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Mumcu AK, Kurnaz S, Kiraz G, Gündüz MK. Comparative effects of 17% ethylenediaminetetraacetic acid and 9% etidronic acid applied with different irrigant activation techniques on the release of growth factors from dentin: in vitro study. BMC Oral Health 2024; 24:612. [PMID: 38802852 DOI: 10.1186/s12903-024-04336-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 05/06/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND Growth factors embedded in the extracellular matrix of the dentin play an important role in the migration, proliferation, and differentiation of dental pulp stem cells in regenerative endodontics. In regenerative endodontic treatments, the type of irrigation solution used is crucial for the release of growth factors (GFs) from the dentin matrix. This study evaluated the effectiveness of different irrigant activation techniques (IAT) using two different chelating agents, 17% ethylenediaminetetraacetic acid (EDTA) and 9% etidronic acid (HEDP), in terms of their GF release. METHODS Seventy-two mandibular premolar teeth were prepared to simulate an open apex. The root fragments were irrigated with 20 ml of 1.5% sodium hypochlorite and 20 ml of saline solution. Eight root fragments were randomly separated for the control group, and the remaining 64 fragments were randomly separated into eight groups based on two different chelating agents (17% EDTA and 9% HEDP) and four different IAT ((conventional needle irrigation (CNI), passive ultrasonic irrigation (PUI), sonic activation with EDDY, and XP-endo Finisher (XPF)). TGF-β1, VEGF-A, BMP-7 and IGF-1 release levels were determined using an ELISA, and statistical analysis was performed using the Kolmogorov-Smirnov test, ANOVA, and the Tukey test (p < .05). RESULTS Compared to the control group, the experimental groups showed significantly higher GF release when using EDTA or HEDP. Among the activation groups, the EDDY group triggered the highest GF release, and the CNI group triggered the lowest. CONCLUSIONS IAT with EDTA and HEDP can increase GF release, with EDDY being the most effective IAT method. Using chelating agents with IAT may be beneficial in regenerative endodontic treatments.
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Affiliation(s)
- Arzu Kaya Mumcu
- Department of Endodontics, Faculty of Dentistry, Kutahya Health Sciences University, Kutahya, Türkiye.
| | - Safa Kurnaz
- Department of Endodontics, Faculty of Dentistry, Kutahya Health Sciences University, Kutahya, Türkiye
| | - Gülsen Kiraz
- Department of Endodontics, Faculty of Dentistry, Kutahya Health Sciences University, Kutahya, Türkiye
| | - Meliha Koldemir Gündüz
- Department of Basic Sciences of Engineering, Faculty of Engineering and Natural Sciences, Kutahya Health Sciences University, Kutahya, Türkiye
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Vieira WDA, de-Jesus-Soares A, Lopes EM, Gomes BPFA, Lima BP. Effect of supplementary sodium hypochlorite agitation techniques on an ex vivo oral multispecies biofilm during passive disinfection of simulated immature roots. Int Endod J 2024. [PMID: 38387884 DOI: 10.1111/iej.14053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 02/08/2024] [Accepted: 02/11/2024] [Indexed: 02/24/2024]
Abstract
AIM To compare the effect of different sodium hypochlorite (NaOCl) agitation techniques on an ex vivo oral multispecies biofilm during passive disinfection of simulated immature roots. METHODOLOGY Extracted human teeth were prepared to simulate immature roots. They were infected with a dental plaque-derived multispecies biofilm and cultured for 14 days. The roots were randomly designated into four groups: (1) negative control (PBS), (2) 1.5% NaOCl (CNI), (3) CNI + Ultrasonic activation (UA), (4) CNI + EasyClean agitation (ECA), (5) CNI + XP-endo finisher agitation (XPF), and (6) positive control (6% NaOCl). Biofilm samples were collected from the root canals and used to determine the number of viable cells (colony-forming units), scanning electron microscopy, and 16S rRNA gene sequencing. The mean colony-forming units per mL (CFU/mL) were analysed using One-way anova. 16S rRNA sequencing data were analysed for alpha (observed OTUs, Shannon index, and Chao1) and beta diversity (Bray-Curtis dissimilarities). The LEfSe analysis was used to determine the effect of treatment procedures on the abundance of root canal microbiota. The significance was set at .05. RESULTS PBS and CNI samples had significantly higher CFU/mL counts than UA, ECA, XPF, and 6% NaOCl samples (p < .05). The pre-treatment, PBS, and CNI groups had significantly greater alpha diversity than the UA, ECA, XPF, and 6% NaOCl groups (p < .05). NaOCl agitation groups and the 6% NaOCl group achieved a more pronounced reduction in bacteria from the genera Fusobacterium, Actinomyces, Porphyromonas, and Capnocytophaga. CONCLUSIONS The effectiveness of passive disinfection protocols was enhanced by NaOCl agitation techniques, suggesting that this supplementary method can improve the outcome of revitalization procedures.
