Structural Analysis of Bovine Root Dentin after Use of Different Endodontics Auxiliary Chemical Substances

IntroductionThe use of chemical substances in endodontics during chemical-mechanical preparation may alter the structure of dentin, mainly collagen, which contributes considerably to the mechanical properties of this structure. This study evaluated the effect of different auxiliary chemical substances during endodontic treatment in root canal walls by implementing polarized light microscopy (PLM) and scanning electron microscopy (SEM).MethodsSixty bovine incisors were randomly divided into six groups (n = 10): G1, 5.25% NaOCl + 17% EDTA; G2, 2% chlorhexidine (CHX) gel; G3, 5.25% NaOCl; G4, 17% EDTA; G5, 2% CHX + 17% EDTA; and G6, 0.9% sodium chloride solution (control). Teeth were chemomechanically prepared and fractured into two fragments. One fragment was used for PLM, and the other was used for SEM analysis.ResultsGroups treated with 5.25% NaOCl, whether associated or not associated to 17% EDTA, presented a significantly different birefringence pattern compared with the control group. The results revealed that groups irrigated with 2% CHX and EDTA, independently or combined, did not present any significant differences compared with the control group. SEM analysis showed structural alterations of the root canal inorganic matrix for all groups that used 17% EDTA.ConclusionsIt is possible to conclude that 5.25% NaOCl, whether associated or not associated with 17% EDTA, causes alterations in the dentin collagen. The obtained SEM images revealed demineralization areas for groups that used 17% EDTA alone or associated with other substances.     

Effects of sodium hypochlorite and RC-prep on bond strengths of resin cement to endodontic surfaces.

There is concern that the use of sodium hypochlorite (NaOCl) and RC-Prep may lower the bond strength of resin cements. The objective of this study was to evaluate the effect of 5% NaOCl and RC-Prep treatment on the bond strength of a resin cement, C&B Metabond. Control roots (group 1) were biomechanically prepared using 0.9% NaCl as an irrigant; group 2, roots with 5% NaOCl; group 3, roots with RC-Prep; group 4, roots with 0.9% NaCl followed by 10% ascorbic acid; group 5, roots with 5% NaOCl followed by 10% ascorbic acid (pH 4); group 6, roots with 5% NaOCl followed by 10% neutral sodium ascorbate; and group 7, roots with RC-Prep followed by 10% ascorbic acid. All roots were then filled with C&B Metabond, incubated in water for 24 h, and then cross-sectioned into six 1-mm thick slabs representing cervical and middle root dentin. The slabs were trimmed and tested for tensile bond strength. The results demonstrated that both 5% NaOCl and RC-Prep produced significantly (p < 0.05) large reductions in resin-dentin bond strengths, and the reductions could be completely reversed by the application of either 10% ascorbic acid or 10% sodium ascorbate.     

Residual Effectiveness of Final Irrigation Regimens on Enteroccus faecalis-infected Root Canals

Introduction

The application of a final irrigating solution that remains active over a fairly long period of time stands as one strategy for preventing bacterial recolonization or eliminating the bacteria that persist after root canal treatment. The aim of this study was to evaluate the residual antimicrobial activity of four final irrigation regimens in root canals contaminated with Enterococcus faecalis.

Methods

Biofilms of E. faecalis were grown in uniradicular roots for 4 weeks. After preparing the roots chemomechanically, four final irrigation regimens were applied: (1) group EDTA-NaOCl, 17% EDTA followed by 5.25% sodium hypochlorite (NaOCl); (2) group MA-NaOCl, 7% maleic acid (MA) followed by 5.25% NaOCl; (3) group EDTA-CHX + CTR, 17% EDTA followed by 2% chlorhexidine (CHX) + 0.2% cetrimide (CTR); and (4) group MA-CHX + CTR, 7% MA followed by 2% CHX + 0.2% CTR. Samples were collected for 60 days to denote the presence of bacterial growth. The Fisher exact test was used to compare the percentages of specimens without E. faecalis regrowth.

