Endodontic Irrigating Solutions Research Articles

Chitosan-based endodontic irrigation solutions and TGF-β1 treatment: Creating the most favourable environment for the survival and proliferation of stem cells of the apical papilla in vitro.

The dental pulp's environment is essential for the regulation of mesenchymal stem cells' homeostasis and thus, it is of great importance to evaluate the materials used in regenerative procedures. To assess invitro (i) the effect of chitosan nanoparticles, 0.2% chitosan irrigation solution, Dual Rinse®, 17% EDTA, 10% citric acid and 2.5% NaOCl on DSCS viability; (ii) the effect of different concentrations of TGF-β1 on DCSC proliferation; and (iii) whether treatment with TGF-β1 following exposure to the different irrigation solutions could compensate for their negative effects. (i) DSCS were treated with three dilutions (1:10, 1:100 and 1:1000) of the six irrigation solutions prepared in DMEM for 10 and 60 min to assess the effect on viability. (ii) The effect of different concentrations (0, 1, 5 and 10 ng/mL) of TGF-β1 on DCSC proliferation was assessed at 1, 3 and 7 days. (iii) The proliferative effect of TGF-β1 following 10-min exposure to 1:10 dilution of each irrigation solution was also tested. We used MTT assay to assess viability and proliferation. We performed statistical analysis using Prism software. (i) The different endodontic irrigation solutions tested showed a significant effect on cell viability (p ≤ .0001). Significant interactions between the endodontic irrigation solutions and their dilutions were also found for all parameters (p ≤ .0001). Chitosan nanoparticles and 0.2% chitosan irrigation solution were the least cytotoxic to DSCS whilst 2.5% NaOCl was the most cytotoxic followed by 17% EDTA. (ii) TGF-β1 at concentrations of 1 and 5 ng/mL resulted in significantly higher proliferation compared to the control group. (iii) Exposure to 17% EDTA or 2.5% NaOCl for 10 min was sufficient to make DSCS cells refractory to the proliferative effects of TGF-β1. DSCS groups treated with TGF-β1 following exposure to chitosan nanoparticles, 0.2% chitosan irrigation solution, Dual Rinse® and 10% CA demonstrated significantly higher proliferation compared to non-TGF-β1-treated groups (p ≤ .0001, p ≤ .0001, p ≤ .0001 and p = .01 respectively). The current study offers data that can be implemented to improve the outcome of regenerative endodontic procedures by using less toxic irrigation solutions and adding TGF-β1 to the treatment protocol.

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 Different Electroconductive Root Canal Irrigations on the Accuracy of Different Apex Locators: An In Vitro Comparative Study.

An accurate working length (WL) estimation is fundamental to a successful endodontic therapy. The objective of this comparative in vitro research was to investigate the performance of iPex II and the Root ZX Mini electronic apex locators (EALs) in measuring root canal WL with different irrigant solutions and their relation to the electrical conductivity of irrigation solutions. Seventy sound permanent lower premolar teeth, each with a single root and developed apices, were used. Under an X15 stereomicroscope, the real working length was determined with the aid of a #10 file. After that, teeth were placed into an alginate model, and the iPex II and Root ZX Mini were used for the detection of electronic working length with various irrigants. Seventy teeth were randomly distributed into seven groups, 10 per each group (group I: dry canal; group II: distilled water; group III: ozonated water; group IV: 5% sodium hypochlorite (NaOCl); group V: 2% chlorhexidine, group VI: 17% ethylenediaminetetraacetic acid (EDTA) solution, and group VII: 17% EDTA gel). The difference in WL was calculated by deducting real working length from its electronic working length. The study also evaluates the electrical conductivity of the seven endodontic irrigant solutions. The two-way analysis of variance (ANOVA) test was used for statistical analysis. Statistically, neither both types of EALs (P = 0.088) nor various irrigating solutions with varying electrical conductivities (P = 0.099) significantly affect the accuracy of EL estimation. There were no significant differences between the accuracy of the Root ZX Mini and the iPex II. The accuracy of both apex locators is unaffected in the presence of various irrigation solutions with varying electrical conductivities in this research.

Adhesion and sealing of different universal adhesive systems associated with bulk-fill resins after using endodontic irrigation solutions: An invitro study.

