Search

The aim of this study is to compare the effect of a single diode laser application and agitation of EDTA with diode laser with different parameters at different time intervals on root fracture. Ninety mandibular incisors were instrumented except the negative control group. The specimens were divided randomly into 10 groups according to final irrigation procedure: ( G1) non-instrumented; ( G2) distilled water; ( G3) 15% EDTA; ( G4) ultrasonically agitated EDTA; ( G5) single 1.5 W/100 Hz Diode laser; ( G6) single 3 W/100 Hz Diode laser; ( G7) 1.5 W/100 Hz Diode laser agitation of EDTA for 20 s; ( G8) 1.5 W/100 Hz Diode laser agitation of EDTA for 40 s; ( G9) 3 W/100 Hz Diode laser agitation of EDTA for 20 s; and ( G10) 3 W/100 Hz Diode laser agitation of EDTA for 40 s. The specimens were filled, mounted in acrylic resin, and compression strength test was performed on each specimen. Statistical analysis was carried out using one way ANOVA and Tukey's post hoc tests ( P = 0.05). The statistical analysis revealed that there were statistically significant differences among the groups ( P < 0.05). Laser-agitated irrigation with a 3 W/100 Hz Diode laser for both 20 s and 40 s decreased the fracture resistance of teeth. [ABSTRACT FROM AUTHOR]

Purpose: New solutions are needed to overcome the disadvantages of irrigation solutions that are frequently used to remove the inorganic part of the smear layer. The goal of the current study was to compare the effect of 5%, 10%, and 17% GA, 9% HEBP, 17% EDTA, and 10% CA on the fracture strength of endodontically treated premolars. Methods: Eighty-eight mandibular premolar teeth were selected. Eleven intact specimens were preserved as negative controls. After root canal preparation, the specimens were divided into 8 groups for the final irrigation procedure: Positive control (distilled water), 17% EDTA, 10% CA, 9% HEBP, 5% GA, 10% GA, and 17% GA (n = 11). After the final irrigation procedure, the root canals were obturated. Access cavities were filled with composite resin. A universal testing machine was used to measure the force required to fracture the specimens. Data were statistically analyzed. Results: The negative control group showed higher fracture strength than all other groups except the positive control group (p < 0.05). There was no statistically significant difference among the EDTA, CA, HEBP, and GA groups (p > 0.05). Conclusion: Within the limitations of this study, 1-minute use of 17% EDTA, 10% CA, 9% HEBP, 5% GA, 10% GA, and 17% GA as final irrigation solutions, in combination with NaOCl, had no effect on the fracture resistance of premolar teeth. [ABSTRACT FROM AUTHOR]

Copyright of Current Research in Dental Sciences is the property of Ataturk University Coordinatorship of Scientific Journals and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: This study evaluated the effect of various endodontic irrigation regimens, using NaOCl followed by different agents for smear layer removal, on the surface and interface of Biodentine with dentine. Materials and methods: Furcal perforations were produced in 60 permanent mandibular molars. The walls of the perforated area were contaminated with blood and then perforations were covered with Biodentine and the teeth were divided into six groups (n = 10). In the control group, all irrigation procedures were performed using distilled water. In the other five groups 5.25% NaOCl was used as initial irrigant followed by: distilled water (DW group); 17% ethylenediaminetetraacetic acid (EDTA group); 37% phosphoric acid (PA group); 10% citric acid (CA group); and 7% maleic acid (MA group). The specimens were analysed using scanning electron microscopy (SEM) before and after the irrigation procedure to evaluate the morphology of Biodentine on the surface. SEM images were analysed qualitatively using a score system (Score 0, no modification between initial and final images; Score 1, modification between initial and final images). Pushout bond strength test was performed 7 days after sample preparation. Data were statistically analysed using Kruskal--Wallis and Dunn tests (P < 0.05). Results: All irrigation regimens modified the topography of Biodentine. The regimens that used NaOCl/DW and NaOCl/EDTA showed significantly lower push-out bond strength values when compared to NaOCl/PA, NaOCl/CA, NaOCl/MA and control (P < 0.05). Conclusions: The regimens using NaOCl/DW or NaOCl/EDTA compromised the push-out bond strength results when compared with other groups. [ABSTRACT FROM AUTHOR]

Purpose: This study compared the effects of different irrigation solutions on the microhardness of root dentin. Methods: Fifty single-rooted human teeth were chosen, and the roots were randomly divided into five groups (n = 10) according to the irrigant used for 5 min: 17% ethylenediaminetetraacetic acid (EDTA), 2% boric acid (BA), 5% BA, 10% BA, and distilled water (DW). After the irrigation procedure, dentin surface microhardness was calculated using a Vickers indenter 100 μm from the root canal lumen. Comparisons between the groups were performed with a two-way ANOVA test and and Tukey's multiple comparison test (p = 0.05). Results: All irrigation solutions decreased the microhardness of root canal dentin. The DW and 2% BA had a minimum effect on the microhardness of root canal dentin, whereas a significant decrease in surface microhardness was found in 10% BA group (p < 0.05). The coronal third of the 10% BA group showed the lowest percentage decrease, with a significant difference between the apical and middle thirds (p < 0.05). Conclusion: In this study, 5% BA and 17% EDTA showed similar effects on the microhardness of root canal dentin. Further clinical research is required to evaluate the biocompatibility and safety of BA solutions. [ABSTRACT FROM AUTHOR]

