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Maiola EC, Boppré LM, Savaris JM, Dias Junior LCDL, Garcia LDFR, Teixeira CDS, Bortoluzzi EA. Did in-between rinsing and agitating with distilled water prevents precipitate formation by the interaction between sodium hypochlorite and chlorhexidine canal irrigants? Microsc Res Tech 2024; 87:315-325. [PMID: 37811954 DOI: 10.1002/jemt.24435] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 08/16/2023] [Accepted: 09/27/2023] [Indexed: 10/10/2023]
Abstract
The interaction of sodium hypochlorite (NaOCl) and chlorhexidine gluconate (CHX) produces an orange-brown precipitate. The present study evaluated the influence of distilled water (H2 O) in different irrigation protocols designed to prevent the formation of precipitate with NaOCl and CHX. Fifty canine teeth were instrumented and split longitudinally. The canal was examined with a stereomicroscope and photographed by canal-thirds. The tooth halves were repositioned and distributed randomly into five groups, according to the final irrigation protocol (n = 10): G1 (control)-Ethylenediaminetetraacetic acid (EDTA) + NaOCl + CHX, conventional irrigation (CI); G2-EDTA + NaOCl + CHX, activated with passive ultrasonic irrigation (PUI); G3-EDTA (PUI) + NaOCl (PUI) + H2 O (CI) + CHX (PUI); G4-EDTA + NaOCl + H2 O + CHX (PUI); G5-EDTA (PUI) + NaOCl (PUI) + H2 O (continuous ultrasonic irrigation [CUI]) + CHX (PUI). The specimens were evaluated with a stereomicroscope and scanning electron microscope (SEM). Energy dispersive x-ray spectroscopy analysis was performed to identify the elemental profile of the irrigated canal walls. The images were scored according to the extensiveness of precipitate. Data were analyzed (Kruskal-Wallis test, α = 5%). Under the stereomicroscope, G1 had significantly higher scores than all the other groups in all canal-thirds (p < .05). All four experimental groups showed similar scores (p > .05). There were no significant differences in precipitate formation among root-thirds in intragroup analysis (p > .05). Upon SEM examination, overall, only G5 had lower scores than G1 (p < .05). Analysis by canal-thirds showed no significant difference among groups and among canal-thirds in the intragroup analysis (p > .05). G1 showed high Cl peaks. In-between irrigation with H2 O activated by CUI is effective in preventing precipitate formation during canal debridement with NaOCl and CHX. RESEARCH HIGHLIGHTS: Continuous ultrasonic irrigation with distilled water was capable to prevent the precipitate formation. The precipitate can be classified as a chemical smear layer.
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Affiliation(s)
- Emanuelle Catherine Maiola
- Postgraduate Program in Dentistry, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil
| | - Letícia Mendes Boppré
- Postgraduate Program in Dentistry, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil
| | - Julia Menezes Savaris
- Postgraduate Program in Dentistry, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil
| | | | | | | | - Eduardo Antunes Bortoluzzi
- Department of Diagnosis & Oral Health, Division of Endodontics, University of Louisville, Louisville, Kentucky, USA
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Kumar M, Shahi S, Agarwal LK, El-Shamy FMM, Gupta K, Aggarwal N. Evaluation of Dissolution of Pulp by Sodium Hypochlorite when Mixed with Tetrasodic Etidronate and Disodic Ethylenediamine Tetraacetate under Controlled Flow. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2024; 16:S684-S686. [PMID: 38595430 PMCID: PMC11001124 DOI: 10.4103/jpbs.jpbs_940_23] [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: 09/24/2023] [Revised: 10/02/2023] [Accepted: 10/03/2023] [Indexed: 04/11/2024] Open
Abstract
Background Sodium hypochlorite serves as the most efficient root canal irrigating fluid. Objectives This study's goal was to assess the replenished NaOCl's capacity to dissolve the tissue of pulp when combined with 9% tetrasodic etidronate (Na4HEBP), 18% tetrasodic etidronate (Na4HEBP), and 17% disodic ethylenediaminetetraacetate (Na2EDTA) under continuous controlled administration. Materials and Methods Hundred and twenty complete undamaged teeth of the anterior mandible extracted due to periodontal problems within forty-eight hours were taken as a source of the pulp tissue. Results It was found that there was a decrease in the weight of pulp tissue in all groups except negative control. Conclusion NaOCl's potential to dissolve tissue with chelating agents like EDTA and HEBP inside the root canal was unaffected when there was controlled administration of EDTA and HEBP.
