Aspects of glass and hybridization protocols for bonding of fiber posts to root dentine.

This study evaluated bond strength of glass fiber posts to root dentin using push-out (PO) and diametral compression (DC), testing glycolic acid as a conditioner and varying dentin moisture. An additional aim was to test whether DC can be an alternative test to PO for bond strength assessment. Eighty bovine teeth were divided into eight groups (n = 10) defined by the use of either 37% glycolic acid or 37% phosphoric acid (PA) on moist or wet dentin before bonding with either Adapter SingleBond/RelyX ARC or One Step Plus/Duo-Link Bisco. Each tooth provided discs with an internal diameter of 2 mm, external diameter of 5 mm, and height of 2 mm, which underwent PO and DC. Finite element analysis (FEA) was carried out on 3D models. When analyzing PO results through linear regression, the highest values of bond strength were observed using glycolic acid on wet dentin in the cervical and middle thirds of the teeth. Analyzing DC results, the only statistical influence on values was the dental thirds. The scatterplot of the DC results and the PO bond strength values indicated no relationship between the results of the two tests (r = 0.03; p = 0.64). PO test detected more sensitive changes in bond strength values than DC.

Antimicrobial action, cytotoxicity and erosive potential of hypochlorous acid obtained from an electrolytic device compared with sodium hypochlorite.

OBJECTIVES: This study aimed to compare the antimicrobial action, cytotoxicity, cleaning ability, and erosion of dentine of hypochlorous acid (HClO) obtained from an electrolytic device at two different concentrations (Dentaqua) and three concentrations of sodium hypochlorite (NaOCl). METHODS: Microbiological test-The root canals of sixty single-rooted extracted human teeth were inoculated with Enterococcus faecalis and divided into 6 groups (n = 10), according to decontamination protocol: DW (control); 1% NaOCl; 2.5% NaOCl; 5.25% NaOCl; 250 ppm HClO and 500 ppm HClO. The colony-forming units were counted to evaluate the decontamination potential of each group, calculating the reduction in bacterial percentage. Cytotoxicity test-Cytotoxicity was evaluated after inoculation of the same tested protocols in fibroblastic cells for 3 min, calculating the cell viability percentages. Specifical statistical analysis was performed (α = 5%). Cleaning ability and erosion-Fifty-six single-rooted bovine lower incisors were divided into seven groups of 8 roots each, being the test groups 1% NaOCl; 2.5% NaOCl; 5,25% NaOCl; 250 ppm HClO and 500 ppm HClO, and a negative and positive control. Negative control was not contaminated, and the other groups were inoculated with Enterococcus faecalis. SEM images were ranked as from the cleanest to the least clean. Erosion was also assessed, being ranked from the least to the most eroded dentine. RESULTS: The highest bacterial reduction was observed in experimental groups, with no statistical differences between them (p > 0.05). The highest number of viable cells was observed in control group, followed by 250 ppm HClO and 500 ppm HClO groups, with statistical differences between them (p < 0.05). 1% NaOCl; 2.5% NaOCl; 5.25% NaOCl and 500 ppm HClO displayed the cleanest areas. All sodium hypochlorite groups displayed erosion with higher ranks with greater concentration, while hypochlorous acid did not display any erosion regardless the concentration. CONCLUSIONS: It is possible to conclude that HClO obtained from an electrolytic device presented high antimicrobial activity and low cytotoxicity in both tested concentrations. 500 ppm HClO did not display erosion and showed great cleaning ability. CLINICAL RELEVANCE: The use of 500 ppm hypochlorous acid may reduce unfavorable behavior of sodium hypochlorite whilst maintaining its antimicrobial action.

Effectiveness of ultrasonic activation over glycolic acid on microhardness, cohesive strength, flexural strength, and fracture resistance of the root dentin.