Background: Growth factors embedded in the extracellular matrix of the dentin play an important role in the migration, proliferation, and differentiation of dental pulp stem cells in regenerative endodontics. In regenerative endodontic treatments, the type of irrigation solution used is crucial for the release of growth factors (GFs) from the dentin matrix. This study evaluated the effectiveness of different irrigant activation techniques (IAT) using two different chelating agents, 17% ethylenediaminetetraacetic acid (EDTA) and 9% etidronic acid (HEDP), in terms of their GF release. Methods: Seventy-two mandibular premolar teeth were prepared to simulate an open apex. The root fragments were irrigated with 20 ml of 1.5% sodium hypochlorite and 20 ml of saline solution. Eight root fragments were randomly separated for the control group, and the remaining 64 fragments were randomly separated into eight groups based on two different chelating agents (17% EDTA and 9% HEDP) and four different IAT ((conventional needle irrigation (CNI), passive ultrasonic irrigation (PUI), sonic activation with EDDY, and XP-endo Finisher (XPF)). TGF-β1, VEGF-A, BMP-7 and IGF-1 release levels were determined using an ELISA, and statistical analysis was performed using the Kolmogorov–Smirnov test, ANOVA, and the Tukey test (p <.05). Results: Compared to the control group, the experimental groups showed significantly higher GF release when using EDTA or HEDP. Among the activation groups, the EDDY group triggered the highest GF release, and the CNI group triggered the lowest. Conclusions: IAT with EDTA and HEDP can increase GF release, with EDDY being the most effective IAT method. Using chelating agents with IAT may be beneficial in regenerative endodontic treatments. [ABSTRACT FROM AUTHOR]

Introduction: Transforming Growth Factor-Beta 1 (TGF-β1) plays a crucial role in the success of Regenerative Endodontic Procedures (REPs) as they directly impact the proliferation and differentiation of stem cells. TGF-β1 is released by conditioning of the dentin matrix using 17% EDTA. EDTA was found to have deleterious effects on dentin especially in immature teeth with fragile dentin walls. Decreasing the irrigation time was reported to decrease these effects. Accordingly, enhancement and activation of the EDTA solution to maintain its efficiency in TGF-β1 release from dentin and thus compensating the reduction in irrigation time was employed. EDTA solution was enhanced by adding Nanobubble (NB) water which contains oxygen filled cavities less than 200 nm in diameter. Additionally, EDTA was activated with XP-endo Finisher rotary file. The aim of this study was to assess the impact of NB enhancement and/or XP-endo Finisher activation of the EDTA solution on the TGF-β1 release from dentin. Methods: Fifty standardized root segments with open apex were allocated to two main groups according to whether EDTA was enhanced with NB water or not, and within each group whether XP-endo Finisher activation was used or not in addition to a Negative Control group. The concentration of the released TGF-β1 in the root canal was measured using enzyme-linked immunosorbent assay (ELISA). The statistical analysis was done using the Shapiro- Wilk, Kolmogorov Smirnov, ANOVA and Post-hoc Tukey tests. Results: All groups released a considerable amount of TGF-β1 with the highest values in the EDTA/NB/XP group, followed by EDTA/NB, EDTA/DW/XP, EDTA/DW and Negative Control groups respectively. Conclusions: The results of this study suggest that NBs can promote the success of REPs since it revealed a significant increase in the TGF-β1 release following its use in the enhancement of the EDTA solution. A comparable effect was obtained by XP-endo finisher activation of the EDTA solution. The combined use of NBs and XP-endo Finisher can be a promising addition in REPs. Accordingly, Enhancement and activation of the EDTA solution may compensate decreasing the EDTA irrigation time attempted to avoid the deleterious effect of EDTA on dentin. [ABSTRACT FROM AUTHOR]

Aim: 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. Materials and Methods: 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. Results: 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. Conclusions: 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. [ABSTRACT FROM AUTHOR]

The activity of biomaterials used during endodontic treatment can be affected by various factors. One of them is the chemical action of the irrigant that they are exposed to. The aim of this multimethod ex vivo study was to evaluate the influence of ethylenediaminetetraacetic acid (EDTA) on the surface appearance and chemical composition of Biodentine used in perforation repair. Twenty material specimens were prepared according to manufacturers' recommendations and divided into two setting-time-based groups, tested after 45 min (group A) and 24 h (group B) of setting. Material was irrigated with 17% EDTA solution with or without simultaneous ultrasonic activation. The surface characteristics and the chemical composition analysis of the Biodentine specimens were performed with the aid of a scanning electron microscope (SEM) and an energy dispersive spectroscopy (EDS) method, respectively. The volumetric loss of material was measured by dedicated digital software in an optical microscope. Statistical analysis was performed. The EDS study confirmed that after the rinsing protocol, the percentage content of elements differed between the groups. The EDTA rinse, whether ultrasonically activated or not, visibly affected the surface appearance and chemical composition of Biodentine. The specimens' surface subjected to irrigation was more irregular under SEM than in a control group. The US activation of the liquid amplified its impact on the tested material. The average volume loss in group A after 5 min irrigation was 3.98 µm3 for each µm2 of the chosen area and it increased up to 7.74 µm3/μm2 after the ultrasonic activation. In group B, indicated volume loss values were 6.30 and 11.70 µm3/μm2 for 5 min irrigation without and with US activation, respectively. Using a 20 min irrigation time and ultrasonic activation increased it up to 32.71 µm3/µm2. Each rinsing protocol involving irrigation with ethylenediaminetetraacetic acid modified the surface features and the chemical composition of the evaluated hydraulic tricalcium silicate cement. Further research is needed to indicate the possible impact of the observed changes on its long-term clinical performance. [ABSTRACT FROM AUTHOR]

