Restorative Dentistry and Endodontics

  • 제45권3호
  • /
  • Pages.39.1-39.11
  • /
  • 2020
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  • 2234-7658(pISSN)
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  • 2234-7666(eISSN)
대한치과보존학회 (The Korean Academy of Conservative Dentistry)
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The effect of root canal irrigants on dentin: a focused review

  • Rath, Priti Pragati (Discipline of Endodontology, Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong) ;
  • Yiu, Cynthia Kar Yung (Discipline of Pediatric Dentistry, Division of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong) ;
  • Matinlinna, Jukka Pekka (Dental Materials Science, Division of Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong) ;
  • Kishen, Anil (Faculty of Dentistry, The University of Toronto) ;
  • Neelakantan, Prasanna (Discipline of Endodontology, Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong)
  • 투고 : 2020.05.05
  • 심사 : 2020.06.09
  • 발행 : 2020.08.31
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초록

Despite the vast literature on the effects of root canal irrigants on the dentin characteristics, the precise effects of clinically relevant irrigation sequences remain unclear. In this review, we systematically dissect the role of different sequential irrigation approaches that are used in clinical endodontics. Using a systematic search strategy, we attempt to answer the question: 'Which irrigating sequence has the most deleterious effects on dentin structure and properties?' The effect of irrigants on the dentin composition and mechanical properties have been reviewed. A wide variety of concentrations, duration and techniques have been employed to characterize the effects of chemicals on dentin properties, thus making it impossible to draw guidelines or recommendations of irrigant sequences to be followed clinically. It was apparent that all the studied irrigation sequences potentially result in some deleterious effects on dentin such as decrease in the flexural strength, microhardness, modulus of elasticity and inorganic content and organic-inorganic ratio of the dentin. However, the literature still lacks comprehensive investigations to compare the deleterious effect of different irrigation sequences, using a wide variety of qualitative and quantitative methods. Such investigations are essential to make clinical recommendations and strategize efforts to minimize chemically-induced damage to dentin characteristics.

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참고문헌

  1. Marshall GW Jr. Dentin: microstructure and characterization. Quintessence Int 1993;24:606-617.
  2. Tjaderhane L, Carrilho MR, Breschi L, Tay FR, Pashley DH. Dentin basic structure and composition-An overview. Endod Topics 2009;20:3-29. https://doi.org/10.1111/j.1601-1546.2012.00269.x
  3. Sloan AJ. Stem cell biology and tissue engineering in dental sciences. Amsterdam: Elsevier/Academic Press; 2015. Chapter 29.
  4. Carda C, Peydro A. Ultrastructural patterns of human dentinal tubules, odontoblasts processes and nerve fibres. Tissue Cell 2006;38:141-150. https://doi.org/10.1016/j.tice.2006.01.002
  5. Nissan R, Segal H, Pashley D, Stevens R, Trowbridge H. Ability of bacterial endotoxin to diffuse through human dentin. J Endod 1995;21:62-64. https://doi.org/10.1016/S0099-2399(06)81096-4
  6. Love RM. Regional variation in root dentinal tubule infection by Streptococcus gordonii. J Endod 1996;22:290-293. https://doi.org/10.1016/S0099-2399(96)80261-5
  7. Wong DT, Cheung GS. Extension of bactericidal effect of sodium hypochlorite into dentinal tubules. J Endod 2014;40:825-829. https://doi.org/10.1016/j.joen.2013.09.045
  8. Berutti E, Marini R, Angeretti A. Penetration ability of different irrigants into dentinal tubules. J Endod 1997;23:725-727. https://doi.org/10.1016/S0099-2399(97)80342-1
  9. Ghorbanzadeh A, Aminsobhani M, Sohrabi K, Chiniforush N, Ghafari S, Shamshiri AR, Noroozi N. Penetration depth of sodium hypochlorite in dentinal tubules after conventional irrigation, passive ultrasonic agitation and Nd: YAG laser activated irrigation. J Lasers Med Sci 2016;7:105-111. https://doi.org/10.15171/jlms.2016.18
