The effect of calcium hypochlorite, associated with EDTA, in the inorganic component of dentin : SEM analysis

O estudo teve como objetivo avaliar a influência da irrigação do canal radicular com hipoclorito de cálcio [Ca(OCl)2] na concentração de 5,25%, associado ao EDTA, sobre o componente inorgânico da dentina em comparação com o hipoclorito de sódio (NaOCl) na mesma concentração. Para tanto, o terço médio e apical de 60 raízes de pré-molares humanos foram divididos aleatoriamente em seis grupos (n=10): Ca(OCl)2 5,25%; Ca(OCl)2 5,25% + EDTA 17%; NaOCl 5,25%; NaOCl 5,25% + EDTA 17%; EDTA 17%; soro. As amostras foram irrigadas com as soluções prédeterminadas conforme o protocolo de irrigação e, a seguir, foram seccionadas longitudinalmente em duas hemi-raízes. Uma das metades foi utilizada para a análise em microscopia eletrônica de varredura (MEV). Imagens dos túbulos dentinários no sentido longitudinal e transversal, na região do lúmen do canal, foram obtidas. Os túbulos dentinários, na secção transversal, foram analisados em relação à remoção da smear layer e da alteração da dentina peritubular Os dados foram submetidos ao teste de Kruskall-Wallis, seguido pelo post-hoc de Dunn (α=.05). Os resultados da análise em MEV dos túbulos no sentido longitudinal foram apresentados descritivamente, de acordo com o arranjo dos túbulos: paralelos ou divergentes. Os grupos EDTA, Ca(OCl)2 + EDTA e NaOCl + EDTA mostraram diferença significativa na remoção da smear layer e alteração no componente inorgânico da dentina quando comparados aos grupos soro, Ca(OCl)2 e NaOCl no terço médio do canal. No terço apical, apenas o grupo NaOCl+EDTA mostrou diferença significativa quando comparado aos grupos soro, Ca(OCl)2 e NaOCl. A avaliação dos túbulos no sentido longitudinal mostrou que nos grupos soro, Ca(OCl)2 e NaOCl os túbulos apresentavam-se obliterados por smear layer e com um arranjo paralelo. No grupo do EDTA, a smear layer foi removida e os túbulos apresentaram arranjo paralelo. Nos grupos Ca(OCl)2 + EDTA e NaOCl + EDTA a smear layer foi removida e os túbulos mostraram arranjo divergente.The present study aimed to evaluate the influence of irrigation of the root canal with calcium hypochlorite [Ca(OCl)2] 5,25%, followed by EDTA, on the inorganic component of dentin compared with sodium hypochlorite (NaOCl) at the same concentration. Thus, the middle and apical third of 60 human premolar roots were randomly divided into six groups (n=10): 5,25% Ca(OCl)2; 5,25% Ca(OCl)2 + 17% EDTA; 5,25% NaOCl; 5,25% NaOCl + 17% EDTA; 17% EDTA; saline solution. The samples were irrigated with predetermined irrigation solutions according to the protocols. The specimens were split longitudinally and only one half was used for the analysis in scanning electron microscopy (SEM). Images of dentinal tubules in longitudinal and transverse direction in the canal lumen were obtained. Tubules in transverse direction were analyzed according to the smear layer removal and alteration of peritubular dentin. Data were submitted to the Kruskall Wallis test, followed by Dunn`s test (α=.05) The results of SEM analysis of dentinal tubules in the longitudinal direction were presented descriptively, according to the arrangement of the tubule: parallel or divergent. EDTA, Ca(OCl)2 + EDTA and NaOCl + EDTA groups showed statistically significant difference in the removal of smear layer and alterations in dentine inorganic component when compared to saline, Ca(OCl)2 and NaOCl groups in the middle third of the canal. However, when observing the apical third, only NaOCl + EDTA group showed statistically significant difference when compared to saline, Ca(OCl)2 and NaOCl groups. The evaluation of the tubules, in longitudinal direction, showed that in the saline, Ca(OCl)2 and NaOCl groups tubules were obliterated by smear layer and showed parallel arrangement. EDTA group was able to remove smear layer and the tubular arrangement was parallel. Ca(OCl)2 + EDTA and NaOCl + EDTA groups removed the smear layer and provided a divergent tubular arrangement

