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Katunarić A, Grgac SF, Gabrić D, Pavelić B, Bago I. Effect of sodium hypochlorite and ethylenediaminotetraacetic acid activated by laser and ultrasonic energy on surface morphology and chemical composition of intracanal dentin. Microsc Res Tech 2024; 87:818-831. [PMID: 38100184 DOI: 10.1002/jemt.24474] [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: 06/18/2023] [Revised: 11/03/2023] [Accepted: 12/05/2023] [Indexed: 03/02/2024]
Abstract
The aim of the study was to evaluate the structural and chemical changes in intracanal dentin after root canal irrigation with sodium hypochlorite (NaOCl) and ethylenediaminetetraacetic acid (EDTA) using additional activation with a novel Er:YAG Shock Wave-Enhanced Emission Photoacoustic Streaming (SWEEPS), ultrasonic irrigation (UI), and Nd:YAG irradiation. Root canals of extracted human premolars were instrumented with distilled water and distributed into groups according to the irrigation protocol used: Group 1: conventional needle irrigation (CI) with 3% NaOCl; group 2: CI with 15% EDTA; and group 3: CI with NaOCl+EDTA. In group 4, root canals were irrigated with NaOCl+EDTA+NaOCl using the following techniques: CI (group 4A), SWEEPS (group 4B), UI (group 4C). In group 4D, root canals were finally irradiated with Nd:YAG laser. After the irrigation, the intracanal dentin sample was collected and analyzed using spectroscope with a Fourier transformation of infrared spectrum in Attenuated total reflection technique (FTIR-ATR) to calculate apatite/collagen ratio. Scanning electron microscopy (SEM) and energy dispersive x-ray spectrometry (EDS) were used to determine its chemical composition. FTIR-ATR showed no significant difference in the phosphate/amid I ratio between the control and the experimental groups (p > 0.05). SWEEPS and UI of NaOCl+EDTA+NaOCl caused the most pronounced decrease of Ca and P (p < 0.05) value compared to CI and control group, and canal wall erosion. SWEEPS and UI of NaOCl+EDTA+NaOCl caused the most pronounced decrease of Ca and P value and significant canal wall erosion. However, no difference in phosphate/amide ratio was reported among groups. RESEARCH HIGHLIGHTS: SWEEPS and UI of NaOCl+EDTA+NaOCl caused the most pronounced decrease of Ca and P values and significant canal wall erosion. There was no difference in phosphate/amide ratio among the irrigation protocols.
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Affiliation(s)
- Adriana Katunarić
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | | | - Dragana Gabrić
- Department of Oral Surgery, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Božidar Pavelić
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Ivona Bago
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
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Marques JA, Falacho RI, Santos JM, Ramos JC, Palma PJ. Effects of endodontic irrigation solutions on structural, chemical, and mechanical properties of coronal dentin: A scoping review. J ESTHET RESTOR DENT 2024; 36:606-619. [PMID: 37698359 DOI: 10.1111/jerd.13135] [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: 05/15/2023] [Revised: 08/29/2023] [Accepted: 08/30/2023] [Indexed: 09/13/2023]
Abstract
OBJECTIVE This review aims to assess structural, chemical, and mechanical properties of coronal dentin after endodontic irrigation. MATERIALS AND METHODS Reporting followed the PRISMA extension for scoping reviews. An electronic search was carried out in PubMed, Embase, and Cochrane Library. Records filtered by language and published up to November 4, 2022 were independently screened by two researchers. Studies evaluating structural, chemical, or mechanical properties of human permanent coronal dentin after irrigation within the scope of nonsurgical root canal treatment were included. Data were extracted regarding study type, sample description and size, experimental groups, outcome, evaluation method, and main findings. RESULTS From the initial 1916 studies, and by adding 2 cross-references, 11 in vitro studies were included. Seven studies provide ultrastructural and/or chemical characterization, and six assessed microhardness and/or flexural strength. One percent to 8% sodium hypochlorite (NaOCl) and 1%-17% ethylenediaminetetraacetic acid (EDTA) were the most commonly tested solutions, with contact times of 2-240 min (NaOCl) and 1-1440 min (EDTA) being evaluated. CONCLUSIONS Overall, the literature is consensual regarding the inevitable impact of NaOCl and chelating agents on coronal dentin, with both deproteinizing and decalcifying effects being concentration- and time-dependent. The alteration of mechanical parameters further confirmed the surface and subsurface ultrastructural and chemical changes. CLINICAL SIGNIFICANCE Endodontic treatment success highly depends on restorative sealing. Understanding the result of exposing coronal dentin, the main substrate for bonding, to irrigants' action is crucial. The deproteinizing and decalcifying effects of NaOCl and chelating agents are both concentration- and time-dependent, causing surface and subsurface ultrastructural, chemical, and mechanical alterations.
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Affiliation(s)
- Joana A Marques
- Institute of Endodontics, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Center for Innovation and Research in Oral Sciences (CIROS), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Rui I Falacho
- Center for Innovation and Research in Oral Sciences (CIROS), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Institute of Oral Implantology and Prosthodontics, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - João Miguel Santos
- Institute of Endodontics, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Center for Innovation and Research in Oral Sciences (CIROS), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Coimbra Institute for Clinical and Biomedical Research (iCBR) and Center of Investigation on Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine and Clinical Academic Center of Coimbra (CACC), Coimbra, Portugal
| | - João Carlos Ramos
- Center for Innovation and Research in Oral Sciences (CIROS), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Institute of Operative Dentistry, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Paulo J Palma
- Institute of Endodontics, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Center for Innovation and Research in Oral Sciences (CIROS), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
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Barakat RM, Almohareb RA, Alsuwaidan M, Faqehi E, Alaidarous E, Algahtani FN. Effect of sodium hypochlorite temperature and concentration on the fracture resistance of root dentin. BMC Oral Health 2024; 24:233. [PMID: 38350980 PMCID: PMC10865544 DOI: 10.1186/s12903-024-03954-y] [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: 08/14/2023] [Accepted: 01/29/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Sodium hypochlorite (NaOCl) is the most efficient root canal irrigant to date. The aim of this study was to compare the effect of NaOCl used at different temperatures and concentrations on the compressive strength of root dentin. MATERIALS AND METHODS Seventy-two extracted human single-canaled straight roots of comparable size and length were selected and randomly divided into six groups (n = 12): Group (A) served as a control with unprepared canals. The other groups were instrumented with rotary ProTaper Universal files up to size F3. Group (B) was irrigated with 1% NaOCl at room temperature, Group (C) with 1% NaOCl heated to 70 °C, Group (D) with 5.25% NaOCl at room temperature, and Group (E) with 5.25% NaOCl heated to 70 °C. Saline was used in Group (F). The roots were sectioned into 2-mm-thick disks that underwent compression testing using a universal testing machine. Data were analyzed using one-way ANOVA and post hoc Tukey tests. The significance level was set at p ≤ 0.05. RESULTS A total of 255 disks were tested. The control group showed the highest compressive strength (p = 0.0112). However, this did not differ significantly from that of heated (p = 0.259) or unheated (p = 0.548) 1% NaOCl. There were no statistically significant differences between the groups of instrumented teeth. CONCLUSION Within the conditions of this study, irrigation with NaOCl at different concentrations and temperatures during root canal preparation did not affect the compressive strength of root dentin. CLINICAL RELEVANCE This study demonstrates that the use of NaOCl as a root canal irrigant is not associated with a clinically relevant decrease in root compressive strength, especially when compared to saline.
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Affiliation(s)
- Reem M Barakat
- Dental Clinics Department, King Abdullah bin Abdulaziz University Hospital, Princess Nourah Bint Abdulrahman University, Box 84428, Riyadh, 11671, Saudi Arabia
| | - Rahaf A Almohareb
- Department of Clinical Dental Sciences, College of Dentistry, Princess Nourah Bint Abdulrahman University, P.O. Box 84428, Riyadh, 11671, Saudi Arabia.
| | - Munirah Alsuwaidan
- Dental Intern, College of Dentistry, Princess Nourah Bint Abdulrahman University, P.O. Box 84428, Riyadh, 1167, Saudi Arabia
| | - Ebtihal Faqehi
- Dental Intern, College of Dentistry, Princess Nourah Bint Abdulrahman University, P.O. Box 84428, Riyadh, 1167, Saudi Arabia
| | - Enas Alaidarous
- Dental Intern, College of Dentistry, Princess Nourah Bint Abdulrahman University, P.O. Box 84428, Riyadh, 1167, Saudi Arabia
| | - Fahda N Algahtani
- Department of Clinical Dental Sciences, College of Dentistry, Princess Nourah Bint Abdulrahman University, P.O. Box 84428, Riyadh, 11671, Saudi Arabia
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Karatas E, Hadis M, Palin WM, Milward MR, Kuehne SA, Camilleri J. Minimally invasive management of vital teeth requiring root canal therapy. Sci Rep 2023; 13:20389. [PMID: 37990070 PMCID: PMC10663499 DOI: 10.1038/s41598-023-47682-9] [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: 09/18/2023] [Accepted: 11/16/2023] [Indexed: 11/23/2023] Open
Abstract
The present study aimed to investigate the possible use of a non-instrumentation technique including blue light irradiation for root canal cleaning. Extracted human single rooted teeth were selected. Nine different groups included distilled water, NaOCl, intra-canal heated NaOCl, and NaOCl + EDTA irrigation after either instrumentation or non-instrumentation, and a laser application group following non-instrumentation technique. The chemical assessment of the root canal dentine was evaluated using energy dispersive spectroscopy (EDS) and Fourier transform infrared (FT-IR) spectroscopy. Surface microstructural analyses were performed by using scanning electron microscopy (SEM). The antimicrobial efficacy of different preparation techniques was evaluated using microbial tests. Light application didn't change the calcium/phosphorus, carbonate/phosphate and amide I/phosphate ratios of the root canal dentin. The root canal dentin preserved its original chemistry and microstructure after light application. The instrumentation decreased the carbonate/phosphate and amide I/phosphate ratios of the root canal dentin regardless of the irrigation solution or technique (p < 0.05). The application of light could not provide antibacterial efficacy to match the NaOCl irrigation. The NaOCl irrigation both in the non-instrumentation and instrumentation groups significantly reduced the number of bacteria (p < 0.05). The use of minimally invasive root canal preparation techniques where the root canal is not instrumented and is disinfected by light followed by obturation with a hydraulic cement sealer reduced the microbial load and preserved the dentin thus may be an attractive treatment option for management of vital teeth needing root canal therapy.
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Affiliation(s)
- E Karatas
- Ataturk University, Erzurum, Turkey
- School of Dentistry, Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, 5, Mill Pool Way Edgbaston, Birmingham, B5 7EG, UK
| | - M Hadis
- School of Dentistry, Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, 5, Mill Pool Way Edgbaston, Birmingham, B5 7EG, UK
| | - W M Palin
- School of Dentistry, Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, 5, Mill Pool Way Edgbaston, Birmingham, B5 7EG, UK
| | - M R Milward
- School of Dentistry, Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, 5, Mill Pool Way Edgbaston, Birmingham, B5 7EG, UK
| | - S A Kuehne
- School of Dentistry, Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, 5, Mill Pool Way Edgbaston, Birmingham, B5 7EG, UK
- School of Science and Technology, Nottingham Trent University, Nottingham, UK
| | - J Camilleri
- School of Dentistry, Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, 5, Mill Pool Way Edgbaston, Birmingham, B5 7EG, UK.
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Yap RC, Alghanem M, Martin N. A narrative review of cracks in teeth: Aetiology, microstructure and diagnostic challenges. J Dent 2023; 138:104683. [PMID: 37713950 DOI: 10.1016/j.jdent.2023.104683] [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: 07/26/2023] [Revised: 08/28/2023] [Accepted: 08/29/2023] [Indexed: 09/17/2023] Open
Abstract
OBJECTIVES To summarize the available evidence of crack formation in teeth and to discuss the limitations of the current clinical diagnostic modalities for crack detection in teeth. BACKGROUND Cracks are a common clinical finding in teeth and yet clinicians still struggle to identify the full extent and orientation of cracks for their appropriate timely management. The biomechanics of crack development can be due to multiple factors and can differ from an unrestored tooth to a restored or endodontically treated tooth. DATA & SOURCES This narrative review has been designed following the guidelines published by Green et al. 2006 [1] Published literature in the English language that addresses the objectives of this review up to July 2022 was sourced from online databases and reference lists. The relevance of the papers was assessed and discussed by two reviewers. A total of 101 publications were included in this narrative review. CONCLUSIONS The initiation and development of cracks in teeth are likely linked to an interplay between the masticatory forces and fracture resistance of the remaining tooth structure. From the identified literature, the quality and quantity of remaining tooth structure in a restored or endodontically-treated tooth affects the biomechanics of crack development compared to an unrestored tooth. The extent, orientation, and size of the cracks do affect a clinician's ability to detect cracks in teeth. There is still a need to develop reliable diagnostic tools that will accurately identify cracks in teeth beneath restorations to enable effective monitoring of their propagation and provide appropriate interventions. CLINICAL SIGNIFICANCE The development and propagation of cracks in an unrestored tooth differ greatly from a restored and endodontically treated tooth; mainly linked to the quantity and quality of the remaining tooth structure and the forces acting on them. Identifying the extent of cracks in teeth remains challenging for early clinical intervention.
