Final Irrigation Solution Research Articles

The effect of different final irrigation solutions on apical impermeability

Aim: This study aimed to compare ethylenediaminetetraacetic acid (EDTA), phytic acid, and citric acid as chelation agents in final irrigation procedures on teeth with apical impermeability.
 Methodology: We used 66 mandibular premolar teeth with a single root and single canal extracted for periodontal or orthodontic reasons. All teeth crowns were removed to achieve a 14-mm root length. Mechanical preparation of the root canal was completed with a Reciproc R25 (VDW, Munich, Germany) file system. Teeth were randomly separated into three groups: Group 1: 5 ml 17% EDTA, Group 2: 5 ml 1% phytic acid, and Group 3: 5 ml 20% citric acid. We used 6 ml 5.25% sodium hypochlorite (NaOCl) in the mechanical preparation of all groups. Three teeth were selected for both the positive and negative control groups. All teeth in the experimental groups were filled by the lateral condensation method using AH Plus canal sealer and gutta-percha. For hardening of the canal sealer, samples were kept at 37 oC and at 100% humidity in a drying oven for 7 days. Later, following removal from the drying oven, two layers of nail polish were used to cover all but the apical 2 mm of each tooth. The teeth were then kept in 2% methylene blue solution at 37 oC for 7 days. The root was divided by cutting in the buccolingual direction and gutta-percha was removed. The dye leakage was measured linearly in millimeters (mm) under a stereomicroscope.
 Results: As a result of the apical leakage assessment, the lowest apical leakage is observed in the phytic acid group. There was a statistically significant difference between the phytic acid group and citric acid group. There was no statistically significant difference between other groups.
 Conclusion: While phytic acid showed similar results with EDTA on apical impermeability, it was more effective than citric acid.
 
 How to cite this article: Akın Tartuk G, Kaya S, Adıgüzel Ö. The effect of different final irrigation solutions on apical impermeability. Int Dent Res 2021;11(Suppl.1):201-5. https://doi.org/10.5577/intdentres.2021.vol11.suppl1.28
 
 Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

Effects of removable dental prostheses on mandibular bone density in postmenopausal osteoporotic patients

Aim: To investigate the effects of removable dental prostheses on mandibular bone density in postmenopausal osteoporotic patients.
 Methodology: The prospective study included 30 female patients aged 45–70 years who had been previously diagnosed with postmenopausal osteoporosis. The patients had no diseases affecting bone metabolism. The patients were divided into two groups: (i) patients who were using removable dental prostheses (n=15) and (ii) patients who were not using removable dental prostheses (n=15) (the control group). A whole-body dual energy x-ray absorptiometry (DXA) scan was performed to calculate the mandibular bone densities of the patients.
 Results: The use of removable mandibular prostheses did not cause a significant change in mandibular bone density.
 Conclusion: The fact that removable mandibular prostheses did not cause a significant change in mandibular bone density could be because the patients started using the removable prostheses long after they lost their teeth.
 
 How to cite this article: Akın Tartuk G, Kaya S. The effect of different final irrigation solutions on apical impermeability. Int Dent Res 2021;11(Suppl.1):201-5. https://doi.org/10.5577/intdentres.2021.vol11.suppl1.28
 
 Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

Survival and Adherence of Apical Stem Cells to Root Canal Dentin after Conditioning with Apple Vinegar

Purpose: To evaluate the survival and adherence of apical stem cells to root canal dentin after conditioning with apple vinegar. Materials and Methods: Stem cells from apical papilla of immature third molars were isolated. Survival of cells was evaluated by MTT test. Adherence of cells was evaluated by level of fibronectin expression and scanning electron microscope (SEM) observation. Thirty dentin discs from premolar teeth, extracted for orthodontic purposes, were immersed in 1.5% NaOCl then washed by PBS and finally divided into five groups regarding the final irrigating solution and time of its application. Group I: EDTA for 5 minutes, Group II: Apple vinegar for 5 minutes, Group III: Distilled water for 5 minutes, Group IV: EDTA for 3 minutes and Group V: Apple vinegar for 3 minutes. Cellular morphology was evaluated by SEM. For that part of the study, twelve root segments were longitudinally sectioned into two halves, and then immersed in 1.5% NaOCl, then rinsed with PBS. Finally, they were divided into three groups regarding the final irrigation. Group I: EDTA, Group II: Apple vinegar and Group III: Distilled water. Samples were rinsed and prepared for examination by SEM. Results: The biocompatibility of tested solutions was arranged in descending manner as following: Apple vinegar > EDTA > cells in media, distilled water and saline > NaOCl. Apple vinegar for 5 minutes released highest amount of fibronectin with statistically significant difference from other groups. Conclusion: apple vinegar promoted survival and attachment of SCAPs better than EDTA.

