The effectiveness of continuous versus sequential chelation in the removal of smear layer and their influence on push-out bond strength of Bio-C sealer (An in vitro study)

Ayat Adham; Ahmed Ali

doi:10.7126/cumudj.1231568

Research Article

The effectiveness of continuous versus sequential chelation in the removal of smear layer and their influence on push-out bond strength of Bio-C sealer (An in vitro study)

Year 2023, Volume: 26 Issue: 2, 112 - 120, 23.06.2023

Ayat Adham , Ahmed Ali

https://doi.org/10.7126/cumudj.1231568

Cited By: 2

Abstract

Objectives: Successful endodontic treatment outcome requires effective shaping and cleaning of root canals. This study aims to evaluate the smear layer removal after continuous chelation (CC) ) NaOCL\HEDP( and sequential chelation (SC) )NaOCL\EDTA( and their influence on the push-out bond strength (POBS) of Bio-C sealer.
Materials and Methods: Palatal roots of the maxillary first molar (n=72) were divided into four groups (n=18) as follows: 3% NaOCL, SC: 3% NaOCL followed by 17% EDTA, CC: 3% NaOCL \9% HEDP and Distilled water. Thirty-two roots (n=8/group) were split longitudinally for smear layer evaluation using SEM. Forty roots were obturated with Guttapercha and Bio-C sealer using a single cone technique. Three sections were taken horizontally from the coronal, middle, and apical third (1.5±0.1 mm thickness) for the push-out test using a universal testing machine. The Kruskal-Wallis and Mann-Whitney tests were used to analyze the SEM data, while the One-way analysis of variance (ANOVA) test and the Tukey test were used to analyze POBS data. Z test to compare failure mode.
Results: There was no difference between SC and CC in the smear layer removal at all thirds (p>0.05). The POBS in CC was significantly higher than SC in all thirds (p<0.05). Failure mode distribution was 53.3% mixed, followed by 26.6% adhesive and 20% cohesive.
Conclusions: NaOCL\HEDP was as effective as NaOCL\EDTA in removing the smear layer. Neither of the two protocols could eliminate the smear layer completely. The bonding strength of Bio-C sealer was optimized by using NaOCL\HEDP combination.

