BioPure MTAD Research Articles

Effectiveness of chitosan nanoparticles, and novel chemical irrigants with surfactant on smear layer removal and microhardness alteration

ObjectiveThis current study was designed to compare and correlate between smear layer eradication and reduction in microhardness by natural 0.2%chitosan nanoparticles and novel chemical irrigants with surfactant at the apical root third. Materials and methodOne hundred and twenty straight single-rooted extracted lower premolars were decoronated and working length obtained with #10 K-file. Pro-taper rotary files were used till apical size F3. The canals were simultaneously flushed with assigned irrigant containing surfactant [(ChX-Ultra, NaOCl-Extra, Pro-EDTA, 0.2%chitosan nanoparticles, Biopure MTAD]. The samples were randomly divided into two equal groups (n = 60). InGroup S (n = 60), the residual smear layer was examined by scanning electron microscope and in Group M(n = 60) microhardness was determined by Vickers Microhardness Tester. Further both groups were divided into six equal groups (n = 10 each) according to assigned irrigating solutions.For smear layer removal; Kruskal-Wallis tests followed by pair wise comparison using Mann Whitney U test was done. For change in microhardness ANOVA and post hoc Tukey tests was done. ResultsMaximum smear layer removal was recorded in Biopure MTAD (1.8 ± 0.63), followed by pro-EDTA (2.2 0 ± 0.63) then 0.2%chitosan (2.6 ± 0.51), then NaOCL Extra (3.5 ± 0.53)and least in CHX-Ultra (4.4 ± 0.52) and saline (5.0 ± 0.00). Pro-EDTA group (12.8 ± 2.47) revealed significant highest reduction in microhardness followed by Biopure MTAD (8.01 ± 3.06), 0.2%chitosan nanoparticles (5.48 ± 2.87), NaOCl-Extra (5.44 ± 1.62) and least recorded in CHX-Ultra (4.94 ± 1.43) and saline (3.04 ± 0.63). ConclusionThe elimination of the smear layer is always accompanied by a reduction in microhardness. Moreover, irrigant with surfactant and chelators enhanced smear layer removal, with best perceived in Biopure MTAD.

Evaluation of surface tensions and root-dentin surface contact angles of different endodontic irrigation solutions

BackgroundSurface tension and contact angle properties, which play a crucial role in determining the effectiveness of irrigation solutions in penetrating dentin surfaces and dentin tubules, are highly important for the development of new irrigation solutions and their preferences. The aim of the current study was to compare the surface tension and contact angle properties of different irrigation solutions used in endodontics, both on the dentin surface and within dentin tubules.MethodsIn this study, the contact angles and surface tensions of 5.25% sodium hypochlorite (NaOCl), 17% ethylenediaminetetraacetic acid (EDTA), 2% chlorhexidine (CHX), 5% boric acid (BA), 0.02% hypochlorous acid (HOCl), 0.2% chlorine dioxide (ClO2), Biopure MTAD, QMix solutions, and distilled water (control group) were measured. Measurements were conducted using a goniometer device (Attension Theta Lite Tensiometer, Biolin Scientific, USA), employing the sessile drop method for contact angle measurements on pre-prepared dentin surfaces, and the pendant drop method for surface tension.ResultsContact angle measurements revealed no statistically significant differences between the contact angle values of MTAD, ClO2, and CHX or between NaOCl, QMix, BA, and HOCl (p > 0.05). However, EDTA exhibited a significantly greater contact angle than did MTAD, ClO2, CHX, NaOCl, QMix, BA, and HOCl (p < 0.05). Furthermore, the contact angle of dentin with distilled water was greater than that with all other solutions tested (p < 0.05). Surface tension measurements revealed that the surface tension values of QMix and MTAD were statistically similar (p > 0.05). CHX exhibited lower surface tension than distilled water and HOCl (p < 0.05), and it also had lower surface tension than ClO2, NaOCl, and BA (p < 0.05). Additionally, the surface tension of the samples treated with EDTA was greater than that of all other solutions tested (p < 0.05).ConclusionThe direct linear relationship between the surface tension of liquids and contact angles on different surfaces may not always hold true, and these values should be considered independently for each solution on various surfaces. Considering the contact angles and surface tension properties of irrigation solutions with root canal dentin, it can be suggested for clinical use that ClO2 could be recommended over NaOCl, and similarly, BA could be recommended over EDTA.