Efficacy of Chitosan as Final Irrigating Solution on TGF-β1 Release from Root Canal Dentin and its Effect on Dental Pulp Stem Cells Response

Purpose: To study the effect of Chitosan final irrigating solution compared with EDTA using different irrigation techniques, on TGF-β1 release from root canal dentin, using enzyme-linked immunosorbent assay (ELISA), and to evaluate the effect of released TGF-β1 on Dental Pulp Stem Cells. Materials and Methods: Human DPSCs were isolated from impacted third molars. Forty eight human root segments were prepared to a standardized truncated cone-shaped canal with an open apex of 1 mm diameter, the volume of prepared segments were determined using CBCT. Samples were randomized into two experimental groups (n=24) regarding the final irrigating solution; Group I: 1.5% NaOCl followed by 17% EDTA, Group II: 1.5% NaOCl followed by 1% Chitosan, then subdivided into subgroups A and B (n = 12) according to the final irrigation technique: A: Needle Irrigation, B: XP-Endo Finisher agitation. The released TGF-β1 were quantified using ELISA at 4 hours, 1 day, and 3 days following irrigation. DPSCs response to1.5% NaOCl, 17% EDTA, 1% Chitosan, and different concentrations of released TGF- β1 was assessed using MTT assay.Results: No statistically significant difference in the quantity of TGF-β1 released by 17% EDTA and 1% Chitosan following needle irrigation or XP Endo Finisher agitation. 1% Chitosan significantly increased DPSCs viability compared to17% EDTA (P < 0.05). TGF-β1 showed significant expansion of viable DPSCs in a positive correlation to its concentration (P <0.001). Conclusions: 1% Chitosan effectively released TGF-β1 from root canal dentin as17% EDTA. The released TGF-β1 promoted DPSCs proliferation at picogram levels in a concentration dependent manner.

Vital pulp therapy in carious pulp-exposed permanent teeth: an umbrella review.

There has been increasing evidence indicating rather high success rates of vital pulp therapies. This umbrella review aimed to provide an overview of existing systematic reviews regarding the outcomes of vital pulp therapy, specifically direct pulp capping, partial pulpotomy and full pulpotomy, in carious pulp-exposed permanent human teeth. The specific PICO questions were as follows: Population - permanent human teeth with carious pulp exposure; Intervention - direct pulp capping with pulp capping materials; Comparators - partial pulpotomy and full pulpotomy; Outcomes - success rate and prognostic factors. PubMed, Ovid and Cochrane databases were searched in conjunction with hand searching. Grey literature was searched too. Study selection, data extraction and study appraisal were performed independently by two authors. A consensus was reached through discussion when disagreements arose. Six articles fulfilled the inclusion criteria. Higher and more predictable success rates of ≥ 2 years were observed for partial pulpotomy and full pulpotomy in carious pulp-exposed permanent human teeth as compared to direct pulp capping. Possible prognostic factors (pre-operative pulp status, pulp capping material and apex closure) yielded conflicting results. Restorative material, periapical status at baseline, final irrigation solution, age and study type did not seem to affect the treatment outcome. Vital pulp therapy is a reliable treatment option for permanent teeth with carious pulp exposure. However, more high-quality studies are required to corroborate this finding. Vital pulp therapy could be considered as an alternative for root canal treatment for carious pulp-exposed permanent teeth.

Investigation of the effect of different chelation solutions on penetration of resin-based and bioceramic sealers with a novel method.