The effect of antimicrobian photodynamic therapy on channels disinfection : a systematic review

A desinfecção do canal radicular é essencial para o sucesso do tratamento endodôntico. A terapia fotodinâmica antimicrobiana (aPDT) vem sendo proposta como um coadjuvante ao tratamento para aumentar os níveis de desinfecção. O objetivo da presente revisão sistemática foi avaliar a redução do conteúdo microbiano dos canais pelo emprego da aPDT. Métodos: Dois revisores independentes realizaram as buscas nos bancos de dados utilizando palavras-chaves que resultassem em artigos relevantes que se enquadrassem nos critérios de inclusão Patient, Intervention, Comparison and Outcome (PICO). Um terceiro revisor realizou analise de inclusão ou de exclusão do artigo, caso houvesse dúvida entre os outros dois. Resultados: Um total de 186 títulos e resumos foi encontrado nas plataformas de buscas. Apenas 12 artigos se enquadraram nos critérios de inclusão da presente revisão. Observou-se que diferentes protocolos são empregados para a realização da aPDT. Com relação a redução do componente microbiano quando empregada a aPDT, oito estudos incluídos relataram que a aPDT foi eficaz quando associada ao tratamento endodôntico. Conclusão: Não há consenso a respeito da capacidade aPDT de reduzir o componente microbiano do sistema de canais radiculares em estudos clínicos randomizados. Para que o nível de evidência seja aumentado é necessário que seja estabelecido um protocolo padrão para o emprego da aPDT.Root canal disinfection is essential for successful endodontic treatment. Antimicrobial photodynamic therapy (aPDT) has been proposed as an adjunct to treatment to increase disinfection levels. The objective of the present systemic review was to evaluate the reduction of the microbial content of the canals by the use of aPDT. Methods: Two independent reviewers searched the databases using keywords that resulted in relevant articles that met the inclusion criteria Patient, Intervention, Comparison and Outcome (PICO). A third reviewer performed inclusion or exclusion analysis of the article if there was doubt between the other two. Results: A total of 186 titles and abstracts were found on the search platforms. Only 12 articles met the inclusion criteria of this review. It was observed that different protocols are employed to perform aPDT. Regarding the reduction of the microbial component when aPDT was employed, eight of the included studies reported that aPDT was effective when associated with endodontic treatment. Conclusion: There is no consensus on the aPDT’s ability to reduce microbial component of the root canal system in randomized clinical trials. A standard protocol for the use of aPDT needs to be established and the level of evidence increased

The effect of calcium hypochlorite, associated with EDTA, in the inorganic component of dentin : SEM analysis