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Affiliation(s)
- Mukesh Kumar
- Department of Conservative Dentistry and Endodontics, Patna Dental College and Hospital, Patna, Bihar, India
| | - Siddharth Shahi
- Department of Conservative Dentistry and Endodontics, Sarjug Dental College, Laheriasarai, Darbhanga, Bihar, India
| | - Lalit Kumar Agarwal
- Department of Conservative Dentistry and Endodontics, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India
| | | | - Khushboo Gupta
- Department of Conservative Dentistry and Endodontics, Chandra Dental College and Hospital, Lucknow, Uttar Pradesh, India
| | - Nidhi Aggarwal
- Department of Conservative Dentistry and Endodontics, MMCDSR, Mullana, Haryana, India
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Navarrete N, Almansa JM, de la Macorra JC, Arias-Moliz MT, Arias A. Effect of the Controlled Delivery of Chelating Agents on the Pulp Tissue Dissolution Ability of Fresh Sodium Hypochlorite Solutions. J Endod 2023; 49:307-312. [PMID: 36574829 DOI: 10.1016/j.joen.2022.12.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 12/15/2022] [Accepted: 12/19/2022] [Indexed: 12/25/2022]
Abstract
INTRODUCTION The purpose of this study was to evaluate pulp tissue dissolution ability of sodium hypochlorite (NaOCl) when mixed with tetrasodic etidronate (Na4HEBP) and disodic ethylenediaminetetraacetate (Na2EDTA) under controlled flow. METHODS Bovine pulp tissue was extracted from the lower incisors of 10 bovine jaws. Pulp specimens were standardized in size (1 × 3 × 10 mm), blotted dry, and weighed (initial weight [T0]: mean (SD) = 31.98 (1.18) mg). Specimens from the same jaw were randomly assigned to 2 control (n = 3 each) and 4 experimental groups (n = 10 each): NC (negative control/distilled water), PC (positive control/6%NaOCl), G1 (3%NaOCl), G2 (3%NaOCl-17% Na2EDTA), G3 (3%NaOCl-18% Na4HEBP), and G4 (3%NaOCl-9% Na4HEBP). Distilled water and NaOCl were provided using a delivery pump under a continuous controlled rate (1 mL/min). A second pump alternately delivered either Na2EDTA or Na4HEBP at the same rate with a 30-second programmed interval. Percentage of tissue weight loss was calculated at 2, 5, and 10 minutes (T2, T5, and T10) and compared among groups with analysis of variance. Free available chlorine and pH were controlled at T0 and T10. RESULTS No tissue remained in PC at T5. No dissolution occurred in NC. There were no significant differences in the percentage of weight loss among experimental groups at any point of time. Some remnant tissue was found in G3 (1.4% ± 2.4) and G4 (1.6% ± 2.3) at T10, whereas nothing was left in G1 and G2. CONCLUSIONS The controlled delivery of Na2EDTA and Na4HEBP did not alter tissue dissolution ability of NaOCl when fresh solutions were mixed in the root canal.
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Affiliation(s)
- Natalia Navarrete
- Department of Clinical Dentistry, Universidad Europea de Madrid, Faculty of Biomedical and Health Sciences
| | - Juan M Almansa
- Department of Conservative and Prosthetic Dentistry, School of Dentistry, Complutense University, Madrid, Spain
| | - José C de la Macorra
- Department of Conservative and Prosthetic Dentistry, School of Dentistry, Complutense University, Madrid, Spain
| | | | - Ana Arias
- Department of Conservative and Prosthetic Dentistry, School of Dentistry, Complutense University, Madrid, Spain.
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Boutsioukis C, Arias-Moliz MT. Present status and future directions - irrigants and irrigation methods. Int Endod J 2022; 55 Suppl 3:588-612. [PMID: 35338652 PMCID: PMC9321999 DOI: 10.1111/iej.13739] [Citation(s) in RCA: 56] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 03/21/2022] [Indexed: 11/30/2022]
Abstract
Irrigation is considered the primary means of cleaning and disinfection of the root canal system. The purpose of this review was to set the framework for the obstacles that irrigation needs to overcome, to critically appraise currently used irrigants and irrigation methods, to highlight knowledge gaps and methodological limitations in the available studies and to provide directions for future developments. Organization of bacteria in biofilms located in anatomic intricacies of the root canal system and the difficulty to eliminate them is the main challenge for irrigants. Sodium hypochlorite remains the primary irrigant of choice, but it needs to be supplemented by a chelator. Delivery of the irrigants using a syringe and needle and activation by an ultrasonic file are the most popular irrigation methods. There is no evidence that any adjunct irrigation method, including ultrasonic activation, can improve the long‐term outcome of root canal treatment beyond what can be achieved by instrumentation and syringe irrigation. It is necessary to redefine the research priorities in this field and investigate in greater depth the penetration of the irrigants, their effect on the biofilm and the long‐term treatment outcome. New studies must also focus on clinically relevant comparisons, avoid methodological flaws and have sufficiently large sample sizes to reach reliable conclusions. Future multidisciplinary efforts combining the knowledge from basic sciences such as Chemistry, Microbiology and Fluid Dynamics may lead to more effective antimicrobials and improved activation methods to bring them closer to the residual biofilm in the root canal system.
