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Introduction: Root canal irrigants combat endodontic microbial flora, effectively targeting resilient microbes like Enterococcus faecalis, which persist despite treatment. Chlorhexidine (CHX), as an irrigant, boasts broad-spectrum antibacterial activity, notable substantivity in dentine, and favorable biocompatibility. In the realm of nanotechnology, the use of silver nanoparticle (AgNP) solutions appears promising, given their strong antibacterial and antimicrobial properties. Objective: The objective of the study was to compare the antimicrobial effectiveness of varying concentrations (1%, 0.75%, and 0.5%) of AgNPs and 2% CHX against E. faecalis. Materials and Methods: Four irrigant solutions, including 1%, 0.75%, and 0.5% AgNPs and 2% CHX with gentamicin as the control, will be assessed. The ATCC 29212 strain of E. faecalis will be cultivated at 37°C on brain–heart infusion Broth plates. After 48 h, the bacterial population will be quantified by counting colony-forming units on agar plates. Each irrigant will be applied to the plates, and the resulting bacterial inhibition zone will be measured. Results: Our study demonstrates the antimicrobial effects of 1%, 0.75%, and 0.5% AgNPs and 2% CHX against E. faecalis. While 2% CHX exhibited superior activity, AgNPs at various concentrations also displayed inhibitory effects against E. faecalis. Conclusion: In conclusion, this study highlights the antimicrobial properties of 1%, 0.75%, and 0.5% AgNPs and 2% CHX against E. faecalis. The results indicate that 2% CHX exhibits superior activity, while AgNPs at various concentrations also demonstrate inhibitory zones against E. faecalis.

BackgroundApical microleakage is considered to be a common reason for the clinical failure of endodontic therapy. Three dimensional sealing of the root canal is one of the main goals of endodontic treatment and is essential for preventing reinfection of the canal and for preserving the health of the periapical tissues, Recently Epoxy resin sealers have been used because of their reduced solubility apical seal and micro-retention to root dentine. Aim and ObjectiveThis in vitro study was done to evaluate and compare the apical sealability of AH Plus and RealSeal SE using 5.25% sodium hypochlorite with 17% EDTA and 10% citric acid as irrigants. Materials and methods: 44 single-rooted premolars were selected and the teeth are randomly divided into 4 groups (n=10) and 2 control groups (n=2). The extent of dye penetration, from the apical to the coronal part of the root canal, was assessed using a stereomicroscope at 10x magnification for all groups.One-way ANOVA and Kruskal-Wallis tests were performed to compare statistically significant differences among the groups, using SPSS software version 10.0. ResultsGroup IV (Citric acid + RealSeal SE) showed a statistically lower mean microleakage when compared to all other groups. ConclusionFrom, the present study, it was concluded that, RealSeal SE sealer with 10% citric acid as irrigant (group IV) showed better apical sealability followed by RealSeal SE sealer with 17% EDTA as irrigant (group III), when compared to AH Plus groups which showed least sealability.

Introduction: Complete eradication of microorganisms from the root canal and three‑dimensional obturation of the canal space are necessary for a successful root canal therapy. In root canal failures, Enterococcus faecalis is the most often detected bacterium. Microorganisms can be eliminated with the aid of chemical irrigation. Objectives: The current research was conducted to evaluate the antimicrobial effect of triphala, neem, and chlorhexidine root canal irrigants. Materials and Method: Mueller‑Hinton agar plates were inoculated with the E. faecalis (ATCC) bacterial culture after it had been cultured overnight in brain heart infusion (BHI) broth. Agar well diffusion was used to measure antibacterial inhibition. After being introduced to their appropriate wells in agar plates, the three research irrigants were incubated for 24 hours at 37°C. Every well’s bacterial inhibition zone was noted. After tabulating the results, statistical analysis was done. Result: When triphala and A. indica extract (neem) were added to chlorhexidine, the highest inhibitory zone against E. faecalis was observed. Conclusion: The herbal remedy triphala and the extract from A. indica exhibited an inhibitory zone when tested against E. faecalis. As a result, these irrigants might be utilized as a substitute for root canal irrigants. [ABSTRACT FROM AUTHOR]

المخلص: أهداف البحث: هدفت الدراسة إلى تقييم فعالية مغلي أوراق الشجرة المعروفة بالمورينجا في إزالة الطبقة السميكة مقارنة بمادتين أخريين وكذلك الأنشطة المضادة للميكروبات. طرق البحث: تم استخراج أوراق الشجرة باستخدام مغلي الماء الساخن بتركيزين مختلفين. تم تحضير ما مجموعه ثلاثين سنا بشريا مستخرجا ذو جذر واحد لتقييم فعالية إزالة الطبقة السميكة. تم حساب وجود الطبقة السميكة في الثلث الأوسط من قناة الجذر باستخدام الميكروسكوب الليزري الماسح الضوئي الحويصلي. ثم تم إجراء النشاط المضاد للبكتيريا على نوعين من البكتيريا باستخدام طريقة تشتت الأغار. النتائج: وجدنا أن التراكيز 2,5% و 5% من المغلي أكثر فعالية بشكل ملحوظ في إزالة الطبقة السميكة، ومع ذلك، لم يتم ملاحظة فرق ملحوظ عند المقارنة مع المادتين الأخريين. أظهرت نتائج اختبار المضادات الحيوية المختبرية أن خمسة بالمائة من المغلي يظهر نشاطا مضادا للميكروبات أعلى ضد كلا المسارين التجريبيين. الاستنتاجات: تشير هذه النتائج إلى أن مغلي أوراق الشجرة يمكن اعتباره محلولا فعالا في علاج الجذور. Abstract: Objective: This study evaluated the effectiveness of moringa (Moringa oleifera) leaves decoction for removing a smear layer compared to sodium hypochlorite (NaOCl) and ethylenediaminetetraacetic acid (EDTA), as well as its antimicrobial activities. Methods: The moringa leaves were extracted using hot water decoction at two different concentrations (2.5% and 5.0% w/v). A total of 30 extracted human single-rooted teeth were prepared to assess the smear layer removal efficacy. The presence of a smear layer in the middle third of the root canal was detected by confocal microscopy. Then the antibacterial effects were assessed against Enterococcus faecalis and Streptococcus mutans bacteria using the agar diffusion method. Results: The 2.5% and 5.0% decoction were significantly more effective than 0.25% NaOCl in removing the smear layer (p 0.05). The in vitro antimicrobial assay showed that 5.0% decoction had higher antimicrobial activity against both of the test pathogens. Conclusion: The findings of this study suggest that moringa leaves decoction can be considered an effective irrigant in endodontics.