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Affiliation(s)
- Rei Chiel Yap
- DClinDent student, School of Clinical Dentistry, The University of Sheffield, S10 2TA, UK.
| | - Meshal Alghanem
- DClinDent student, School of Clinical Dentistry, The University of Sheffield, S10 2TA, UK.
| | - Nicolas Martin
- Professor of Restorative Dentistry, School of Clinical Dentistry, The University of Sheffield, S10 2TA, UK.
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Rai S, Sundaramoorthy N, Mahalaxmi S, Purushothaman PV. Bioburden assessment of necrotic teeth disinfected with sodium hypochlorite, diode laser, and photodynamic therapy using flow cytometry-a randomized double-blinded clinical trial. Lasers Med Sci 2023; 38:216. [PMID: 37735303 DOI: 10.1007/s10103-023-03877-0] [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: 09/10/2022] [Accepted: 09/06/2023] [Indexed: 09/23/2023]
Abstract
This study aimed to comparatively evaluate the disinfecting potential of sodium hypochlorite, diode laser, and photodynamic therapy in non-vital teeth with or without periapical rarefaction. Forty-five patients with the diagnosis of pulp necrosis with apical rarefaction were randomly assigned to three groups (n = 15) based on the disinfection protocol. Access cavities were prepared and pre-instrumentation microbial samples were taken using a paper point. Working length determination followed by cleaning and shaping with rotary files was performed. The canals were lubricated with ethylenediaminetetraacetic acid (EDTA) during instrumentation and finally rinsed with copious amounts of saline. Canals in group 1 were irrigated with 5 mL of 5.25% NaOCl, those in group 2 received irradiation with 808-nm diode laser (30 s, 7W), and those in group 3 were soaked with methylene blue photosensitizer (5 min) before irradiation with 660-nm diode laser (3 min). Post-disinfection microbial samples were collected using a paper point. Pre- and post-disinfection live bacterial counts were analyzed using a flow cytometer. The data were statistically analyzed using one-way ANOVA and Student's t-test. Comparison of pre-instrumentation mean live bacterial count showed no significant difference between the groups (p > 0.05). The mean live bacterial count post-disinfection was 41.07%, 46.99%, and 34.45% in groups 1-3 respectively. A significant reduction in the bacterial count was seen following disinfection in all the groups (p < 0.05). It can be concluded that both diode laser and photodynamic therapy were equally effective as 5.25% NaOCl in reducing the bioburden in root canals. TRIAL REGISTRATION: CTRI/2018/03/012667.
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Affiliation(s)
- Sadhana Rai
- Department of Conservative Dentistry and Endodontics, SRM Institute of Science and Technology, SRM Dental College, Bharathi Salai, Ramapuram, Chennai, 600089, India
| | - Nagarathinam Sundaramoorthy
- Department of Conservative Dentistry and Endodontics, SRM Institute of Science and Technology, SRM Dental College, Bharathi Salai, Ramapuram, Chennai, 600089, India
| | - Sekar Mahalaxmi
- Department of Conservative Dentistry and Endodontics, SRM Institute of Science and Technology, SRM Dental College, Bharathi Salai, Ramapuram, Chennai, 600089, India.
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Omar N, Abdelraouf RM, Hamdy TM. Effect of different root canal irrigants on push-out bond strength of two novel root-end filling materials. BMC Oral Health 2023; 23:193. [PMID: 37009885 PMCID: PMC10068155 DOI: 10.1186/s12903-023-02858-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 03/06/2023] [Indexed: 04/04/2023] Open
Abstract
BACKGROUND The aim of this in vitro study was to evaluate push-out bond strength of different root-end filling materials using various irrigant solutions. METHODS A push-out bond strength test was performed to evaluate the bond strength of two experimental root-end filling materials: namely, nano-hybrid mineral trioxide aggregate (MTA) and polymethyl methacrylate (PMMA) cement filled with 20% weight nano hydroxyapatite (nHA) fillers compared to conventional MTA. The irrigant solutions employed were sodium hypochlorite (NaOCl) in concentrations 1%, 2.5% and 5.25% and 2% chlorhexidine gluconate (CHX) followed by application of 17% ethylene diamine tetra-acetic acid (EDTA). A freshly extracted sixty single-rooted human maxillary central incisors were used. The crowns were removed, the canal apex was widened to simulate immature teeth. Each type of irrigation protocols was performed. After application and setting of the root-end filling materials, a slice of one mm thickness was cut transversely from the apical end of each root. Specimens were stored for 1 month in artificial saliva and were subjected to a push-out test to evaluate the shear bond strength. Data were analyzed using two-way ANOVA and Tukey test. RESULTS The experimental nano-hybrid MTA showed the highest significant push-out bond strength values when irrigated by NaOCl at several concentrations (1%, 2.5% and 5.25%) (P< 0.05). Meanwhile, irrigation with 2% CHX resulted in highest bond strength values in nano-hybrid white MTA (18 MPa) and PMMA filled with 20% weight nHA (17.4 MPa) with nonsignificant difference between them (p = 0.25). In each root-end filling material, irrigation with 2% CHX led to the highest significant bond strength, followed by NaOCl 1%, while the least significant bond strength was produced after irrigation with NaOCl 2.5% and 5.25% (P< 0.05). CONCLUSION Considering the limitations of this study, it may be concluded that the application of 2% CXH and 17% EDTA provides superior push-out bond strength to root canal dentin compared with irrigation with NaOCl irrigants and 17% EDTA, experimental nano-hybrid MTA root-end filling material provides enhanced shear bond strength than conventional micron-sized MTA root-end filling material.
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Affiliation(s)
- Nada Omar
- Restorative and Dental Materials Department, Oral and Dental Research Institute, National Research Centre (NRC), Giza, Dokki, 12622, Egypt
| | - Rasha M Abdelraouf
- Biomaterials Department, Faculty of Dentistry, Cairo University, Cairo, 11553, Egypt
| | - Tamer M Hamdy
- Restorative and Dental Materials Department, Oral and Dental Research Institute, National Research Centre (NRC), Giza, Dokki, 12622, Egypt.
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Al-Helou N, Zaki AA, Al Agha M, Moawad E, Jarad F. Which endodontic access cavity is best? A literature review. Br Dent J 2023; 234:335-339. [PMID: 36899249 DOI: 10.1038/s41415-023-5581-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 10/19/2022] [Accepted: 11/01/2022] [Indexed: 03/12/2023]
Abstract
The preparation of an access cavity is the first part of endodontic treatment and is a key stage in the healing of both periapical and pulpal infections. It should allow endodontists to remove obstructions in the pulp chamber, locate all canal orifices and clean the entire root canal system with minimum coronal tooth structure removed. This has been done traditionally through establishing straight line access. The development of minimally invasive endodontics aimed to preserve as much of the natural tooth structure as possible, particularly dentine, while undertaking root canal treatment, resulting in the development of other access cavity preparations. This includes conservative, ultra conservative (ninja), truss, guided access, caries-orientated and restorative access cavities. These access cavity preparations also gained popularity due to increased magnification and enhanced lighting, allowing practitioners to visualise the pulpal space in greater detail throughout treatment.Our current recommendation is to conduct access cavities traditionally rather than conservatively. Ideally, conservative access cavities need magnification, which might not be available for all clinicians. With traditional access cavity, the procedure takes less time and it is more predictable to locate the canal orifices, deliver irrigation effectively, avoid iatrogenic damage with biomechanical preparation and achieve better obturation.
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Affiliation(s)
- Noor Al-Helou
- Dental Core Trainee in Restorative Dentistry, The Royal London Dental Hospital, London, UK.
| | - Ammar Ahmed Zaki
- Academic Clinical Fellow in Prosthodontics, The Royal London Dental Hospital, London, UK
| | - Mustafa Al Agha
- Clinical Lecturer in Endodontics, Liverpool University Dental Hospital, Liverpool, UK
| | - Emad Moawad
- Specialist in Endodontics and Senior Clinical Lecturer, Liverpool University Dental Hospital, Liverpool, UK
| | - Fadi Jarad
- Professor of Restorative Dentistry, Liverpool University Dental Hospital, Liverpool, UK
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Chauhan N, Kumar G, Goswami M, Johar S, Sharma A. Antimicrobial efficacy of sodium hypochlorite, saline, and Er, Cr:YSGG laser-assisted disinfection in root canal treatment of primary molars: An in vivo study. J Indian Soc Pedod Prev Dent 2023; 41:70-75. [PMID: 37282415 DOI: 10.4103/jisppd.jisppd_98_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/08/2023] Open
Abstract
Aim The aim of the study was to compare the antimicrobial efficacy of sodium hypochlorite (NaOCl), Saline, and Er, Cr:YSGG laser-assisted disinfection through microbiological analysis in root canal treatment of primary molars. Materials and Methods Forty-five primary teeth were selected for this study as per the inclusion and exclusion criteria in the age group of 4-8 years and then randomly allocated to Three Groups A, B, and C. In Group A, during root canal treatment, irrigation was done using NaOCl, in Group B, laser-assisted disinfection was done using Er, Cr:YSGG laser, and in Group C, saline was used as an irrigating agent. This was followed by obtaining pre- and postirrigation samples from the canals for microbiological investigation in all the groups. Data analysis was performed using Statistical Package for the Social Science-21 (SPSS-21). Results NaOCl was more effective against aerobic bacteria while Er, Cr:YSGG laser was more effective against anaerobic bacteria when used for disinfection in root canal treatment. There was a significant difference among the three groups (P > 0.05). Conclusion The study showed that NaOCl and Er, Cr:YSGG laser have antimicrobial effects when used for disinfection in root canal treatment of primary teeth. Moreover, the study also shows that Er, Cr:YSGG laser may be used as a valuable tool for laser-assisted disinfection in root canal treatment of primary teeth.
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Affiliation(s)
- Neha Chauhan
- Department of Pediatric and Preventive Dentistry, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Gyanendra Kumar
- Department of Pediatric and Preventive Dentistry, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Mridula Goswami
- Department of Pediatric and Preventive Dentistry, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Smriti Johar
- Department of Pediatric and Preventive Dentistry, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Abha Sharma
- Department of Microbiology, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, New Delhi, India
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Effect of Endodontic Irrigating Solutions on Radicular Dentine Structure and Matrix Metalloproteinases-A Comprehensive Review. Dent J (Basel) 2022; 10:dj10120219. [PMID: 36547035 PMCID: PMC9776432 DOI: 10.3390/dj10120219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 11/17/2022] [Accepted: 11/21/2022] [Indexed: 11/24/2022] Open
Abstract
Irrigating solutions play an important role in the eradication of intracanal microbes and debris dissolution during endodontic treatment. Different combinations of solutions and protocols have been advocated, with sodium hypochlorite (NaOCl), ethylenediamine tetra acetic acid (EDTA), and chlorhexidine (CHX) remaining the most widely used ones by many clinicians. Although these solutions provide efficient inorganic dissolution and antimicrobial capacity, their use has also been reported to cause undesired effects on root dentin composition and mechanical and biomechanical properties, such as microhardness, surface roughness, bond strength, and matrix metalloproteinase (MMP) activity. Several corroborating studies attribute these changes in mechanical properties of dentine to the use of irrigating solutions, and there are limited reports on how the solutions affect the expression of MMPs, which may be a correlating link to understanding the role of these enzymes in dentin collagen and changes in the mechanical properties of dentin. Hence, using the basis of several studies from the literature, the objective is to comprehensively review the influence of individual and combined irrigating solutions on root dentine structure and the activity of the MMPs.
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Padmakumar I, Hinduja D, Mujeeb A, Kachenahalli Narasimhaiah R, Kumar Saraswathi A, Mirza MB, Robaian A, Basheer SN, Karobari MI, Scardina GA. Evaluation of Effects of Various Irrigating Solutions on Chemical Structure of Root Canal Dentin Using FTIR, SEM, and EDS: An In Vitro Study. J Funct Biomater 2022; 13:jfb13040197. [PMID: 36278666 PMCID: PMC9590088 DOI: 10.3390/jfb13040197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 10/14/2022] [Accepted: 10/14/2022] [Indexed: 12/02/2022] Open
Abstract
Background: Sequential chemical application for irrigating a root canal during chemomechanical debridement can affect the dentin microstructure. Understanding the effects of various irrigants on chemical properties of dentin can elucidate their effects on physical properties and thereby explain the higher incidence of structural failure in endodontically treated teeth. This in vitro research aimed to compare and evaluate the effects of three different irrigating solutions on the chemical structure of root canal dentin in extracted human teeth. Methods: Forty-eight extracted single-rooted mandibular premolar teeth were sectioned at the cemento−enamel junction by a diamond disc and were then randomly assigned to four groups of twelve samples each. The groups were irrigated using 5.25% NaOCl, ozonated olive oil, silver citrate, or distilled water. Dentin sections measuring 1.5 mm were obtained from the root portion and each section and were analyzed using Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), and electron-dispersive spectroscopy (EDS). FTIR and EDS values are reported as means ± standard deviations. Data were analyzed using an ANOVA and a post hoc Bonferroni test (p < 0.05). Results: A comparison of the FTIR and EDS values among the groups using ANOVA revealed statistically significant differences in the organic and inorganic peak values among the groups. An intergroup comparison between NaOCl with silver citrate and ozonated olive oil revealed significant reductions in the carbonate and phosphate peak values in the NaOCl group (p < 0.05). The EDS values tabulated for the carbon, oxygen, phosphorous, and calcium peak levels showed significant differences between the groups using an ANOVA. An SEM analysis was conducted under 1500× magnification, which revealed smear layer removal in the silver citrate group. Conclusions: The silver citrate solution and the ozonated olive oil caused less changes in the organic and mineral contents of dentin than sodium hypochlorite.
