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      Scanning Electron Microscopic Evaluation of Efficacy of 17% Ethylenediaminetetraacetic Acid and Chitosan for Smear Layer Removal with Ultrasonics: An In vitro Study

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          Abstract

          Introduction:

          The main aim of root canal treatment is cleaning, shaping and then obturating three dimensionally to prevent reinfection. This includes chemicomechanical cleansing by instrumentation and the use of irrigating solutions. Therefore, the purpose of this study was to compare the smear layer removal from root canal dentine subjected to two root canal irrigants, 17% EDTA and 0.2% Chitosan, a new irrigant using Scanning Electron Microscope.

          Methodology:

          40 single rooted premolars were decoronated followed by instrumentation with I Race files and intermediate irrigation with 3% sodium hypochlorite and activation with ultrasonics. Then the samples were longitudinally sectioned and place in the respective test solutions and their controls for 5 minutes. Scanning Electron Microscopic evaluation was further carried out.

          Results:

          The results of the present study indicates that the Chitosan which was proved effective in removing smear layer.

          Conclusion:

          A moderate concentration of 0.2% chitosan removes the smear layer with greater efficiency.

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          Chelating agents in root canal treatment: mode of action and indications for their use.

          Chelating agents were introduced into endodontics as an aid for the preparation of narrow and calcified root canals in 1957 by Nygaard-Østby. A liquid solution of ethylenediaminetetraacetic acid (EDTA) was thought to chemically soften the root canal dentine and dissolve the smear layer, as well as to increase dentine permeability. Although the efficacy of EDTA preparations in softening root dentine has been debated, chelator preparations have regained popularity recently. Almost all manufacturers of nickel-titanium instruments recommend their use as a lubricant during rotary root canal preparation. Additionally, a final irrigation of the root canal with 15-17% EDTA solutions to dissolve the smear layer is recommended in many textbooks. This paper reviews the relevant literature on chelating agents, presents an overview of the chemical and pharmacological properties of EDTA preparations and makes recommendations for their clinical use.
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            Time-dependent effects of EDTA on dentin structures.

            The purpose of this study was to evaluate the effects of EDTA on smear layer removal and on the structure of dentin, after 1 and 10 min of application. Six extracted single-rooted teeth were instrumented to #60. Apical and coronal thirds of each root were removed, leaving a 5 mm middle third that was then cut longitudinally into two equal segments. Using 10 ml of 17% EDTA solution, halves belonging to the same root were irrigated for 1 and 10 min, respectively. All specimens were subjected to irrigation with 10 ml of 5% NaOCl. Then all the specimens were prepared for SEM evaluation. The results showed that 1 min EDTA irrigation is effective in removing the smear layer. However a 10-min application of EDTA caused excessive peritubular and intertubular dentinal erosion. Therefore we suggest that this procedure should not be prolonged >1 min during endodontic treatment.
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              Tissue dissolution by sodium hypochlorite: effect of concentration, temperature, agitation, and surfactant.

              Sodium hypochlorite is the most commonly used endodontic irrigant because of its antimicrobial and tissue-dissolving activity. The aim of this study was to evaluate and compare the effects of concentration, temperature, and agitation on the tissue-dissolving ability of sodium hypochlorite. In addition, a hypochlorite product with added surface active agent was compared with conventional hypochlorite solutions. Three sodium hypochlorite solutions from two different manufacturers in concentrations of 1%, 2%, 4%, and 5.8% were tested at room temperature, 37 degrees C, and 45 degrees C with and without agitation by ultrasonic and sonic energy and pipetting. Distilled and sterilized tap water was used as controls. Pieces of bovine muscle tissue (68 +/- 3 mg) were placed in 10 mL of each solution for five minutes. In selected samples, agitation was performed for one, two, or four 15-second periods per each minute. The tissue specimens were weighed before and after treatment, and the percentage of weight loss was calculated. The contact angle on dentin of the three solutions at concentrations of 1% and 5.8% was measured. Weight loss (dissolution) of the tissue increased almost linearly with the concentration of sodium hypochlorite. Higher temperatures and agitation considerably enhanced the efficacy of sodium hypochlorite. The effect of agitation on tissue dissolution was greater than that of temperature; continuous agitation resulted in the fastest tissue dissolution. Hypochlorite with added surface active agent had the lowest contact angle on dentin and was most effective in tissue dissolution in all experimental situations. Optimizing the concentration, temperature, flow, and surface tension can improve the tissue-dissolving effectiveness of hypochlorite even 50-fold. Copyright 2010 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.
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                Author and article information

                Journal
                Contemp Clin Dent
                Contemp Clin Dent
                CCD
                Contemporary Clinical Dentistry
                Medknow Publications & Media Pvt Ltd (India )
                0976-237X
                0976-2361
                Oct-Dec 2017
                : 8
                : 4
                : 621-626
                Affiliations
                [1] Department of Conservative Dentistry and Endodontics, S.M.B.T. Dental College and Hospital, Sangamner, Ahmednagar, India
                [1 ] Department of Conservative Dentistry and Endodontics, Aditya Dental College and Hospital, Beed, Maharashtra, India
                Author notes
                Address for correspondence: Dr. Aradhana Babu Kamble, S.M.B.T. Dental College and Hospital, Sangamner, Maharashtra, India. E-mail: aradhanakamble@ 123456gmail.com
                Article
                CCD-8-621
                10.4103/ccd.ccd_745_17
                5754985
                29326515
                f286faed-690b-46f2-9bab-0ddbde30ff9c
                Copyright: © 2017 Contemporary Clinical Dentistry

                This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

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                Categories
                Original Article

                Dentistry
                chitosan,ethylenediaminetetraacetic acid,irrigants,scanning electron microscope,ultrasonic

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