Keywords

Bio-C sealer, Dual rinseHEDP, EDTA, Push-out, Smear layer

Supporting Institution

university of Baghdad

Project Number

511522

Thanks

none

References

1. Mounes B, Alhashimi R. The push out bond strength of bioceramic sealer (Total Fill) after warm and cold obturation techniques an in vitro comparative study. J Baghdad Coll Dent 2022; 34 :7-16.
2. Kandaswamy, D., & Venkateshbabu, N. Root canal irrigants. J Conserv Dent 2010 ;13: 256–264.
3. Polineni, S., Bolla, N., Mandava, P., Vemuri, S., Mallela, M. & Gandham, V. M. Marginal adaptation of newer root canal sealers to dentin: a SEM study. J Conserv Dent 2016; 19:360-363.
4. Al-Khafaji HA, Al-Huwaizi HF. Cleaning efficiency of root canals using different rotary instrumentation systems: a comparative in vitro study. Int J Med Res Health Sci 2019;8:89-93.
5. Abu Al-Timan, J. A., Al-Huwaizi, H. F. & Abed, H. H.. The Effectiveness of Chelating Property of Chitosan Nanoparticles on Dentin. Ind J Public Health Res Dev 2019; 10: 1088-1093.
6. Alamoudi, R. The smear layer in endodontic: To keep or remove ; an updated overview. Saudi Endod J 2019; 9:71-81.
7. Lottanti S, Gautschi H, Sener B, Zehnder M. Effects of ethylenediaminetetraacetic, etidronic, and peracetic acid irrigation on human root dentine and the smear layer. Int Endod J 2009 ;42:335-343.
8. Grawehr M, Sener B, Waltimo T, Zehnder M. Interactions of ethylenediamine tetraacetic acid with sodium hypochlorite in aqueous solutions. Int Endod J 2003 ;36:411-415.
9. Yasuda G, Inage H, Kawamoto R, Shimamura Y, Takubo C, Tamura Y. Changes in elastic modulus of adhesive and adhesive-infiltrated dentin during storage in water. J Oral Sci. 2008 ;50:481-486.
10. Zehnder M, Schmidlin P, Sener B, Waltimo T. Chelation in root canal therapy reconsidered. J Endod 2005;31:817-20.
11. Tartari T, Guimarães BM, Amoras LS, Duarte MA, Silva e Souza PA, Bramante CM. Etidronate causes minimal changes in the ability of sodium hypochlorite to dissolve organic matter. Int Endod J 2015;48:399-404.
12. Zollinger A, Mohn D, Zeltner M, Zehnder M. Short-term storage stability of NaOCl solutions when combined with Dual Rinse HEDP.Int Endod J 2018 ;51:691-696.
13. Al-Qazwini AA, Al-Hashimi RA. In Vitro Comparative Assessment Of The Effect Of Gutta-Fusion Obturation On The Push Out Bond Strenght Of Three Types Of Sealers. J Baghdad Coll Dent 2017 ;29:13-19.
14. Naeem AM, Al-Zaka IM. The influence of different root canal irrigants on the push-out bond strength of AH plus and Bioceramic sealers. J Baghdad Coll Dent 2021 ;33:21-29.
15. Zordan-Bronzel CL, Esteves Torres FF, Tanomaru-Filho M, Chávez-Andrade GM, Bosso-Martelo R, Guerreiro-Tanomaru JM. Evaluation of Physicochemical Properties of a New Calcium Silicate-based Sealer, Bio-C Sealer. J Endod 2019; 45:1248-1252.
16. Nagendrababu V, Murray PE, Ordinola-Zapata R, Peters OA, Rôças IN, Siqueira JF, et al. PRILE 2021 guidelines for reporting laboratory studies in Endodontology: A consensus-based development. Int Endod J 2021;54:1482-1490.
17. Kfir A, Goldenberg C, Metzger Z, Hülsmann M, Baxter S. Cleanliness and erosion of root canal walls after irrigation with a new HEDP-based solution vs. traditional sodium hypochlorite followed by EDTA. A scanning electron microscope study. Clin Oral Investig 2020;24:3699-3706.
18. Neelakantan P, Nandagopal M, Shemesh H, Wesselink P. The effect of root dentin conditioning protocols on the push-out bond strength of three calcium silicate sealers. Int J Adhes Adhes 2015 ;60:104-108.
19. Hülsmann M, Heckendorff M, Schäfers F. Comparative in-vitro evaluation of three chelator pastes. Int Endod J 2002;35:668-679.
