the smear layer.

Materials and Methods:

We included 50 human lower premolar teeth whose crowns were sectioned at cementoenamel junction. The sample was randomly grouped into five groups, each with 10 teeth. Group 1: 1 mL of 17% EDTA as final rinse for 1 min, Group 2: 1 mL of 17% EDTA for 30 s, Group 3: 5 mL of MTAD for 2.5 min, Group 4: 5 mL of MTAD for 5 min, and Group 5: saline. The specimens were sectioned vertically all along the long axis and fixed on an aluminum stub for gold ion sputtering. Scanning electron microscope was used to observe the specimens, and photomicrographs were taken at coronal, middle, and apical thirds of canal, and assessed by Torabinejad scoring system by two examiners, and the observations were analyzed statistically.

Results:

When Group 1 and Group 2 and Groups 3 and 4 were compared, we found a significant variation in removal of smear layer at cervical and middle thirds, and insignificant difference at apical third. In comparison with EDTA and saline, MTAD was more efficient significantly in middle and cervical thirds and insignificant at apical third.

Conclusion:

MTAD is an efficient irrigant for removing smear layer than EDTA and saline.

Smear Layer Removing Ability of Root Canal Irrigation Solutions: A Review

AIM

The purpose of this review is to address the smear layer removing the ability of root different canal irrigants including ethylenediaminetetraacetic acid (EDTA), a mixture of tetracycline, acid and detergent (MTAD), tetraclean, citric acid, Q-Mix, maleic acid, and smear clear.

BACKGROUND

Smear layer is a layer which is produced during instrumentation. It contains both organic and inorganic materials. It may also contain bacteria and their byproduct considering the root canal situation. This layer may prevent the penetration of the healing material introduced to the canal to the interior of the dentinal tubules. In addition, it can affect the adaptation of sealing materials to the root canal walls.

REVIEW RESULTS

The smear layer removal ability of MTAD is superior and faster than EDTA. Tetraclean is similarly composed of an acid, an antibiotic, and a detergent. The presence of doxycycline is believed to help the smear layer removal ability of these irrigants. Antibiotics such as tetracycline had similar smear layer removal ability as even citric acid. EDTA is an amino acid with a chelating ability that sequestrates metal ions. Some believed EDTA smear layer removing ability is better than MTAD, tetraclean, SmearClear, and 20% citric acid which is controversial in case of comparison between MTAD and EDTA. Phosphoric acid is efficient enough to be comparable to EDTA in removing the smear layer. Maleic acid is an organic compound with acid etching smear layer removal. Its ability seems to be similar or even better than EDTA. Citric acid as another organic acid is believed to be used as smear removing agent. HEBP is another chelating agent that can be used in combination with NaOCl; however, HEBP is a weak decalcifying agent compared to EDTA and hence cannot be applied as a mere final rinse. QMiX is a combination of CHX, EDTA, and detergent and should be used at final rinse. It is believed that QMiX is as efficient as EDTA. Smear clear is a 17% EDTA solution including an anionic and cationic (cetrimide) surfactant. The ability of QMiX is similar to EDTA.

CONCLUSION

There are different canal irrigation solutions with various smear layer removal ability that some should be used as a mere final rinse and some should not.

CLINICAL SIGNIFICANCE

The usage of canal irrigation solutions depends on the clinical situation and preference of the dentists. This study provides a good guide for clinician of the field.

Role of EDTA on the Pd(II) adsorption characteristics of chitosan cross-linked 3-amino-1,2,4-triazole-5-thiol derivative from synthetic electroless plating solutions

This article targets the efficacy of chitosan cross-linked 3-Amino-1,2,4-triazole-5-thiol derivative for the recovery of Pd from synthetic electroless plating solutions (ELP) whose solution chemistry complexity is brought forward with ethylenediaminetetraacetic acid (EDTA), ammonium hydroxide (NH₄OH), and surfactant (cetyl trimethyl ammonium bromide (CTAB)). Batch adsorption characteristics of the resin were investigated in the parametric range of 2-10 pH, 0.2-2 g L^-1 adsorbent dosage, 5-1080 min contact time, 50-300 mg L^-1 Pd concentration and 25-60 °C operating temperature. Equilibrium, kinetic and thermodynamic model fitness studies were also considered. Pd(II) adsorption characteristics were determined using NaOH, KOH and HCl solutions with variant eluent concentrations (0.1-2 N). The solution chemistry complexity has been evaluated to have profound impact in detrimentally influencing Pd sorption characteristics of the CH-AZ resin. The resin has been characterized to be highly effective for Pd removal from synthetic ELP solutions but with moderate efficacy towards the noble metal recovery and reuse.

