Residues of different gel formulations on dentinal walls: A SEM/EDS analysis

The aim of this study was to evaluate the presence of residues of sodium hypochlorite gel, chlorhexidine gel, and EDTA gel on dentinal walls after canal preparation through chemical SEM‐ elemental chemical microanalysis (EDS) analysis. Forty‐eight single‐rooted teeth were selected. They had their crowns sectioned and were instrumented with a reciprocating system. The canals were irrigated with 5 mL of saline solution during root canal preparation. After instrumentation, the root canals were irrigated with 3 mL 17% EDTA followed by 1 min of ultrasonic passive activation (3× 20 sec) to remove the smear layer, and then irrigated with 3 mL of saline solution. The specimens were randomized into three groups (n = 12) according to the chemical substance that filled the root canal for 30 min: GI: 5.5% sodium hypochlorite gel; GII: 2% chlorhexidine gel; GIII: 24% EDTA gel; Negative control group: no substance was used. Then, the root canals were irrigated with 6 mL of saline solution followed by 1 min of ultrasonic passive activation (3× 20 sec). After ultrasonic activation, the canals were irrigated with 2 mL saline. The roots were sectioned, and the percentage of each chemical element present in the samples was analyzed through chemical SEM‐EDS microanalysis. All experimental groups showed a significantly higher percentage of chemical elements (Na and/or Cl) than the control group (P < 0.03). This in vitro study has shown that, regardless of chemical solutions used even after the final irrigation protocol, chemical residues of different substances remained attached to the root canal walls. Microsc. Res. Tech. 78:495–499, 2015. © 2015 Wiley Periodicals, Inc.     

Evaluation of different irrigation protocols concerning the formation of chemical smear layer

The aim of this work was to evaluate, by means of scanning electron microscopy (SEM) and electron dispersive spectroscopy (EDS), the different irrigation protocols concerning the formation of chemical smear layer (CSL). Fifty‐five teeth were instrumented by using distilled water (DW) as irrigant. Next, the teeth were submitted to a protocol for removal of the mechanical smear layer produced. The teeth were divided into 11 groups, according to irrigation regimen. Then, the teeth were prepared and analyzed with SEM and EDS. Only in Group 1 [1 mL sodium hypochlorite (NaOCl) + 10 mL DW + 1 mL chlorhexidine (CHX) solution], Group 2 [1 mL NaOCl + 10 mL DW + 1 mL ethylenediaminetetraacetic acid (EDTA) + 10 mL DW + 1 mL CHX solution], and Group 3 [1 mL NaOCl + 10 mL DW + 1 mL citric acid (CA) + 10 mL DW + 1 mL CHX solution], the formation of CSL was observed. In the groups where CHX gel was used alone or in association with EDTA, CA, phosphoric acid (PA), and CHX solution, no formation of CSL was observed. According to the results found in the cases in which one wants to associate NaOCl with CHX, the protocol using PA (1 mL NaOCl + 10 mL DW + 1 mL PA + 10 mL DW + 1 mL CHX solution) did not induce formation of CSL. Microsc. Res. Tech., 2013. © 2012 Wiley Periodicals, Inc.     

Disinfection and surface changes of gutta‐percha cones after immersion in sodium hypochlorite solution containing surfactant

In this study, we evaluated the effectiveness of 1 and 5.25% NaOCl solutions, with or without surfactant, in disinfecting gutta‐percha cones. Surface changes of the gutta‐percha cones after disinfection were also assessed under scanning electron microscopy (SEM). One‐hundred and eight gutta‐percha cones previously contaminated with Enterococcus faecalis were left in contact for 30 s or 1 min with the following solutions (n = 12): 1% NaOCl; 1% NaOCl + 2% cetrimide; 5.25% NaOCl; 5.25% NaOCl + 2% cetrimide. Positive control group was composed by the remaining contaminated cones (n = 12), and the negative control group by noncontaminated cones (n = 12). The cones were kept in Eppendorf tubes containing Trypticase Soy Broth at 37°C for 24 hr, and then, the presence of turbidity was analyzed. Ten additional cones (n = 2) were observed under SEM to evaluate surface changes after 1 min of disinfection. The data analysis (Kruskal–Wallis test, α = 5%) demonstrated that regardless the presence of surfactant, the NaOCl solutions used were effective in the disinfection when cones were immersed for 1 min. However, at the 30‐s period, only the 5.25% NaOCl solution was effective. SEM analysis demonstrated that NaOCl solutions promoted the formation of sodium chloride crystals on cones surface, less visible when the 1% NaOCl associated to surfactant was used. The addition of surfactant did not affect the disinfection capacity of NaOCl solutions. However, the surfactant has apparently inhibited the sodium chloride crystals deposition on the cones surface when associated to 1% NaOCl solution.     