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Affiliation(s)
- C Boutsioukis
- Department of Endodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - M T Arias-Moliz
- Department of Microbiology, Faculty of Dentistry, University of Granada, Granada, Spain
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Boutsioukis C, Arias-Moliz MT, Chávez de Paz LE. A critical analysis of research methods and experimental models to study irrigants and irrigation systems. Int Endod J 2022; 55 Suppl 2:295-329. [PMID: 35171506 PMCID: PMC9314845 DOI: 10.1111/iej.13710] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 02/07/2022] [Accepted: 02/08/2022] [Indexed: 11/28/2022]
Abstract
Irrigation plays an essential role in root canal treatment. The purpose of this narrative review was to critically appraise the experimental methods and models used to study irrigants and irrigation systems and to provide directions for future research. Studies on the antimicrobial effect of irrigants should use mature multispecies biofilms grown on dentine or inside root canals and should combine at least two complementary evaluation methods. Dissolution of pulp tissue remnants should be examined in the presence of dentine and, preferably, inside human root canals. Micro-omputed tomography is currently the method of choice for the assessment of accumulated dentine debris and their removal. A combination of experiments in transparent root canals and numerical modeling is needed to address irrigant penetration. Finally, models to evaluate irrigant extrusion through the apical foramen should simulate the periapical tissues and provide quantitative data on the amount of extruded irrigant. Mimicking the in vivo conditions as close as possible and standardization of the specimens and experimental protocols are universal requirements irrespective of the surrogate endpoint studied. Obsolete and unrealistic models must be abandoned in favour of more appropriate and valid ones that have more direct application and translation to clinical Endodontics.
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Affiliation(s)
- C Boutsioukis
- Department of Endodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - M T Arias-Moliz
- Department of Microbiology, Faculty of Dentistry, University of Granada, Granada, Spain
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Tartari T, Borges MMB, de Araújo LBB, Vivan RR, Bonjardim LR, Duarte MAH. Effects of heat in the properties of NaOCl alone and mixed with etidronate and alkaline tetrasodium EDTA. Int Endod J 2021; 54:616-627. [PMID: 33219520 DOI: 10.1111/iej.13450] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 11/02/2020] [Accepted: 11/17/2020] [Indexed: 01/15/2023]
Abstract
AIM To assess the free available chlorine concentration (FAC), organic tissue dissolution and smear layer removal capacity of sodium hypochlorite (NaOCl) alone and when mixtured with etidronate (HEDP) and tetrasodium EDTA (Na4 EDTA), and heated to different temperatures. METHODOLOGY Mixtures at 1 : 1 ratio of 5% NaOCl with distilled water (considered NaOCl alone), 18% HEDP or 10% Na4 EDTA were heated to 25 °C, 37 °C, 48 °C and 60 °C. The FAC in the mixtures was assessed at 5, 10, 20, 30, 60 and 120 min. Samples of bovine muscle tissue (n = 10) were prepared with similar size and weighed before and after 5, 10 and 15 min of immersion in the mixtures heated to the different temperatures to verify organic matter dissolution. The intergroup results were compared statistically using one-way analysis of variance (anova) and intragroup by two-way analysis of variance (anova), both followed by Tukey's multiple-comparison test (α < 0.01). Bovine dentine blocks (n = 10) were analysed by scanning electron microscopy before and after immersion in the mixtures, and the time taken to remove the smear layer from the surfaces of the samples was determined. The Friedman test was used to compare the scores of the same group (α < 0.01), and the Kruskal-Wallis test with Dunn's post hoc was used to compare the different groups (α < 0.01). Saline solution was used as a control in the experiments of tissue dissolution and smear layer removal, RESULTS: Heating NaOCl alone did not affect its FAC. The higher the temperature of the mixtures with the chelators, the lower the FAC. Organic tissue dissolution was improved by increases in temperature of NaOCl alone and its mixture with HEDP (P < 0.01); however, the mixture with Na4 EDTA had no improvement (P > 0.01). Smear layer removal by NaOCl alone was enhanced by heating resulting in lower scores in some samples and became more rapid in the mixtures with the chelators. The saline solution did not promote tissue dissolution nor smear layer removal (P > 0.01). CONCLUSION In this laboratory study, heating NaOCl alone or when mixed with HEDP improved its capacity to dissolve organic matter and remove the smear layer. However, the mixture with HEDP required frequent refreshment to retain these effects when heated. Due to the acceleration in the reaction between the irrigants, very rapid reductions in the free available chlorine in the mixtures with Na4 EDTA heated to the different temperatures occurred.
