Effect Of Irrigating Solutions Research Articles

The effect of irrigation solutions and sterilization process on the surface properties of ProTaper Next and TruNatomy rotary files: An atomic force microscopy study

Aim: This study sought to evaluate the effects of different irrigation solutions and sterilization processes on the surface properties of ProTaper Next (PTN; Dentsply-Maillefer, Ballaigues, Switzerland) and TruNatomy (TN; Dentsply Sirona, Ballaigues, Switzerland) nickel-titanium rotary files. Methodology: 30 ProTaper Next and 30 TruNatomy files were used. Both types of files were divided into five groups. The files in three groups were dipped into 5.25% NaOCI (CanalPro, Coltene/Whaledent, Altstätten, Switzerland), BioAKT (New Tech Solutions s.r.l., Brescia, Italy), and 18% etidronic acid (Dual Rinse HEDP, Medcem, Weinfelden, Switzerland), respectively, for 5 minutes, while the files in the fourth group were exposed to five autoclave cycles. The files in the fifth (control) group did not receive any treatment. Scans were performed from five different points using an atomic force microscope (AFM). The assumption of the conformity of the quantitative variables to a normal distribution was evaluated using the Kolmogorov-Smirnov test. A one-way analysis of variance was used to compare the quantitative measures between more than two independent groups, while the post-hoc least significant difference test was used for the pairwise comparisons (p˂0.05). Results: AFM images of the PTN and TN files in all the groups revealed surface irregularities. The root mean square (RMS) and depth values of the files dipped in NaOCI, BioAKT, and Etidronic acid were statistically higher than those of the control group (p<0.05). Moreover, the RMS and depth values were statistically higher in the files that had been subjected to five autoclave cycles when compared with the control group (p<0.05). The RMS values and depth values among the groups were found to be compatible. Conclusion: All the applications increased the surface roughness of the PTN and TN files. The Etidronic acid and sterilization applications were found to increase the RMS and depth values ​​the most when compared with the control group. How to cite this article: Öztekin F, Elmalı E. The effect of irrigation solutions and sterilization process on the surface properties of ProTaper Next and TruNatomy rotary files: An atomic force microscopy study. Int Dent Res 2022;12(2):39-46. https://doi.org/10.5577/intdentres.2022.vol12.no2.1 Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

Biomechanical Effect of Irrigants in Noninstrumented Dentin: Systematic Review and Meta-Analysis

One aspect of special concern in endodontics is the effect of irrigating solutions on the biomechanical properties of dentine. A systematic review of in vitro studies was conducted to analyze and systematize the effect of endodontic irrigating solutions on biomechanical properties in noninstrumented dentine, according to published in vitro studies. A literature review was conducted on different databases including papers from 2009 to 2019. Two researchers identified in vitro studies on permanent teeth root dentine that reported control group, featured nonmechanical preparation, and sample size ≥ 10. An instrument was designed for bias assessment in three categories (High-Uncertain-Low), applying 17 criteria. Using the PRISMA tool, an electronic search found 9,026 titles. From these, 28 were subjected to full-text analysis and 9 were chosen for qualitative analysis. It was identified that chelates decrease microhardness and stiffness. It was also inferred that the proteolytic effect of NaOCl reduces the elasticity modulus and flexural strength. The heterogeneity analysis, with a value I2:92% for microhardness and I2:81% for roughness, revealed high heterogeneity among the included studies. The random effect model identified with 95% confidence that NaOCl and EDTA significantly decrease microhardness: -3.00[-4.22, -1.78]; EDTA 17% at 15 min being on average the lowest value: -6.66[-8.32, -5.00]. For roughness, all the proposed solutions increased significantly: 2.37[1.67, 3.08]; the highest, 3.94[2.84, 5.04], was recorded by NaOCl2.5%-15 min. In contrast, CLX registered a high roughness value: 3.33[1.88, 4.77]. Dentinal microhardness reduction associated to chelates is a concentration and time- dependent variable. Collagen degradation by NaOCl is a time and concentration-dependent variable.