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Affiliation(s)
- Indu Padmakumar
- Department of Conservative Dentistry and Endodontics, SJM Dental College and Hospital, Chitradurga 577501, Karnataka, India
| | - Dharam Hinduja
- Department of Conservative Dentistry and Endodontics, SJM Dental College and Hospital, Chitradurga 577501, Karnataka, India
| | - Abdul Mujeeb
- Department of Conservative Dentistry and Endodontics, SJM Dental College and Hospital, Chitradurga 577501, Karnataka, India
- Correspondence: (A.M.); (M.I.K.); (G.A.S.)
| | | | - Ashwini Kumar Saraswathi
- Department of Conservative Dentistry and Endodontics, SJM Dental College and Hospital, Chitradurga 577501, Karnataka, India
| | - Mubashir Baig Mirza
- Conservative Dental Science Department, College of Dentistry, Prince Sattam bin Abdulaziz University, AlKharj 11942, Saudi Arabia
| | - Ali Robaian
- Conservative Dental Science Department, College of Dentistry, Prince Sattam bin Abdulaziz University, AlKharj 11942, Saudi Arabia
| | - Syed Nahid Basheer
- Department of Restorative Dental Sciences, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia
| | - Mohmed Isaqali Karobari
- Department of Conservative Dentistry & Endodontics, Saveetha Dental College & Hospitals, Saveetha Institute of Medical and Technical Sciences University, Chennai 600077, Tamil Nadu, India
- Department of Restorative Dentistry & Endodontics, Faculty of Dentistry, University of Puthisastra, Phnom Penh 12211, Cambodia
- Correspondence: (A.M.); (M.I.K.); (G.A.S.)
| | - Giuseppe Alessandro Scardina
- Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, 90133 Palermo, Italy
- Correspondence: (A.M.); (M.I.K.); (G.A.S.)
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Mannocci F, Bitter K, Sauro S, Ferrari P, Austin R, Bhuva B. Present status and future directions: The restoration of root filled teeth. Int Endod J 2022; 55 Suppl 4:1059-1084. [PMID: 35808836 PMCID: PMC9796050 DOI: 10.1111/iej.13796] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 07/04/2022] [Accepted: 07/05/2022] [Indexed: 12/30/2022]
Abstract
This narrative review will focus on a number of contemporary considerations relating to the restoration of root filled teeth and future directions for research. Clinicians are now more than ever, aware of the interdependence of the endodontic and restorative aspects of managing root filled teeth, and how these aspects of treatment are fundamental to obtaining the best long-term survival. To obtain the optimal outcomes for patients, clinicians carrying out endodontic treatment should have a vested interest in the restorative phase of the treatment process, as well as an appreciation for the structural and biomechanical effects of endodontic-restorative procedures on restoration and tooth longevity. Furthermore, the currently available research, largely lacks appreciation of occlusal factors in the longevity of root filled teeth, despite surrogate outcomes demonstrating the considerable influence this variable has. Controversies regarding the clinical relevance of minimally invasive endodontic and restorative concepts are largely unanswered with respect to clinical data, and it is therefore, all too easy to dismiss these ideas due to the lack of scientific evidence. However, conceptually, minimally invasive endodontic-restorative philosophies appear to be valid, and therefore, in the pursuit of improved clinical outcomes, it is important that the efficacies of these treatment protocols are determined. Alongside an increased awareness of the preservation of tooth structure, developments in adhesive bonding, ceramic materials and the inevitable integration of digital dentistry, there is also a need to evaluate the efficacy of new treatment philosophies and techniques with well-designed prospective clinical studies.
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Affiliation(s)
- Francesco Mannocci
- Department of EndodonticsFaculty of Dentistry, Oral and Craniofacial SciencesKing's College LondonLondonUK
| | - Kerstin Bitter
- Department of Operative and Preventive DentistryCharité ‐ University Medicine BerlinBerlinGermany
| | - Salvatore Sauro
- Departamento de Odontología, Facultad de Ciencias de la SaludUniversidad CEU‐Cardenal Herrera ValenciaAlfara del PatriarcaSpain
| | - Paolo Ferrari
- Department of Operative DentistryUniversity of ParmaParmaItaly
| | - Rupert Austin
- Department of ProsthodonticsFaculty of Dentistry, Oral and Craniofacial SciencesKing's College LondonLondonUK
| | - Bhavin Bhuva
- Department of EndodonticsFaculty of Dentistry, Oral and Craniofacial SciencesKing's College LondonLondonUK
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Antibacterial efficiency of adjuvant photodynamic therapy and high-power diode laser in the treatment of young permanent teeth with chronic periapical periodontitis. A prospective clinical study. Photodiagnosis Photodyn Ther 2022; 41:103129. [PMID: 36156313 DOI: 10.1016/j.pdpdt.2022.103129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 09/11/2022] [Accepted: 09/19/2022] [Indexed: 02/05/2023]
Abstract
BACKGROUND The study aimed at determining antibacterial efficiency of adjuvant photodynamic therapy (PDT) and high-power diode laser (DL) in the treatment of chronic periapical periodontitis (CPP) in young permanent teeth. METHODS Forty-four young permanent teeth with CPP were randomly divided into three groups (PDT, DL and control). Each tooth underwent standard chemo-mechanical treatment, while within tested groups was additionally treated by PDT or DL. Bacterial identification and quantification were provided by MALDI-TOF spectrometry and plate counting assay, performed after accessing the canal, following chemo-mechanical preparation, and after PDT or DL procedure where applicable. RESULTS Thirty-nine young permanent teeth with CCP (patients age 9.77 ± 1.43) completed the study. Before the treatments, 202 isolates belonging to 13 genera/species, including Streptococcus (36), Actinomyces (34), Peptostreptococcus micros (27), Veillonella (25) and Enterococcus faecalis (22), were recovered. Chemo-mechanical treatment reduced CFU count in the all three groups (p < 0.001), but complete eradication was not observed for any of isolated species. Adjuvant PDT and DL completely eradicated isolates of 8 and 6 bacterial genera/species, resulting in complete bacterial elimination from 53.8% and 30.8% of root canals, respectively. In the rest canals, total Δlog CFUs were 4.71 and 4.58. CONCLUSION The results indicated that both PDT and DL could be performed as adjuvants to standard endodontic treatment of the young permanent teeth with CPP.
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Mohan JM, Amreen K, Javed A, Dubey SK, Goel S. Miniaturized 3D printed electrochemical platform with optimized Fibrous carbon electrode for non-interfering hypochlorite sensing. CHEMOSPHERE 2022; 302:134915. [PMID: 35568213 DOI: 10.1016/j.chemosphere.2022.134915] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 01/27/2022] [Accepted: 05/07/2022] [Indexed: 06/15/2023]
Abstract
3D printing technology based electrochemical device can provide ease of fabrication, cost effectiveness, rapid detection and lower limit of detection. Herein, a novel, customized, portable and inexpensive 3D printed electrochemical device, has been presented. Fibrous carbon Toray paper, deposited with gold nanoparticles through electrodeposition, used as a working electrode which Further device was tested with 1 mM sodium hypochlorite using cyclic voltammetry (CV) and square wave voltammetry (SWV) in 0.1 M PBS. Hypochlorite has a pivotal role in supporting the growing chemical and paper industries and finds diverse uses in several clinical applications. It is primarily used for disinfecting food, water and surfaces. The scan rate study was carried out from 20 mVs-1 to 250 mVs-1 using cyclic voltammetry technique. The diffusion coefficient obtained from scan rate effect was 1.39 × 10-6 cm2s-1. The concentration range was evaluated with SWV technique, in a linear range of 0.6 μM-40 μM, with a detection limit of 0.7 μM. The device was further analyzed to ensure non-interference from co-existing chemicals like sodium chloride, potassium nitrate, sodium carbonate, sodium nitrite. Real sample analysis was done with sea, artificial sea and tap water with impressive recovery values. In summary, the developed working electrode can be customized and modified based on testing analyte; thus, the proposed device can be used for various other biochemical analytes.
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Affiliation(s)
- Jaligam Murali Mohan
- Department of Mechanical Engineering, Birla Institute of Technology and Science (BITS) Pilani, Hyderabad Campus, Hyderabad, 500078, India
| | - Khairunnisa Amreen
- MEMS, Microfluidics and Nano Electronics Laboratory, Department of Electrical and Electronics Engineering, Birla Institute of Technology and Science (BITS) Pilani, Hyderabad Campus, Hyderabad, 500078, India
| | - Arshad Javed
- Department of Mechanical Engineering, Birla Institute of Technology and Science (BITS) Pilani, Hyderabad Campus, Hyderabad, 500078, India
| | - Satish Kumar Dubey
- Department of Mechanical Engineering, Birla Institute of Technology and Science (BITS) Pilani, Hyderabad Campus, Hyderabad, 500078, India
| | - Sanket Goel
- MEMS, Microfluidics and Nano Electronics Laboratory, Department of Electrical and Electronics Engineering, Birla Institute of Technology and Science (BITS) Pilani, Hyderabad Campus, Hyderabad, 500078, India.
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Xu H, Ye Z, Zhang A, Lin F, Fu J, Fok ASL. Effects of concentration of sodium hypochlorite as an endodontic irrigant on the mechanical and structural properties of root dentine: A laboratory study. Int Endod J 2022; 55:1091-1102. [PMID: 35833329 PMCID: PMC9545283 DOI: 10.1111/iej.13800] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 07/03/2022] [Accepted: 07/04/2022] [Indexed: 11/30/2022]
Abstract
AIM The use of high-concentration sodium hypochlorite (NaOCl) as an endodontic irrigant remains controversial because of its potential impact on the fracture strength of endodontically-treated teeth. This study evaluated the effects of using different NaOCl concentrations, with 2-min-ethylenediaminetetraacetic acid (EDTA) as the final active irrigant, on the biomechanical and structural properties of root dentine. METHODOLOGY A new test method, which is more clinically relevant, was utilized to calculate the fracture strength of root dentine. Bovine incisors were used to obtain root dentine discs. The root canals were enlarged to mean diameter of 2.90 mm with a taper of 0.06. The resulting discs were divided into 5 groups (n=20) and treated with different concentrations of NaOCl (5.25%, 2.5%, and 1.3%) for 30 min plus 17% EDTA for 2 min. The discs were then loaded to fracture by a steel rod with the same taper through the central hole. The fractured specimens were examined by scanning electron microscopy to evaluate changes in the dimensions of the remaining intertubular dentine and the tubular radius. Micro-hardness was also measured with a Knoop diamond indenter along a radius to determine the depth of dentine eroded by the irrigation. Results were analyzed by one-way ANOVA and the Tukey test. The level of significance was set at α = 0.05. RESULTS The damage by NaOCl increased with its concentration. 5.25% NaOCl greatly reduced the fracture strength of root dentine from 172.10±30.13 MPa to 114.58±26.74 MPa. The corresponding reduction in micro-hardness at the root canal wall was 34.1%. The damages reached a depth of up to 400 μm (p < 0.05). Structural changes involved degradation of the intratubular wall leading to enlarged dentinal tubules and the loss of intertubular dentine. Changes in the microstructural parameters showed positive linear relationships with the fracture strength. CONCLUSIONS With the adjunctive use of EDTA, NaOCl caused destruction to the intratubular surface near the root canal and, consequently, reduced the root dentine's mechanical strength. The higher the concentration of NaOCl, the greater the effect. Therefore, endodontists should avoid using overly high concentration of NaOCl for irrigation to prevent potential root fracture in endodontically-treated teeth.
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Affiliation(s)
- Haiping Xu
- Department of Stomatology, the Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, China.,Minnesota Dental Research Center for Biomaterials and Biomechanics, School of Dentistry, University of Minnesota, MN, United States
| | - Zhou Ye
- Minnesota Dental Research Center for Biomaterials and Biomechanics, School of Dentistry, University of Minnesota, MN, United States.,Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong S.A.R, China
| | - Anqi Zhang
- Minnesota Dental Research Center for Biomaterials and Biomechanics, School of Dentistry, University of Minnesota, MN, United States
| | - Fei Lin
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Jing Fu
- Department of Stomatology, the Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, China
| | - Alex S L Fok
- Minnesota Dental Research Center for Biomaterials and Biomechanics, School of Dentistry, University of Minnesota, MN, United States
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Patel S, Bhuva B, Bose R. Vertical root fractures in root treated teeth-current status and future trends. Int Endod J 2022; 55 Suppl 3:804-826. [PMID: 35338655 PMCID: PMC9324143 DOI: 10.1111/iej.13737] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/22/2022] [Accepted: 03/23/2022] [Indexed: 11/28/2022]
Abstract
Vertical root fracture (VRF) is a common reason for the extraction of root filled teeth. The accurate diagnosis of VRF may be challenging due to the absence of clinical signs, whilst conventional radiographic assessment is often inconclusive. However, an understanding of the aetiology of VRFs, and more importantly, the key predisposing factors, is crucial in identifying teeth that may be susceptible. Thorough clinical examination with magnification and co-axial lighting is essential in identifying VRFs, and although CBCT is unable to reliably detect VRFs per se, the pattern of bone loss typically associated with VRF can be fully appreciated, and therefore, increases the probability of correct diagnosis and management. The prevalence of VRFs in root filled teeth is significantly greater than in teeth with vital pulps, demonstrating that the combination of loss of structural integrity, presence of pre-existing fractures and biochemical effects of loss of vitality, are highly relevant. Careful assessment of the occlusal scheme, presence of deflective contacts and identification of parafunctional habits is imperative in both preventing and managing VRFs. Furthermore, anatomical factors such as root canal morphology, may predispose certain teeth to VRF. The influence of access cavity design and root canal instrumentation protocols should be considered although the impact of these on the fracture resistance of root filled teeth is not clearly validated. The post-endodontic restoration of root filled teeth should be expedient and considerate to the residual tooth structure. Posts should be placed 'passively' and excessive 'post-space' preparation should be avoided. This narrative review aims to present the aetiology, potential predisposing factors, histopathology, diagnosis and management of VRF and present perspectives for future research. Currently, there are limited options other than extraction for the management of VRF, although root resection may be considered in multi-rooted teeth. Innovative techniques to 'repair' VRFs using both orthograde and surgical approaches require further research and validation. The prevention of VRFs is critical; identifying susceptible teeth, utilizing conservative endodontic procedures, together with expedient and appropriate post-endodontic restorative procedures is paramount to reducing the incidence of terminal VRFs.
