Evaluation of the Actual Chlorine Concentration and the Required Time for Pulp Dissolution Using Different Naocl Irrigating Solutions

INTRODUCTION The goal of root canal treatment is to shape and clean the endodontic space, reducing the bacterial load and removing the pulp tissue. Obviously, the action of the endodontic instruments is limited to the main canals, regardless of the complexity of the endodontic space. Consequently, finding the best possible cleaning technique, which can be obtained chemically using irrigation solutions, is a fundamental aid in the endodontic therapy. One of the most commonly used root canal irrigant is sodium hypochlorite (NaOCl), available in various commercial formulations. The effectiveness of NaOCl is undeniable. However, the action of dissolution of the pulp tissue is merely dependent on the concentration and the characteristics of the irrigant itself. AIM The aim of this study is to evaluate the effective concentration of different commercial formulas of sodium hypochlorite, by evaluating the percentage of total chlorine in each product. The dissolution capacity of the pulp tissue of each of the tested products was then analyzed by measuring the required time. MATERIALS AND METHODS Three commercial types of sodium hypochlorite were selected for this study: 5% NaOCl (ACE, Procter & Gamble), 5% NaOCl (N5, Simit Dental) and 6% NaOCl (CanalPro, Coltene). For each product, 10 packages were used, from which samples of the product were taken and 30 x 5 ml tubes were filled. All samples were divided into 3 groups and were analyzed using the DIN EN ISO 7393-2 method and the percentage of total chlorine (expressed as a percentage) was calculated. 40 samples of vital pulp were obtained from teeth freshly extracted for periodontal reasons and stored in physiological solution. In order to unify the size and weight of the samples (0.0001 mg), a microtome and a precision balance (Pro Explorer Ohaus) were used. Each sample, carefully examined by stereomicroscope (40x), was placed in artificial plastic containers and submerged in 0.1 ml of irrigating solution at room temperature (26 ° C). A fourth control group used saline solution as irrigant. Simultaneously with the insertion of the irrigating solution, a digital stopwatch was activated and the time necessary for the complete dissolution of the pulp sample was measured. The data obtained were subjected to statistical analysis. RESULTS The average percentages of chlorine detected for each group were: 4.26% (ACE), 5.16% (N5) and 5.97% (CanalPro). The Kruskal-Wallis test showed statistically significant differences between the different commercial formulations of hypochlorite (P <0.05). CanalPro showed the lowest values, while ACE showed the highest values of dissolution time of the pulp. DISCUSSION The analysis of the total chlorine percentage found that the actual concentration of the sodium hypochlorite in the samples is close to the values declared by the manufacturers both in the case of N5 and CanalPro. On the contrary, the concentration detected in the samples of common bench bleach (ACE) is significantly lower, which has average values less than 5%. This explains the longer time taken for the complete dissolution of the pulp tissue. The average dissolution time of the pulp samples was in fact inversely proportional to the concentration detected in the tested irrigants, so that a lower time corresponds to a higher concentration.

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Impact of Adjunctive Laser Irradiation on the Bacterial Load of Dental Root Canals: A Randomized Controlled Clinical Trial

Antibiotics ◽

10.3390/antibiotics10121557 ◽

2021 ◽

Vol 10 (12) ◽

pp. 1557

Author(s):

Johannes-Simon Wenzler ◽

Wolfgang Falk ◽

Roland Frankenberger ◽

Andreas Braun

Keyword(s):