Comparative Evaluation of Cleaning Efficacy of Self-adjusting File and WaveOne File: An in vitro Scanning Electron Microscopic Study

AIM

This study aims to compare the cleaning efficacy of root canal walls using two rotary single file systems: self-adjusting file (SAF) and WaveOne (WO).

MATERIALS AND METHODS

Forty extracted human premolars with similar range of canal curvature were selected, decoronated, working length determined and roots were divided into two groups of 20 samples each: Group I - SAF and Group II - WO. All root canals were irrigated with 3% sodium hypochlorite (NaOCl) and 17% ethylenediaminetetraacetic acid (EDTA). The roots were sectioned longitudinally and subjected to scanning electron microscopic examination. The amount of debris and smear layer was evaluated using five score index at coronal, middle and apical third levels. Statistical analysis was performed using the Chi-square test and significance was set at a P < 0.05.

RESULTS

Statistically significant difference was observed between the groups in cleaning the apical third. Group I (SAF) showed better canal cleanliness compared to Group II (WO) in the apical third.

CONCLUSION

Within the limitations of this study, SAF in combination with 3% NaOCl and 17% EDTA irrigating solution had significantly better cleaning efficacy in the apical third of root canals when compared to WO rotary file system.

Evaluation of Influence of Widening Apical Preparation of Root Canals on Efficiency of Ethylenediaminetetraacetic Acid Agitation Protocols: Study by Scanning Electron Microscopy

AIM

The purpose of this study was to evaluate the influence of widening the apical root canal preparation (RCP) on the efficiency of different ethylenediaminetetraacetic acid (EDTA) agitation protocols on smear layer removal: EDTA; EDTA + Easy Clean in rotary movement (ECROT); EDTA + Easy Clean in reciprocating movement (ECREC); and EDTA + Passive ultrasonic irrigation (PUI).

MATERIALS AND METHODS

A total of 80 mandibular premolars had their crowns sectioned and then were divided into two groups according to widening: size 25 or 40, 0.08 taper. Sequentially they were once again allocated to subgroups according to the agitation protocol performing eight experimental groups (n = 10). Ten additional teeth were prepared for controls (C+/C-). The specimens were then submitted to the cleaning protocols and thereafter cleaved and microphotographed by variable pressure scanning electron microscopy (SEM) at previously determined points along their root thirds (750*). Scores were attributed to the images, and data were analyzed by the Kruskal-Wallis, Student-Newman-Keuls and Friedman tests.

RESULTS

A higher widening was observed to have a positive influence on cleaning efficiency offering significant differences in global and apical third evaluations (p < 0.05). Relative to the agitation, significant differences were observed mainly in the apical third, with PUI and ECROT providing the best results (p < 0.05); no difference for C+ was observed when higher widening was employed.

CONCLUSION

A greater widening of the apical third provided a significant improvement in the action of the agitation/activation protocols. Moreover, the PUI and ECROT activation methods were shown to be superior to the use of EDTA solely, particularly in the apical third.

CLINICAL SIGNIFICANCE

The findings of this study reinforce the need for clinical use of additional methods to complement cleaning. Therefore, it is important for professionals to have knowledge and command of these protocols to obtain more satisfactory results.

A comparative evaluation of shear bond strength of composite resin to pulp chamber dentin treated with sodium thiosulfate and proanthocyanidin: An in vitro study

Aim:

Based on the importance of coronal sealing right after endodontic treatment, this in vitro study aimed to evaluate the difference of shear bond strength to pulp chamber dentin treated with sodium thiosulfate and proanthocyanidin (PA).

Materials and Methods:

Fifteen extracted mandibular molar teeth were decoronated at the level of cementoenamel junction horizontally. The individual teeth were then sectioned mesiodistally to expose the pulp chamber dentin using a diamond disc. The specimens were randomly divided into three groups (n = 10). Group A: control group, treated with 5.25% sodium hypochlorite (NaOCl) for 30 min followed by a final rinse with 17% ethylenediaminetetraacetic acid (EDTA) solution for 3 min; Group B: after pretreatment with NaOCl and EDTA, it is further treated with 5% sodium thiosulfate (Na₂S₂O₃) for 10 min; and Group C: after pretreatment with NaOCl and EDTA, it is further treated with 6.5% PA for 10 min. After drying the specimens, a bonding agent namely One Coat Bond SL (SwissTEC, Coltene) was applied to the pulp chamber dentin followed by a composite restoration (SwissTEC, Coltene). Each specimen was then tested under a universal testing machine at the dentin/resin interface to determine the shear bond strength.

