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Research Articles
Effect of phytic acid as an endodontic chelator on resin adhesion to sodium hypochlorite-treated dentin
Mohannad Nassar, Noriko Hiraishi, Md. Sofiqul Islam, Maria JRH. Romero, Masayuki Otsuki, Junji Tagami
Restor Dent Endod 2020;45(4):e44.   Published online August 24, 2020
DOI: https://doi.org/10.5395/rde.2020.45.e44
AbstractAbstract PDFPubReaderePub
Objectives

Phytic acid (IP6), a naturally occurring agent, has been previously reported as a potential alternative to ethylenediaminetetraacetic acid (EDTA). However, its effect on adhesion to sodium hypochlorite (NaOCl)-treated dentin and its interactions with NaOCl have not been previously reported. Thus, in this study, the effects of IP6 on resin adhesion to NaOCl-treated dentin and the failure mode were investigated and the interactions between the used agents were analyzed.

Materials and Methods

Micro-tensile bond strength (µTBS) testing was performed until failure on dentin treated with either distilled water (control), 5% NaOCl, or 5% NaOCl followed with chelators: 17% EDTA for 1 minute or 1% IP6 for 30 seconds or 1 minute. The failed specimens were assessed under a scanning electron microscope. The reaction of NaOCl with EDTA or IP6 was analyzed in terms of temperature, pH, effervescence, and chlorine odor, and the effects of the resulting mixtures on the color of a stained paper were recorded.

Results

The µTBS values of the control and NaOCl with chelator groups were not significantly different, but were all significantly higher than that of the group treated with NaOCl only. In the failure analysis, a distinctive feature was the presence of resin tags in samples conditioned with IP6 after treatment with NaOCl. The reaction of 1% IP6 with 5% NaOCl was less aggressive than the reaction of the latter with 17% EDTA.

Conclusions

IP6 reversed the adverse effects of NaOCl on resin-dentin adhesion without the chlorine-depleting effect of EDTA.

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Effect of acidic solutions on the microhardness of dentin and set OrthoMTA and their cytotoxicity on murine macrophage
Soram Oh, Hiran Perinpanayagam, Yoon Lee, Jae-Won Kum, Yeon-Jee Yoo, Sang-Min Lim, Seok Woo Chang, Won-Jun Shon, Woocheol Lee, Seung-Ho Baek, Kee-Yeon Kum
Restor Dent Endod 2016;41(1):12-21.   Published online December 1, 2015
DOI: https://doi.org/10.5395/rde.2016.41.1.12
AbstractAbstract PDFPubReaderePub
Objectives

To evaluate the effects of three acids on the microhardness of set mineral trioxide aggregate (MTA) and root dentin, and cytotoxicity on murine macrophage.

Materials and Methods

OrthoMTA (BioMTA) was mixed and packed into the human root dentin blocks of 1.5 mm diameter and 5 mm height. Four groups, each of ten roots, were exposed to 10% citric acid (CA), 5% glycolic acid (GA), 17% ethylenediaminetetraacetic acid (EDTA), and saline for five minutes after setting of the OrthoMTA. Vickers surface microhardness of set MTA and dentin was measured before and after exposure to solutions, and compared between groups using one-way ANOVA with Tukey test. The microhardness value of each group was analyzed using student t test. Acid-treated OrthoMTA and dentin was examined by scanning electron microscope (SEM). Cell viability of tested solutions was assessed using WST-8 assay and murine macrophage.

Results

Three test solutions reduced microhardness of dentin. 17% EDTA demonstrated severe dentinal erosion, significantly reduced the dentinal microhardness compared to 10% CA (p = 0.034) or 5% GA (p = 0.006). 10% CA or 5% GA significantly reduced the surface microhardness of set MTA compared to 17% EDTA and saline (p < 0.001). Acid-treated OrthoMTA demonstrated microporous structure with destruction of globular crystal. EDTA exhibited significantly more cellular toxicity than the other acidic solutions at diluted concentrations (0.2, 0.5, 1.0%).

Conclusions

Tested acidic solutions reduced microhardness of root dentin. Five minute's application of 10% CA and 5% GA significantly reduced the microhardness of set OrthoMTA with lower cellular cytotoxicity compared to 17% EDTA.

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Effect of intracanal medicaments used in endodontic regeneration procedures on microhardness and chemical structure of dentin
Ghaeth Hamdon Yassen, George Joseph Eckert, Jeffrey Allen Platt
Restor Dent Endod 2015;40(2):104-112.   Published online December 24, 2014
DOI: https://doi.org/10.5395/rde.2015.40.2.104
AbstractAbstract PDFPubReaderePub
Objectives

This study was performed to investigate the effects of different intracanal medicaments on chemical structure and microhardness of dentin.

