sodium-hypochlorite and Tooth-Erosion

The aim was to assess the effects of 1% peracetic acid (PAA) as a single endodontic irrigant on microhardness, roughness, and erosion of root canal dentin, compared with 2.5% sodium hypochlorite (NaOCl) and with 2.5% NaOCl combined with 17% EDTA. Forty human, single-rooted tooth hemisections were submitted to Knoop microhardness test, before and after the following irrigation protocols: PAA = 1% PAA; NaOCl = 2.5% NaOCl; NaOCl-EDTA-NaOCl = 2.5% NaOCl +17% EDTA +2.5% NaOCl; and SS = saline. Another 40 roots were instrumented, irrigated with the same protocols, and sectioned longitudinally. The roughness analysis was performed on the mesial section using a confocal laser scanning microscope, whereas erosion was analyzed on each third of the distal section, using a scanning electron microscope. The data were analyzed using ANOVA and Tukey post-tests, and Kruskal-Wallis and Dunn post-tests (α = .05). The PAA and NaOCl-EDTA-NaOCl groups showed no significant differences (p > .05); both promoted reduction in microhardness and increase in roughness, compared with the NaOCl and SS groups (p < .05). NaOCl-EDTA-NaOCl promoted higher erosion in the cervical and middle thirds than the other groups (p < .05); there was no difference among PAA, NaOCl, and SS (p > .05). There was also no difference among the groups regarding the apical third (p > .05). PAA used as a single endodontic irrigant caused reduction in root canal dentin microhardness and increase in roughness in a similar way to NaOCl-EDTA-NaOCl; however, PAA caused less erosion than NaOCl-EDTA-NaOCl.

Topics: Dental Pulp Cavity; Dentin; Humans; Microscopy, Electron, Scanning; Peracetic Acid; Root Canal Irrigants; Root Canal Preparation; Sodium Hypochlorite; Surface Properties; Tooth Erosion; Tooth Root

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.

Topics: Biguanides; Citric Acid; Dental Pulp Cavity; Dentin; Edetic Acid; Hardness Tests; Humans; Materials Testing; Microscopy, Electron, Scanning; Peracetic Acid; Polymers; Random Allocation; Reproducibility of Results; Root Canal Irrigants; Root Canal Therapy; Smear Layer; Sodium Hypochlorite; Statistics, Nonparametric; Surface Properties; Tooth Erosion

The purpose of this study was to examine the level of erosion in root dentin caused by different irrigation methods and protocols.. Thirty-five extracted upper molar teeth were instrumented and divided into 7 groups to undergo treatment by different methods: negative control, GentleWave System (Sonendo Inc, Laguna Hills, CA), and syringe needle irrigation following different protocols. The teeth were instrumented to size #25/.08 or #30/.09 for needle irrigation groups and to ProTaper size S1 for the GentleWave group under 5% sodium hypochlorite (NaOCl). The needle irrigation groups were subjected to final rinses of 2 minutes of 3% NaOCl + 2 minutes of 8% EDTA (3% N2 + 8% E2), 2 minutes of 3% NaOCl + 2 minutes of 8% EDTA + 1 minute of 3% NaOCl (3% N2 + 8% E2 + 3% N1), 2 minutes of 5% NaOCl + 2 minutes of 17% EDTA (5% N2 + 17% E2), 2 minutes of 5% NaOCl + 2 minutes of 17% EDTA + 1 minute of 5% NaOCl (5% N2 + 17% E2 + 5% N1), and 5 minutes of 5% NaOCl + 5 minutes of 17% EDTA + 5 minutes of 5% NaOCl (5% N5 + 17% E5 + 5% N5), respectively. The root canal surface was observed by scanning electron microscopy, and the dentin composition was analyzed by continuous line scanning for 300 μm into dentin using energy-dispersive X-ray spectroscopy.. A slight but statistically significant decrease of calcium and an increase of carbon was measured in the 5% N2 + 17% E2 group in comparison with the control; no significant difference was found among GentleWave, 3% N2 + 8% E2, and 5% N2 + 17% E2 (P > .05). A final 1-minute rinse with 3% or 5% NaOCl reduced calcium and phosphorus to a significantly lower level than in groups without a 1-minute final rinse (P < .05). Final irrigation with 5% NaOCl for 5 minutes removed almost all calcium and phosphorus. Scanning electron microscopy showed canal wall erosion when an additional final irrigation with NaOCl was done.. NaOCl followed by final EDTA irrigation performed either by syringe needle or the GentleWave System caused minimal dentin erosion. Erosion was measured as increased loss of calcium and phosphorus in samples in which additional final irrigation was performed using NaOCl after EDTA.