This study aimed to investigate the effects of different chelation solutions on the penetration of resin-based and bioceramic root canal sealers into dentinal tubules using a device that assembles conventional microplate detection with automated digital microscopy. Eighty-four single-rooted teeth were prepared with 30.07 nickel-titanium instruments and divided into four groups of 21 according to the final irrigation solutions used: saline (control), ethylenediaminetetraacetic acid (EDTA), maleic acid (MA), and etidronic acid (HEBP). The samples were obturated with AH Plus, MTA Fillapex, or EndoSequence BC Sealer using the single-cone technique. The roots were then sectioned horizontally at 2, 6, and 10 mm and examined using a Cytation 5 reader and Gen5 software. Data were compared using two-way analysis of variance followed by univariate analyses and Tukey's multiple comparison test (p < .05). The mean penetration depth in the apical thirds was higher in the MA group than in the other groups (p =.013). The mean depth in the middle and coronal thirds was almost equal in the EDTA and HEBP groups. The mean depth was significantly higher in the coronal thirds of the root canals than in any other section in all final irrigation solution groups (p <.001). EndoSequence BC Sealer displayed higher penetration depth than AH Plus and MTA Fillapex, although the differences between the examined sealers were not statistically significant. The chelation solutions increased root canal sealer penetration into the dentinal tubule.

Effect of final irrigating solutions on penetration depth of resin-based sealers into dentinal tubules.

Background:The goal of root canal therapy depends on chemomechanical debridement and three-dimensional filling of the root canal system.[1]Aim:The aim of this study is to assess the effect of NaOCl + Ethylenediaminetetraacetic acid (EDTA) and Twin Kleen as a final irrigating solution on the depth of penetration of AH Plus and Perma Evolution sealers into the dentinal tubules.Materials and Methods:Forty mandibular premolars were decoronated and instrumented up to size 30. Moreover, randomly assigned into two groups based on final rinse Group A (n = 20): 5.25% NaOCl + 17% EDTA. Group B (n = 20): Twin Kleen solution. Resin sealers were labeled with few grains of fluorescent rhodamine B dye and subdivided into two subgroups, Subgroup A1and B1 (n1= 10): AH Plus; Subgroup A2 and B2 (n2= 10): Perma Evolution and obturated. Confocal laser scanning microscopy was used to examine the sections taken 2, 5, and 8 mm from the apex. Images were exported to Image J software to determine the sealer penetration depth.Statistical Analysis:Independent t-test and one-way analysis of variance followed by Tukey's HSD post hoc test.Results:Maximum depth of sealer penetration was seen in Twin Kleen in all sections. Perma Evolution showed highest sealer penetration at the middle and apical third region of root canal for both groups.Conclusions:Final irrigation with Twin Kleen produced highest sealer penetration than with EDTA.

The effect of natural reducing agents on push-out bond strength of AH plus and BioRoot RCS to sodium hypochlorite treated root dentin.

Aims:To evaluate the effect of natural anticoagulants 6.5% proanthocyanidin (PA) and 25% bamboo salt on push-out bond strength (PBS) of AH Plus and BioRoot RCS to dentin.Subjects and Methods:30 single-rooted extracted human teeth were collected. After establishing the working length samples were prepared up to size F3. 5 ml of 3% NaOCl was used as irrigant during instrumentation followed by rinse with 5 ml of 17% ethylenediaminetetraacetic acid. Samples were randomly divided into groups based on the final irrigation solution: Group I – AH plus sealer group, Ia – Saline group, Ib – PA group, Ic – Bamboo salt (BS) group. Group II – BioRoot RCS group, IIa – Saline group, IIb – PA group, IIc – BS group. After obturation, samples were embedded in self-cure acrylic resin and 2 mm thick root slices were made at coronal middle and apical 3rd. These slices were subjected to PBS testing followed by stereomicroscopic examination for checking the mode of failure.Statistical Analysis Used:Kruskal–Wallis and Dunn's post hoc test.Results:3% NaOCl significantly decreased the bond strength of AH Plus as compared to BioRoot RCS to dentin (P < 0.05). Both PA and BS were capable of increasing the PBS of AH Plus and BioRoot RCS to NaOCl-treated dentin.Conclusions:Final irrigation with antioxidants such as PA and BS eliminates the risk of reduced bond strength of sealer to root canal walls, which ensues following the use of NaOCl as an irrigant.