Effect of Addition of Cetylpyridinium Chloride Cationic Surfactant on the Antimicrobial Activity of Chlorhexidine Endodontic Irrigant.

Endodontic irrigants are essential for disinfecting the root canal system. None of the currently available irrigants perfume sufficiently. However, most products contain surfactants, which enhance the antimicrobial properties of the irrigants. To evaluate the effect of cetylpyridinium chloride (CPC) surfactant on the antimicrobial activity of chlorhexidine and compare it with that of chlorhexidine (CHX) and Biopure MTAD against Enterococcus faecalis, Staphylococcus aureus, and Candida albicans. In this in vitro study, three microorganisms were used (E. faecalis, S. aureus, and C. albicans), and each organism was treated with three different irrigants: 2% CHX, 2% CHX + 0.2% CPC, and 100% Biopure MTAD. The antimicrobial activity was evaluated by direct contact assay for 5 min of contact time. The colony-forming unit per mL was calculated after antimicrobial treatment and 24 hr of incubation at 37°C. The data were statistically analyzed using Statistical Package for Social Science (SPSS) version 22. The Kruskal-Wallis and the multiple Wilcoxon sum rank tests were used. The level of significance was set at 0.05. The result showed a nonsignificant difference between the different irrigants against E. faecalis. Among S. aureus subgroups, 2% CHX was statistically significant and more efficient than MTAD. Among C. albicans subgroups, 2% CHX and combined irrigant (2% CHX + 0.2% CPC) were statistically more efficient than MTAD. The 2% CHX and combined irrigants were equally effective against all the tested microorganisms. All the used irrigants have comparable effects against E. faecalis after 5 min. CHX have a comparable effects to that of the combined irrigant and more efficient against S. aureus than MTAD. CHX and the combined irrigant have potent antimicrobial activity against C. albicans superior to MTAD. CPC surfactant can be used with CHX to overcome its clinical drawbacks or limitations without altering or reducing its antimicrobial activity.

Comparative Evaluation of Residual Antibacterial Substantivity of Chlorhexidine, MTAD and Chitosan Against Enterococcus Faecalis in Human Root Dentin - An In vitro Study.

Complex anatomy of the root canal system results in incomplete debridement with mechanical instrumentation, leaving some areas or root canal walls untouched. There comes the significance of endodontic irrigants with residual antibacterial substantivity which prolongs the post-antibiotic effect, thereby improving the success and predictability of endodontic treatment. To comparatively evaluate the residual antibacterial substantivity of 2% chlorhexidine, Biopure MTAD and 2% chitosan against Enterococcus faecalis at intervals of 1, 14 and 28 days. Seventy-five therapeutically extracted permanent single rooted mandibular premolars teeth were selected. Dentin blocks of 4 mm thickness were prepared and enlarged to 1.6 mm. The autoclaved blocks were inoculated with 24-hour colonies of pure cultures of E. faecalis for 14 days. After the contamination period, canals of each dentin block were irrigated with 5 ml of sterile saline and dried with sterile paper points. A total of 75 dentin blocks were randomly divided into five groups as follows: Group A (21 specimens): 2% chlorhexidine, Group B (21 specimens): Biopure MTAD, Group C (21 specimens): 2% chitosan, Group D (6 specimens): positive control (infected dentin tubes) and Group E (six specimens): negative control (sterile dentin tubes). Then, the lumens of dentin blocks were irrigated with the respective irrigants for 10 mins and were dried using sterile paper points. The specimens were then incubated at 37°C for 28 days to maintain humidity. At experimental intervals of 1, 14 and 28 days, dentin shavings were removed from the canals of respective groups by circumferential filing with sterile no. 35 Hedstrom files. The powdered dentin samples obtained with each dentin block were observed for colony forming units (CFUs) using a Digital Colony counter and were expressed as CFUs/mL. All the irrigants in the study showed a significant decrease in CFUs from day 1 to day 28 indicating that they have residual antibacterial substantivity against E. faecalis. Group B (Biopure MTAD) showed significantly least mean CFUs compared to Group A (2% CHX) and Group C (2% chitosan) against E. faecalis at B1(day 1), B2(day 14) and B3(day 28). Group A (2% CHX) showed significantly higher mean CFUs than Group C (2% chitosan) at A1(day 1). Group C (2% chitosan) showed significantly higher mean CFUs compared to Group A (2% CHX) at C2(day 14) and C3 (day 28). MTAD showed statistically higher residual antibacterial substantivity against E. faecalis at experimental periods of 1, 14 and 28 days. The residual antibacterial effect of 2% chitosan was better compared to 2% CHX at day 1. The residual antimicrobial substantivity of 2% CHX was higher compared to 2% chitosan at intervals of 14 and 28 days.