Laser Irradiation ◽

Sodium Hypochlorite ◽

Root Canal ◽

Pathogenic Bacteria ◽

Continuous Wave ◽

Bacterial Load ◽

Root Canal Treatment ◽

Controlled Clinical Trial ◽

Sodium Hypochlorite Solution ◽

Filling Material

Successful root canal treatment depends on the adequate elimination of pathogenic bacteria. This study evaluated the effectiveness of a novel 445-nm semiconductor laser in reducing bacteria after chemomechanical root canal treatment. Microbiological specimens from 57 patients were collected after emergency endodontic treatment, in the following sequence: 1, removal of the temporary filling material; 2, chemomechanical treatment; 3, rinsing with sodium hypochlorite (3%) along with one of three adjuvant protocols (n = 19 in each group). The adjuvant procedures were: (a) sodium hypochlorite rinsing alone (3%); (b) laser irradiation; (c) combined sodium hypochlorite rinsing and laser irradiation. The diode laser was set to 0.59 W in continuous-wave mode (CW) for 4 × 10 s. After the flooding of the root canal with saline, specimens were collected using paper points and analyzed microbiologically. Statistically significant reductions in the bacterial load were observed in all three groups (p < 0.05): 80.5% with sodium hypochlorite rinsing alone and 58.2% with laser therapy. Both results were lower than with the combination of sodium hypochlorite rinsing and 445-nm laser irradiation, at 92.7% (p < 0.05). Additional disinfection of the root canal can thus be achieved with 445-nm laser irradiation after conventional chemical disinfection with sodium hypochlorite solution.

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Effect of Passive Ultrasonic Irrigation on Apical Extrusion of Irrigating Solution

European Journal of Dentistry ◽

10.1055/s-0039-1697378 ◽

2008 ◽

Vol 02 (03) ◽

pp. 198-203 ◽

Cited By ~ 13

Author(s):

Tamer Tasdemir ◽

Kursat Er ◽

Davut Celik ◽

Tahsin Yildirim

Keyword(s):

Stainless Steel ◽

Sodium Hypochlorite ◽

Root Canal ◽

Control Group ◽

Passive Ultrasonic Irrigation ◽

Root Canals ◽

Apical Extrusion ◽

Ultrasonic Irrigation ◽

The Mean ◽

Mandibular Incisors

ABSTRACTObjectives: To determine the influence of passive ultrasonic irrigation (PUI) on apical extrusion of irrigating solution.Methods: Twenty freshly extracted maxillary and mandibular incisors with single straight root canals were instrumented with ProTaper rotary files. During final irrigation, the root canals were filled with 2.5% sodium hypochlorite (NaOCl) solution and PUI was performed with a piezoelectronic unit. A stainless steel instrument (size 15) was inserted into the root canal and the irrigant was ultrasonically activated for one minute. This sequence was repeated three times, resultingin a total PUI time of three minutes. The volume of extruded irrigant was measured by Pipetman pipettes. The data were statistically analyzed with the Mann-Whitney U test.Results: The mean volume of apical extruded irrigant was 2.15 �L for the PUI group and 14 �L forthe control group. The experimentalgroup extruded significantly smaller amounts of irrigant than the control group (P<.05).Conclusions: The PUI procedure as a final irrigation was associated with less apical extrusion of the irrigating solution. (Eur J Dent 2008;2:198-203)

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The effect of temperature on the tissue dissolution capacity of 10% calcium hypochlorite solution

RGUHS Journal of Dental Sciences ◽

10.26715/rjds.10_1_3 ◽

2018 ◽

Vol 10 (1) ◽

pp. 13-19

Author(s):

Kiran Kumar N ◽

Biji Brigit K ◽

Savitha B Naik ◽

Seema Merwade

Keyword(s):

Sodium Hypochlorite ◽

Room Temperature ◽

Effect Of Temperature ◽

Control Group ◽

Pulp Tissue ◽

Calcium Hypochlorite ◽

Hypochlorite Solution ◽

Percentage Difference ◽

Intergroup Comparison ◽

Bonferroni Test

BACKGROUND: The cytotoxicity of Sodium hypochlorite has always been a concern when used as an endodontic irrigant. Quest for an equally effective, but less toxic substitute has led to researches on Calcium hypochlorite (Ca(ClO)2 ) solutions. But it has been proven that 10% Calcium hypochlorite solution at room temperature (250 C) demonstrated slower rate of tissue dissolution than Sodium hypochlorite. Aim: This study was performed to assess if preheating enhanced the tissue dissolution capacity of 10% Ca(ClO)2 . MATERIALS AND METHODS: Human pulp tissue was obtained from freshly extracted single rooted mandibular premolars. The tissue weight was standardized to 9.5mg. The test groups consisted of freshly prepared Ca(ClO)2 solutions at room temperature (250 C), 450 C and 600 C. Ten specimens were assigned to each group with each specimen immersed in 2ml of the test solution. Five specimens immersed in normal saline made the control group. Every five minutes the tissue was retrieved, blotted dry, weighed and immersed back in fresh 2 ml of solution. This was continued for 60 minutes or till complete dissolution. The percentage difference in weight at each interval was calculated. The values obtained were statistically analyzed using one –way ANOVA. Intergroup comparison at different time intervals was done using Bonferroni test. RESULTS: Ca(ClO)2 solution at 600 C dissolved the tissue significantly faster than other solutions. The tissue dissolution rate of solution at 450 C was greater than that at 250 C. (P< 0.05) CONCLUSION: Within the limitations of this study, it can be concluded that preheating 10% Ca(ClO)2 solution significantly enhanced its tissue dissolution capacity.