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Affiliation(s)
- T Tartari
- Department of Operative Dentistry, Endodontics, and Dental Materials, University of São Paulo, Bauru, Brazil
| | - M M B Borges
- Department of Operative Dentistry, Endodontics, and Dental Materials, University of São Paulo, Bauru, Brazil
| | - L B B de Araújo
- Department of Operative Dentistry, Endodontics, and Dental Materials, University of São Paulo, Bauru, Brazil
| | - R R Vivan
- Department of Operative Dentistry, Endodontics, and Dental Materials, University of São Paulo, Bauru, Brazil
| | - L R Bonjardim
- Department of Biological Science, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - M A H Duarte
- Department of Operative Dentistry, Endodontics, and Dental Materials, University of São Paulo, Bauru, Brazil
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Ozlek E, Neelakantan P, Khan K, Cheung GSP, Rossi-Fedele G. Debris extrusion during root canal preparation with nickel-titanium instruments using liquid and gel formulations of sodium hypochlorite in vitro. AUST ENDOD J 2020; 47:130-136. [PMID: 32748569 DOI: 10.1111/aej.12424] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 07/07/2020] [Accepted: 07/08/2020] [Indexed: 11/30/2022]
Abstract
This study compared the amount of apically extruded debris during root canal preparation with three single-file systems using liquid and gel-based formulations of sodium hypochlorite (NaOCl) or distilled water. Seventy-two single-canalled roots were divided into three groups: HyFlex EDM (Coltene-Whaledent); Reciproc Blue (VDW); and F-One Blue (Shanghai Fanta) and then divided into three subgroups: NaOCl liquid (Imicrly), NaOCl gel (Cerkamed Medical) and distilled water. The amount of extruded debris was calculated by determining the dry weight of the debris collected. Data were analysed using Kruskal-Wallis test with Bonferroni correction. Debris extrusion occurred in all subgroups. Both the instrument and the irrigant had an impact. The F-One Blue tended to extrude the least debris, though no significant difference was observed in the pairwise comparisons between instruments. NaOCl liquid resulted in significantly more extruded debris than NaOCl gel or distilled water. The results lead us to conclude that the NaOCl gel reduced debris extrusion compared to NaOCl liquid.
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Affiliation(s)
- Esin Ozlek
- Department of Endodontics, Faculty of Dentistry, The University of Van Yuzuncu Yil, Van, Turkey
| | - Prasanna Neelakantan
- Discipline of Endodontology, Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, Hong Kong
| | - Khadija Khan
- Discipline of Endodontology, Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, Hong Kong
| | - Gary S P Cheung
- Discipline of Endodontology, Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, Hong Kong
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Güçlüer Ö, Akarsu E, Yavuz E, Er K, Kuştarcı A. Human pulp tissue dissolution ability of different extracts of Sapindus mukorossi: An in vitro study. CHINESE HERBAL MEDICINES 2020; 12:178-182. [PMID: 36119798 PMCID: PMC9476676 DOI: 10.1016/j.chmed.2019.11.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 09/20/2019] [Accepted: 11/15/2019] [Indexed: 11/30/2022] Open
Abstract
Objective Due to the many negative properties of sodium hypochlorite used in current root canal treatment, interest in biocompatible natural agents is increasing day by day. The aim of this study was to evaluate whether various extract solutions of Sapindus mukorossi have dissolution effects on human pulp tissues. Methods Primarily powder extracts were obtained by extracting fruit shells of S. mukorossi in different solvents (ethanol, methanol, buthanol and distilled water). The test solutions were prepared and randomly separated into six groups with 10 samples in each group: ethanol extract, methanol extract, butanol extract, distilled water extract of S. mukorossi, sodium hypochlorite (NaOCl) and the control group. Among these, S. mukorossi extracts were separated into two subgroups, depending on their concentration level (50 µg/mL and 100 µg/mL). The pulp tissues of freshly extracted human molars were used for dissolution test. The weights of the pulpal tissues were measured and recorded for two times after the samples were placed in the solutions. Statistical analysis for all descriptive statistics was performed using SPSS 22 (P < 0.05). Results Our results showed that maximum percent yield of preparation was obtained in methanol extract of S. mukorossi. Among all of the groups, the best dissolution capacity was seen in the NaOCl group (positive control group). Among S. mukorossi groups, the best tissue solvent solution was found in SMM group at 50 µg/mL and SMB group at 100 µg/mL. Conclusion The different extracts of S. mukorossi had a capacity to dissolve pulp tissue but this capacity was less than NaOCl. Therefore, further studies will enable the creation of a commercial solution for clinical use by increasing the effectiveness of S. mukorossi while combining it with other endodontic irrigation solutions.