OBJECTIVES: The aim of this study was to evaluate the effectiveness of ultrasonic activation (US) over glycolic acid on microhardness, cohesive strength, flexural strength, and fracture resistance of root dentin, comparing with conventional final irrigation protocols. METHODS: Samples were obtained from 140 extracted bovine teeth and distributed into four test groups: microhardness (50 teeth), cohesive strength (15 teeth), flexural strength (15 teeth), and fracture resistance (60 teeth). In all four tests, specimens were subdivided into five groups, according to final irrigation protocols: G1: distilled water (DW); G2: 17% ethylenediaminetetraacetic acid (EDTA); G3: 17% glycolic acid (GA); G4: 17% EDTA + US; and G5: 17% GA + US. The duration time of each protocol was set in 1 min. After irrigation protocols, the Vickers tester was used to evaluate microhardness and the universal testing machine was used to evaluate the cohesive strength, flexural strength, and fracture resistance of the root dentin. One-way ANOVA test and the Tukey HSD were used for multiple comparison tests in all evaluations (α = 5%). RESULTS: In general, groups 2 (EDTA), 4 (EDTA + US), and 5 (GA + US) promoted the highest reduction of microhardness, being statistically different from other groups (p < 0.05). Cohesive strength, flexural strength, and fracture resistance data revealed that no differences between groups were observed (p > 0.05). CONCLUSIONS: The association of GA and US results in microhardness reduction, with no influence on cohesive strength, flexural strength, and fracture resistance of the root dentin. CLINICAL RELEVANCE: The use of US over GA has no influence on some mechanical properties of root dentin.

Oral bacterial decontamination using an innovative prototype for photocatalytic disinfection.

OBJECTIVES: The aim of this study was to evaluate the effectiveness of a prototype photocatalytic device for bacterial decontaminations of the oral cavity. METHODS: Sixty-four subjects (18-65) were selected and randomly assigned to eight groups (n = 8), according to oral disinfection protocol: (G1): distilled water (control); (G2): 1.5% hydrogen peroxide (HP); (G3): 3.0% HP; (G4): 0.12% chlorhexidine (CHX); (G5): Germinator; (G6): 1.5% HP + Germinator; (G7): 3.0%HP + Germinator; (G8): 0.12% CHX + Germinator. Stimulated saliva was collected before and after a 3-min mouthwash and/or Germinator application. The patients were kept relaxed and retained saliva 5-10 min, spitting out into the tube for 3 min. The percentage bacterial reduction was checked by counting the colony-forming units (CFUs) after culturing on blood agar plates. Data were subjected to one-way ANOVA followed by Tukey's post hoc test (α = 5%) for statistical significance. RESULTS: The highest bacterial reduction was observed in groups 3 (3.0% HP), 6 (1.5% HP + Germinator), and 7 (3.0% + Germinator), with no statistically significant difference between them (p > 0.05). Groups 6 (1.5% HP + Germinator) and 8 (0.12% CHX + Germinator) showed higher bacterial reduction than groups 2 (1.5% HP) and 4 (0.12% CHX) (p < 0.05). Finally, group 5 (Germinator) showed higher bacterial reduction than control group (DW) and group 4 (0.12% CHX) (p < 0.05). CONCLUSIONS: The photocatalytic disinfection was effective against oral bacteria and improved the antimicrobial action of 1.5% HP and 0.12%. CLINICAL SIGNIFICANCE: The photocatalytic disinfection can be an alternative protocol to provide the oral decontamination.

Antimicrobial activity of glycolic acid as a final irrigant solution for root canal preparation.

The objective of this study was to evaluate the antimicrobial capacity of glycolic acid (GA) at different concentrations as a final irrigant during the preparation of root canals. The sample consisted of 77 extracted single-rooted human teeth with complete root formation, no previous endodontic treatment, and a root length of at least 14 mm. The root canals were prepared in a standardized manner with a rotary file system. During this process, irrigation was performed with 2.5% sodium hypochlorite (NaOCl), and the final irrigant was 17% ethylenediaminetetraacetic acid (EDTA). After the root canal sterilization procedure, Enterococcus faecalis was cultured in a Petri dish, and 70 sterilized root canals were inoculated with a suspension containing 3.0 × 108 colony-forming units (CFUs) per milliliter. The roots were divided into 7 groups (n = 10) according to the following solutions: 0.9% sodium chloride (NaCl); 6% NaOCl; 17% EDTA; 10%, 17%, or 25% GA; or 17% citric acid (CA). The capacity of the different substances to reduce E faecalis was evaluated by counting the CFUs before and after treatment with the final irrigant solutions. Data were subjected to an analysis of variance and the Tukey test at a 5% significance level. The greatest bacterial reduction was observed in the group irrigated with NaOCl (P < 0.05). There were no statistically significant differences among the groups irrigated with GA in different concentrations (P > 0.05), but they all demonstrated greater disinfection capacity than CA and EDTA (P < 0.05). CA showed significantly greater antimicrobial capacity than EDTA (P < 0.05). EDTA showed significantly greater antimicrobial capacity only in relation to NaCl (P < 0.05). At different concentrations, GA demonstrated greater capacity to eliminate E faecalis from root canals than did EDTA.