Results:

Both the groups in which 5% Na₂S₂O₃ and 6.5% PA were used for 10 min showed bond strength that was found to be statistically higher than the positive control (P < 0.05).

Conclusion:

The use of Na₂S₂O₃ and PA can significantly increase the bond strength of composite resin to NaOCl/EDTA-treated dentin, allowing adhesive restorations to be immediately applied after endodontic treatment.

Root canal irrigants influence the hydrophobicity and adherence of Staphylococcus epidermidis to root canal dentin: an in vitro study

Objectives

To determine the effect of root canal irrigants on the hydrophobicity and adherence of Staphylococcus epidermidis (S. epidermidis) to root canal dentin in vitro.

Materials and Methods

Root dentin blocks (n = 60) were randomly divided into 4 groups based on the irrigation regimen: group 1, saline; group 2, 5.25% sodium hypochlorite (NaOCl); group 3, 5.25% NaOCl followed by 17% ethylenediaminetetraacetic acid (EDTA); group 4, same as group 3 followed by 2% chlorhexidine (CHX). The hydrophobicity of S. epidermidis to root dentin was calculated by cell surface hydrophobicity while the adherence was observed by fluorescence microscopy, and bacteria were quantified using ImageJ software (National Institutes of Health). Statistical analysis of the data was done using Kruskal-Wallis test and Mann-Whitney U test (p = 0.05).

Results

The hydrophobicity and adherence of S. epidermidis to dentin were significantly increased after irrigating with group 3 (NaOCl-EDTA) (p < 0.05), whereas in group 4 (NaOCl-EDTA-CHX) both hydrophobicity and adherence were significantly reduced (p < 0.05).

Conclusions

The adherence of S. epidermidis to dentin was influenced differently by root canal irrigants. Final irrigation with CHX reduces the bacterial adherence and may impact biofilm formation.

Risks of using EDTA as an agent for trace metals dosing in anaerobic digestion of olive mill solid waste

Low concentrations of trace elements in many organic wastes recommend their supplementation in order to avoid potential limitations. Different chelating agents have been used to ensure an adequate trace metal pool in the soluble fraction, by forming dissolved complexes. Ethylenediaminetetraacetic acid (EDTA) is probably the most common, although several negative effects could be associated with its usage. Biomethane potential tests were performed using Olive Mill Solid Waste as the substrate, supplementing different combinations of Fe, Co, Ni, Ba, always under the presence of EDTA. Results show that Ni and Co slightly recovered biodegradability. However, Ba supplementation resulted in worsening the methane yield coefficient in all cases. High concentration of EDTA led to decrease in the activity of anaerobic digestion. High availability of EDTA induces the capture of trace metals like Co or Ni, key trace metals for anaerobic biomass activity. While supplementing trace metals, the addition of Ba and/or EDTA must be carefully considered.

Effects of smear layer removal agents on the physical properties and microstructure of mineral trioxide aggregate cement

OBJECTIVE

To compare the effect of QMix (Dentsply Sirona), 7% maleic acid (MA), and 17% ethylenediaminetetraacetic acid (EDTA) on the microhardness, flexural strength and microstructure of mineral trioxide aggregate (MTA; ProRoot MTA, Dentsply Sirona).

METHODS

Forty MTA specimens were divided into four groups: [I] QMix [II] 7% MA [III] 17% EDTA and [IV] distilled water (control). After treatment with 5mL of the respective solution for 1min, the specimens were tested for microhardness using a Knoop hardness tester. Forty additional specimens were similarly treated and evaluated for the flexural strength using a universal testing machine. For microstructure evaluation, MTA specimens were treated in a similar manner and examined by X-ray diffractometry and scanning electron microscopy (SEM).

RESULTS

For microhardness, there were no differences between distilled water, QMix and EDTA groups. However, MTA exposed to distilled water had higher microhardness than MA. When compared with QMix and EDTA, MA had lower microhardness; there was no difference between EDTA and QMix. For flexural strength, distilled water group had higher flexural strength than the other agents. There were no differences between EDTA vs MA and EDTA vs QMix. Specimens treated with QMix had higher flexural strength than MA. X-ray diffraction indicated that EDTA inhibited hydration of MTA. For SEM, all the tested agents altered the microstructure of MTA when compared to distilled water.

CONCLUSION

MA had more detrimental effect on the physical properties of MTA and EDTA was more detrimental to the hydration of MTA.