  10. Sulkala M, Tervahartiala T, Sorsa T, Larmas M, Salo T, Tjaderhane L. Matrix metalloproteinase-8 (MMP-8) is the major collagenase in human dentin. Arch Oral Biol 2007;52:121-127. https://doi.org/10.1016/j.archoralbio.2006.08.009
  11. Martin-De Las Heras S, Valenzuela A, Overall CM. The matrix metalloproteinase gelatinase A in human dentine. Arch Oral Biol 2000;45:757-765. https://doi.org/10.1016/S0003-9969(00)00052-2
  12. Marashdeh MQ, Gitalis R, Levesque C, Finer Y. Endodontic pathogens possess collagenolytic properties that degrade human dentine collagen matrix. Int Endod J 2019;52:416-423. https://doi.org/10.1111/iej.13018
  13. Gu LS, Huang XQ, Griffin B, Bergeron BR, Pashley DH, Niu LN, Tay FR. Primum non nocere - The effects of sodium hypochlorite on dentin as used in endodontics. Acta Biomater 2017;61:144-156. https://doi.org/10.1016/j.actbio.2017.08.008
  14. Siqueira JF Jr, Perez AR, Marceliano-Alves MF, Provenzano JC, Silva SG, Pires FR, Vieira GC, Rocas IN, Alves FR. What happens to unprepared root canal walls: a correlative analysis using micro-computed tomography and histology/scanning electron microscopy. Int Endod J 2018;51:501-508. https://doi.org/10.1111/iej.12753
  15. Peters OA, Arias A, Paque F. A Micro-computed tomographic assessment of root canal preparation with a novel instrument, TRUShape, in mesial roots of mandibular molars. J Endod 2015;41:1545-1550. https://doi.org/10.1016/j.joen.2015.06.007
  16. Haapasalo M, Shen Y, Qian W, Gao Y. Irrigation in endodontics. Dent Clin North Am 2010;54:291-312. https://doi.org/10.1016/j.cden.2009.12.001
  17. Krause TA, Liewehr FR, Hahn CL. The antimicrobial effect of MTAD, sodium hypochlorite, doxycycline, and citric acid on Enterococcus faecalis. J Endod 2007;33:28-30. https://doi.org/10.1016/j.joen.2006.08.011
  18. Zehnder M. Root canal irrigants. J Endod 2006;32:389-398. https://doi.org/10.1016/j.joen.2005.09.014
  19. Sim TP, Knowles JC, Ng YL, Shelton J, Gulabivala K. Effect of sodium hypochlorite on mechanical properties of dentine and tooth surface strain. Int Endod J 2001;34:120-132. https://doi.org/10.1046/j.1365-2591.2001.00357.x
  20. Slutzky-Goldberg I, Maree M, Liberman R, Heling I. Effect of sodium hypochlorite on dentin microhardness. J Endod 2004;30:880-882. https://doi.org/10.1097/01.DON.0000128748.05148.1E
  21. Uzunoglu E, Aktemur S, Uyanik MO, Durmaz V, Nagas E. Effect of ethylenediaminetetraacetic acid on root fracture with respect to concentration at different time exposures. J Endod 2012;38:1110-1113. https://doi.org/10.1016/j.joen.2012.04.026
  22. Gu XH, Mao CY, Kern M. Effect of different irrigation on smear layer removal after post space preparation. J Endod 2009;35:583-586. https://doi.org/10.1016/j.joen.2009.01.006
  23. Calt S, Serper A. Time-dependent effects of EDTA on dentin structures. J Endod 2002;28:17-19. https://doi.org/10.1097/00004770-200201000-00004
  24. Grawehr M, Sener B, Waltimo T, Zehnder M. Interactions of ethylenediamine tetraacetic acid with sodium hypochlorite in aqueous solutions. Int Endod J 2003;36:411-417. https://doi.org/10.1046/j.1365-2591.2003.00670.x
  25. Prado M, Gusman H, Gomes BP, Simao RA. Scanning electron microscopic investigation of the effectiveness of phosphoric acid in smear layer removal when compared with EDTA and citric acid. J Endod 2011;37:255-258. https://doi.org/10.1016/j.joen.2010.11.011
  26. Paque F, Boessler C, Zehnder M. Accumulated hard tissue debris levels in mesial roots of mandibular molars after sequential irrigation steps. Int Endod J 2011;44:148-153. https://doi.org/10.1111/j.1365-2591.2010.01823.x
  27. Lottanti S, Gautschi H, Sener B, Zehnder M. Effects of ethylenediaminetetraacetic, etidronic and peracetic acid irrigation on human root dentine and the smear layer. Int Endod J 2009;42:335-343. https://doi.org/10.1111/j.1365-2591.2008.01514.x
  28. Ulusoy OI, Zeyrek S, Celik B. Evaluation of smear layer removal and marginal adaptation of root canal sealer after final irrigation using ethylenediaminetetraacetic, peracetic, and etidronic acids with different concentrations. Microsc Res Tech 2017;80:687-692. https://doi.org/10.1002/jemt.22851