Results

All root canals in which the final irrigant was 5.25% NaOCl yielded positive cultures on the fifth day. Groups EDTA-CHX + CTR and MA-CHX + CTR with a final irrigation of 2% CHX + 0.2% CTR showed respective percentages of samples without regrowth of 72.1% and 66.8% at 60 days. There were no statistically significant differences between these groups.

Conclusions

The combination of 2% CHX + 0.2% CTR would be an effective alternative final irrigation regimen given its antimicrobial action over time.     

Quantitative analysis of the effect of irrigant solution sequences on dentin erosion

Objective

The purpose of the study was to examine the level of erosion on root canal wall dentin caused by immersion in different irrigant solutions in alternative sequences.

Methods

Dentin specimens from teeth with one root canal were instrumented and randomly divided into five groups. Each group was subjected to 17% EDTA, 17% ethyleneglycoltetraacetic acid (EGTA), or 10% citric acid (CA) and 5.25% sodium hypochlorite (NaOCl) varying the time of irrigant exposure and the order of the irrigants. The specimens were examined by scanning electron microscopy (SEM), and randomized digital images of the dentin surface were taken. The area of tubule openings was measured by a semiautomatic method.

Results

No erosion was detected when demineralizing agents were used as a final rinse after NaOCl. However, the erosion of peritubular and intertubular dentin was detected when EDTA, EGTA, or CA were used first followed by 5.25% NaOCl (P < .05), and an increase over 100% in the area of dentin tubule openings was measured (P < .01).

Conclusions

NaOCl used as a final irrigant solution after demineralization agents causes marked erosion of root canal dentin.     

Differential aggressiveness of ethylenediamine tetraacetic acid in causing canal wall erosion in the presence of sodium hypochlorite

Objective

This study tested the hypothesis that the use of ethylenediamine tetraacetic acid (EDTA) as a final irrigant causes canal wall erosion only after prolonged use of 5.25% sodium hypochlorite (NaOCl) as the initial irrigant.

Methods

Two irrigation protocols were employed: (1) 5.25% NaOCl as the initial irrigant for 10 min and 17% EDTA as the final irrigant for 2 min; and (2) 5.25% NaOCl for 60 min and 17% EDTA for 2 min. Flexural strengths of dentine beams prepared from human mid-coronal dentine were evaluated using a miniature three-point bending device after they were irrigated with either protocol. Transmission electron microscopy was used to examine the conditions of instrumented canal walls irrigated with either protocol after they were bonded with methacrylate resin-based sealers.

Results

Immersion of dentine beams in NaOCl for 60 min instead of 10 min prior to the use of EDTA resulted in a significant (p < 0.001) decline in flexural strength. For both NaOCl initial rinsing times, a 2-min final irrigation with EDTA created similar 0.5 μm thick demineralisation fronts. However, extensive surface and subsurface erosion of radicular dentine was seen only when the dentine was immersed in NaOCl for 60 min.

Conclusion

The apparent aggressiveness of EDTA in causing canal wall erosion is attributed to the prolonged use of NaOCl. The associated decline in dentine flexural strength has potential clinical relevance when thin pulp chamber dentine is immersed in NaOCl for lengthy periods during canal instrumentation. This may render root-treated teeth more prone to vertical fracture.     

Evaluation of the interaction between endodontic sealers and dentin treated with different irrigant solutions

Introduction

Dentin surface treatment with different substances might cause alterations in chemical and structural compositions of the human dentin. The aim of this study was to investigate the wettability of endodontic sealers in contact with dentin treated with 5.25% sodium hypochlorite (NaOCl) and 2% chlorhexidine (CHX) in the presence or absence of smear layer.