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Efficacy of EDTA and HEDP Chelators in the Removal of Mature Biofilm of Enterococcus faecalis by PUI and XPF File Activation

Dentistry Journal ◽

10.3390/dj9040041 ◽

2021 ◽

Vol 9 (4) ◽

pp. 41

Author(s):

Alejandro Álvarez-Sagües ◽

Nerea Herce ◽

Ulises Amador ◽

Francisco Llinares-Pinel ◽

Estanislao Nistal-Villan ◽

...

Keyword(s):

Enterococcus Faecalis ◽

Sodium Hypochlorite ◽

Root Canal ◽

Ethylenediaminetetraacetic Acid ◽

Control Group ◽

Untreated Control Group ◽

Ultrasonic Activation ◽

Biofilm Removal ◽

Proper Comparison ◽

Antibacterial Capacity

Background: Biofilm removal from the root canal during endodontic treatment is necessary to prevent further complications. Irrigation is essential to success. Several irrigants have been proposed without a proper comparison. The aim of the study is to compare the antibacterial capacity of different activated irrigants using passive ultrasonic activation (PUI) or XP-Endo finisher (XPF). Methods: A total of 100 instrumented teeth were incubated in an Eppendorf tube containing 0.5 McFarland of Enterococcus faecalis and incubated for 2 weeks at 37 °C. Roots were divided into 5 groups (n = 20) according to the irrigant type: ethylenediaminetetraacetic acid (EDTA) (17%), ethydronic acid (HEDP) (9%) mixed with 5.25% sodium hypochlorite (NaOCl), EDTA (17%) mixed with 5.25% NaOCl, PBS, and a control group. Each group was divided into two subgroups (n = 10): PUI and XPF. Results: As compared to the untreated control group, the irrigators included in the study had a significant effect in bacteria reduction. The obtained results show HEDP to be the most effective irrigant, since no bacteria were recovered after treatment of this group, followed by EDTA mixed with NaOCl and, finally, the EDTA-irrigated group. Conclusions: HEDP is the best irrigating agent in combination with XPF or PUI file activation to eliminate bacteria in our experimental model.

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Efficacy evaluation of a cordless ultrasonic unit in achieving reduction of bacterial load within a root canal system as compared to a conventional ultrasonic unit and negative pressure irrigation

Evidence-Based Endodontics ◽

10.1186/s41121-019-0019-z ◽

2019 ◽

Vol 4 (1) ◽

Author(s):

Randall Mikulik ◽

Ali Naji ◽

Ransome van der Hoeven ◽

Igor Tsesis ◽

Eyal Rosen ◽

...

Keyword(s):

Sodium Hypochlorite ◽

Negative Pressure ◽

Root Canal ◽

Bacterial Load ◽

Sodium Thiosulfate ◽

Efficacy Evaluation ◽

Human Teeth ◽

Canal Irrigation ◽

Root Canal Irrigation ◽

Significant Difference

Abstract Introduction Increase in efficacy during root canal irrigation may contribute to better treatment outcomes. This study investigated the efficacy of ultrasonic and negative pressure irrigation systems using sodium hypochlorite (NaOCl) in the reduction of bacterial load in human teeth. One hundred thirty-one single-rooted teeth were cleaned and shaped, autoclaved, and incubated with E. faecalis. Teeth were randomly assigned to three experimental groups (n = 40) and treated in the presence of 1% sodium hypochlorite using EndoUltra cordless ultrasonic, conventional ultrasonic, and Endovac negative pressure irrigation. Syringe irrigation controls were treated with 1% sodium hypochlorite and phosphate-buffered saline via side-vented needle irrigation. All groups with NaOCl received 5% sodium thiosulfate neutralization for 5 min after treatment. Samples of root canal fluid and dentin chips were acquired from canals before and after treatment, incubated on BHI agar, and colony forming units categorized according to quantity. Wilcoxon rank-sum and Bonferroni tests were used for statistical analysis. p values less than 0.05 were considered significant. Results Endovac group was significantly better in eliminating bacteria from the root canals than 1% NaOCl (p = 0.006) and PBS syringe irrigation (p = 0.015). However, it was not significantly different from the two ultrasonic groups (p > 0.05). Both ultrasonic groups showed better performance than 1% NaOCl and PBS syringe irrigation, however, not statistically significant (p < 0.03). There was no significant difference between the two ultrasonic devices (p > 0.05). Conclusion EndoVac may be an important tool for bacterial load reduction in oval canals.