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Affiliation(s)
- Öznur Güçlüer
- Department of Endodontics, Faculty of Dentistry, Akdeniz University, Antalya 07070, Turkey
- Corresponding author.
| | - Esin Akarsu
- Department of Chemistry, Faculty of Science, Akdeniz University, Antalya 07070, Turkey
| | - Emre Yavuz
- Department of Chemistry, Faculty of Science, Akdeniz University, Antalya 07070, Turkey
| | - Kürşat Er
- Department of Endodontics, Faculty of Dentistry, Akdeniz University, Antalya 07070, Turkey
| | - Alper Kuştarcı
- Department of Endodontics, Faculty of Dentistry, Akdeniz University, Antalya 07070, Turkey
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Conde AJ, Peña A, Estevez R, Loroño G, Rossi-Fedele G, Cisneros R. The effect of a preparation containing glycocholic acid and/or agitation on the tissue dissolution ability of sodium hypochlorite. AUST ENDOD J 2020; 46:338-342. [PMID: 32212289 DOI: 10.1111/aej.12406] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2020] [Indexed: 11/28/2022]
Abstract
This study assessed the porcine palatal mucosa dissolution, from artificial grooves, by a final rinse of sodium hypochlorite (NaOCl) solely or mixed with Keratobacter ((KB); or agitation) passive ultrasonic irrigation (PUI) or sonic activation (SA). Soft-tissue samples (n = 123) were weighed and placed inside root canal grooves in central maxillary incisors. The specimens were randomly divided into six test groups (n = 20): NaOCl 3% with or without KB and the irrigation dynamics: positive pressure (PP), SA or PUI. An EDTA intermediate rinse was included. Soft-tissue weights were measured subsequently. The NaOCl + KB_PUI group showed the highest mean weight reduction, whilst the NaOCl_PP group recorded the lowest. NaOCl + KB subgroups were associated with hastened reduction compared with NaOCl subgroups. NaOCl_PP presented with significantly lower weight reduction when compared with the remaining experimental groups. The addition of KB to NaOCl or its agitation enhances tissue dissolution ex vivo. The agitation of KB-containing mixtures offers no further benefits.
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Affiliation(s)
- Antonio J Conde
- Postgraduate Program in Endodontics, European University of Madrid, Madrid, Spain
| | - Alejandro Peña
- Postgraduate Program in Endodontics, European University of Madrid, Madrid, Spain
| | - Roberto Estevez
- Postgraduate Program in Endodontics, European University of Madrid, Madrid, Spain
| | - Gaizka Loroño
- Postgraduate Program in Endodontics, European University of Madrid, Madrid, Spain
| | - Giampiero Rossi-Fedele
- Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
| | - Rafael Cisneros
- Postgraduate Program in Endodontics, European University of Madrid, Madrid, Spain
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10
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Calcium Hypochlorite Solutions - An In Vitro Evaluation of Antimicrobial Action and Pulp Dissolution. Eur Endod J 2019; 4:15-20. [PMID: 32161881 PMCID: PMC7006560 DOI: 10.14744/eej.2018.64936] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 11/19/2018] [Accepted: 11/29/2018] [Indexed: 11/20/2022] Open
Abstract
Objective: To compare the antimicrobial activity and tissue dissolution capacity of calcium hypochlorite (Ca(OCl)2) solution with sodium hypochlorite (NaOCl) solution at 0.5%, 1.0%, 2.5%, and 5.25% concentrations. Methods: To determine the inhibition halos produced by the tested substances against Enterococcus faecalis, the agar diffusion method was employed. Additionally, the broth contact method was used to determine the time required for the inhibition of E. faecalis. Bovine pulp fragments were used to test the dissolution. Half of the pulps were freely deposited samples in cell culture wells, and the remaining samples were fixed on bovine dentine bases. Results: For both Ca(OCl)2 and NaOCl solutions, the greatest inhibition zones were observed at 5.25% con-centration. However, the most significant inhibition zone was measured with 5.25% Ca(OCl)2 solution (17.38 mm). Hypochlorite solutions at 2.5% and 5.25% concentrations required less time to inhibit E. faecalis than those at 0.5% and 1.0% concentrations (P<0.05). There was no difference in inhibition times between 2.5% and 5.25% hypochlorite solutions (P>0.05). The most effective hypochlorite solution concentrations were 5.25% and 2.5% for dissolving pulp fragments (P<0.05). Additionally, suspended pulp fragments were more susceptible to dissolution than fragments attached to dentine blocks (P<0.05), except for 0.5% Ca(OCl)2. Conclusion: Ca(OCl)2 solutions showed antimicrobial activity against E. faecalis and can dissolve pulp tissues. Future studies are warranted to examine the suitability of Ca(OCl)2 in the chemico–mechanical preparation of the root canal system.