Methods

Thirty-six dentin slices were used. They were irrigated with NaOCl and washed with distilled water (DW) to simulate irrigation during chemomechanical preparation. After this procedure, the samples were divided into 6 groups: group 1, DW (control); group 2, NaOCl + DW; group 3, CHX + DW; group 4, ethylenediaminetetraacetic acid (EDTA) + DW; group 5, EDTA + DW + NaOCl + DW; group 6, EDTA + DW + CHX + DW. The Ramé-Hart goniometer was used to measure the contact angle between the dentin surfaces and the AH Plus and Real Seal SE sealers. Data were statistically analyzed.

Results

With regard to the contact angle between AH Plus and treated surfaces, the values of contact angle were lower when CHX was used, regardless of the presence or absence of smear layer. When Real Seal SE was evaluated, in the absence of smear layer, CHX presented lower values of contact angle. In the presence of smear layer, the use of NaOCl and CHX did not favor the spread of the sealer.

Conclusions

The present study has revealed that smear layer removal and final flush with CHX favor the wettability of AH Plus and Real Seal SE sealers.     

Effects of time and concentration of sodium ascorbate on reversal of NaOCl-induced reduction in bond strengths

The use of NaOCl as an endodontic irrigant lowers the bond strength of resin cements but this can be reversed by the use of 10% sodium ascorbate for 10 min. The objective of this study was to evaluate the effect of time and concentration of ascorbate at restoring the bond strength. Group 1 roots were prepared using 0.9% NaCl as an irrigant; group 2 roots were irrigated with 5.25% NaOCl; group 3 roots were irrigated with 5.25% NaOCl followed by 10% ascorbate for 10 min; group 4 roots were irrigated with 5.25% NaOCl followed by 10% ascorbate for 3 min; group 5 roots were irrigated with 5.25% NaOCl followed by 10% ascorbate for 1 min; and group 6 roots were irrigated with 5.25% NaOCl followed by 20% ascorbate for 1 min. All roots were then filled with C&B Metabond, stored 1 day in water, and then cross-sectioned into 6 slabs, 1 mm thick, that were trimmed and tested for tensile bond strength. The results demonstrated that 5.25% NaOCl irrigation produced (p < 0.05) significant reduction in resin-dentin bond strengths, but this can be reversed by 10% ascorbate treatment for 1 min.     

Cyclic Fatigue Resistance of Nickel-Titanium Instruments after Immersion in Irrigant Solutions with or without Surfactants

Introduction

The aim of the study was to assess cyclic fatigue resistance of reciprocating (Reciproc and WaveOne) and continuous rotating (ProTaper) nickel-titanium files after immersion in different irrigation solutions with or without surfactants during several short time periods.

Methods

A total of 270 new Reciproc R25, WaveOne Primary, and ProTaper F2 files were tested. Instruments of each brand were divided into 1 control group (n = 10) formed by new files and 4 test groups (n = 20) formed by instruments dynamically immersed at 37°C for 16 mm in 5.25% sodium hypochlorite (NaOCl), Hypoclean (5.25% NaOCl with surfactant), 17% EDTA, or EDTA Plus (17% EDTA with surfactant). Each test group was subdivided into 2 subgroups (n = 10) on the basis of the time of dynamic immersion in the endodontic irrigant solution (45 seconds or 3 minutes). Resistance to cyclic fatigue was determined by recording time to fracture in a stainless steel artificial canal with a 60° angle of curvature and 5-mm radius of curvature. The fracture surface was examined by using scanning electron microscopy.

Results

Immersion in NaOCl did not reduce the cyclic fatigue of reciprocating or continuous nickel-titanium files. The 17% EDTA reduced the fatigue resistance of all instruments after 3 minutes. The immersion in irrigants with surfactants did not influence the cyclic fatigue of instruments except for Reciproc immersed in Hypoclean solution.

Conclusions

EDTA immersion reduced the cyclic fatigue resistance of all instruments after 3 minutes. Addition of surfactants did not influence the cyclic fatigue of files except when added to NaOCl when it contacts Reciproc instruments.     

