The use of NaOCl after or in combination with a chelator caused the greatest reduction of E. faecalis. Diode laser and Er:YAG laser activation were superior to ultrasonics in dentinal tubule disinfection.
Neelakantan P, Varughese AA, Sharma S, Subbarao CV, Zehnder M, De‐Deus G. Continuous chelation irrigation improves the adhesion of epoxy resin‐based root canal sealer to root dentine. International Endodontic Journal
Abstract
Aim To test the impact of continuous chelation by NaOCl+ etidronic acid (HEBP) during instrumentation, and a final rinse of EDTA or NaOCl + HEBP on the dentine bond strength of an epoxy resin sealer (AH Plus).
Methodology Single‐rooted teeth (n = 100) were divided into five groups (n = 20) based on the irrigation protocol and their root canals instrumented using a rotary Ni‐Ti system: 2.5% NaOCl during instrumentation followed by bi‐distilled water (G1) or 17% EDTA (G2) as final rinse; 1 : 1 mixture of 5% NaOCl and 18% HEBP during instrumentation, and the same mixture (G3), 17% EDTA (G4) or bi‐distilled water (G5) as final rinse. Canals were filled with AH Plus. Roots were sectioned, and push‐out tests were performed in coronal, middle and apical root thirds. Results were analysed using analysis of variance (anova) and Bonferroni test for multiple comparisons. The alpha‐type error was set at 0.05 for all the analyses.
Results Push‐out bond strength was highest in coronal and lowest in apical root thirds (P < 0.05). Groups that used NaOCl + HEBP irrigation during instrumentation had significantly higher bond strengths than groups following the NaOCl‐EDTA irrigation in all root thirds (P < 0.05). The use of a strong chelator as final flush further increased bond strengths (G4, P < 0.05).
Conclusion The continuous chelation irrigation protocol optimizes the bond strength of an epoxy resin sealer to dentine.
Reciprocation movement offers a more predictable and safer approach of root canal preparation, in addition to producing less postoperative pain. The need for patients to take analgesics may reduce following this approach.
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