Miriam Fátima Zaccaro Scelza

Efficacy of Final Irrigation—A Scanning Electron Microscopic Evaluation

The purpose of this in vitro study was to determine the degree of removal of pulpal remnants and smear layer from root canals after final irrigation with three different solutions. During instrumentation the step-back preparation and 1% NaOCl were used. The final 4-min, 30-ml irrigation varied as follows: group I, 10 ml of 1% NaOCl + 10 ml of 10% citric acid + 10 ml of distilled water; group II, 15 ml of 0.5% NaOCl + 15 ml of EDTA-T; and group III, 10 ml of 5% NaOCl + 10 ml of 3% H2O2 + 10 ml of 5% NaOCl. Scanning electron microscopic photomicrographs were evaluated for the mean number of visible open dentinal tubules by three observers. The largest number of visible tubules in the three groups was in the cervical third, followed by the middle and apical thirds. There was no statistically significant difference between groups I and II when third was compared with third; however, groups I and II had significantly more visible dentinal tubules than group III.

Cytotoxic Effects of 10% Citric Acid and EDTA-T used as Root Canal Irrigants: An In Vitro Analysis

EDTA-T and 10% citric acid used as root canal irrigants lead to more visible dentinal tubules than 5% sodium hypochlorite associated with 3% hydrogen peroxide. However, these cleansing agents must be compatible with apical periodontal tissue. We analyzed the cytotoxicity of 10% citric acid and EDTA-T in cultured fibroblasts using Trypan blue. The solutions were diluted to 1%, 0.1%, and 0.01% and applied to NIH 3T3 cell cultures. Cells grown on fresh DMEM served as a control. After 0, 6, 12, and 24 h (short-term assay, viability) and 1, 3, 5, and 7 days (long-term assay, survival), the cells were counted using a hemocytometer. In short-term tests, cell viability ranged from 85% to 99% for all experimental groups with no statistical differences when compared with control cultures, except for the group treated with 1% EDTA-T, which caused a progressive decrease in cell viability. In long-term tests, all cultures increased in number from day 1 to the end of the experimental period, showing no inhibition of cell proliferation, except for the cultures treated with 1% EDTA-T, which totally prevented cell growth. All dilutions of 10% citric acid were more biocompatible than EDTA-T. Cultures treated with citric acid had a higher percentage of viable cells in the short-term assays, and the cells retained their self-renewal capacity.

The Influence of Dentin Age and the Presence of Cracks in Removal of the Root Filling Material

Introduction: This study evaluated the removal of the filling material during endodontic retreatment considering the presence of cracks and the dentin age. Methods and Materials: A total of 20 freshly extracted single-rooted teeth were categorized into the following two groups according to the age of the patients: Group Young (Y; aged 18-30 years) and Group Old (O; aged ≥60 years). Each tooth specimen was scanned by microcomputed tomography (micro-CT) subsequently after endodontic retreatment with the Reciproc instruments (REC). The images were analyzed for differences in the volume of dentin cracks and the presence of the filling material in the middle and apical thirds of the teeth among the groups, according to the dentin age. Results: The micro-CT images showed that after retreatment, there were more cracks in the old root dentin than those in the young root dentin, although the difference was not statistically significant (P>0.05). The greatest reduction in the filling material was achieved when the old root dentin with cracks was retreated when compared with that of the young root dentin with cracks, but the difference was not statistically significant (P>0.05). Conclusion: The dentinal age and the presence of cracks were not found to be relevant factors for the removal of the filling material.

Effect of Citric Acid and Ethylenediaminetetraacetic Acid on the Surface Morphology of Young and Old Root Dentin

Introduction: The aim of this in vitro study was to evaluate the effect of 10% citric acid and 17% ethylenediaminetetraacetic acid (EDTA) irrigating solutions on the surface morphology of young and old root dentin by determining the number and diameter of dentinal tubules using scanning electron microscopy (SEM). Methods and Materials: Fifty healthy human teeth collected from young (≤30 years) and old (≥60 years) individuals (n=25) were first prepared with a Largo bur #2 to produce smear layer on the root canal surface. Subsequently, the crowns and the root middle and apical thirds were sectioned and removed, and the cervical thirds were sectioned vertically in the buccal-lingual direction into two equal halves. The obtained samples were then immersed in 2.5% sodium hypochlorite for 30 min and randomly separated into two treatment groups for each age group. In each age group, ten samples were selected as controls and did not receive any type of treatment. The rest of the specimens were then rinsed, dried and treated for 4 min with 10% citric acid or 17% EDTA. The samples were then assessed with SEM regarding the number and diameter of dentinal tubules. All data were assessed using Student’s t-test. The level of significance was set at 0.05. Results: Regardless of the type of treatment, no significant differences were observed in the number of open tubules between the young and old root dentin (P>0.05). Nonetheless, the diameter of the tubules in the old root dentin was larger when 17% EDTA was used (P<0.05). Both, young and old root dentin did not differ with the 10% citric acid treatment (P>0.05). Conclusion: The results showed that 17% EDTA treatment induced a significant demineralization in old root dentin.