This study aimed to evaluate the color stability and solubility of Biodentine and NeoPutty in contact with different irrigation solutions.

Biodentine and NeoPutty were set in cylindrical molds with 7 mm diameter and 1.5 mm high and immersed in distilled water, 17% ethylenediaminetetraacetic acid (EDTA), 2% chlorhexidine (CHX), 9% 1-hydroxyethylidene 1,1-diphosphonate (HEDP), and 5% sodium hypochlorite (NaOCl) solutions for 24 hours. The color change was measured with a spectrophotometer. The solubility values were calculated as the mass loss was expressed as a percentage of the original mass using an analytical balance with 10⁻⁴ g accuracy. Data were analyzed with Kruskal-Wallis followed by Mann-Whitney U tests, and 2-way analysis of variance test followed by Bonferroni corrections for pairwise comparisons for solubility and color stability with a 5% significance threshold, respectively.

Biodentine exhibited higher color changes compared to the NeoPutty contact with all solutions except distilled water (p < 0.05). Both hydraulic cements (HCs) showed higher discoloration values immersion in CHX followed by NaOCl. No statistically significant difference was found between Biodentine and NeoPutty regardless of irrigation solution in terms of solubility (p > 0.05). Solubility values were lower in the distilled water group compared to EDTA and CHX (p < 0.05).

Tested HCs showed solubility and color changes at various rates. NeoPutty could be an appropriate material in aesthetic areas. The usage of HEDP as an irrigant solution can be considered suitable for various endodontic treatments due to its relatively lower solubility and discoloration values.

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.

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%.

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).

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.

This study investigated the effects of various concentrations of sodium hypochlorite (NaOCl) on human whole-blood clotting kinetics, the structure of the blood clots formed, and transforming growth factor (TGF)-β1 release.

Human whole blood was collected from 5 healthy volunteers and divided into 4 groups: CG (control, 0.5 mL of blood), BN_0.5 (0.5 mL of blood with 0.5 mL of 0.5% NaOCl), BN₃ (0.5 mL of blood with 0.5 mL of 3% NaOCl), and BN_5.25 (0.5 mL of blood with 0.5 mL of 5.25% NaOCl). The effects of NaOCl on clotting kinetics, structure of fibrin and cells, and release of TGF-β1 were assessed using thromboelastography (TEG), scanning electron microscopy (SEM), and enzyme-linked immunosobent assay, respectively. Statistical analysis was conducted using the Kruskal Wallis and Mann-Whitney U tests, followed by the post hoc Dunn test. A p value < 0.05 indicated statistical significance.

The blood samples in BN_0.5 and BN₃ did not clot, whereas the TEG of BN_5.25 showed altered clot formation. Samples from the CG and BN₃ groups could only be processed with SEM, which showed that the latter lacked fibrin formation and branching of fibers, as well as clumping of red blood cells with surface roughening and distortion. TGF-β1 release was significantly highest in BN₃ when all groups were compared to CG (p < 0.05).

Each concentration of NaOCl affected the release of TGF-β1 from blood clots and altered the clotting mechanism of blood by affecting clotting kinetics and cell structure.

This study aimed to investigate the anti-erosive/abrasive effect of resin infiltration of previous deproteinized dentin.

Dentin slabs were randomly assigned to 3 groups (n = 15): Control (no deproteinization; no resin infiltrant applied), RI (no deproteinization; resin infiltrant applied), and DRI (deproteinization; resin infiltrant applied). After undergoing the assigned treatment, all slabs were subjected to an in vitro cycling model for 5 days. The specimens were immersed in citric acid (0.05 M, pH = 3.75; 60 seconds; 3 times/day) and brushed (150 strokes). Between the challenges, the specimens were exposed to a remineralizing solution (60 minutes). The morphological alterations were analyzed by mechanical profilometry (µm) and scanning electron microscopy (SEM). Data were submitted to one-way analysis of variance (ANOVA) and Tukey tests (p < 0.05).