Materials and Methods

Fifty human dentin discs were obtained from intact third molars and randomly assigned into two control groups and three treatment groups. The first control group received no treatment. The second control group (no medicament group) was irrigated with sodium hypochlorite (NaOCl), stored in humid environment for four weeks and then irrigated with ethylenediaminetetraacetic acid (EDTA). The three treatment groups were irrigated with NaOCl, treated for four weeks with either 1 g/mL triple antibiotic paste (TAP), 1 mg/mL methylcellulose-based triple antibiotic paste (DTAP), or calcium hydroxide [Ca(OH)2] and finally irrigated with EDTA. After treatment, one half of each dentin disc was subjected to Vickers microhardness (n = 10 per group) and the other half was used to evaluate the chemical structure (phosphate/amide I ratio) of treated dentin utilizing attenuated total reflection Fourier transform infrared spectroscopy (n = 5 per group). One-way ANOVA followed by Fisher's least significant difference were used for statistical analyses.

Results

Dentin discs treated with different intracanal medicaments and those treated with NaOCl + EDTA showed significant reduction in microhardness (p < 0.0001) and phosphate/amide I ratio (p < 0.05) compared to no treatment control dentin. Furthermore, dentin discs treated with TAP had significantly lower microhardness (p < 0.0001) and phosphate/amide I ratio (p < 0.0001) compared to all other groups.

Conclusions

The use of DTAP or Ca(OH)2 medicaments during endodontic regeneration may cause significantly less microhardness reduction and superficial demineralization of dentin compared to the use of TAP.

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Calcium hydroxide dressing residues after different removal techniques affect the accuracy of Root-ZX apex locator
Emel Uzunoglu, Ayhan Eymirli, Mehmet Özgür Uyanik, Semra Çalt, Emre Nagas
Restor Dent Endod 2015;40(1):44-49.   Published online November 5, 2014
DOI: https://doi.org/10.5395/rde.2015.40.1.44
AbstractAbstract PDFPubReaderePub
Objectives

This study compared the ability of several techniques to remove calcium hydroxide (CH) from the root canal and determined the influence of CH residues on the accuracy of the electronic apex locator.

Materials and Methods

Root canals of 90 human maxillary lateral incisors with confirmed true working length (TWL) were prepared and filled with CH. The teeth were randomly assigned to one of the experimental groups according to the CH removal technique (n = 14): 0.9% saline; 0.9% saline + master apical file (MAF); 17% ethylenediamine tetraacetic acid (EDTA); 17% EDTA + MAF; 5.25% sodium hypochlorite (NaOCl); 5.25% NaOCl + MAF. Six teeth were used as negative control. After CH removal, the electronic working length was measured using Root-ZX (Morita Corp.) and compared with TWL to evaluate Root-ZX accuracy. All specimens were sectioned longitudinally, and the area of remaining CH (CH) and total canal area were measured using imaging software.

Results

The EDTA + MAF and NaOCl + MAF groups showed better CH removal than other groups (p < 0.05). Root-ZX reliability to prevent overestimated working length to be > 85% within a tolerance of ± 1.0 mm (p < 0.05). There was strong negative correlation between amount of CH residues and EAL accuracy (r = -0.800 for ± 0.5 mm; r = -0.940 for ± 1.0 mm).

Conclusions

The mechanical instrumentation improves the CH removal of irrigation solutions although none of the techniques removed the dressing completely. Residues of CH medication in root canals affected the accuracy of Root-ZX adversely.

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Original Articles
Effect of soft chelating irrigation on the sealing ability of GP/AH Plus root fillings
Yi-Suk Yu, Tae-Gun Kim, Kwang-Won Lee, Mi-Kyung Yu
J Korean Acad Conserv Dent 2009;34(6):484-490.   Published online November 30, 2009
DOI: https://doi.org/10.5395/JKACD.2009.34.6.484
AbstractAbstract PDFPubReaderePub

The purpose of this study was to evaluate the effect of soft chelating irrigant on the sealing ability of root fillings by using a glucose leakage test.

A total of 45 single-rooted teeth were selected for the study. The teeth were decoronated leaving a total length of 13mm. The root canals prepared using K3 NiTi rotary instruments to an apical dimension of size 45(0.06 taper). The specimens were then randomly divided into 3 experimental groups of 13 roots each and 2 control groups of 3 roots each. Specimen in each group were prepared with different irrigation protocols : group 1, 2.5% NaOCl; group 2, 2.5% NaOCl and 17% EDTA; group 3, 2.5% NaOCl and 15% HEBP. The root canals were filled with gutta-percha and AH Plus sealer using lateral condensation. After 7 days in 37℃, 100% humidity, the coronal-to-apical microleakage was evaluated quantitatively using a glucose leakage model. The leaked glucose concentration was measured with spectrophotometry at 1, 4, 7, 14, 21 and 28 days.

There was a tendency of increase in leakage in all experimental groups during experimental period. HEBP-treated dentin showed no significant difference with EDTA-treated dentin during experimental period. From the 21th day onward, HEBP-treated dentin showed significantly lower leakage than smear-covered dentin. HEBP-treated dentin displayed a similar sealing pattern to EDTA-treated dentin and a better sealing ability than smear-covered dentin. Consequently, a soft chelator(HEBP) could be considered as the possible alternative to EDTA.