Effect of root canal preparation techniques on chlorhexidine substantivity on human dentin: a chemical analysis.

OBJECTIVES: Chlorhexidine binds to dentine to provide sustained action. The aim of the present study was to evaluate and compare the substantivity of chlorhexidine using manual, rotary, and reciprocating systems for root canal preparation. METHODS: Forty-five extracted human single-rooted teeth were used for this study. The samples were divided into three groups (n = 15) according to the instrumentation technique used: manual instrumentation (K-File), rotary instrumentation (ProTaper), and reciprocating instrumentation (Reciproc R25). Chlorhexidine gel (2%) was used as auxiliary chemical substance during root canal preparation. Longitudinal grooves were carved on the free surfaces of the roots, providing two halves of each root and resulting in 30 samples per group. Each group was randomly divided into three subgroups (n = 10), and substantivity was evaluated after 48 h, 7 days, and 30 days of incubation. The amount of CHX (in mg/mL) was measured through reverse-phase high-performance liquid chromatography. Statistical analysis was performed by analysis of variance and the Tukey test for post hoc comparisons (α = 0.05). RESULTS: The manual did not show a statistical significant difference with rotary instrumentation (P > 0.05), but higher CHX substantivity was recorded in all periods of observation when compared to reciprocating instrumentation (P < 0.05). CONCLUSIONS: The CHX substantivity on human dentine is lowest when using reciprocating compared to manual and rotary instrumentation. CLINICAL SIGNIFICANCE: Using chemical analysis, this study showed that a manual and rotary multi-instrument system results in greater chlorhexidine substantivity on human dentin than a reciprocating single-instrument system.

Comparative evaluation of the retaining of QMix and chlorhexidine formulations on human dentin: a chemical analysis.

OBJECTIVES: The purpose of this study was to investigate, in vitro, the retaining of 2 % CHX gel, 2 % CHX liquid and QMix (an endodontic irrigant) within a root canal for 24 h, 30, 90, and 120 days by chemical analysis. METHODS: Eighty extracted human teeth were used for this study. The samples were divided into four groups (G1-G4), according to the chemical auxiliary substance used to perform the instrumentation: G1 (control): distilled water, G2: 2 % CHX gel, G3: 2 % CHX liquid, and G4: QMix. The roots were prepared up to the instrument #45 by serial instrumentation. Longitudinal grooves were carved on the free surfaces of the roots, providing 2 halves of each root and resulting in 40 samples per group. Each group was randomly divided into four subgroups (n = 10), and substantivity was evaluated after 24 h, 30, 90, and 120 days. The amount of 2 % CHX gel, 2 % CHX liquid, and QMix (in micrograms) was measured through reverse-phase high-performance liquid chromatography. Statistical analysis was performed by ANOVA and Games-Howell test for post-hoc comparisons (α = 0.05). RESULTS: CHX gel, CHX liquid, and QMix were retained in dentin up to 120 days. Significantly less substantivity was observed for QMix, irrespective of the period of time. Statistically significant higher values were observed for CHX gel after 24 h, while no differences were noted between CHX gel and CHX liquid after 30, 90, and 120 days of evaluation (p < 0.05). CONCLUSIONS: Two percent CHX (gel and liquid) and QMix are retained in root canal dentin for up to 120 days. CLINICAL RELEVANCE: This study proposes an alternative of auxiliary chemical substance to be used during the chemo-mechanical preparation.