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Aims: Chitosan‐based biomaterials exhibit several properties of biological interest for endodontic treatment. Herein, a low molecular weight chitosan (CH) solution was tested for its antimicrobial activity against Enterococcus faecalis (E. faecalis) and effects on dentine structure. Methodology: The root canal of 27 extracted uniradicular teeth were biomechanically prepared, inoculated with a suspension of E. faecalis and randomly assigned to be irrigated with either 5.25% sodium hypochlorite (NaClO), 0.2% CH or sterile ultrapure water (W). Bacteriologic samples were collected from root canals and quantified for of E. faecalis colony‐forming units (CFUs). The effectiveness of CH over E. faecalis biofilms was further measured using the MBEC Assay®. Additionally, dentine beams and dentine powder were obtained, respectively, from crowns and roots of 20 extracted third molars. Dentine samples were treated or not with 17% EDTA and immersed in either CH or W for 1 min. The effects of CH on dentine structure were evaluated by assessment of the modulus of elasticity, endogenous proteolytic activity and biochemical modifications. Results: The number of E. faecalis CFUs was significantly lower for samples irrigated with CH and NaClO. No significant differences were found between CH and NaClO treatments. Higher modulus of elasticity and lower proteolytic activity were reported for dentine CH‐treated specimens. Chemical interaction between CH and dentine was observed for samples treated or not with EDTA. Conclusions: Present findings suggest that CH could be used as an irrigant during root canal treatment with the triple benefit of reducing bacterial activity, mechanically reinforcing dentine and inhibiting dentine proteolytic activity. [ABSTRACT FROM AUTHOR]

Background: Sodium hypochlorite (NaOCl) and ethylenediaminetetraacetic acid (EDTA) and/or calcium hydroxide (Ca(OH)2) are commonly used during root canal treatment. Evaluation of their effectiveness regarding clinical and patient‐related outcomes requires further understanding. Objectives: To assess the effectiveness of root canal irrigation and dressing for the treatment of teeth with apical periodontitis (AP). Methods: A search was conducted in the PubMed‐MEDLINE, Scopus, EMBASE, Google scholar databases and available repositories, followed by hand searches, until July 2021. Eligibility criteria followed the a priori formulated Population, Intervention, Comparator, Outcomes, Timing, and Study design (PICOTS) framework. Clinical studies restricted to English language were included. The revised Cochrane risk‐of‐bias tool for randomised trials (RoB 2) was used to assess the quality of included studies. Meta‐analyses were performed using the fixed‐effect model to obtain Risk Ratio (RR) and 95% Confidence Interval (CI), with sensitivity analysis. Overall quality of evidence of meta‐analyses was assessed through the Grading of Recommendations Assessment, Development, and Evaluation tool. Results: The search identified 1357 records of which six fulfilled the inclusion criteria, providing data for 'irrigation' from 212 teeth and for 'dressings' from 438 teeth. Two studies reported no significant difference regarding the outcome 'pain at 7 days' using 2% chlorhexidine vs. 5.25% NaOCl and EDTA or after using different concentrations of NaOCl (1% vs. 5%). No significant difference was detected between different NaOCl concentrations regarding the reduction of AP. A meta‐analysis was possible for the comparison of single‐visit (SV) versus multiple‐visits including the use of Ca(OH)2 demonstrating a significant effect in favour of SV (RR: 1.10; 95% CI: 1.03–1.19; p =.007; I2 = 0). RoB of included studies was moderate to low. Discussion: The use of Ca(OH)2 for the treatment of AP may not be beneficial. There is scarce or no evidence fulfilling the proposed PICOTS regarding irrigants and dressings. Conclusions: There is moderate certainty that SV treatment is associated with better radiographic evidence of normal periodontal ligament space (strict criteria) compared with the use of Ca(OH)2. Reduction of AP is comparable after irrigation with 1% and 5% NaOCl, whereas postoperative pain at 7 days for the irrigants assessed is similar. Registration: PROSPERO database CRD42021260271. [ABSTRACT FROM AUTHOR]

Introduction: Enterococcus faecalis is one of the most prevalent pathogens in infected root canals. Even though the role of irrigants in controlling pathogens is well established, there is a chance for drug resistance and cytotoxicity in using chemical irrigants, Therefore newer researches have forced the man to look the herbal way. Aim of the Study: This study aims to evaluate and compare the anti-bacterial effects of nonherbal and herbal root canal irrigants on E. faecalis. Methodology: The study was conducted on 110 permanent extracted human teeth each root canal was inoculated with a culture suspension of E. faecalis and then randomly assigned into groups, (i) Herbal group (QMix™ 2 in 1, Endoseptone, Biopure MTAD) and (ii) Nonherbal group (Morinda citrifolia juice, Triphala juice, Coconut milk), and control group (Sodium hypochlorite and Distilled water). Colony forming units (CFUs) were evaluated and counted at baseline (S0), immediatedly after irrigation (S1) and after 3 days (S2). The Friedman two-way ANOVA was used to compare the obtained mean of log CFU. Results: Both the herbal and nonherbal groups had a significant reduction in the number of CFUs. The greatest anti-microbial effects were observed in nonherbal group against E. faecalis. Conclusion: While the herbal group also demonstrated significant reductions, the nonherbal group experienced the greatest overall anti-microbial effects of the various irrigants. Research into the herbal irrigants is necessary since they have the potential to be effective irrigants. [ABSTRACT FROM AUTHOR]

Aim: The study compared the penetration depth and area of Bacillus subtilis and Pseudomonas aeruginosa biosurfactants inside the dentinal tubules against sodium hypochlorite at three levels (coronal, middle, and apical) under a confocal laser scanning microscope. Materials and Methodology: Three experimental groups and one control were created using freshly extracted thirty-five maxillary central incisors; Group 1: B. subtilis biosurfactant; Group 2: P. aeruginosa biosurfactants; Group 3: sodium hypochlorite; and Group 4: distilled water. The experimental data were statistically analyzed by two-way analysis of variance, duly coupled with Tukey's post hoc test to draw concrete conclusions between paired comparisons, and P < 0.05 was considered statistically significant. Results: P. aeruginosa and B. subtilis biosurfactant showed the maximum mean penetration depth and area at all the level as compared to sodium hypochlorite. Conclusion: Biosurfactants showed better results than sodium hypochlorite in reaching to higher penetration depth and area at all the three levels. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this systematic review was to evaluate the superiority of sodium hypochlorite (NaOCl) liquid or NaOCl gel in disinfecting root canals. Methods: Online electronic databases such as PubMed-MEDLINE, Scopus, and Embase were explored for suitable studies. In this evaluation, papers were deemed eligible for the data extraction if they included in vitro experiments using NaOCl liquid or NaOCl gel for canal irrigation and its influence on the smear layer, as well as their elimination of the bacteria from the root canal. The review was registered in International Prospective Register of Systematic Reviews with registration number CRD420223441126. Results: One hundred and sixty-one articles were found after initial screening and four articles were included for qualitative synthesis. Overall risk of bias was "high." Two studies did not show significant variations among 2.5% NaOCl solution and gel. Conclusion: As per rigorous investigation done, NaOCl solution proved more efficient against Enterococcus faecalis than its gel form. More research is needed to determine the best effective NaOCl type, concentration, duration, and treatment regimens. [ABSTRACT FROM AUTHOR]