Control and RI groups presented mineral wear and did not significantly differ from each other (p = 0.063). DRI maintained a protective layer preserving the dentin (p < 0.001). After erosive/abrasive cycles, it was observed that in group RI, only 25% of the slabs partially evidenced the presence of the infiltrating, while, in the DRI group, 80% of the slabs presented the treated surface entirely covered by a resin-component layer protecting the dentin surface as observed in SEM images.

The removal of the organic content allows the resin infiltrant to efficiently protect the dentin surface against erosive/abrasive lesions.

The aim of this study was to assess the physicochemical properties, cytotoxicity and penetration into dentinal tubules of ChlorCid™ Surf (3% sodium hypochlorite [NaOCl] with surfactant) in comparison to ChlorCid™ (3% NaOCl without surfactant).

The physicochemical properties evaluated were pH, surface tension, free available chlorine (FAC) and contact angle. Cytotoxicity was evaluated in L929 fibroblasts exposed to the solutions by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide and neutral red assays. Assessment of penetration into dentinal tubules was performed by staining single-rooted permanent human teeth with crystal violet (n = 9), which were irrigated with the solutions and analyzed in cervical, middle and apical segments. Data were analyzed by one-way analysis of variance (ANOVA) and Tukey's post-test, 2-way ANOVA and Bonferroni's post-test or t-test (α = 0.05).

ChlorCid™ Surf and ChlorCid™ FAC values were close to those indicated by the manufacturer. ChlorCid™ Surf showed lower surface tension and contact angle on dentin, and higher pH than ChlorCid™ (p < 0.05). The penetration of ChlorCid™ Surf was higher in cervical and middle segments, compared with ChlorCid™ (p < 0.05). There was no difference in irrigant cytotoxicity (p > 0.05).

ChlorCid™ Surf showed lower surface tension, lower contact angle on root canal dentin, higher penetration into dentinal tubules and more alkaline pH, compared with ChlorCid™. However, both solutions showed similar cytotoxicity and FAC content.

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.

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.

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.

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

Irrigants are imperative in endodontic therapy for the elimination of pathogens from the infected root canal. The present study compared the antimicrobial efficacy of octenidine dihydrochloride (OCT) with chlorhexidine (CHX) and sodium hypochlorite (NaOCl) against Staphylococcus epidermidis (S. epidermidis) for root canal disinfection.

The minimum inhibitory concentration (MIC) was obtained using serial dilution method. The agar diffusion method was then used to determine the zones of inhibition for each irrigant. Lastly, forty 6-mm dentin blocks were prepared from human mandibular premolars and inoculated with S. epidermidis. Samples were randomly divided into 4 groups of 10 blocks and irrigated for 3 minutes with saline (control), 2% CHX, 3% NaOCl, or 0.1% OCT. Dentin samples were then collected immediately for microbial analysis, including an analysis of colony-forming units (CFUs).

The MICs of each tested irrigant were 0.05% for CHX, 0.25% for NaOCl, and 0.0125% for OCT. All tested irrigants showed concentration-dependent increase in zones of inhibition, and 3% NaOCl showed the largest zone of inhibition amongst all tested irrigants (p < 0.05). There were no significant differences among the CFU measurements of 2% CHX, 3% NaOCl, and 0.1% OCT showing complete elimination of S. epidermidis in all samples.

This study showed that OCT was comparable to or even more effective than CHX and NaOCl, demonstrating antimicrobial activity at low concentrations against S. epidermidis.

The aim of this systematic review was to critically analyze previously published studies of the effects of dentin surface pretreatment with deproteinizing agents on the bonding of self-etch (SE) adhesives to dentin. Additionally, a meta-analysis was conducted to quantify the effects of the above-mentioned surface pretreatment methods on the bonding of SE adhesives to dentin.

