Restorative Dentistry and Endodontics

The Korean Academy of Conservative Dentistry (대한치과보존학회)
권호 표지
DOI QR코드

DOI QR Code

Dentinal tubule penetration of sodium hypochlorite in root canals with and without mechanical preparation and different irrigant activation methods

  • Renata Aqel de Oliveira (Department of Conservative Dentistry, School of Dentistry, Federal University of Rio Grande do Sul (UFRGS)) ;
  • Theodoro Weissheimer (Department of Conservative Dentistry, School of Dentistry, Federal University of Rio Grande do Sul (UFRGS)) ;
  • Gabriel Barcelos So (Department of Conservative Dentistry, School of Dentistry, Federal University of Rio Grande do Sul (UFRGS)) ;
  • Ricardo Abreu da Rosa (Department of Conservative Dentistry, School of Dentistry, Federal University of Rio Grande do Sul (UFRGS)) ;
  • Matheus Albino Souza (Department of Endodontics, School of Dentistry, University of Passo Fundo (UPF)) ;
  • Rodrigo Goncalves Ribeiro (Department of Endodontics, School of Dentistry, State University of Western Parana (UNIOESTE)) ;
  • Marcus Vinicius Reis So (Department of Conservative Dentistry, School of Dentistry, Federal University of Rio Grande do Sul (UFRGS))
  • Received : 2022.05.23
  • Accepted : 2022.10.04
  • Published : 2023.02.28
Download PDF
⟨ Previous Next ⟩

Abstract

Objectives: This study evaluated the dentinal penetration depth of 2.5% sodium hypochlorite (NaOCl) in root canals with and without preparation and different irrigant activation protocols. Materials and Methods: Sixty-three bovine mandibular incisors were randomly allocated to 6 groups (n = 10): G1, preparation + conventional needle irrigation (CNI); G2, preparation + passive ultrasonic irrigation (PUI); G3, preparation + Odous Clean (OC); G4, no preparation + CNI; G5, no preparation + PUI; G6, no preparation + OC; and CG (negative control; n = 3). Samples were filled with crystal violet for 72 hours. Irrigant activation was performed. Samples were sectioned perpendicularly along the long axis, 3 mm and 7 mm from the apex. Images of the root thirds of each block were captured with a stereomicroscope and analyzed with an image analysis software. One-way analysis of variance, followed by the Tukey post hoc test, and the Student's t-test were used for data analysis, with a significance level of 5%. Results: The NaOCl penetration depth was similar when preparation was performed, regardless of the method of irrigation activation (p > 0.05). In the groups without preparation, G6 showed greater NaOCl penetration depth (p < 0.05). The groups without preparation had a greater NaOCl penetration depth than those with preparation (p = 0.0019). Conclusions: The NaOCl penetration depth was similar in groups with root canal preparation. Without root canal preparation, OC allowed deeper NaOCl penetration. The groups without preparation had greater NaOCl penetration than those undergoing root canal preparation.