Featured Application: Through this initial in vitro study, the most effective and safe concentration of EEP can be established, which will give a useful insight into the biocompatibility and safe concentration of EEP in root canal treatment. Further, the findings from this study will lead to further exploration on the antibacterial properties of the solution against other oral bacteria and the antibiofilm effect against multi-species biofilm, which is more clinically relevant. This will later help in the establishment of the solution as a potential alternative endodontic irrigation solution. Concerns have been raised about the usage of sodium hypochlorite (NaOCl) in endodontics following its toxic effects. Effective ecoproduce (EEP), an organic solution produced through the fermentation of fruit peels, exhibits antibacterial and antibiofilm action, suggesting its potential as an endodontic irrigant. However, studies on its cytotoxicity are limited. This in vitro study aimed to evaluate the cytotoxic effects of EEP at different concentrations and fermentation periods against the MC3T3-E1 cell. EEP derived from orange and pineapple peel waste and fermented for 3 and 6 months was prepared from 100% to 0.78% concentration. Briefly, 2.5% NaOCl was used as the comparison group. Cell viability was analysed using Alamar Blue and Live and Dead Cell assay. A transmission electron microscope (TEM) was used to evaluate ultrastructural changes to the cells. Data analysis was performed using a two-way mixed Analysis of Variance (ANOVA). EEP exhibited concentration-dependent cytotoxicity regardless of the fermentation period (p > 0.05). A concentration below 6.25% was non-cytotoxic and comparable to the negative control (p > 0.05). Live and Dead Cell assay and TEM analysis complement the findings. The mean cell viability of EEP at all concentrations for both fermentation periods was significantly higher than that of 2.5% NaOCl (p < 0.05). Conclusively, 6.25% EEP fermented for 3 and 6 months are non-cytotoxic and can serve as an alternative endodontic irrigants. [ABSTRACT FROM AUTHOR]

Abstract Background The aim of this in vitro study was to evaluate push-out bond strength of different root-end filling materials using various irrigant solutions. Methods A push-out bond strength test was performed to evaluate the bond strength of two experimental root-end filling materials: namely, nano-hybrid mineral trioxide aggregate (MTA) and polymethyl methacrylate (PMMA) cement filled with 20% weight nano hydroxyapatite (nHA) fillers compared to conventional MTA. The irrigant solutions employed were sodium hypochlorite (NaOCl) in concentrations 1%, 2.5% and 5.25% and 2% chlorhexidine gluconate (CHX) followed by application of 17% ethylene diamine tetra-acetic acid (EDTA). A freshly extracted sixty single-rooted human maxillary central incisors were used. The crowns were removed, the canal apex was widened to simulate immature teeth. Each type of irrigation protocols was performed. After application and setting of the root-end filling materials, a slice of one mm thickness was cut transversely from the apical end of each root. Specimens were stored for 1 month in artificial saliva and were subjected to a push-out test to evaluate the shear bond strength. Data were analyzed using two-way ANOVA and Tukey test. Results The experimental nano-hybrid MTA showed the highest significant push-out bond strength values when irrigated by NaOCl at several concentrations (1%, 2.5% and 5.25%) (P< 0.05). Meanwhile, irrigation with 2% CHX resulted in highest bond strength values in nano-hybrid white MTA (18 MPa) and PMMA filled with 20% weight nHA (17.4 MPa) with nonsignificant difference between them (p = 0.25). In each root-end filling material, irrigation with 2% CHX led to the highest significant bond strength, followed by NaOCl 1%, while the least significant bond strength was produced after irrigation with NaOCl 2.5% and 5.25% (P< 0.05). Conclusion Considering the limitations of this study, it may be concluded that the application of 2% CXH and 17% EDTA provides superior push-out bond strength to root canal dentin compared with irrigation with NaOCl irrigants and 17% EDTA, experimental nano-hybrid MTA root-end filling material provides enhanced shear bond strength than conventional micron-sized MTA root-end filling material.

Introduction: various irrigation devices and chemical solutions are being developed and improved nowadays for better penetration deep into the complex root canal system. Activation of irrigating solutions enhances the solution effectiveness. Evidence in the literature suggests that ultrasonic irrigation is much more effective in this respect than syringe irrigation alone. Passive ultrasonic irrigation (PUI) and/or ultrasonically activated irrigation (UAI): nowadays, the two terms, PUI and UAI, are interchangeable in the literature and represent the same technique. Literature data have shown that combining ultrasonically activated NaOCl with EDTA results in significantly greater removal of the smear layer. Conclusion: the use of ultrasonic activation of the irrigating solution after root canal preparation significantly improves the removal of debris from hard-to-reach areas such as isthmuses, lateral canals and the apical delta.

Background: Herbal medicine is regaining a strong position in health care by virtue of better safety and minimal toxicity as compared to conventional chemotherapies. It is making a place in dental care in the form of various toothpastes, lotions, and mouthwashes. It has been analyzed that very few discrete herbal irrigants have an action comparable to that of sodium hypochlorite. No data about any study on penetration depth and penetration area for herbal-based irrigants used in root canal treatment are available. Aim: The aim of this study was to assess the efficacy of Withania somnifera extracts by assessing its penetration depth and area inside dentinal tubules using a confocal laser scanning microscope. Materials and Methods: Freshly extracted 25 maxillary central incisors were divided into three groups: Group 1: W. somnifera; Group 2: sodium hypochlorite; and Group 3: distilled water. Results: W. somnifera showed better results with respect to penetration depth and area inside the dentinal tubules thansodium hypochlorite. Conclusion: From the study, it can be concluded that W. somnifera extract-based irrigant may be used as an alternative to sodium hypochlorite-based irrigant. It also shows that more herbal drugs need such types of screening and incorporation in dental practice to reduce the potential side effects of the conventional drugs used in daily practice. [ABSTRACT FROM AUTHOR]

The root canal system is a very complex structure. Mere instrumentation with hand files or rotary instruments does not clean the canals of debris and microbes. This makes irrigation a vital step in root canal treatment. Irrigants are chemicals that interact with each other when used in combination. A thorough understanding of the chemical nature of the irrigants is necessary to prevent any undesired effects during or after root canal therapy. An automated search was conducted for articles and published data on the interaction between sodium or calcium hypochlorite and other root canal irrigants. References of the selected articles were also searched manually for related articles. The present study focused on root canal irrigants and the byproducts of their interaction, published from 2012 to 2022. In the present review, ten studies were included. These studies were based on the interaction between sodium or calcium hypochlorite and other root canal irrigants and the byproducts formed in the process. Six of the ten studies were performed on extracted teeth, and four were conducted in test tubes. It was observed that NaOCl and CHX formed precipitates with other irrigants. These precipitates block the dentinal tubules, and precipitates like PCA have been proven to be carcinogenic. Thus, intermediate irrigants like distilled water must be used to flush out one irrigant before using another. It is necessary to follow a suggested irrigation protocol to avoid the precipitation of harmful chemicals in the root canals that may also interfere with the bonding of root canal sealers. [ABSTRACT FROM AUTHOR]