CLINICAL SIGNIFICANCE

The present study highlights the effect of newer chelating agents on the physical properties and microstructure of MTA. Preventing the deterioration of MTA is important for its long term success in endodontic procedures.

In Vitro Leukoagglutination: A Rare Hematological Cause of Spurious Leukopenia

Leukopenia secondary to leukocytic agglutination is caused by an ethylene diamine tetra acetic acid (EDTA) which may appear in both benign and malignant states. Ethylene diamine tetra acetic acid induced platelets clumping in peripheral blood has been well established, but invitro leukocytic aggregation is very rarest hematological finding. Pseudo-leukopenia resulting from leukoagglutinins has been reported in the cirrhotic state, infections, autoimmune disorders, uremia, in immunosuppressed state or in various malignancies. Though the condition seems to be benign but very important to be detected as these artifactual findings lead to unnecessary investigations and remarkably changed the overall management plan. Here we report the case of a young patient with this rare finding who was admitted to our hospital with progressive labor pains. The analysis of ethylene diaminetetraacetic acid (EDTA), anticoagulated blood was done on automated hematology analyzer reveals leukopenia. The peripheral smear examination revealed multiple aggregates of leukocytes. On repeat sampling in citrate anticoagulant, the complete blood count showed total leukocytic count of 16.5x109/L with absolute neutrophilic count of 11.5x109/L. This is a rare case of spurious leukopenia secondary to in-vitro leukocytic agglutination provoked by EDTA anticoagulant.

A comparative evaluation of the effect of 8% and 17% ethylenediaminetetraacetic acid exposure for 1 min and 10 min on the fracture resistance of endodontically treated roots: An in vitro study

Objective:

The objective of this study was to evaluate the effect of 8% and 17% ethylenediaminetetraacetic acid (EDTA) exposure for 1 min and 10 min on the fracture resistance of endodontically treated roots.

Methodology:

Sixty human single-rooted teeth were decoronated and divided into six groups (n = 10). Canal preparation was carried out except in negative control group, using the ProTaper rotary file system. Final irrigation was performed using distilled water, 17% EDTA for 1 min and 10 min, 8% EDTA for 1 min and 10 min. Thereafter, roots were obturated with ProTaper F3 Gutta-percha points and AH Plus sealer using a single-cone technique. The specimens were loaded vertically at 1 mm/min crosshead speed until vertical root fracture occurred. Results were evaluated statistically with one-way analysis of variance and post hoc Tukey test.

Results:

Analysis of results showed that the unprepared roots showed the highest fracture resistance and roots irrigated with 17% EDTA for 10 min showed the lowest fracture resistance. The mean fracture resistance of unprepared roots, roots irrigated with 8% EDTA for 10 min and 17% EDTA for 1 min was significantly higher than roots irrigated with 8% EDTA for 1 min, 17% EDTA for 10 min and distilled water.

Conclusion:

From a clinical viewpoint, if EDTA has to be used, it is safer to use higher concentration for a shorter application time or a low concentration with a longer application time. Prolonged use of high concentrations of EDTA might increase the risk of root fracture.

Identification of the immunogenic epitopes of the whole venom component of the Hemiscorpius lepturus scorpion using the phage display peptide library

The venom of the Hemiscorpius lepturus scorpion contains mixtures of bioactive compounds that disturb biochemical and physiological functions of the victims. Hemiscorpius lepturus envenomation is recognized as a serious health concern in tropical regions. So far, there is no preventive procedure, and the main focus is on treatment of victims with an antiserum purified from hyper-immunized horses. Although antisera can neutralize the venom, they, in some cases, lead to anaphylactic shock and even death. Selection of peptides mimicking antigenic and immunogenic epitopes of toxins from random peptide libraries is a novel approach for the development of recombinant toxins and poly-epitopic vaccine. To achieve this aim, a phage display peptide library and three rounds of biopanning were performed on immobilized antibodies (IgGs) purified from the sera of hyper-immunized horses. The results show that the highest binding of the phage to immobilized horse antibodies occurred in the third round of biopanning. Over 125 individual clones carrying mimotopes of Hemiscorpius lepturus toxins were selected and subjected for sequencing. The sequencing results identified unique peptides mimicking the antigenic and immunogenic epitopes of Hemiscorpius lepturus toxins. The results of this study provide a basis for further studies and the development of a putative epitopic vaccine and a recombinant toxin.