Keywords

References

  1. Murray PE, Garcia-Godoy F, Hargreaves KM. Regenerative endodontics: a review of current status and a call for action. J Endod 2007;33:377-390. https://doi.org/10.1016/j.joen.2006.09.013
  2. Banchs F, Trope M. Revascularization of immature permanent teeth with apical periodontitis: new treatment protocol? J Endod 2004;30:196-200. https://doi.org/10.1097/00004770-200404000-00003
  3. Kim SG, Malek M, Sigurdsson A, Lin LM, Kahler B. Regenerative endodontics: a comprehensive review. Int Endod J 2018;51:1367-1388. https://doi.org/10.1111/iej.12954
  4. Iwaya SI, Ikawa M, Kubota M. Revascularization of an immature permanent tooth with apical periodontitis and sinus tract. Dent Traumatol 2001;17:185-187. https://doi.org/10.1034/j.1600-9657.2001.017004185.x
  5. Jeeruphan T, Jantarat J, Yanpiset K, Suwannapan L, Khewsawai P, Hargreaves KM. Mahidol study 1: comparison of radiographic and survival outcomes of immature teeth treated with either regenerative endodontic or apexification methods: a retrospective study. J Endod 2012;38:1330-1336. https://doi.org/10.1016/j.joen.2012.06.028
  6. American Association of Endodontists (AAE): AAE clinical considerations for a regenerative procedure. Revised 6-8-16. https://www.aae.org/uploadedfiles/publications_and_research/research/currentregenerativeendodonticconsiderations.pdf (updated 2016; cited January 14, 2022). 
  7. Galler KM, Krastl G, Simon S, Van Gorp G, Meschi N, Vahedi B, Lambrechts P. European Society of Endodontology position statement: revitalization procedures. Int Endod J 2016;49:717-723. https://doi.org/10.1111/iej.12629
  8. Verma P, Nosrat A, Kim JR, Price JB, Wang P, Bair E, Xu HH, Fouad AF. Effect of residual bacteria on the outcome of pulp regeneration in vivo. J Dent Res 2017;96:100-106. https://doi.org/10.1177/0022034516671499
  9. Vishwanat L, Duong R, Takimoto K, Phillips L, Espitia CO, Diogenes A, Ruparel SB, Kolodrubetz D, Ruparel NB. Effect of bacterial biofilm on the osteogenic differentiation of stem cells of apical papilla. J Endod 2017;43:916-922. https://doi.org/10.1016/j.joen.2017.01.023
  10. Lee C, Song M. Failure of regenerative endodontic procedures: case analysis and subsequent treatment options. J Endod 2022;48:1137-1145. https://doi.org/10.1016/j.joen.2022.06.002
  11. Martin DE, De Almeida JF, Henry MA, Khaing ZZ, Schmidt CE, Teixeira FB, Diogenes A. Concentration-dependent effect of sodium hypochlorite on stem cells of apical papilla survival and differentiation. J Endod 2014;40:51-55. https://doi.org/10.1016/j.joen.2013.07.026
  12. Elnaggar SE, El Backly RM, Zaazou AM, Morsy Elshabrawy S, Abdallah AA. Effect of different irrigation protocols for applications in regenerative endodontics on mechanical properties of root dentin. Aust Endod J 2021;47:228-235. https://doi.org/10.1111/aej.12457
  13. Zeng Q, Nguyen S, Zhang H, Chebrolu HP, Alzebdeh D, Badi MA, Kim JR, Ling J, Yang M. Release of growth factors into root canal by irrigations in regenerative endodontics. J Endod 2016;42:1760-1766. https://doi.org/10.1016/j.joen.2016.04.029
  14. Galler KM, Grubmuller V, Schlichting R, Widbiller M, Eidt A, Schuller C, Wolflick M, Hiller KA, Buchalla W. Penetration depth of irrigants into root dentine after sonic, ultrasonic and photoacoustic activation. Int Endod J 2019;52:1210-1217. https://doi.org/10.1111/iej.13108
  15. Virdee SS, Farnell DJ, Silva MA, Camilleri J, Cooper PR, Tomson PL. The influence of irrigant activation, concentration and contact time on sodium hypochlorite penetration into root dentine: an ex vivo experiment. Int Endod J 2020;53:986-997. https://doi.org/10.1111/iej.13290
  16. Tungsawat P, Arunrukthavorn P, Phuntusuntorn P, Opatragoon S, Sirirangsee P, Inklub S. Comparison of the effect of three irrigation techniques and root canal preparation size on sodium hypochlorite penetration into root canal dentinal tubules. Int J Dent 2021;2021:6612588.
  17. Sasanakul P, Ampornaramveth RS, Chivatxaranukul P. Influence of adjuncts to irrigation in the disinfection of large root canals. J Endod 2019;45:332-337. https://doi.org/10.1016/j.joen.2018.11.015
  18. Dos Reis S, Cruz VM, Hungaro Duarte MA, da Silveira Bueno CE, Vivan RR, Pelegrine RA, Bruno KF, Kato AS. Volumetric analysis of irrigant extrusion in immature teeth after different final agitation techniques. J Endod 2020;46:682-687. https://doi.org/10.1016/j.joen.2020.01.014