This scoping review aimed to synthesize and explore the current boundaries and limitations of laboratory research on the effectiveness of continuous chelation irrigation protocol in endodontics. This scoping review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Extension for Scoping Reviews. Literature search was conducted on Pubmed and Scopus to identify all laboratory studies evaluating smear layer and hard-tissue debris removal or, antimicrobial efficacy, or dentine erosion induced by continuous chelation. Two independent reviewers performed the all review steps and the relevant items were recorded. Seventy-seven potentially relevant studies were identified. Finally, 23 laboratory studies met the eligibility criteria for qualitative synthesis. Seven studies focused on the smear layer/debris removal outcome, 10 on antimicrobial activity, and 10 on dentine erosion. In general, the continuous chelation protocol was equally or more effective in the cleanliness of root canals and antimicrobial activity compared with traditional sequential protocol. In addition, etidronate solutions seemed to be milder chelating agents compared to those with EDTA, thus resulting in reduced or no dentine erosion and roughness modification. Yet, the methodological differences among the included studies limit the results' generalizability. The continuous chelation seems to be equally or more effective in all investigated outcomes when compared with the traditional sequential protocol. The methodological variability among the studies and shortcomings in the methods employed limit the generalizability and clinical relevance of the results. Standardized laboratory conditions combined with reliable three-dimensional investigation approaches are necessary to obtain clinically informative findings. [ABSTRACT FROM AUTHOR]

Background and Objectives: Successful root canal treatment depends on the thorough removal of biofilms through chemomechanical preparation. This study aimed to investigate and compare the cleaning and disinfecting efficiency of oval-shaped root canals using XP-endo Shaper (XPS), ProTaper Next (PTN), and HyFlex CM (HCM) in combination with passive ultrasonic irrigation (PUI). Materials and Methods: Ninety extracted teeth were contaminated and randomly divided into three groups: XPS, PTN, and HCM. Each group was assigned to three subgroups: subgroup A (sterile saline), subgroup B (3% sodium hypochlorite and 17% ethylenediaminetetraacetic acid), and subgroup C (3% sodium hypochlorite, 17% ethylenediaminetetraacetic acid, and PUI). Bacterial sampling was conducted both from baseline samples and samples after chemomechanical preparation. Scanning electron microscopy (SEM) was used to evaluate the residue bacterial biofilms, hard tissue debris, and smear layers on the buccolingual walls of oval-shaped root canals. Results: When combined with sterile saline, XPS demonstrated a higher reduction of bacterial counts and was more effective in eradicating Enterococcus faecalis in the middle third of the canals compared to the other instruments (p < 0.05). Additionally, when used with antimicrobial irrigants, XPS was more effective in disinfecting the coronal third of the canals than the other instruments (p < 0.05). Furthermore, XPS reduced hard tissue debris more effectively in the middle third of canals than in the apical third (p < 0.05). Conclusions: XPS outperforms PTN and HCM in disinfecting oval-shaped root canals. Despite the fact that combining XPS and PUI improves cleaning and disinfecting, removing hard tissue debris from the critical apical area remains challenging. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the release levels of transforming growth factor beta-1 (TGF-β1), bone morphogenetic protein-7 (BMP-7), insulin-like growth factor-1 (IGF-1), and vascular endothelial growth factor-A (VEGF-A) from the dentin matrix using 10% and 17% ethylenediaminetetraacetic acid (EDTA) and 10% and 20% citric acid during regenerative endodontic procedures. Methods: Fifty mandibular single-rooted premolar teeth were used. 8-mm cylindrical roots were irrigated with 1.5% sodium hypochlorite. Root segments were divided into groups by 20 mL of final irrigants: saline, 10% or 17% EDTA, and 10% or 20% citric acid. The samples were placed into culture medium and kept in an incubator at 37°C for 24 h. The supernatants were collected to measure the levels of growth factors with an enzyme-linked immunosorbent assay. The data were evaluated using a one-way analysis of variance. Results: EDTA or citric acid increased the release levels of all growth factors compared to the control group. The greatest amount of TGF-β1 release was measured with 17% EDTA; however, it was not significantly different from 10% citric acid. The lowest amount of BMP-7 released was with 10% citric acid, which was significantly different from the other groups. Conclusion: The 17% EDTA and 10% citric acid solutions had a similar effect on the release of growth factors from the dentin matrix. [ABSTRACT FROM AUTHOR]

Objective: This study assessed the push-out bond strength (POBS) of an epoxy resin-based sealer in oval-shaped root canals after a final irrigation protocol using XP-endo Finisher and ultrasonic activation. Materials and methods: Thirty oval-shaped human root canals were prepared with Reciproc R25 and a final irrigation regimen using 5.25% sodium hypochlorite and 17% ethylenediaminetetraacetic acid (EDTA) was performed. The teeth were divided into three groups (n = 10) according to the final irrigation activation technique: no activation (control), ultrasonic activation and XP-endo Finisher activation. Specimens were filled only with AH Plus sealer and the POBS test was used to measure the bond strength between the root canal dentine and AH Plus sealer. The data obtained from the POBS test were analysed using two-way analysis of variance and Tukey post-hoc tests (P < 0.05). Results: The POBS values decreased from the coronal to the apical direction (P < 0.05). There was a significant association between the activation technique and the root canal third (P < 0.05). In the coronal and middle third, XP-endo Finisher and ultrasonic activation showed higher POBS than the control group (P < 0.05). In the apical third, XP-endo Finisher showed higher POBS than ultrasonic activation (P < 0.05) and the control group (P < 0.001). Ultrasonic activation also showed higher POBS values in the apical third when compared to the control group (P < 0.05). Conclusions: The activation of root canal irrigants influenced POBS of root canal sealers in the different root thirds of oval-shaped canals. The use of XP-endo Finisher file resulted in better POBS than ultrasonic activation in the apical third. [ABSTRACT FROM AUTHOR]