Evaluating the Effect of CPP-ACP as a Final Irrigant in Improving the Micro-Hardness of Erosive Root Dentin and its Influence on the Bond Strength of Self Etch Resin Sealer - An In-vitro Study

INTRODUCTION

Smear layer removal from the root canal wall involves the use of 17% EDTA and 5.25% sodium hypochlorite, which thereby improves the adhesion of obturating materials to root dentin. But these chemical irrigants have shown to decrease micro hardness, increase roughness, cause erosion and reduce the root dentin fracture toughness. To combat these adverse effects, studies can be focussed on the remineralisation of the erosive root dentin and this novel idea has been utilized in the present study.

AIM

To evaluate the micro hardness of erosive root dentin when Casein Phosphopeptide-Amorphous Calcium Phosphate (CPP-ACP) was used as a final irrigant and its influence on resin sealer bonding tested by push-out bond strength method.

MATERIALS AND METHODS

Sixty extracted maxillary incisors were divided into three groups based on the final irrigation protocol. Group 1-normal saline, Group 2-17% EDTA (Ethylene Diamine Tetraacetic Acid) + 5.25% NaOCl (Sodium Hypochlorite), Group 3 - 17% EDTA + 5.25% NaOCl + CPP-ACP; each group was divided into two subgroups. Half the specimens of each group were evaluated for Vicker's micro hardness test after the treatment. In continuation with the above methodology the remaining specimens were tested for push-out bond strength after obturation of the specimens with self etch adhesive resin sealer and conventional 6% gutta percha cones.

RESULTS

Micro hardness was statistically analysed using Kruskal Wallis test and push-out bond strength was evaluated using Mann Whitney test and paired t-test. CPP-ACP treated group showed increased micro hardness (p<0.05). There was no statistically significant difference between the push-out bond strength values between group EDTA + NaOCl group and EDTA + NaOCl + CPP-ACP group.

CONCLUSION

Within the limitations of this study it can be concluded that, CPP-ACP improved the micro hardness of erosive root dentin and is not affecting its bond strength. Therefore, CPP-ACP may be used before bonding procedures for promoting remineralization of root dentin.

Impact of Various Irrigating Agents on Root Fracture: An in vitro Study

INTRODUCTION

Irrigating solutions are used for cleaning and removing dentinal debris, and the other remains from pulpal space during biomechanical preparation. Therefore, we evaluated the impact of various irrigating agents on root fracture at 5-minute time exposure.

MATERIALS AND METHODS

We sectioned 60 permanent maxillary premolars with fully formed root structures transversely maintaining the root length of approximately 14 mm. Five study groups were made comprising ethylenediaminetetraacetic acid (EDTA), cetrimide, citric acid, and so on as various irrigating agents. A universal force test machine was used to calculate the force which was enough to fracture each root. Analysis of variance (ANOVA) test was used to access the level of significance.

RESULTS

About 10% citric acid solution as an irrigating agent showed minimal fracture opposing results, whereas 10% EDTA solution showed the maximum fracture resistance of root portion.

CLINICAL SIGNIFICANCE

Selection of suitable EDTA concentration that has minimal adverse effect on the mechanical properties of the tooth is very important for the successful management of tooth fracture.

CONCLUSION

About 10% EDTA provided the highest fracture resistance, necessitating the use of irrigating solution in root canal therapy (RCT). Further research with higher and different study groups is required to search for more efficient irrigating solution to improve the outcome of RCT.

Effect of combination of ethylenediaminetetraacetic acid + tetracycline with coronally positioned flap in the treatment of gingival recession: A clinical study

CONTEXT

Gingival recession is the apical migration of gingival margin results from destruction of the connective tissue leading to various esthetic problems. Many surgical procedures have been attempted to achieve root coverage that include free gingival grafts, pedicle flaps such as semilunar coronally repositioned flaps (SCRFs) and guided tissue regeneration. The exposed root surface has undergone substantial alterations and may no longer serve as an appropriate substrate for cell attachment and fiber development. When the denuded root surfaces are treated with biomodifiers following mechanical instrumentation, the resulting surface favors both the attachment of fibroblasts and new connective tissue attachment. It was then necessary to evaluate the surface characteristics of the acid demineralized root surface and its effect on periodontal wound healing.

AIM

To evaluate the effect of the combination of ethylenediaminetetraacetic acid (EDTA) and tetracycline as root bio-modifiers along with SCRF for root coverage.

SETTINGS AND DESIGN

Twenty subjects were randomly assigned into two groups as cases (SCRF + EDTA + tetracycline [TTC]) and controls (SCRF).