O estudo teve como objetivo avaliar a influência da irrigação do canal radicular com hipoclorito de cálcio [Ca(OCl)2] na concentração de 5,25%, associado ao EDTA, sobre o componente inorgânico da dentina em comparação com o hipoclorito de sódio (NaOCl) na mesma concentração. Para tanto, o terço médio e apical de 60 raízes de pré-molares humanos foram divididos aleatoriamente em seis grupos (n=10): Ca(OCl)2 5,25%; Ca(OCl)2 5,25% + EDTA 17%; NaOCl 5,25%; NaOCl 5,25% + EDTA 17%; EDTA 17%; soro. As amostras foram irrigadas com as soluções prédeterminadas conforme o protocolo de irrigação e, a seguir, foram seccionadas longitudinalmente em duas hemi-raízes. Uma das metades foi utilizada para a análise em microscopia eletrônica de varredura (MEV). Imagens dos túbulos dentinários no sentido longitudinal e transversal, na região do lúmen do canal, foram obtidas. Os túbulos dentinários, na secção transversal, foram analisados em relação à remoção da smear layer e da alteração da dentina peritubular Os dados foram submetidos ao teste de Kruskall-Wallis, seguido pelo post-hoc de Dunn (α=.05). Os resultados da análise em MEV dos túbulos no sentido longitudinal foram apresentados descritivamente, de acordo com o arranjo dos túbulos: paralelos ou divergentes. Os grupos EDTA, Ca(OCl)2 + EDTA e NaOCl + EDTA mostraram diferença significativa na remoção da smear layer e alteração no componente inorgânico da dentina quando comparados aos grupos soro, Ca(OCl)2 e NaOCl no terço médio do canal. No terço apical, apenas o grupo NaOCl+EDTA mostrou diferença significativa quando comparado aos grupos soro, Ca(OCl)2 e NaOCl. A avaliação dos túbulos no sentido longitudinal mostrou que nos grupos soro, Ca(OCl)2 e NaOCl os túbulos apresentavam-se obliterados por smear layer e com um arranjo paralelo. No grupo do EDTA, a smear layer foi removida e os túbulos apresentaram arranjo paralelo. Nos grupos Ca(OCl)2 + EDTA e NaOCl + EDTA a smear layer foi removida e os túbulos mostraram arranjo divergente.The present study aimed to evaluate the influence of irrigation of the root canal with calcium hypochlorite [Ca(OCl)2] 5,25%, followed by EDTA, on the inorganic component of dentin compared with sodium hypochlorite (NaOCl) at the same concentration. Thus, the middle and apical third of 60 human premolar roots were randomly divided into six groups (n=10): 5,25% Ca(OCl)2; 5,25% Ca(OCl)2 + 17% EDTA; 5,25% NaOCl; 5,25% NaOCl + 17% EDTA; 17% EDTA; saline solution. The samples were irrigated with predetermined irrigation solutions according to the protocols. The specimens were split longitudinally and only one half was used for the analysis in scanning electron microscopy (SEM). Images of dentinal tubules in longitudinal and transverse direction in the canal lumen were obtained. Tubules in transverse direction were analyzed according to the smear layer removal and alteration of peritubular dentin. Data were submitted to the Kruskall Wallis test, followed by Dunn`s test (α=.05) The results of SEM analysis of dentinal tubules in the longitudinal direction were presented descriptively, according to the arrangement of the tubule: parallel or divergent. EDTA, Ca(OCl)2 + EDTA and NaOCl + EDTA groups showed statistically significant difference in the removal of smear layer and alterations in dentine inorganic component when compared to saline, Ca(OCl)2 and NaOCl groups in the middle third of the canal. However, when observing the apical third, only NaOCl + EDTA group showed statistically significant difference when compared to saline, Ca(OCl)2 and NaOCl groups. The evaluation of the tubules, in longitudinal direction, showed that in the saline, Ca(OCl)2 and NaOCl groups tubules were obliterated by smear layer and showed parallel arrangement. EDTA group was able to remove smear layer and the tubular arrangement was parallel. Ca(OCl)2 + EDTA and NaOCl + EDTA groups removed the smear layer and provided a divergent tubular arrangement

Effect of final irrigation protocols on microhardness reduction and erosion of root canal dentin