Effect of irrigation solutions on the coronal discoloration induced by mineral trioxide aggregate cements containing different radiopacifiers

The aim of this study was to assess the discoloration of coronal tooth structure irrigated with different irrigation solutions and filled with calcium silicate-based materials containing bismuth oxide or calciumzirconia complex as radiopacifier. In this ex vivo study, 72 bovine enamel-dentin blocks were prepared and divided into three groups. The dentinal cavities in each group were irrigated with 5.25% sodium hypochlorite (NaOCl), 2% chlorhexidine (CHX), or normal saline for 30 min. After that, irrigation solutions were removed using a cotton pellet. Each group was then randomly divided into two subgroups according to the cavity-filling materials (ProRoot mineral trioxide aggregate [MTA] and RetroMTA). The color assessments were performed before filling the cavities and 1 month and 6 months after filling the cavities. Data were analyzed with two-way ANOVA. The level of statistical significance was set at P < 0.05. The effect of irrigation solution on the color change of calcium silicate-based materials was not statistically significant at none of the time intervals (P = 0.334 and P= 0.252, respectively, for ProRoot MTA and RetroMTA). ProRoot MTA caused a significantly higher color change compared with RetroMTA exposed to different irrigation solutions at each time interval (P < 0.001). Color change of both materials exposed to each irrigation solution significantly increased over time (P < 0.05). Under the condition of this ex vivo study, irrigation of dentin with NaOCl and CHX and then removing the excess solution might be ineffective in increasing the tooth color change potential of either bismuth oxide or zirconium-containing calcium silicate-based materials. Furthermore, calcium silicate-based material, which contained bismuth oxide, caused higher tooth discoloration.

Effect of different irrigation solutions and techniques on push-out bond strength of resin-based sealer

Aim To evaluate the effect of irrigation solutions [sodium hypochlorite (NaOCl), chlorhexidine (CHX), and normal physiological saline] and different irrigation techniques (conventional needle, EndoVac, and CanalBrush) on push-out bond strength of AH Plus resin-based sealer. Materials and methods Ninety mandibular freshly extracted premolars were selected and divided into three groups according to the irrigation solutions; group I: 5.25% NaOCl, group II: 2% CHX, group III: normal physiological saline solution. Then each group was subdivided into three subgroups according to the irrigation techniques; subgroup A: 27 G side beveled needle, subgroup B: EndoVac irrigating system, subgroup C: medium-sized CanalBrush (30/0.04). Root canals of all groups were prepared using ProTaper Universal Ni-Ti rotary system up to file F4 (40/0.06) and filled by single cone technique using AH Plus sealer. 2 mm thick horizontal sections from the coronal, middle and apical thirds of each root were sliced for the push-out bond strength measurement and tested using universal testing machine. Data were analyzed using one-way analysis of variance in a level of significance (P ≤ 0.05). Results The highest mean push-out bond strength values were recorded for EndoVac system followed by CanalBrush and Needle in all groups and at all root canal levels. In comparison of irrigation solutions in needle subgroup; the highest values were recorded for CHX and least for NaOCl at coronal and middle root levels. While in the apical section, the highest and least mean push-out bond strength values were recorded for CHX and saline respectively. Regarding EndoVac and CanalBrush; the highest push-out bond strength values were recorded for CHX followed by saline and NaOCl at all root canal levels. Conclusions Whenever root canal obturation using AH Plus sealer, it is preferred to use 2% CHX solution throughout and after instrumentation via EndoVac system for improved bond strength. The coronal sections showed higher bond strength than middle and apical sections.

Effects of Irrigation Solutions on Root Canal Dentin

Effects of Irrigation Solutions on Root Canal Dentin

A prospective randomized double-blind study on the effects of the temperature of irrigation solutions on thermoregulation and postoperative complications in percutaneous nephrolithotomy.