Copyright of Meandros Medical & Dental Journal is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To compare the ability of 5% carbohydrate derived-fulvic acid (CHD-FA) with 17%ethylenediamine tetraaceticacid (EDTA) on smear layer removal when used as a final irrigant, and to assess their effect on root dentin microhardness. Methods: A total of 56 single-rooted human mandibular premolars were decoronated to obtain standardized root length of 12 mm. Canal patency was established using 10 size K-file, working length was determined. Based on the irrigation regimen, samples were assigned into three groups; 17% EDTA, 5% CHD-FA and distilled water (control). The canals were instrumented with Protaper till F3 size. A standardized volume of 5 mL of each testing solution was used for 1 min. Roots were longitudinally split into two halves with one half of the samples for SEM analysis to evaluate the smear layer removal at coronal, middle, and apical thirds of root dentin. The other halves of the samples were subjected to Vickers microhardness testing. The data was statistically analyzed using Kruskal Wallis and Post Hoc test (P<0.05). Results: 5% CHD-FA and 17% EDTA showed significant smear layer removal at all levels compared to distilled water (P<0.05). In the apical third, 5% CHD-FA showed significantly increased smear layer removal than EDTA (P<0.05). Microhardness testing of apical third showed significantly lesser reduction in microhardness for CHD-FA than EDTA (P<0.05). Conclusion: 5% CHD-FA could be a promising final irrigant for smear layer removal with decreased microhardness reduction on root dentin compared to 17% EDTA. [ABSTRACT FROM AUTHOR]

Objective: This study was undertaken to compare microhardness and erosion susceptibility of root dentine in teeth extracted from diabetic and non-diabetic donors after the application of different root canal irrigants. Methods: Forty-eight single-rooted premolars with single canals (24 each from diabetic and non-diabetic) were selected, and root canals were shaped by using rotary ProTaper files. Dentine slices of 4 mm were transversely sectioned from the middle root third. Specimens were assigned to four subgroups (n=6) and irrigated for 5 minutes: 1) 2.6% sodium hypochlorite (NaOCl); 2) 17% ethylenediaminetetraacetic acid (EDTA); 3) 2% chlorhexidine (CHX); and 4) normal saline. Surface microhardness was determined at 100- and 500-µm depths from the pulp--dentine interface. Scanning electron microscope (SEM) was used to determine the severity of dentine erosion. Data were analyzed by using two-way ANOVA, Post-hoc Tukey's, and Chi-square tests (P<0.05). Results: Diabetes as well as NaOCl and EDTA decreased surface microhardness of dentine significantly (P<0.05). Diabetes had little effect on the erosion susceptibility of dentine (P>0.05). Conclusion: Root canal irrigants can significantly lower the microhardness; specifically, in diabetic patients, and may be a factor affecting the longevity of root canal-treated teeth. [ABSTRACT FROM AUTHOR]

Aim: The purpose of the present study is to evaluate the effectiveness of different irrigation techniques EndoVac, RinsEndo, Canal CleanMax (CCMax), SonicMax, Passive Ultrasonic Irrigation (PUI), and Manual Needle Irrigation (MNI) on dentin erosion and smear layer removal using Scanning electron microscopy (SEM). Materials and Methods: Seventy extracted single-rooted teeth were instrumented with ProTaper rotary instruments. The roots were randomly divided into six experimental groups (n = 10): EndoVac, RinsEndo, CCMax, SonicMax, PUI, and MNI. Final irrigation was performed with NaOCl followed by ethylenediaminetetraacetic acid and NaOCl. Six roots served as control and were irrigated with only NaOCl. Next, the roots were sectioned in a buccolingual direction and the halves were examined by SEM. Smear layer and erosion scores were recorded in the cervical, middle and apical third of the roots. Data analysis was performed using the Kruskal–Wallis and Mann–Whitney U-tests with a level of significance α = 0.05. Results: PUI had the greatest amount of smear layer compared to other groups (P < 0.001). However, SonicMax had the greatest degree of erosion compared to RinsEndo, MNI, PUI, and EndoVac groups (P < 0.001) and CCMax group (P < 0.05). Conclusions: RinsEndo and EndoVac techniques left the least amount of smear layer while causing erosion the least compared to CCMax, PUI, and MNI techniques. [ABSTRACT FROM AUTHOR]

Objective: The aim of this randomized controlled clinical trial was to investigate the antimicrobial efficacy of traditional positive pressure (PP) irrigation compared with apical negative pressure (ANP) in tapered as well as non-tapered root canal preparation techniques.Method and Materials: Patients referred for treatment of mandibular permanent molars with necrotic pulps and apical periodontitis were considered for this study. A total of 32 eligible teeth were evaluated based on strict inclusion and exclusion criteria and randomly assigned as follows: Group 1: LightSpeed LSX 0.02 preparation and A NP irrigation (n = 8). Group 2: LightSpeed LSX 0.02 preparation and PP irrigation (n = 8). Group 3: ProTaper preparation and A NP irrigation (n = 8). Group 4: ProTaper preparation and PP irrigation (n = 8). A ll teeth were sampled immediately upon access (S1), after completion of the chemo- mechanical preparation (S2), and one week later after intracanal medication (S3). All samples were microbiologically processed immediately and plated in duplicates on aerobic plates, anaerobic plates, and chocolate plates and colonies statistically analyzed. Results: No statistically significant differences were found between groups at S1. When comparing colony-forming unit (CFU) levels at S1 and S2 within groups, the reduction was statistically significant in all groups. While no significant difference was found in the proportion of teeth that culture positive at either S2 or S3 by shaping groups, a significant difference was noted when comparing PP irrigation and A NP groups. The percentage of samples in the PP irrigation group with a negative culture at both time points was 67%, compared to 100% among the A NP group. Conclusion: Within the limitations of the present study, taper and apical size failed to demonstrate a difference in microbiological reduction of cultivable bacteria. On the other hand, A NP revealed a significant difference when compared to PP irrigation. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to evaluate the in vitro efficacy of the RinsEndo device to remove the smear layer and debris in root canals. Materials and methods: Three groups of teeth (20 teeth in each) were instrumented with ProTaper files to F3 and irrigated as follows: Group 1 (control): syringe irrigation with 20 ml of 3% sodium hypochlorite (NaOCl), then a flush-flow with 2 ml 8% ethylenediaminetetraacetic acid (EDTA) solution and a final rinse with 3 ml 3% NaOCl; Group 2: irrigation by RinsEndo with the same irrigants and volumes as in Group 1; Group 3: irrigation by RinsEndo, 20 ml NaOCl then 2 ml EDTA, and the final rinse with 3 ml 3% NaOCl activated by passive ultrasonic irrigation. Teeth were split longitudinally, and the middle and apical thirds of the root walls were observed by a scanning electron microscope (SEM). Mean scores for the smear layer and debris were compared between the groups (Kruskal-Wallis and Mann-Whitney tests). Results: No significant difference was found between the smear layer scores (P > 0.05). For debris, Group 3 showed significant differences from Group 1 (P = 0.001) in the apical third. Conclusions: RinsEndo used alone did not show improved removal of debris and smear layer when compared with manual syringe irrigation. RinsEndo used in conjunction with ultrasonic irrigation removes debris better than manual irrigation. [ABSTRACT FROM AUTHOR]