  29. Ordinola-Zapata R, Bramante CM, Cavenago B, Graeff MS, Gomes de Moraes I, Marciano M, Duarte MA. Antimicrobial effect of endodontic solutions used as final irrigants on a dentine biofilm model. Int Endod J 2012;45:162-168. https://doi.org/10.1111/j.1365-2591.2011.01959.x
  30. Arias-Moliz MT, Ordinola-Zapata R, Baca P, Ruiz-Linares M, Garcia Garcia E, Hungaro Duarte MA, Monteiro Bramante C, Ferrer-Luque CM. Antimicrobial activity of chlorhexidine, peracetic acid and sodium hypochlorite/etidronate irrigant solutions against Enterococcus faecalis biofilms. Int Endod J 2015;48:1188-1193. https://doi.org/10.1111/iej.12424
  31. Neelakantan P, Sharma S, Shemesh H, Wesselink PR. Influence of irrigation sequence on the adhesion of root canal sealers to dentin: a fourier transform infrared spectroscopy and push-out bond strength analysis. J Endod 2015;41:1108-1111. https://doi.org/10.1016/j.joen.2015.02.001
  32. Dotto L, Sarkis Onofre R, Bacchi A, Rocha Pereira GK. Effect of root canal irrigants on the mechanical properties of endodontically treated teeth: a scoping review. J Endod 2020;46:596-604.e3. https://doi.org/10.1016/j.joen.2020.01.017
  33. Dogan H, Qalt S. Effects of chelating agents and sodium hypochlorite on mineral content of root dentin. J Endod 2001;27:578-580. https://doi.org/10.1097/00004770-200109000-00006
  34. Sayin TC, Serper A, Cehreli ZC, Kalayci S. Calcium loss from root canal dentin following EDTA, EGTA, EDTAC, and tetracycline-HCl treatment with or without subsequent NaOCl irrigation. J Endod 2007;33:581-584. https://doi.org/10.1016/j.joen.2006.12.010
  35. Wang Z, Maezono H, Shen Y, Haapasalo M. Evaluation of root canal dentin erosion after different irrigation methods using energy-dispersive x-ray spectroscopy. J Endod 2016;42:1834-1839. https://doi.org/10.1016/j.joen.2016.07.024
  36. Zhang K, Kim YK, Cadenaro M, Bryan TE, Sidow SJ, Loushine RJ, Ling JQ, Pashley DH, Tay FR. Effects of different exposure times and concentrations of sodium hypochlorite/ethylenediaminetetraacetic acid on the structural integrity of mineralized dentin. J Endod 2010;36:105-109. https://doi.org/10.1016/j.joen.2009.10.020
  37. Zhang K, Tay FR, Kim YK, Mitchell JK, Kim JR, Carrilho M, Pashley DH, Ling JQ. The effect of initial irrigation with two different sodium hypochlorite concentrations on the erosion of instrumented radicular dentin. Dent Mater 2010;26:514-523. https://doi.org/10.1016/j.dental.2010.01.009
  38. Baldasso FE, Cardoso LR, Silva VD, Morgental RD, Kopper PM. Evaluation of the effect of four final irrigation protocols on root canal dentin components by polarized light microscopy and scanning electron microscopy. Microsc Res Tech 2017;80:1337-1343. https://doi.org/10.1002/jemt.22946
  39. Eldeniz AU, Erdemir A, Belli S. Effect of EDTA and citric acid solutions on the microhardness and the roughness of human root canal dentin. J Endod 2005;31:107-110. https://doi.org/10.1097/01.don.0000136212.53475.ad
  40. Akcay I, Erdilek N, Sen BH. The efficacy of an experimental single solution versus alternate use of multiple irrigants on root dentin microhardness. J Clin Exp Dent 2013;5:e83-e88. https://doi.org/10.4317/jced.51007
  41. Kara Tuncer A, Tuncer S, Siso SH. Effect of QMix irrigant on the microhardness of root canal dentine. Aust Dent J 2015;60:163-168. https://doi.org/10.1111/adj.12242
  42. Saghiri MA, Delvarani A, Mehrvarzfar P, Malganji G, Lotfi M, Dadresanfar B, Saghiri AM, Dadvand S. A study of the relation between erosion and microhardness of root canal dentin. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009;108:e29-e34.
  43. Aranda-Garcia AJ, Kuga MC, Chavez-Andrade GM, Kalatzis-Sousa NG, Hungaro Duarte MA, Faria G, Reis So MV, Faria NB Jr. Effect of final irrigation protocols on microhardness and erosion of root canal dentin. Microsc Res Tech 2013;76:1079-1083. https://doi.org/10.1002/jemt.22268
  44. Ulusoy OI, Gorgul G. Effects of different irrigation solutions on root dentine microhardness, smear layer removal and erosion. Aust Endod J 2013;39:66-72. https://doi.org/10.1111/j.1747-4477.2010.00291.x
  45. Baldasso FE, Roleto L, da Silva VD, Morgental RD, Kopper PM. Effect of final irrigation protocols on microhardness reduction and erosion of root canal dentin. Br Oral Res 2017;31:e40.