Context: Sodium hypochlorite, a gold standard for irrigation in endodontics, has disadvantages like toxicity and root dentin weakening. Alternatives derived from natural products are being explored. Aims: This systematic review was done to understand the clinical benefits of natural irrigants when compared with a standard irrigant, sodium hypochlorite. Settings and design registration: This systematic review was registered with PROSPERO (2018 CRD42018112837) Methods and material: This review was done in conformation to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA 2020) statement. In vivo studies using at least one natural irrigant and sodium hypochlorite (NaOCl) were included. Studies using them as medicaments were excluded. PubMed, Cochrane and SCOPUS were searched. RevMan tool for Risk of Bias 2 (RoB 2) and risk-of-bias tool to assess non-randomized studies of interventions (ROBINS-I) were used. GRADEpro was used to assess certainty of evidence. Results: Ten articles (6 RCTs and 4 clinical studies) on approximately 442 patients were included. Seven natural irrigants were evaluated clinically. Due to the heterogeneity, meta-analysis could not be conducted. Antimicrobial efficacy was found to be similar for castor oil, neem, garlic-lemon, noni, papaine and NaOCl. Neem, papaine-chloramine, neem-NaOCl and neem-CHX were superior, while propolis, miswak and garlic were inferior to NaOCl. Post-operative pain was less for neem. There was no significant difference between papaine-chloramine, garlic extract and sodium hypochlorite in clinical/radiographic success. Conclusions: The studied natural irrigants are not more efficacious than NaOCl. At the moment, they cannot replace NaOCl routinely and may only substitute in select cases. [ABSTRACT FROM AUTHOR]

Aim: The study compared the penetration depth and area of Bacillus subtilis and Pseudomonas aeruginosa biosurfactants inside the dentinal tubules against sodium hypochlorite at three levels (coronal, middle, and apical) under a confocal laser scanning microscope. Materials and Methodology: Three experimental groups and one control were created using freshly extracted thirty-five maxillary central incisors; Group 1: B. subtilis biosurfactant; Group 2: P. aeruginosa biosurfactants; Group 3: sodium hypochlorite; and Group 4: distilled water. The experimental data were statistically analyzed by two-way analysis of variance, duly coupled with Tukey's post hoc test to draw concrete conclusions between paired comparisons, and P < 0.05 was considered statistically significant. Results: P. aeruginosa and B. subtilis biosurfactant showed the maximum mean penetration depth and area at all the level as compared to sodium hypochlorite. Conclusion: Biosurfactants showed better results than sodium hypochlorite in reaching to higher penetration depth and area at all the three levels.

Aim: The purpose of this systematic review was to evaluate the superiority of sodium hypochlorite (NaOCl) liquid or NaOCl gel in disinfecting root canals. Methods: Online electronic databases such as PubMed-MEDLINE, Scopus, and Embase were explored for suitable studies. In this evaluation, papers were deemed eligible for the data extraction if they included in vitro experiments using NaOCl liquid or NaOCl gel for canal irrigation and its influence on the smear layer, as well as their elimination of the bacteria from the root canal. The review was registered in International Prospective Register of Systematic Reviews with registration number CRD420223441126. Results: One hundred and sixty-one articles were found after initial screening and four articles were included for qualitative synthesis. Overall risk of bias was “high.” Two studies did not show significant variations among 2.5% NaOCl solution and gel. Conclusion: As per rigorous investigation done, NaOCl solution proved more efficient against Enterococcus faecalis than its gel form. More research is needed to determine the best effective NaOCl type, concentration, duration, and treatment regimens.

Introduction Endodontically treated teeth are usually weaker due to the loss of tooth structure. As most of the crown of the tooth is destroyed, the most common retention for restoration is application of a fiber-reinforced composite posts in the root canal. In endodontically treated teeth, there are two main problems in the restorative procedure: reduced resistance of the remaining tooth structure and choosing the necessary adequate retention for restoration. The aim of this work was to evaluate the impact of irrigation protocol on the bond strength of two types of fiber posts luted with two different adhesive cements. Materials and method In this in vitro study, 48 single-rooted teeth (incisors, single-rooted second premolars) extracted for orthodontic and periodontal reasons were used. The teeth were divided into the four groups of 12 teeth depending on the type of fiber post used as well as the irrigation agent. Each group was further divided into the two subgroups of six teeth depending on the material and cementation technique. Results In all cross-sectional statistics the difference appeared only when different types of irrigants were used and they changed bond strength between dentin and bonding material. Conclusions Irrigation protocol has a significant influence on the bond strength of composite post, independent of the type of post and cementation material used.

Aim: The purpose of this study is to evaluate and compare the efficacy of 17% EDTA, 18% etidronic acid, and 0.2% chitosan nanoparticle solution in smear layer removal using SEM image analysis. Methods: Thirty freshly extracted mandibular premolars were used. After biomechanical preparation, the samples were divided into Group I (17% EDTA), Group II (18% etidronic acid), and Group III (0.2% chitosan nanoparticle solution) containing 10 samples each. Longitudinal sectioning of the samples was done. The samples were observed under SEM at apical, middle, and coronal levels. The images were scored according to the criteria by Hullsman. Statistical analysis was done, with the significance level set at P < 0.05, and performed with SPSS 16.0 statistical package for Windows. Results: Smear layer removal at coronal, middle, and apical thirds was more effective when final irrigation was performed using 0.2% chitosan solution, followed by 17% EDTA. At the apical third, all the irrigants showed poor smear layer removing property, but chitosan showed comparatively better results. Conclusion: 0.2% chitosan nanoparticle solution was more effective in removing the smear layer when compared to 17% EDTA and 18% etidronic acid irrigants.

Background: The aim of this in vitro study was to evaluate push-out bond strength of different root-end filling materials using various irrigant solutions. Methods: A push-out bond strength test was performed to evaluate the bond strength of two experimental root-end filling materials: namely, nano-hybrid mineral trioxide aggregate (MTA) and polymethyl methacrylate (PMMA) cement filled with 20% weight nano hydroxyapatite (nHA) fillers compared to conventional MTA. The irrigant solutions employed were sodium hypochlorite (NaOCl) in concentrations 1%, 2.5% and 5.25% and 2% chlorhexidine gluconate (CHX) followed by application of 17% ethylene diamine tetra-acetic acid (EDTA). A freshly extracted sixty single-rooted human maxillary central incisors were used. The crowns were removed, the canal apex was widened to simulate immature teeth. Each type of irrigation protocols was performed. After application and setting of the root-end filling materials, a slice of one mm thickness was cut transversely from the apical end of each root. Specimens were stored for 1 month in artificial saliva and were subjected to a push-out test to evaluate the shear bond strength. Data were analyzed using two-way ANOVA and Tukey test. Results: The experimental nano-hybrid MTA showed the highest significant push-out bond strength values when irrigated by NaOCl at several concentrations (1%, 2.5% and 5.25%) (P< 0.05). Meanwhile, irrigation with 2% CHX resulted in highest bond strength values in nano-hybrid white MTA (18 MPa) and PMMA filled with 20% weight nHA (17.4 MPa) with nonsignificant difference between them (p = 0.25). In each root-end filling material, irrigation with 2% CHX led to the highest significant bond strength, followed by NaOCl 1%, while the least significant bond strength was produced after irrigation with NaOCl 2.5% and 5.25% (P< 0.05). Conclusion: Considering the limitations of this study, it may be concluded that the application of 2% CXH and 17% EDTA provides superior push-out bond strength to root canal dentin compared with irrigation with NaOCl irrigants and 17% EDTA, experimental nano-hybrid MTA root-end filling material provides enhanced shear bond strength than conventional micron-sized MTA root-end filling material. [ABSTRACT FROM AUTHOR]