The combination of ethylenediaminetetraacetic acid (EDTA) and sodium hypochlorite (NaOCl) has been advocated as an effective irrigation methodology to remove organic and inorganic matter in root canal therapy. Yet, it was suggested that both solutions might lead to structural changes of the dentinal wall surface, depending on the order of application which might affect sealer mechanical retention. This study aims to evaluate the effect of different irrigating protocols on dentin surface roughness using quantitative 3D surface texture analysis. Data stems from 150 human root dentin sections, divided into five groups, each prepared according to one of the following protocols: Negative control; 17% EDTA; 17% EDTA followed by 5.25% NaOCl; 5.25% NaOCl; and 5.25% NaOCl followed by 17% EDTA. Each dentin sample was examined for its three-dimensional surface texture using a high-resolution confocal disc-scanning measuring system. EDTA 17% and the combined EDTA 17% with NaOCl 5.25% showed considerably higher roughness properties compared to the control and to NaOCl 5.25% alone. However, the irrigation sequence did not affect the dentin roughness properties. Therefore, mechanical retention is probably not dependent upon the selection of irrigation protocol sequence. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the antimicrobial and antibiofilm activity of two chelating agents: ethylenediaminetetraacetic acid (EDTA) combined or not with detergents, and etidronic acid combined with sterile saline. The bacterial inhibitory and bactericidal concentrations (MIC and MBC, respectively) were determined on Enterococcus faecalis ATCC 4083 strain. Antimicrobial tests were performed on a biofilm model after treatment with the chelating agents at different times (1, 3, and 5 min) using a biofilm eradication concentration (MBEC) and confocal laser scanning microscope (CLSM) assays. Quantification of cell biomass and percentage of live and dead cells in the biomass was assessed for each group. The normality of the distributions for each variable was assessed using the D'Agostino and Pearson's omnibus normality test. The comparison of bacterial viability among groups and between any two groups was performed using the non-parametric Kruskal–Wallis one-way analysis of variance and the Dunn's test, respectively. No significant between-group difference was observed regarding biomass reduction. On the other hand, EDTA combined with detergents displayed a substantial increase of the dead bacteria ranging between 35 and 43%; whereas, the number of cells killed in the control group and in the other treated groups always ranged between 1 and 6%, at all experimental times. The addition of detergents to EDTA can improve its anti-biofilm activity by reducing EPS production and enhancing the killing of sessile bacterial cells. Clinical relevance EDTA presents a relevant antimicrobial activity when combined with surface-active agents. [ABSTRACT FROM AUTHOR]

Objective. To compare the efficacy of various techniques used for final irrigation on sealer penetration in the apical one-third of curved root canals. Material and Methods. Sixty-five freshly extracted maxillary first molar teeth with mesiobuccal roots having more than 20° of root curvature were used. The root canals were instrumented and randomly divided into four experimental groups and one control group. In the 4 experimental groups, 3 ml of 17% EDTA followed by 3 ml of 5.25% NaOCl was delivered with the use of the following protocols: Group 1: manual dynamic activation (MDA), Group 2: sonic irrigation (SI), Group 3: passive ultrasonic irrigation (PUI), and Group 4: conventional needle irrigation (CI). All teeth were obturated with gutta-percha and AH Plus sealer labeled with fluorescent dye. Transverse sections at 2 mm and 4 mm distance from the root apex were examined with the aid of confocal laser scanning microscopy. Total percentage (%) and maximum depth (μm) of sealer penetration were measured. Results. All the experimental groups exhibited significantly higher penetration rates than the control group at both sections (p < 0.05). However, no significant differences were found in the penetration depth and percentage among the four experimental groups evaluated at both sections (p > 0.05). Conclusion. PUI, SI, and MDA did not significantly improve sealer penetration in the apical portion of curved root canals when compared to conventional needle irrigation. [ABSTRACT FROM AUTHOR]

Aim: This study presented to compare the antimicrobial effect of MTAD, 17% EDTA, and 3% NaOCl, against Enterococcus faecalis (E. faecalis). Methodology: The study utilized 40 extracted human primary teeth with single root canal. The samples were instrumented and sterilized, and then, these teeth were infected with E. faecalis for 2 weeks, after that tooth were divided randomly into 2 groups according to the irrigants used. All the samples were incubated in brain heart infusion (BHI) broth. Irrigation processes were completed according to each material instruction. The effectiveness of irrigants was evaluated by comparison between the pre-irrigation and post- irrigation samples using serial dilution (CFU/ml). Statistical analysis was done using one-way anova with dunnett t3 post hoc test. Results: all samples treated with MTAD showed nearly complete absence of bacteria. the samples treated 3% NaOCl and 17% EDTA showed similar result to the first group, Statistical analysis of the data using dunnett t3 test showed there is no significant difference between the groups (P > 0.05). Conclusion: The study concluded that MTAD was effective as 3% NaOCl -17% EDTA against E. faecalis. [ABSTRACT FROM AUTHOR]