Evaluation Of the Antibacterial Effect of MTAD And Vanillin Against Root Canal Bacteria Running Title: MTAD And Vanillin Against Root Canal Bacteria

Objective: Comparison of the effectiveness of Bio pure MTAD (mixture of Doxycycline, citric acid and a detergent) versus vanillin(V) as an endodontic aqueous solutions for tested canals infected with E. faecalis and S. Mutans. Materials and methods : Fourty human extracted lower bicusped teeth (single-rooted) unit at the cementoenamel junction (CEJ) were decoronated. Thereafter, the teeth were prepared with Protper NiTi rotary files till (F3 [30/.06). Then samples are often divided into “2” main groups (18/each), infected by bacteria and incubated in brain heart infusion (BHI) for forty-eight hours at “37°C”. Then the teeth were sub-divided into three groups(N=6) according to the irrigation protocol (MTAD, V, and Distilled water”DW”, which was the control group ”Gp.”).-ve control(N=4). Dentin chips were removed from the canals by sterile low-speed handpiece spherical bur, transfered to BHI, then cultured to count the growing colonies which were recorded as colony forming unit (CFU).Results : Siginficant differences were found in the bactericidal efficacy of (Bio pure MTAD, V and DW) irrigations. Conclusion:Bio pure MTAD had the maximum antibacterial efficacy on E.faecalis and S. mutans as compared to vanillin and DW. Significance and impact of the study: Understanding the mode of action of natural antimicrobials(V) on endodontic therapy may facilitate their application as natural endodontic solutions, particularly for their potential use in endodontic irrigation protocol employing multiple hurdles.Additionally compared these natural compound with artificial one like MTAD and so on.

Outcome of single-visit root canal treatment with or without MTAD: A randomized controlled clinical trial.

This study aimed to investigate 2-year changes in periapical trabecular patterns in single-rooted teeth with apical periodontitis using fractal analysis and periapical index (PAI) after root canal treatment performed with or without BioPure MTAD solution. In this randomized clinical trial, 100 patients were selected and randomized to either the BioPure MTAD or the control groups. Initial periapical radiographs were obtained for each participant before and 2 years after root canal treatment. The region of interest in the periapical lesion around the root apex was selected from the paired periapical radiographs, and then, the fractal dimension (FD) was calculated. With regards to the classification of periapical status, PAI was labelled as "healed" (PAI ≤ 2) or "unhealed" (PAI ≥ 3). After 24 months, 28 patients did not comply with the follow-up and the data of 72 patients were compared. When the initial and the follow-up PAI scores were compared, the decrease was statistically significant in 33 of 37 teeth (89.2%) and 32 of 35 teeth (91.4%) in the BioPure MTAD and control group, respectively. In both groups, statistically significant increases were observed in FD values after 2 years in all patients (p < .001). No significant difference was found between the two groups amongst decreased PAI scores and increased FD values. Root canal treatments with or without BioPure MTAD irrigation contributed to periapical healing in single-visit root canal treatment. Two years after root canal treatment, the extent of the periapical trabecular bone radiographically increased, as the FD and PAI data revealed.