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Affiliation(s)
- Walbert de Andrade Vieira
- Division of Endodontics, Department of Restorative Dentistry, Piracicaba Dental School, Universidade Estadual de Campinas - UNICAMP, Piracicaba, Brazil
| | - Adriana de-Jesus-Soares
- Division of Endodontics, Department of Restorative Dentistry, Piracicaba Dental School, Universidade Estadual de Campinas - UNICAMP, Piracicaba, Brazil
| | - Erica M Lopes
- Division of Endodontics, Department of Restorative Dentistry, Piracicaba Dental School, Universidade Estadual de Campinas - UNICAMP, Piracicaba, Brazil
| | - Brenda P F A Gomes
- Division of Endodontics, Department of Restorative Dentistry, Piracicaba Dental School, Universidade Estadual de Campinas - UNICAMP, Piracicaba, Brazil
| | - Bruno P Lima
- Division of Basic Sciences, Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, Minneapolis, Minnesota, USA
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Timponi Goes Cruz A, Antoniw Klemz A, Ribeiro Rosa EA, Soares Grecca F, Mattos B, Piasecki L, Machado R, Ignácio SA, da Silva Neto UX. Cleaning and disinfection of the root canal system provided by four active supplementary irrigation methods. Sci Rep 2024; 14:3795. [PMID: 38361036 PMCID: PMC10869831 DOI: 10.1038/s41598-024-53375-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 01/31/2024] [Indexed: 02/17/2024] Open
Abstract
This in vitro study evaluated the bacterial reduction provided by the EndoActivator (EA), Easy Clean (EC), passive ultrasonic irrigation (PUI), and XP-Endo Finisher. Eight-four mesial roots of mandibular first molars were instrumented, inoculated with Enterococcus faecalis, and divided into four groups (n. 20). Bacterial reduction in the main canals and dentinal tubules were respectively determined by MTT assays and Live/Dead BackLight technique through confocal laser scanning microscopy (CLSM) at 50, 100, and 150 µm in-depth (n. 10 per group). Statistical analyses were conducted following a significance level of 95% (P < 0.05). A significant statistical difference was just identified between XPF and EC in the main canals. In the dentinal tubules from the main root canals, at 100 and 150 µm in-depths, significant statistical differences were only observed between XPF and EC (P = 0.027) for the former and between XPF and EC (P = 0.011) and XPF and PUI (P = 0.021) for the latter. In the dentinal tubules from the isthmus, at 100 µm in-depth, statistically relevant differences did occur between XPF and EC (P = 0.038) and EC and EA (P = 0.029). At 150 µm in-depth, these differences were only significant by comparing XPF and PUI (P = 0.025) and XPF and EC (P = 0.036). Although no irrigation method could thoroughly disinfect the RCS, bacterial reduction indexes were generally better after using XPF.
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Affiliation(s)
- Alessandra Timponi Goes Cruz
- Department of Endodontics, College of Dentistry, Pontifical Catholic University of Paraná-PUC/PR, Curitiba, Paraná, Brazil
| | - Adriane Antoniw Klemz
- Department of Endodontics, College of Dentistry, Pontifical Catholic University of Paraná-PUC/PR, Curitiba, Paraná, Brazil
| | - Edvaldo Antônio Ribeiro Rosa
- Department of Biosciences, College of Dentistry, Pontifical Catholic University of Paraná-PUC/PR, Curitiba, Paraná, Brazil
| | - Fabiana Soares Grecca
- Department of Endodontics, College of Dentistry, Federal University of Rio Grande do Sul-UFRGS, Porto Alegre, Rio Grande do Sul, Brazil
| | - Bianca Mattos
- Department of Endodontics, College of Dentistry, Pontifical Catholic University of Paraná-PUC/PR, Curitiba, Paraná, Brazil
| | - Lucila Piasecki
- Department of Periodontics & Endodontics, College of Dentistry, University at Buffalo, Buffalo, NY, USA
| | - Ricardo Machado
- Clinical practice limited to Endodontics, Navegantes, Santa Catarina, Brazil.