MATERIALS AND METHODS

Twenty-four percentage EDTA and 100 mg/ml TTC hydrochloride were used along with semilunar coronally positioned flap. The clinical parameters such as recession height, the width of keratinized tissue, recession width, clinical attachment level, probing depth, plaque index, and gingival index were recorded at baseline, 1 and 3 months.

STATISTICAL ANALYSES USED

The clinical parameters were compared using post-hoc test and the comparison between cases and controls was done using Mann-Whitney U-test.

RESULTS

No statistical significant difference has been observed between the groups.

CONCLUSION

It was concluded that no clinical benefit was observed after the application of a combination of 100 mg/ml TTC hydrochloride and 24% EDTA on the root surface.

Effect of irrigating solutions used for postspace treatment on the push-out bond strength of glass fiber posts

Aim:

To evaluate the effect of different irrigating solutions on postspace treatments on the push-out bond strength of glass fiber posts.

Materials and Methods:

Thirty mandibular premolar roots were decoronated and endodontically treated. Postspaces were prepared and roots were divided into three groups: In group 1: 2.5% sodium hypochlorite irrigation (control), group 2: 17% ethylenediaminetetraacetic acid (EDTA) with hand activation, group 3: 17% EDTA irrigation with photon-induced photoacoustic streaming (PIPS) has been done to the postspaces. Scanning electron microscope (SEM) analysis has been made for two samples of each group. Fiber posts were then luted with resin cement. Each root was prepared for push-out test. Data have been statistically analyzed.

Results:

SEM results showed clean postwalls with both group 2 and group 3, whereas group 1 showed adhesion of resin cement to intraradicular dentine. When all groups were compared, the bond strength values are higher with group 2 followed by group 3.

Conclusion:

Within the limitations of the study, clean postwalls and the highest bond strength values were obtained from 17% EDTA with hand activation and 17% EDTA with PIPS.

Regenerative potential of immature permanent non-vital teeth following different dentin surface treatments

This study evaluates the regenerative potential of immature permanent non-vital teeth following different dentin surface treatments in dogs. Periapical lesions and necrotic pulps were induced in 288 roots of 144 teeth in twelve dogs. Teeth were randomly divided into 3 equal groups according to the evaluation period. Each group was subdivided into 8 subgroups according to the treatment modalities including; blood clot, blood clot and collagen, blood clot and Ethylenediaminetetraacetic acid (EDTA), blood clot, collagen and EDTA, blood clot and Mixture Tetracycline Citric Acid and Detergent (MTAD), blood clot, collagen and MTAD, positive control and negative control. Apart from control subgroups, all infected root canals were cleaned with sodium hypochlorite solution and triple antibiotics paste before different treatment protocols. After different treatments, the root length, thickness and apical diameter were evaluated by radiographic examination. Histopathological examination was carried out to evaluate the inflammation, bone/root resorption, tissue in-growth in pulp space, new hard tissue formation and apical closure. Using EDTA solution as a surface modifier showed significantly higher levels of tissue in-growth in the pulp space after 6 weeks and 3 months. Addition of collagen as a scaffold caused significantly more bone/root resorption than the other subgroups while EDTA caused significantly lower inflammatory cell counts only after 2 weeks. Final rinse with 17% EDTA solution before blood clot induction has positive impact on tissue interaction along dentinal walls without modification of the cell type. Moreover, the use of collagen as a scaffold material and MTAD as a surface modifier did not improve the quality of the regenerative process.

Selective extraction and release using (EDTA-Ni)-layered double hydroxide coupled with catalytic oxidation of 3,3',5,5'-tetramethylbenzidine for sensitive detection of copper ion

Copper is an important heavy metal in various biological processes. Many methods have been developed for detecting of copper ions (Cu(2+)) in aqueous samples. However, an easy, cheap, selective and sensitive method is still desired. In this study, a selective extraction-release-catalysis approach has been developed for sensitive detection of copper ion. Ethylenediaminetetraacetic acid (EDTA) chelated with nickel ion (Ni(2+)) were intercalated in a layered double hydroxide via a co-precipitation reaction. The product was subsequently applied as sorbent in dispersive solid-phase extraction for the enrichment of Cu(2+) at pH 6. Since Cu(2+) has a stronger complex formation constant with EDTA, Ni(2+) exchanged with Cu(2+) selectively. The resulting sorbent containing Cu(2+) was transferred to catalyze the 3,3',5,5'-tetramethylbenzidine oxidation reaction, since Cu(2+) could be released by the sorbent effectively and has high catalytic ability for the reaction. Blue light emitted from the oxidation product was measured by ultraviolet-visible spectrophotometry for the determination of Cu(2+). The extraction temperature, extraction time, and catalysis time were optimized. The results showed that this method provided a low limit of detection of 10nM, a wide linear range (0.05-100μM) and good linearity (r(2)=0.9977). The optimized conditions were applied to environmental water samples. Using Cu(2+) as an example, this work provided a new and interesting approach for the convenient and efficient detection of metal cations in aqueous samples.