The purpose of this systematic review was to evaluate how an antioxidant treatment would influence the immediate bond strength of dental adhesives to endodontically treated dentine. Scientific evidence was researched in five databases using selected descriptors. Two independent reviewers conducted the investigation and assessed the data and methodological quality of the studies. Inclusion and exclusion criteria were specified for article selection; only studies in English and published between 2001 and 2022 were evaluated. A total of 18 studies were selected and analysed. According to most studies, the irrigation procedure and substrate preparation in endodontic therapy may affect the immediate bond strength. Antioxidants can improve bond strength and adhesion following the use of the most frequently used irrigants in root canal treatments. Therefore, antioxidant treatment can be considered a proper technique to enhance the bond strength of endodontically treated teeth. [ABSTRACT FROM AUTHOR]

This study examined the effect of 1.5% NaOCl, 17% EDTA, and curcumin on the proliferation, attachment, and differentiation of dental pulp stem cells (DPSCs) placed on the dentin specimens. MTT assay was performed to evaluate the proliferation of DPSCs on the dentin specimens treated with different concentrations of NaOCl, 17% EDTA, and curcumin (0.97–250 μM). Cell-adhering ability of DPSCs was tested via the LDH assay to calculate the attached DPSCs. In addition, the western blotting assay was performed to investigate the expression levels of fibronectin as a cell-adhesion marker and analyze the expressions level of differentiation markers, including DMP-1, OCN, ALP, and DSPP, to detect the odontogenic potential of hDPCs. NaOCl had lower toxicity on DPSCs at lower concentrations (P < 0.001). The cytotoxicity of irrigants increased with increased dosage. The difference between the cell-adhesion ability of NaOCl and curcumin was not significant (∼4.4 MU/mL), whereas EDTA (∼3.8 MU/mL) exhibited the lowest release of LDH and less damage to hDPSCs. Regarding fibronectin expression, the pattern differed between irrigants in inducing cell adhesion. NaOCl increased fibronectin expression more than EDTA and curcumin. All the treated groups upregulated the expression of DSPP, DMP-1, OCN, and ALP compared to the control group, in which NaOCl showed a higher effect on the overexpression of differentiation markers. The results showed that all the tested irrigants could be used in regenerative endodontic treatment. However, as an herbal-based and biocompatible irrigant, curcumin exhibited fewer adverse effects than NaOCl and EDTA. [ABSTRACT FROM AUTHOR]

Introduction: For successful endodontics, there should be proper cleaning and shaping of the canal before the obturation. Various agitation techniques help in the removal of the debris and smear layer. With the removal of this debris and smear layer, there will be a better opening of dentinal tubules and penetration of sealer in the tubule. Aim: To evaluate the effectiveness of removal of debris and smear layer from prepared root canals by comparing ultrasonic agitation, F-file agitation, and NaviTip FX needle agitation using Sodium hypochlorite (NaOCl) and SmearClear as irrigants. Materials and Methods: The present in-vitro study included 60 bilaterally matched pairs of extracted human premolar teeth with single canal and mature apices, were collected. All teeth were decoronated at the cementoenamel junction. The teeth were grooved longitudinally on the buccal and lingual surfaces. Instrumentation was done using K3 rotary files up to #40 and irrigation was carried out using 2 mL syringes mounted with Max-i-probe needles. Agitation procedure (n=10 for each group) was done as follows. Group 1: Ultrasonic agitation of 2.5% NaOCl for 30 seconds. Group 2: F-file agitation of 2.5% NaOCl for 30 seconds Group 3: NaviTip FX agitation of 2.5% NaOCl for one minute continuously. Group 4: Ultrasonic agitation of SmearClear for 30 seconds. Group 5: F-file agitation of SmearClear for 30 seconds. Group 6: NaviTip FX agitation of SmearClear for one minute continuously. The roots were split into two halves using a chisel and mallet. The amount of debris and smear layer was assessed using SEM at 1000X magnification at each root canal’s coronal, middle, and apical areas. Statistical analysis was done using Kruskal-Wallis and Mann-Whitney U test. Results: Statistically significant difference was obtained in the reduction of debris and smear layer between 2.5% NaOCl and SmearClear. Ultrasonic agitation of SmearClear was better than F-file agitation and NaviTip FX. In both debris and smear layer removal (p-value

Aim: The purpose of this study is to evaluate and compare the efficacy of 17% EDTA, 18% etidronic acid, and 0.2% chitosan nanoparticle solution in smear layer removal using SEM image analysis. Methods: Thirty freshly extracted mandibular premolars were used. After biomechanical preparation, the samples were divided into Group I (17% EDTA), Group II (18% etidronic acid), and Group III (0.2% chitosan nanoparticle solution) containing 10 samples each. Longitudinal sectioning of the samples was done. The samples were observed under SEM at apical, middle, and coronal levels. The images were scored according to the criteria by Hullsman. Statistical analysis was done, with the significance level set at P < 0.05, and performed with SPSS 16.0 statistical package for Windows. Results: Smear layer removal at coronal, middle, and apical thirds was more effective when final irrigation was performed using 0.2% chitosan solution, followed by 17% EDTA. At the apical third, all the irrigants showed poor smear layer removing property, but chitosan showed comparatively better results. Conclusion: 0.2% chitosan nanoparticle solution was more effective in removing the smear layer when compared to 17% EDTA and 18% etidronic acid irrigants. [ABSTRACT FROM AUTHOR]