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Analysis of two irrigation methods in root canal disinfection against E. Faecalis biofilm under the influence of the concentration, volumen, and time in contact of the irrigant

Research Society and Development ◽

10.33448/rsd-v10i8.17478 ◽

2021 ◽

Vol 10 (8) ◽

pp. e32610817478

Author(s):

Ana Luiza Rezende Fernandes ◽

Ana Grasiela da Silva Limoeiro ◽

Augusto Shoji Kato ◽

Rina Andrea Pelegrine ◽

Alexandre Sigrist de Martin ◽

...

Keyword(s):

Root Canal ◽

Ex Vivo ◽

Bacterial Load ◽

Cumulative Effect ◽

Control Group ◽

Sterile Saline ◽

Root Canal Disinfection ◽

Efficient Reduction ◽

Ultrasonic Irrigation ◽

Conventional Irrigation

The purpose of this ex vivo study was to evaluate the effectiveness of two irrigation techniques against E. Faecalis biofilm: conventional irrigation (CI) and passive ultrasonic irrigation (PUI). Furthermore, to investigate a possible cumulative effect of disinfection in the final irrigation, leaving the hypochlorite in the root canal for 2 or 5 minutes without agitation. A total of 63 premolars were divided into 9 groups (n = 7): Groups CI - 2.5 and CI - 5.25: Conventional irrigation with 2.5% and 5.25% NaOCl, respectively, a total of 6 mL for 1 min. Groups CI/PUI - 2.5 and CI/PUI - 5.25: CI + PUI with 2.5% and 5.25% NaOCl respectively, a total of 12 mL for 2 min. Groups CI/PUI - 2.5-2 (total of 14 mL for 4 min) and CI/PUI - 2.5-5 (total of 14 mL for 7 min): CI + PUI, plus final irrigation leaving the NaOCl 2,5% in the root canal for 2 or 5 minutes without agitation, respectively. Groups CI/PUI - 5,25-2 (total of 14 mL for 4 min) and CI/PUI - 5,25-5 (total of 14 mL for 7 minutes): CI + PUI, plus final irrigation leaving the NaOCl 5,25% in the root canal for 2 or 5 minutes without agitation, respectively. Control Group: CI + PUI, final irrigation leaving sterile saline solution for 5 min. The CI/PUI - 5,25 group showed a significantly greater reduction of E. faecalis than in the CI/PUI - 2.5 group. All other groups did not differ significantly from each other. The control group showed a less efficient reduction of E. faecalis. The CI associated with PUI was sufficiently able to reduce the bacterial load of E. faecalis. The final irrigation, leaving the hypochlorite in the root canal for 2 or 5 minutes without agitation did not demonstrate relevance in this study. Successive changes of the irrigating liquid, resulting in greater volume, demonstrated better results in disinfecting the root canal system.

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Evaluation of Different Passive Ultrasonic Irrigation Protocols on the Removal of Dentinal Debris from Artificial Grooves

Brazilian Dental Journal ◽

10.1590/0103-6440201600725 ◽

2016 ◽

Vol 27 (5) ◽

pp. 568-572 ◽

Cited By ~ 6

Author(s):

Rodrigo Ricci Vivan ◽

Jussaro Alves Duque ◽

Murilo Priori Alcalde ◽

Marcus Vinicius Reis Só ◽

Clóvis Monteiro Bramante ◽

...