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Iglesias JE, Pinheiro LS, Weibel DE, Montagner F, Grecca FS. Influence of surfactants addition on the properties of calcium hypochlorite solutions. J Appl Oral Sci 2019; 27:e20180157. [PMID: 30624467 PMCID: PMC6322640 DOI: 10.1590/1678-7757-2018-0157] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2018] [Accepted: 08/21/2018] [Indexed: 11/25/2022] Open
Abstract
Objectives The aim of this study was to evaluate the influence of surfactants 0.2% or 0.1% cetrimide (Cet) or 0.008% benzalkonium chloride (BAK) on 2.5% calcium hypochlorite (Ca(OCl)2), and compare to sodium hypochlorite (NaOCl), regarding the properties of pH, free chlorine content, surface tension, contact angle, pulp dissolution and antimicrobial activity. Material and Methods The pH and free chlorine content were evaluated by digital pHmeter and by titration, respectively. Surface tension was measured by the platinum ring technique with a Du Noüy tensiometer. The solution's contact angle in human dentin surfaces was checked by Drop Shape Analyzer software. Bovine pulps were used for pulp dissolution analysis and the dissolving capacity was expressed by percent weight loss. Antimicrobial activity over Enterococcus faecalis was evaluated by the agar diffusion method. Results Surfactants addition to Ca(OCl)2 and NaOCl did not alter the pH, free chlorine content and pulp dissolution properties. Ca(OCl)2 had the highest surface tension among all tested solutions. When surfactants were added to Ca(OCl)2 and NaOCl, there was a significant reduction of surface tension and contact angle values. The addition of 0.2% or 0.1% Cet enhanced antimicrobial activity of both Ca(OCl)2 and NaOCl. Conclusion Surfactant addition to 2.5% Ca(OCl)2 has shown acceptable outcomes for pH, free chlorine content, surface tension, contact angle, pulp dissolution and antimicrobial activity. Furthermore, the addition of 0.2% Cet showed better results for all tested properties.
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Affiliation(s)
- Júlia Eick Iglesias
- Universidade Federal do Rio Grande do Sul, Faculdade de Odontologia, Departamento de Odontologia Conservadora, Porto Alegre, Rio Grande do Sul, Brasil
| | - Lucas Siqueira Pinheiro
- Universidade Federal do Rio Grande do Sul, Faculdade de Odontologia, Departamento de Odontologia Conservadora, Porto Alegre, Rio Grande do Sul, Brasil
| | - Daniel Eduardo Weibel
- Universidade Federal do Rio Grande do Sul, Instituto de Química, Departamento de Físico-Química, Porto Alegre, Rio Grande do Sul, Brasil
| | - Francisco Montagner
- Universidade Federal do Rio Grande do Sul, Faculdade de Odontologia, Departamento de Odontologia Conservadora, Porto Alegre, Rio Grande do Sul, Brasil
| | - Fabiana Soares Grecca
- Universidade Federal do Rio Grande do Sul, Faculdade de Odontologia, Departamento de Odontologia Conservadora, Porto Alegre, Rio Grande do Sul, Brasil
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Peña López A, Conde AJ, Estevez R, Valencia de Pablo O, Rossi-Fedele G, Cisneros R. Sodium Hypochlorite and a Preparation Containing Glycocholic Acid and Surfactants Have a Synergistic Action on Organic Tissue Dissolution In Vitro. J Endod 2018; 44:813-815. [PMID: 29550010 DOI: 10.1016/j.joen.2018.01.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2017] [Revised: 01/08/2018] [Accepted: 01/09/2018] [Indexed: 10/17/2022]
Abstract
INTRODUCTION The aim of this study was to evaluate porcine palatal mucosa dissolution by sodium hypochlorite (NaOCl) with or without an auxiliary dissolving agent containing glycocholic acid and a mixture of surfactants (Keratobacter [KB]; Saint Joseph DID, Valencia, Spain). METHODS One hundred forty samples were obtained from porcine palatal mucosa and weighed using a high-precision balance. The samples were randomly divided into 4 experimental groups (n = 35) based on the test solution used: distilled water (the negative control), CanalPro NaOCl 6% (Coltene Whaledent, Altstätten, Switzerland), KB, and a 9:1 vol/vol mixture of NaOCl with KB (NaOCl + KB). After 5, 10, 15, and 20 minutes of immersion in the solutions at 27°C ± 1°C, the samples were weighted by a blinded assessor. The intergroup weight at the different time points was statistically analyzed using the analysis of variance test with the Bonferroni posttest. RESULTS All test groups presented with tissue dissolution although complete dissolution did not occur in any sample. The largest percent in weight reduction occurred between time points (t) = 0 minutes and t = 5 minutes for the NaOCl + KB group (22.5%) followed by KB (18.5%) for the same time period. NaOCl presented with similar tissue dissolution activity during the different time points, ranging from 7.8% (t = 10 minutes-t = 15 minutes) to 6.8% (t = 15 minutes-t = 20 minutes). Significant weight differences were found among the different experimental groups after 5, 10, and 15 minutes of incubation, with the only exception being KB versus NaOCl + KB. No significant differences were found when comparing the test groups at t = 20 minutes. CONCLUSIONS The addition of KB to NaOCl increased porcine palatal mucosa dissolution in vitro.