This study investigated the effects of irrigation solutions, administered at either 21 or 37°C in percutaneous nephrolithotomy (PCNL), on hypothermia and related postoperative complications such as late emergence and late recovery from anesthesia, shivering, lactic acidosis, and excess bleeding. Sixty patients who were scheduled for PCNL were enrolled in this prospective randomized double-blind study. Irrigation solutions at room temperature were administered to patients in group R (30 patients), and warmed irrigation solutions were administered to patients in group W (30 patients). The two groups were compared for core and peripheral body temperature, incidence of hypothermia, duration of emergence from anesthesia, duration of recovery from anesthesia, shivering, lactic acidosis, and hemoglobin levels. Hypothermia was incident in 19patients (63.3%) in group W and in 27 patients (90%) in group R at the end of surgery. The difference between the initial and the final core body temperature was 0.9±0.6°C group W and 1.4±0.7°C in group R (p=0.003). The extubation time was 4.4±2.2min in group W and 5.9±3min in group R (p=0.032). Shivering was detected in seven patients (23.3%) in group W and in 15patients (50%) in group R (p=0.032). The recovery duration was 49.8±24.6min in group W and 67.6±33.9min in group R (p=0.023). Administration of irrigation solutions at room temperature in PCNL operations causes the body temperature to decrease significantly, which results in postoperative complications such as late emergence from anesthesia, late recovery from anesthesia, and shivering.

Effect of Irrigation Solutions on Adhesion of Endorez Sealer to Root Canal Dentin

Effect of Irrigation Solutions on Adhesion of Endorez Sealer to Root Canal Dentin

The effect of irrigation solutions with or without sodium ascorbate on the microleakage of class II composite restorations

To compare the effects of four different irrigation solutions [sodium hypochlorite (NaOCl), ethylenediaminetetraacetic acid (EDTA), chlorhexidine (CHX), and sterile saline] on the microleakage of class II composite restorations. The effects of the four irrigation solutions individually and in combination with sodium ascorbate on the microleakage of class II composite restorations were also investigated. A total of 180 permanent molar teeth were used, and class II cavities (3 mm wide × 1.5 mm deep) with gingival margins ended 1 mm below the cementoenamel junction were prepared and divided randomly into nine groups ( n = 20 in each group). The four different irrigation solutions with or without sodium ascorbate were used and applied in this study. All of the groups were restored using Filtek P60. The specimens were thermocycled between 5°C and 55°C with 30-second dwell times for 5000 cycles. The samples were then immersed in 0.5% methylene blue dye for 24 h and sectioned longitudinally. Dye penetration at the occlusal and gingival margins was quantified by stereomicroscopy at ×15 magnification. Use of the NaOCl solution caused greater microleakage than the other irrigation solutions on the gingival surfaces, whereas use of sodium ascorbate reduced the microleakage. When NaOCl is used as the canal irrigation solution, subsequent use of sodium ascorbate may reduce the microleakage.

Effects of irrigation solutions on the surface of protaper instruments: A microscopy study

The aim of this study was to evaluate the effects of sodium hypochlorite (NaOCl), chlorhexidine digluconate (CHX), and mixture of tetracycline, citric acid, and detergent (MTAD) solutions on the surfaces of nickel titanium (NiTi) rotary files with scanning electron microscopy (SEM) and atomic force microscopy (AFM). Irrigation solutions including 2.5% NaOCl, 5% NaOCl, 2% CHX, and MTAD were used. Four new ProTaper rotary NiTi files (F3) were immersed in each four irrigation solutions for 10 min, separately. One untreated NiTi file was used as a control specimen. The surface analysis was performed with SEM and AFM. The surface analysis in AFM was performed on 12 different regions located between first and second millimeters from the tip. SEM images were taken with different magnifications. No surface alteration was recorded under SEM evaluation. AFM revealed that the root mean square (RMS) values of all treated specimens were statistically higher than the control sample (P < 0.05). The sample which was treated with CHX showed lowest RMS values in test groups. All tested solutions caused surface alterations. CHX demonstrated limited surface alterations when compared to the other tested solutions.