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Affiliation(s)
- Shanon Patel
- Department of Endodontology, King's College London Dental Institute, London, UK.,Specialist Practice, London, UK
| | - Bhavin Bhuva
- Department of Endodontology, King's College London Dental Institute, London, UK
| | - Raul Bose
- Department of Endodontology, King's College London Dental Institute, London, UK
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Kapralos V, Valen H, Koutroulis A, Camilleri J, Ørstavik D, Sunde PT. The dentine-sealer interface: modulation of antimicrobial effects by irrigation. Int Endod J 2022; 55:544-560. [PMID: 35080277 DOI: 10.1111/iej.13692] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 01/19/2022] [Accepted: 01/20/2022] [Indexed: 11/29/2022]
Abstract
AIM Assess whether sodium hypochlorite (NaOCl) or chlorhexidine (CHX) and two irrigation protocols may alter the antibacterial properties of dentine and three endodontic sealers using a novel ex vivo tooth model. METHODOLOGY Prior to antibacterial testing, the tooth model was validated by means of scanning electron microscopy (SEM) to evaluate the separation between dentine and sealer surfaces. Root blocks prepared from extracted human roots were pretreated with 17% EDTA + 0.9% saline and subsequently treated with 1% NaOCl (G1), 2% CHX (G2) or no irrigant (G3). Two irrigation protocols were further investigated, "1% NaOCl + 17% EDTA" (P1) and "1% NaOCl + 17% EDTA + 2% CHX" (P2). Following irrigation, the root blocks were either filled with AH Plus, BioRoot RCS and Pulp Canal Sealer (PCS), or left empty. All groups were incubated for 1, 7 and 28 days. Direct contact tests for planktonic E. faecalis and 48 hours E. faecalis biofilms were performed at the level of dentine and sealer surfaces. Statistical analysis was performed on the bacterial survival between irrigants (G1, G2 and G3) and between irrigation protocols (P1 and P2) (p<0.05). RESULTS The model was considered reproducible as SEM examination of dentine samples indicated consistent separation between dentine and sealer surfaces. Irrigation with CHX (G2) and irrigation protocol (P2) enhanced the antibacterial properties of dentine without sealer application as well as dentine in contact with all three sealers tested, especially against planktonic E. faecalis. G2 and P2 also improved the antibacterial effect of AH Plus surfaces for all three incubation times. No irrigation groups (G1, G2) or irrigation protocols (P1, P2) altered the antibacterial properties of BioRoot RCS surfaces against planktonic bacteria or biofilms. Only BioRoot RCS surfaces eliminated the planktonic E. faecalis in all irrigation groups (G1, G2, G3) and protocols (P1, P2) investigated while PCS surfaces eliminated E. faecalis in biofilms in all groups up to 7 days. CONCLUSIONS The tooth model was reproducible. CHX improved the antibacterial activity upon both sealer and dentine surfaces. Among sealers, BioRoot RCS was less affected by NaOCl and CHX, and exhibited high antibacterial properties regardless the irrigation applied.
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Affiliation(s)
- V Kapralos
- Section of Endodontics, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Box 1109 Blindern, 0317, Oslo, Norway
| | - H Valen
- Nordic Institute of Dental Materials (NIOM), Sognsveien 70 A, 0855, Oslo, Norway
| | - A Koutroulis
- Section of Endodontics, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Box 1109 Blindern, 0317, Oslo, Norway
| | - J Camilleri
- School of Dentistry, Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, United Kingdom
| | - D Ørstavik
- Section of Endodontics, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Box 1109 Blindern, 0317, Oslo, Norway
| | - P T Sunde
- Section of Endodontics, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Box 1109 Blindern, 0317, Oslo, Norway
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Wong J, Manoil D, Näsman P, Belibasakis GN, Neelakantan P. Microbiological Aspects of Root Canal Infections and Disinfection Strategies: An Update Review on the Current Knowledge and Challenges. FRONTIERS IN ORAL HEALTH 2022; 2:672887. [PMID: 35048015 PMCID: PMC8757850 DOI: 10.3389/froh.2021.672887] [Citation(s) in RCA: 51] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 05/17/2021] [Indexed: 02/06/2023] Open
Abstract
The oral cavity is the habitat of several hundreds of microbial taxa that have evolved to coexist in multispecies communities in this unique ecosystem. By contrast, the internal tissue of the tooth, i.e., the dental pulp, is a physiologically sterile connective tissue in which any microbial invasion is a pathological sign. It results in inflammation of the pulp tissue and eventually to pulp death and spread of inflammation/infection to the periradicular tissues. Over the past few decades, substantial emphasis has been placed on understanding the pathobiology of root canal infections, including the microbial composition, biofilm biology and host responses to infections. To develop clinically effective treatment regimens as well as preventive therapies, such extensive understanding is necessary. Rather surprisingly, despite the definitive realization that root canal infections are biofilm mediated, clinical strategies have been focused more on preparing canals to radiographically impeccable levels, while much is left desired on the debridement of these complex root canal systems. Hence, solely focusing on "canal shaping" largely misses the point of endodontic treatment as the current understanding of the microbial aetiopathogenesis of apical periodontitis calls for the emphasis to be placed on "canal cleaning" and chemo-mechanical disinfection. In this review, we dissect in great detail, the current knowledge on the root canal microbiome, both in terms of its composition and functional characteristics. We also describe the challenges in root canal disinfection and the novel strategies that attempt to address this challenge. Finally, we provide some critical pointers for areas of future research, which will serve as an important area for consideration in Frontiers in Oral Health.
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Affiliation(s)
- Jasmine Wong
- Discipline of Endodontology, Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - Daniel Manoil
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institute, Huddinge, Sweden
| | - Peggy Näsman
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institute, Huddinge, Sweden
| | - Georgios N Belibasakis
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institute, Huddinge, Sweden
| | - Prasanna Neelakantan
- Discipline of Endodontology, Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
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Nassar S, Shetty H, S. Nair P, Gowri S, Jayaprakash K. Comparative evaluation of fracture resistance of endodontically treated bicuspids instrumented with hand files, trunatomy, protaper next, protaper gold, and waveone – An In vitro study. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2022; 14:S600-S604. [PMID: 36110709 PMCID: PMC9469274 DOI: 10.4103/jpbs.jpbs_739_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 12/23/2021] [Accepted: 12/27/2021] [Indexed: 11/30/2022] Open
Abstract
Aim: The study aims to compare and evaluate the fracture resistance of endodontically treated bicuspids instrumented with Hand Files, TruNatomy (TRN), ProTaper Next (PTN), ProTaper Gold (PTG), and WaveOne (WO). Materials and Methods: In total, 45 extracted single-rooted human premolar teeth were selected and sectioned at or below the cementoenamel junction to obtain roots 15 mm long. The samples were divided into four experimental groups and one control group (n = 9): instrumentation with nickel–titanium (NiTi) Hand Files (control group), instrumentation with TRN files, instrumentation with PTN files, instrumentation with PTG files, and instrumentation with WO files. The samples were obturated by lateral compaction technique using gutta-percha points and AH Plus sealer. A vertical load was applied to the tooth using the universal testing machine (Tecsol-TSI-BDS-2Kn-Sr No. 170710) for the fracture resistance test. Statistical analysis was performed. Results: The study reported that teeth instrumented with NiTi hand files exhibited the highest fracture resistance when compared to all the rotary and reciprocating file systems. Among rotary and reciprocating instruments, root prepared with TRN files showed the most significant resistance to fracture compared with PTN, PTG, and WO files. Conclusion: Within the limitations of this study, it can be concluded that minimally invasive instrumentation of the system preserves more pericervical dentin, which may increase the resistance to fracture. Results of this study and other studies support the use of minimally tapered instruments to improve the fracture resistance of endodontically treated teeth.
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Abuljadayel J, Shafei J, Fairaq M, Mirza A, Samman AB, Abdulshakoor A, Jalal N, Ashgar S, Al-Said H. A comparative evaluation of the antimicrobial effect of six natural products in comparison to 2.5% sodium hypochlorite against Enterococcus faecalis: An in vitro study. SAUDI JOURNAL FOR HEALTH SCIENCES 2022. [DOI: 10.4103/sjhs.sjhs_149_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Li ALB, Markvart M, Abbott PV. Effect of different concentrations of sodium hypochlorite on the compressive strength of endodontically-treated roots. J Endod 2021; 48:370-374. [PMID: 34952101 DOI: 10.1016/j.joen.2021.12.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 12/08/2021] [Accepted: 12/14/2021] [Indexed: 11/17/2022]
Abstract
INTRODUCTION The aim was to compare the compressive strength of dentin after irrigation with different concentrations of sodium hypochlorite (NaOCl). METHODS Two hundred and fifty-nine extracted human tooth roots with no root caries or previous endodontic treatment were collected. They were sorted by size and length, and assigned to 7 groups (n=37): negative control (no instrumentation, no irrigant), positive control (saline irrigant), 1%, 2.5%, 4%, 5.25%, and 10% NaOCl. A total of 13 mL NaOCl or saline (in 1mL increments) was used per canal while being instrumented to #35 files (approximately 13 min). EDTAC (15%) was then used to remove smear layer (2 min), followed by NaOCl as a final rinse. The roots were sectioned into 2mm thick discs and subjected to compression testing. RESULTS There was a significant difference between the negative control group and all instrumented groups (P < .05). The positive control group was significantly different to the 5.25% group (P < .05) and had a low P-value when compared to the 2.5% group and the other higher concentrations (P ≅ .1). When the NaOCl groups were compared to each other, there was a significant difference between 1% NaOCl and all higher concentrations (P < .05), but no significant difference when 2.5% NaOCl was compared to higher concentrations. CONCLUSION A concentration of 1% NaOCl had the least effect on the compressive strength of dentin and this was significantly different to all higher concentrations tested. Therefore, the use of concentrations of NaOCl above 1% should be reconsidered.
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Affiliation(s)
- Alexiea Lulue Benjamin Li
- University of Copenhagen Department of Odontology Section of Clinical Oral Microbiology, Cariology and Endodontics, Nørre Allé 20, 2200 Copenhagen N, Denmark; UWA Dental School, The University of Western Australia, 35 Stirling Highway, Crawley WA 6009, Australia
| | - Merete Markvart
- University of Copenhagen Department of Odontology Section of Clinical Oral Microbiology, Cariology and Endodontics, Nørre Allé 20, 2200 Copenhagen N, Denmark
| | - Paul V Abbott
- UWA Dental School, The University of Western Australia, 35 Stirling Highway, Crawley WA 6009, Australia.
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Effect of Sodium Hypochlorite Concentration in Continuous Chelation on Dislodgement Resistance of an Epoxy Resin and Hydraulic Calcium Silicate Sealer. Polymers (Basel) 2021; 13:polym13203482. [PMID: 34685241 PMCID: PMC8537795 DOI: 10.3390/polym13203482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 10/05/2021] [Accepted: 10/07/2021] [Indexed: 11/17/2022] Open
Abstract
The conditioning of the root canal wall during chemo-mechanical root canal treatment differentially affects the adhesion of root canal sealers. This investigation evaluated the impact of sodium hypochlorite (NaOCl) concentration as used in a root canal irrigation concept called continuous chelation, with 1-hydroxyethylidene-1,1-diphosphonic acid (HEDP) contained in the NaOCl solution that is applied. Fourier-transform infrared spectra of the dentinal wall were gathered. The consequential effects on push-out bond strength of an epoxy resin (AH Plus) versus a hydraulic CaSi sealer (BioRoot RCS) were assessed. Single-rooted extracted human teeth were used and irrigated with pure NaOCl at a concentration of 0% (physiological saline), 2.5%, or 5.25%. Dual Rinse HEDP (9%) was added to the solutions, or not added for further control. Pure NaOCl solutions caused a decrease in the amide III: phosphate ratios, which was counter-acted by the addition of HEDP. It was observed that the adhesion of the epoxy resin sealer under investigation was negatively affected by this NaOCl deproteinization of the canal wall in a dose-dependent manner, while the opposite was observed with the CaSi sealer. HEDP when used in conjunction with NaOCl was beneficial for the adhesion of both sealers.
