Keywords
Endodontics
Root canal irrigants
Sodium hypochlorite
How to Cite
Abstract
Aim: To compare the influence of two methods of agitation of endodontics irrigants, by diffusion of calcium hydroxide [Ca(OH)2] through the dentinal tubules, measuring the pH of the medium where they were kept. Methods: Twenty mandibular incisors were prepared using a WaveOne Gold Large file, in a reciprocating movement, and then divided into (n = 10): gutta-percha cone (GPC) or Easy Clean system (ECS) agitation of 1% sodium hypochlorite and 17% ethylenediaminetetraacetic acid. The specimens were filled with Ca(OH)2 paste, placed in flasks with 4 mL of deionized water, and stored in an incubator. The pH was read using a digital pH meter immediately after storage (T0), after 7 (T1), 14 (T2), 21 (T3), and 35 (T4) days. Results: Statistical difference between groups was observed regardless of the day pH was measured (p < 0.01). From T2 on, ECS presented higher pH values in comparison with GPC, with significant difference (p < 0.01). Conclusion: Agitation of endodontic irrigants with ECS enhances the Ca(OH)2 diffusion, providing higher pH values, from the 14th day on, when compared with GPC.
References
European Society of Endodontology. Quality guidelines for endodontic treatment: consensus report of the European Society of Endodontology. Int Endod J. 2006 Dec;39(12):921-30. doi: 10.1111/j.1365-2591.2006.01180.x.
Vertucci FJ. Root canal morphology and its relationship to endodontic procedures. Endod Topics. 2005 Aug;10(1):3-29. doi: 10.1111/j.1601-1546.2005.00129.x.
Zehnder M. Root canal irrigants. J Endod. 2006 May;32(5):389-98. doi: 10.1016/j.joen.2005.09.014.
Estrela C, Estrela CR, Barbin EL, Spanó JC, Marchesan MA, Pécora JD. Mechanism of action of sodium hypochlorite. Braz Dent J. 2002;13(2):113-7. doi: 10.1590/s0103-64402002000200007.
Dioguardi M, Gioia GD, Illuzzi G, Laneve E, Cocco A, Troiano G. Endodontic irrigants: different methods to improve efficacy and related problems. Eur J Dent. 2018 Jul-Sep;12(3):459-66. doi: 10.4103/ejd.ejd_56_18.
Mohammadi Z, Shalavi S. Antimicrobial activity of sodium hypochlorite in endodontics. J Mass Dent Soc. 2013 Spring;62(1):28-31.
Haapasalo M, Shen Y, Wang Z, Gao Y. Irrigation in endodontics. Br Dent J. 2014 Mar;216(6):299-303. doi: 10.1038/sj.bdj.2014.204.
Peters OA, Laib A, Göhring TN, Barbakow F. Changes in root canal geometry after preparation assessed by high-resolution computed tomography. J Endod. 2001 Jan;27(1):1-6. doi: 10.1097/00004770-200101000-00001.
Giardino L, Pedullà E, Cavani F, Bisciotti F, Giannetti L, Checchi V, et al. Comparative evaluation of the penetration depth into dentinal tubules of three endodontic irrigants. Materials (Basel). 2021 Oct;14(19):5853. doi: 10.3390/ma14195853.
Martinho JP, França S, Paulo S, Paula AB, Coelho AS, Abrantes AM, et al. Effect of different irrigation solutions on the diffusion of MTA cement into the root canal dentin. Materials (Basel). 2020 Dec;13(23):5472. doi: 10.3390/ma13235472.
Azim AA, Aksel H, Zhuang T, Mashtare T, Babu JP, Huang GT. Efficacy of 4 irrigation protocols in killing bacteria colonized in dentinal tubules examined by a novel confocal laser scanning microscope analysis. J Endod. 2016 Jun;42(6):928-34. doi: 10.1016/j.joen.2016.03.009.
Siqueira JF Jr, Rôças IN. Clinical implications and microbiology of bacterial persistence after treatment procedures. J Endod. 2008 Nov;34(11):1291-1301.e3. doi: 10.1016/j.joen.2008.07.028.
Virdee SS, Seymour DW, Farnell D, Bhamra G, Bhakta S. Efficacy of irrigant activation techniques in removing intracanal smear layer and debris from mature permanent teeth: a systematic review and meta-analysis. Int Endod J. 2018 Jun;51(6):605-21. doi: 10.1111/iej.12877.
Plotino G, Cortese T, Grande NM, Leonardi DP, Goirgio GD, Testarelli L, et al. New technologies to improve root canal disinfection. Braz Dent J. 2016 Jan-Feb;27(1):3-8. doi: 10.1590/0103-6440201600726.
Iandolo A, Amato M, Abdellatif D, Barbosa AFA, Pantaleo G, Blasi A, et al. Effect of different final irrigation protocols on pulp tissue dissolution from an isthmus model. Aust Endod J. 2021 Dec;47(3):538-43. doi: 10.1111/aej.12518.
Di Spirito F, Pisano M, Caggiano M, Bhasin P, Lo Giudice R, Abdellatif D. Root canal cleaning after different irrigation techniques: an ex vivo analysis. Medicina (Kaunas). 2022 Jan;58(2):193. doi: 10.3390/medicina58020193.
Kato AS, Cunha RS, da Silveira Bueno CE, Pelegrine RA, Fontana CE, de Martin AS. Investigation of the efficacy of passive ultrasonic irrigation versus irrigation with reciprocating activation: an environmental scanning electron microscopic study. J Endod. 2016 Apr;42(4):659-63. doi: 10.1016/j.joen.2016.01.016.