An electronic search was performed using the following databases: Scopus, PubMed and ScienceDirect. The online search was performed using the following keywords: ‘dentin’ or ‘hypochlorous acid’ or ‘sodium hypochlorite’ and ‘self-etch adhesive.’ The following categories were excluded during the assessment process: non-English articles, randomized clinical trials, case reports, animal studies, and review articles. The reviewed studies were subjected to meta-analysis to quantify the effect of the application time and concentration of sodium hypochlorite (NaOCl) and hypochlorous acid (HOCl) deproteinizing agents on bonding to dentin.

Only 9 laboratory studies fit the inclusion criteria of this systematic review. The results of the meta-analysis revealed that the pooled average microtensile bond strength values to dentin pre-treated with deproteinizing agents (15.71 MPa) was significantly lower than those of the non-treated control group (20.94 MPa).

In light of the currently available scientific evidence, dentin surface pretreatment with deproteinizing agents does not enhance the bonding of SE adhesives to dentin. The HOCl deproteinizing agent exhibited minimal adverse effects on bonding to dentin in comparison with NaOCl solutions.

To determine the effect of root canal irrigants on the hydrophobicity and adherence of Staphylococcus epidermidis (S. epidermidis) to root canal dentin in vitro.

Root dentin blocks (n = 60) were randomly divided into 4 groups based on the irrigation regimen: group 1, saline; group 2, 5.25% sodium hypochlorite (NaOCl); group 3, 5.25% NaOCl followed by 17% ethylenediaminetetraacetic acid (EDTA); group 4, same as group 3 followed by 2% chlorhexidine (CHX). The hydrophobicity of S. epidermidis to root dentin was calculated by cell surface hydrophobicity while the adherence was observed by fluorescence microscopy, and bacteria were quantified using ImageJ software (National Institutes of Health). Statistical analysis of the data was done using Kruskal-Wallis test and Mann-Whitney U test (p = 0.05).

The hydrophobicity and adherence of S. epidermidis to dentin were significantly increased after irrigating with group 3 (NaOCl-EDTA) (p < 0.05), whereas in group 4 (NaOCl-EDTA-CHX) both hydrophobicity and adherence were significantly reduced (p < 0.05).

The adherence of S. epidermidis to dentin was influenced differently by root canal irrigants. Final irrigation with CHX reduces the bacterial adherence and may impact biofilm formation.

The purpose of this study was to compare the antibacterial activity of urushiol against Enterococcus faecalis (E. faecalis) to that of NaOCl.

The canals of thirty two single rooted human teeth were instrumented with Ni-Ti files (ProTaper Next X1, X2, X3, Dentsply). A pure culture of E. faecalis ATCC 19433 was prepared in sterile brain heart infusion (BHI) broth. The teeth were submerged in the suspension of E. faecalis and were incubated at 37℃ for 7 days to allow biofilm formation. The teeth were randomly divided into three experimental groups according to the irrigant used, and a negative control group where no irrigant was used (n = 8). Group 1 used physiologic normal saline, group 2 used 6% NaOCl, and group 3 used 10 wt% urushiol solution. After canal irrigation, each sample was collected by the sequential placement of 2 sterile paper points (ProTaper NEXT paper points, size X3, Dentsply). Ten-fold serial dilutions on each vials, and 100 µL were cultured on a BHI agar plate for 8 hours, and colony forming unit (CFU) analysis was done. The data were statistically analyzed using Kruskal-Wallis and Mann-whitney U tests.

Saline group exhibited no difference in the CFU counts with control group, while NaOCl and urushiol groups showed significantly less CFU counts than saline and control groups (p < 0.05).

The result of this study suggests 10% urushiol and 6% NaOCl solution had powerful antibacterial activity against E. faecalis when they were used as root canal irrigants.

Sodium hypochlorite (NaOCl) is an excellent bactericidal agent, but it is detrimental to stem cell survival, whereas intracanal medicaments such as calcium hydroxide (Ca[OH]₂) promote the survival and proliferation of stem cells. This study evaluated the effect of sequential NaOCl and Ca[OH]₂ application on the attachment and differentiation of dental pulp stem cells (DPSCs).