Comparative Evaluation of Antimicrobial Activity of Herbal and Nonherbal Root Canal Irrigants on Enterococcus faecalis: An in vitro Study

Introduction: Enterococcus faecalis is one of the most prevalent pathogens in infected root canals. Even though the role of irrigants in controlling pathogens is well established, there is a chance for drug resistance and cytotoxicity in using chemical irrigants, Therefore newer researches have forced the man to look the herbal way. Aim of the Study: This study aims to evaluate and compare the anti-bacterial effects of nonherbal and herbal root canal irrigants on E. faecalis. Methodology: The study was conducted on 110 permanent extracted human teeth each root canal was inoculated with a culture suspension of E. faecalis and then randomly assigned into groups, (i) Herbal group (QMix™ 2 in 1, Endoseptone, Biopure MTAD) and (ii) Nonherbal group (Morinda citrifolia juice, Triphala juice, Coconut milk), and control group (Sodium hypochlorite and Distilled water). Colony forming units (CFUs) were evaluated and counted at baseline (S0), immediatedly after irrigation (S1) and after 3 days (S2). The Friedman two-way ANOVA was used to compare the obtained mean of log CFU. Results: Both the herbal and nonherbal groups had a significant reduction in the number of CFUs. The greatest anti-microbial effects were observed in nonherbal group against E. faecalis. Conclusion: While the herbal group also demonstrated significant reductions, the nonherbal group experienced the greatest overall anti-microbial effects of the various irrigants. Research into the herbal irrigants is necessary since they have the potential to be effective irrigants.

Farklı Tiplerdeki Kök Kanal Yıkama Solüsyonlarının İnsan Osteoblastik Hücre Canlılığı Üzerine Etkileri

ABSTRACT&#x0D; Objective: Root canal irrigation is very important for successful root canal treatment. During this procedure, root dentin and periapical tissues are in contact with irrigation solutions. These solutions should ideally remove pulpal tissues without damaging the oral tissues. The aim of this study was to evaluate the effects of 7 different irrigation solutions (Rocanal, BioPure MTAD, SmearClear, chlorhexidine gluconate, EDTA, hydrogen peroxide, NaOCl) on the viability of human osteoblastic cell lines (SaOS-2).&#x0D; Methods: The tested solutions were diluted with culture medium and prepared in 6 different concentrations (1:2, 1:4, 1:8, 1:16, and 1:32). SaOS-2 cells were exposed to all concentrations of irrigation solutions, respectively (n = 12). Cell culture medium without test material was used as a control group. Cell viability was evaluated with the MTT cytotoxicity test. The cell viability of the control group was equal to 100%, and the data were statistically evaluated by One-way ANOVA and post-hoc Tukey's HSD tests.&#x0D; Results: All tested solutions had cytotoxic effects on SaOS-2 cells at all concentrations (P &lt; 0.05). There was difference in percentage between the cell viability values of the materials (P

Comparative evaluation of root canal dentin erosion after using different smear layer removing solutions for root canal irrigation by scanning electron microscope (SEM) and energy dispersive x-ray spectroscopy (EDS): An in-vitro study

Objective: To evaluate and compare the effect of different final irrigating solutions (17% EDTA, Smear Clear, QMix and BioPure MTAD) on root canal dentin erosion in the coronal, middle and apical third of root by Scanning Electron Microscope (SEM) and Energy Dispersive Spectroscopy (EDS). Materials and Methods: A total of 105 recently extracted mandibular premolars were taken and decoronated to a standardized root length of 12mm. They were prepared using ProTaper system up to size F3. Initial rinse was done with sodium hypochlorite. After completion of root canal preparation, all root canals were subjected to final irrigation protocol. Group 1 was irrigated with 17% EDTA for 1 min. Group 2 was irrigated with Smear Clear for 1 min. Group 3 was irrigated with QMix for 1 min. Group 4 was irrigated with MTAD for 5 min. Group 5 was irrigated with distilled water. Out of 21 samples in each group, 10 were analysed by SEM and 11 were analysed by EDS. Results: The results of the SEM analysis revealed that the use of 17% EDTA and Smear Clear resulted in significantly more erosion than the use of QMix and MTAD. No statistically significant difference was observed at the coronal, middle and apical thirds in the amount of dentin erosion. The results of EDS analysis revealed that all treatment groups significantly decreased calcium content in comparison to control group. However, no significant difference was observed among EDTA, Smear Clear, Qmix and MTAD in decreasing calcium levels in dentin. Conclusion: BioPure MTAD and QMiX cause negligible dentin erosion and thus can be used as alternative final irrigating solutions after sodium hypochlorite instead of EDTA and Smear Clear.