Topics: Calcium; Carbon; Dental Pulp Cavity; Dentin; Edetic Acid; Humans; Microscopy, Electron, Scanning; Molar; Needles; Phosphorus; Root Canal Irrigants; Root Canal Preparation; Root Canal Therapy; Sodium Hypochlorite; Spectrometry, X-Ray Emission; Surface Properties; Syringes; Therapeutic Irrigation; Time Factors; Tooth Erosion; Tooth Root

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.. 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).. 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).. Desy Clean can be a promising agent as an irrigation solution with optimal smear layer removal capacity and less erosive effects.

Topics: Acetic Acid; Boric Acids; Citric Acid; Dental Pulp Cavity; Dentin; Drug Combinations; Edetic Acid; Humans; Hydrogen Peroxide; In Vitro Techniques; Materials Testing; Microscopy, Electron, Scanning; Photography; Random Allocation; Root Canal Irrigants; Root Canal Preparation; Smear Layer; Sodium Benzoate; Sodium Hypochlorite; Sorbic Acid; Tooth Erosion

This study aimed to compare the effects of different irrigants on root dentine microhardness, erosion and smear layer removal. A total of 72 root dentine slices were divided into six groups, according to the final irrigants used: Group 1: 17% ethylenediamine tetra-acetic acid (EDTA) + 2.5% NaOCl, Group 2: 7% maleic acid (MA) + 2.5% sodium hypochloride (NaOCl), Group 3: 1.3% NaOCl + mixture of tetracycline, acid and detergent (MTAD), Group 4: Smear Clear + 2.5% NaOCl, Group 5: 5% NaOCl, Group 6: saline. Vickers microhardness values were measured before and after treatment. In total, 42 root-halves were prepared for scanning electron microscope to evaluate the amount of smear and erosion in the coronal, middle and apical thirds. Data were analysed using two-way anova, Duncan and two-proportion z-tests. Maleic acid showed the greatest reduction in dentine microhardness (P < 0.05), followed by EDTA and MTAD. EDTA, maleic acid, MTAD and Smear Clear removed smear layer efficiently in the coronal and middle thirds of root canal. However, in the apical region, maleic acid showed more efficient removal of the smear layer than the other irrigants (P < 0.05).

Topics: Citric Acid; Dental Pulp Cavity; Dentin; Doxycycline; Drug Combinations; Edetic Acid; Hardness; Humans; Maleates; Materials Testing; Microscopy, Electron, Scanning; Polysorbates; Root Canal Irrigants; Smear Layer; Sodium Chloride; Sodium Hypochlorite; Tooth Apex; Tooth Erosion

This study aimed at evaluating the effect of functional monomers in all-in-one adhesive systems on formation of acid-base resistant zone (ABRZ) in enamel and dentin. Experimental adhesive systems containing one of three functional monomers; MDP, 3D-SR and 4-META were applied to enamel or dentin surface and light-cured. A universal resin composite was then placed. The specimens were subjected to a demineralizing solution (pH 4.5) and 5% NaClO for acid-base challenge and then observed by SEM. The ABRZ was clearly observed in both enamel and dentin interfaces. However, enamel ABRZ was thinner than dentin ABRZ in all adhesives. Morphology of the ABRZ was different between enamel and dentin, and also among the adhesives. Funnel-shaped erosion was observed only in the enamel specimen with the 4-META adhesive. The formation of enamel/dentin ABRZ was confirmed in all adhesives, but the morphology was influenced by the functional monomers.

Topics: Acetic Acid; Bisphenol A-Glycidyl Methacrylate; Boron Compounds; Calcium Chloride; Composite Resins; Dental Enamel; Dental Materials; Dentin; Humans; Hydrogen-Ion Concentration; Methacrylates; Methylmethacrylates; Microscopy, Electron, Scanning; Phosphates; Polyethylene Glycols; Polymethacrylic Acids; Resin Cements; Sodium Hypochlorite; Temperature; Time Factors; Tooth Demineralization; Tooth Erosion; Water

This study tested the hypothesis that the use of ethylenediamine tetraacetic acid (EDTA) as a final irrigant causes canal wall erosion only after prolonged use of 5.25% sodium hypochlorite (NaOCl) as the initial irrigant.. Two irrigation protocols were employed: (1) 5.25% NaOCl as the initial irrigant for 10 min and 17% EDTA as the final irrigant for 2 min; and (2) 5.25% NaOCl for 60 min and 17% EDTA for 2 min. Flexural strengths of dentine beams prepared from human mid-coronal dentine were evaluated using a miniature three-point bending device after they were irrigated with either protocol. Transmission electron microscopy was used to examine the conditions of instrumented canal walls irrigated with either protocol after they were bonded with methacrylate resin-based sealers.. Immersion of dentine beams in NaOCl for 60 min instead of 10 min prior to the use of EDTA resulted in a significant (p<0.001) decline in flexural strength. For both NaOCl initial rinsing times, a 2-min final irrigation with EDTA created similar 0.5 microm thick demineralisation fronts. However, extensive surface and subsurface erosion of radicular dentine was seen only when the dentine was immersed in NaOCl for 60 min.. The apparent aggressiveness of EDTA in causing canal wall erosion is attributed to the prolonged use of NaOCl. The associated decline in dentine flexural strength has potential clinical relevance when thin pulp chamber dentine is immersed in NaOCl for lengthy periods during canal instrumentation. This may render root-treated teeth more prone to vertical fracture.

