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      Effects of Different Irrigation Solutions on Root Fracture Resistance: An in Vitro Study

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          Abstract

          Introduction:

          The aim of this in vitro study was to evaluate the effects of sodium hypochlorite (NaOCl), ethylenediaminetetraacetic acid (EDTA), chlorhexidine (CHX) and hydroxyethylidene bisphosphonate (HEBP), also known as etidronate, on susceptibility to root fracture resistance (RFR) in human teeth subjected to endodontic preparation.

          Methods and Materials:

          Seventy extracted single-rooted human teeth were selected, endodontically prepared using the ProTaper Next rotary system (PTN, Dentsply, Maillefer, Ballaigues, Switzerland) and then randomly divided according to the following irrigation regimes ( n=10): G1, saline solution (0.9% NaCl); G2, 2.5% NaOCl + 17% EDTA; G3, 2% CHX gel + 17% EDTA; and G4, a mixture of 5% NaOCl + 18% HEBP. After this step, all samples received a final irrigation with distilled water. The samples were subjected to axial forces by mechanical compression testing in a universal testing machine (Dynamometers KRATOS, LTDA, SP, Brazil). Data analyses included the Shapiro-Wilk normality test, analysis of variance (one-way ANOVA) and a subsequent multiple comparison test (Tukey’s test).

          Results:

          The results indicated that G1 (0.9% NaCl) presented greater resistance to root fracture. No significant differences were observed in G2 (2.5% NaOCl + 17% EDTA) and G3 (2% CHX gel + 17% EDTA). A significant difference was identified in G4 (mixture of 5% NaOCl + 18% HEBP) ( P<0.05).

          Conclusion:

          A mixture of 5% NaOCl + 18% HEBP resulted in a lower fracture resistance when used to irrigate canals during endodontic instrumentation.

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          Most cited references29

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          A scanning electron microscopic evaluation of four root canal irrigation regimens.

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            Effect of sodium hypochlorite on mechanical properties of dentine and tooth surface strain.

            The aim of this study was to test the null hypothesis that sodium hypochlorite irrigation of root canals does not alter the properties of dentine and contribute to the weakening of root-treated teeth. The effect of two concentrations (0.5%, 5.25%) of sodium hypochlorite (NaOCl) and saline on (i) the elastic modulus and flexural strength of machined dentine bars, and (ii) changes in strain of 'whole' extracted human teeth were evaluated. One hundred standardized plano-parallel dentine bars (> 11.7 x 0.8 x 0.8 mm) were randomly divided into the three groups, immersed for 2 h in the respective solutions and then subjected to a three-point bend test. Changes in strain of each of 10 teeth on cyclical nondestructive occlusal loading were measured using electrical resistance strain gauges bonded to the cervical aspects. Each tooth had its crown and enamel reduced and root canal prepared. These were irrigated sequentially in a series of four separate, 30-minute regimes; initial-saline, 0.5% NaOCl, 5.25% NaOCl and final-saline. The changes in strains after each irrigation regime were compared. There was a significant decrease in elastic modulus of the dentine bars immersed in 5.25% NaOCl compared with the saline group (P < 0.01). There was also a significant decrease in flexural strength of the dentine bars in the 5.25% NaOCl group compared to both the saline and 0.5% NaOCl groups (P < 0.01). The strain data from the nondestructive tooth loading tests revealed significant increases in tensile strain between the initial-saline and the final-saline stages (P < 0.01). Significant increases in compressive strains were also found between initial-saline and 5.25% NaOCl; and between 0.5% NaOCl and 5.25% NaOCl stages (P < 0.01). The null hypothesis was rejected, 5.25% NaOCl reduced the elastic modulus and flexural strength of dentine. Irrigation of root canals of single, mature rooted premolars with 5.25% NaOCl affected their properties sufficiently to alter their strain characteristics when no enamel was present.
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              The effects of canal preparation and filling on the incidence of dentinal defects.

              To evaluate ex vivo the incidence of defects in root dentine before and after root canal preparation and filling. Eighty extracted mandibular premolars were divided equally in four groups. Group 1 was left unprepared. All other root canals were prepared using Gates Glidden drills and System GT files up to size-40, 0.06 taper at the working length. Group 2 was not filled while the canals of the other groups were filled with gutta-percha and AH26, either with a master cone and passive insertion of secondary gutta percha points (group 3) or lateral compaction (group 4). Roots were then sectioned horizontally 3, 6, and 9 mm from the apex and observed under a microscope. The presence of dentinal defects (fractures, craze lines or incomplete cracks) was noted and the differences between the groups were analysed with the Fisher's exact test. No defects were observed in the roots with unprepared canals. The overall difference between the groups was significant (P < 0.05). Canal preparation alone created significantly more defects than unprepared canals (P < 0.05). The total number of defects after lateral compaction was significantly larger than after noncompaction canal filling. Root canal preparation and filling of extracted teeth created dentine defects such as fractures, craze lines and incomplete cracks.
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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
                Summer 2018
                : 13
                : 3
                : 367-372
                Affiliations
                [a ] Department of Endodontics, Federal University of Pará, School of Dentistry, Belém, PA, Brazil ;
                [b ] Department of Operative Dentistry, Federal University of Pará, School of Dentistry, Belém, PA, Brazil
                Author notes
                [* ]Corresponding author: Patrícia de Almeida Rodrigues, Federal University of Pará, School of Dentistry. Street Augusto Corrêa n 1, Guamá, 66050-380, Belém, Pará, Brazil. Tel: +55-91 981347899, E-mail: patsilesouza@uol.com.br
                Article
                10.22037/iej.v13i3.19247
                6064013
                30083208
                ca10d9ed-9857-4437-a2b7-318ca8d4fa7e

                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.

                History
                : 28 February 2018
                : 2 June 2018
                : 12 June 2018
                Categories
                Original Article

                Dentistry
                chlorhexidine,edta,etidronic acid,root canal irrigant,sodium hypochlorite
                Dentistry
                chlorhexidine, edta, etidronic acid, root canal irrigant, sodium hypochlorite

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