Antimicrobial action and cytotoxicity of hypochlorous acid obtained from an innovative electrolytic device - An in vitro study.

OBJECTIVE: This study evaluated the antimicrobial effect and cytotoxicity of hypochlorous acid(HClO) obtained from an innovative electrolytic device. DESIGN: The root canals of fifty extracted human teeth were inoculated with Enterococcus faecalis and divided into 5 groups (n = 10): DW (control); 2% chlorhexidine gel(CHX); 2.5% sodium hypochlorite(NaOCl); 250 ppm HClO and 500 ppm HClO. The counting of colony forming units evaluated the decontamination potential of each group. Cytotoxicity was evaluated after inoculation of tested protocols in fibroblastic cells for 3 min, calculating the cell viability. Specific statistical analysis was performed (α = 5%). RESULTS: The highest bacterial reduction was observed in experimental groups, with no statistical differences from each other (p > 0.05). The highest number of viable cells was observed in control group, followed by 250 ppm HClO and 500 ppm HClO groups, with statistical differences from each other (p < 0.05). CONCLUSIONS: It could be concluded that HClO presented high antimicrobial activity and low cytotoxicity at both tested concentrations.

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

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.

Does photobiomodulation on the root surface decrease the occurrence of root resorption in reimplanted teeth? A systematic review of animal studies.

This review aimed to answer the following question "Does photobiomodulation treatment of the root surface decrease the occurrence of root resorption in reimplanted teeth?" Electronic searches were performed in the MEDLINE/PubMed, Cochrane Library, Scopus, Web of Science, Embase, and Grey Literature Report databases. Risk of bias was evaluated using SYRCLE Risk of Bias tool. The Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) tool was used to assess the certainty of evidence. In total, 6 studies were included. Five studies reported a reduced occurrence of root resorption in teeth that received photobiomodulation treatment of the root surface prior to replantation. Only 1 study reported contradictory results. The photobiomodulation parameters varied widely among studies. GRADE assessment showed a low certainty of evidence. It can be inferred that photobiomodulation treatment of the root surface prior to replantation of teeth can reduce the occurrence of root resorption. Nonetheless, further clinical studies are needed. Trial Registration: PROSPERO Identifier: CRD42022349891.

Effect of glycolic acid and EDTA on dentin mechanical properties.

The aim of this study was to evaluate the effect of glycolic acid (GA) and EDTA on dentin mechanical properties. For the cohesive strength, flexural strength and fracture strength tests, the hourglass of root dentin, dentin sticks and roots standardised to 1 mm thickness were used respectively. ANOVA and Tukey tests were used for statistical analysis (P < 0.05). The results showed that EDTA and GA 17% reduced the cohesive strength values when compared to distilled water (control; P = 0.0022 and P = 0.0016 respectively), whereas the values for GA 10% group were similar to those of the control group (P = 0.093). No statistically significant difference was found among the groups for the flexural strength test (P = 0.1974). Fracture strength test showed that EDTA and GA 17% were statistically similar to each other (P = 0.7694) and statistically inferior to GA 10% (P = 0.0007 and P = 0.0004 respectively). It was concluded that 10% GA showed fewer negative effects on dentin mechanical properties.

Effect of bioceramic root canal sealers on the bond strength of fiber posts cemented with resin cements.

This study aimed to evaluate the influence of calcium silicate-based sealers on the bond strength of fiber posts using conventional and self-adhesive resin cement. Sixty single-rooted teeth were selected. The canals were prepared with a reciprocating instrument 40.06. The roots were randomly distributed in six groups (n = 10) according to the strategies for root canal filling and fiber posts cementation: AH Plus/RelyX ARC; AH Plus/RelyX U200; Bio C Sealer/RelyX ARC; Bio C Sealer/RealyX U200; Sealer Plus BC/RelyX ARC; and Sealer Plus BC/RelyX U200. The roots were transversally sectioned, and one slice per post-third was obtained. The push-out test was performed at a crosshead speed of 1mm/min. The failure patterns were described after assessment with a stereomicroscope with a 10× magnification. Bond strength was calculated and analyzed using the ANOVA and Tukey test. AH Plus did not influence the bond strength of fiber posts cemented with conventional (RelyX ARC) or with self-adhesive resin cement (RelyX U200). The lowest bond strength values were obtained when calcium silicate-based sealers were associated with conventional resin cement (Bio C Sealer/RelyX ARC and Sealer Plus BC/RelyX ARC). Except for Sealer Plus BC/RelyX ARC, all groups presented lower bond strength at the apical portion compared to the cervical portion of the post. Adhesive failures between cement and post and cement and dentin were predominant (55.3%). Calcium silicate-based sealers decreased the bond strength of fiber posts cemented with conventional resin cement.

