Restorative Dentistry and Endodontics

The Korean Academy of Conservative Dentistry (대한치과보존학회)
권호 표지
DOI QR코드

DOI QR Code

A new phantom to evaluate the tissue dissolution ability of endodontic irrigants and activating devices

  • Received : 2019.11.16
  • Accepted : 2020.03.23
  • Published : 2020.11.30
Download PDF
⟨ Previous Next ⟩

Abstract

Objective: The aim of this study was to introduce a gelatin/bovine serum albumin (BSA) tissue standard, which provides dissolution properties identical to those of biological tissues. Further, the study evaluated whether the utilization of endodontic activating devices led to enhanced phantom dissolution rates. Materials and Methods: Bovine pulp tissue was obtained to determine a benchmark of tissue dissolution. The surface area and mass of samples were held constant while the ratio of gelatin and BSA were varied, ranging from 7.5% to 10% gelatin and 5% BSA. Each sample was placed in an individual test tube that was filled with an appropriate sodium hypochlorite solution for 1, 3, and 5 minutes, and then removed from the solution, blotted dry, and weighed again. The remaining tissue was calculated as the percent of initial tissue to determine the tissue dissolution rate. A radiopaque agent (sodium diatrizoate) and a fluorescent dye (methylene blue) were added to the phantom to allow easy quantification of phantom dissolution in a canal block model when activated using ultrasonic (EndoUltra) or sonic (EndoActivator) energy. Results: The 9% gelatin + 5% BSA phantom showed statistically equivalent dissolution to bovine pulp tissue at all time intervals. Furthermore, the EndoUltra yielded significantly more phantom dissolution in the canal block than the EndoActivator or syringe irrigation. Conclusions: Our phantom is comparable to biological tissue in terms of tissue dissolution and could be utilized for in vitro tests due to its injectability and detectability.