Efficacy of Multiple Rotary File Systems in Retreatment of Oval-shaped Root Canals in Mandibular Molars: A Cone-Beam Computed Tomography Study

Aim: To evaluate effectiveness of multiple rotary file systems on removal of the filling materials during retreatment of oval-shaped root canals. Methods: 40 oval root canals were instrumented with ProTaper Next to size X4. The canals were allocated into two equal groups according to the final rinse, Group I: with Biopure MTAD, and Group II: with 17% EDTA. All the canals were obturated with bioceramic based root canal sealer and gutta-percha using lateral compaction technique. According to the used retreatment rotary system, each group were further subdivided into two equal subgroups including subgroups Ia & IIa using D-Race (DR1) + XP-endo Shaper (XPS) + XP-endo Finisher R (XPFR), and subgroups Ib & IIb using R-Endo retreatment files up to R3 + Revo-S rotary files up to (40/.06). CBCT scans were used to calculate the remaining amount of root filling materials at the pre scan (after obturation), and that of air at the post scan (after retreatment). The dentin volumes were also recorded at both scans to analyze the amount of remaining filling materials. Results: No significant differences were recorded regarding the amount of residual filling material with the tested systems (p > 0.05). Intra subgroups assessments showed more filling material removed when using a larger sized final instrument (p < 0.001). Conclusions: Tested file systems were evenly efficient in removing filling materials from oval-shaped root canals of extracted molars. Types of chelators used and bioceramic based sealer had no significant validity on effectiveness of removal of root canal filling material.

Antimicrobial Efficiency of Biopure MTAD and Sodium Hypochlorite as Endodontic Irrigants

Antimicrobial Efficiency of Biopure MTAD and Sodium Hypochlorite as Endodontic Irrigants

Effect of laser-activated irrigation on smear layer removal and sealer penetration: An in vitro study.

Introduction:The present study was carried out with the objective of evaluation of efficacy of two root canal irrigants (LARGAL ULTRA and Biopure mixture of tetracycline, acid, and detergent [MTAD]) in smear layer removal and sealer penetration along the canal walls and to apprise any change in their efficacy when they were activated with two different types of lasers (neodymium-doped yttrium aluminum garnet [Nd:YAG] and erbium-doped yttrium aluminum garnet [Er:YAG]). The analysis was done with the help of confocal laser scanning microscope.Materials and Methods:The curved root canals (>20°) from 140 extracted human molars (negative control, n = 20) were prepared to size #25.06 with NaOCl irrigation. Teeth were divided into two experimental groups with sample size 60 each (Group I, II). Groups further divided into subgroups IA, IB, and IC and IIA, IIB, and IIC with sample size twenty each. Group IA, Largal Ultra irrigation without LAI; Group IB, Largal Ultra irrigation with Nd:YAG; Group IC, Largal ultra with Er:YAG; Group IIA, MTAD irrigation without LAI; Group IIB, MTAD irrigation with Nd:YAG; Group IIC, MTAD irrigation with Er:YAG. Teeth were obturated with gutta-percha and fluorescent dye labeled sealer. Transverse sections at 3 mm from root apex were examined with confocal laser scanning microscopy, and the percentage of sealer penetration into dentinal tubules was measured.Statistical Analysis:Analysis of variance calculated (e.g., one-way between-subjects ANOVA) and Tukey's test was performed for each mean comparison.Results:Difference between control and Group IIc (65.48 ± 0.57) was highest, followed by control and Group Ic (54.92 ± 0.57) and minimum between Group Ib and Group IIa (0.23 ± 0.57). Order of percent diffusion in the present study was: Group IIc > Group Ic > Group IIb > Group Ib ≈ Group IIa > Group Ia > Control (P <.001).Conclusions:It was inferred that, among the two irrigating solutions tested, Biopure MTAD is more proficient than Largal Ultra. Laser activation of final irrigating solution has been shown to allow better sealer penetration, with Er:YAG laser being more potent than Nd:YAG laser.