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Girotto AC, Abuna G, Sanchez-Puetate C, Piccioni MA, Porto TS, Kuga MC. Effect of different adhesive strategies and storage time on bond strength of bifunctional monomers to simulated endodontically-treated dentin. Dent Mater J 2021; 40:1410-1417. [PMID: 34321370 DOI: 10.4012/dmj.2021-074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Adhesive strategies were evaluated on the bond strength of bi-functional monomers bonded to endodontically-treated-dentin (ETD). Superficial dentin was removed on human molars. Teeth were immersed in 5 mL 2.5% NaOCl, followed by immersion in 5 mL 17% EDTA. Dentin surface impregnated with epoxy resin-based sealer was then divided four groups (n=10): Scotchbond Multi-Purpose (SBMP); Single Bond Universal (SBU); Optibond All-in-One (OPB); and Tetric-N-Bond Universal (TBU). After 24-h or 1-year-of-storage specimens were submitted to microtensile bond strength (µTBS) and failure classification. A confocal laser scanning microscope (CLSM) evaluated the hybrid layer formation. Two-way ANOVA and Tukey-HSD test were performed (α=5%). The µTBS did not present statistical differences among adhesive strategies after 24-h. Significant differences were found after 1-year-of-storage. CLSM analysis showed water infiltration and consequently degradation of the hybrid layer after 1-year-of-storage. The use of SBU universal adhesive on the self-etching mode on ETD produced more stable bond over the 1-year-of-storage.
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Affiliation(s)
- Aline Carvalho Girotto
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP)
| | - Gabriel Abuna
- Department of General Dentistry, School of Dental Medicine, East Carolina University
| | | | - Mayra Andressa Piccioni
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP)
| | - Thiago Soares Porto
- Division of Restorative and Prosthetic Dentistry, College of Dentistry, The Ohio State University
| | - Milton Carlos Kuga
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP)
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Wong J, Zou T, Lee AHC, Zhang C. The Potential Translational Applications of Nanoparticles in Endodontics. Int J Nanomedicine 2021; 16:2087-2106. [PMID: 33727815 PMCID: PMC7955783 DOI: 10.2147/ijn.s293518] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 01/26/2021] [Indexed: 12/13/2022] Open
Abstract
Nanotechnology has substantially progressed in the past decades, giving rise to numerous possible applications in different biomedical fields. In particular, the use of nanoparticles in endodontics has generated significant interest due to their unique characteristics. As a result of their nanoscale dimensions, nanoparticles possess several properties that may enhance the treatment of endodontic infections, such as heightened antibacterial activity, increased reactivity and the capacity to be functionalized with other reactive compounds. Effective disinfection and sealing of the root canal system are the hallmarks for successful endodontic treatment. However, the presence of bacterial biofilms and resistance to endodontic disinfectants pose a significant challenge to this goal. This has encouraged the investigation of antibacterial nanoparticle-based irrigants and intracanal medicaments, which may improve the elimination of endodontic infections. In addition, photosynthesizer-functionalized nanoparticles could also serve as a worthy adjunct to root canal disinfection strategies. Furthermore, despite the myriad of commercially available options for endodontic obturation, the "ideal" material has yet to be conceived. This has led to the development of various experimental nanoparticle-incorporated obturation materials and sealers that exhibit a range of favourable physicochemical properties including enhanced antibacterial efficacy and bioactivity. Nanoparticle applications also show promise in the field of regenerative endodontics, such as supporting the release of bioactive molecules and enhancing the biophysical properties of scaffolds. Given the constantly growing body of research in this field, this article aims to present an overview of the current evidence pertaining to the potential translational applications of nanoparticles in endodontics.
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Affiliation(s)
- Jasmine Wong
- Restorative Dental Sciences (Endodontics), Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region
| | - Ting Zou
- Restorative Dental Sciences (Endodontics), Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region
| | - Angeline Hui Cheng Lee
- Restorative Dental Sciences (Endodontics), Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region
| | - Chengfei Zhang
- Restorative Dental Sciences (Endodontics), Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region
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25
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Quercetin as an Auxiliary Endodontic Irrigant for Root Canal Treatment: Anti-Biofilm and Dentin Collagen-Stabilizing Effects In Vitro. MATERIALS 2021; 14:ma14051178. [PMID: 33802293 PMCID: PMC7959140 DOI: 10.3390/ma14051178] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 02/19/2021] [Accepted: 02/25/2021] [Indexed: 01/02/2023]
Abstract
Bacterial reinfection and root fracture are the main culprits related to root canal treatment failure. This study aimed to assess the utility of quercetin solution as an adjunctive endodontic irrigant that does not weaken root canal dentin with commitment anti-biofilm activity and bio-safety. Based on a noninvasive dentin infection model, dentin tubules infected with Enterococcus faecalis (E. faecalis) were irrigated with sterile water (control group), and 0, 1, 2, 4 wt% quercetin-containing ethanol solutions. Live and dead bacteria percentages in E. faecalis biofilms were analyzed by confocal laser scanning microscopy (CLSM). Elastic modulus, hydroxyproline release and X-ray photoelectron spectroscopy (XPS) characterization were tested to evaluate the irrigants’ collagen-stabilizing effect. The cytotoxicity was tested by CCK-8 assay. Quercetin increased the proportion of dead bacteria volumes within E. faecalis and improved the flexural strength of dentin compared to control group (p < 0.05). Quercetin-treated dentin matrix had less elasticity loss and hydroxyproline release after collagenase degradation (p < 0.05). Moreover, quercetin solutions revealed an increase in the C-O peak area under both C1s and O1s narrow-scan spectra of XPS characterization, and no cytotoxicity (p > 0.05). Quercetin exhibited anti-biofilm activity, a collagen-stabilizing effect with cytocompatibility, supporting quercetin as a potential candidate for endodontic irrigant.
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Xu H, Ye N, Lin F, Heo YC, Fok ASL. A new method to test the fracture strength of endodontically-treated root dentin. Dent Mater 2021; 37:796-804. [PMID: 33653597 DOI: 10.1016/j.dental.2021.02.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 02/02/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To develop a new method to test the fracture strength of endodontically-treated root dentin. METHOD Bovine tooth roots were transversely cut into 2-mm thick sections and the root canals were enlarged with a taper of 0.06. An outer layer of resin composite was bonded to each section to make the root canal-to-outer radius ratio smaller than 1/3. The resulting discs were treated with irrigants at the inner surface and then fractured by inserting through the center a steel rod of the same taper attached to a universal test system. Fracture strength was calculated by using Lame's equations for thick-walled cylinders. Micro-indentation was performed to evaluate the depth of dentin affected by irrigation. Finite element analysis (FEA) was performed to verify the reasonableness of using resin composite to surround the dentin section as well as the analytical solution. RESULTS The fracture strength of endodontically-treated root dentin based on the analytical solution for a homogeneous section was 139.69 ± 32.59 MPa. However, FEA that took into account root canal softening caused by the irrigants showed that this was overestimated by about 33.5%. The corrected fracture strength of treated dentin was 114.58 ± 26.74 MPa. By incorporating the layer of affected dentin into the analytical solution, the difference in the fracture-causing stress between the analytical and numerical solutions dropped to around 9.5%. SIGNIFICANCE A relatively simple but clinically relevant method has been developed for measuring the fracture strength of endodontically-treated root dentin. The method could be applied to root dentin that is treated by conventional canal opening and irrigation.
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Affiliation(s)
- Haiping Xu
- Department of Stomatology, The Affiliated Hospital of Qingdao University, College of Stomatology, Qingdao University, Qingdao 266003, China; Minnesota Dental Research Center for Biomaterials and Biomechanics, School of Dentistry, University of Minnesota, MN 55455, United States
| | - Ning Ye
- Minnesota Dental Research Center for Biomaterials and Biomechanics, School of Dentistry, University of Minnesota, MN 55455, United States; Department of Mechanical Engineering, College of Science and Engineering, University of Minnesota, MN 55455, United States
| | - Fei Lin
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - Young Cheul Heo
- Minnesota Dental Research Center for Biomaterials and Biomechanics, School of Dentistry, University of Minnesota, MN 55455, United States
| | - Alex S L Fok
- Minnesota Dental Research Center for Biomaterials and Biomechanics, School of Dentistry, University of Minnesota, MN 55455, United States.
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Bhuva B, Giovarruscio M, Rahim N, Bitter K, Mannocci F. The restoration of root filled teeth: a review of the clinical literature. Int Endod J 2021; 54:509-535. [PMID: 33128279 DOI: 10.1111/iej.13438] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 10/26/2020] [Accepted: 10/27/2020] [Indexed: 02/06/2023]
Abstract
Clinicians often face dilemmas regarding the most appropriate way to restore a tooth following root canal treatment. Whilst there is established consensus on the importance of the ferrule effect on the predictable restoration of root filled teeth, other factors, such as residual tooth volume, tooth location, number of proximal contacts, timing of the definitive restoration and the presence of cracks, have been reported to influence restoration and tooth survival. The continued evolution of dental materials and techniques, combined with a trend towards more conservative endodontic-restorative procedures, prompts re-evaluation of the scientific literature. The aim of this literature review was to provide an updated overview of the existing clinical literature relating to the restoration of root filled teeth. An electronic literature search of the PubMed, Ovid (via EMBASE) and MEDLINE (via EMBASE) databases up to July 2020 was performed to identify articles that related the survival of root filled teeth and/or restoration type. The following and other terms were searched: restoration, crown, onlay, root canal, root filled, post, clinical, survival, success. Wherever possible, only clinical studies were selected for the literature review. Full texts of the identified articles were independently screened by two reviewers according to pre-defined criteria. This review identifies the main clinical factors influencing the survival of teeth and restorations following root canal treatment in vivo and discusses the data related to specific restoration type on clinical survival.
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Affiliation(s)
- B Bhuva
- Department of Endodontics, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - M Giovarruscio
- Department of Endodontics, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK.,Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - N Rahim
- Department of Endodontics, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - K Bitter
- Department of Operative and Preventive Dentistry, Charité - University Medicine, Berlin, Germany
| | - F Mannocci
- Department of Endodontics, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
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28
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Effects of different irrigation protocols on dentin surfaces as revealed through quantitative 3D surface texture analysis. Sci Rep 2020; 10:22073. [PMID: 33328515 PMCID: PMC7744534 DOI: 10.1038/s41598-020-79003-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 11/24/2020] [Indexed: 11/20/2022] Open
Abstract
The combination of ethylenediaminetetraacetic acid (EDTA) and sodium hypochlorite (NaOCl) has been advocated as an effective irrigation methodology to remove organic and inorganic matter in root canal therapy. Yet, it was suggested that both solutions might lead to structural changes of the dentinal wall surface, depending on the order of application which might affect sealer mechanical retention. This study aims to evaluate the effect of different irrigating protocols on dentin surface roughness using quantitative 3D surface texture analysis. Data stems from 150 human root dentin sections, divided into five groups, each prepared according to one of the following protocols: Negative control; 17% EDTA; 17% EDTA followed by 5.25% NaOCl; 5.25% NaOCl; and 5.25% NaOCl followed by 17% EDTA. Each dentin sample was examined for its three-dimensional surface texture using a high-resolution confocal disc-scanning measuring system. EDTA 17% and the combined EDTA 17% with NaOCl 5.25% showed considerably higher roughness properties compared to the control and to NaOCl 5.25% alone. However, the irrigation sequence did not affect the dentin roughness properties. Therefore, mechanical retention is probably not dependent upon the selection of irrigation protocol sequence.
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29
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Root fractures in seniors: Consequences of acute embrittlement of dentin. Dent Mater 2020; 36:1464-1473. [DOI: 10.1016/j.dental.2020.08.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 07/03/2020] [Accepted: 08/29/2020] [Indexed: 12/17/2022]
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30
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Trautmann E, Attin T, Mohn D, Zehnder M. Hydrogen Peroxide Versus Sodium Hypochlorite: All a Matter of pH? J Endod 2020; 47:297-302. [PMID: 33129899 DOI: 10.1016/j.joen.2020.10.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 10/23/2020] [Accepted: 10/24/2020] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Hydrogen peroxide (H2O2) and sodium hypochlorite (NaOCl) solutions are similar in that they contain oxidizing agents with a bleaching effect. NaOCl solutions are stable at a high pH, at which they also exert increased cleansing/proteolysis. On the other hand, H2O2 solutions are natively acidic, yet gain bleaching power on organic stains when alkalized. It was investigated whether alkalizing a H2O2 solution would also let it dissolve soft tissue or increase its bleaching power on blood-stained dentin. METHODS The stability of alkalized H2O2 solutions was assessed by iodometric titration. Soft tissue dissolution was investigated on porcine palatal mucosa. The bleaching effect (ΔL∗) after 60 minutes of exposure was monitored in blood-stained human dentin using a calibrated spectrophotometer. To compare similar molarities, 2.5% H2O2 solutions were used here, and 5.0% NaOCl was used as the positive control, whereas nonbuffered saline solution served as the negative control. RESULTS Adding alkali (NaOH) to the H2O2 solutions rendered them unstable in a dose-dependent manner. A H2O2 solution of pH 11.1 was chosen for the main experiments (tissue dissolution and bleaching effect) and compared with a native counterpart (pH = 4.7). Alkalizing the H2O2 solution had no discernible effect on its soft tissue dissolution or bleaching power (P = .75 compared with the native H2O2 solution). The NaOCl solution of similar molar concentration had a considerably (P < .001) higher tissue dissolving and bleaching effect under current conditions. CONCLUSIONS The proteolytic/bleaching effects of NaOCl solutions are unique and cannot be achieved by altering the pH of peroxide solutions.
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Affiliation(s)
- Erik Trautmann
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Thomas Attin
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Dirk Mohn
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland; Department of Chemistry and Applied Biosciences, Institute for Chemical and Bioengineering, ETH Zurich, Zurich, Switzerland
| | - Matthias Zehnder
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.