DPSCs were obtained from human third molars. All dentin specimens were treated with 5.25% NaOCl for 30 min. DPSCs were seeded on the dentin specimens and processed with additional 1 mg/mL Ca[OH]₂, 17% ethylenediaminetetraacetic acid (EDTA) treatment, file instrumentation, or a combination of these methods. After 7 day of culture, we examined DPSC morphology using scanning electron microscopy and determined the cell survival rate with 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. We measured cell adhesion gene expression levels after 4 day of culture and odontogenic differentiation gene expression levels after 4 wk using quantitative real-time polymerase chain reaction.

DPSCs did not attach to the dentin in the NaOCl-treated group. The gene expression levels of fibronectin-1 and secreted phosphoprotein-1 gene in both the Ca[OH]₂- and the EDTA-treated groups were significantly higher than those in the other groups. All Ca[OH]₂-treated groups showed higher expression levels of dentin matrix protein-1 than that of the control. The dentin sialophosphoprotein level was significantly higher in the groups treated with both Ca[OH]₂ and EDTA.

The application of Ca[OH]₂ and additional treatment such as EDTA or instrumentation promoted the attachment and differentiation of DPSCs after NaOCl treatment.

This study evaluated the maximum depth and percentage of irrigant penetration into dentinal tubules by passive ultrasonic irrigation (PUI).

Thirty extracted human teeth were instrumented and divided into three groups. According to final irrigation regimen, 5.25% sodium hypochlorite (Group A, NaOCl), 2% chlorhexidine (Group B, CHX) and saline solution (Group C, control group) were applied with Irrisafe 20 tips (Acteon) and PUI. Irrigant was mixed with 0.1% rhodamine B. Sections at 2 mm, 5 mm, and 8 mm from the apex were examined with confocal laser scanning microscopy (CLSM). The percentage and maximum depth of irrigant penetration were measured. Kruskal-Wallis test and Mann-Whitney test were performed for overall comparison between groups at each level and for pairwise comparison, respectively. Within a group, Wilcoxon test was performed among different levels. p values less than 0.05 were considered significant.

In all groups, highest penetration depth and percentage of penetration were observed at the 8 mm level. At 2 mm level, Groups A and B had significantly greater depths and percentages in penetration than Group C (p < 0.05), but there were no significant differences between Groups A and B. At 5 mm level, penetration depths and percentage of penetration was not significantly different among the groups.

NaOCl and CHX applied by PUI showed similar depth and percentage of penetration at all evaluated levels.

The usage of medicinal plants as natural antimicrobial agents has grown in many fields including dental medicine. The aim of this in vitro study was three-fold: (i) to determine the chemical compositions of the Ferula gummosa essential oil (FGEO), (ii) to compare the antimicrobial efficacy of the oil with sodium hypochlorite (NaOCl) and chlorhexidine (CHX), (iii) to assess the toxic behavior of FGEO in different concentrations compared to 5% NaOCl and 0.2% CHX.

Gas chromatography/mass spectrometry (GC/MS) was used to determine the chemical compositions of the oil. The disk diffusion method and a broth micro-dilution susceptibility assay were exploited to assess the antimicrobial efficacy against Enterococcus faecalis, Staphylococcus aureus, Streptococcus mitis, and Candida albicans. The cytocompatibility of the FGEO was assessed on L929 fibroblasts, and compared to that of NaOCl and CHX.

Twenty-seven constituents were recognized in FGEO. The major component of the oil was β-pinene (51.83%). All three irrigants significantly inhibited the growth of all examined microorganisms compared to the negative control group. FGEO at 50 µg/mL was effective in lower concentration against Enterococcus faecalis than 5% NaOCl and 0.2% CHX, and was also more potent than 0.2% CHX against Candida albicans and Staphylococcus aureus. FGEO was a cytocompatible solution, and had significantly lower toxicity compared to 5% NaOCl and 0.2% CHX.

FGEO showed a promising biological potency as a root canal disinfectant. More investigations are required on the effectiveness of this oil on intracanal bacterial biofilms.

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.

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.

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).

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.