Assessment of Antimicrobial Activity of Different Intracanal Medicaments against Enterococcus faecalis and Candida albicans: An In Vitro Study

The aim of the present study was to compare the anti-microbial efficacy of various intracanal medicaments againstEnterococcus faecalis (E. faecalis) andCandida albicans (C. albicans). Materials and methods: Sixty single rooted, non-carious, permanent mandibular premolars with no developmental defects that were previously extracted for the orthodontic purpose were included in this study. E. faecalis andC. albicans strains were cultured on brain heart infusion (BHI) and sabouraud dextrose (SD) agar plates respectively. Sixty specimens were divided into two main groups and three subgroups with 10 teeth receiving a medicament; group I: E. faecalis (Subgroup Ia: BioPure MTAD, Subgroup Ib: propolis, Subgroup Ic: Triple antibiotic paste), group II:C. albicans (Subgroup IIa: BioPure MTAD, Subgroup IIb: propolis, Subgroup IIc: Triple antibiotic paste). The antimicrobial activity of the intracanal medicaments against E. faecalis and C. albicans were assessed at the end of 2nd and 7th day. The mean zones of inhibition were analyzed with a one-way ANOVA test. After 2 days, the mean zone of inhibition of E. faecalis andC. albicans was maximum for triple antibiotic paste (24.74 ± 0.622 mm, 28.22 ± 0.489 mm), followed by BioPure MTAD (19.58 ± 1.734 mm, 24.75 ± 0.954 mm) and propolis (13.10 ± 0.278 mm, 17.96 ± 0.163 mm). Similarly, the mean zone of inhibition of E. faecalis and C. albicans was maximum for triple antibiotic paste (26.86 ± 0.112 mm, 32.10 ± 0.908 mm), followed by BioPure MTAD (20.13 ± 1.842 mm, 27.22 ± 1.977) and propolis (14.11 ± 0.101 mm, 19.90 ± 0.742 mm) after 7 days. Statistically significant differences (p <0.0001) were found between the groups. Present study concluded that the antimicrobial effectiveness of triple antibiotic paste was significantly more than BioPure MTAD and propolis against E. faecalis and C. albicans at the end of 2nd and 7th day. An endodontic treatment is considered successful only when the root canals are completely eradicated of microorganisms. As the morphology of the root canals is complex, mechanical instrumentation alone cannot completely debride them. Thus, the role of intracanal medicaments in complementing the mechanical instrumentation becomes important.

Effect of different irrigating solutions with surfactants on the microhardness and smear layer removal of root canal dentin: An in vitro study.

Aim:The present in vitro study was undertaken to check the effect of the different irrigating solutions with surfactants, i.e., sodium hypochlorite-(Naocl)-Extra, chlorhexidine (CHX)-Ultra, ethylenediaminetetraacetic acid (EDTA), QMix, and BioPure MTAD on the microhardness and smear layer removal of root canal dentin.Materials and Methods:A total of 120 straight rooted lower premolars were collected and were randomly divided into 2 equal groups of 60 each (n = 60). The microhardness of the samples was evaluated by Vickers hardness tester and the removal of smear layer by scanning electron microscope after irrigation of the samples with the tested solutions.Results:CHX-Ultra showed the least microhardness reduction, and EDTA showed the maximum microhardness reduction in all the tested groups. BioPure MTAD showed the maximum removal of smear layer in the apical third, and CHX-Ultra showed the minimal smear layer removal in the apical third.Conclusion:During smear layer removal, irrigating solutions cause alterations in the chemical composition of dentin, which may decrease the microhardness of the root dentin causing erosion and affecting the clinical performance of the endodontically treated teeth. Irrigating solution with maximum smear layer removal with minimum changes in microhardness should be used.