Evaluation of the interaction between sodium hypochlorite and several formulations containing chlorhexidine and its effect on the radicular dentin—SEM and push‐out bond strength analysis

The aim of the current study was to evaluate the presence of debris and smear layer after endodontic irrigation with different formulations of 2% chlorhexidine gluconate (CHX) and its effects on the push‐out bond strength of an epoxy‐based sealer on the radicular dentin. One hundred extracted human canines were prepared to F5 instrument and irrigated with 2.5% sodium hypochlorite and 17% ethylenediaminetetraacetic acid. Fifty teeth were divided into five groups (n = 10), according to the final irrigation protocol with different 2% CHX formulations: G1 (control, no final rinse irrigation), G2 (CHX solution), G3 (CHX gel), G4 (Concepsis), and G5 (CHX Plus). In sequence, the specimens were submitted to scanning electron microscopy (SEM) analysis, in the cervical‐medium and medium‐apical segments, to evaluate the presence of debris and smear layer. The other 50 teeth were treated equally to a SEM study, but with the root canals filled with an epoxy‐based endodontic sealer and submitted to a push‐out bond strength test, in the cervical, middle, and apical thirds. G2, G3, G4, and G5 provided higher precipitation of the debris and smear layer than G1 (P < 0.05), but these groups were similar to each other (P > 0.05), in both segments. The values obtained in the push out test did not differ between groups, independent of the radicular third (P > 0.05). The CHXs formulations caused precipitation of the debris and smear layer on the radicular dentin, but these residues did not interfere in the push‐out bond strength of the epoxy‐based sealer. Microsc. Res. Tech. 77:17–22, 2014. © 2013 Wiley Periodicals, Inc.     

Effect of EDTA,sodium, and calcium hypochlorite on the inorganic component of root canal dentin: A SEM analysis

This study evaluated the influence of canal irrigation protocols with 5.25% calcium hypochlorite [Ca(OCl)₂], 5.25% sodium hypochlorite (NaOCl) and 17% EDTA solution on the inorganic component of root canal dentin. Sixty roots were randomly divided into six groups (n = 10): Saline solution (SS) (control); Saline solution (SSE) +17% EDTA; CH ? 5.25% Ca(OCl)₂; CHE ? 5.25% Ca(OCl)₂ + 17% EDTA; SH ? 5.25% NaOCl; SHE ? 5.25% NaOCl +17% EDTA. After canal irrigation, the specimens were longitudinally split and analyzed by scanning electron microscopy (SEM). Dentinal tubules were observed in transverse (middle and apical thirds) direction. The images were classified in scores, according to smear layer removal and peritubular dentin alteration, and data were analyzed by Kruskal–Wallis's test, followed by Dunn's test (α = 0.05). In the middle third, all groups with EDTA presented better removal of the smear layer with higher peritubular dentin alteration (p < .05). In the apical third, this happened only in SHE (p < .05). Ca(OCl)₂ and NaOCl exhibit similar performance to remove smear layer and alteration of the inorganic component in the middle third. In the apical third, NaOCl associated with EDTA showed better performance in smear layer removal.     