Background: Sequential chemical application for irrigating a root canal during chemomechanical debridement can affect the dentin microstructure. Understanding the effects of various irrigants on chemical properties of dentin can elucidate their effects on physical properties and thereby explain the higher incidence of structural failure in endodontically treated teeth. This in vitro research aimed to compare and evaluate the effects of three different irrigating solutions on the chemical structure of root canal dentin in extracted human teeth. Methods: Forty-eight extracted single-rooted mandibular premolar teeth were sectioned at the cemento–enamel junction by a diamond disc and were then randomly assigned to four groups of twelve samples each. The groups were irrigated using 5.25% NaOCl, ozonated olive oil, silver citrate, or distilled water. Dentin sections measuring 1.5 mm were obtained from the root portion and each section and were analyzed using Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), and electron-dispersive spectroscopy (EDS). FTIR and EDS values are reported as means ± standard deviations. Data were analyzed using an ANOVA and a post hoc Bonferroni test (p < 0.05). Results: A comparison of the FTIR and EDS values among the groups using ANOVA revealed statistically significant differences in the organic and inorganic peak values among the groups. An intergroup comparison between NaOCl with silver citrate and ozonated olive oil revealed significant reductions in the carbonate and phosphate peak values in the NaOCl group (p < 0.05). The EDS values tabulated for the carbon, oxygen, phosphorous, and calcium peak levels showed significant differences between the groups using an ANOVA. An SEM analysis was conducted under 1500× magnification, which revealed smear layer removal in the silver citrate group. Conclusions: The silver citrate solution and the ozonated olive oil caused less changes in the organic and mineral contents of dentin than sodium hypochlorite. [ABSTRACT FROM AUTHOR]

Concerns have been raised about the usage of sodium hypochlorite (NaOCl) in endodontics following its toxic effects. Effective ecoproduce (EEP), an organic solution produced through the fermentation of fruit peels, exhibits antibacterial and antibiofilm action, suggesting its potential as an endodontic irrigant. However, studies on its cytotoxicity are limited. This in vitro study aimed to evaluate the cytotoxic effects of EEP at different concentrations and fermentation periods against the MC3T3-E1 cell. EEP derived from orange and pineapple peel waste and fermented for 3 and 6 months was prepared from 100% to 0.78% concentration. Briefly, 2.5% NaOCl was used as the comparison group. Cell viability was analysed using Alamar Blue and Live and Dead Cell assay. A transmission electron microscope (TEM) was used to evaluate ultrastructural changes to the cells. Data analysis was performed using a two-way mixed Analysis of Variance (ANOVA). EEP exhibited concentration-dependent cytotoxicity regardless of the fermentation period (p > 0.05). A concentration below 6.25% was non-cytotoxic and comparable to the negative control (p > 0.05). Live and Dead Cell assay and TEM analysis complement the findings. The mean cell viability of EEP at all concentrations for both fermentation periods was significantly higher than that of 2.5% NaOCl (p < 0.05). Conclusively, 6.25% EEP fermented for 3 and 6 months are non-cytotoxic and can serve as an alternative endodontic irrigants.

Introduction: Cleaning and shaping of the root canal has been really challenging for even the most experienced endodontist. Endodontic instrumentation within the basis canal is an infelicitous occurrence which will obstruct the basis canal procedure and therefore the outcome with more complication. When a new instrument or system is introduced, it's generally claimed by the manufacturer to be more efficient in preparing the canal and more immune to separation. Doing a passage treatment (RCT), for the foremost part, isn't a sophisticated task and therefore the procedure should become easier and more systematic because the clinician gains more experience. So, the present survey was aimed at doing an online questionnaire based survey to assess the choice and usages of root canal instruments for clinical practice among endodontists in Tamilnadu. Study results revealed that, Even though 70% of the population was aware of the usage of root canal instruments, the knowledge regarding the various parameters to identify the usage and choice of various root canal instruments is still lacking in the rest. Aim: The aim of the study was to create knowledge and usage about root canal instruments in Endodontists. Materials & Methods-A questionnaire based survey was conducted among 100 populations of experienced endodontists, academician, general practitioner and PG of random selection, the responses were collected in 'google docs' and the values were estimated in SPSS version (23.0). Results: The respondents Endodontists have a greater and sufficient knowledge and awareness on root canal instruments, where (p = 0.000 < 0.05) is statistically significant. Conclusion: From the study, we can conclude that all the population have been well educated on their knowledge and awareness on usage of root canal instruments. In particular, Experienced endodontists have shown precision and this also determines that they have immense knowledge about usage of root canal instruments. [ABSTRACT FROM AUTHOR]

60 extracted single rooted premolar human teeth were used in this study. The canal spaces of all the teeth were prepared with a round bur (1.3mm diameter). The specimens were sectioned horizontally at the mid root level dentin into 1.5±0.2 mm thick slices. The slices were randomly divided into 2 groups (n=30), group 1- Biodentine and group 2- MTA. The samples were wrapped in wet gauze, placed in an incubator, and were allowed to set for 10 min at 37°C with 100% humidity. After incubation, the samples in each group were divided into 5 subgroups to be immersed into irrigants (NAOCL, MTAD, QMIX, SMEAR CLEAR AND SALINE). After 30 min of immersion, all samples of Group 1 and Group 2 were removed from the test solutions, rinsed with distilled water, and allowed to set for 48 h at 37°C with 100% humidity in an incubator. The push out bond strength values were measured by using a universal testing machine. One-way Analysis of Variance (ANOVA), Post hoc Tukey test and independent test were used for statistical analysis in the present study. Biodentine showed greater pushout bond strength than MTA. Among the irrigants saline showed the highest pushout bond strength followed by NAOCL>MTAD>smear clear>Qmix. [ABSTRACT FROM AUTHOR]

Aim: The addition of etidronic acid (HEDP) to sodium hypochlorite (NaOCl) could increase the antibiofilm potency of the irrigant, whilst maintaining the benefits of continuous chelation. Studies conducted so far have shown that mixing HEDP with NaOCl solutions of relatively low concentration does not compromise the antibiofilm efficacy of the irrigant. However, the working lifespan of NaOCl may decrease resulting in a reduction of its antibiofilm efficacy over time (efficiency). In this regard, continuous irrigant replenishment needs to be examined. This study investigated the response of a dual‐species biofilm when challenged with 2% and 5% NaOCl mixed with HEDP for a prolonged timespan and under steady laminar flow. Methodology: Dual‐species biofilms comprised of Streptococcus oralis J22 and Actinomyces naeslundii T14V‐J1 were grown on human dentine discs in a constant depth film fermenter (CDFF) for 96 h. Biofilms were treated with 2% and 5% NaOCl, alone or mixed with HEDP. Irrigants were applied under steady laminar flow for 8 min. Biofilm response was evaluated by means of optical coherence tomography (OCT). Biofilm removal, biofilm disruption, rate of biofilm loss and disruption as well as bubble formation were assessed. One‐way anova, Wilcoxon's signed‐rank test and Kruskal–Wallis H test were performed for statistical analysis of the data. The level of significance was set at a ≤.05. Results: Increasing NaOCl concentration resulted in increased biofilm removal and disruption, higher rate of biofilm loss and disruption and increased bubble formation. Mixing HEDP with NaOCl caused a delay in the antibiofilm action of the latter, without compromising its antibiofilm efficacy. Conclusions: NaOCl concentration dictates the biofilm response irrespective of the presence of HEDP. The addition of HEDP resulted in a delay in the antibiofilm action of NaOCl. This delay affects the efficiency, but not the efficacy of the irrigant over time. [ABSTRACT FROM AUTHOR]