This study aimed to evaluate the interface of universal adhesive (UA) with bulk-fill resin (BF) and dentin, after endodontic irrigation. The pulp chamber of 96 molars was irrigated with chlorhexidine 2% (CHX) or sodium hypochlorite 5.25% (NaOCl) and restored according to three restorative protocols. Microtensile bond strength (μTBS) and nanoleakage tests were performed after 24 h of thermocycling. Kruskal Wallis, Mann-Whitney and Wilcoxon were performed (p < 0.05). Comparing restorative systems, a difference was found only when irrigated with CHX after 24 h. CHX provided higher μTBS than NaOCl after 24 h for two restorative protocols; after thermocycling, NaOCl provided the greatest μTBS than CHX for one group. Decreased μTBS was observed for all restorative systems when CHX was used after thermocycling. NaOCl demonstrated the highest nanoleakage. The composition of UA influenced the immediate adhesion and sealing to BF when CHX was used; ageing has a deteriorating effect on adhesion and sealing for all restorative systems.

Effect of sodium hypochlorite, ethylenediaminetetraacetic acid, and dual-rinse irrigation on dentin adhesion using an etch-and-rinse or self-etch approach

The aim was to investigate the influence of endodontic irrigation solutions and protocols on the micro-tensile bond strength (μTBS) to dentin using an etch-and-rinse (ER) or self-etch (SE) adhesive approach. Eighty extracted human molars were ground to dentin. After pretreating for 27 min (21 min–3 min–3 min) with five different endodontic irrigation protocols (Group 1: NaOCl–EDTA–NaOCl; Group 2: NaOCl–NaOCl–EDTA; Group 3: NaOCl–NaCl–NaOCl; Group 4: Dual Rinse–Dual Rinse–Dual Rinse; Group 5: NaCl–NaCl–NaCl), an ER (Optibond FL, Kerr) or a SE (Clearfil SE Bond, Kuraray) adhesive system was applied. After light-curing, composite build-ups were made and cut into dentin-composite sticks. μTBS and failure modes were analyzed. Nonparametric statistical analyses (α = 0.05) were performed for comparison of the five groups within each type of adhesive as well as between the two adhesive systems used. The use of an ER instead of a SE adhesive system resulted in significantly higher μTBS for all irrigation protocols except for group 1 (NaOCl–EDTA–NaOCl) and 2 (NaOCl–NaOCl–EDTA). A statistical difference between the five different endodontic irrigation protocols was only found within the SE adhesive group, where group 1 (NaOCl–EDTA–NaOCl) achieved highest values. The use of an ER adhesive system cancels out the effect of the endodontic irrigation solution. The highest μTBS was achieved when using a NaOCl–EDTA–NaOCl-irrigation protocol in combination with Clearfil SE Bond, which shows that the selection of the endodontic irrigation should match the corresponding SE adhesive system.

Effect of diode laser irradiation and application of nanoparticle herbal endodontic irrigation solutions on Candida albicans and Enterococcus faecalis bacteria

Effect of diode laser irradiation and application of nanoparticle herbal endodontic irrigation solutions on Candida albicans and Enterococcus faecalis bacteria

Eradication of mature biofilm from the isthmus region using Er, Cr: YSGG Laser as an activator of 2% chlorhexidine gluconate.

Challenges in the root canal system, such as isthmus, may limit the action of endodontic equipment and irrigation solutions, so using laser agitation is recommended to upgrade the removal of microbial biofilm. The objective of this study is to assess the effectiveness of the laser in photon-induced photoacoustic streaming protocol agitation of 2% chlorohexidine gluconate in removing mature biofilm in complex root canal systems. Seventy-five mesial roots of the lower first and second molars were separated and cultivated with Enterococcus faecalis bacteria for 30 days (except for the negative control group samples). The samples were divided into four groups (n=15), one group acted as a positive control, other groups were irrigated with 2% chlorohexidine gluconate, some of them were agitated with a passive ultrasonic device, while the other samples were agitated by an Erbium, chromium-doped yttrium, scandium, gallium, and garnet laser in photon-induced photoacoustic streaming protocol. An atomic force microscope was used as a new method to get the results in the isthmus area; A scanning electron microscope was also used in the study to examine the samples before and after the treatment. Statistical Package for Social Sciences software was used to collect and analyze data, and two-way ANOVA was used to compare the means of the test groups. According to the atomic force microscope and scanning electron microscope analyses, Erbium laser and passive ultrasonic activation groups showed higher antimicrobial efficacy than the syringe irrigation group (p<0.05). According to the study's results, the agitation of chlorohexidine gluconate fluid by Erbium laser in photon-induced photoacoustic streaming at 0.75 W offers better Enterococcus faecalis biofilm removal in the difficult-to-reach areas of lower first and second molars. Key words:Atomic force microscope, 2% chlorhexidine gluconate, Enterococcus faecalis, Erbium, chromium-doped yttrium, scandium, gallium, garnet laser, passive ultrasonic.