Effect of chemical irrigants on the bond strength of a self-etching adhesive to pulp chamber dentin

The aim of this study was to evaluate the influence of endodontic irrigants on adhesion to pulp chamber dentin. Seventy crowns of bovine incisors were cut to expose the pulp chamber. Specimens were divided into seven groups, according to the irrigant solution used: G1, 0.9% sodium chlorite (control); G2, 5.25% NaOCl; G3, 5.25% NaOCl + 17% EDTA; G4, 2% chlorhexidine solution; G5, 2% CHX solution + 17% EDTA; G6, 2% chlorhexidine in a gel base; and G7, 2% CHX gel + 17% EDTA. After irrigation, Clearfil SE Bond was applied to pulp chamber dentin, followed by Filtek Z250 composite. Six rectangular sticks were obtained from each specimen and dentin/resin interface was tested in tension. Bond strength means were analyzed by ANOVA and Tukey test. There was a significant decrease in bond strength associated to NaOCl, whereas chlorhexidine irrigation showed no effects on adhesion. It was concluded that endodontic irrigants affected differently bond strength to pulp chamber dentin.     

Inhibitory activity of root canal irrigants against Candida albicans, Enterococcus faecalis and Staphylococcus aureus

The present study evaluated the antimicrobial activity of three root canal irrigants against Enterococcus faecalis, Candida albicans, and Staphylococcus aureus. These microorganisms were incubated in the presence of citric acid (6 and 10%), EDTA (17%), and NaOCl (0.5, 1.0, 2.5, and 5.25%). Agar diffusion tests were performed and redox indicator resazurin was used to evaluate the inhibitory effect of the irrigants on the metabolic activity of these microorganisms. The mean diameters of the inhibition zones for the C. albicans cultures were 11.6 mm (17% EDTA), 5.5 mm (0.5% NaOCl), 12.9 mm (1% NaOCl), 22.1 mm (2.5% NaOCl), and 28.5 mm (5.25% NaOCl). The mean diameters of the inhibition zones for E. faecalis were 2.8 mm (1% NaOCl), 5.4 mm (2.5% NaOCl), and 8.3 mm (5.25% NaOCl). For S. aureus, the mean values were 8.0 mm (17% EDTA), 3.0 mm (1% NaOCl), 8.8 mm (2.5% NaOCl), and 10.0 mm (5.25% NaOCl). Most of the irrigant solutions presented effective antimicrobial activity against C. albicans. A high inhibitory effect on the metabolic activity of E. faecalis was detected when the microorganisms were incubated with 17% EDTA. The same result was reached when S. aureus was incubated in the presence of > 2.5% NaOCl. Altogether, these results indicate that 2.5% and 5.25% NaOCl are microbicides against S. aureus while 0.5% and 1% NaOCl are only microbiostatic against the tested bacteria. The 6% and 10% citric acid as well as 17% EDTA did not affect the viability of any of the assayed microorganisms.     

Antimicrobial and cytotoxic effects of phosphoric acid solution compared to other root canal irrigants

Phosphoric acid has been suggested as an irrigant due to its effectiveness in removing the smear layer.

Objectives

: The purpose of this study was to compare the antimicrobial and cytotoxic effects of a 37% phosphoric acid solution to other irrigants commonly used in endodontics.

Material and Methods

: The substances 37% phosphoric acid, 17% EDTA, 10% citric acid, 2% chlorhexidine (solution and gel), and 5.25% NaOCl were evaluated. The antimicrobial activity was tested against Candida albicans, Staphylococcus aureus, Enterococcus faecalis, Escherichia coli, Actinomyces meyeri, Parvimonas micra, Porphyromonas gingivalis, and Prevotella nigrescens according to the agar diffusion method. The cytotoxicity of the irrigants was determined by using the MTT assay.

Results

: Phosphoric acid presented higher antimicrobial activity compared to the other tested irrigants. With regard to the cell viability, this solution showed results similar to those with 5.25% NaOCl and 2% chlorhexidine (gel and solution), whereas 17% EDTA and 10% citric acid showed higher cell viability compared to other irrigants.