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Mello I, Michaud PL, Butt Z. Fracture Resistance of Immature Teeth Submitted to Different Endodontic Procedures and Restorative Protocols. J Endod 2020; 46:1465-1469. [PMID: 32615172 DOI: 10.1016/j.joen.2020.06.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 06/10/2020] [Accepted: 06/19/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The purpose of this in vitro study was to determine whether the methods used to treat endodontically and restore anterior immature teeth with a necrotic pulp influence their resistance to fracture. METHODS After access opening and cleaning and shaping, 80 specimen teeth were assigned into 5 groups according to the endodontic obturation method and coronal restoration as follows: A1, apexification with a composite restoration in the crown area; A2, apexification with a composite restoration in the crown and 3 mm into the root; IR, immediate revascularization with a composite restoration in the crown area; SR, successful revascularization with a composite in the crown area; and the control group, a mature tooth treated with gutta-percha and sealer with a composite restoration in the crown area. The teeth were mounted in acrylic blocks and brought to fracture under compressive forces in a universal testing machine. Both the fracture strength and the location where the fracture occurred were recorded. RESULTS There were no statistically significant differences in the fracture resistance among the 5 groups (1-way analysis of variance, F4 = .545, P = .703). No statistically significant differences were found in the location where the fracture occurred either (χ24 = 4.1, P = .391). CONCLUSIONS Within the limitations of this in vitro study, it can be concluded that the treatment options used to treat nonvital immature teeth provided the same resistance to fracture.
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Affiliation(s)
- Isabel Mello
- Department of Dental Clinical Sciences, Faculty of Dentistry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Pierre-Luc Michaud
- Department of Dental Clinical Sciences, Faculty of Dentistry, Dalhousie University, Halifax, Nova Scotia, Canada.
| | - Zahndra Butt
- Department of Dental Clinical Sciences, Faculty of Dentistry, Dalhousie University, Halifax, Nova Scotia, Canada
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Lei L, Zheng L, Xiao H, Zheng J, Zhou Z. Wear mechanism of human tooth enamel: The role of interfacial protein bonding between HA crystals. J Mech Behav Biomed Mater 2020; 110:103845. [PMID: 32957176 DOI: 10.1016/j.jmbbm.2020.103845] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 04/29/2020] [Accepted: 05/04/2020] [Indexed: 11/18/2022]
Abstract
Human tooth enamel, the most mineralized tissue in body, contains less than 2 wt% protein. Consequently, the importance of the protein to enamel mechanical response has always been overlooked. In this study, the role of minor protein in providing enamel microstructure and mechanical performance, especially tribological properties, were studied using deproteinization treatment and nano-indentation/scratch technique. Via the change from the original to the deproteinated conditions, a nanostructure degeneration from the assembly of hydroxyapatite (HA) crystals into nano-fibers to crystal aggregation has been found between the high-wear-resistance and low-wear-resistance on the enamel surface. Correspondingly, an energy dissipation to cause a unit volume of wear on enamel surface decreases by 50%, and wear volume increases by 80%. With the presence of protein, the occurrence of enamel wear requires to break the interfacial protein bonding between the HA crystals in nano-fibers and the break dissipates considerable energy, which benefits the enamel to resist wear. Thus, the protein in enamel, although of a very low content, is essential to resisting wear by mediating the assembly of rigid HA crystals via interfacial protein bonding. Replicating functions of the protein component will be critical to the successful development of bio-inspired materials that are designed for wear-resistance.
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Affiliation(s)
- Lei Lei
- Tribology Research Institute, Key Laboratory of Advanced Technologies of Materials, Ministry of Education, Southwest Jiaotong University, Chengdu, 610031, China
| | - Liang Zheng
- Institute of Oceanographic Instrumentation, Shandong Provincial Key Laboratory of Marine Monitoring Instrument and Equipment Technology, Qilu University of Technology (Shandong Academy of Sciences), Qingdao, 266061, China
| | - Heng Xiao
- Tribology Research Institute, Key Laboratory of Advanced Technologies of Materials, Ministry of Education, Southwest Jiaotong University, Chengdu, 610031, China
| | - Jing Zheng
- Tribology Research Institute, Key Laboratory of Advanced Technologies of Materials, Ministry of Education, Southwest Jiaotong University, Chengdu, 610031, China.
| | - Zhongrong Zhou
- Tribology Research Institute, Key Laboratory of Advanced Technologies of Materials, Ministry of Education, Southwest Jiaotong University, Chengdu, 610031, China
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Bosaid F, Aksel H, Makowka S, Azim AA. Surface and structural changes in root dentine by various chelating solutions used in regenerative endodontics. Int Endod J 2020; 53:1438-1445. [PMID: 32619296 DOI: 10.1111/iej.13354] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 06/25/2020] [Accepted: 06/26/2020] [Indexed: 01/16/2023]
Abstract
AIM To evaluate the effects of the prolonged use of various irrigant solutions used during regenerative endodontic procedures on the physical and chemical structure of root canal dentine in extracted human teeth. METHODOLOGY Sixtyroot dentine samples from extracted, single-rooted, human teeth were assigned to 10 groups. Eight groups were irrigated with 1.5% NaOCl for 5 min, followed by 3%, 10%, 17% EDTA or 10% citric acid (CA) for 5 or 10 min. One group received only NaOCl irrigation, and samples with only distilled water irrigation were used as a control group. The changes in microhardness and flexural strength were determined using Vickers and 3-point flexural tester, respectively. Molecular and elemental compositions were recorded using FTIR and EDS spectroscopy. Data were analysed using one-way anova, Kruskal-Wallis and Mann-Whitney U tests. RESULTS The application of 1.5% NaOCl for 5 min did not affect the mineral content or microhardness of dentine (P > 0.05). However, it significantly decreased the dentine collagen peak values (P < 0.05), which was similar to the control group after the use of chelating agents (EDTA and 10% of CA) (P > 0.05). The effect of EDTA on the inorganic content was not concentration and time dependent (P > 0.05). CA resulted in a significantly greater reduction in the inorganic contents compared with the control and EDTA groups (P < 0.05). Regardless of the time, EDTA and CA significantly decreased dentine microhardness compared to the control (P < 0.05) with the greatest reduction in the CA groups (P < 0.05). NaOCl alone was associated with the lowest flexural strength, while none of the other irrigation regimens significantly decreased the flexural strength compared to the control group (P> 0.05). CONCLUSIONS Use of 1.5% NaOCl for 5 min decreased the collagen content of samples of human dentine from extracted teeth while EDTA and 10% citric acid mostly affected the inorganic content and microhardness of dentine surfaces. None of the irrigant solutions significantly decreased the mechanical properties of the entire dentine specimen.
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Affiliation(s)
- F Bosaid
- Division of Endodontics, University at Buffalo, School of Dental Medicine, Buffalo, NY, USA
| | - H Aksel
- Division of Endodontics, University at Buffalo, School of Dental Medicine, Buffalo, NY, USA
| | - S Makowka
- Dental Materials Research Laboratory, University at Buffalo, School of Dental Medicine, Buffalo, NY, USA
| | - A A Azim
- Division of Endodontics, University at Buffalo, School of Dental Medicine, Buffalo, NY, USA
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Mello I, Michaud PL, Tanner N. Resistance to fracture of extracted teeth used for pre-clinical endodontic procedures: Influence of storage conditions. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2020; 24:272-275. [PMID: 31925845 DOI: 10.1111/eje.12494] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 12/12/2019] [Accepted: 01/07/2020] [Indexed: 06/10/2023]
Abstract
OBJECTIVES The purpose of this in vitro study was to determine whether different storage conditions used during endodontic procedures affect the fracture resistance of extracted teeth used for pre-clinical dental education. METHODS Freshly extracted mandibular incisors and canines were sterilised in an autoclave for 40 minutes at 24°F under a pressure of 20 psi and then stored in distilled water at 4°C until use. Specimens were randomly assigned to two groups based on the storage method used whilst undergoing endodontic procedures. Between endodontic sessions, teeth in the Wet Group (n = 16 incisors; n = 4 canines) were stored in distilled water and teeth in the Dry Group (n = 16 incisors; n = 4 canines) were stored in a dry container. All specimens were kept at room temperature and away from sunlight. Endodontic treatments were performed in 3 sessions over a 3-week period. The specimens were then brought to fracture under compressive forces along the long axis of the tooth in an Instron universal testing machine. The data were analysed using t tests (α = 0.05). RESULTS None of the teeth fractured during endodontic procedures. However, the compressive load required to fracture teeth stored under wet conditions was significantly higher than the load needed for teeth stored dry (P < .05). CONCLUSIONS Fracture resistance is affected by storage conditions; teeth stored in water have a higher resistance to fracture than teeth that are stored dry. Fracture resistance was, however, not reduced enough to lead to tooth fracture during pre-clinical endodontic procedures.
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Affiliation(s)
- Isabel Mello
- Department of Dental Clinical Sciences, Faculty of Dentistry, Dalhousie University, Halifax, NS, Canada
| | - Pierre-Luc Michaud
- Department of Dental Clinical Sciences, Faculty of Dentistry, Dalhousie University, Halifax, NS, Canada
| | - Nicole Tanner
- Dental Hygiene student, School of Dental Hygiene, Dalhousie University, Halifax, NS, Canada
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Dotto L, Sarkis Onofre R, Bacchi A, Rocha Pereira GK. Effect of Root Canal Irrigants on the Mechanical Properties of Endodontically Treated Teeth: A Scoping Review. J Endod 2020; 46:596-604.e3. [DOI: 10.1016/j.joen.2020.01.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 01/23/2020] [Accepted: 01/26/2020] [Indexed: 11/27/2022]
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Effect of a new irrigant solution containing glycolic acid on smear layer removal and chemical/mechanical properties of dentin. Sci Rep 2020; 10:7313. [PMID: 32355304 PMCID: PMC7193634 DOI: 10.1038/s41598-020-64450-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 04/14/2020] [Indexed: 11/19/2022] Open
Abstract
The objective of this study was to evaluate the effects of glycolic acid (GA) (with pH 1.2 and 5) and ethylenediaminetetraacetic acid (EDTA) on the chemical and mechanical properties of dentin to investigate the potential use of GA as final irrigant in the root canal therapy. Specifically, changes in microhardness, smear layer removal, erosion, mineral content distribution, apatite/collagen ratio and flexural strength of mineralized dentin treated with GA were assessed. Saline solution was used as a negative control. Knoop microhardness (KHN) was measured on the root canal lumen of root segments. Dentin beams were used for 3-point flexural strength (σ) test. Scanning electron microscopy (SEM) images of root sections were obtained for evaluation of smear layer removal and dentin erosion on root segments and energy dispersive X-ray spectroscopy (EDS) was used for mineral content distribution. The apatite/collagen ratio (A/C) in dentin powder were examined by Fourier transform infrared (FTIR) spectroscopy. KHN, σ and A/C results were statistically analyzed with ANOVA and Tukey tests (α = 0.05). Smear layer and dentin erosion scores were analyzed with Kruskal-Wallis and Dunn tests (α = 0.05). Root dentin treated with EDTA and GA presented similar KHN regardless of the pH (p > 0.05). However, KHN was significantly reduced in EDTA and GA groups when compared to control group (p<0.001). GA showed the same ability to remove the smear layer and to cause dentin erosion as EDTA. EDS results showed that the GA and EDTA solutions did not alter the dentin mineral content distribution. The apatite/collagen ratio reduced with all irrigant solution and was the lowest with GA pH 5 (p<0.001), while σ was not significantly affected by the experimental solutions (p = 0.559). It can be concluded that GA has similar ability to remove the smear layer than EDTA. GA does not affect negatively the chemical/mechanical properties and it does not increase dentin erosion. The use of GA with low pH seems to promote less change in collagen/apatite ratio, but further studies are needed to establish an ideal clinical protocol. Therefore, this study supports the potential use of GA as an alternative final irrigation solution for root canal preparation.
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Li Y, Wang Y, Chen X, Jiang W, Jiang X, Zeng Y, Li X, Feng Z, Luo J, Zhang L. Antimicrobial peptide GH12 as root canal irrigant inhibits biofilm and virulence of Enterococcus faecalis. Int Endod J 2020; 53:948-961. [PMID: 32189340 DOI: 10.1111/iej.13296] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 03/15/2020] [Accepted: 03/16/2020] [Indexed: 02/05/2023]
Abstract
AIM The objectives of this laboratory-based study were to investigate the effects of GH12 on Enterococcus faecalis biofilm and virulence. METHODOLOGY Minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of GH12 against E. faecalis were first determined. A time-kill assay was further conducted. The effects of GH12 on the expression of virulence and stress genes in E. faecalis were evaluated by RT-qPCR. Crystal violet stain was used to investigate the effects of GH12 on E. faecalis biofilm formation and 1-day-old biofilm. Finally, an ex vivo tooth model contaminated with E. faecalis was used to evaluate the antimicrobial activity of GH12 as an irrigant by CFU counting, SEM and CLSM. One-way anova and Tukey's multiple comparisons test were used to compare the differences amongst groups (α = 0.05). RESULTS The MICs and MBCs of GH12 against E. faecalis were 8.0 ± 0.0 and 16.0 ± 0.0 mg L-1 , respectively, and GH12 at 32.0 mg L-1 reduced the bacterial numbers by more than 99.9% within 1 min. Various virulence genes (efaA, esp and gelE) and stress genes (dnaK, groEL, ctsR and clpPBCEX) in E. faecalis were significantly downregulated by GH12 at sub-MIC levels (P < 0.05). Additionally, both E. faecalis biofilm formation and the biomass of 1-day-old E. faecalis biofilm were significantly reduced by GH12 (P < 0.05). Elimination of E. faecalis in biofilms from root canal walls was achieved through irrigation with 64.0 mg L-1 GH12 for 30 min. CLSM analysis revealed that GH12 at 64.0 mg L-1 was most effective in eliminating bacteria within dentinal tubules (P < 0.05). CONCLUSION In a laboratory setting, and when used as an irrigant, GH12 suppressed E. faecalis, downregulated specific virulence and stress-associated genes, eliminated intracanal E. faecalis protected by biofilms and killed bacteria in dentinal tubules. These results emphasize the need for preclinical and clinical studies to explore the potential of GH12 as an antimicrobial agent during root canal treatment.