The Effect of Irrigation Solution at Different Temperatures on Articular Cartilage Metabolism

The purpose of this study was to determine the effects of saline solution at different temperatures on the metabolism of chondrocytes. Porcine osteochondral explants were precultured under laboratory conditions. The cartilage explants were placed in saline solution. Twenty-four explants were randomly divided into 4 groups. Explants were immersed at 4°C group I, at room temperature (24°C) in group II, at normal knee temperature (32°C) in group III, and at near-core body temperature (37°C) in group IV. All specimens were immersed for 2 hours. Lactate and proteoglycan production and RNA yield analysis were performed to evaluate the changes in cartilage metabolism at different temperatures. Explants immersed in cold (4°C) saline solution showed the significantly lowest RNA yields, lactate production, and proteoglycan content. Explants immersed in cold solutions (4°C and 24°C) showed significantly lower RNA yields, lower lactate production, and lower proteoglycan content than explants in warmer solution groups (32°C and 37°C). The findings of this study suggest that short-term exposures to cold including room temperature may have markedly detrimental effects on chondrocyte function. Our findings also indicate that exposures to cold saline solution suppress chondrocyte metabolism and RNA synthesis. Using warmer irrigation solution that is closer to body temperature is more physiologic and causes less ultrastructural damage than colder solution.

The effect of irrigation solutions on the apical sealing ability in different root canal sealers

The aim of this study was to assess the effect of three root canal irrigation solutions on the apical sealing ability of three root canal obturation materials: gutta-percha/AH plus or MM-seal and Resilon/Epiphany SE. A total of 100 teeth with single straight root canals were randomly divided into three equal groups of 30 samples each, with the other 10 teeth (5 positive and 5 negative) used as controls. Each irrigation group was divided into three groups according to the use of three different root canal obturation materials (n = 10): Gutta-percha with AH plus or MM-seal, Resilon with Epiphany SE. The crowns were removed at the cementoenamel junction with a diamond disc under water coolant. The root canals were prepared using step-back technique and irrigation with either sodium hypochlorite (2.5%), chlorhexidine (2%), or MTAD solutions. The roots were obturated with lateral condensation technique using one of the obturation materials. The root surfaces was coated with two layer nail varnish (except apex), placed in 2% methylene blue dye solution, and centrifuged at 3,000 rpm for 5 minutes. Irrigation solutions affected the apical sealing ability of all the sealers. The chlorhexidine irrigation solution exhibited higher apical leakage values than did MTAD and NaOCl in all canal sealers, although the MTAD irrigation solution groups showed the least leakage values. The apical sealing ability of AH plus, Epiphany SE and MM-seal root canal sealers decreased when the chlorhexidine was used as an irrigation solution.

Effects of Irrigation Solutions on Dentin Wettability and Roughness

Introduction Irrigation solutions are used to disinfect the root canal, flush out debris, and dissolve pulp tissue. It is hypothesized that irrigation solutions might influence the physicochemical properties of human root canal dentin including the wettability and roughness. Methods The roots of 20 human permanent anterior teeth were sectioned longitudinally into dentin slices and randomly divided into 4 groups with different treatments as follows: (1) 17% ethylenediaminetetraacetic acid (EDTA) for 10 minutes, (2) 5.25% NaOCl for 10 minutes, (3) 3% H 2O 2 for 10 minutes, and (4) distilled water as control. Wettability was evaluated by contact angle measurement. Atomic force microscopy was used to measure the surface roughness (Ra). Results Water contact angles significantly decreased from 54.35 degrees (control) to 22.04 and 46.35 degrees on the dentin treated by 5.25% NaOCl and 3% H 2O 2, respectively, with the wettability increasing accordingly (both P < .05). The roughness of dentin surfaces (Ra) was increased from 85.39 (control) to 121.90 and 140.49 nm by 5.25% NaOCl and 17% EDTA, respectively (both P < .05). Conclusions These findings indicated that all the irrigation solutions could alter the physicochemical characteristics of dentin surfaces and might influence bacterial adhesion.

The effect of sodium hypochlorite and chlorhexidine on cultured human periodontal ligament cells.