Conclusion

: Phosphoric acid demonstrated higher antimicrobial activity and cytotoxicity similar to that of 5.25% NaOCl and 2% chlorhexidine (gel and solution).     

Effective Analysis of the Use of Peracetic Acid after Instrumentation of Root Canals Contaminated with Enterococcus faecalis

Introduction

The aim of this study was to evaluate the effectiveness of peracetic acid (PAA) in cleaning root canals contaminated with Enterococcus faecalis.

Methods

Sixty first and second mandibular molars were used. Their mesiobuccal canals were prepared with the Reciproc System (VDW, Munich, Germany). The canals were irrigated with 10 mL saline during instrumentation. The teeth were randomly divided into 3 groups (n = 20), according to the irrigation solution to be used after instrumentation: group PAA (5 mL 1% PAA), group EDTA/sodium hypochlorite (NaOCl) (5 mL 17% EDTA followed by 5 mL 2.5% sodium hypochlorite), and group S (5 mL saline). Microbiological samples were collected before instrumentation and after final irrigation. Bacterial quantification was performed by counting the number of colony-forming units (CFUs/mL). The results were analyzed by the nonparametric Wilcoxon and Kruskal-Wallis tests.

Results

The 3 groups showed a significant reduction (P < .05) in CFUs/mL after final irrigation. PAA and NaOCl associated with EDTA produced a significantly higher reduction in CFUs/mL (P < .05) compared with saline. There was no statistically significant difference between PAA and EDTA + 2.5% NaOCl (P > .05).

Conclusions

According to the results of the present study, the effectiveness of 1% PAA was similar to that of 17% EDTA + 2.5% NaOCl in cleaning curved root canals contaminated with E. faecalis.     

Immediate Shear Bond Strength of Resin Cements to Sodium Hypochlorite–treated Dentin

Introduction

The purpose of this in vitro study was to evaluate the immediate shear bond strength of different categories of resin cements on sodium hypochlorite (NaOCl)-treated dentin and to evaluate if the bond was improved by a subsequent treatment with 10% sodium ascorbate before adhesive procedures.

Methods

This study tested immediate shear bond strengths to human dentin of 5 resin cements: Variolink II (Ivoclar Vivadent, Schaan, Liechtenstein), Multilink (Ivoclar Vivadent), Clearfil Esthetic Cement EX (Kuraray, Tokyo, Japan), SpeedCEM (Ivoclar Vivadent), and Clearfil SA Cement (Kuraray). All cements were tested with no NaOCl pretreatment of the dentin (negative control) and with a 20-minute exposure of the dentin to 6% NaOCl before bonding procedures. The cements found to have decreased bond strengths to NaOCl-treated dentin were tested with the dentin exposed to 10% sodium ascorbate after NaOCl exposure. The sodium ascorbate exposure times tested were 5 seconds and 1 minute.

Results

The mean and standard deviation values for immediate shear bond strength (MPa) for the negative control group were as follows: Variolink II, 18.8 ± 4.2; Multilink, 29.1 ± 7.1; Clearfil Esthetic Cement EX, 20.7 ± 4.9; SpeedCEM, 17.8 ± 4.2; and Clearfil SA Cement, 7.2 ± 2.8. The results for the NaOCl exposure group were as follows: Variolink II, 24.0 ± 6.7; Multilink, 34.1 ± 6.1; Clearfil Esthetic Cement EX, 20.7 ± 6.8; SpeedCEM, 0.0 ± 0.0; and Clearfil SA Cement, 0.1 ± 0.1. The results for the 5-second sodium ascorbate group were the following: SpeedCEM, 8.5 ± 2.6, and Clearfil SA Cement, 4.3 ± 2.0. The following results were found for the 1-minute sodium ascorbate group: SpeedCEM, 12.2 ± 3.2, and Clearfil SA Cement, 4.8 ± 1.0.