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Affiliation(s)
- Alejandro Peña López
- Postgraduate Program in Endodontics, European University of Madrid, Madrid, Spain
| | - Antonio J Conde
- Postgraduate Program in Endodontics, European University of Madrid, Madrid, Spain
| | - Roberto Estevez
- Postgraduate Program in Endodontics, European University of Madrid, Madrid, Spain
| | | | | | - Rafael Cisneros
- Postgraduate Program in Endodontics, European University of Madrid, Madrid, Spain
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Estevez R, Conde AJ, Valencia de Pablo O, de la Torre F, Rossi-Fedele G, Cisneros R. Effect of Passive Ultrasonic Activation on Organic Tissue Dissolution from Simulated Grooves in Root Canals Using Sodium Hypochlorite with or without Surfactants and EDTA. J Endod 2017; 43:1161-1165. [DOI: 10.1016/j.joen.2017.01.041] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 01/25/2017] [Accepted: 01/30/2017] [Indexed: 12/29/2022]
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Niewierowski RS, Scalzilli LR, Morgental RD, Figueiredo JAPD, Vier-Pelisser FV, Borba MGD, Ghisi AC. Bovine Pulp Tissue Dissolution Ability of Irrigants Associated or Not to Ultrasonic Agitation. Braz Dent J 2017; 26:537-40. [PMID: 26647942 DOI: 10.1590/0103-6440201300243] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2015] [Accepted: 07/14/2015] [Indexed: 11/21/2022] Open
Abstract
The aim of this study was to evaluate the tissue dissolution ability of different irrigating solutions associated or not to ultrasonic agitation. Ninety bovine pulp fragments (n=10 per group) were weighed and then placed individually in Eppendorf test tubes containing the following irrigants: G1- 2.5% sodium hypochlorite (NaOCl); G2- 2.5% NaOCl + ultrasonic agitation (US); G3- 2.5% NaOCl + 0.2% cetrimide (CTR); G4- 2.5% NaOCl + 0.2% CTR + US; G5- 400 ppm Sterilox (SX); G6- SX + US; G7- 0.2% CTR; G8- 0.2% CTR + US; G9- saline solution. Two blinded observers assessed the samples continuously for the first 4 h, and then every hour for the next 12 h. Dissolution speed was calculated by dividing the initial pulp weight (mg) by the period of time until complete dissolution (min). Data were compared by ANOVA and Tukey post hoc test with a 5% significance level. G1 to G4 dissolved pulp fragments completely and G2 was significantly faster than the other groups. G5 to G9 did not exhibit dissolving activity. In conclusion, only groups containing NaOCl were capable of pulp tissue dissolution, which was enhanced by ultrasonic agitation, but did not alter when 0.2% cetrimide was associated. This isolated solution and Sterilox showed no dissolving capacity, regardless the use of ultrasound.