Effect of different final irrigation solutions on push-out bond strength of root canal filling material

Background: The adhesion of root canal filling material to dentin is one of the crucial factors in determining the success of endodontic treatment. However, the smear layer that forms during instrumentation serves as an interface that impedes the bonding mechanism of the filling material. A proper irrigation solution is required to remove the smear layer and provide a dentin surface that supports the bonding mechanism of the filling material in establishing good adhesion. Purpose: This study aims to evaluate and compare the bond strength of filling material with different final irrigation solutions. Methods: Mandibular premolars were prepared by a crown down, pressure-less technique and divided into three final irrigation groups (2.5% NaOCl, 17% EDTA and 20% citric acid). The root canal of each tooth was obturated using epoxy sealer and gutta-percha. A two-millimetre-thick section of the apical third portion of each group was arranged for the push-out assessment using a universal testing machine in an apical to coronal direction at 1 mm/min crosshead speed. Results: A one-way ANOVA test indicated the difference in push-out bond strength among the groups (p&lt;0.05). A post hoc Bonferroni test presented a statistically significant difference in the bond-strength value between the 2.5% NaOCl group compared with the 20% CA group (p&lt;0.05). Conclusion: The push-out bond strength of root canal filling material is increased by applying a chelating agent as the final irrigation solution where 20% of CA presents the highest push-out bond strength.

Impact of Irrigation Solutions on the Apical Sealing Potential of Different Endodontic Sealers Used with the Continuous-wave Obturation Technique: An In vitro Study

Abstract Aim: This study is aimed to evaluate the impact of three irrigating solutions on the apical sealing ability of three endodontic sealers. Materials and Methods: One hundred maxillary central incisors were decoronated, and their roots were assigned into three experimental groups (n = 30 each) according to the nature of the irrigating solution and two control groups (n = 5 each). Each experimental group was divided equally into three subgroups (n = 10 each) according to the type of root canal sealer. All root canals were instrumented using ProTaper Universal rotary system and irrigated with 3% sodium hypochlorite (NaOCl/Group 1), 3% hydrogen peroxide (H2O2/Group 2), and 2% chlorhexidine gluconate (CHX/Group 3). The final irrigating solutions for all groups were 17% ethylenediaminetetraacetic acid (EDTA) and distilled water. The continuous-wave technique was used to fill the prepared canals with the following materials: MTA-Fillapex/Gutta-percha (Subgroup A), AH Plus/Gutta-percha (Subgroup B), and Realseal SE/Realseal (Subgroup C). The microleakage was assessed after 72 hours using the linear dye penetration method. The results were statistically analyzed with one-way analysis of variance. Results: Significant differences were found only between the experimental groups (P &lt; 0.05). All root canal sealers after irrigation with 3% H2O2 showed the lowest amount of leakage. The highest apical leakage was observed when 3% NaOCl and 2% CHX were used. Conclusions: The type of irrigating solution could affect the apical sealing ability of experimental sealers used with the continuous-wave obturation technique. Root canal irrigation with 3% H2O2 +17% EDTA increased the apical sealing ability of all root canal sealers. Root canal irrigation with 3% NaOCl or 2% CHX +17% EDTA decreased the apical sealing ability of all root canal sealers.

Influence of the Chelating Solutions in the Resistance of Glass Fiber Posts to the Root Dentin.

Objective This study aimed to evaluate the influence of chelating agents (EDTA, citric acid and Tetraclean) on glass fiber posts adhesion to root dentin. Materials and Methods Forty mandibular premolars single canals, with complete apical root, straight, circular cross sections were selected, accessed and had the cervical third prepared with Gates-Glidden drills, then included in resin, instrumented with ProTaper Universal and the root canal obturation was carried out. After, the samples were randomly divided into 4 groups (n = 10) to test the final irrigation solutions: G1:17% EDTA; G2:10% citric acid; G3: Tetraclean and G4: saline solution (control). After 30 days of storage (36.5° C and 100% humidity), the post preparation was performed leaving 4 mm of apical endodontic filling. Then, a fiber-glass post previously selected was coated with ED Primer adhesive system and resin sealer Panavia, installed and stored for 24 hours at 37°C. The samples were subjected to a tensile test with a constant speed of 1 mm/min with 2000 Kgf. The results were analyzed with the ANOVA test. Results The statistical analyzes indicated no significant differences between the groups (p > 0.05). Conclusion The type of chelating agent used in the final irrigation of the endodontic treatment did not influence the tensile strength of the fixation system used to sealer the glass fiber posts to the intracanal dentin.

Time-Dependent Effect of Chitosan Nanoparticles as Final Irrigation on the Apical Sealing Ability and Push-Out Bond Strength of Root Canal Obturation.