Conclusions

The resin cements tested varied in their capacity to adhere to NaOCl-treated dentin. Some resin cements exhibited equal or improved bond strengths (P < .05), whereas others exhibited significantly decreased bond strengths (P < .05). For the susceptible resin cements, a rinse of 10% sodium ascorbate provided an immediate restoration of at least 50% of the original bond strength (P < .05). The efficacy of sodium ascorbate may vary among resin cements.     

Efficacy of various concentrations of NaOCl and instrumentation techniques in reducing Enterococcus faecalis within root canals and dentinal tubules

AIM: To evaluate the efficacy of 0.5%, 2.5% and 5.25% sodium hypochlorite (NaOCl) as intracanal irrigants associated with hand and rotary instrumentation techniques against Enterococcus faecalis within root canals and dentinal tubules. METHODOLOGY: A total of 180 extracted human premolar teeth were infected for 21 days with E. faecalis. The specimens were divided into 12 groups, as follows: group 1: 5.25% NaOCl + Hybrid technique (Valdrighi et al. 1998); group 2: 5.25% NaOCl + nickel-titanium (NiTi) rotary technique 4 mm shorter than the apex (by FOP-UNICAMP); group 3: 5, 25% NaOCl + NiTi rotary technique (Hero 642); group 4: 2.5% NaOCl +Hybrid technique; group 5: 2.5% NaOCl + NiTi rotary technique 4 mm shorter than the apex; group 6: 2.5% NaOCl + NiTi rotary technique (Hero 642); group 7: 0.5% NaOCl + Hybrid technique; group 8: 0.5% NaOCl + NiTi rotary technique 4 mm shorter than the apex; group 9: 0.5% NaOCl + NiTi rotary technique (Hero 642); group 10: sterile saline solution + Hybrid technique; group 11: sterile saline solution + NiTi rotary technique 4 mm shorter than the apex; group 12: sterile saline solution + NiTi rotary technique (Hero 642). Canals were sampled before and after preparation. After serial dilution, samples were plated onto brain heart infusion (BHI) agar, and the colony forming units (CFU) that were grown were counted. The teeth were sectioned into three thirds and dentine chips were removed from the canals with conical burs. The samples obtained with each bur were immediately collected into test tubes containing BHI broth, and were incubated at 37 degrees C and plated onto BHI agar. The CFU were counted and analysed. RESULTS: At all depths and thirds of the root canals and for all techniques used, 5.25% NaOCl was shown to be the most effective irrigant solution tested when dentinal tubules were analysed, followed by 2.5% NaOCl. No differences among concentrations in cleaning the canals were found. CONCLUSIONS: Especially at higher concentrations, NaOCl, was able to disinfect the dentinal tubules, independent of the canal preparation technique used.     

Evaluation of the colour change in enamel and dentine promoted by the interaction between 2% chlorhexidine and auxiliary chemical solutions

To evaluate the colour change in enamel and dentine, promoted by interaction of 2% chlorhexidine gluconate (CHX) with 5.25% sodium hypochlorite (NaOCl) and 17% ethylenediaminetetraacetic acid (EDTA). Fragments containing enamel and dentine were obtained from the crowns of extracted bovine incisors. Before and after immersion of the samples in the substances, they were evaluated with reference to the colour of the enamel and dentine. The values obtained in numerical scores were subjected to statistical analysis using Wilcoxon test. A colour change in the enamel and dentine in groups treated with CHX gel + NaOCl and CHX gel + NaOCl + EDTA, and a change in colour only in the dentine in groups treated with CHX solution + NaOCl and CHX solution + NaOCl + EDTA. When used prior to NaOCl, CHX has the ability to induce a colour change in dental structures.     