20. Donnermeyer D, Vahdat-Pajouh N, Schäfer E, Dammaschke T. Influence of the final irrigation solution on the push-out bond strength of calcium silicate-based, epoxy resin-based and silicone-based endodontic sealers. Odontology 2019;107:231 -236.
21. Ulusoy, Ö. İ., Zeyrek, S. & Çelik, B. Evaluation of smear layer removal and marginal adaptation of root canal sealer after final irrigation using ethylenediaminetetraacetic, peracetic, and etidronic acids with different concentrations. Microsc Res Tech 2017; 80 :687-692.
22. Deari S, Mohn D, Zehnder M. Dentine decalcification and smear layer removal by different ethylenediaminetetraacetic acid and 1‐hydroxyethane‐1, 1‐diphosphonic acid species. Int Endod J 2019 ;52:237-243.
23. Hussein, E. R., Shukri, b. M. S. & Ibrahim, R. H.. The effect of chitosan nanoparticle, citric acid, and ethylenediaminetetraacetic acid on dentin smear layer using two different irrigation needles: A scanning electron microscope study. J Conserv Dent 2022 ;25:431-435.
24. Yadav, H. K., Tikku, A., Chandra, A., Yadav, R. K. & Patel, D. K. Efficacy of etidronic acid, BioPure MTAD and SmearClear in removing calcium ions from the root canal: An in vitro study. Eur J Dent 2015; 9:523-528.
25. Tartari, T., Bachmann, L., Zancan, R., Vivan, R. R., Duarte, M. A. H. & Bramante, C. M. Analysis of the effects of several decalcifying agents alone and in combination with sodium hypochlorite on the chemical composition of dentine. Int Endod J 2018; 51:e42-e54.
26. Ribeiro RG, Marchesan MA, Silva RG, Sousa-Neto MD, Pécora JD. Dentin permeability of the apical third in different groups of teeth. Braz Dent J 2010;21:216-219.
27. Mandke, L. & Padhye, L. Apical vapour lock effect in endodontics–a review. Int J Contemp Med Res 2018; 5:14-17.
28. Upadhyay, S.T., T.P. Purayil, and N.V. Ballal, Evaluation of push-out bond strength of GuttaFlow 2 to root canal dentin treated with different smear layer removal agents. Saudi Endod J 2018 ; 8128-8132.
29. Paulson L, Ballal NV, Bhagat A. Effect of root dentin conditioning on the pushout bond strength of biodentine. J Endod 2018 ;44:1186-1190.
30. Neelakantan P, Varughese A, Sharma S, Subbarao C, Zehnder M, De‐Deus G. Continuous chelation irrigation improves the adhesion of epoxy resin‐based root canal sealer to root dentine. Inter Endod J 2012 ;45:1097-1102.
31. Gawdat SI, Bedier MM. Influence of dual rinse irrigation on dentinal penetration of a bioceramic root canal sealer: Confocal microscopic Analysis. Aust Endod J. 2021;47.
32. Lee YL, Lin FH, Wang WH, Ritchie HH, Lan WH, Lin CP. Effects of EDTA on the hydration mechanism of mineral trioxide aggregate. J Dent Res 2007 ;86:534-538.
33. Atmeh A, Chong E, Richard G, Festy F, Watson T. Dentin-cement interfacial interaction: calcium silicates and polyalkenoates. J Dent Res 2012 ;91:454-459.
34. Anju PK, Purayil TP, Ginjupalli K, Ballal NV. Effect of chelating agents on push-out bond strength of NeoMTA Plus to root canal dentin. Pesqui Bras em Odontopediatria e Clín Integr. 2022; 22.
35. Gündoğar, M., Sezgin, G. P., Erkan, E. & Özyılmaz Ö, Y. The influence of the irrigant QMix on the push-out bond strength of a bioceramic endodontic sealer. Eur Oral Res 2018;52: 64-68.
36. Camilleri, J. Color Stability of White Mineral Trioxide Aggregate in Contact with Hypochlorite Solution. J Endod 2014 ; 40:436-440.
37. Falakaloğlu S, Gündoğar M. Evaluation of the push out of bond strength of different bioceramic root canal sealers with different obturation techniques.G Ital Endod. 2022 ;36:151-157.
38. Caceres, C., Larrain, M. R., Monsalve, M. & Pena-Bengoa, F. Dentinal tubule penetration and adaptation of bio-C sealer and AH-plus: A comparative SEM evaluation. Eur Endod J 2021; 6:216-220.

