Effect of Different Irrigation Solutions on the Diffusion of MTA Cement into the Root Canal Dentin.

José Pedro Martinho,Sara França,Henrique Girão,Siri Paulo,Eunice Carrilho,Carlos Miguel Marto,Maria Filomena Botelho,Anabela Baptista Paula,Francisco Caramelo,Ana Sofia Coelho,Manuel Marques-Ferreira,Ana Margarida Abrantes

doi:10.3390/ma13235472

Abstract

(1) Aim: This study aims to analyze the in vitro infiltration of a silicate root canal sealer into dentinal tubules after using different endodontic irrigating solutions. (2) Methods: Twenty-nine teeth with single roots were separated into three groups according to the final irrigation protocol: G1 n = 10) = 17% EDTA (ethylenediaminetetraacetic acid) + 3.0% sodium hypochlorite (NaOCl), G2 (n = 10) = 17% EDTA + 2.0% chlorhexidine and G3 (Control group, n = 9) = 17% EDTA + saline solution. Root canals were filled using cold lateral compaction technique with MTA Fillapex sealer and gutta-percha. The sealer was labeled with rhodamine B. The teeth were segmented at the middle and third apical sections, which were visualized using 10× confocal laser microscopy to determine the sealer penetration percentage. (3) Results: In the apical section, no statistically significant differences were found between the groups regarding sealer penetration. In the middle section, Group 1 obtained the highest percentage, and Group 2 the lowest (p = 0.004). Group 1 also presented statistically significant differences in the Control Group (p = 0.031) and had close sealer penetration values. Meanwhile, the Control Group (p = 0.023) and Group 2 (p = 0.029) revealed a significant decrease of sealer penetration between the apical and middle sections. (4) Conclusion: The obtained results support that final irrigation with NaOCl promoted similar sealer penetration in the apical and middle sections. On the other hand, a significant decrease in the sealer penetration of the middle section was observed for the chlorhexidine and saline groups. Compared to other irrigant solutions, NaOCl promotes more uniform sealer penetration, which can correlate with better sealing and, consequently, higher endodontic treatment success.

Highlights

Endodontic treatment aims to maintain healthy periapical tissue and prevent the reinfection of the root canal system
The present study aimed to compare the penetration of Mineral trioxide aggregate (MTA) Fillapex® into dentinal tubules after final irrigation with saline solution, chlorhexidine and sodium hypochlorite
Since we aimed to determine the penetration of the sealer into the root dentinal tubules, the incorporation of Rhodamine B into the sealer was essential to observe the extent of sealer adaptation and penetration, as proven previously [33,34]

Summary

Introduction

Endodontic treatment aims to maintain healthy periapical tissue and prevent the reinfection of the root canal system. In addition to a substantial part of the root walls not being touched by these instruments [6], mechanical preparation promotes the formation of an organic and inorganic debris layer designated by the smear layer [7]. The presence of this 2–5 μm thick layer prevents the penetration of the intracanal medication and the filling material into the dentinal tubules, so its removal is vital to improving the adaptation of the filling material to the root canal walls [7,8].

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Methods

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Discussion

Conclusion