Keyword(s):

Sodium Hypochlorite ◽

Root Canal ◽

Root Apex ◽

Control Group ◽

Passive Ultrasonic Irrigation ◽

Similar Performance ◽

Ultrasonic Device ◽

Ultrasonic Irrigation

Abstract The aim of this study was to evaluate the influence of different passive ultrasonic irrigation protocols on the removal of debris in artificially created grooves in the cervical, middle and apical root thirds. Forty extracted bovine incisor roots were instrumented to 1 mm of the root apex with a R50 Reciproc instrument and irrigated with 2.5% sodium hypochlorite. The roots were then inserted in a muffle and cleaved into two hemisections. Grooves (3-mm long) were done at 2, 7 and 12 mm from the root apex in one hemisection and filled with dentinal debris. The hemisections were regrouped into the muffle and divided into 4 groups (n=10) according to the final irrigation protocol: Control group: 3x20 s using a #30 gauge needle without agitation of the irrigating solution; Group PUI-s (static passive ultrasonic irrigation): 3x20 s of passive ultrasonic irrigation with the tip of the insert maintained static on the apical third; Group PUI-t (passive ultrasonic irrigation per third): 20 s of PUI in each third; Group PUI-d (passive dynamic ultrasonic irrigation): 3x20 s of PUI dynamically moving the insert in the whole extent of the root canal. In all groups, was used a total of 6 mL of 2.5% sodium hypochlorite as irrigant. After these procedures, the grooves were analyzed with a stereomicroscope and assigned scores as regards removal of the debris. The data were analyzed statistically (a=0.05). The results showed a better cleaning in all the groups where the irrigating solution was agitated with ultrasonic device than in the control group (p<0.05). In the apical third, the PUI-d and PUI-s showed similar performance (p>0.05) and a better cleanness than PUI-t (p<0.05). The dynamic and static methods of agitation of the irrigating solution provided more effective cleaning. PUI-d provided the most completely clean grooves suggesting that its use is the most adequate in cases of teeth with complex canal anatomy.

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PERBEDAAN KHASIAT ANTIBAKTERI BAHAN IRIGASI LARUTAN PROPOLIS DAN SODIUM HYPOCHLORITE TERHADAP BAKTERI Streptococcus viridans

Conservative Dentistry Journal ◽

10.20473/cdj.v8i1.2018.42-48 ◽

2019 ◽

Vol 8 (1) ◽

pp. 42

Author(s):

Tabita Kusumawardhani ◽

Sukaton Sukaton ◽

Achmad Sudirman

Keyword(s):

Sodium Hypochlorite ◽

Root Canal ◽

Antibacterial Effect ◽

Inhibition Zone ◽

Streptococcus Viridans ◽

Control Group ◽

Canal Irrigation ◽

Root Canal Irrigation ◽

Significant Difference ◽

Potential Use

Background. Bacteria is main etiologycal factor of pulpo-periapical disease. Therefore, eliminating bacteria is the important part on root canal treatment. It can be obtained by using irrigation agent that has antibacterial effect and endodontic sterilization agent. Beside of its antibacterial effect, the ideal irrigation agent should has an ability to remove necrotic tissue and less toxic. Propolis is well known as a natural substain that has antibacterial effect and less toxicity. So, it has a potential use as irrigation agent compared with common root canal irrigation agent, sodium hypochloryte. Purpose. The aim of this study was to observed the difference of antibacterial effect between propolis solution and sodium hypochlorite. Method. Nine samples of Streptococcus viridans were prepared and each sample devided into three parts namely group P (propolis solution), group N (sodium hypochlorite), and control group S (saline). Each group was treated with 0,01 cc agent of root canal irrigation, then was stored in incubator 370C for 24 hours. After that, inhibition zone diameter of each group was observed.Result. The average of inhibition zone diameters in sodium hypochlorite’s group was 23,47 mm; in propolis solution’s group was 18,70 mm. There were significant difference of antibacterial effect between propolis solution and sodium hypochlorite, against Streptococcus viridans. Conclussion. Antibacterial effect of sodium hypochlorite is higher than propolis solution, but we should consider the potential use of natural agent-propolis solution as root canal irrigation due to its antibacterial effect.

