Influence of Commonly Used Endodontic Irrigants on the Setting Time and Metal Composition of Various Base Endodontic Sealers.

Jerry Jose,Deepti Shrivastava,Kavalipurapu Venkata Teja,Roshan Noor Mohamed,Manish Ranjan,Anil Kumar Nagarajappa,Mohammad Khursheed Alam,Kumar Chandan Srivastava,Valentino Natoli,Krishnamachari Janani

doi:10.3390/polym14010027

Abstract

The present study aimed to evaluate if commonly used endodontic irrigants such as 3% sodium hypochlorite (NaOCl, Prime Dental, Thane, India), 2% chlorhexidine (CHX, Sigma-Aldrich Co., St. Louis, MO, USA), and 17% ethylenediaminetetraacetic acid (EDTA, Meta-Biomed Co. Ltd., Cheongju-si, South Korea) influenced the setting time and metal composition of different base endodontic sealers on exposure. AH Plus (Dentsply De Trey GmbH, Konstanz, Germany), Sealapex (SybronEndo, Orange, CA, USA), mineral trioxide aggregate (MTA) Fillapex (Angelus Soluções Odontológicas, Londrina, Brazil), and Tubli-Seal (Kerr Dental, Orange, CA, USA) were selected as the different base representatives of endodontic sealers. These sealers were exposed to 3% NaOCl, 2% CHX, and 17% EDTA, and the individual setting time of the sealers was analyzed. The samples were analyzed for heavy metal elements such as chromium (Cr), nickel (Ni), cobalt (Co), cadmium (Cd), arsenic (As), mercury (Hg), lead (Pb), and beryllium (Be) by using inductively coupled plasma mass spectrometry (ICP-MS) analysis. For statistical analysis, one-way ANOVA and post hoc Tukey’s tests were used. All selected sealers showed variation in setting time post-exposure to different irrigants. MTA Fillapex had the shortest mean setting time (215.7 min, post-exposure at 187.3 min) (p < 0.05). Mean setting time was also affected for AH Plus (479.6 min, post-exposure at 423.9 min) (p < 0.05) and Tubli-Seal (514.7 min, post-exposure at 465.2 min) (p < 0.05). Sealapex showed the maximum reduction of setting time (864.8 min, post-exposure at 673.4 min) (p < 0.05). All tested sealers showed heavy metals (Cr, Ni, Co, Cd, As, Hg, and Pb) in their composition, and the quantities were influenced by interaction with different irrigants. The heavy metal Be was not seen in any of the samples. Sealapex showed the longest setting time in comparison to other test sealers. Heavy metals were most present in Sealapex, followed by AH Plus, Tubli-Seal, and MTA Fillapex. MTA Fillapex was seen to have the shortest setting time, and heavy metal composition was least affected on interaction with different commonly used endodontic irrigants. Further, this study provides significant insight into the influence of different endodontic irrigants on interaction with different base endodontic sealers, which has not been reported previously, and future studies should emphasize endodontic irrigant-sealer interactions and their possible effects in the long run.

Highlights

Endodontic sealers are considered to be one of the fundamental requisites of endodontic therapy, with the primary function to fill voids and infiltrate areas of the root canal system such as lateral and accessory canals where the core obturating material fails to reach, resulting in a complete seal of the root canal complexities [1]
mineral trioxide aggregate (MTA) Fillapex (Angelus Soluções Odontológicas, Londrina, Brazil), though not a true representative of this class of sealers, which consists of both Portland cement and butyl ethylene glycol disalicylate with a high resin/MTA ratio, has been shown to exhibit lower viscosity, lower solubility, better bioactivity, and better osteoconductive properties, compared to other base endodontic sealers [15]
Prior studies have reported to some extent about influence of endodontic irrigants on the physicochemical properties of endodontic sealers [24], for instance, Rocha et al [25] showed that irrigants such as 2% CHX and 2.5% NaOCl had influenced the properties of epoxy-based endodontic sealers’ bond strength on radicular dentin

Summary

Introduction

Endodontic sealers are considered to be one of the fundamental requisites of endodontic therapy, with the primary function to fill voids and infiltrate areas of the root canal system such as lateral and accessory canals where the core obturating material fails to reach, resulting in a complete seal of the root canal complexities [1]. Tubli-Seal (Kerr Dental, Orange, CA, USA) was introduced, which showed advantages such as less cytotoxic effect on extraradicular cells and better dissolution properties, compared to epoxy-based sealers [8,9]. With the introduction of calcium hydroxide-based sealers with salicylate components such as Sealapex (SybronEndo, Orange, CA, USA), a significant increase in antibacterial properties was witnessed, mainly due to alkaline pH properties causing denaturation of bacterial proteins, making them less toxic to vital tissues. They stimulate osteogenic and cementogenic properties of bone-forming cells in comparison to resin-based sealer [12,13]. MTA Fillapex (Angelus Soluções Odontológicas, Londrina, Brazil), though not a true representative of this class of sealers, which consists of both Portland cement and butyl ethylene glycol disalicylate with a high resin/MTA ratio, has been shown to exhibit lower viscosity, lower solubility, better bioactivity, and better osteoconductive properties, compared to other base endodontic sealers [15]

Methods

Findings

Discussion

Conclusion