Background: Subcutaneous ureteral bypass (SUB) device placement is an increasingly popular treatment option for decompression of ureteral obstruction in cats. Mineralization occlusion of the device occurs in a minority of cases but is the most common complication. Objective: To evaluate a 2% tetrasodium ethylenediaminetetraacetic acid (tEDTA) solution for treatment of mineralization occlusion in cats with SUBs. Animals: Six client‐owned cats (8 obstructed devices). Methods: Case series. Each cat was found to have device occlusion based on a combination of ultrasound examination, SUB irrigation, and failure to identify another cause of device obstruction. Each SUB was drained, irrigated using sterile saline, and infused with 1‐2 mL of 2% tEDTA solution. Success was defined as normalization of flow during subsequent ultrasound visualization while irrigating. The volume and frequency of tEDTA instillations, time to achieve device patency, follow‐up biochemical and ultrasound findings, and future reobstruction events were recorded. Results: Resolution of mineralization was documented in all 8 SUBs. Reobstruction events occurred in 2 cats, all of which resolved after additional tEDTA infusions, but 1 cat ultimately required device exchange at 356 days from the first tEDTA infusion. In 1 cat, a single infusion was prematurely discontinued because of persistent pelvic dilatation after 1.25 mL of tEDTA had been instilled. No complications were observed. Conclusions and Clinical Importance: Tetrasodium EDTA infusions can be safely considered as a treatment option for mineralized SUB devices in cats. This solution was easily infused, well tolerated, and avoided the need for SUB device exchange in the majority of cats in which it was used. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this study was to evaluate the effectiveness of 2.5% sodium hypochlorite associated with 17% Ethylenediaminetetraacetic acid (NaOCl-EDTA), versus that of 1% peracetic acid (PA), in removing the smear layer, as assessed by scanning electron microscopy (SEM), and in exerting bactericidal action against Enterococcus faecalis (E. faecalis), as assessed by the real-time polymerase chain reaction (real-time PCR). Methods and Materials: Fifty-five extracted mandibular single-rooted premolars were selected, and divided into two experimental groups (NaOCl-EDTA and PA; n=25) and one control group (0.9% saline; n=5). Pre- and postinstrumentation samples were collected and assessed for the presence of E. faecalis using real-time PCR. The teeth were instrumented using hand files and the ProTaper Universal system (hybrid technique) for a standardized time of 7 min. A total of 20 mL of NaOCl followed by 5 mL of EDTA were applied during instrumentation in the NaOCl-EDTA group, whereas 20 mL of PA and 20 mL of saline were applied in the PA and control groups, respectively. An additional 5 mL of saline was applied in all the groups to neutralize the environment. A scoring system was used to conduct the SEM assessment. The results were submitted to the Kruskal-Wallis test, complemented by Dunn's test (SEM analysis) (P<0.05). Results: A significant microbial reduction was observed in both the PA and the NaOCl-EDTA groups (P<0.05). In the PA group, the presence of a smear layer in the apical third was significantly greater than in the cervical third (P<0.05); no significant differences were observed between the middle and cervical thirds, or between the middle and apical thirds (P>0.05). In the NaOCl-EDTA group, the smear layer scores were significantly higher in the apical third than in the cervical and middle thirds (P<0.05). Conclusion: This in vitro study showed that there was no significant difference between PA and NaOCl-EDTA irrigation regimens regarding either antimicrobial action against E. faecalis or removal of the smear layer, except for greater removal in the middle third by the NaOCl-EDTA group. [ABSTRACT FROM AUTHOR]

Background: Mixing sodium hypochlorite (NaOCl) with chlorhexidine (CHX) forms a brown precipitate. QMix-2in1 (QMix) was introduced as a final irrigant. Manufacturer recommends interim flushing with saline between the application of NaOCl and QMix to prevent formation of precipitation. This study assessed whether para-chloroaniline (PCA) is formed after mixing NaOCl with QMix. Methods: Commercially available, 5.25% NaOCl solution, 2% CHX, QMix, 15% ethylenediaminetetraacetic acid (EDTA) and 98% PCA in powder form were used. Groups were prepared at room temperature. Group 1, 98% PCA in powder form; Group 2, 2% chlorhexidine (CHX); Group 3, QMix; Group 4, 5.25% sodium hypochlorite (NaOCl) mixed with QMix; Group 5, 5.25% NaOCl mixed with CHX; Group 6, 15% EDTA mixed with CHX. The precipitates were extracted and analysed with Proton Nuclear Magnetic Resonance (1H-NMR) and Infrared (IR) Spectroscopy, using PCA as an internal standard. Results: No PCA was found in any of the irrigant-mixture groups tested. Conclusions: This study used the interpretation of spectral results for the amino signals of precipitate formed after mixing QMix with 5.25% NaOCl using different nondestructive analysis methods, with PCA as an internal standard (control). We conclude that mixing QMix or 2%CHX with 5.25% NaOCl does not yield free PCA. [ABSTRACT FROM AUTHOR]

Aim: To compare and evaluate the cleaning ability of two reciprocating systems, that is, WaveOne (WO) and self-adjusting files (SAF) in terms of removal of smear layer using sodium hypochlorite (NaOCl) and chlorhexidine gluconate (CHX) at apical one-third of the root canal. Materials and Methods: Forty-three human maxillary anterior teeth were selected. The canal was instrumented manually up to a number 25 K-file size. WO and SAF were used to prepare the root canals. The following groups were studied: Group 1 using WO:-Group 1a = 5% NaOCl + 17% ethylenediaminetetraacetic acid (EDTA), Group 1b = 2% CHX + 17% EDTA, Group 2 using SAF:-Group 2a = 5% NaOCl + 17% EDTA, Group 2b = 2% CHX + 17% EDTA. All roots were split longitudinally and subjected to scanning electron microscopic. The presence of smear layer apical thirds was evaluated using a 5-score evaluation system. Chi-square tests were used for statistical analysis. Results: The results showed no significant difference in smear layer removal among both reciprocating system and among the irrigants. Group 2a exhibited the best results and was close to significant difference in score (P > 0.05). The NaOCl + EDTA solution used in Group 1a and Group 2a could effectively remove the smear layer in most of the specimens. However, SAF was more effective than WO in the apical third of the canal. Conclusion: The results obtained from the present study suggest that using the SAF system and continuous irrigation action with NaOCl and EDTA solution could overcome the difficulty of removing smear layer even in hard-to-reach regions of the root canal. [ABSTRACT FROM AUTHOR]