Rodrigues CT, Duarte MAH, Guimarães BM, Vivan RR, Bernardineli N. Comparison of two methods of irrigant agitation in the removal of residual filling material in retreatment. Braz Oral Res. 2017 Dec 18;31:e113. doi: 10.1590/1807-3107BOR-2017.vol31.0113.
Siqueira JF, Lopes HP. Mechanisms of antimicrobial activity of calcium hydroxide: A critical review. Int Endod J. 1999 Sep;32(5):361-9. doi: 10.1046/j.1365-2591.1999.00275.x.
Misra P, Bains R, Loomba K, Singh A, Sharma VP, Murthy RC, et al. Measurement of pH and calcium ions release from different calcium hydroxide pastes at different intervals of time: Atomic spectrophotometric analysis. J Oral Biol Craniofac Res. 2017 Jan-Apr;7(1):36-41. doi: 10.1016/j.jobcr.2016.04.001.
de Almeida Barbosa M, de Oliveira KV, Dos Santos VR, da Silva WJ, Tomazinho FSF, Baratto-Filho F, et al. Effect of vehicle and agitation methods on the penetration of calcium hydroxide paste in the dentinal tubules. J Endod. 2020 Jul;46(7):980-6. doi: 10.1016/j.joen.2020.03.026.
Athanassiadis B, Abbott PV, Walsh LJ. The use of calcium hydroxide, antibiotics and biocides as antimicrobial medicaments in endodontics. Aust Dent J. 2007 Mar;52(1 Suppl):S64-82. doi: 10.1111/j.1834-7819.2007.tb00527.x.
Batista VES, Olian DD, Mori GG. Diffusion of hydroxyl ions from calcium hydroxide and Aloe vera pastes. Braz Dent J. 2014;25(3):212-6. doi: 10.1590/0103-6440201300021.
Huang TY, Gulabivala K, Ng YL. A bio-molecular film ex-vivo model to evaluate the influence of canal dimensions and irrigation variables on the efficacy of irrigation. Int Endod J. 2008 Jan;41(1):60-71. doi: 10.1111/j.1365-2591.2007.01317.x.
Oliveira KV, Silva BMD, Leonardi DP, Crozeta BM, Sousa-Neto MD, Baratto-Filho F, et al. Effectiveness of different final irrigation techniques and placement of endodontic sealer into dentinal tubules. Braz Oral Res. 2017 Dec;31:e114. doi: 10.1590/1807-3107BOR-2017.vol31.0114.
Cesario F, Hungaro Duarte MA, Duque JA, Alcalde MP, de Andrade FB, Reis So MV, et al. Comparisons by microcomputed tomography of the efficiency of different irrigation techniques for removing dentinal debris from artificial grooves. J Conserv Dent. 2018 Jul-Aug;21(4):383-7. doi: 10.4103/JCD.JCD_286_16.
de Oliveira RL, Guerisoli DMZ, Duque JA, Alcalde MP, Onoda HK, Domingues FHF, et al. Computed microtomography evaluation of calcium hydroxide-based root canal dressing removal from oval root canals by different methods of irrigation. Microsc Res Tech. 2019 Mar;82(3):232-7. doi: 10.1002/jemt.23164.
Castelo-Baz P, Varela-Patiño P, Cantatore G, Domínguez-Perez A, Ruíz-Piñón M, Miguéns-Vila R, et al. In vitro comparison of passive and continuous ultrasonic irrigation in curved root canals. J Clin Exp Dent. 2016 Oct;8(4):e437-41. doi: 10.4317/jced.53023.
Coronas VS, Villa N, Nascimento ALD, Duarte PHM, Rosa RAD, Só MVR. Dentinal tubule penetration of a calcium silicate-based root canal sealer using a specific calcium fluorophore. Braz Dent J. 2020 Mar-Apr;31(2):109-15. doi: 10.1590/0103-6440202002829.
Walsh LJ, George R. Activation of alkaline irrigation fluids in Endodontics. Materials (Basel). 2017 Oct;10(10):1214. doi: 10.3390/ma10101214.
Cai M, Abbott P, Castro Salgado J. Hydroxyl ion diffusion through radicular dentine when calcium hydroxide is used under different conditions. Materials (Basel). 2018 Jan;11(1):152. doi: 10.3390/ma11010152.
Sharma G, Ahmed HMA, Zilm PS, Rossi-Fedele G. Antimicrobial properties of calcium hydroxide dressing when used for long-term application: a systematic review. Aust Endod J. 2018 Apr;44(1):60-5. doi: 10.1111/aej.12216.
Nascimento GG, Rabello DGD, Corazza BJM, Gomes APM, Silva EG, Martinho FC. Comparison of the effectiveness of single- and multiple-sessions disinfection protocols against endotoxins in root canal infections: Systematic review and meta-analysis. Sci Rep. 2021 Jan;11(1):1226. doi: 10.1038/s41598-020-79300-3.
Plataniotis E, Abbott P. A comparison of hydroxyl ion diffusion through root dentine from various calcium hydroxide preparations. Aust Endod J. 2018 May 28. doi: 10.1111/aej.12281.
Eftekhar B, Moghimipour E, Eini E, Jafarzadeh M, Behrooz N. Evaluation of hydroxyl ion diffusion in dentin and injectable forms and a simple powder-water calcium hydroxide paste: an in vitro study. Jundishapur J Nat Pharm Prod. 2014 Jun;9(3):e14029. doi: 10.17795/jjnpp-14029.
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2022 Lucas Takeo Wakasugui, Camila Paiva Perin, Allan Abuabara, Marilisa Carneiro Leão Gabardo, Flares Baratto-Filho, Liliane Roskamp, Natanael Henrique Ribeiro Mattos
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