Keywords

References

  1. Nair PN, Henry S, Cano V, Vera J. Microbial status of apical root canal system of human mandibular first molars with primary apical periodontitis after "one-visit" endodontic treatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2005;99:231-252.
  2. Zehnder M. Root canal irrigants. J Endod 2006;32:389-398.
  3. Peters OA, Peters CI, Basrani B. Cleaning and shaping of the root canal system. In: Cohen S, Hargreaves KM, editors. Cohen's pathways of the pulp. St. Louis, MO: Elsevier; 2006. p.209-357.
  4. Clarkson RM, Podlich HM, Savage NW, Moule AJ. A survey of sodium hypochlorite use by general dental practitioners and endodontists in Australia. Aust Dent J 2003;48:20-26.
  5. Naenni N, Thoma K, Zehnder M. Soft tissue dissolution capacity of currently used and potential endodontic irrigants. J Endod 2004;30:785-787.
  6. Baumgartner JC, Cuenin PR. Efficacy of several concentrations of sodium hypochlorite for root canal irrigation. J Endod 1992;18:605-612.
  7. Poggio C, Ceci M, Beltrami R, Colombo M, Dagna A. Viscosity of endodontic irrigants: influence of temperature. Dent Res J (Isfahan) 2015;12:425-430.
  8. Cheung GS, Stock CJ. In vitro cleaning ability of root canal irrigants with and without endosonics. Int Endod J 1993;26:334-343.
  9. Yang SF, Rivera EM, Baumgardner KR, Walton RE, Stanford C. Anaerobic tissue-dissolving abilities of calcium hydroxide and sodium hypochlorite. J Endod 1995;21:613-616.
  10. Cunningham WT, Balekjian AY. Effect of temperature on collagen-dissolving ability of sodium hypochlorite endodontic irrigant. Oral Surg Oral Med Oral Pathol 1980;49:175-177.
  11. Zehnder M, Kosicki D, Luder H, Sener B, Waltimo T. Tissue-dissolving capacity and antibacterial effect of buffered and unbuffered hypochlorite solutions. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2002;94:756-762.
  12. Christensen CE, McNeal SF, Eleazer P. Effect of lowering the pH of sodium hypochlorite on dissolving tissue in vitro. J Endod 2008;34:449-452.
  13. Stojicic S, Zivkovic S, Qian W, Zhang H, Haapasalo M. Tissue dissolution by sodium hypochlorite: effect of concentration, temperature, agitation, and surfactant. J Endod 2010;36:1558-1562.
  14. Koskinen KP, Stenvall H, Uitto VJ. Dissolution of bovine pulp tissue by endodontic solutions. Eur J Oral Sci 1980;88:406-411.
  15. The SD. The solvent action of sodium hypochlorite on fixed and unfixed necrotic tissue. Oral Surg Oral Med Oral Pathol 1979;47:558-561.
  16. Clarkson RM, Moule AJ, Podlich H, Kellaway R, Macfarlane R, Lewis D, Rowell J. Dissolution of porcine incisor pulps in sodium hypochlorite solutions of varying compositions and concentrations. Aust Dent J 2006;51:245-251.
  17. Macedo RG, Wesselink PR, Zaccheo F, Fanali D, Van Der Sluis LW. Reaction rate of NaOCl in contact with bovine dentine: effect of activation, exposure time, concentration and pH. Int Endod J 2010;43:1108-1115.
  18. Cameron JA. The use of 4 per cent sodium hypochlorite, with or without ultrasound, in cleansing of uninstrumented immature root canals; SEM study. Aust Dent J 1987;32:204-213.
  19. Pascon FM, Puppin-Rontani RM. The influence of cleansers on the permeability index of primary tooth root dentin. J Clin Pediatr Dent 2006;31:93-97.
  20. Gu LS, Kim JR, Ling J, Choi KK, Pashley DH, Tay FR. Review of contemporary irrigant agitation techniques and devices. J Endod 2009;35:791-804.
  21. Christo JE, Zilm PS, Sullivan T, Cathro PR. Efficacy of low concentrations of sodium hypochlorite and low-powered Er,Cr:YSGG laser activated irrigation against an Enterococcus faecalis biofilm. Int Endod J 2016;49:279-286.
  22. Linde A. The extracellular matrix of the dental pulp and dentin. J Dent Res 1985;64 Spec No:523-529.
  23. de Almeida LH, Leonardo NG, Gomes AP, Giardino L, Souza EM, Pappen FG. Pulp tissue dissolution capacity of sodium hypochlorite combined with cetrimide and polypropylene glycol. Braz Dent J 2013;24:477-481.
  24. Selvam S, Sarkar I. Bile salt induced solubilization of methylene blue: study on methylene blue fluorescence properties and molecular mechanics calculation. J Pharm Anal 2017;7:71-75.
  25. Culjat MO, Goldenberg D, Tewari P, Singh RS. A review of tissue substitutes for ultrasound imaging. Ultrasound Med Biol 2010;36:861-873.
  26. Moffitt T, Chen YC, Prahl SA. Preparation and characterization of polyurethane optical phantoms. J Biomed Opt 2006;11:041103.
  27. Pogue BW, Patterson MS. Review of tissue simulating phantoms for optical spectroscopy, imaging and dosimetry. J Biomed Opt 2006;11:041102.
  28. Kutty SK, Lekshmi MS, Mohan A, Isaac L. Pulp tissue dissolution in endodontics- A review. Int J Appl Dent Sci 2017;3:193-6.
  29. Frank RM, Nalbandian J. Structure and ultrastructure of the dental pulp. In: Berkovitz BK, Boyde A, Frank RM, Hohling HJ, Moxham BJ, Nalbandian J, Tonge CH, editors. Teeth. Berlin: Springer; 1989. p.249-307.
  30. Madsen EL, Zagzebski JA, Banjavie RA, Jutila RE. Tissue mimicking materials for ultrasound phantoms. Med Phys 1978;5:391-394.
  31. Hand RE, Smith ML, Harrison JW. Analysis of the effect of dilution on the necrotic tissue dissolution property of sodium hypochlorite. J Endod 1978;4:60-64.
  32. Turkun M, Cengiz T. The effects of sodium hypochlorite and calcium hydroxide on tissue dissolution and root canal cleanliness. Int Endod J 1997;30:335-342.
  33. Beltz RE, Torabinejad M, Pouresmail M. Quantitative analysis of the solubilizing action of MTAD, sodium hypochlorite, and EDTA on bovine pulp and dentin. J Endod 2003;29:334-337.
  34. Abou-Rass M, Oglesby SW. The effects of temperature, concentration, and tissue type on the solvent ability of sodium hypochlorite. J Endod 1981;7:376-377.
  35. Moorer WR, Wesselink PR. Factors promoting the tissue dissolving capability of sodium hypochlorite. Int Endod J 1982;15:187-196.
  36. Estrela C, Estrela CR, Barbin EL, Spano JC, Marchesan MA, Pecora JD. Mechanism of action of sodium hypochlorite. Braz Dent J 2002;13:113-117.
  37. Ahmad M, Pitt Ford TR, Crum LA. Ultrasonic debridement of root canals: an insight into the mechanisms involved. J Endod 1987;13:93-101.
  38. Cameron JA. The synergistic relationship between ultrasound and sodium hypochlorite: a scanning electron microscope evaluation. J Endod 1987;13:541-545.
  39. Weller RN, Brady JM, Bernier WE. Efficacy of ultrasonic cleaning. J Endod 1980;6:740-743.
  40. Sabins RA, Johnson JD, Hellstein JW. A comparison of the cleaning efficacy of short-term sonic and ultrasonic passive irrigation after hand instrumentation in molar root canals. J Endod 2003;29:674-678.
  41. Mayer BE, Peters OA, Barbakow F. Effects of rotary instruments and ultrasonic irrigation on debris and smear layer scores: a scanning electron microscopic study. Int Endod J 2002;35:582-589.
  42. Cymerman JJ, Jerome LA, Moodnik RM. A scanning electron microscope study comparing the efficacy of hand instrumentation with ultrasonic instrumentation of the root canal. J Endod 1983;9:327-331.
  43. van der Sluis LW, Versluis M, Wu MK, Wesselink PR. Passive ultrasonic irrigation of the root canal: a review of the literature. Int Endod J 2007;40:415-426.