Comparative evaluation of cytotoxic effects of MTAD and sodium hypochlorite using lactate dehydrogenase and trypan blue assays: An in vitro study

Aim: This study aims to examine the cytotoxic effects of BioPure MTAD and three clinical concentrations of sodium hypochlorite (NaOCl) solutions (1%, 3%, and 5%) on cultured human periodontal ligament (PDL) cells. Materials and Methods: Human PDL cells were grown on cell culture plates and were placed in contact with various concentrations of tested irrigants. Cytotoxicity of both BioPure MTAD and different concentrations of NaOCl was assessed for immediate short-term intervals (1, 5, 10, and 15 min) and midterm intervals as well (24, 48, 72, and 96 h). Different parameters of toxicity such as lactate dehydrogenase assay and trypan blue dye exclusion assay were studied along with morphological changes at all the different time points. The mean zones of inhibition were calculated for each group and were statistically analyzed. Results: BioPure MTAD was least toxic of all test irrigants in short-term and midterm time intervals. 5% NaOCl showed the maximum cytotoxicity at short-term time intervals. All cells died within the first 24 h for all three NaOCl concentrations. Conclusions: BioPure MTAD showed minimal toxicity and the three concentrations (1%, 3%, and 5%) of NaOCl showed detrimental effects on the PDL cells and its toxicity was dose dependent.

Cytotoxicity Evaluation of Combination Irrigant Regimens with MTAD on Two Different Cell Lines.

Background:Effective management of smear layer ensures adequate clinical success. Use of sodium hypochlorite (NaOCl)/ethylenediaminetetraacetic acid regimen has been the gold standard with limitations. Commercial irrigants incorporate surface modifiers to address these drawbacks. The aim of this study was to evaluate the cytotoxicity of combination regimens on target and nontarget cell lines by trypan blue assay.Materials and Methods:Nonsurfactant combination regimen of chlorhexidine (CHX) and NaOCl (2% CHX + 2.5% NaOCl) and surfactant regimens of CHX with cetrimide (CTR) (2% CHX + 0.5% CTR) and CHX with sodium dodecyl sulfate (2% CHX + 1% SDS) were prepared. 0.9% normal saline (NS) and Biopure MTAD (100%) served as control. Cytotoxicity was evaluated on human gingival fibroblast (HGF) and Henrietta Lacks (HeLa) cell lines by trypan blue assay. Thirty microliter of the cell suspension was treated with 20 μl of irrigants. The cell suspension was loaded into Neubauer chamber after 5 min and cell count was performed under inverted microscope and expressed as viability percentage.Results:Nonsurfactant combination comprising of 2% CHX + 2.5% NaOCl formed a brownish precipitate while surfactant combination regimes were stable without any precipitate formation. NS and 2% CHX + 0.5% CTR had greater viability scores on both cell lines. Two percent CHX + 1% SDS had better viability on HeLa but were severely cytotoxic on HGF. Two percent CHX + 2.5% NaOCl and MTAD were found to be severely cytotoxic on HeLa with limited viability on HGF.Conclusion:The variation in data obtained could be possibly attributed to the difference in the cellular membrane composition and mechanism of action of combination regimens. Experimental surfactant regimen 2% CHX + 0.5% CTR shows lower cytotoxicity than MTAD.

A comparative study to evaluate the effect of different irrigating solutions on the smear layer

Aim: This study compared the capability of Biopuer MTAD, QMixTM2in1, 17% EDTA, 6.25% Morinda Citrifolia juice, 2% Nano-Chitosan, 2% Chitosan, 2% Chlorhexidine and distilled water in smear layer removal. Methods: eighty extracted premolars having single root canals were distributed into eight groups allocated to the final irrigant used. Roots were separated in bacco-lingual direction into two equal halves then analyzed using Scanning Electron Microscope (SEM) at the coronal, middle, and apical parts. Results: In the coronal and middle parts of the roots the Biopure MTAD showed the highest mean values of smear layer elimination, followed by 17% EDTA, QMixTM2in1, and then 6.25% MCJ. While 2% nano-chitosan, 2% chitosan, 2% CHX and distilled water showed the least mean values of smear layer elimination. The capability of smear layer elimination decreased in the apical third for Biopuer MTAD, 17% EDTA, QMixTM2in1and 6.25 % MCJ. It was only inhibited with 2% nano-chitosan, 2%chitosan, 2% CHX and distilled water. Conclusion: the study concluded that Biopuer MTAD had the highest mean value for smear layer removal in middle, coronal and to a lesser degree in apical thirds.