Evaluation of cytotoxicity of 3.8 % SDF and BioAKT solutions on the viability of dental pulp stem cells

IntroductionNonsurgical endodontic therapies have evolved from classic endodontic therapies to regenerative endodontic treatments (RETs) in recent years. In context of the cytotoxic activity of the most commonly used endodontic irrigant, NaOCl, newer endodontic irrigating solutions should be tested for its effective use in RETs. The aim of this trial was to examine and assess the cytotoxic response of 3.8 % SDF and BioAKT irrigating solutions on the viability of DPSCs. MethodsThe viability of DPSCs cultivated in 5.25 % NaOCl, 3.8 % SDF & BioAKT at dilutions of 1:100,1:20 &1:10 were evaluated through MTT assay after 10 min, 60 min and 24 h incubation, detection of apoptosis and ALP activity after 7,14 & 21-days incubation. A two-way analysis of variance (ANOVA) with post hoc Turkey HSD was performed to determine significant differences between the specimens tested. ResultsWhen compared to the control at all time periods, all test specimens at varied dilutions (1:100, 1:20, and 1:10) caused no cytotoxic effects. The maximum number of live cells and ALP activity was observed with DPSCs cultivated in BioAKT followed by 3.8 % SDF and 5.25 % NaOCl at all time intervals. ConclusionDifferent doses of 3.8 % SDF and BioAKT solution revealed encouraging outcomes when compared to 5.25 % NaOCl in terms of viability, proliferation and long-term ALP functioning potential when cultivated in DPSCs.

Dual effectiveness of a novel all-in-one endodontic irrigating solution in antibiofilm activity and smear layer removal.

The continuous destruction of dental hard tissues increases the risk of bacterial invasion, which leads to pulp infections. Irrigation is critical for successful root canal treatment in terms of infection control. However, no single irrigant covers all of the functions demanded, including antibiofilm and tissue-dissolving activities. The aim of this study was to investigate the antimicrobial properties of Triton, an all-in-one irrigant, on Enterococcus faecalis and multispecies oral biofilms in dentin canals, as well as its ability to remove the smear layer. Dentin blocks (192 specimens) were prepared from single-root human teeth and then assigned to 48 groups (24 groups for each biofilm type). Serial centrifugation was used for bacterial introduction into dentinal tubules. After 3weeks, half of the specimens were created a uniform smear layer. The following treatments were applied: short time (separate): Triton, 6% NaOCl, 2% NaOCl, and water (all for 3min); short time (combined): Triton (3 + 1min), 6% NaOCl +17% EDTA (3 + 1 or 2 + 1min), and 2% NaOCl +17% EDTA (3 + 1min); and long time: Triton (3 + 3min), 6% NaOCl (5min), 6% NaOCl +17% EDTA (5 + 1min), and water (3 + 3min). Confocal laser scanning microscopy and scanning electron microscopy were employed to examine the antimicrobial activity and smear layer removal, respectively. The results revealed that despite the absence or presence of the smear layer, Triton (3 + 3min) showed the highest killing for both tested biofilms (61.53%-72.22%) among all groups (p < 0.05). Furthermore, the smear layer was removed by Triton after 3 + 3min, exposing open dentin canals. These findings demonstrated that Triton can provide dual benefits of antibiofilm and smear layer removal capabilities simultaneously, indicating a simplified and effective strategy for application in root canal treatment.

