The influence of the addition of surfactants to sodium hypochlorite on the removal of hard tissue debris

Abstract

AimTo evaluate the effect of the addition of surfactants to sodium hypochlorite (NaOCl) on the removal of accumulated hard tissue debris (AHTD), before and after final irrigation with 17% EDTA, from mesial canals of mandibular molars through microcomputed tomographic (micro‐CT) analysis.MethodologyThirty moderately curved mandibular mesial roots with Vertucci type II canal configuration were selected and scanned in a micro‐CT device at an isotropic resolution of 22.9 μm. The specimens were assigned to three groups (n = 10) with respect to the root length, degree of curvature of the mesial root, volume and 3D anatomy of the root canals according to the irrigating solution used during root canal preparation: 2.5% NaOCl and 0.1% Benzalkonium Chloride, 2.5% NaOCl and 0.1% Tween 80 and 2.5% NaOCl without additives. The root canals were instrumented up to Reciproc R25 instrument. Then, the specimens were scanned again after canal preparation and after final irrigation with 17% EDTA, and the registered data sets were examined to evaluate the percentage of AHTD. For comparison between the different groups before and after using 17% EDTA, the Kruskal–Wallis test was used with a significance level of 5%. For comparison between the same groups before and after using 17% EDTA, the Wilcoxon test was used with a significance level of 5%.ResultsNone of the irrigant solutions tested was able to completely eliminate hard tissue debris from mesial canals of mandibular molars. There were no significant differences in the percentage of AHTD amongst the different irrigation solutions (P > 0.05). Final irrigation with 17% EDTA significantly reduced the percentage of AHTD (P < 0.05), without differences amongst the groups (P > 0.05).ConclusionsThe addition of surfactants to NaOCl did not affect the removal of AHTD from mesial canals of extracted mandibular molars. Final irrigation with 17% EDTA significantly improved AHTD removal.

Effect of passive ultrasonic irrigation on hard tissue debris removal: a systematic review and meta-analysis

“…Regarding chelating agents, previous studies showed an additional effect of EDTA in removing AHTD. 17,36 In this systematic review, the irrigation with a chelating agent (EDTA) was found to be performed in two 29,31 of the three selected studies.…”

Micro-CT Evaluation of Different Root Canal Irrigation Protocols on the Removal of Accumulated Hard Tissue Debris: A Systematic Review and Meta-Analysis

“…Its success depends on broader principles, for which sufficient mechanical preparation, thorough disinfection and obturation with no voids are important [ 1 , 2 ]. Accumulated hard tissue debris (AHTD) is produced during the mechanical preparation process and pile up in the root canal system, which usually compromise the success of endodontic treatment [ 3 , 4 ]. Research has shown that root canal irrigation helps to remove AHTD; however, no irrigation protocol has been found to completely remove AHTD due to the anatomical complexity of the root canal system, especially in isthmus and apical regions [ 5 , 6 ].…”

Confocal Laser Scanner Evaluation of Bactericidal Effect of Chitosan Nanodroplets Loaded with Benzalkonium Chloride

“…Sodium hypochlorite (NaOCl) is the most used irrigant during root canal preparation due to its high capacity for tissue dissolution and a well-known antimicrobial activity [ 12 ]. Surfactants are associated with NaOCl to improve its properties, such as dissolution of organic tissues, antimicrobial activity and penetration into the root canal system [ 13 ].…”