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Debris Removal Using a Hydroxyapatite Nanoparticle-Containing Solution (Vector Polish) with Sonic or Ultrasonic Agitation

Materials ◽

10.3390/ma14164750 ◽

2021 ◽

Vol 14 (16) ◽

pp. 4750

Author(s):

Michael Hülsmann ◽

Christoph Beckmann ◽

Steffi Baxter

Keyword(s):

Sodium Hypochlorite ◽

Root Canal ◽

Control Group ◽

Hydroxyapatite Nanoparticles ◽

Solution Vector ◽

Ultrasonic Agitation ◽

Mechanical Removal ◽

Debris Removal ◽

Ultrasonic Irrigation ◽

Four Score

Chemomechanical preparation of the root canal system is considered to be the most important part of root canal treatment, including both mechanical removal of tissue remnants and dentine chips, and chemical elimination of biofilm and microorganisms. A number of different solutions and agitation techniques have been proposed for that purpose. It was the aim of the present study to investigate whether root canal cleanliness can be improved by using a hydroxyapatite nanoparticle-containing solution with and without sonic or ultrasonic agitation. Seventy-four single-rooted teeth were divided into four experimental groups (n = 15) and two control groups (n = 7). All teeth were split longitudinally and a groove and three holes were cut into the root canal wall and filled with dentinal debris. Final irrigation was performed using sodium hypochlorite or a hydroxyapatite nanoparticle-containing solution (Vector polish) activated with a sonically or an ultrasonically driven endodontic file. Two calibrated investigators rated the remaining debris using a four-score scale. The results were analyzed using a non-parametric test with α < 0.05. Sonic and ultrasonic irrigation with sodium hypochlorite cleaned the grooves and holes well from debris. The hydroxyapatite nanoparticles activated by a sonic file cleaned grooves and holes equally well. Ultrasonically activated nanoparticles performance was clearly inferior. The syringe control-group left large amounts of debris in grooves and holes. The use of the hydroxyapatite nanoparticles used in this study did not improve removal of debris.

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Comparison of Antimicrobial Activity of Sodium Hypochlorite (NaOCI) 2.5%, Microemulsion of Myrtus 10%, Microemulsion of Thyme 0.6% on the Enterococcus Faecalis After Root Canal Filling

Journal of Arak University of Medical Sciences ◽

10.32598/jams.24.3.6321.1 ◽

2021 ◽

Vol 24 (3) ◽

pp. 424-437

Author(s):

Forough Khodadadnejad ◽

◽

Majid Akbari ◽

Fateme Abdolalian ◽

Mahboube Daneshvar ◽

...

Keyword(s):

Antimicrobial Activity ◽

Enterococcus Faecalis ◽

Sodium Hypochlorite ◽

Root Canal ◽

Negative Control Group ◽

Negative Control ◽

Endodontic Treatment ◽

Control Group ◽

Root Canal Filling ◽

Anterior Teeth

Background and Aim: The success of endodontic treatment depends on the complete elimination of pathogenic bacteria inside the root canal. Enterococcus faecalis, a gram-positive, pathogenic, and anaerobic cocci, are the primary etiology of root canal infection in treated and untreated teeth and are highly associated with endodontic treatment failure. This study aimed to compare the antimicrobial activity of Sodium hypochlorite 2.5%, microemulsion of Myrtus 10%, and microemulsion of Thyme 0.6% on the E. faecalis after root canal filling. Methods & Materials: In this experimental study, 25 extracted single canal human anterior teeth were collected, and their crowns were cut. Then after washing and cleaning, and filling, the sterilization was done using an autoclave. Then, except 5 teeth (negative control group), the teeth were smeared with E. faecalis and then divided into 5 groups randomly represented the irrigation by Sodium hypochlorite 2.5%, microemulsion of Myrtus 10%, and microemulsion of Thyme 0.6%, with a positive control group and negative control group. The teeth were filled with gutta-percha and then incubated in an incubator for 90 days at a temperature of 37°C. Finally, the comparison of CFU in the groups due to abnormal data distribution was performed using the Kruskal-Wallis test. Ethical Considerations: The Ethics Committee of Arak University of Medical Sciences approved this study (Code: IR.ARAKMU.REC.1398.297). Results: According to the results of this study, the correlation between the groups of cultured teeth was not significant(P>0.05). The specimens washed with microemulsion of the Thyme 0.6% had the highest positive number of cultures; the specimens washed by Sodium hypochlorite 2.5% had the lowest number of cultures. Conclusion: This study showed that no statistically significant difference exists in their antimicrobial activity after root canal therapy after the use of different wash solutions.

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