Influence of photodynamic therapy, different final irrigants, and ultrasonic activation on the bond strength of glass fiber posts to root dentin.

OBJECTIVE: To evaluate the influence of photodynamic therapy (PDT), different final irrigants, and ultrasonic activation (US) on the bond strength of glass fiber posts (GFP) to root dentin. METHODS: One hundred twenty bovine roots were divided into 12 groups according to PDT application, the type of final endodontic irrigant, and US. The samples were divided into 12 groups (n = 10): G1-DW(distilled water); G2-DW+US; G3-17% EDTA; G4-17% EDTA+US; G5-17% GA (glycolic acid); G6-17% GA+US; G7-PDT+DW; G8-PDT+DW+US; G9-PDT+17% EDTA; G10-PDT+17% EDTA+US; G11-PDT+17% GA; G12-PDT+17% GA+US. After cementing the glass fiber posts with resin cement, roots were sectioned into 2-mm-thick slices. One slice from the cervical third and another from the middle third were used for the push out test (PO), and the other two for the diametral compression test (DC). Thus, 10 samples were obtained per third for each mechanical test (n = 10). Kruskal-Wallis and Student-Newman-Keuls tests were used to analyze PO and DC data, and Pearson's correlation test was used to verify the relationship between the variables. Failure patterns were analyzed with chi-square test. RESULTS: Significant differences were found in the PO test among the experimental groups (p < 0.001; power=1.00). PDT improved bond strength when using EDTA. PDT and US increased bond strength when using GA. Favorable failure patterns occurred more frequently in Group GA+US. There was no correlation between data obtained with PO and DC tests (r = 0.112; p = 0.729). CONCLUSION: PDT provided the highest bond strength values of GFP to root dentin when associated with GA and US or when associated only with EDTA.

Effect of root-canal sealer on the bond strength of fiberglass post to root dentin.

OBJECTIVE: To evaluate the effects of different root-canal sealers on the bond strength of a fiberglass post cemented with self-adhesive resin cements. MATERIAL AND METHODS: Forty extracted maxillary single-rooted canines were prepared with the crown-down technique and randomly divided into four groups according to the tested sealer: Group 1: control group, gutta-percha cone only (no sealer); Group 2: EndoREZ; Group 3: Sealapex; Group 4: Endofill. The roots were obturated with the gutta-percha cone using the cold lateral compaction technique. Fiberglass posts were cemented into the prepared post spaces with the self-adhesive cement RelyX Unicem. Bonded specimens were sectioned into 1-mm thick slabs and a push-out test was performed in a universal machine. RESULTS: Data were subjected to ANOVA and Tukey tests (α = 0.05). No significant difference was detected between Groups 1-3 (P > 0.05). Group 4 showed a lower bond strength than the other sealers (P < 0.05). CONCLUSIONS: Endofill negatively interfered with the bond to root dentine; however, EndoRez and Sealapex did not affect the bond strength of the fiberglass post cemented with self-adhesive resin cements.

Influence of ultrasonic activation on antimicrobial activity of a new final irrigant containing glycolic acid: An in vitro study.