The objective of this study was to examine the effects of sodium hypochlorite (NaOCl) and chlorhexidine (CHx) on cultured human periodontal ligament (PDL) cells in vitro. The effects of irrigation solutions on human PDL cells were evaluated by propidium iodide fluorescence cytotoxicity assay, protein synthesis assay, and mitochondrial activity. Both NaOCl and CHx were cytotoxic to human PDL cells in a concentration- and contact time-dependent manner. In addition, CHx inhibited protein synthesis in human PDL cells. Although NaOCl displayed cellular cytotoxicity, it showed no protein inhibition in the PDL cells. Furthermore, both NaOCl and CHx exhibited an inhibitory effect on mitochondrial activity on human PDL cells. This study suggests that these irrigation fluids may cause detrimental effects on vital tissues. Its clinical significance, however, needs to be evaluated further because concentration used, exposure time to the agent, and exposure surface area are important factors affecting the resulting effect.

Effects of irrigation solutions on corneal endothelial function.

Rabbit corneas were perfused in vitro with an irrigation solution for 90 minutes. This was followed by 6 hours of perfusion with tissue culture medium TC199 during which endothelial function was assessed by monitoring rates of swelling during a period of perfusion in the absence of bicarbonate ions, and subsequent rates of thinning when bicarbonate ions were restored to the perfusate. Corneal thickness (measured with an ultrasonic pachymeter) immediately following excision was 401 microns (SD 19, n = 23). During the 90 minute perfusion at 35 degrees C, corneas exposed to balanced salt solution (BSS), Hartmann's solution or 0.9% NaCl (all initially at room temperature) swelled, respectively, at 14 (SD 2.3, n = 4), 11 (SD 2.6, n = 4), and 70 (SD 4.3, n = 4) microns/h. Cold Hartmann's solution (initially at 4 degrees C) caused corneas to swell at 9 (SD 2.3, n = 4) microns/h. On the other hand, corneas perfused with BSS Plus thinned at 9 (SD 3.4, n = 4) microns/h and TC199 with Earle's salts had little effect on thickness. Rates of swelling and thinning during the following assessment perfusion showed no apparent effects of prior exposure to any of the irrigation solutions on the barrier properties or pump function of the endothelium. Despite this, the increased thickness of corneas exposed initially to BSS, cold Hartmann's solution, or 0.9% NaCl was not fully reversed, even by the end of the 6 hour assessment perfusion. In contrast, the swelling observed in corneas exposed to Hartmann's solution at room temperature was reversed and these corneas had returned to their normal thickness by the end of the assessment period. All corneas, even those exposed to 0.9% NaCl, had an intact endothelial mosaic with no evidence of damage or cell loss, although morphological differences in cell shape and the appearance of cell borders were evident compared with freshly isolated cornea.

Effect of irrigation solutions on the filling of lateral root canals.

Abstract An in vitro study involving 66 single–rooted human teeth was performed. The teeth were divided into 3 groups: control group, root canals instrumented and irrigated with distilled water; experimental group A, root canals instrumented and irrigated with 15% EDTA; and experimental group B, root canals instrumented and irrigated with 5% sodium hypochlorite. All canals were filled with laterally condensed gutta‐percha and Diaket® A. Radiographs were taken mesiodistally and buccolingually and the number of lateral canals filled in the various teeth was counted. The group treated with 15% EDTA showed a significantly larger number of filled lateral canals than the groups irrigated with distilled water or sodium hypochlorite.

Further studies on effects of irrigation solutions on rat bladders.

Further studies on the effects of certain irrigating fluids on the rat bladder for 18 hours are reported. The results have shown that the degradation product p-choloroaniline is not a significant factor in chlorhexidine-digluconate associated erosive cystitis. A high percentage of kanamycin-colistin and povidone-iodine irrigations were associated with erosive cystitis and suggested a possible complication with human usage. Picloxydine irrigations appeared to have a lower incidence of erosive cystitis but further studies would have to be performed before it could be recommended for use in urological procedures.