Effect of post-space treatment on retention of fiber posts in different root regions using two self-etching systems

The effect of post-space treatment on the retention of fiber posts in different root regions was evaluated using two self-etching systems. Post spaces were prepared in extracted premolars and then the root canals were subjected to one of the following post-space treatments: (i) water irrigation (control); (ii) etching with 35% phosphoric acid for 30 s; (iii) irrigation with 17% EDTA followed by 5.25% sodium hypochlorite (NaOCl); and (iv) ultrasonic agitation associated with 17% EDTA and 5.25% NaOCl irrigating solutions. The dentin surfaces were examined under scanning electron microscopy (SEM) after different post-space treatments. Fiber posts were then luted in the treated roots using resin cement with either Clearfil SE Bond or Clearfil DC Bond, and the thin-slice push-out test was performed. Scanning electron microscopy showed that all the post-space treatments tested were effective in removal of the smear layer of debris, or sealer/gutta-percha remnants, on the root canal. The apical push-out strength was affected by post-space treatment. Both 35% phosphoric acid etching and ultrasonic agitation in combination with EDTA/NaOCl irrigation improved the apical push-out strength of the fiber post, regardless of the type of self-etching system. A solo irrigation with an EDTA/NaOCl solution resulted in a lower apical push-out strength compared with the other two experimental groups.     

A collagen ''bio-molecular film''ex vivo model to evaluate the efficacy of dynamic irrigation using the RinsEndo® system

Aim To characterise changes in the chemical composition of dentine after exposure to sodium hypochlorite and ethylenediaminetetracetic acid (EDTA) using ATR‐FTIR and Raman spectroscopy. Methodology Crown dentine was acquired from recently extracted molars stored in formal‐saline (group A) or saline and frozen at ?2^oC (group B); it was then ground and sieved into a range of particle sizes. Samples from both groups (n = 5 each) were analysed with FTIR to investigate the influence of storage medium and to assign FTIR spectral peaks for collagen, carbonate, phosphate. As no differences were found, the samples were pooled for subsequent experiments. Ten samples of particle size range 38–75 μm were used to study the effect of mass ratio of NaOCl (2.5%): dentine over 5–10 min. Thirty samples of all sizes were reacted with 2.5% sodium hypochlorite at 1:0.5 (dentine:NaOCl) mass ratio for 2–10 min; EDTA (n = 90) for 5–1440 min; NaOCl for 10 min followed by EDTA for 10 mins (n = 30); the latter samples were further exposed to NaOCl for 10 min after obtaining FTIR spectra. Results FTIR spectra from the surface of the particles (~1.5 μm depth) were obtained for all the samples and Raman spectra (40 μm depth) were obtained for one sample each reacted either with NaOCl or EDTA. Spectral peak assignment was confirmed by previous data. Storage media had no effect on outcome measures used. The dentine:NaOCl ratio influenced collagen depletion. NaOCl affected the collagen FTIR peaks, mostly in the first 2–4 min, but only influenced the phosphate and carbonate peaks slightly. EDTA affected the phosphate:collagen peaks, which reduced over time, whilst the collagen peak values showed an increase. The two solutions (NaOCl and EDTA) used alternately, respectively increased collagen or phosphate peaks depending on the final solution used. Conclusions These series of investigations confirmed that sodium hypochlorite depletes the organic content of dentine and EDTA depletes the inorganic content. Used alternately, they have the ability to progressively degrade dentine structure.     

Effect of EDTA,Sonic, and Ultrasonic Activation on the Penetration of Sodium Hypochlorite into Simulated Lateral Canals: An In Vitro Study