Year 2023, Volume: 26 Issue: 2, 112 - 120, 23.06.2023

Ayat Adham , Ahmed Ali

https://doi.org/10.7126/cumudj.1231568

Cited By: 2

Abstract

Project Number

511522

References

1. Mounes B, Alhashimi R. The push out bond strength of bioceramic sealer (Total Fill) after warm and cold obturation techniques an in vitro comparative study. J Baghdad Coll Dent 2022; 34 :7-16.
2. Kandaswamy, D., & Venkateshbabu, N. Root canal irrigants. J Conserv Dent 2010 ;13: 256–264.
3. Polineni, S., Bolla, N., Mandava, P., Vemuri, S., Mallela, M. & Gandham, V. M. Marginal adaptation of newer root canal sealers to dentin: a SEM study. J Conserv Dent 2016; 19:360-363.
4. Al-Khafaji HA, Al-Huwaizi HF. Cleaning efficiency of root canals using different rotary instrumentation systems: a comparative in vitro study. Int J Med Res Health Sci 2019;8:89-93.
5. Abu Al-Timan, J. A., Al-Huwaizi, H. F. & Abed, H. H.. The Effectiveness of Chelating Property of Chitosan Nanoparticles on Dentin. Ind J Public Health Res Dev 2019; 10: 1088-1093.
6. Alamoudi, R. The smear layer in endodontic: To keep or remove ; an updated overview. Saudi Endod J 2019; 9:71-81.
7. Lottanti S, Gautschi H, Sener B, Zehnder M. Effects of ethylenediaminetetraacetic, etidronic, and peracetic acid irrigation on human root dentine and the smear layer. Int Endod J 2009 ;42:335-343.
8. Grawehr M, Sener B, Waltimo T, Zehnder M. Interactions of ethylenediamine tetraacetic acid with sodium hypochlorite in aqueous solutions. Int Endod J 2003 ;36:411-415.
9. Yasuda G, Inage H, Kawamoto R, Shimamura Y, Takubo C, Tamura Y. Changes in elastic modulus of adhesive and adhesive-infiltrated dentin during storage in water. J Oral Sci. 2008 ;50:481-486.
10. Zehnder M, Schmidlin P, Sener B, Waltimo T. Chelation in root canal therapy reconsidered. J Endod 2005;31:817-20.
11. Tartari T, Guimarães BM, Amoras LS, Duarte MA, Silva e Souza PA, Bramante CM. Etidronate causes minimal changes in the ability of sodium hypochlorite to dissolve organic matter. Int Endod J 2015;48:399-404.
12. Zollinger A, Mohn D, Zeltner M, Zehnder M. Short-term storage stability of NaOCl solutions when combined with Dual Rinse HEDP.Int Endod J 2018 ;51:691-696.
13. Al-Qazwini AA, Al-Hashimi RA. In Vitro Comparative Assessment Of The Effect Of Gutta-Fusion Obturation On The Push Out Bond Strenght Of Three Types Of Sealers. J Baghdad Coll Dent 2017 ;29:13-19.
14. Naeem AM, Al-Zaka IM. The influence of different root canal irrigants on the push-out bond strength of AH plus and Bioceramic sealers. J Baghdad Coll Dent 2021 ;33:21-29.
15. Zordan-Bronzel CL, Esteves Torres FF, Tanomaru-Filho M, Chávez-Andrade GM, Bosso-Martelo R, Guerreiro-Tanomaru JM. Evaluation of Physicochemical Properties of a New Calcium Silicate-based Sealer, Bio-C Sealer. J Endod 2019; 45:1248-1252.
16. Nagendrababu V, Murray PE, Ordinola-Zapata R, Peters OA, Rôças IN, Siqueira JF, et al. PRILE 2021 guidelines for reporting laboratory studies in Endodontology: A consensus-based development. Int Endod J 2021;54:1482-1490.
17. Kfir A, Goldenberg C, Metzger Z, Hülsmann M, Baxter S. Cleanliness and erosion of root canal walls after irrigation with a new HEDP-based solution vs. traditional sodium hypochlorite followed by EDTA. A scanning electron microscope study. Clin Oral Investig 2020;24:3699-3706.
18. Neelakantan P, Nandagopal M, Shemesh H, Wesselink P. The effect of root dentin conditioning protocols on the push-out bond strength of three calcium silicate sealers. Int J Adhes Adhes 2015 ;60:104-108.
19. Hülsmann M, Heckendorff M, Schäfers F. Comparative in-vitro evaluation of three chelator pastes. Int Endod J 2002;35:668-679.
20. Donnermeyer D, Vahdat-Pajouh N, Schäfer E, Dammaschke T. Influence of the final irrigation solution on the push-out bond strength of calcium silicate-based, epoxy resin-based and silicone-based endodontic sealers. Odontology 2019;107:231 -236.