  19. Faria G, Viola KS, Coaguila-Llerena H, Oliveira LR, Leonardo RT, Aranda-Garcia AJ, Guerreiro-Tanomaru JM. Penetration of sodium hypochlorite into root canal dentine: effect of surfactants, gel form and passive ultrasonic irrigation. Int Endod J 2019;52:385-392. https://doi.org/10.1111/iej.13015
  20. van der Sluis LW, Vogels MP, Verhaagen B, Macedo R, Wesselink PR. Study on the influence of refreshment/activation cycles and irrigants on mechanical cleaning efficiency during ultrasonic activation of the irrigant. J Endod 2010;36:737-740. https://doi.org/10.1016/j.joen.2009.12.004
  21. Haapasalo M, Orstavik D. In vitro infection and disinfection of dentinal tubules. J Dent Res 1987;66:1375-1379. https://doi.org/10.1177/00220345870660081801
  22. Brittan JL, Sprague SV, Macdonald EL, Love RM, Jenkinson HF, West NX. In vivo model for microbial invasion of tooth root dentinal tubules. J Appl Oral Sci 2016;24:126-135. https://doi.org/10.1590/1678-775720150448
  23. Kakoli P, Nandakumar R, Romberg E, Arola D, Fouad AF. The effect of age on bacterial penetration of radicular dentin. J Endod 2009;35:78-81. https://doi.org/10.1016/j.joen.2008.10.004
  24. Kontakiotis EG, Tsatsoulis IN, Filippatos CG, Agrafioti A. A quantitative and diametral analysis of human dentinal tubules at pulp chamber ceiling and floor under scanning electron microscopy. Aust Endod J 2015;41:29-34. https://doi.org/10.1111/aej.12068
  25. Grundling GL, Zechin JG, Jardim WM, de Oliveira SD, de Figueiredo JA. Effect of ultrasonics on Enterococcus faecalis biofilm in a bovine tooth model. J Endod 2011;37:1128-1133. https://doi.org/10.1016/j.joen.2011.05.006
  26. Schilke R, Lisson JA, Bauss O, Geurtsen W. Comparison of the number and diameter of dentinal tubules in human and bovine dentine by scanning electron microscopic investigation. Arch Oral Biol 2000;45:355-361. https://doi.org/10.1016/S0003-9969(00)00006-6
  27. Camargo CH, Siviero M, Camargo SE, de Oliveira SH, Carvalho CA, Valera MC. Topographical, diametral, and quantitative analysis of dentin tubules in the root canals of human and bovine teeth. J Endod 2007;33:422-426. https://doi.org/10.1016/j.joen.2006.12.011
  28. Schmalz G, Hiller KA, Nunez LJ, Stoll J, Weis K. Permeability characteristics of bovine and human dentin under different pretreatment conditions. J Endod 2001;27:23-30. https://doi.org/10.1097/00004770-200101000-00007
  29. Gu Y, Perinpanayagam H, Kum DJ, Yoo YJ, Jeong JS, Lim SM, Chang SW, Baek SH, Zhu Q, Kum KY. Effect of different agitation techniques on the penetration of irrigant and sealer into dentinal tubules. Photomed Laser Surg 2017;35:71-77. https://doi.org/10.1089/pho.2016.4125
  30. Vadhana S, Latha J, Velmurugan N. Evaluation of penetration depth of 2% chlorhexidine digluconate into root dentinal tubules using confocal laser scanning microscope. Restor Dent Endod 2015;40:149-154. https://doi.org/10.5395/rde.2015.40.2.149
  31. 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
  32. 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
  33. Lui JN, Kuah HG, Chen NN. Effect of EDTA with and without surfactants or ultrasonics on removal of smear layer. J Endod 2007;33:472-475. https://doi.org/10.1016/j.joen.2006.12.007
  34. 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;42:659-663. https://doi.org/10.1016/j.joen.2016.01.016
  35. Tay FR, Gu LS, Schoeffel GJ, Wimmer C, Susin L, Zhang K, Arun SN, Kim J, Looney SW, Pashley DH. Effect of vapor lock on root canal debridement by using a side-vented needle for positive-pressure irrigant delivery. J Endod 2010;36:745-750. https://doi.org/10.1016/j.joen.2009.11.022
  36. Castelo-Baz P, Martin-Biedma B, Cantatore G, Ruiz-Pinon M, Bahillo J, Rivas-Mundina B, Varela-Patino P. In vitro comparison of passive and continuous ultrasonic irrigation in simulated lateral canals of extracted teeth. J Endod 2012;38:688-691. https://doi.org/10.1016/j.joen.2011.12.032
  37. Boutsioukis C, Arias-Moliz MT. Present status and future directions - irrigants and irrigation methods. Int Endod J 2022;55 Supplement 3:588-612. https://doi.org/10.1111/iej.13739
  38. Wagner MH, da Rosa RA, de Figueiredo JA, Duarte MA, Pereira JR, So MV. Final irrigation protocols may affect intraradicular dentin ultrastructure. Clin Oral Investig 2017;21:2173-2182. https://doi.org/10.1007/s00784-016-2006-x