Introduction The goal of this study was to compare the impact of NaOCl, EDTA, and chitosan on the cyclic fatigue of 2Shape, HyFlex EDM, and RACE EVO. Methods A total of 120 new 2Shape (n = 40), HyFlex EDM (n = 40), and RACE EVO (n = 40) files were subdivided randomly into four groups (n = 10): Group (A) with no immersion, Group (B) with immersion in 5.25% NaOCl for 5 min, Group (C) with immersion in 17% EDTA for 5 min, and Group (D) with immersion in 0.2% chitosan for 5 min. The files were rotated in an artificial canal with a 5 mm radius and a 60° curvature at body temperature until they fractured, and the number of cycles to fracture was measured. ANOVA test and Tukey post-hoc test were used to analyze the data. Results Immersion of the files in NaOCl, EDTA, or chitosan solutions had no significant effect on the number of cycles to fracture (P > 0.05). Conclusion The irrigation solutions did not have any influence on the cyclic fatigue of the tested files.

This study is a literature review in order to irrigants in endodontics. A successful endodontic treatment relies on eradicating the germs found in the canal system and preventing reinfection. Alongside the irrigants commonly used in endodontics, in order for the treatment to be successful there have been introduced different irrigation systems that bring benefits such as: decreased time to act and the way of penetration at the isthmi level and lateral canals and of irrigation substances, where instrumentation is not sufficient.

The purpose of this systematic review was to evaluate how an antioxidant treatment would influence the immediate bond strength of dental adhesives to endodontically treated dentine. Scientific evidence was researched in five databases using selected descriptors. Two independent reviewers conducted the investigation and assessed the data and methodological quality of the studies. Inclusion and exclusion criteria were specified for article selection; only studies in English and published between 2001 and 2022 were evaluated. A total of 18 studies were selected and analysed. According to most studies, the irrigation procedure and substrate preparation in endodontic therapy may affect the immediate bond strength. Antioxidants can improve bond strength and adhesion following the use of the most frequently used irrigants in root canal treatments. Therefore, antioxidant treatment can be considered a proper technique to enhance the bond strength of endodontically treated teeth.

The endodontic management of necrotic immature permanent teeth is often challenging for the clinician. Regenerative endodontic treatment has emerged as an important alternative to the traditional apexification treatment in such cases. In regenerative endodontics, elimination of microbes from the root canal is important for the survival, proliferation, and differentiation of stem cells. Translational studies suggest that irrigants and medicaments used for root canal disinfection may adversely affect stem cells and ultimately, the regenerative outcome. Conventionally, irrigants and medicaments have been chosen for their maximum antimicrobial effect without considering their effects on stem cells and the dentinal microenvironment. In this review, advances in disinfection for regenerative endodontics are discussed.

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

Background: Enhancement of the temperature of sodium hypochlorite (NaOCl) solution would increase its cleaning potential and decontamination of the root canal system. Therefore, the aim of the present in vitro investigation was to compare the efficacy of different methods of NaOCl heating by evaluating the temperature profiles developed at different levels of the root canal system. Methods: Five thermocouples were applied at different levels of the root canal system of extracted human premolars. NaOCl solution was heated according to two methods: extraoral heating (50 °C, 60 °C, and 70 °C) using a magnetic hotplate heater and intracanal heating by F-06, XF-30/04, and ML-12 pluggers at 100 °C, 150 °C, and 180 °C. Results: The extraoral heating method was ineffective to produce a significant temperature increase at the root apex. Comparable results were obtained using the intracanal heating method through the ML-12 plugger that showed slightly better results only when set at 180 °C. On the other hand, negligible differences were observed in terms of temperature maintenance at several levels of the root between the F-06 and XF-30/04 pluggers, even though the time intervals were higher in case of XF-30/04. Conclusions: The intracanal heating method provided a better temperature persistence in the middle third of the root canal system. Conversely, extraoral heating was ineffective to produce a significant temperature increase at the apex of the root. Comparable results were obtained even using the ML-12 plugger. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate the influence of various irrigants on the dislodgement resistance of MTA Repair HP, MTA Angelus, and MTA Flow to root dentin. Three slices (1.0 ± 0.1 mm) were prepared from the middle third of 20 human maxillary anterior teeth. On each dentin disc, three perpendicular simulated perforation holes with a standardized 0.8 mm diameter were created. The sections from the same root were distributed arbitrarily into three groups (n = 20) for smear layer removal procedure: ethylenediaminetetraacetic acid (EDTA), chitosan-based silver nanoparticles (AgNPs-chitosan), and maleic acid (MA). Afterwards, the holes were randomly filled with one of the three investigated cements. The samples were submitted to the push-out test using a universal measuring system. Kruskal–Wallis and Mann–Whitney U tests were used to assess statistical differences among the groups. When the results were evaluated, it was found that the types of cement and chelating agents significantly affected the dislocation resistance (P < 0.05). EDTA provided a higher dislocation resistance with the investigated cements in comparison to MA and AgNPs-chitosan (P < 0.05). Furthermore, it was observed that MTA Flow and MTA Angelus presented improved dislocation resistance values than the MTA Repair HP when used with EDTA (P < 0.05). The findings indicated that EDTA increased the dislodgement resistance of the investigated cements. In conclusion, when EDTA used, MTA Flow, and MTA Angelus showed higher dislocation resistance values. [ABSTRACT FROM AUTHOR]

The microflora in the root canal system (RCS) of teeth and dentinal tubules (DT) exists in the form of a biofilm – an organized community of microorganisms. At present, chemical and mechanical methods are used to control biofilm in RCS and DT, implying the instrumental treatment of RCS and the use of disinfectants in the form of irrigants or temporary root dressings. The purpose of this review is to analyze the accumulated information on the effectiveness of well-known modern methods and clinical strategies for combating intra-root infection to improve the quality of endodontic treatment.

Introduction/Objective. Irrigation has an important role in root canal cleaning and its efficiency depends on the type of irrigants, the amount, the technique and the irrigation protocol. The aim of this work was to estimate the efficiency of cleaning of the canal walls by using scanning electron microscope analysis after the instrumentation by rotary NiTi instruments with the use of three different irrigation solutions and two final irrigation protocols. Methods. Sixty extracted human incisors were divided into two groups after the rotary instrumentation with the iRace instruments. In both groups, the same amount (1.5 ml) of three solutions (2% sodium hypochlorite solution, 2% chlorhexidine solution, and 10% citric acid solution) and total final irrigation time (90 seconds) was the same. The final irrigation in the first group was accomplished using the technique of continuous irrigation and in the second group it was done using the intermittent protocol. The roots were cut longitudinally and analyzed by thirds (coronal, middle, and apical) on a scanning electron microscope (JSM 6460LV, JEOL Ltd., Tokyo, Japan) with 1,000× magnification. Results. The most efficient cleaning of the root canal walls in both groups was seen after the use of citric acid with the intermittent protocol of the final irrigation (90.7% clean walls), while the least efficient was the final irrigation by chlorhexidine with continuous irrigation (80.3%). The most efficient cleaning of the canal walls in both groups was observed in the coronal third and the largest amount of the smear layer in the apical third. Conclusion. The most efficient cleaning of the canal was achieved by the use of citric acid and the intermittent protocol of the final irrigation. In all tested solutions, the intermittent protocol of irrigation was more efficient than continuous irrigation.

