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.
Highlights
Though EDTA is widely used in daily clinical practice, it has several disadvantages such as cytotoxicity, reduced bonding of resin sealers, reduced smear layer removal efficacy in apical third, loss of available chlorine when mixed with NaOCl, and precipitate formation with chlorhexidine [5,6,7,8,9]
The maximum decrease was seen in the groups with pure NaOCl without the addition of HEDP
The HEDP counter-acted this effect in a dose-dependent manner
Summary
During mechanical instrumentation of the root canal, a smear layer is formed on the radicular dentin and clogs the orifices of the dentinal tubules [1]. This smear layer can contain bacteria and prevent antimicrobial agents and sealants from gaining access to underlying contaminated dentinal tubules [2,3]. An alternating application of ethylenediaminetetraacetic acid and sodium hypochlorite (NaOCl) is frequently recommended for the effective removal of smear layer from the root canal system [4]. Rather than removing a smear layer that has already formed, the continuous application of a combined solution of HEDP and
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