Abstract

This study aimed to examine the penetration depth into dentinal tubules of some chelating agents. The 17% EDTA and two preparations containing surfactants (Smear Clear, Bioakt Endo) were tested. Surface tension and liquid viscosity were measured using a Dynamic Contact Angle Analyzer and a Haake rotational rheometer. To measure the penetration depth inside dentinal tubules, thirty maxillary central incisors were selected from a pool of extracted human permanent teeth and allocated to three experimental groups (10 samples each), as well as were mechanically shaped and cleansed with 5.25% NaOCl, followed by each of the chelators being labeled with 0.1 wt % Rhodamine B according to final irrigation protocol established. The samples were embedded in an epoxy resin, after which 200 μm thick transverse sections were obtained at 2, 5, and 8 mm from the apex with a saw microtome. The specimens were then observed using a confocal laser microscope (CLSM) and the penetration of the labeled solution was measured in every third of each sample. Statistical analysis was performed using ANOVA or Kruskal–Wallis tests according to the distribution of data, evaluated with the Shapiro–Wilk normality test. Viscosity and surface tension tests have shown that BioAKT Endo has the lowest values compared to EDTA and Smear Clear. The medium penetration depth did not significantly differ among the three irrigants, while it increased considerably from the apical to the coronal level in all groups. Additionally, the maximum penetration depth increased significantly from the apical to coronal level, while among groups, BioAKT Endo showed the highest values at the apical and middle level compared to the other irrigants. No significant differences were observed among the three groups in medium and maximum penetration depths when the entire root was considered. New irrigants containing surfactants show reduced surface tension and, in one case (BioAKT Endo), viscosity. The lowering of the surface tension allows for better penetration of liquids into dentinal tubules than EDTA alone, thus improving the cleaning of the root canal system.

Highlights

  • The primary goal of endodontic therapy is to eradicate bacteria from the infected root canals and prevent their reinfection [1]

  • The 17% ethylenediaminetetraacetic acid (EDTA) solution had the highest surface tension value compared to all other solutions (p < 0.001), while Bioakt Endo had the lowest one

  • As for medium penetration, since no significant differences emerged among the irrigants, the null hypothesis must be accepted, it must be rejected for the maximum penetration depth as BioAKT Endo and Smear Clear had significantly better performances

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Summary

Introduction

The primary goal of endodontic therapy is to eradicate bacteria from the infected root canals and prevent their reinfection [1]. The antibacterial effect, achieved by endodontic treatment, is more likely affected by the degree of the penetration of irrigants to scavenge bacteria residing deeply inside infected dentinal tubules than by the instrumentation of the root canal system because the shaping protocol revealed deficient debridement and areas untouched by both the manual K-files and rotary or reciprocating instruments [6]. Due to these limitations, in recent years, research on root canal irrigation quality and efficiency has focused on irrigating solutions with better cleaning and antibacterial activity as a necessary complement to mechanical preparation. Due to their high surface tension, both irrigants do not deeply penetrate into dentinal tubules or other irregularities as isthmuses [8]

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