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Affiliation(s)
- Renata Senger Niewierowski
- Clinical Department, Dental School, PUCRS - Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Luíza Rodrigues Scalzilli
- Clinical Department, Dental School, PUCRS - Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Renata Dornelles Morgental
- Department of Semiology and Clinics, Dental School, UFPel - Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | | | - Fabiana Vieira Vier-Pelisser
- Clinical Department, Dental School, PUCRS - Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Maristela Gutierrez de Borba
- Clinical Department, Dental School, PUCRS - Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Alexandre Corrêa Ghisi
- Clinical Department, Dental School, PUCRS - Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
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Macedo HSD, Messias DCF, Rached-Júnior FJ, Oliveira LTD, Silva-Sousa YTC, Raucci-Neto W. 1064-nm Nd:YAG and 980-nm Diode Laser EDTA Agitation on the Retention of an Epoxy-Based Sealer to Root Dentin. Braz Dent J 2016; 27:424-9. [PMID: 27652705 DOI: 10.1590/0103-6440201601006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Accepted: 07/01/2016] [Indexed: 11/22/2022] Open
Abstract
Root canal irrigants are used to minimize the negative effects of smear layer on endodontic sealer retention. The aim of this study was to evaluate the efficacy of agitation of 17% ethylenediaminetetraacetic acid (EDTA) with ultrasonic, 1064-nm Nd:YAG and 980-nm diode laser on the retention of an epoxy-based sealer to the root canal walls. Forty single-rooted bovine teeth were instrumented with ProTaper rotary system and divided into four groups according to the final irrigation protocol (n = 10): (1) 17% EDTA (control); (2) 17% EDTA with 50-s ultrasonic agitation; (3) 17% EDTA with 50-s diode laser (2-W) agitation; and (4) 17% EDTA with 50-s Nd:YAG (1.5-W) laser agitation. After endodontic filling with gutta-percha F5 master cone and Sealer 26, the roots were sectioned at the cervical, middle, and apical root thirds to obtain 1.5-mm slices. Push-out tests were performed using a universal testing machine at a 1 mm/min crosshead speed. Data were analyzed using two-way ANOVA and Tukey's tests (α=0.05). Apical root thirds had significant higher retention values than cervical and middle thirds (p < 0.05). EDTA with 1064-nm Nd:YAG or 980-nm diode laser presented the highest retention values and was significantly different from EDTA with ultrasonic agitation and EDTA only (p < 0.05). Adhesive failures were predominant to EDTA only group. Mixed failures were predominant to all agitation groups. 1064-nm Nd:YAG and 980-nm diode laser EDTA agitation enhanced the retention of the epoxy-based sealer to the root canal walls compared with that due to EDTA only or EDTA with ultrasonic agitation.
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Leonardo NGES, Carlotto IB, Luisi SB, Kopper PMP, Grecca FS, Montagner F. Calcium Hypochlorite Solutions: Evaluation of Surface Tension and Effect of Different Storage Conditions and Time Periods over pH and Available Chlorine Content. J Endod 2016; 42:641-5. [DOI: 10.1016/j.joen.2016.01.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Revised: 01/11/2016] [Accepted: 01/12/2016] [Indexed: 11/27/2022]
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The Effect of Surfactants on the Stability of Sodium Hypochlorite Preparations. J Endod 2015; 41:1344-8. [DOI: 10.1016/j.joen.2015.03.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Revised: 03/16/2015] [Accepted: 03/16/2015] [Indexed: 11/20/2022]
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van der Sluis L, Boutsioukis C, Jiang LM, Macedo R, Verhaagen B, Versluis M. Root Canal Irrigation. SPRINGER SERIES ON BIOFILMS 2015. [DOI: 10.1007/978-3-662-47415-0_9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Oliveira JS, Raucci Neto W, Faria NSD, Fernandes FS, Miranda CES, Rached-Junior FJA. Quantitative Assessment of Root Canal Roughness with Calcium-Based Hypochlorite Irrigants by 3D CLSM. Braz Dent J 2014; 25:409-15. [DOI: 10.1590/0103-6440201302433] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2014] [Accepted: 09/19/2014] [Indexed: 11/22/2022] Open
Abstract
Chemical solutions play important roles in endodontic treatment and promote ultrastructural changes in dentin surface. The aim of this study was to quantify root canal roughness at different concentrations of calcium hypochlorite (Ca(OCl)2) and sodium hypochlorite (NaOCl) by confocal laser scanning microscopy (CLSM). Fifty-two human mandibular premolars were sectioned and randomly organized into thirteen groups (n=8): saline (control); 1%, 2.5% and 5% NaOCl; 1%, 2.5% and 5% Ca(OCl)2; the hypochlorite groups were further divided into with or without EDTA. The chlorine concentrations of the different solutions were measured by iodine titration (%). The superficial roughness (Sa) was quantified by CLSM. Ca(OCl)2 presented substantial decrease in chlorine concentration that differed from the package indication, but without compromising the dentin ultrastructure changes. There were no significant differences in dentin roughness between Ca(OCl)2 or NaOCl at all studied concentrations. The combination with EDTA provided similar roughness values among the solutions (p>0.05). The 5% Ca(OCl)2 and NaOCl solutions significantly increased dentin roughness and did not differ from the EDTA association (p>0.05). Ca(OCl)2 promoted similar dentin roughness as the NaOCl at the same concentrations and combined with EDTA. It may be concluded that Ca(OCl)2 modified the root canal dentin roughness similarly to NaOCl, at the same concentrations and EDTA combinations used in this study. Ca(OCl)2 and NaOCl, both at 5%, significantly altered dentin roughness, overcoming EDTA association, thus Ca(OCl)2 concentrations ranging from 1% to 2.5% may be suitable solutions for root canal irrigation protocols.
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