| | - Sérgio Aparecido Ignácio
- Department of Statistics, College of Dentistry, Pontifical Catholic University of Paraná-PUC/PR, Curitiba, Paraná, Brazil
| | - Ulisses Xavier da Silva Neto
- Department of Endodontics, College of Dentistry, Pontifical Catholic University of Paraná-PUC/PR, Curitiba, Paraná, Brazil
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Keles A, Askerbeyli Ors S, Purali N, Kucukkaya Eren S. Effect of different sealer activation techniques on dentinal tubule penetration. AUST ENDOD J 2023; 49:470-475. [PMID: 36723389 DOI: 10.1111/aej.12738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 01/09/2023] [Accepted: 01/18/2023] [Indexed: 02/02/2023]
Abstract
The aim of this study was to evaluate the influence of different activation techniques on dentin tubule penetration of root canal sealer. Seventy-five teeth with single canals were chemomechanically prepared. A calcium silicate-based sealer was stained with a fluorescent dye (rhodamine B), placed into the canals and activated according to the following groups: control (no activation), EDDY, EndoActivator, ultrasonic and XP-Endo Finisher. Then, the samples were obturated. The percentages of sealer penetration at various depth levels of root sections were measured with confocal laser scanning microscopy. XP-Endo Finisher presented the highest penetration at 50 μm (p < 0.05). XP-Endo Finisher showed similar penetration with EDDY at 100 and 200 μm (p > 0.05) while presented higher penetration than the other groups (p < 0.05). At 500 μm, XP-Endo Finisher presented higher penetration than EndoActivator (p < 0.05) while similar penetration with the other groups (p > 0.05). XP-Endo Finisher can be recommended for activation during sealer placement for better penetration into dentin tubules.
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Affiliation(s)
- Ahmet Keles
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Sevinc Askerbeyli Ors
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Nuhan Purali
- Departmant of Biophysics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Selen Kucukkaya Eren
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
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Matoso FB, Montagner F, Jardine AP, Quintana RM, Grecca FS, Kopper PMP. Effect of different disinfection protocols in bacterial viability of an intraradicular biofilm formed in situ. Braz Dent J 2023; 34:42-49. [PMID: 37466524 PMCID: PMC10355264 DOI: 10.1590/0103-6440202305244] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 04/18/2023] [Indexed: 07/20/2023] Open
Abstract
The present study aimed to evaluate bacterial viability after the use of different disinfection protocols in root canals infected with a multispecies biofilm (MB) formed in situ. Palatal roots with a single canal were obtained from extracted maxillary molars and sterilized before being inserted into the mouth. The roots were contaminated with a MB in an intraoral appliance worn by ten volunteers. All volunteers wore six roots simultaneously in two intraoral devices for 21 days. One root from each volunteer was assigned to each group (n=10): PUI - passive ultrasonic irrigation; EC - Easy Clean; XPF - XP-endo Finisher; aPDT - antimicrobial photodynamic therapy; CI - conventional irrigation; and NC - negative control. The samples were evaluated under confocal laser scanning microscopy. The percentage of viable cells (VC) was calculated over the total percentage of MB biovolume. Data were statistically analyzed (α=5%). The cell viability in the entire root canal or for each third was compared between groups (Kruskal-Wallis test, Dunn post-hoc test) and for the same group (Friedman test, Dunn post-hoc test). Disinfection protocols were not significantly different from each other (P>.05). Samples in EC, PUI, and aPDT had lower cell viability than in NC (P<.05). In the coronal third of samples in the EC, XPF, PUI and aPDT, the percentage of VC biovolume was lower than in the NC (P<.05). The percentage of VC in EC samples was lower in the coronal and middle thirds than in the apical third (P<.05). EC, PUI and aPDT had significant effects on cell viability in intraradicular multispecies biofilm formed in situ when compared with untreated samples.