21. Ulusoy, Ö. İ., Zeyrek, S. & Çelik, B. Evaluation of smear layer removal and marginal adaptation of root canal sealer after final irrigation using ethylenediaminetetraacetic, peracetic, and etidronic acids with different concentrations. Microsc Res Tech 2017; 80 :687-692.
22. Deari S, Mohn D, Zehnder M. Dentine decalcification and smear layer removal by different ethylenediaminetetraacetic acid and 1‐hydroxyethane‐1, 1‐diphosphonic acid species. Int Endod J 2019 ;52:237-243.
23. Hussein, E. R., Shukri, b. M. S. & Ibrahim, R. H.. The effect of chitosan nanoparticle, citric acid, and ethylenediaminetetraacetic acid on dentin smear layer using two different irrigation needles: A scanning electron microscope study. J Conserv Dent 2022 ;25:431-435.
24. Yadav, H. K., Tikku, A., Chandra, A., Yadav, R. K. & Patel, D. K. Efficacy of etidronic acid, BioPure MTAD and SmearClear in removing calcium ions from the root canal: An in vitro study. Eur J Dent 2015; 9:523-528.
25. Tartari, T., Bachmann, L., Zancan, R., Vivan, R. R., Duarte, M. A. H. & Bramante, C. M. Analysis of the effects of several decalcifying agents alone and in combination with sodium hypochlorite on the chemical composition of dentine. Int Endod J 2018; 51:e42-e54.
26. Ribeiro RG, Marchesan MA, Silva RG, Sousa-Neto MD, Pécora JD. Dentin permeability of the apical third in different groups of teeth. Braz Dent J 2010;21:216-219.
27. Mandke, L. & Padhye, L. Apical vapour lock effect in endodontics–a review. Int J Contemp Med Res 2018; 5:14-17.
28. Upadhyay, S.T., T.P. Purayil, and N.V. Ballal, Evaluation of push-out bond strength of GuttaFlow 2 to root canal dentin treated with different smear layer removal agents. Saudi Endod J 2018 ; 8128-8132.
29. Paulson L, Ballal NV, Bhagat A. Effect of root dentin conditioning on the pushout bond strength of biodentine. J Endod 2018 ;44:1186-1190.
30. Neelakantan P, Varughese A, Sharma S, Subbarao C, Zehnder M, De‐Deus G. Continuous chelation irrigation improves the adhesion of epoxy resin‐based root canal sealer to root dentine. Inter Endod J 2012 ;45:1097-1102.
31. Gawdat SI, Bedier MM. Influence of dual rinse irrigation on dentinal penetration of a bioceramic root canal sealer: Confocal microscopic Analysis. Aust Endod J. 2021;47.
32. Lee YL, Lin FH, Wang WH, Ritchie HH, Lan WH, Lin CP. Effects of EDTA on the hydration mechanism of mineral trioxide aggregate. J Dent Res 2007 ;86:534-538.
33. Atmeh A, Chong E, Richard G, Festy F, Watson T. Dentin-cement interfacial interaction: calcium silicates and polyalkenoates. J Dent Res 2012 ;91:454-459.
34. Anju PK, Purayil TP, Ginjupalli K, Ballal NV. Effect of chelating agents on push-out bond strength of NeoMTA Plus to root canal dentin. Pesqui Bras em Odontopediatria e Clín Integr. 2022; 22.
35. Gündoğar, M., Sezgin, G. P., Erkan, E. & Özyılmaz Ö, Y. The influence of the irrigant QMix on the push-out bond strength of a bioceramic endodontic sealer. Eur Oral Res 2018;52: 64-68.
36. Camilleri, J. Color Stability of White Mineral Trioxide Aggregate in Contact with Hypochlorite Solution. J Endod 2014 ; 40:436-440.
37. Falakaloğlu S, Gündoğar M. Evaluation of the push out of bond strength of different bioceramic root canal sealers with different obturation techniques.G Ital Endod. 2022 ;36:151-157.
38. Caceres, C., Larrain, M. R., Monsalve, M. & Pena-Bengoa, F. Dentinal tubule penetration and adaptation of bio-C sealer and AH-plus: A comparative SEM evaluation. Eur Endod J 2021; 6:216-220.

There are 38 citations in total.

Details

Primary Language	English
Subjects	Health Care Administration
Journal Section	Original Research Articles
Authors	Ayat Adham 0000-0003-4100-4692 Ahmed Ali 0000-0002-1083-9913
Project Number	511522
Publication Date	June 23, 2023
Submission Date	January 9, 2023
Published in Issue	Year 2023Volume: 26 Issue: 2

Cite

EndNote	Adham A, Ali A (June 1, 2023) The effectiveness of continuous versus sequential chelation in the removal of smear layer and their influence on push-out bond strength of Bio-C sealer (An in vitro study). Cumhuriyet Dental Journal 26 2 112–120.

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