Endocrine disrupting alkylphenolic chemicals and other contaminants in wastewater treatment plant effluents, urban streams, and fish in the Great Lakes and Upper Mississippi River Regions

Urban streams are an integral part of the municipal water cycle and provide a point of discharge for wastewater treatment plant (WWTP) effluents, allowing additional attenuation through dilution and transformation processes, as well as a conduit for transporting contaminants to downstream water supplies. Domestic and commercial activities dispose of wastes down-the-drain, resulting in wastewater containing complex chemical mixtures that are only partially removed during treatment. A key issue associated with WWTP effluent discharge into streams is the potential to cause endocrine disruption in fish. This study provides a long-term (1999-2009) evaluation of the occurrence of alkylphenolic endocrine disrupting chemicals (EDCs) and other contaminants discharged from WWTPs into streams in the Great Lakes and Upper Mississippi River Regions (Indiana, Illinois, Michigan, Minnesota, and Ohio). The Greater Metropolitan Chicago Area Waterways, Illinois, were evaluated to determine contaminant concentrations in the major WWTP effluents and receiving streams, and assess the behavior of EDCs from their sources within the sewer collection system, through the major treatment unit processes at a WWTP, to their persistence and transport in the receiving stream. Water samples were analyzed for alkylphenolic EDCs and other contaminants, including 4-nonylphenol (NP), 4-nonylphenolpolyethoxylates (NPEO), 4-nonylphenolethoxycarboxylic acids (NPEC), 4-tert-octylphenol (OP), 4-tert-octylphenolpolyethoxylates (OPEO), bisphenol A, triclosan, ethylenediaminetetraacetic acid (EDTA), and trace elements. All of the compounds were detected in all of the WWTP effluents, with EDTA and NPEC having the greatest concentrations. The compounds also were detected in the WWTP effluent dominated rivers. Multiple fish species were collected from river and lake sites and analyzed for NP, NPEO, NPEC, OP, and OPEO. Whole-body fish tissue analysis indicated widespread occurrence of alkylphenolic compounds, with the highest concentrations occurring in streams with the greatest WWTP effluent content. Biomarkers of endocrine disruption in the fish indicated long-term exposure to estrogenic chemicals in the wastewater impacted urban waterways.

Comparative evaluation of a new endodontic irrigant - mixture of a tetracycline isomer, an Acid, and a detergent to remove the intracanal smear layer: a scanning electron microscopic study

BACKGROUND

The most important and demanding aspect of endodontic therapy is considered to be cleaning and shaping. Irrigation is considered a vital adjunct to instrumentation of the root canal for canal debridement. Until date, there is no single solution that simultaneously removes the smear layer and disinfects the entire root canal system. Thus, this in vitro study was designed to evaluate the efficiency of a new irrigation solution mixture of a tetracycline isomer, an acid, and a detergent (MTAD) (BioPure, Dentsply) containing a mixture of tetracycline (doxycycline hydrochloride), an acid (citric acid) and a detergent (Tween 80) in comparison with normal saline, 5% NaOCl and 17% ethylenediaminetetraacetic acid (EDTA) to remove intracanal smear layer.

MATERIALS AND METHODS

A total of 60 single rooted teeth were irrigated with Saline (Group A), 5% NaOCl (Group B), 17% EDTA (Group C) and MTDA (Group D). The extent of removal of smear layer and erosion was assessed using scanning electron microscope.

RESULTS

Irrigation with 5% NaOCl and MTAD as a final flush produced the cleanest surface with all the dentinal tubules open. No conjugation or erosion of dentinal tubules was noted (P > 0.05).

CONCLUSION

MTAD flush was the most effective debridement regimen in all the three thirds of the canal showing its ability to reach the apex with no conjugation and erosion of dentinal tubules.