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Affiliation(s)
- Y Li
- State Key Laboratory of Oral Diseases & National Clinical Research Centre for Oral Disease, Sichuan University, Chengdu, China.,Department of Cariology and Endodontics West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Y Wang
- State Key Laboratory of Oral Diseases & National Clinical Research Centre for Oral Disease, Sichuan University, Chengdu, China.,Department of Cariology and Endodontics West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - X Chen
- State Key Laboratory of Oral Diseases & National Clinical Research Centre for Oral Disease, Sichuan University, Chengdu, China
| | - W Jiang
- State Key Laboratory of Oral Diseases & National Clinical Research Centre for Oral Disease, Sichuan University, Chengdu, China.,Department of Cariology and Endodontics West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - X Jiang
- State Key Laboratory of Oral Diseases & National Clinical Research Centre for Oral Disease, Sichuan University, Chengdu, China.,Department of Cariology and Endodontics West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Y Zeng
- State Key Laboratory of Oral Diseases & National Clinical Research Centre for Oral Disease, Sichuan University, Chengdu, China.,Department of Cariology and Endodontics West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - X Li
- State Key Laboratory of Oral Diseases & National Clinical Research Centre for Oral Disease, Sichuan University, Chengdu, China.,Department of Cariology and Endodontics West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Z Feng
- State Key Laboratory of Oral Diseases & National Clinical Research Centre for Oral Disease, Sichuan University, Chengdu, China.,Department of Cariology and Endodontics West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - J Luo
- State Key Laboratory of Oral Diseases & National Clinical Research Centre for Oral Disease, Sichuan University, Chengdu, China.,Department of Cariology and Endodontics West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - L Zhang
- State Key Laboratory of Oral Diseases & National Clinical Research Centre for Oral Disease, Sichuan University, Chengdu, China.,Department of Cariology and Endodontics West China Hospital of Stomatology, Sichuan University, Chengdu, China
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Yang SY, Liu Y, Mao J, Wu YB, Deng YL, Qi SC, Zhou YC, Gong SQ. The antibiofilm and collagen-stabilizing effects of proanthocyanidin as an auxiliary endodontic irrigant. Int Endod J 2020; 53:824-833. [PMID: 32053733 DOI: 10.1111/iej.13280] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 02/11/2020] [Indexed: 11/29/2022]
Abstract
AIM To evaluate the antibiofilm effect of proanthocyanidin (PA) solution as an irrigant against Enterococcus faecalis (E. faecalis) and its influence on the mechanical properties and biodegradation resistance of demineralized root dentine. METHODOLOGY Enterococcus faecalis were introduced into human root dentine tubules by a serial centrifugation method and grown for 1 week. Dentine blocks infected with 1-week-old E. faecalis biofilms were treated with the following irrigants: sterile water (control), 2% chlorhexidine (CHX), 2% PA, 5% PA and 10% PA. After treatment, the live and dead bacteria proportions within E. faecalis biofilms were analysed using confocal laser scanning microscopy. To evaluate the biostability of fully demineralized dentine treated by the aforementioned irrigants, the elastic modulus and hydroxyproline release of human dentine incubated in collagenase solution were tested at baseline, after irrigant treatment and after biodegradation, respectively. Furthermore, the surface chemical bond of demineralized dentine collagen treated by various irrigants was characterized by X-ray photoelectron spectroscopy (XPS). Statistical analysis was performed using one-way anova and Tukey's post hoc multiple comparisons with the significance level at 5%. RESULTS The proportion of dead E. faecalis volume was significantly higher in the PA and CHX groups than that in the control group (P < 0.05). PA irrigation significantly increased the mechanical properties of demineralized dentine (P < 0.05), and the effect was enhanced with increasing PA concentration. CHX and PA groups had significantly less elasticity loss and hydroxyproline release (P < 0.05). The biomodification of dentine collagen by PA was verified by increased C-O/C-N peak percentage under C1s and C-O peak percentage under O1s narrow-scan XPS spectra. CONCLUSIONS Proanthocyanidin killed E. faecalis within biofilms and enhanced the biostability of the collagen matrix of demineralized root dentine. It might be used as an auxiliary endodontic irrigant with antibiofilm and collagen-stabilizing effects.
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Affiliation(s)
- S Y Yang
- Center of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Y Liu
- Laboratory of Biomimetic Nanomaterials, Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China
| | - J Mao
- Center of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Y B Wu
- Center of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Y L Deng
- Center of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - S C Qi
- Department of Stomatology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Y C Zhou
- The Stony Brook School, Stony Brook, NY, USA
| | - S Q Gong
- Center of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Baras BH, Melo MAS, Thumbigere-Math V, Tay FR, Fouad AF, Oates TW, Weir MD, Cheng L, Xu HHK. Novel Bioactive and Therapeutic Root Canal Sealers with Antibacterial and Remineralization Properties. MATERIALS (BASEL, SWITZERLAND) 2020; 13:E1096. [PMID: 32121595 PMCID: PMC7084849 DOI: 10.3390/ma13051096] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 02/20/2020] [Accepted: 02/21/2020] [Indexed: 02/07/2023]
Abstract
According to the American Dental Association Survey of Dental Services Rendered (published in 2007), 15 million root canal treatment procedures are performed annually. Endodontic therapy relies mainly on biomechanical preparation, chemical irrigation and intracanal medicaments which play an important role in eliminating bacteria in the root canal. Furthermore, adequate obturation is essential to confine any residual bacteria within the root canal and deprive them of nutrients. However, numerous studies have shown that complete elimination of bacteria is not achieved due to the complex anatomy of the root canal system. There are several conventional antibiotic materials available in the market for endodontic use. However, the majority of these antibiotics and antiseptics provide short-term antibacterial effects, and they impose a risk of developing antibacterial resistance. The root canal is a dynamic environment, and antibacterial and antibiofilm materials with long-term effects and nonspecific mechanisms of action are highly desirable in such environments. In addition, the application of acidic solutions to the root canal wall can alter the dentin structure, resulting in a weaker and more brittle dentin. Root canal sealers with bioactive properties come in direct contact with the dentin wall and can play a positive role in bacterial elimination and strengthening of the root structure. The new generation of nanostructured, bioactive, antibacterial and remineralizing additives into polymeric resin-based root canal sealers are discussed in this review. The effects of these novel bioactive additives on the physical and sealing properties, as well as their biocompatibility, are all important factors that are presented in this article.
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Affiliation(s)
- Bashayer H. Baras
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, MD 21201, USA; (B.H.B.); (V.T.-M.); (T.W.O.)
- Department of Restorative Dental Science, College of Dentistry, King Saud University, Riyadh 11451, Saudi Arabia
| | - Mary Anne S. Melo
- Division of Operative Dentistry, Department of General Dentistry, University of Maryland School of Dentistry, Baltimore, MD 21201, USA;
| | - Vivek Thumbigere-Math
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, MD 21201, USA; (B.H.B.); (V.T.-M.); (T.W.O.)
| | - Franklin R. Tay
- Department of Endodontics, Dental College of Georgia, Augusta University, Augusta, GA 30912, USA;
| | - Ashraf F. Fouad
- Division of Comprehensive Oral Health, Adams School of Dentistry, University of North Carolina, Chapel Hill, NC 27599-7450, USA;
| | - Thomas W. Oates
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, MD 21201, USA; (B.H.B.); (V.T.-M.); (T.W.O.)
| | - Michael D. Weir
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, MD 21201, USA; (B.H.B.); (V.T.-M.); (T.W.O.)
| | - Lei Cheng
- Department of Operative Dentistry and Endodontics, West China School of Stomatology, State Key Laboratory of Oral Diseases, Sichuan University, Chengdu 610000, China
| | - Hockin H. K. Xu
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, MD 21201, USA; (B.H.B.); (V.T.-M.); (T.W.O.)
- Center for Stem Cell Biology & Regenerative Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA
- Marlene and Stewart Greenebaum Cancer Center, University of Maryland School of Medicine, Baltimore, MD 21201, USA
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Pedersen ND, Uzunoglu-Özyürek E, Dogan Buzoglu H. Influence of different irrigation protocols on microhardness and flexural strength values of young and aged crown dentin. Gerodontology 2019; 37:53-58. [PMID: 31746036 DOI: 10.1111/ger.12444] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 08/26/2019] [Accepted: 10/18/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To investigate the effect of different irrigation protocols on microhardness (MH) and flexural strength (FS) values of young and aged crown dentin. BACKGROUND In addition to ageing, root canal irrigation might also affect the mechanical properties of coronal dentin walls. MATERIALS AND METHODS One hundred and twenty dentin bars (2 mm × 2 mm × 8 mm) were obtained from the crowns of extracted, non-caries, human molars of young and older patients (n = 60 bars; average patient ages: 16.7 and 65.4, respectively). Subgroups were formed as follows: 2.5%NaOCl(sodium hypochlorite)+5%EDTA(ethylenediaminetetraacetic acid), 2.5%NaOCl + 15%EDTA, 2.5%NaOCl, 5%EDTA, 15%EDTA and Saline. NaOCl and saline were used for 20 minutes and EDTA solutions for 1 minute. MH values of each sample were measured before and after the irrigation protocols. The same samples were also submitted for FS analysis. The data were statistically analysed. RESULTS Young samples had lower MH values at pre- and post-treatment compared to aged samples (P < .05). A significant decrease was observed in MH values of aged samples exposed to 2.5%NaOCl and both NaOCl + EDTA combinations (P < .05). FS values of the young saline-treated group were statistically higher than aged ones (P < .05). Both NaOCl + EDTA combinations caused a significant decrease in FS values of young samples compared to saline (P < .05). CONCLUSION Ageing has a significant effect on the MH and FS values of crown dentin samples. 5% EDTA solutions revealed similar results to 15%EDTA regarding MH and FS values of crown dentin in both age groups. The NaOCl + EDTA combination had a prominent effect than EDTA alone, on MH values of young-, and FS values of aged dentin samples.
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Affiliation(s)
- Nurab Deniz Pedersen
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Emel Uzunoglu-Özyürek
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Hatice Dogan Buzoglu
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
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Baras BH, Sun J, Melo MAS, Tay FR, Oates TW, Zhang K, Weir MD, Xu HH. Novel root canal sealer with dimethylaminohexadecyl methacrylate, nano-silver and nano-calcium phosphate to kill bacteria inside root dentin and increase dentin hardness. Dent Mater 2019; 35:1479-1489. [DOI: 10.1016/j.dental.2019.07.014] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 07/10/2019] [Accepted: 07/15/2019] [Indexed: 12/14/2022]
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Browne JT, Ng Y, Odlyha M, Gulabivala K, Bozec L. Influence of root maturity or periodontal involvement on dentinal collagen changes following Na
OC
l irrigation: an
ex vivo
study. Int Endod J 2019; 53:97-110. [DOI: 10.1111/iej.13200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 08/05/2019] [Indexed: 11/29/2022]
Affiliation(s)
- J. T. Browne
- Unit of Endodontology Divisions of Restorative Dental Science UCL Eastman Dental Institute University College London LondonUK
| | - Y.‐L. Ng
- Unit of Endodontology Divisions of Restorative Dental Science UCL Eastman Dental Institute University College London LondonUK
| | - M. Odlyha
- Department of Biological Sciences Birkbeck University of LondonLondon UK
| | - K. Gulabivala
- Unit of Endodontology Divisions of Restorative Dental Science UCL Eastman Dental Institute University College London LondonUK
| | - L. Bozec
- Biomaterials & Tissue Engineering UCL Eastman Dental Institute University College London London UK
- Faculty of Dentistry University of Toronto Toronto Canada
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Petridis X, Busanello FH, So MVR, Dijkstra RJB, Sharma PK, van der Sluis LWM. Factors affecting the chemical efficacy of 2% sodium hypochlorite against oral steady-state dual-species biofilms: Exposure time and volume application. Int Endod J 2019; 52:1182-1195. [PMID: 30807649 PMCID: PMC7328852 DOI: 10.1111/iej.13102] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Accepted: 02/22/2019] [Indexed: 01/06/2023]
Abstract
AIM To study the influence of time and volume of 2% sodium hypochlorite (NaOCl) on biofilm removal and to investigate the changes induced on the biofilm architecture. Steady-state, dual-species biofilms of standardized thickness and a realistic contact surface area between biofilms and NaOCl were used. METHODOLOGY Streptococcus oralis J22 and Actinomyces naeslundii T14V-J1 biofilms were grown on saliva-coated hydroxyapatite discs within sample holders in the Constant Depth Film Fermenter (CDFF) for 96 h. Two per cent NaOCl was statically applied for three different time intervals (60, 120 and 300 s) and in two different volumes (20 and 40 μL) over the biofilm samples. The diffusion-driven effects of time and volume on biofilm disruption and dissolution were assessed with Optical Coherence Tomography (OCT). Structural changes of the biofilms treated with 2% NaOCl were studied with Confocal Laser Scanning Microscopy (CLSM) and Low Load Compression Testing (LLCT). A two-way analysis of variance (2-way anova) was performed, enabling the effect of each independent variable as well as their interaction on the outcome measures. RESULTS Optical coherence tomography revealed that by increasing the exposure time and volume of 2% NaOCl, both biofilm disruption and dissolution significantly increased. Analysis of the interaction between the two independent variables revealed that by increasing the volume of 2% NaOCl, significant biofilm dissolution could be achieved in less time. Examination of the architecture of the remaining biofilms corroborated the EPS-lytic action of 2% NaOCl, especially when greater volumes were applied. The viscoelastic analysis of the 2% NaOCl-treated biofilms revealed that the preceding application of higher volumes could impact their subsequent removal. CONCLUSIONS Time and volume of 2% NaOCl application should be taken into account for maximizing the anti-biofilm efficiency of the irrigant and devising targeted disinfecting regimes against remaining biofilms.