Abstract This study aimed to evaluate the effect of final irrigation protocols on microhardness reduction and erosion of root canal dentin. Sixty root canals from mandibular incisors were instrumented and randomly divided into six groups (n = 10) according to the irrigant used: QMiX, 17% EDTA, 10% citric acid (CA), 1% peracetic acid (PA), 2.5% NaOCl (solution control), and distilled water (negative control). The chelating solutions were used to irrigate the canal followed by 2.5% NaOCl as a final flush. After the irrigation protocols, all specimens were rinsed with 10 mL of distilled water to remove any residue of the chemical solutions. Before and after the final irrigation protocols, dentin microhardness was measured with a Knoop indenter. Three indentations were made at 100 µm and 500 µm from the root canal lumen. Afterwards, the specimens were prepared for scanning electron microscopic analysis and the amount of dentin erosion was examined. Wilcoxon and Kruskal-Wallis tests were used to analyze the results with a significance level set at 5%. At 100 µm, all protocols significantly reduced dentin microhardness (p < .05), while at 500 µm, this effect was detected only in the EDTA and QMiX groups (p < .05). CA was the irrigant that caused more extensive erosion in dentinal tubules, followed by PA and EDTA. QMiX opened dentinal tubules, but did not cause dentin erosion. Results suggest that QMiX and 17% EDTA reduced dentin microhardness at a greater depth. Additionally, QMiX did not cause dentin erosion

Effect of final irrigation protocols on microhardness reduction and erosion of root canal dentin

Abstract: This study aimed to evaluate the effect of final irrigation protocols on microhardness reduction and erosion of root canal dentin. Sixty root canals from mandibular incisors were instrumented and randomly divided into six groups (n = 10) according to the irrigant used: QMiX, 17% EDTA, 10% citric acid (CA), 1% peracetic acid (PA), 2.5% NaOCl (solution control), and distilled water (negative control). The chelating solutions were used to irrigate the canal followed by 2.5% NaOCl as a final flush. After the irrigation protocols, all specimens were rinsed with 10 mL of distilled water to remove any residue of the chemical solutions. Before and after the final irrigation protocols, dentin microhardness was measured with a Knoop indenter. Three indentations were made at 100 µm and 500 µm from the root canal lumen. Afterwards, the specimens were prepared for scanning electron microscopic analysis and the amount of dentin erosion was examined. Wilcoxon and Kruskal-Wallis tests were used to analyze the results with a significance level set at 5%. At 100 µm, all protocols significantly reduced dentin microhardness (p < .05), while at 500 µm, this effect was detected only in the EDTA and QMiX groups (p < .05). CA was the irrigant that caused more extensive erosion in dentinal tubules, followed by PA and EDTA. QMiX opened dentinal tubules, but did not cause dentin erosion. Results suggest that QMiX and 17% EDTA reduced dentin microhardness at a greater depth. Additionally, QMiX did not cause dentin erosion

Effect of final irrigation protocols on microhardness reduction and erosion of root canal dentin

Abstract: This study aimed to evaluate the effect of final irrigation protocols on microhardness reduction and erosion of root canal dentin. Sixty root canals from mandibular incisors were instrumented and randomly divided into six groups (n = 10) according to the irrigant used: QMiX, 17% EDTA, 10% citric acid (CA), 1% peracetic acid (PA), 2.5% NaOCl (solution control), and distilled water (negative control). The chelating solutions were used to irrigate the canal followed by 2.5% NaOCl as a final flush. After the irrigation protocols, all specimens were rinsed with 10 mL of distilled water to remove any residue of the chemical solutions. Before and after the final irrigation protocols, dentin microhardness was measured with a Knoop indenter. Three indentations were made at 100 µm and 500 µm from the root canal lumen. Afterwards, the specimens were prepared for scanning electron microscopic analysis and the amount of dentin erosion was examined. Wilcoxon and Kruskal-Wallis tests were used to analyze the results with a significance level set at 5%. At 100 µm, all protocols significantly reduced dentin microhardness (p < .05), while at 500 µm, this effect was detected only in the EDTA and QMiX groups (p < .05). CA was the irrigant that caused more extensive erosion in dentinal tubules, followed by PA and EDTA. QMiX opened dentinal tubules, but did not cause dentin erosion. Results suggest that QMiX and 17% EDTA reduced dentin microhardness at a greater depth. Additionally, QMiX did not cause dentin erosion