The effect of laterally positioned flap-revised technique and 24% ethylenediaminetetraacetic acid root conditioning on root coverage: A case report

Complete root coverage is considered the true goal of treatment of gingival recession defects because only complete coverage assures recovery from the hypersensitivity and esthetic defects associated with recession areas. Previous studies have shown that the laterally positioned flap (LPF) technique or root surface biomodification yields a higher percentage of complete root coverage upon gingival recession treatment. This article highlights the use of the laterally positioned pedicle flap-revised technique (LPFRT) as a modification of the LPF technique, along with 24% EDTA gel as a root surface biomodification agent, in the management of localized gingival recession defects. Clinical examination revealed a Miller class II recession defect on the buccal aspect of the lower right central incisor, as well as the presence of aberrant frenum pull adjacent to the recession defect. The LPFRT, together with 24% EDTA gel, was speculated to cover the gingival recession defect. The frenectomy, along with periosteal fenestration, was planned simultaneously with LPFRT. After 6 months of therapy, the clinical condition was stable with complete root coverage and satisfactory healing of the gingival tissues at both the donor and recipient sites with no signs of inflammation.

Assay for characterizing the recovery of vertebrate cells for adhesion measurements by single-cell force spectroscopy

Single-cell force spectroscopy (SCFS) is becoming a widely used method to quantify the adhesion of a living cell to a substrate, another cell or tissue. The high sensitivity of SCFS permits determining the contributions of individual cell adhesion molecules (CAMs) to the adhesion force of an entire cell. However, to prepare adherent cells for SCFS, they must first be detached from tissue-culture flasks or plates. EDTA and trypsin are often applied for this purpose. Because cellular properties can be affected by this treatment, cells need to recover before being further characterized by SCFS. Here we introduce atomic force microscopy (AFM)-based SCFS to measure the mechanical and adhesive properties of HeLa cells and mouse embryonic kidney fibroblasts while they are recovering after detachment from tissue-culture. We find that mechanical and adhesive properties of both cell lines recover quickly (<10 min) after detachment using EDTA, while trypsin-detached fibroblasts require >60 min to fully recover. Our assay introduced to characterize the recovery of mammalian cells after detachment can in future be used to estimate the recovery behavior of other adherent cell types.

An in vitro evaluation of passive ultrasonic agitation of different irrigants on smear layer removal after post space preparation: a scanning electron microscopic study

This study evaluated the removal of debris and smear layer after post space preparation using different irrigations and passive ultrasonic agitation. Sixty human premolars were decoronated and post space prepared after endodontic therapy. The samples were then randomly divided into three experimental groups (Groups A, B, C) and one control group (Group D) with fifteen samples in each group. Groups A and B samples were treated with 10 % citric acid and 17 % ethylenediamintetraacetic acid (EDTA), respectively and passive ultrasonic agitation was done, rinsed with sodium hypochlorite and finally flushed with saline. Group C samples were conditioned with 36 % phosphoric acid and then rinsed with saline. The control group was treated with 3 % sodium hypochlorite, passive ultrasonic agitation done and flushed with saline. The samples were sectioned and evaluated for debris and smear layer removal under scanning electron microscope. 10 % citric acid showed the best removal of smear layer when compared with 17 % EDTA and 36 % phosphoric acid, but was not statistically significant (p > 0.05). The difference in scoring for debris and smear layer removal in the coronal, middle and apical third of post space of experimental groups in comparison with control group was statistically significant (p < 0.001).

Comparative gene expression analysis of Dtg, a novel target gene of Dpp signaling pathway in the early Drosophila melanogaster embryo

In the early Drosophila melanogaster embryo, Dpp, a secreted molecule that belongs to the TGF-β superfamily of growth factors, activates a set of downstream genes to subdivide the dorsal region into amnioserosa and dorsal epidermis. Here, we examined the expression pattern and transcriptional regulation of Dtg, a new target gene of Dpp signaling pathway that is required for proper amnioserosa differentiation. We showed that the expression of Dtg was controlled by Dpp and characterized a 524-bp enhancer that mediated expression in the dorsal midline, as well as, in the differentiated amnioserosa in transgenic reporter embryos. This enhancer contained a highly conserved region of 48-bp in which bioinformatic predictions and in vitro assays identified three Mad binding motifs. Mutational analysis revealed that these three motifs were necessary for proper expression of a reporter gene in transgenic embryos, suggesting that short and highly conserved genomic sequences may be indicative of functional regulatory regions in D. melanogaster genes. Dtg orthologs were not detected in basal lineages of Dipterans, which unlike D. melanogaster develop two extra-embryonic membranes, amnion and serosa, nevertheless Dtg orthologs were identified in the transcriptome of Musca domestica, in which dorsal ectoderm patterning leads to the formation of a single extra-embryonic membrane. These results suggest that Dtg was recruited as a new component of the network that controls dorsal ectoderm patterning in the lineage leading to higher Cyclorrhaphan flies, such as D. melanogaster and M. domestica.