Efficacy of new irrigating solution on smear layer removal in apical third of root canal: A scanning electron microscope study

Aims:The aim of this in vitro study is to evaluate and compare the smear layer removal efficacy of etidronic acid-based irrigating solution with others in the apical third of the root canal.Materials and Methods:Forty human single-rooted mandibular premolar teeth were taken and decoronated to standardize the canal length. After biomechanical preparation, teeth were randomly divided into four groups (n = 10) and the final irrigation was carried out with tested irrigants. Group I: normal saline (negative control); Group II: 5.25% sodium hypochlorite (NaOCl) with surfactant and 17% ethylenediaminetetraacetic acid (EDTA) with surfactant; Group III: freshly mixed BioPure MTAD; and Group IV: freshly mixed Chloroquick solution. The teeth were split into two halves and observed under a scanning electron microscope to analyze the amount of smear layer present.Statistical Analysis:Data were analyzed using the Kruskal–Wallis test and Mann–Whitney test.Results:Group II (5.25% NaOCl with surfactant followed by 17% EDTA with surfactant) showed least smear layer scores (1.1 ± 0.3162). This was followed by Group III (MTAD) (2.2 ± 0.4216) and then Group IV (Chloroquick) (2.4 ± 0.5164).Conclusion:Sequential use of 5.25% NaOCl with surfactant and 17% EDTA with surfactant was found to be the most efficient than MTAD and Chloroquick in the removal of smear layer in the apical third of root canal.

Comparative antimicrobial efficacy of selected root canal irrigants on commonly isolated microorganisms in endodontic infection.

Objective:This study aims to evaluate and compare the antimicrobial efficacy of three selected root canal irrigants (BioPure MTAD, metronidazole, aztreonam) against microbes commonly isolated from polymicrobial microbiota of root canal infection.Materials and Methods:This study was designed with four experimental groups (Group I – Bacteroides fragilis, Group II – Propionibacterium acnes, Group III – Enterococcus faecalis, Group IV – Candida albicans) based on the microbes selected for the study. Group I and Group II bacteria were used to compare and evaluate antimicrobial effect of BioPure MTAD, metronidazole, aztreonam, and normal saline. Group III and Group IV bacteria were used to compare and evaluate antimicrobial efficacy of BioPure MTAD, aztreonam, and normal saline. Normal saline was used as a control irrigant in this study. Agar disc diffusion method was applied to assess and compare the antimicrobial action of selected irrigants.Results:Metronidazole was found to be the most effective root canal irrigant against B. fragilis and P. acnes among the tested irrigants. Mean zone of inhibition against E. faecalis has been shown to be maximum by BioPure MTAD, followed by aztreonam. Antifungal effect against C. albicans was only shown by BioPure MTAD.Conclusions:Overall, BioPure MTAD is the most effective root canal irrigant as it has shown an antibacterial effect against all the tested microorganisms. However, metronidazole showed maximum antibacterial effect against obligate anaerobes. Aztreonam also showed an antibacterial effect in the present study, raising its possibility to be used as a root canal irrigant in the future.

EFFECT OF BIOPURE MTAD, SODIUM HYPOCHLORITE AND EDTA ON DENTIN MICROHARDNESS: IN VITRO STUDY

Objectives: The aim of this study was to evaluate the microhardness of root dentin wall before and after irrigation with BioPure MTAD, 17% Ethylenediamine tetra acetic acid (EDTA) and sodium hypochlorite (NaOCl).Study Design: Sixty-four freshly human extracted single-rooted teeth was used in this study. The teeth were divided into 4 groups, according to the irriganting solution used as final rinse: group (1) BioPure MTAD, group (2) 17% EDTA, group (3) 5.25% NaOCL and group (4) control group (distilled water). The teeth were sectioned longitudinally and prepared for evaluation of microhardness of root dentine before and after irrigation with each irrigants which the baseline microhardness testing was carried out using Vickers Microhardness Tester.Results: The results were statistically analyzed (p<0.05) showing significant difference between all the irriganting solutions in relation to the control group.Conclusion: The EDTA and BioPure MTAD drastically reduced the microhardness of root canal dentin followed by NaOCL.