Materials and Methods Fifty-six premolars were used in this study and divided by two evaluations: 28 teeth for apical sealing ability and 28 others for bond strength. Each study was assigned randomly into two groups of fourteen teeth: Group-1, final irrigation with 17% EDTA; Group-2, with 0.5% chitosan nanoparticles. Each group was further divided into two groups of 7 each: Group-A, final irrigation was applied for 1 minute; Group-B, for 3 minutes. All teeth were obturated with epoxy resin-based sealer and gutta-percha. In the apical sealing ability study, the obturated teeth were immersed in 2% methylene blue and observed under a stereomicroscope (8x magnification). In the bond strength study, the teeth were tested using the push-out technique and observed under a stereomicroscope (40x magnification) to determine the failure type. Data from each evaluation were analysed with two-way ANOVA followed by the LSD test. Results Final irrigation using 0.5% chitosan nanoparticles produced the same apical sealing ability and bond strength as 17% EDTA (p > 0.05). A significant difference occurred between application times (p < 0.05). The failure type was observed predominantly as cohesive, and the least was adhesive. Conclusion Regardless of the final irrigation solution used, 3-minute application time produced greater apical sealing ability and push-out bond strength than 1-minute application time.

Effect of a new irrigant solution containing glycolic acid on smear layer removal and chemical/mechanical properties of dentin

The objective of this study was to evaluate the effects of glycolic acid (GA) (with pH 1.2 and 5) and ethylenediaminetetraacetic acid (EDTA) on the chemical and mechanical properties of dentin to investigate the potential use of GA as final irrigant in the root canal therapy. Specifically, changes in microhardness, smear layer removal, erosion, mineral content distribution, apatite/collagen ratio and flexural strength of mineralized dentin treated with GA were assessed. Saline solution was used as a negative control. Knoop microhardness (KHN) was measured on the root canal lumen of root segments. Dentin beams were used for 3-point flexural strength (σ) test. Scanning electron microscopy (SEM) images of root sections were obtained for evaluation of smear layer removal and dentin erosion on root segments and energy dispersive X-ray spectroscopy (EDS) was used for mineral content distribution. The apatite/collagen ratio (A/C) in dentin powder were examined by Fourier transform infrared (FTIR) spectroscopy. KHN, σ and A/C results were statistically analyzed with ANOVA and Tukey tests (α = 0.05). Smear layer and dentin erosion scores were analyzed with Kruskal-Wallis and Dunn tests (α = 0.05). Root dentin treated with EDTA and GA presented similar KHN regardless of the pH (p > 0.05). However, KHN was significantly reduced in EDTA and GA groups when compared to control group (p<0.001). GA showed the same ability to remove the smear layer and to cause dentin erosion as EDTA. EDS results showed that the GA and EDTA solutions did not alter the dentin mineral content distribution. The apatite/collagen ratio reduced with all irrigant solution and was the lowest with GA pH 5 (p<0.001), while σ was not significantly affected by the experimental solutions (p = 0.559). It can be concluded that GA has similar ability to remove the smear layer than EDTA. GA does not affect negatively the chemical/mechanical properties and it does not increase dentin erosion. The use of GA with low pH seems to promote less change in collagen/apatite ratio, but further studies are needed to establish an ideal clinical protocol. Therefore, this study supports the potential use of GA as an alternative final irrigation solution for root canal preparation.

The Effect of Silver, Zinc Oxide, and Titanium Dioxide Nanoparticles Used as Final Irrigation Solutions on the Fracture Resistance of Root-Filled Teeth.

AimThis study was conducted to evaluate the effect of three nanoparticle solutions used as final root canal irrigants on the fracture resistance of endodontically treated roots.Materials and MethodsSixty intact single-rooted premolar teeth were used after removing the crowns below the cementum–enamel junction to standardize the length of the remaining roots to 13 mm. After instrumenting the roots using ProTaper Universal rotary instruments up to size F4, the roots were randomly divided into six groups (n=10) according to the final irrigating solutions: Group 1: normal saline; Group 2: 2% chlorhexidine (CHX); Group 3: 17% EDTA+2.5% NaOCl; Group 4: 17% EDTA+0.1% silver nanoparticle (SNP) solution; Group 5: 17% EDTA+0.1% titanium dioxide nanoparticle (TNP) solution; Group 6: 17% EDTA+0.1% zinc oxide nanoparticle (ZNP) solution. After filling the root canals with gutta-percha and AH Plus sealer, the fracture resistance (FR) values were measured. The data were subjected to the one-way analysis of variance and the Tamhane post hoc test (p=0.05).ResultsEDTA + NaOCl had the lowest FR value, followed by normal saline and CHX (p values < 0.05). No significant difference was found between the FR of roots irrigated with CHX and normal saline (p > 0.05). The application of nanoparticles (SNP, TNP, and ZNP) was associated with a significantly greater FR than that of other irrigation solutions (p values < 0.05).ConclusionThe final irrigation of root canals with nanoparticles enhanced the fracture resistance of the endodontically treated roots. The lowest FR value was observed for NaOCl.