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Affiliation(s)
- X. Petridis
- Department of Conservative DentistryCenter for Dentistry and Oral HygieneUniversity Medical Center GroningenUniversity of GroningenGroningenThe Netherlands
| | - F. H. Busanello
- Conservative Dentistry DepartmentSchool of DentistryFederal University of Rio Grande do SulPorto AlegreRio Grande do SulBrazil
| | - M. V. R. So
- Conservative Dentistry DepartmentSchool of DentistryFederal University of Rio Grande do SulPorto AlegreRio Grande do SulBrazil
| | - R. J. B. Dijkstra
- Department of Conservative DentistryCenter for Dentistry and Oral HygieneUniversity Medical Center GroningenUniversity of GroningenGroningenThe Netherlands
| | - P. K. Sharma
- Department of Biomedical EngineeringUniversity Medical Center GroningenUniversity of GroningenGroningenThe Netherlands
| | - L. W. M. van der Sluis
- Department of Conservative DentistryCenter for Dentistry and Oral HygieneUniversity Medical Center GroningenUniversity of GroningenGroningenThe Netherlands
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Gulabivala K, Ng YL. Value of root-filled teeth in maintaining a functional dentition for life. Br Dent J 2019; 226:769-784. [DOI: 10.1038/s41415-019-0313-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Zollinger A, Attin T, Mohn D, Zehnder M. Effects of endodontic irrigants on blood and blood-stained dentin. Heliyon 2019; 5:e01794. [PMID: 31193548 PMCID: PMC6536424 DOI: 10.1016/j.heliyon.2019.e01794] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 03/13/2019] [Accepted: 05/20/2019] [Indexed: 11/17/2022] Open
Abstract
Objectives This study aimed to investigate bleaching effects of common endodontic irrigants on human whole blood and blood-stained dentin. Specifically, it was assessed whether sodium hypochlorite at a clinically recommended concentration (2.5% NaOCl) would bleach with similar efficacy as a peroxide-based irrigant at higher molarity (5% H2O2). Furthermore, the effects of a NaOCl-compatible chelator with a high affinity to iron (Dual Rinse HEDP) were investigated. Methods Human whole blood was mixed at a 1:20 ratio with either phosphate-buffered saline, 9% HEDP, 2.5% NaOCl, 2.5% NaOCl containing 9% HEDP, or 5% H2O2. Effects were assessed spectrometrically and photographically. Human dentin specimens were prepared with a methacrylate reservoir for liquids and a polished assessment side over 1 mm dentin thickness. Dentin was stained using human whole blood for 3 weeks and subsequently exposed to the irrigants for 60 min. Measurements were performed in the CIELAB color space. Results were compared using parametric tests with the alpha-type error set to 5%. Results When directly exposed, the solutions containing NaOCl completely discolored the blood, while the 5% H2O2 exerted a bleaching effect without complete dissolution of dissolved matter, and the pure 9% HEDP had no effect at all. The NaOCl solutions bleached blood-stained dentin more efficiently than H2O2 (p < 0.05). Conclusions Under the current conditions, the 2.5% NaOCl solution had a stronger bleaching effect on blood and blood-stained dentin than 5% H2O2. HEDP did not have any direct impact on blood color or NaOCl-derived bleaching.
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Affiliation(s)
- Adrian Zollinger
- Clinic of Preventive Dentistry, Periodontology and Cariology, University of Zurich, Center of Dental Medicine, Switzerland
| | - Thomas Attin
- Clinic of Preventive Dentistry, Periodontology and Cariology, University of Zurich, Center of Dental Medicine, Switzerland
| | - Dirk Mohn
- Clinic of Preventive Dentistry, Periodontology and Cariology, University of Zurich, Center of Dental Medicine, Switzerland
- Institute for Chemical and Bioengineering, Department of Chemistry and Applied Biosciences, ETH Zurich, Switzerland
| | - Matthias Zehnder
- Clinic of Preventive Dentistry, Periodontology and Cariology, University of Zurich, Center of Dental Medicine, Switzerland
- Corresponding author.
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Chubb DWR. A review of the prognostic value of irrigation on root canal treatment success. AUST ENDOD J 2019; 45:5-11. [DOI: 10.1111/aej.12348] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2019] [Indexed: 11/29/2022]
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47
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Baras BH, Wang S, Melo MAS, Tay F, Fouad AF, Arola DD, Weir MD, Xu HHK. Novel bioactive root canal sealer with antibiofilm and remineralization properties. J Dent 2019; 83:67-76. [PMID: 30825569 DOI: 10.1016/j.jdent.2019.02.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 02/09/2019] [Accepted: 02/20/2019] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES (1) To develop a novel bioactive root canal sealer with antibiofilm and remineralization properties using dimethylaminohexadecyl methacrylate (DMAHDM) and nanoparticles of amorphous calcium phosphate (NACP); (2) investigate the effects on E. faecalis biofilm inhibition, sealer flow and sealing ability, compared with an epoxy-resin-based sealer AH Plus; and (3) investigate the calcium (Ca) and phosphate (P) ion release from the sealers. METHODS A series of dual-cure endodontic sealers were formulated with DMAHDM and NACP at 5% and 20% by mass, respectively. Flow properties and sealing ability of the sealers were measured. Colony-forming units (CFU), live/dead assay, and polysaccharide production of biofilms on sealers were determined. Ca and P ion releases from the sealers were measured. RESULTS The new sealer containing 20% NACP and 5% DMAHDM yielded a paste flow of (28.99 ± 0.69) mm, within the range of ISO recommendations. The sealing properties of the sealer with 5% DMAHDM and 20% NACP were similar to a commercial control (p > 0.05). The sealer with DMAHDM decreased E. faecalis biofilm CFU by more than 4 orders of magnitude, compared to AH plus and experimental controls. The sealer with 20% NACP and 5% DMAHDM had relatively high levels of Ca and P ion release necessary for remineralization. CONCLUSIONS A new bioactive endodontic sealer was developed with strong antibiofilm activity against E. faecalis biofilms and high levels of Ca and P ion release for remineralization, without compromising the paste flow and sealing properties. CLINICAL SIGNIFICANCE The bioactive antibacterial and remineralizing root canal sealer is promising to inhibit E. faecalis biofilms to prevent endodontic treatment failure and secondary endodontic infections, while releasing high levels of Ca and P ions that could remineralize and strengthen the tooth structures and potentially prevent future root fractures and teeth extractions.
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Affiliation(s)
- Bashayer H Baras
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, MD 21201, USA; Department of Restorative Dental Science, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Suping Wang
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, MD 21201, USA; Department of Operative Dentistry and Endodontics & Stomatology Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Mary Anne S Melo
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, MD 21201, USA
| | - Franklin Tay
- Department of Endodontics, Dental College of Georgia, Augusta University, Augusta, GA, USA
| | - Ashraf F Fouad
- Department of Endodontics, School of Dentistry, University of North Carolina, Chapel Hill, NC 27599-7450, USA
| | - Dwayne D Arola
- Department of Materials Science and Engineering, University of Washington, Seattle, WA 98195, USA
| | - Michael D Weir
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, MD 21201, USA.
| | - Hockin H K Xu
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, MD 21201, USA; Center for Stem Cell Biology & Regenerative Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA; Marlene and Stewart Greenebaum Cancer Center, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
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Souza EM, Quadros JDRP, Silva EJNL, De-Deus G, Belladonna FG, Maia-Filho EM. Volume and/or Time of NaOCl Influences the Fracture Strength of Endodontically Treated Bovine Teeth. Braz Dent J 2019; 30:31-35. [DOI: 10.1590/0103-6440201902076] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 08/07/2018] [Indexed: 11/22/2022] Open
Abstract
Abstract The aim of this study was to evaluate whether amplifying the volume and/or time of contact of NaOCl affects the fracture strength of endodontically treated bovine teeth. Four bovine incisors from 10 animals were allocated into 4 groups using a split-mouth design. Root canals were instrumented using a sequence of 4 manual stainless steel files and irrigated with a 5.25% alkalized NaOCl solution. The total volume and time of irrigation, per sample, varied among the groups as following: standard volume and time of contact - 15 mL/11.5 min; volume raise - 30 mL/11.5 min; time of contact raise - 15 mL/19 min; and volume and time of contact raise - 30 mL/19 min. Samples were subjected to a fracture resistance assay. At p=0.05, two-way ANOVA statistically scrutinized the results. Effect size of NaOCl time of contact and volume were also calculated (η2). The variation in time (p=0.000), volume of irrigation (p=0.000) and the combination of both (p=0.038) negatively influenced the fracture resistance. Standard volume and time of irrigation showed the highest fracture strength while isolated increase in volume or time reduced in 25% and 37%, respectively, the fracture resistance; the simultaneous increase in volume and time of irrigation promoted a reduction of 47%. Effect size of NaOCl time of contact was superior (0.746) than the volume (0.564). Raising the volume and/or time of a 5.25% alkalized NaOCl solution reduces the fracture resistance of endodontically treated bovine teeth.
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49
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Morgan AD, Ng YL, Odlyha M, Gulabivala K, Bozec L. Proof-of-concept study to establish an in situ method to determine the nature and depth of collagen changes in dentine using Fourier Transform Infra-Red spectroscopy after sodium hypochlorite irrigation. Int Endod J 2018; 52:359-370. [PMID: 30144371 DOI: 10.1111/iej.13004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 08/22/2018] [Indexed: 11/28/2022]
Abstract
AIM To establish a method using Fourier Transform Infra-Red spectroscopy (FTIR) to characterize the nature and depth of changes in dentinal collagen following exposure to sodium hypochlorite (NaOCl) during root canal irrigation in an ex vivo model. METHODOLOGY Fourier Transform Infra-Red spectroscopy was used to assess the changes in dentinal collagen when the root canal was exposed to NaOCl. The changes in dentinal collagen caused by NaOCl irrigation of root canals in transverse sections of roots, at 0.5 mm from the canal wall and 0.5 mm from the external root surface, were assessed by FTIR. The data were analysed using paired t-test with 5% significance level. RESULTS Fourier Transform Infra-Red spectroscopy confirmed that NaOCl exposure caused alterations in the chemistry and structure of collagen in dentine. FTIR spectra obtained from dentine surfaces and dentine adjacent to root canals exposed to NaOCl, all consistently showed degradation and conformational change of the collagen structure. FTIR data from the ex vivo model showed that the depth of effect of NaOCl extended to at least 0.5 mm from the canal wall. CONCLUSION In extracted human teeth, NaOCl caused changes in dentinal collagen that were measurable by FTIR. In an ex vivo model, the depth of effect into dentine extended at least 0.5 mm from the canal wall.
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Affiliation(s)
- A D Morgan
- Unit of Endodontology, Division of Restorative Dental Science, UCL Eastman Dental Institute, London, UK
| | - Y-L Ng
- Unit of Endodontology, Division of Restorative Dental Science, UCL Eastman Dental Institute, London, UK
| | - M Odlyha
- Department of Biological Sciences, Birkbeck, University of London, London, UK
| | - K Gulabivala
- Unit of Endodontology, Division of Restorative Dental Science, UCL Eastman Dental Institute, London, UK
| | - L Bozec
- Division of Biomaterials & Tissue Engineering, UCL Eastman Dental Institute, London, UK
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50
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Coaguila-Llerena H, Stefanini da Silva V, Tanomaru-Filho M, Guerreiro Tanomaru JM, Faria G. Cleaning capacity of octenidine as root canal irrigant: A scanning electron microscopy study. Microsc Res Tech 2018; 81:523-527. [DOI: 10.1002/jemt.23007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 01/31/2018] [Accepted: 02/06/2018] [Indexed: 11/06/2022]
Affiliation(s)
- Hernán Coaguila-Llerena
- Araraquara School of Dentistry, Department of Restorative Dentistry; UNESP - São Paulo State University; Araraquara SP Brazil
| | - Virgínia Stefanini da Silva
- Araraquara School of Dentistry, Department of Restorative Dentistry; UNESP - São Paulo State University; Araraquara SP Brazil
| | - Mario Tanomaru-Filho
- Araraquara School of Dentistry, Department of Restorative Dentistry; UNESP - São Paulo State University; Araraquara SP Brazil
| | | | - Gisele Faria
- Araraquara School of Dentistry, Department of Restorative Dentistry; UNESP - São Paulo State University; Araraquara SP Brazil
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