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      Root Canal Irrigants and Dentin Bonding: An Update

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          Abstract

          The purpose of the review was to assess the effect of root canal irrigants on dentin bonding. A PubMed-based search was conducted on the articles published from 1980 to 2016. A brief overview and reviewing the effect on dentin bonding of common root canal irrigation solutions such as sodium hypochlorite (NaOCl), chlorhexidine (CHX), ethylenediaminetetraacetic acid (EDTA), mixture of a tetracycline, acid and a detergent (MTAD) and ozone was conducted. Findings showed that, depending on the type of dentin bonding, using NaOCl may decrease, increase or not affect the bond strength. In addition, due to its broad-spectrum matrix metalloproteinase-inhibitory effect, CHX as well as MTAD can significantly improve the resin-dentin bond stability. However, the effect of ozone therapy on bond strength was controversial.

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          Most cited references 69

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          A critical review of the durability of adhesion to tooth tissue: methods and results.

          The immediate bonding effectiveness of contemporary adhesives is quite favorable, regardless of the approach used. In the long term, the bonding effectiveness of some adhesives drops dramatically, whereas the bond strengths of other adhesives are more stable. This review examines the fundamental processes that cause the adhesion of biomaterials to enamel and dentin to degrade with time. Non-carious class V clinical trials remain the ultimate test method for the assessment of bonding effectiveness, but in addition to being high-cost, they are time- and labor-consuming, and they provide little information on the true cause of clinical failure. Therefore, several laboratory protocols were developed to predict bond durability. This paper critically appraises methodologies that focus on chemical degradation patterns of hydrolysis and elution of interface components, as well as mechanically oriented test set-ups, such as fatigue and fracture toughness measurements. A correlation of in vitro and in vivo data revealed that, currently, the most validated method to assess adhesion durability involves aging of micro-specimens of biomaterials bonded to either enamel or dentin. After about 3 months, all classes of adhesives exhibited mechanical and morphological evidence of degradation that resembles in vivo aging effects. A comparison of contemporary adhesives revealed that the three-step etch-and-rinse adhesives remain the 'gold standard' in terms of durability. Any kind of simplification in the clinical application procedure results in loss of bonding effectiveness. Only the two-step self-etch adhesives approach the gold standard and do have some additional clinical benefits.
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            Sodium hypochlorite in endodontics: an update review.

            The major objective in root canal treatment is to disinfect the entire root canal system. This requires that the pulpal contents be eliminated as sources of infection. This goal may be accomplished using mechanical instrumentation and chemical irrigation, in conjunction with medication of the root canal between treatment sessions. Microorganisms and their by-products are considered to be the major cause of pulpal and periradicular pathosis. In order to reduce or eliminate bacteria and pulpal tissue remnants, various irrigation solutions have been suggested to be used during treatment. Sodium hypochlorite, an excellent non-specific proteolytic and antimicrobial agent, is the most common irrigation solution used during root canal therapy. The purpose of this paper was to review different aspects of sodium hypochlorite use in endodontics.
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              Chlorhexidine arrests subclinical degradation of dentin hybrid layers in vivo.

              The recent paradigm that endogenous collagenolytic and gelatinolytic activities derived from acid-etched dentin result in degradation of hybrid layers requires in vivo validation. This study tested the null hypothesis that there is no difference between the degradation of dentin bonded with an etch-and-rinse adhesive and that in conjunction with chlorhexidine, an MMP inhibitor, applied after phosphoric-acid-etching. Contralateral pairs of bonded Class I restorations in primary molars of clinical subjects were retrieved after a six-month period of intra-oral functioning and processed for transmission electron microscopy. Hybrid layers from the chlorhexidine-treated teeth exhibited normal structural integrity of the collagen network. Conversely, abnormal hybrid layers were seen in the control teeth, with progressive disintegration of the fibrillar network, to the extent that it was beyond detection by collagen staining. Self-destruction of collagen matrices occurs rapidly in resin-infiltrated dentin in vivo and may be arrested with the use of chlorhexidine as an MMP inhibitor.
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                Author and article information

                Journal
                Iran Endod J
                Iran Endod J
                IEJ
                Iranian Endodontic Journal
                Iranian Center for Endodontic Research (Tehran, Iran )
                1735-7497
                2008-2746
                Spring 2017
                : 12
                : 2
                : 131-136
                Affiliations
                [a ] Iranian Center for Endodontic Research, Research Institute of Dental Sciences, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran ;
                [b ] Department of Oral and Maxillofacial Surgery, Hamedan University of Medical Sciences, Hamedan, Iran ;
                [c ] Private Practice, Hamedan, Iran;
                [d ] Department of Neuroscience, Reproductive and Odontostomatological Sciences, Federico II University of Naples, Naples, Italy
                Author notes
                [* ]Corresponding author: Saeed Asgary, Iranian Center for Endodontic Research Shahid Beheshti University of Medical Sciences, Tehran, Iran. Tel: +98-21 22413897, E-mail: saasgary@yahoo.com
                Article
                10.22037/iej.2017.27
                5421266
                14aa2b9f-4715-4954-839a-8abf7c1f0add

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License, ( http://creativecommons.org/licenses/by/3.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                Categories
                Review Article

                Dentistry

                bond strength, chlorhexidine, edta, mtad, ozone, sodium hypochlorite

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