A wide plethora of chemical endodontic irrigants are used to achieve the desired results in terms of disinfection and removal of debris besides mechanical means. However, their detrimental properties such as allergic potential, cytotoxicity, antimicrobial resistance, and safety concerns have intrigued researchers over the years to look for safer options. During the past decade, the number of studies has increased utilizing herbs as irrigating solutions. This literature review was conducted to summarize the existing knowledge and provide a comprehensive review of clinical trials on herbal irrigating solutions in pediatric dental patients. An exhaustive literature search was performed in the indexed databases electronically for publications in peer reviewed scientific journals to find the relevant clinical studies evaluating efficacy of herbal root canal irrigants employed in primary teeth.

Introduction: The goal of this study was to compare the impact of NaOCl, EDTA, and chitosan on the cyclic fatigue of 2Shape, HyFlex EDM, and RACE EVO. Methods: A total of 120 new 2Shape (n=40), HyFlex EDM (n=40), and RACE EVO (n=40) files were subdivided randomly into four groups (n=10): Group (A) with no immersion, Group (B) with immersion in 5.25% NaOCl for 5 min, Group (C) with immersion in 17% EDTA for 5 min, and Group (D) with immersion in 0.2% chitosan for 5 min. The files were rotated in an artificial canal with a 5mm radius and a 60° curvature at body temperature until they fractured, and the number of cycles to fracture was measured. ANOVA test and Tukey post-hoc test were used to analyze the data. Results: Immersion of the files in NaOCl, EDTA, or chitosan solutions had no significant effect on the number of cycles to fracture (P > 0.05). Conclusion: The irrigation solutions did not have any influence on the cyclic fatigue of the tested files. [ABSTRACT FROM AUTHOR]

The aim of this study was to compare the effects of new irrigation solvent mixtures with Methyl ethyl ketone (MEK)/Tetrachloroethylene (TCE) and MEK/Orange oil (OOil), and different agitation techniques on dentin hardness. One hundred forty-four mandibular teeth were prepared and standardized, with each root's middle part transversely sectioned. Initial hardness was measured using a Vickers microhardness tester. Specimens were divided into four groups of agitation techniques (n = 36): no agitation; EndoActivator; IrriSafe; and XP-endo Finisher R. Each group was subdivided into six subgroups of irrigation protocols (n = 6): saline solution; NaOCl + EDTA; NaOCl + EDTA + MEK/TCE; MEK/TCE; NaOCl + EDTA + MEK/OOil; MEK/OOil. Final hardness was measured. The irrigation protocols NaOCl + EDTA, NaOCl + EDTA + MEK/TCE, and NaOCl + EDTA + MEK/OOil significantly decreased dentin hardness, while MEK/OOil increased it (p < 0.05). Comparing to NaOCl + EDTA sequence, dentin hardness increased significantly with the additional exposure to MEK/TCE (3%NaOCl + 17%EDTA + MEK/TCE) or MEK/OOil (3%NaOCl + 17%EDTA + MEK/OOil) (p < 0.05). There were no significant differences regarding agitation effects on dentin hardness decrease. The irrigation protocols affected dentin hardness significantly. However, the additional solvent proposals do not seem to address further concerns on dentin's mechanical properties. Agitation did not show any influence on dentin's hardness reduction. [ABSTRACT FROM AUTHOR]

Background: Sequential chemical application for irrigating a root canal during chemomechanical debridement can affect the dentin microstructure. Understanding the effects of various irrigants on chemical properties of dentin can elucidate their effects on physical properties and thereby explain the higher incidence of structural failure in endodontically treated teeth. This in vitro research aimed to compare and evaluate the effects of three different irrigating solutions on the chemical structure of root canal dentin in extracted human teeth. Methods: Forty-eight extracted single-rooted mandibular premolar teeth were sectioned at the cemento–enamel junction by a diamond disc and were then randomly assigned to four groups of twelve samples each. The groups were irrigated using 5.25% NaOCl, ozonated olive oil, silver citrate, or distilled water. Dentin sections measuring 1.5 mm were obtained from the root portion and each section and were analyzed using Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), and electron-dispersive spectroscopy (EDS). FTIR and EDS values are reported as means ± standard deviations. Data were analyzed using an ANOVA and a post hoc Bonferroni test (p < 0.05). Results: A comparison of the FTIR and EDS values among the groups using ANOVA revealed statistically significant differences in the organic and inorganic peak values among the groups. An intergroup comparison between NaOCl with silver citrate and ozonated olive oil revealed significant reductions in the carbonate and phosphate peak values in the NaOCl group (p < 0.05). The EDS values tabulated for the carbon, oxygen, phosphorous, and calcium peak levels showed significant differences between the groups using an ANOVA. An SEM analysis was conducted under 1500× magnification, which revealed smear layer removal in the silver citrate group. Conclusions: The silver citrate solution and the ozonated olive oil caused less changes in the organic and mineral contents of dentin than sodium hypochlorite.

Aim: To evaluate & compare antimicrobial efficacy of two herbal products as root canal irrigants in primary endodontic infections. Methodology: 78 patients were selected, out of which only 66 patients met the inclusion criteria & were furtherrandomly divided into 3 groups (n=22 each), Group-1: 2.5% Sodium Hypochlorite, Group - 2: Chitosan, Group - 3: Propolis. Access cavity was prepared & working length was determined radiographically. A sterile paper point was inserted into the canal for 60 sec. Three samples were taken for each tooth. Biomechanical preparation was done upto master apical size #40 K-file. Irrigation was done with the respective irrigants. Post instrumentation sample (S2) was collected in the similar manner as S1. Microbiological samples (S1, S2) were preincubated for 30 minutes and plated on Brain heart infusion agar. Colonies were counted after 24 hours using classic bacterial counting method. Normality of data was checked using Shapiro wilk testand intra/intergroup comparison was done using Anova& Post hoc Tukey test. Results: The mean bacterial counts of Group-II were found to be lower than that of Group- III & Group- I. However, the difference was not statistically significant when compared to Group- I but the difference was statistically significant with Group- III. Summary and Conclusion: It can be concluded that herbal products have shown significant antimicrobial activity in comparison to 2.5 % Sodium hypochlorite in primary endodontic infections in patients and can be recommended for use in clinical situations. [ABSTRACT FROM AUTHOR]