Evaluation of The Interaction Between Alternative Endodontic Irrigation Solutions

Statement of the problem: For successful endodontic treatment, mechanical cleaning and chemical irrigation can be used together. Since the-re is not yet a single solution sufficient for both root canal cleaning alone, combined use of irrigants is recommended for the synergistic effect. Poly-hexanide (PHMB), boric acid, phytic acid, peracetic acid, and hypochlorous acid are relatively new alternative endodontic irrigation solutions and there are no studies in the literature on the combined use of alternative solutions. Objective: This study aimed to evaluate the interactions that would result from applying PHMB as a substitute for CHX following alternative in-termediate irrigation solutions that might be utili-zed with NaOCl. Materials &amp; Methods: Eight microtubes were used for this study. 0.5ml of 5%NaOCl was placed in each microtube first, the microtubes were divided into two groups as the final product CHX and Polyhexanide, and the two groups were divided into four groups with different irrigants in themselves. The study was conducted at room temperature and the images of the mixtures were photographed at 1 min, 10 min, 20 min, 30 min, and 1 hour. Groups; G1: NaOCl+ 1%Phytic acid +0.1%Polyhexanide, G2: NaOCl+ 0.02%Hypochlorous acid +0.1%Polyhexanide, G3: NaOCl+ 2% Peracetic acid +0.1%Polyhexanide, G4: NaOCl+ 5% Boric acid +0.1%Polyhexanide, G5: NaOCl+ Phytic acid+ 2%CHX, G6: NaOCl+ 0.02%Hypochlorous acid +2%CHX, G7: NaOCl+ 2% Peracetic acid+2%CHX, G8: NaOCl+ 5% Boric acid + 2%CHX. Results: White or brown precipitates occurred as soon as the soluti-ons were applied to all of the CHX groups; milky-white precipitate was only seen in the Polyhexanide group's Phytic acid-added group. After 5 minutes, air bubbles were seen in the Polyhexanide group that had Peracetic acid ad-ded, whereas the CHX group had an increase in brown precipitates. Conclusions: Considering the current research conditions, In clinical practice, the administration of Polyhexanite as the last irrigant and the com-bination of NaOCl with boric acid or hypochlorous acid can be advised.

ANTIMICROBIAL SCREENING OF COTINUS COGGYGGRIA SCOP LEAVES EXTRACT FOR ITS APPLICATION IN ENDODONTICS

For the new Millennium our knowledge of persistent bacteria, disinfecting agents and safety concerns has greatly increased and to achieve predictable, complete disinfection of the root canal system with minimal side-effects, there is no doubt that more innovative basic and biological approach is needed. In this sense, the search of alternative natural preparations for the disinfection of root canals remains relevant. The aim of our research was determination the antimicrobial activity of Cotinus coggygria leaves extract water solutions against Enterococcus faecalis. Microbiological study was conducted at the Laboratory of General Microbiology of Bacteriophage Analytical Diagnostic Center. The&nbsp;In vitro&nbsp;studies seems encouraging as 2% extract was found to be most effective against Streptococcus spp., while extract 10% solutions were observed to be most effective against Enterococcus faecalis. Pronounced antibacterial activity suggests successful application of Cotinus coggygria Scop extract solutions in Endodontic Practice. The in vivo study is in progress for recommending this novel herbal preparation as an alternative antimicrobial endodontic irrigating solution.

Chemical changes in root canal dentin of primary teeth after endodontic irrigation

Background: The current root canal irrigants used in dentistry are either antibacterial or decalcifying agents or their combinations. These agents can alter the chemical structure of dentin as well as change its permeability and solubility characteristics. Aim: The aim of this study was to evaluate the mineral content of root canal dentin after irrigating with five different endodontic irrigation solutions Materials and Methods: Sixty primary anterior teeth were selected for the study. Cleaning and shaping was done by step-back technique and divided randomly into six groups (n = 10): BioPure™ MTAD (Group 1), QMix™ 2-in-1 solution (Group 2), 0.9% normal saline (Group 3), coconut water (Group 4), and 5.25% NaOCl (Group 5) and the uninstrumented ten teeth were grouped as Group 6. After irrigation with final irrigants, the teeth were longitudinally divided into two halves. The levels of six elements calcium, phosphorus, oxygen, carbon, arsenic, and fluoride at the coronal and middle third in each specimen was assessed using scanning electron microscopy and energy-dispersive X-ray analysis. Statistical analysis was done by SPSS version 20 using one-way analysis of variance, and the comparison of means was conducted using post hoc Tukey test. Results: There was a statistically significant reduction in the calcium level at the coronal third of radicular dentin after irrigating with five different irrigants when compared with the uninstrumented teeth group. The phosphate level at the coronal third of the radicular dentin significantly increased in all the groups except for the saline group. The other elements such as oxygen, fluoride, and arsenic also showed significant differences in the coronal and middle levels after the irrigation. Conclusion: The endodontic irrigation by various irrigants changed the mineral levels in primary tooth dentin