The Effect of Chitosan Nanoparticle as A Final Irrigation Solution on The Smear Layer Removal, Micro-hardness and Surface Roughness of Root Canal Dentin

Background:Root canal irrigation is one of the most important stages during root canal treatment. One of the requirements of root canal irrigation material is that it can eradicate the smear layer but does not alter the physical properties of the root canal dentin.Objective:To investigate the effect of chitosan nanoparticle as a final irrigation solution on the smear layer removal, micro-hardness and surface roughness of root canal dentin.Methods:Seventy-two premolars used in this study and divided by three evaluations, namely smear layer removal, micro-hardness and surface roughness. Each study used 24 teeth and was assigned randomly into three groups of eight teeth. Group-1, final irrigation with 17% EDTA; group-2, with 0.2% chitosan nanoparticles; group-3, with 2.5% NaOCl. Specimens were evaluated for smear layer removal, micro-hardness and surface roughness using a Scanning Electron Microscope, Vickers hardness tester and surface roughness measuring instrument, respectively. Data obtained from smear layer removal evaluation were statically analyzed using Kruskal-Wallis and Mann-Whitney U and data from micro-hardness and surface roughness were analyzed using one-way ANOVA and Tukey’s test.Results:Final irrigation using 0.2% chitosan nanoparticles produced similar smear layer removal than 17% EDTA (P&gt;0.05), but it was greater than 2.5% NaOCl (P&lt;0.05). Chitosan had higher micro-hardness and lower surface roughness than EDTA (P&lt;0.05), but it was the same as 2.5% NaOCl (P&gt;0.05).Conclusion:Final irrigation using 0.2% chitosan nanoparticles had the same effect on smear layer removal compared to 17% EDTA; however, 0.2% chitosan produced higher micro-hardness and lower surface roughness of root canal dentin than 17% EDTA.

Efficacy of Apple vinegar as Final Irrigating Solution in Removing Smear Layer Using XP-Endo Finisher File

Purpose: This study was assessed the efficacy of Apple vinegar as final irrigating solution in removing smear layer using XP-Endo Finisher File by scanning microscope. Material and Methods: Fifty single rooted lower premolars were selected and prepared using Universal ProTaper rotary files. Samples were divided into two main groups (I,II) regarding the final rinse used (20 samples each) and control group (10 samples): Group I: rinsed with 17% EDTA, Group II: rinsed with Apple vinegar and Control group: irrigated with sterile saline. Each group was subdivided into two subgroups (A,B) regarding the agitation file. Subgroup A: Conventional irrigation, Subgroup B: agitated with XP Endo Finisher. Samples were grooved longitudinally and smear layer was assessed. Results: no statistically significant difference in the median scores of smear layer produced by 17% EDTA and Apple Vinegar at coronal, middle and apical root levels when conventional irrigation or XP Endo Finisher were used. There was a significant difference between two irrigating techniques at apical level when 17% EDTA used as final rinse, where XP Endo Finisher showed statistically significant lower median score (P≤ 0.05). Conclusions: Apple vinegar presented similar smear layer removal efficiency from intraradicular dentin compared to 17% EDTA when used as final rinse. XP-Endo Finisher is a successful agitation system for removal of smear layer from intraradicular dentin.

Chitosan: A natural substitute of EDTA solution for final irrigation in endodontics treatment.

