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Evaluation of Root Canal Dentin Erosion after Different Irrigation Methods Using Energy-dispersive X-ray Spectroscopy. 2016

Zhejun Wang, and Hazuki Maezono, and Ya Shen, and Markus Haapasalo
Division of Endodontics, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, The University of British Columbia, Vancouver, Canada.

BACKGROUND The purpose of this study was to examine the level of erosion in root dentin caused by different irrigation methods and protocols. METHODS Thirty-five extracted upper molar teeth were instrumented and divided into 7 groups to undergo treatment by different methods: negative control, GentleWave System (Sonendo Inc, Laguna Hills, CA), and syringe needle irrigation following different protocols. The teeth were instrumented to size #25/.08 or #30/.09 for needle irrigation groups and to ProTaper size S1 for the GentleWave group under 5% sodium hypochlorite (NaOCl). The needle irrigation groups were subjected to final rinses of 2 minutes of 3% NaOCl + 2 minutes of 8% EDTA (3% N2 + 8% E2), 2 minutes of 3% NaOCl + 2 minutes of 8% EDTA + 1 minute of 3% NaOCl (3% N2 + 8% E2 + 3% N1), 2 minutes of 5% NaOCl + 2 minutes of 17% EDTA (5% N2 + 17% E2), 2 minutes of 5% NaOCl + 2 minutes of 17% EDTA + 1 minute of 5% NaOCl (5% N2 + 17% E2 + 5% N1), and 5 minutes of 5% NaOCl + 5 minutes of 17% EDTA + 5 minutes of 5% NaOCl (5% N5 + 17% E5 + 5% N5), respectively. The root canal surface was observed by scanning electron microscopy, and the dentin composition was analyzed by continuous line scanning for 300 μm into dentin using energy-dispersive X-ray spectroscopy. RESULTS A slight but statistically significant decrease of calcium and an increase of carbon was measured in the 5% N2 + 17% E2 group in comparison with the control; no significant difference was found among GentleWave, 3% N2 + 8% E2, and 5% N2 + 17% E2 (P > .05). A final 1-minute rinse with 3% or 5% NaOCl reduced calcium and phosphorus to a significantly lower level than in groups without a 1-minute final rinse (P < .05). Final irrigation with 5% NaOCl for 5 minutes removed almost all calcium and phosphorus. Scanning electron microscopy showed canal wall erosion when an additional final irrigation with NaOCl was done. CONCLUSIONS NaOCl followed by final EDTA irrigation performed either by syringe needle or the GentleWave System caused minimal dentin erosion. Erosion was measured as increased loss of calcium and phosphorus in samples in which additional final irrigation was performed using NaOCl after EDTA.