This study evaluated the influence of ultrasonic activation (US) on the antimicrobial activity of a new final irrigant containing glycolic acid (GA). Extracted teeth were used, being 70 to counting of colony-forming units (CFUs) and 35 to confocal laser scanning microscopy. Samples were inoculated with Enterococcus faecalis and divided into 7 groups: distilled water + US; 17% EDTA; Qmix; 17% GA; 17% EDTA + US; QMix + US; and 17% GA + US and kept in contact with test solution for 1 min in the groups with or no US. In the CFUs, the highest bacterial reduction was observed in QMix + US group, followed by QMix and GA + US. In the confocal evaluation, the lowest number of viable cells was observed in EDTA + US, with no statistical difference from QMix, QMix + US and GA + US (P > 0.05). The use of US improves the antimicrobial activity of EDTA and GA, being statistically different from the isolated use of these final irrigants in both evaluation tests.

Influence of a glycolic acid-based final irrigant for photosensitizer removal of photodynamic therapy on the microhardness and colour change of the dentin structure.

INTRODUCTION: This study aimed to evaluate the influence of glycolic acid-based final irrigant for photosensitizer removal of photodynamic therapy on the microhardness and colour change of the dentin structure. METHODS: Eighty extracted single-rooted human incisors were used. Sample preparation and root split resulted in 160 samples, 80 samples being used for microhardness and 80 samples for colour change evaluation. In the first, PDT protocol was performed and 80 samples were randomly divided into 4 groups (n = 20), according to the final irrigation protocol: distilled water (DW); 17 % ethylenediaminetetraacetic acid (EDTA); QMix; 17 % glycolic acid (GA). Microhardness was evaluated using the Vicker tester, before and after, PDT and final irrigation protocols, calculating the percentage of microhardness reduction. In the second evaluation, PDT and final irrigation protocols were performed in the same way. Colour change was evaluated using digital spectrophotometer before and after these protocols, calculating the ΔE colour change using the CIELAB system (L*a*b* values). Specific statistical analysis was performed for both evaluations (α = 5%). RESULTS: The highest percentage of microhardness reduction was observed in 17 % EDTA, QMix and 17 % GA groups, with no significant difference among them (p > 0.05). Furthermore, none of these protocols was effective in photosensitizer removal, and all final irrigation protocols were statically similar to control group (p > 0.05). CONCLUSIONS: GA promotes microhardness reduction and also contributes to the colourization of dentin structure during the photosensitizer removal process, followingPDT .

Influence of the apical limit of instrumentation and photodynamic therapy on the postoperative pain of lower molars with asymptomatic apical periodontitis.

INTRODUCTION: The aim of present study was to evaluate the influence of apical limit of instrumentation and PDT on the postoperative pain of lower molars with asymptomatic apical periodontitis. METHODS: Forty patients were included in the present study and were divided into 4 groups (n=10), according to apical limit of instrumentation and use of PDT: instrumentation at 0.0 measurement; instrumentation at 0.0 measurement+PDT; instrumentation 1mm beyond 0.0 measurement; instrumentation 1mm beyond 0.0 measurement+PDT. In the PDT, the root canals were filled with 0.01% methylene blue, remaining for 5 min. The low-intensity laser was used with 100 mW, 660-690 nm wavelength), using intra-canal fibre. Root canals were irradiated for 90 s, delivering total dose of 9 J and energy density of 320 J/cm2. After root canal preparation and PDT protocols, root canals were filled with gutta-percha and AH Plus endodontic sealer, being sealed with composite resin.The evaluation of postoperative pain was performed by visual analog scale after 24, 48, 72 hours and 7 days. Data were analysed by specific statistical tests, at level of 5%. RESULTS: No statistical significant difference was observed among experimental groups in all evaluation periods, as well as in the intragroup analysis over time, regarding postoperative pain and analgesic medication consumption (p>0.05). CONCLUSIONS: Apical limit of instrumentation and PDT have no influence on the postoperative pain of lower molars with asymptomatic apical periodontitis.

Antibacterial Efficacy of the Grape Seed Extract as an Irrigant for Root Canal Preparation.

