Impact of final rinse with saline or alcohol solution on root canal sealability
DOI:
https://doi.org/10.61872/sdj-2024-04-01PMID:
39279338Keywords:
endodontics, root canal filling, irrigation, sealer, leakage, NaOCl, HEDPAbstract
Endodontic irrigation protocols are not only used to clean and disinfect the root canal system, but also to condition the canal wall dentine for subsequent root filling. In this study we tested whether a final irrigation step with saline solution or 80% ethanol improved root canal sealabilty by two popular sealers, an epoxy resin (AH Plus) and a hydraulic calcium silicate cement-based product (BioRoot RCS). Root canals in extracted single-rooted human teeth were instrumented and filled with a matched gutta-percha cone and sealer. During instrumentation and prior to root filling, sealer-specific irrigation protocols were applied. These involved a combined sodium hypochlorite/1-hydroxyethylidene-1,1-diphosphonic acid application, which was followed by irrigation with ethylenediaminetetraacetic acid (EDTA) for AH Plus. Protocols were followed by a 5-ml ultimate rinse with saline solution or 80% ethanol. No such final rinse was the control (N = 9). Canals were then dried with matched paper points. One week after root filling and storage of the teeth at 37°C in a humid environment, Rhodamine B was used to trace leakage. Two-way ANOVA revealed that the type of sealer had a significant (P < 0.05) impact on apical dye penetration while the final rinse did not (P > 0.05). AH Plus provided the slightly better seal (P < 0.05). Leakage occurred between the sealer and the dentin with AH Plus, and between the sealer-to-dentin as well as the sealer-to-gutta-percha interface with BioRoot RCS. In summary and under current conditions, there was no benefit from applying saline or ethanol as an ultimate rinsing solution prior to drying the canal with matched paper points.
References
Neelakantan P, Subbarao C, Subbarao CV, De-Deus G, Zehnder M. The impact of root dentine conditioning on sealing ability and push-out bond strength of an epoxy resin root canal sealer. Int Endod J. 2011;44:491-498.
Fernandes Zancan R, Hadis M, Burgess D et al. A matched irrigation and obturation strategy for root canal therapy. Sci Rep. 2021;11:4666.
Ballal NV, Roy A, Zehnder M. Effect of sodium hypochlorite concentration in continuous chelation on dis-lodgement resistance of an epoxy resin and hydraulic calcium silicate sealer. Polymers (Basel). 2021;13
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 analy-sis. J Endod. 2015;41:1108-1111.
Buchbinder M, Bartels HA. Criticism of the use of root canal cultures in evaluating antibiotic therapy. Oral Surgery. 1951
Zamany A, Spångberg LS. An effective method of inactivating chlorhexidine. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002;93:617-620.
Dutner J, Mines P, Anderson A. Irrigation trends among American Association of Endodontists members: a web-based survey. J Endod. 2012;38:37-40.
Willershausen I, Wolf TG, Schmidtmann I et al. Survey of root canal irrigating solutions used in dental prac-tices within Germany. Int Endod J. 2015;48:654-660.
Pashley DH, Tay FR, Carvalho RM et al. From dry bonding to water-wet bonding to ethanol-wet bonding. A review of the interactions between dentin matrix and solvated resins using a macromodel of the hybrid layer. Am J Dent. 2007;20:7-20.
Hosoya N, Nomura M, Yoshikubo A, Arai T, Nakamura J, Cox CF. Effect of canal drying methods on the apical seal. J Endod. 2000;26:292-294.
Razmi H, Bolhari B, Karamzadeh Dashti N, Fazlyab M. The Effect of canal dryness on bond strength of bioc-eramic and epoxy-resin sealers after irrigation with sodium hypochlorite or chlorhexidine. Iran Endod J. 2016;11:129-133.
Reyes-Carmona JF, Felippe MS, Felippe WT. A phosphate-buffered saline intracanal dressing improves the biomineralization ability of mineral trioxide aggregate apical plugs. J Endod. 2010;36:1648-1652.
Arias-Moliz MT, Camilleri J. The effect of the final irrigant on the antimicrobial activity of root canal sealers. J Dent. 2016;52:30-36.
Zollinger A, Mohn D, Zeltner M, Zehnder M. Short-term storage stability of NaOCl solutions when com-bined with Dual Rinse HEDP. Int Endod J. 2018;51:691-696.
Zehnder M. Root canal irrigants. J Endod. 2006;32:389-398.
Neelakantan P, Varughese AA, Sharma S, Subbarao CV, Zehnder M, De-Deus G. Continuous chelation irrigation improves the adhesion of epoxy resin-based root canal sealer to root dentine. Int Endod J. 2012;45:1097-1102.
Wang JS, Bai W, Wang Y, Liang YH. Effect of different dentin moisture on the push-out strength of bioc-eramic root canal sealer. J Dent Sci. 2023;18:129-134.
Editorial Board of the Journal of Endodontics. Wanted: a base of evidence. J Endod. 2007;33:1401-1402.
Rechenberg DK, De-Deus G, Zehnder M. Potential systematic error in laboratory experiments on microbial leakage through filled root canals: review of published articles. Int Endod J. 2011;44:183-194.
Paque F, Sirtes G. Apical sealing ability of Resilon/Epiphany versus gutta-percha/AH Plus: immediate and 16-months leakage. Int Endod J. 2007;40:722-729.
Barborka BJ, Woodmansey KF, Glickman GN, Schneiderman E, He J. Long-term clinical outcome of teeth obturated with resilon. J Endod. 2017;43:556-560.
De-Deus G. Research that matters - root canal filling and leakage studies. Int Endod J. 2012;45:1063-1064.
Viapiana R, Moinzadeh AT, Camilleri L, Wesselink PR, Tanomaru Filho M, Camilleri J. Porosity and sealing ability of root fillings with gutta-percha and BioRoot RCS or AH Plus sealers. Evaluation by three ex vivo methods. Int Endod J. 2016;49:774-782.
Saavedra FM, Pelepenko LE, Boyle WS, Zhang A, Staley C, Herzberg MC, Marciano MA, Lima BP. In vitro physicochemical characterization of five root canal sealers and their influence on an ex vivo oral multi-species biofilm community. Int Endod J. 2022;55:772-783.
Spångberg LS, Acierno TG, Yongbum Cha B. Influence of entrapped air on the accuracy of leakage studies using dye penetration methods. J Endod. 1989;15:548-551.
Camilleri J, Pitt Ford TR. Evaluation of the effect of tracer pH on the sealing ability of glass ionomer cement and mineral trioxide aggregate. Journal of Materials Science: Materials in Medicine. 2008;19:2941-2948.
Jorge J, Castro GR, Martines Utrera MA. Comparison among different pH values of Rhodamine B solution impregnated into mesoporous silica. Orbital: The Electronic Journal of Chemistry. 201323-29.
Khalil I, Naaman A, Camilleri J. Properties of tricalcium silicate sealers. J Endod. 2016;42:1529-1535.
Lee KW, Williams MC, Camps JJ, Pashley DH. Adhesion of endodontic sealers to dentin and gutta-percha. J Endod. 2002;28:684-688.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Nidambur Vasudev Ballal, Rajkumar Narkedamalli, Josette Camilleri, Vasileios Kapralos, Matthias Zehnder
This work is licensed under a Creative Commons Attribution 4.0 International License.