  46. Zaparolli D, Saquy PC, Cruz-Filho AM. Effect of sodium hypochlorite and EDTA irrigation, individually and in alternation, on dentin microhardness at the furcation area of mandibular molars. Braz Dent J 2012;23:654-658. https://doi.org/10.1590/S0103-64402012000600005
  47. Dineshkumar MK, Vinothkumar TS, Arathi G, Shanthisree P, Kandaswamy D. Effect of ethylene diamine tetra-acetic acid, $MTAD^{TM}$, and HEBP as a final rinse on the microhardness of root dentin. J Conserv Dent 2012;15:170-173. https://doi.org/10.4103/0972-0707.94587
  48. Ghisi AC, Kopper PM, Baldasso FE, Sturmer CP, Rossi-Fedele G, Steier L, Figueiredo JA, Morgental RD, Vier-Pelisser FV. Effect of super-oxidized water, sodium hypochlorite and EDTA on dentin microhardness. Braz Dent J 2014;25:420-424. https://doi.org/10.1590/0103-6440201300129
  49. Mai S, Kim YK, Arola DD, Gu LS, Kim JR, Pashley DH, Tay FR. Differential aggressiveness of ethylenediamine tetraacetic acid in causing canal wall erosion in the presence of sodium hypochlorite. J Dent 2010;38:201-206. https://doi.org/10.1016/j.jdent.2009.10.004
  50. Cecchin D, Soares Giaretta V, Granella Cadorin B, Albino Souza M, Vidal CM, Paula Farina A. Effect of synthetic and natural-derived novel endodontic irrigant solutions on mechanical properties of human dentin. J Mater Sci Mater Med 2017;28:141. https://doi.org/10.1007/s10856-017-5960-1
  51. Marending M, Paque F, Fischer J, Zehnder M. Impact of irrigant sequence on mechanical properties of human root dentin. J Endod 2007;33:1325-1328. https://doi.org/10.1016/j.joen.2007.08.005
  52. Qian W, Shen Y, Haapasalo M. Quantitative analysis of the effect of irrigant solution sequences on dentin erosion. J Endod 2011;37:1437-1441. https://doi.org/10.1016/j.joen.2011.06.005
  53. Estrela C, Estrela CR, Barbin EL, Spano JC, Marchesan MA, Pecora JD. Mechanism of action of sodium hypochlorite. Braz Dent J 2002;13:113-117. https://doi.org/10.1590/S0103-64402002000200007
  54. Gelse K, Poschl E, Aigner T. Collagens--structure, function, and biosynthesis. Adv Drug Deliv Rev 2003;55:1531-1546. https://doi.org/10.1016/j.addr.2003.08.002
  55. Oyarzun A, Cordero AM, Whittle M. Immunohistochemical evaluation of the effects of sodium hypochlorite on dentin collagen and glycosaminoglycans. J Endod 2002;28:152-156. https://doi.org/10.1097/00004770-200203000-00002
  56. Mohammadi Z. Sodium hypochlorite in endodontics: an update review. Int Dent J 2008;58:329-341. https://doi.org/10.1111/j.1875-595X.2008.tb00354.x
  57. Hulsmann M. Effects of mechanical instrumentation and chemical irrigation on the root canal dentin and surrounding tissues. Endod Topics 2013;29:55-86. https://doi.org/10.1111/etp.12047
  58. Pascon FM, Kantovitz KR, Sacramento PA, Nobre-dos-Santos M, Puppin-Rontani RM. Effect of sodium hypochlorite on dentine mechanical properties. A review. J Dent 2009;37:903-908. https://doi.org/10.1016/j.jdent.2009.07.004
  59. Violich DR, Chandler NP. The smear layer in endodontics - a review. Int Endod J 2010;43:2-15. https://doi.org/10.1111/j.1365-2591.2009.01627.x
  60. Correr GM, Alonso RC, Grando MF, Borges AF, Puppin-Rontani RM. Effect of sodium hypochlorite on primary dentin--a scanning electron microscopy (SEM) evaluation. J Dent 2006;34:454-459. https://doi.org/10.1016/j.jdent.2005.10.003
  61. Zou L, Shen Y, Li W, Haapasalo M. Penetration of sodium hypochlorite into dentin. J Endod 2010;36:793-796. https://doi.org/10.1016/j.joen.2010.02.005
  62. Di Renzo M, Ellis TH, Sacher E, Stangel I. A photoacoustic FTIRS study of the chemical modifications of human dentin surfaces: II. Deproteination. Biomaterials 2001;22:793-797. https://doi.org/10.1016/S0142-9612(00)00239-8

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