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Affiliation(s)
- Felipe Barros Matoso
- Graduate Program in Dentistry, Federal University of Rio Grande
do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Francisco Montagner
- Graduate Program in Dentistry, Federal University of Rio Grande
do Sul (UFRGS), Porto Alegre, RS, Brazil
| | | | - Ramiro Martins Quintana
- Graduate Program in Dentistry, Federal University of Rio Grande
do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Fabiana Soares Grecca
- Graduate Program in Dentistry, Federal University of Rio Grande
do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Patricia Maria Poli Kopper
- Graduate Program in Dentistry, Federal University of Rio Grande
do Sul (UFRGS), Porto Alegre, RS, Brazil
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Dede M, Basche S, Neunzehn J, Dannemann M, Hannig C, Kühne MT. Efficacy of Endodontic Disinfection Protocols in an E. faecalis Biofilm Model-Using DAPI Staining and SEM. J Funct Biomater 2023; 14:jfb14040176. [PMID: 37103266 PMCID: PMC10145082 DOI: 10.3390/jfb14040176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 03/15/2023] [Accepted: 03/21/2023] [Indexed: 04/28/2023] Open
Abstract
The aim of this study was to investigate the antimicrobial efficacy of different disinfection protocols in a novel Enterococcus faecalis biofilm model based on a visualization method and to evaluate the potential alteration of dentinal surface. A total of 120 extracted human premolars were allocated to 6 groups with different irrigation protocols. The assessment of the effectiveness of each protocol and the alteration of dentinal surface were visualized by using SEM and fluorescence microscopy (DAPI). A dense E. faecalis biofilm with a penetration depth of 289 μm (medial part of the root canal) and 93 μm (apical part) validated that the biofilm model had been successfully implemented. A significant difference between the 3% NaOCl groups and all the other groups in both observed parts of the root canal (p < 0.05) was detected. However, the SEM analysis revealed that the dentinal surface in the 3% NaOCl groups was severely altered. The established biofilm model and the visualization method based on DAPI are appropriate for bacterial quantification and evaluation of the depth effect of different disinfection protocols in the root canal system. The combination of 3% NaOCl with 20% EDTA or MTAD with PUI allows the decontamination of deeper dentine zones within the root canal but simultaneously alters the dentinal surface.
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Affiliation(s)
- Maria Dede
- Policlinic of Operative and Pediatric Dentistry, Medical Faculty Carl Gustav Carus, TU Dresden, 01307 Dresden, Germany
- Department of Endodontics, School of Dentistry, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Sabine Basche
- Policlinic of Operative and Pediatric Dentistry, Medical Faculty Carl Gustav Carus, TU Dresden, 01307 Dresden, Germany
| | - Jörg Neunzehn
- Vertriebsgesellschaft GmbH, Geistlich Biomaterials, Schneidweg 5, 76534 Baden-Baden, Germany
| | - Martin Dannemann
- Faculty of Automotive Engineering, Institute of Energy and Transport Engineering, Westsächsische Hochschule Zwickau, 08056 Zwickau, Germany
| | - Christian Hannig
- Policlinic of Operative and Pediatric Dentistry, Medical Faculty Carl Gustav Carus, TU Dresden, 01307 Dresden, Germany
| | - Marie-Theres Kühne
- Policlinic of Operative and Pediatric Dentistry, Medical Faculty Carl Gustav Carus, TU Dresden, 01307 Dresden, Germany
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de Oliveira HF, da Silva Júnior IF, Teixeira LCG, Camilo NG, de Almeida Decurcio D, Guedes OA, de Araújo Estrela CR. Influence of different agitation techniques on bacterial reduction in curved root canals. AUST ENDOD J 2022; 49:104-110. [PMID: 35488771 DOI: 10.1111/aej.12623] [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: 09/22/2021] [Revised: 02/18/2022] [Accepted: 04/04/2022] [Indexed: 11/30/2022]
Abstract
The aim of this study was to evaluate the influence of agitation techniques on bacterial reduction in curved root canals. Eighty human mandibular molars were prepared, inoculated with Enterococcus faecalis and incubated at 37°C for 60 days. Then, specimens were randomly separated into two test groups (n = 36) and two control groups (n = 04) according to agitation technique: Passive ultrasonic irrigation (PUI, Irrisonic) and XP-endo Finisher (XPF). Microbial samples were collected before and after instrumentation and after final agitation using sterile paper points. Bacterial growth was analysed by turbidity of culture medium and UV spectrophotometry. The Wilcoxon rank test was used for the paired analysis, while the Mann-Whitney U-test was used for the non-paired analysis. The samples collected after final agitation were significantly different between test groups (p < 0.05). Bacterial reduction was greater in the PUI than in the XPF (p < 0.05) group. The irrigant agitation provided significant bacterial reduction. The use of the PUI showed better results.
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Affiliation(s)
| | | | | | - Naira Geovana Camilo
- Department of Endodontics, School of Dentistry, Evangelical University of Goiás, Goiás, Brazil
| | | | - Orlando Aguirre Guedes
- Department of Endodontics, School of Dentistry, Evangelical University of Goiás, Goiás, Brazil
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