Effect of intracanal and extracanal heating on pulp dissolution property of continuous chelation irrigant

Abstract

Context: Extracanal and intracanal heating of sodium hypochlorite (NaOCl) improve its pulp dissolution, but limited literature is available on its effect as a combined single irrigant with etidronate. Aim: The aim of this study is to compare the effect of temperature on the effectiveness of NaOCl and continuous chelation protocol on the time required for the dissolution of vital and necrotic pulp. Materials and Methods: Dissolution time of 120 standardized bovine (buffalo) pulp fragments, divided into 12 subgroups based on tissue type (vital/necrotic), irrigant (NaOCl/continuous chelation), and temperature (extracanal, intracanal, and nonheated irrigant), was noted. Conical glass tips mimicking the root canal were considered specimen containers. About 0.2 ml of irrigant corresponding to the irrigation protocol was taken in them and then pulp samples were added to it. Samples were observed using loupes under 2.5 X magnification. Dissolution time was recorded using a stopwatch. The study was approved by the Institutional Ethical Committee (SDC/2019/591). Statistical Analysis Used: Two-way analysis of variance; statistical product and service solutions version 25. The level of significance was set at P < 0.05. Results: Time for pulp dissolution by continuous chelation mixture was significantly more as compared to NaOCl alone in all subgroups. Pulp tissue dissolution for both vital and necrotic pulp was improved by the increase in temperature of both irrigants and dissolution time was more for necrotic than vital tissue. Pulp tissue dissolution was significantly better by intracanal heating as compared to extracanal heating. Conclusion: Although intracanal heating of continuous chelation mixture improves its pulp dissolution capacity significantly as compared to extracanal heating and nonheating protocol but pulpal dissolution capacity of nonheated 5% NaOCl still remains significantly better as compared to intracanal and extracanal heated continuous chelation mixture.

RETRACTED: Traditional and Recent Root Canal Irrigation Methods and Their Effectiveness: A Review

“…EDTA was introduced in endodontics by Nygaard-Ostby in 1957. Today, 17% of EDTA solutions are associated with a detergent for greater flow [54,55].…”

Effect of prewarming and continuous warming on tissue dissolving ability of Triton™ versus Twin Kleen™: An in vitro study

“…in their study reported that pulp dissolution by continuous chelation was lower than hypochlorite even after warming. [ 16 ] Zollinger et al . stated that heating of NaOCl and HEDP is not beneficial as HEDP decomposes to acetic acid and phosphonic acid, which is neutralized by NaOCl.…”

“…The authors stated that NaOCl when mixed with HEDP retained its TDA at RT but lost its effect on heating to higher temperatures. [ 10 16 17 ]…”

Narrative Review on Methods of Activating Irrigation Liquids for Root Canal Treatment

“…There are two ways to increase the temperature of irrigating solution: extracanal (heating of the solution before injection to the root canal) and intracanal (heating directly inside the root canal with heat carriers). According to research, intracanal heating of NaOCl is more efficacious than extracanal heating [50]. The former technique caused much better cleansing of the walls of the root canal from debris in comparison to the latter [51].…”

“…One must bear in mind, that patients subjected to irrigation with EDDY complained about post-treatment pain more frequently than a group of patients treated with MDA. It might be related to the much more frequent pushing of irrigants through the apical foramen caused by using EDDY [50].…”