Mode of cell death of co-cultured dental mesenchymal stem cells following exposure to endodontic irrigating solutions

Aims: This in vitro study aimed to determine the mode of cell death of co-cultured dental mesenchymal stem cells following exposure to different irrigating solutions.Methods and Material: Mesenchymal stem cells of the apical papilla (SCAPs) and periodontal ligament stem cells (PDLSCs) were isolated from the periapical region of a third molar of an 18-year-old patient and cultured. Adequate number of cells in each well, 6-well plate inserts were placed over the wells. The cells were then randomly exposed to 17% ethylenediaminetetraacetic acid (EDTA), 1.5% sodium hypochlorite (NaOCL), 2% chlorhexidine (CHX) and saline. After 1, 5, and 10 minutes cells were trypsinized and underwent flow cytometry. Apoptotic and necrotic cells were quantified. Data were analyzed using the One-way ANOVA and Tukey’s post-hoc test. Results: With increasing exposure time, cell viability is decrease and the mode of cells death was necrosis in CHX and NaOCL groups and necrosis plus late apoptosis in 1 and 10 minutes in EDTA group.Conclusion: Maximum cell death occurred following exposure to EDTA while minimum cell death occurred following exposure to CHX. Necrosis was the dominant mode of cell death in all groups.

An Evaluation of Cytotoxicity of Iron Oxide Nanoparticles with Hydrogen Peroxide Endodontic Irrigant

Aims: The aim of this research was to determine the cytotoxic effect of different concentrations of iron oxide nanoparticles (IONPs) in combination with hydrogen peroxide ( H2O2) in vitro as a potential endodontic irrigating solution. Materials and Methods: Cytotoxicity of IONPs at concentrations (8, 4, 2, 1, 0.5, and 0.25 mg/ml) with 3% H2O2 were evaluated on cultured Human Dermal Fibroblast (HDFn) cell line. Cytotoxicity was assessed after 10 minutes of exposure using the Mosmann’s Tetrazolium Toxicity (MTT) assay. Results: Tukey’s test indicated that no significant difference in cell viability was found at lower concentrations (0.2, 0.5, 1, and 2 mg/ml). While at a concentration of 4 and 8 mg/ml, the cell viability was not significantly different from each other whereas, significantly different from previous concentrations. Conclusion: From the gained data, it can be deduced that IONPs+H2O2 had almost no cytotoxic effect on HDFn cell viability at concentrations 0.2, 0.5, 1, and 2 mg/ml, while a moderate decrease of survival has been observed at concentrations 4 and 8 mg/ml.

Application of Copper Nanoparticles in Dentistry.

Nanoparticles based on metal and metallic oxides have become a novel trend for dental applications. Metal nanoparticles are commonly used in dentistry for their exclusive shape-dependent properties, including their variable nano-sizes and forms, unique distribution, and large surface-area-to-volume ratio. These properties enhance the bio-physio-chemical functionalization, antimicrobial activity, and biocompatibility of the nanoparticles. Copper is an earth-abundant inexpensive metal, and its nanoparticle synthesis is cost effective. Copper nanoparticles readily intermix and bind with other metals, ceramics, and polymers, and they exhibit physiochemical stability in the compounds. Hence, copper nanoparticles are among the commonly used metal nanoparticles in dentistry. Copper nanoparticles have been used to enhance the physical and chemical properties of various dental materials, such as dental amalgam, restorative cements, adhesives, resins, endodontic-irrigation solutions, obturation materials, dental implants, and orthodontic archwires and brackets. The objective of this review is to provide an overview of copper nanoparticles and their applications in dentistry.