UI MeSH Term Description Entries
D007507 Therapeutic Irrigation The washing of a body cavity or surface by flowing water or solution for therapy or diagnosis. Douching,Lavage,Douchings,Irrigation, Therapeutic,Irrigations, Therapeutic,Lavages,Therapeutic Irrigations
D008855 Microscopy, Electron, Scanning Microscopy in which the object is examined directly by an electron beam scanning the specimen point-by-point. The image is constructed by detecting the products of specimen interactions that are projected above the plane of the sample, such as backscattered electrons. Although SCANNING TRANSMISSION ELECTRON MICROSCOPY also scans the specimen point by point with the electron beam, the image is constructed by detecting the electrons, or their interaction products that are transmitted through the sample plane, so that is a form of TRANSMISSION ELECTRON MICROSCOPY. Scanning Electron Microscopy,Electron Scanning Microscopy,Electron Microscopies, Scanning,Electron Microscopy, Scanning,Electron Scanning Microscopies,Microscopies, Electron Scanning,Microscopies, Scanning Electron,Microscopy, Electron Scanning,Microscopy, Scanning Electron,Scanning Electron Microscopies,Scanning Microscopies, Electron,Scanning Microscopy, Electron
D008963 Molar The most posterior teeth on either side of the jaw, totaling eight in the deciduous dentition (2 on each side, upper and lower), and usually 12 in the permanent dentition (three on each side, upper and lower). They are grinding teeth, having large crowns and broad chewing surfaces. (Jablonski, Dictionary of Dentistry, 1992, p821) Molars
D009339 Needles Sharp instruments used for puncturing or suturing. Hypodermic Needles,Hypodermic Needle,Needle,Needle, Hypodermic,Needles, Hypodermic
D010758 Phosphorus A non-metal element that has the atomic symbol P, atomic number 15, and atomic weight 31. It is an essential element that takes part in a broad variety of biochemical reactions. Black Phosphorus,Phosphorus-31,Red Phosphorus,White Phosphorus,Yellow Phosphorus,Phosphorus 31,Phosphorus, Black,Phosphorus, Red,Phosphorus, White,Phosphorus, Yellow
D002118 Calcium A basic element found in nearly all tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. Coagulation Factor IV,Factor IV,Blood Coagulation Factor IV,Calcium-40,Calcium 40,Factor IV, Coagulation
D002244 Carbon A nonmetallic element with atomic symbol C, atomic number 6, and atomic weight [12.0096; 12.0116]. It may occur as several different allotropes including DIAMOND; CHARCOAL; and GRAPHITE; and as SOOT from incompletely burned fuel. Carbon-12,Vitreous Carbon,Carbon 12,Carbon, Vitreous
D003786 Dental Pulp Cavity The space in a tooth bounded by the dentin and containing the dental pulp. The portion of the cavity within the crown of the tooth is the pulp chamber; the portion within the root is the pulp canal or root canal. Pulp Canal,Pulp Chamber,Root Canal,Cavities, Dental Pulp,Cavity, Dental Pulp,Dental Pulp Cavities,Pulp Cavities, Dental,Pulp Cavity, Dental,Canal, Pulp,Canal, Root,Canals, Pulp,Canals, Root,Chamber, Pulp,Chambers, Pulp,Pulp Canals,Pulp Chambers,Root Canals
D003804 Dentin The hard portion of the tooth surrounding the pulp, covered by enamel on the crown and cementum on the root, which is harder and denser than bone but softer than enamel, and is thus readily abraded when left unprotected. (From Jablonski, Dictionary of Dentistry, 1992) Dentine,Dentines,Dentins
D004492 Edetic Acid A chelating agent that sequesters a variety of polyvalent cations such as CALCIUM. It is used in pharmaceutical manufacturing and as a food additive. EDTA,Edathamil,Edetates,Ethylenediaminetetraacetic Acid,Tetracemate,Calcium Disodium Edetate,Calcium Disodium Versenate,Calcium Tetacine,Chelaton 3,Chromium EDTA,Copper EDTA,Coprin,Dicobalt EDTA,Disodium Calcitetracemate,Disodium EDTA,Disodium Ethylene Dinitrilotetraacetate,Distannous EDTA,Edetate Disodium Calcium,Edetic Acid, Calcium Salt,Edetic Acid, Calcium, Sodium Salt,Edetic Acid, Chromium Salt,Edetic Acid, Dipotassium Salt,Edetic Acid, Disodium Salt,Edetic Acid, Disodium Salt, Dihydrate,Edetic Acid, Disodium, Magnesium Salt,Edetic Acid, Disodium, Monopotassium Salt,Edetic Acid, Magnesium Salt,Edetic Acid, Monopotassium Salt,Edetic Acid, Monosodium Salt,Edetic Acid, Potassium Salt,Edetic Acid, Sodium Salt,Ethylene Dinitrilotetraacetate,Ethylenedinitrilotetraacetic Acid,Gallium EDTA,Magnesium Disodium EDTA,N,N'-1,2-Ethanediylbis(N-(carboxymethyl)glycine),Potassium EDTA,Stannous EDTA,Versenate,Versene,Acid, Edetic,Acid, Ethylenediaminetetraacetic,Acid, Ethylenedinitrilotetraacetic,Calcitetracemate, Disodium,Dinitrilotetraacetate, Disodium Ethylene,Dinitrilotetraacetate, Ethylene,Disodium Versenate, Calcium,EDTA, Chromium,EDTA, Copper,EDTA, Dicobalt,EDTA, Disodium,EDTA, Distannous,EDTA, Gallium,EDTA, Magnesium Disodium,EDTA, Potassium,EDTA, Stannous,Edetate, Calcium Disodium,Ethylene Dinitrilotetraacetate, Disodium,Tetacine, Calcium,Versenate, Calcium Disodium

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