Topics: Analysis of Variance; Dental Pulp Cavity; Dental Stress Analysis; Dentin; Drug Synergism; Edetic Acid; Humans; Microscopy, Electron, Transmission; Pliability; Root Canal Irrigants; Smear Layer; Sodium Hypochlorite; Statistics, Nonparametric; Tooth Demineralization; Tooth Erosion

This study compared the efficacy of BioPure MTAD (Dentsply Tulsa, Tulsa, OK), 17% EDTA, and 42% citric acid in endodontic smear layer removal and degree of erosion in the apical third of endodontic canals.. Ninety-six extracted single-rooted human teeth were randomized into four groups (n = 24) and instrumented using System GT nickel-titanium rotary instruments (Dentsply Tulsa, Tulsa, OK). Each canal was irrigated with one of the following solutions: BioPure MTAD, 17% EDTA, 42% citric acid, or 5.25% NaOCl (control). Next, all specimens were irrigated with 5.25% NaOCl.. Evaluation by scanning electron microscopy showed no significant differences among test irrigants in removing the smear layer. However, the efficacy of BioPure MTAD and 17% EDTA in removing the smear layer was significantly greater than 5.25% NaOCl (control). The erosive effects of irrigating solutions could not be evaluated.. In conclusion, the protocols used in this study were not sufficient to completely remove the smear layer in the apical third of prepared root canals.

Topics: Adult; Citric Acid; Doxycycline; Edetic Acid; Humans; Microscopy, Electron, Scanning; Middle Aged; Polysorbates; Root Canal Irrigants; Root Canal Preparation; Smear Layer; Sodium Hypochlorite; Tooth Erosion; Treatment Failure

The remineralization of acid-etched enamel after brushing with and without a non-fluoride abrasive dentifrice was investigated using scanning electron microscopy after sodium hypochlorite (NaOCl) or ethylenediamine tetra-acetic acid treatment, of the specimens. Ground enamel pieces were etched with 30% phosphoric acid for 60 s and attached to resin plates. They were exposed to the oral environment of 4 subjects for 8 weeks and brushed for 1 min daily. Paste and brushing caused the acid-etched enamel to erode selectively, i.e., deep grooves were formed in the prism peripheral regions, while projections of the prism bodies showing a relatively low density of crystallites were retained. Brushing without dentifrice, on the other hand, caused about 0.5 micron thick pellicle with tag-like structures to cover the etched enamel. Fine mineral granules, presumably derived from saliva and minute fragments of etched crystallites, were precipitated on the enamel surface as a thin layer with the pellicle. These results indicate that daily brushing without dentifrice induces the remineralization of acid-etched enamel by depositing salivary components, while paste brushing will lead to abrasion of the weakened enamel.

Topics: Acid Etching, Dental; Adolescent; Adult; Calcium Phosphates; Child; Crystallography; Dental Deposits; Dental Enamel; Dental Pellicle; Dentifrices; Edetic Acid; Female; Humans; Male; Microscopy, Electron, Scanning; Middle Aged; Phosphoric Acids; Saliva; Sodium Hypochlorite; Tooth Abrasion; Tooth Erosion; Tooth Remineralization; Toothbrushing

Cervical abrasion and erosion lesions were restored with composite resin restorations bonded with four different dentin-bonding resins, an enamel-bonding resin, or restorations of a glass ionomer cement. The long-term clinical retention of the restorations were evaluated during a 4-year period. The surrounding enamel was not acid-etched. Four cleaning methods for dentin pretreatment were used to study their effects on the bonding between dentin and the restorative materials. The dentin was treated with either (1) etching for 60 seconds or (2) 15 seconds with 37% phosphoric acid, (3) cleaning with 5% sodium hypochlorite (NaOCL) for 20 seconds, or (4) cleaning with Tubulicid etchant for 60 seconds. None of the composite resin restorations, regardless of pretreatment or bonding method, showed acceptable restorations. All glass ionomer cement restorations were retained after pretreatment with Tubulicid etchant and 5% NaOCL after a 6-month period. Full acceptance, in other words, 3 year retention, was reached only after pretreatment with NaOCL.

Topics: Acid Etching, Dental; Adhesives; Adult; Aged; Chlorhexidine; Composite Resins; Dental Bonding; Dental Restoration, Permanent; Dentin; Evaluation Studies as Topic; Female; Glass Ionomer Cements; Humans; Male; Middle Aged; Phosphoric Acids; Sodium Hypochlorite; Surface-Active Agents; Time Factors; Tooth Abrasion; Tooth Erosion