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Time-dependent effects of EDTA application on removal of smear layer in the root canal system
Ja-Kyong Lee, Sang-Hyuk Park, Gi-Woon Choi
J Korean Acad Conserv Dent 2006;31(3):169-178.   Published online May 31, 2006
DOI: https://doi.org/10.5395/JKACD.2006.31.3.169
AbstractAbstract PDFPubReaderePub

This study was to verify that the combined application of NaOCl and EDTA was more effective in removal of smear layer than the application of NaOCl alone. Furthermore it was aimed to find out the optimal time for the application of EDTA.

Thirty five single rooted teeth were cleaned and shaped. NaOCl solution was used as an irrigant during instrumentation. After instrumentation, root canals of the control group were irrigated with 5 ml of NaOCl for 2 minutes. 30 sec, 1 min, and 2 min group were irrigated with 5 ml of 17% EDTA for 30 sec, 1 min, and 2 min respectively. Then the roots were examined with scanning electron microscopy for evaluating removal of smear layer and erosion of dentinal tubule.

The results were as follows;

The control group:

The smear layer was not removed at all.

The other groups:

1) Middle⅓: All groups showed almost no smear layer. And the erosion occurred more frequently as increasing irrigation time.

2) Apical⅓: The cleaning effect of 2 min group was better than the others.

The results suggest that 2 min application of 17% EDTA should be adequate to remove smear layer on both apical⅓ and middle⅓.

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THE EFFECT OF SMEAR LAYER TREATMENT ON THE MICROLEAKAGE
Jung-Min Lee, Sang-Hyuk Park, Gi-Woon Choi
J Korean Acad Conserv Dent 2006;31(5):378-389.   Published online January 14, 2006
DOI: https://doi.org/10.5395/JKACD.2006.31.5.378
AbstractAbstract PDFPubReaderePub
Abstract

The purpose of this study was to compare the sealing ability of root canal obturation with or without the treatment of smear layer. Eighty extracted human teeth with one canal were selected. Instrumentation was performed with crown-down technique. After instrumentation, root canals of the NaOCl group and NaOCl-6 group were irrigated with 3% NaOCl. EDTA group and EDTA-6 group were irrigated with 17% EDTA. Then all teeth were obturated using continuous wave obturation technique.

NaOCl group and EDTA group were immersed in methylene blue solution for 84hours. NaOCl-6 group and EDTA-6 group were immersed in methylene blue solution for 6months. The teeth were sectioned at 1.5 mm (Level 1), 3.0 mm (Level 2) and 4.5 mm (Level 3) from the root apex. The length of dye-penetrated interface and the circumferential length of canal at each level were measured using Sigma-Scan Pro 5.0.

The mean leakage ratio was decreased cervically.

NaOCl group showed higher mean leakage ratio than EDTA group at each level. But there was significant difference at level 1 only (p < 0.05).

NaOCl-6 group showed higher mean leakage ratio than EDTA-6 group at each level. But there was significant difference at level 1 only (p < 0.05).

NaOCl-6 group showed higher mean leakage ratio than NaOCl group at each level. But there was significant difference at level 1 only (p < 0.05).

EDTA-6 group showed higher mean leakage ratio than EDTA group at each level. But there was no significant difference.

In NaOCl group and NaOCl-6 group, scanning electron micrographs of tooth sections generally covered with smear layer. In EDTA group and EDTA-6 group, tooth sections showing the penetration of sealers to opened dentinal tubules. The results suggest that removal of smear layer was effective to reduce the apical microleakage of the root canal.

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The effects of EDTA and pulsed Nd:YAG laser on apical leakage of canal obturation
Jin-Soo Kwon, Hee-Joo Lee, Bock Hur
J Korean Acad Conserv Dent 2003;28(1):50-56.   Published online January 31, 2003
DOI: https://doi.org/10.5395/JKACD.2003.28.1.050
AbstractAbstract PDFPubReaderePub

The purpose of this study was to evaluate the effects of EDTA and pulsed Nd:YAG laser on apical leakage of canal obturation. Forty-eight single-rooted teeth were used in this study. The teeth were instrumented up to a size 40 K-file and irrigated with 2.5% NaOCl between each file size. And the teeth were divided into 4 groups. In group A, the root canals were irrigated with a final flush of 5ml 2.5% NaOCl as a control group. The teeth in group B were irrigated with a final flush of 5ml 17% EDTA. The teeth in group C and D were irradiated by pulsed Nd:YAG laser(laser parameters were set at 1W, 100mJ, 10Hz, and 2W, 100mJ, 20Hz respectively).

The results were as follows:

1. Apical leakage was observed in 50% of samples in group A, 30% of samples in group B, 20% of samples in group C, and 10% of samples in group D.

2. The teeth in group B had less leakage than group A, but there was no statistically significant differences(p>0.05).

3. The teeth in group C, D had less leakage than group A, and there was statistically significant differences(p<0.05).

4. The teeth in group C, D had less leakage than group B, but there was no statistically significant differences(p>0.05).

5. There was no significant differences in apical leakage between group C and group D(p>0.05).

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