Objective: The purpose of this research was to compare relative effectiveness of sodium hypochlorite 5.25% (NaOCl), 2% chlorhexidine gel (CHX) and 6.5 % grape seed extract (GSE) against Enterococcus faecalis using instrument Reciproc R25 in root canal preparation. Methods: Forty-five mesiobuccal root canals from extracted human maxillary molars were collected and infected with Enterococcus faecalis. The samples were divided into five groups according to the different types of irrigants: saline (positive control) (n=5); in the other groups were used 10 root canals for each group: NaOCl+EDTA; CHX gel+EDTA; GSE solution+EDTA; GSE gel+EDTA. All the groups were prepared with reciprocating instruments Reciproc R25. Bacterial reduction was measured by two-way ANOVA (P<0.001) followed by Tukey HSD post-hoc tests, from the counting of colony forming units (CFUs) from samples collected before instrumentation and after. The significance level established at 5% (P<0.05). Results: The group prepared with the NaOCl resulted in highest antimicrobial capacity among of all (P>0.05), followed by CHX and GSE gel (P<0.05). Control and GSE solution showed similar results (P<0.05) and resulted in the lowest percentage of the reduction of the microorganism into the root canals. Conclusion: NaOCl had the higher elimination capacity of Enterococcus faecalis than GSE and CHX.

Glycolic acid: Characterization of a new final irrigant and effects on flexural strength and structural integrity of dentin.

The aim of this study was to characterize glycolic acid (GA) and examine its effects on powder and flexural strength of dentin. Particle size and energy-dispersive EDS in GA powder was performed for chemical analysis. Surface tension and pH levels of ethylenediaminetetraacetic acid (EDTA), citric acid (CA), and GA solutions were evaluated at different times and temperatures. Dentin powder and mineralized dentin beams were immersed for 1 min in EDTA, CA, or GA solutions and subjected to Fourier transform infrared spectroscopy for apatite/collagen ratio analysis and 3-point flexure test, respectively. GA showed the largest particle size (µm), and its surface tension was similar to that of EDTA and CA. Surface tension decreased in solutions of higher concentrations. GA showed pH stability at all times and temperatures evaluated. The apatite/collagen ratio reduced with increased GA concentrations, while flexural strength was not significantly affected by GA concentration. GA seems a good choice as a final irrigation solution after root canal preparation.

Effect of a new irrigant solution containing glycolic acid on smear layer removal and chemical/mechanical properties of dentin.

The objective of this study was to evaluate the effects of glycolic acid (GA) (with pH 1.2 and 5) and ethylenediaminetetraacetic acid (EDTA) on the chemical and mechanical properties of dentin to investigate the potential use of GA as final irrigant in the root canal therapy. Specifically, changes in microhardness, smear layer removal, erosion, mineral content distribution, apatite/collagen ratio and flexural strength of mineralized dentin treated with GA were assessed. Saline solution was used as a negative control. Knoop microhardness (KHN) was measured on the root canal lumen of root segments. Dentin beams were used for 3-point flexural strength (σ) test. Scanning electron microscopy (SEM) images of root sections were obtained for evaluation of smear layer removal and dentin erosion on root segments and energy dispersive X-ray spectroscopy (EDS) was used for mineral content distribution. The apatite/collagen ratio (A/C) in dentin powder were examined by Fourier transform infrared (FTIR) spectroscopy. KHN, σ and A/C results were statistically analyzed with ANOVA and Tukey tests (α = 0.05). Smear layer and dentin erosion scores were analyzed with Kruskal-Wallis and Dunn tests (α = 0.05). Root dentin treated with EDTA and GA presented similar KHN regardless of the pH (p > 0.05). However, KHN was significantly reduced in EDTA and GA groups when compared to control group (p<0.001). GA showed the same ability to remove the smear layer and to cause dentin erosion as EDTA. EDS results showed that the GA and EDTA solutions did not alter the dentin mineral content distribution. The apatite/collagen ratio reduced with all irrigant solution and was the lowest with GA pH 5 (p<0.001), while σ was not significantly affected by the experimental solutions (p = 0.559). It can be concluded that GA has similar ability to remove the smear layer than EDTA. GA does not affect negatively the chemical/mechanical properties and it does not increase dentin erosion. The use of GA with low pH seems to promote less change in collagen/apatite ratio, but further studies are needed to establish an ideal clinical protocol. Therefore, this study supports the potential use of GA as an alternative final irrigation solution for root canal preparation.