Aim To evaluate the effect of chlorhexidine ( CHX) on fracture resistance of roots treated with different concentrations of ethylenediaminetetraacetic acid ( EDTA). Methodology One hundred and twenty intact single-rooted premolar teeth were sectioned below the cementum-enamel junction to standardize the length of the teeth to 12 mm. The canals of one hundred specimens were instrumented with ProTaper Universal rotary instruments up to size F4 and were randomly divided into five groups ( n = 20) according to the final irrigating solutions: Group 1: distilled water ( DW); Group 2: 5% EDTA and 2.5% Na OCl; Group 3: 17% EDTA and 2.5% Na OCl; Group 4: 5% EDTA, 2.5% Na OCl, DW and 2% CHX; Group 5: 17% EDTA and 2.5% Na OCl, DW and 2% CHX. Root canals were filled with gutta-percha and epoxy resin-based root canal sealer using a single-cone technique. Twenty teeth served as negative controls and were not instrumented nor root filled (Group 6). All specimens were embedded in self-curing acrylic resin and loaded vertically at 0.5 mm min−1 until fracture occurred. The data were evaluated statistically using one-way anova test followed by Holm-Sidak's multiple comparison test ( P < 0.05). Results Group 1 (only DW) had the lowest vertical fracture strength, followed by Group 3 (17% EDTA and 2.5% Na OCl; P < 0.05). Group 6 (negative control group) had the highest fracture resistance. Final irrigation with CHX following irrigation with 17% EDTA or 5% EDTA and 2.5% Na OCl (groups 4 and 5) significantly increased the fracture resistance of roots ( P < 0.05). However, the difference between Group 4 and Group 5 was not significant ( P > 0.05). Conclusions Intracanal CHX rinse of EDTA/Na OCl-treated root dentine enhanced the fracture resistance of roots filled with AH Plus. [ABSTRACT FROM AUTHOR]

Background: This study investigated the ability of different irrigation protocols to keep dentinal tubules (DT) open and avoid their blockage by the smear layer (SL) during the cleaning and shaping procedure (CSP). Methods: Twenty-five extracted teeth were divided into five groups ( n = 5): group 1, NaOCl was kept in the canal during instrumentation and then washed out with distilled water, and the canal was irrigated with NaOCl with EndoVac in between files; group 2, the same procedure as group 1, but NaOCl was replaced by EDTA; group 3, EDTA was kept in the canal during instrumentation and then washed out with distilled water, and the canal was irrigated with NaOCl with EndoVac in between files; group 4, the same as group 3, but NaOCl and EDTA were alternated; and group 5 (control), the procedure was the same with group 1, but NaOCl was replaced by distilled water. A scanning electron microscope was used to evaluate the cleanliness of DT at three different levels of the canals. Results: Groups 3 and 4 showed better ability to keep DT open during CSP than the other groups. Group 4 only showed statistically significant better results than group 3 at middle third ( P < 0.0001). Conclusions: Alternating the use of NaOCl and EDTA with water in between can keep DT open better and avoid their blockage by SL during CSP compared with the use of NaOCl or EDTA alone. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to evaluate the effect of 8% and 17% ethylenediaminetetraacetic acid (EDTA) exposure for 1 min and 10 min on the fracture resistance of endodontically treated roots. Methodology: Sixty human single-rooted teeth were decoronated and divided into six groups (n = 10). Canal preparation was carried out except in negative control group, using the ProTaper rotary file system. Final irrigation was performed using distilled water, 17% EDTA for 1 min and 10 min, 8% EDTA for 1 min and 10 min. Thereafter, roots were obturated with ProTaper F3 Gutta-percha points and AH Plus sealer using a single-cone technique. The specimens were loaded vertically at 1 mm/min crosshead speed until vertical root fracture occurred. Results were evaluated statistically with one-way analysis of variance and post hoc Tukey test. Results: Analysis of results showed that the unprepared roots showed the highest fracture resistance and roots irrigated with 17% EDTA for 10 min showed the lowest fracture resistance. The mean fracture resistance of unprepared roots, roots irrigated with 8% EDTA for 10 min and 17% EDTA for 1 min was significantly higher than roots irrigated with 8% EDTA for 1 min, 17% EDTA for 10 min and distilled water. Conclusion: From a clinical viewpoint, if EDTA has to be used, it is safer to use higher concentration for a shorter application time or a low concentration with a longer application time. Prolonged use of high concentrations of EDTA might increase the risk of root fracture. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was to investigate the smear layer removal and erosive capacity of various irrigation solutions with sequential use of NaOCl on instrumented root canal walls. Methods: The root canals of single-rooted teeth were instrumented with ProTaper rotary instrument. Then, the teeth were randomly divided into five experimental groups. The root canals were irrigated with one of the following solutions (5 mL/1 min): 5 % EDTA, 5 % boric acid (BA), a mixture of BA and CA, 2.5 % citric acid (CA) and 5 % Desy Clean. After irrigating with 2.5 % NaOCl and distilled water, the roots were split into two halves and each half was prepared for SEM examination. Representative photographs were taken from each third at x500 and x1000 magnifications. Double blind scoring was performed by two calibrated observers for smear layer and erosion. The scores were statistically analyzed using Kruskal-Wallis, Dunn's post hoc and Spearman's correlation tests (p = 0.05). Results: There were statistically significant differences among the solutions by means of smear layer and erosion (p < 0.05). While 2.5 % CA solution was the most effective solution in removal of smear layer, it was also the most erosive solution (p < 0.05). 5 % Desy Clean removed smear layer effectively and caused less erosion. There was a negative, but statistically significant correlation between presence of smear layer and erosion (r= -0.684; p< 0.0001). Conclusion: Desy Clean can be a promising agent as an irrigation solution with optimal smear layer removal capacity and less erosive effects. [ABSTRACT FROM AUTHOR]