The purpose of this study was to assess the quantity of the chelated calcium ions and the smear layer removal efficiency after root canal final irrigation with three different solutions. Forty-five teeth were instrumented with rotary-files, then randomly divided into 3 equal groups (n = 15) depending on the final irrigation solution; group I: 17% ethylenediaminetetraacetic acid (EDTA), group II: 0.2% chitosan, and group III: 10% trisodium citrate. According to the time of application, every group was divided into 3 subgroups (1 min, 5 min, and 24 h). The quantification analysis of chelated calcium ions was performed by flame atomic absorption spectrometry (FAAS). Then, the presence of smear layer was examined by splitting the samples longitudinally and using scanning electron microscopy (SEM) to examine coronal, middle, and apical root canal levels. One-way analysis of variance (ANOVA) test was used for the evaluation of treatment effect. Kruskal-Wallis test was executed to detect a significant difference between groups, while Mann-Whitney U test has determined the difference between each two groups for smear layer. Both 17% EDTA and 0.2% chitosan had not been statistically significant difference for smear layer removal efficiency and observed calcium ion concentrations. Although, they were more efficient of 10% trisodium citrate with a significant difference (P < 0.05). The application time of the chelators' solutions must not exceed 5 min to completely remove smear layer, and 0.2% chitosan is a natural substitute for 17% EDTA with a safety application for 24 h.

Kitosan ve EDTA Solüsyonlarının Sonik ve Ultrasonik Sistemler ile Aktive Edilmesinin Dentin Mikrosertliğine Olan Etkisi

Objective: The aim of this in vitro study is to assess the effect of activation of EDTA and chitosan by different irrigation activation systems on the microhardness of root canal dentin. Material and Methods: A total of 60 single-rooted extracted mandibular premolars were prepared and randomly distributed into two groups (n=30) based on the final irrigant: Group 1, 0.2% chitosan; Group 2, 17% EDTA. Then, specimens of both groups were randomly divided into three subgroups (n=10) based on the irrigant activation; Subgroup A (Sonic), Subgroup B (Ultrasonic) and Subgroup C (Conventional irrigation, control group). The specimens (n=60) were embedded into resin blocks and sectioned horizontally 1 mm thick sections from 2,5 and 8 mm levels from the apex. All samples were used to determine the microhardness of dentin using a Vicker's microhardness tester. The data were analyzed using the three-way analysis of variance (ANOVA) and Tukey post-hoc tests to detect the effects of the independent variables (final irrigation solution, final irrigation techniques, and root canal thirds) on microhardness. Results: The three-way ANOVA indicated that chitosan exhibited a significantly lower microhardness value than EDTA (p<0.001). Also, regardless of the usage of final irrigation, both PUI and EA had significantly lower microhardness than CI (p<0.001). Conclusion: Chitosan as compared to EDTA (i), sonic (EA) and ultrasonic (PUI) final irrigation activation methods as compared to the traditional syringe method (CIS) (ii), apical and mid regions of the root as compared to its coronal region (iii), showed lower microhardness values.

Effect of Contact Times of Chitosan Nanoparticle as a Final Irrigation Solution on Microhardness and Surface Roughness of Root Canal Dentin

Effect of Contact Times of Chitosan Nanoparticle as a Final Irrigation Solution on Microhardness and Surface Roughness of Root Canal Dentin

Effect of different chelating agents on the bond strength of a silicone-based root canal sealer to root dentin.

Aim:The purpose of this study was to evaluate the impact of 7% maleic acid (MA), 17% ethylenediaminetetraacetic acid (EDTA) solution, 10% citric acid (CA), or 2.25% peracetic acid (PAA) on the dislodgment resistance of a silicone-based root canal sealer.Materials and Methods:Ninety-five mandibular incisors were shaped to size R50. The specimens were randomly assigned to the following five groups (n = 15) based on the final irrigation solution: 5% sodium hypochlorite (NaOCl), 17% EDTA, 7% MA, 10% CA, and 2.25% PAA. Four specimens from each group were examined under scanning electron microscope. All the remaining canals were obturated with GuttaFlow® Bioseal. Bond strength was assessed using the push-out test. The data were analyzed statistically by two-way analysis of variance and Bonferroni tests at the significance level of P = 0.05.Results:The roots irrigated with chelators showed statistically significantly higher bond strength than the roots irrigated with NaOCl (P < 0.05). Overall, MA showed the highest bond strength, but there was no statistically significant difference among the other chelating solutions (P > 0.05).Conclusions:The bond strength of the GuttaFlow Bioseal to the root canal dentin may increase by the removal of smear layer. Final irrigation with the investigated chelators resulted in similar bond strength of the GuttaFlow Bioseal.