Evaluation of smear layer removal and marginal adaptation of root canal sealer after final irrigation using ethylenediaminetetraacetic,peracetic, and etidronic acids with different concentrations

The purpose of this study was to investigate the effects of different irrigation solutions on the smear layer removal and marginal adaptation of a resin‐based sealer to root canal dentine. A total of 152 instrumented roots were irrigated with the following irrigants: 9,18% etidronic acid (HEBP), 0.5, 1,2% peracetic acid (PAA), 17% ethylenediaminetetraacetic acid (EDTA), saline. The amount of smear layer was evaluated using scanning electron microscope (SEM) in seventy root samples. Eighty‐two roots were filled with AH Plus and gutta‐percha. Slices obtained from apical third of each specimen were viewed with SEM to assess marginal adaptation. Use of 9% and 18% HEBP resulted in more efficient smear layer removal in the apical third than the other chelators (p < 0.05). Higher smear layer scores in the coronal and middle thirds were obtained from 0.5%, 1% PAA groups. Regarding marginal adaptation, 18% HEBP group showed the lowest gap size values (p < 0.05), and better marginal adaptation. Etidronic acid is a promising candidate for final irrigation of root canals.     

Qualitative analysis of files of four different rotary systems,before and after being used for the twelfth time

The aim of this study was to make a comparative evaluation of the surface topography of the cervical third and tip of four different rotary systems, before and after being used 12 times, in resin blocks with simulated root canals with standardized 45° curvatures, and analyzed by scanning electronic microscopy (SEM). A total of 1,440 resin blocks with simulated root canals and standardized curvatures were used. The blocks were divided into four groups and prepared by the crown down technique according to the manufacturers' recommendations: Group 1 (G1)—K3®, Group 2 (G2)—Protaper Universal®, Group 3 (G3)—Twisted Files®, and Group 4 (G4)—Biorace®. After each preparation, the instruments were washed and autoclaved. A total of 24 instruments were selected, being three new instruments and three after having been used for the 12th time, from each group. These instruments were analyzed by SEM. To perform the evaluation, 24 micrographs were observed by 12 evaluators who attributed a score to the images according to a template. In the qualitative analysis of the cervical region and tip of new instruments, it was observe that the files of Groups G4 and G2 were the least rough and those of G1, the roughest. In the same manner, the cervical region of the instruments was qualitatively analyzed after the 12th time of using them, and there was no statistically significant difference at a level of 1% (ANOVA P < 0.01) between G2 and G4 as well as between G1 and G3. As regards the tip, it was observed that there was no statistically significant difference, at a level of 1%, between the groups: G1 and G3, G1 and G4, and between G3 and G4, and there was statistically significant difference at a level of 1%, between group G2 and the other groups, with G3 having the greatest roughness (ANOVA P < 0.01). Microsc. Res. Tech., 2013. © 2012 Wiley Periodicals, Inc.     

Surface change of root canal dentin after the use of irrigation activation protocols: Electron microscopy and an energy‐dispersive X‐ray microanalysis

This study evaluated the mineral contents of root‐canal dentin after treatment with different irrigation activation protocols. One hundred and eight maxillary lateral incisor teeth were randomly divided into eight experimental groups and one control group. Root canals were prepared using ProTaper rotary files, with the exception of the Self‐Adjusting File (SAF) group. Canals were irrigated with 2 mL of 5% sodium hypochlorite (NaOCl) at each instrument change, and received a final flush with 10 mL of 17% ethylenediaminetetraacetic acid (EDTA) and 10 mL of 5% NaOCl for 1 min. The control group was irrigated with distilled water. Group I (GI): Needle syringe irrigation; Group II (GII): NaviTip FX; Group III (GIII): CanalBrush; Group IV (GIV): Manual dynamic activation with gutta‐percha; Group V (GV): Passive ultrasonic irrigation; Group VI (GVI): EndoActivator; Group VII (GVII): EndoVac; Group VIII (GVIII): SAF. The level of elemental composition was analyzed by a scanning electron microscopy and an energy‐dispersive spectrometer (EDS) system. The results were then statistically analyzed by one‐way ANOVA and Tukey tests. Ca/P ratio was changed after treatment with SAF and EndoActivator. The Ca, P, Mg, and S level changes were not statistically significant (P > 0.05). Final irrigation activation protocols did not alter the mineral level of root dentin surface. Microsc. Res. Tech. 76:893–896, 2013. © 2013 Wiley Periodicals, Inc.