IntroductionThe purpose of this study was to evaluate the penetration of 5.25% sodium hypochlorite alone or in combination with 17% EDTA in simulated lateral canals using sonic and ultrasonic activation.MethodsFour hundred and eighty simulated lateral canals were created in 80 single rooted cleared teeth by inserting 06 K-files at 2, 4.5 and 6 mm of working length. Samples were mounted on clear silicon to simulate the presence of surrounding periodontal tissues and its effects on fluid dynamics and then randomly assigned to four experimental groups: 1 (n = 20) 5.25% NaOCl + sonic activation; 2 (n = 20) 5.25% NaOCl + ultrasonic activation; 3 (n = 20) 5.25% NaOCl + 17% EDTA + sonic activation and 4 (n = 20) 5.25% NaOCl + 17% EDTA + ultrasonic activation. Sonic activation was delivered using the Endoactivator® inserted 2 mm short of working length and activated for 1 minute. Ultrasonic activation was performed with a stainless steel ultrasonic file inserted 2 mm short of working length and passively activated for 3 cycles of 20 seconds each. Samples were evaluated by direct observation of the images recorded under the operating microscope and by radiographic evaluation after irrigation with a contrast solution.ResultsSonic and ultrasonic activation resulted in a better irrigation of the lateral canals at 4.5 and 2 mm from working length compared to traditional needle irrigation alone. Traditional needle irrigation alone demonstrated significantly less penetration of irrigant into the lateral canals and was limited to the level of penetration of the needle.ConclusionThe addition of EDTA did not result in better penetration of irrigants into the lateral canals.     

Concentration-dependent Effect of Sodium Hypochlorite on Stem Cells of Apical Papilla Survival and Differentiation

Introduction

Intracanal disinfection is a crucial step in regenerative endodontic procedures. Most published cases suggest the use of sodium hypochlorite (NaOCl) as the primary irrigant. However, the effect of clinically used concentrations of NaOCl on the survival and differentiation of stem cells is largely unknown. In this study, we tested the effect of various concentrations of NaOCl on the stem cells of the apical papilla (SCAPs) survival and dentin sialophosphoprotein (DSPP) expression.

Methods

Standardized root canals were created in extracted human teeth and irrigated with NaOCl (0.5%, 1.5%, 3%, or 6%) followed by 17% EDTA or sterile saline. SCAPs in a hyaluronic acid–based scaffold were seeded into the canals and cultured for 7 days. Next, viable cells were quantified using a luminescence assay, and DSPP expression was evaluated using quantitative real-time polymerase chain reaction.

Results

There was a significant reduction in survival and DSPP expression in the group treated with 6% NaOCl compared with the untreated control group. Comparable survival was observed in the groups treated with the lower concentrations of NaOCl, but greater DSPP expression was observed in the 1.5% NaOCl group. In addition, 17% EDTA resulted in increased survival and DSPP expression partially reversing the deleterious effects of NaOCl.

Conclusions

Collectively, the results suggest that dentin conditioning with high concentrations of NaOCl has a profound negative effect on the survival and differentiation of SCAPs. However, this effect can be prevented with the use of 1.5% NaOCl followed by 17% EDTA. The inclusion of this irrigation regimen might be beneficial in regenerative endodontic procedures.     

Quantitative analysis of the solubilizing action of MTAD,sodium hypochlorite,and EDTA on bovine pulp and dentin

Necrotic bovine pulp and dentin were used in this study as model tissues to represent the organic and inorganic components of the smear layer present in instrumented root canals. The capabilities of endodontic irrigants to dissolve pulverized forms of these tissues were compared. Lyophilized tissue samples were mixed for 2 h at 37 degrees C with MTAD, three concentrations of sodium hypochlorite (NaOCl), 17% EDTA, or isotonic saline. Undissolved tissues were rinsed with water and lyophilized. The change in tissue weight after exposure to an irrigant was measured to quantify solubilization. The results showed that various concentrations of NaOCl removed organic components of pulp and dentin effectively. As pulp solubilizers 5.25% and 2.60% NaOCl were equal (>90%), and 5.25% NaOCl was capable of dissolving virtually the entire organic component of dentin. EDTA was capable of solubilizing inorganic material in dentin and organic material in pulp and likely also in dentin. It dissolved >70% of the dentin and >51% of the pulp. The solubilizing effects of MTAD on pulp and dentin were somewhat similar to those of EDTA. The major difference between the actions of these solutions was a high binding affinity of doxycycline present in MTAD for the dentin.