Aims: Comparative evaluation of cleaning efficacy of smear layer removal by different irrigating solutions such as 2.5% sodium hypochlorite (NaOCl), 17% ethylenediaminetetraacetic acid (EDTA) with 2.5% NaOCl, 10% citric acid with 2.5% NaOCl and 1% tetracycline Hydrochloride (HCl) with 2.5% NaOCl for smear layer removal in the apical third of root canal. Settings and Design: In vitro material science study. Materials and Methods: Seventy-five single rooted permanent maxillary central incisor teeth were subjected to standardized root canal instrumentation (crown down technique). The teeth were randomly divided into five groups with 15 teeth in each groups: (1) Normal saline (n = 15) (2) 2.5% NaOCl (n = 15) (3) 17% EDTA + 2.5% NaOCl (n = 15) (4) 10% citric acid + 2.5% NaOCl (n = 15) (5) 1.0% tetracycline HCL + 2.5% NaOCl (n = 15). After final irrigation, the teeth were prepared for scanning electron microscope analysis to evaluate the cleaning of apical third of radicular dentine to determine the presence or absence of smear layer. Statistical Analysis Used: The results were analyzed by nonparametric statistical analysis techniques. Kruskal-Wallis test, Mann-Whitney test and Chi-square tests were carried out. Results: There was no significant statistical difference in the efficacy of smear layer removal when 2.5% NaOCl was compared with 17% EDTA with 2.5% NaOCl, 10% citric acid with 2.5% NaOCl and 1% tetracycline HCl with 2.5% NaOCl in apical third of root canals. Conclusions: The present study suggests that irrigating agents, citric acid and tetracycline HCl can be used as an alternative to EDTA for the removal of smear layer in endodontics. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to assess the antibacterial efficacy of three different herbal irrigants against Enterococcus faecalis. Materials and Methods: Single rooted teeth were extracted due to orthodontic and periodontal reasons. The teeth were then inoculated with E. faecalis. The teeth were randomly divided into three experimental groups and two control groups of six samples each. Group 1 specimens were treated with 5.2% sodium hypochlorite (NaOCL) for 30 min followed by 5 mmol/L Ethylenediaminetetraacetic acid (EDTA) for 5 min and saline as final irrigant. Group 2 specimens were treated with and 5.2% NaOCl for 30 min as final irrigant. Group 3 were treated with Morinda citrifolia (MC) for 30 min as final irrigant. Group 4 were treated with Azadiracta indica (AI) as final irrigant. Group 5 were treated with green tea (GT) for 30 min as final irrigant. The dentin specimens were carefully spread onto a microscope slide and stained with BacLight and examined in a confocal laser scanning microscope set to monitor fluorescein isothiocyanate and propidium iodide. A total of nine fields were examined for each treatment and the bacteria presented were counted. Statistical Analysis: Using the one-way ANOVA with multiple comparison, significantly less bacteria were found adhering to the samples treated with Neem followed by NaOCL, GT, MC, Saline. Results: AI treatment produced the maximum reduction in adherence of E. faecalis to dentin (9.30%) followed by NaOCl (12.50%), GT (27.30%), MC (44.20%) and saline (86.70%). Conclusion: Neem is effective in preventing adhesion of E. faecalis to dentin. [ABSTRACT FROM AUTHOR]

Sobhani OE, Gulabivala K, Knowles JC, Ng Y-L. The effect of irrigation time, root morphology and dentine thickness on tooth surface strain when using 5% sodium hypochlorite and 17% EDTA. International Endodontic Journal, 43, 190–199, 2010. Aim To evaluate the effect of irrigation with 5% sodium hypochlorite (NaOCl) alone and in conjunction with 17% ethylenediaminetetraacetic acid (EDTA) on tooth surface strain (TSS) and to analyse the influence of irrigation time, root morphology and dentine thickness. Methodology Thirty-six single-rooted pre-molars with single canals had their crown and enamel reduced and root canals prepared using a standardized protocol. Teeth were grouped according to anatomical criteria and randomly distributed to experimental irrigation groups: (A) saline (negative control); (B) 5% NaOCl (positive control); (C) 5% NaOCl alternated with 17% EDTA. TSS was measured using electrical strain gauges bonded to the cervico-proximal part of the tooth. Teeth, mounted in clear acrylic resin placed in a universal testing machine, were subjected to nine consecutive 10-min irrigation periods followed by non-destructive occlusal loading to record TSS. Statistical analysis was carried out using two-way hierarchicalanova and post hoc multiple comparisons. Results Two groups showed an increase in TSS from the baseline (initial 10-min irrigation with saline). Group A showed a negligible reduction of 1.2% (343–339 με), which was not statistically significant ( P = 0.7). Group B showed a highly significant ( P = 0.001) increase in TSS by 53.7% (178–253 με), and group C showed a significant ( P = 0.02) increase in TSS by 17.4% (163–192 με). The rate of change in TSS was significantly different between test groups. The length of the tooth ( P = 0.04) as well as the mesio-distal ( P = 0.05) width had significant effects on TSS. Conclusions Irrigation with 5% with or without 17% EDTA increased TSS. The increase was significantly greater with 5% NaOCl alone than with 5% NaOCl alternated with 17% EDTA in contrast to previous findings with longer duration of irrigant exposure. Tooth length and mesio-distal root width significantly contributed to the increase in TSS. [ABSTRACT FROM AUTHOR]