An Overview on Endodontic Irrigation Solution Role in Management

The main objective of endodontic treatment is the total removal of any necrotic tissues and microorganisms along with their byproducts found within the infected root canal to treat and prevent the recolonization of these micrbad oorganisms. To date, no known irrigant has a 100% elimination rate on microorganisms, many combinations of irrigates have been suggested, and care must be taken to their mixing interaction and side effects. The irrigant of choice varies from one practitioner to another,

En-face optical coherence tomography analysis of gold and silver nanoparticles in endodontic irrigating solutions: An in vitro study.

Optical coherence tomography (OCT) is a non-invasive, non-radioactive optical diagnostic method based on low-coherence interferometry, which achieves images with different orientation. In dentistry, its major advantage is represented by the localization and characterization of the smallest defects in hard dental tissues, dental materials and of the smallest details in dental anatomy (supplementary canals, recesses, isthmuses, or intra-radicular connections). The aim of the present in vitro study was to evaluate using c-scan en-face optical coherence tomography, the optical opacity, and the distribution inside the root canal lumen of several extracted human teeth of silver and gold nanoparticles from special irrigating solutions used in endodontic treatment. Twelve root canals from 5 human teeth were instrumented using the ProTaper Universal system after initial negotiation with hand K-files ISO no. 10 and rotary nickel-titanium PathFile instruments. An initial c-scan OCT analysis was performed for each sample to confirm that the root canal lumen was empty from radiopaque materials (Group 1). Teeth were first irrigated with NanoCare Plus (Group 2) and then with NanoCare Gold (Group 3) and C-scans were repeated after each irrigation method. The OCT investigation started at the tooth apex, at a depth of 1 mm from its tip. Subsequently, 100 slices of 10 microns were obtained from each root canal. Images were captured and then analyzed with ImageJ software to calculate the level of grey inside the root canal lumen. The highest values of grey were obtained in the samples irrigated with NanoCare Gold after NanoCare Plus (Group 3). The present study proved that both nanoparticles inserted in root canal irrigants were evidenced through OCT imagistic analysis due to their optical opacity, which allowed their highlighting in an empty root canal lumen, after the endodontic treatment was performed and the root canal was cleaned and shaped using specific protocols.

Investigation of the Change in Color Caused by the Contact of Calcium Silicate-Based Materials with Endodontic Irrigation Solutions

Introduction: Although calcium silicate-based cements are very successful in healing, they cause esthetic problems and dissatisfaction, especially in anterior teeth because they cause discoloration in the teeth. This study aimed to detect the color changes that occur as a result of contact of BIOfactor mineral trioxide aggregate (MTA) and biodentin with three different irrigation agents. Methods: The materials to be tested (G1: BIOfactor MTA and G2: Biodentin) were prepared as per the manufacturer's directions. The prepared materials were placed in cylindrical molds of 8 mm diameter and 3 mm height and kept in a 37°C oven for 24 h to complete their hardening. Subsequently, the samples were immersed in one of three different irrigation solutions (5% sodium hypochlorite, 17% ethylenediaminetetraacetic acid [EDTA] or saline) for 24 h. After drying, spectrophotometer was utilized to quantify color under consistent laboratory light by the same administrator. Results: Significantly, more color changes were observed in the G1 group compared to the G2 group (P = 0.05). Although color changes were detected in all subgroups of G1 and G2 groups as a result of contact with different irrigation materials, it was determined that these changes were not statistically significant (P &gt; 0.05). The irrigation agent that caused the most discoloration was saline (12.33 ± 6.87) in G1 group and EDTA (7.05 ± 3.48) in G2 group. Conclusion: As a result of this study, significantly more color changes were found in BIOfactor MTA than biodentin. It was found that different irrigation agents did not cause statistically significant color changes.

Critical review on root canal irrigants used in dentistry

The purpose of the endodontic treatment is to eliminating the entire pulp including both vital and necrotic tissues along with the microorganisms and its byproducts from root canal system, with the help of chemical and mechanical aids. The present article summarizes a brief note on endodontic irrigant solutions and also its negative impact which should also be considered to lead a discovery of better endodontic treatment systems.

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.