CC BY-NC-ND 4.0 · Eur J Dent 2015; 09(04): 523-528
DOI: 10.4103/1305-7456.172613
Original Article
Dental Investigation Society

Efficacy of etidronic acid, BioPure MTAD and SmearClear in removing calcium ions from the root canal: An in vitro study

Hemant Kumar Yadav
1   Department of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
,
A. P. Tikku
2   Department of Conservative Dentistry and Endodontics, Faculty of Dental Sciences, King George Medical University, Lucknow, Uttar Pradesh, India
,
Anil Chandra
2   Department of Conservative Dentistry and Endodontics, Faculty of Dental Sciences, King George Medical University, Lucknow, Uttar Pradesh, India
,
Rakesh Kumar Yadav
2   Department of Conservative Dentistry and Endodontics, Faculty of Dental Sciences, King George Medical University, Lucknow, Uttar Pradesh, India
,
Devendra Kumar Patel
3   Analytical Chemistry Laboratory, Regulatory Toxicology Group, CSIR- Indian Institute of Toxicology Research, Lucknow, Uttar Pradesh, India
› Author Affiliations
Further Information

Publication History

Publication Date:
23 September 2019 (online)

ABSTRACT

Objective: The purpose of this study was to quantify the amount of calcium ions removed from the root canal by etidronic acid (HEBP), BioPure MTAD, and SmearClear using atomic absorption spectrophotometer. Materials and Methods: Fifty (n = 50) freshly extracted human mandibular premolar teeth were collected and decoronated at the cementoenamel junction. The canals were prepared in a crown down fashion using the rotary system and copiously irrigated with 1.0% sodium hypochlorite. All specimens were rinsed with the deionized water. Based on the type of chelating agent used, the samples (n = 10) were randomly divided into five (four test and one negative control) groups. Accordingly, Group I - 9% HEBP, Group II - 18% HEBP, Group III - SmearClear, Group IV - BioPure MTAD, and Group V - normal Saline. Subsequent to irrigation, the solution was collected in a test tube and subjected to atomic absorption spectrophotometer for the quantification of calcium ions removed from the root canal. Results: The mean concentration of calcium ions removed from the root canal (mean ± standard deviation) in all groups (I–V) were 13.32 ± 0.54 μg/ml, 16.36 ± 0.27 μg/ml, 20.04 ± 0.24 μg/ml, 18.15 ± 0.39 μg/ml, and 8.74 ± 0.49 μg/ml, respectively. Conclusions: SmearClear was the most effective agent for the removal of calcium ions from the root canal. Hence, its combined use with an organic solvent can be recommended for efficient smear layer removal.

 
  • REFERENCES

  • 1 McComb D, Smith DC. A preliminary scanning electron microscopic study of root canals after endodontic procedures. J Endod 1975; 1: 238-42
  • 2 Lester KS, Boyde A. Scanning electron microscopy of instrumented, irrigated and filled root canals. Br Dent J 1977; 143: 359-67
  • 3 Violich DR, Chandler NP. The smear layer in endodontics – A review. Int Endod J 2010; 43: 2-15
  • 4 Scelza MF, Teixeira AM, Scelza P. Decalcifying effect of EDTA-T, 10% citric acid, and 17% EDTA on root canal dentin. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2003; 95: 234-6
  • 5 Rotstein I, Dankner E, Goldman A, Heling I, Stabholz A, Zalkind M. Histochemical analysis of dental hard tissues following bleaching. J Endod 1996; 22: 23-5
  • 6 Hülsmann M, Heckendorff M, Lennon A. Chelating agents in root canal treatment: Mode of action and indications for their use. Int Endod J 2003; 36: 810-30
  • 7 Baumgartner JC, Mader CL. A scanning electron microscopic evaluation of four root canal irrigation regimens. J Endod 1987; 13: 147-57
  • 8 Grawehr M, Sener B, Waltimo T, Zehnder M. Interactions of ethylenediamine tetraacetic acid with sodium hypochlorite in aqueous solutions. Int Endod J 2003; 36: 411-7
  • 9 Zehnder M, Schmidlin P, Sener B, Waltimo T. Chelation in root canal therapy reconsidered. J Endod 2005; 31: 817-20
  • 10 Russell RG, Rogers MJ. Bisphosphonates: From the laboratory to the clinic and back again. Bone 1999; 25: 97-106
  • 11 De-Deus G, Reis CM, Fidel RA, Fidel SR, Paciornik S. Co-site digital optical microscopy and image analysis: An approach to evaluate the process of dentine demineralization. Int Endod J 2007; 40: 441-52
  • 12 Lui JN, Kuah HG, Chen NN. Effect of EDTA with and without surfactants or ultrasonics on removal of smear layer. J Endod 2007; 33: 472-5
  • 13 De-Deus G, Reis C, Fidel S, Fidel R, Paciornik S. Dentine demineralization when subjected to EDTA with or without various wetting agents: A co-site digital optical microscopy study. Int Endod J 2008; 41: 279-87
  • 14 Torabinejad M, Khademi AA, Babagoli J, Cho Y, Johnson WB, Bozhilov K. et al. A new solution for the removal of the smear layer. J Endod 2003; 29: 170-5
  • 15 Mancini M, Armellin E, Casaglia A, Cerroni L, Cianconi L. A comparative study of smear layer removal and erosion in apical intraradicular dentine with three irrigating solutions: A scanning electron microscopy evaluation. J Endod 2009; 35: 900-3
  • 16 Marques AA, Marchesan MA, Sousa-Filho CB, Silva-Sousa YT, Sousa-Neto MD, Cruz-Filho AM. Smear layer removal and chelated calcium ion quantification of three irrigating solutions. Braz Dent J 2006; 17: 306-9
  • 17 Spanó JC, Silva RG, Guedes DF, Sousa-Neto MD, Estrela C, Pécora JD. Atomic absorption spectrometry and scanning electron microscopy evaluation of concentration of calcium ions and smear layer removal with root canal chelators. J Endod 2009; 35: 727-30
  • 18 Moodnik RM, Dorn SO, Feldman MJ, Levey M, Borden BG. Efficacy of biomechanical instrumentation: A scanning electron microscopic study. J Endod 1976; 2: 261-6
  • 19 Hülsmann M, Hahn W. Complications during root canal irrigation – Literature review and case reports. Int Endod J 2000; 33: 186-93
  • 20 Serper A, Ozbek M, Calt S. Accidental sodium hypochlorite-induced skin injury during endodontic treatment. J Endod 2004; 30: 180-1
  • 21 Hennequin M, Pajot J, Avignant D. Effects of different pH values of citric acid solutions on the calcium and phosphorus contents of human root dentin. J Endod 1994; 20: 551-4
  • 22 Dogan H, Qalt S. Effects of chelating agents and sodium hypochlorite on mineral content of root dentin. J Endod 2001; 27: 578-80
  • 23 Calt S, Serper A. Time-dependent effects of EDTA on dentin structures. J Endod 2002; 28: 17-9
  • 24 Seidberg BH, Schilder H. An evaluation of EDTA in endodontics. Oral Surg Oral Med Oral Pathol 1974; 37: 609-20
  • 25 Andersen O, Aaseth J. Molecular mechanisms of in vivo metal chelation: Implications for clinical treatment of metal intoxications. Environ Health Perspect 2002; 110 (Suppl. 05) 887-90
  • 26 Gledhill WE, Feijtel CJ. Environmental properties and safety assessment of organic phosphonates used for detergent and water treatment applications. In: Hutzinger O. editor. The Handbook of Environmental Chemistry. Berlin, Heidelberg: Springer; 1992: p. 261-85
  • 27 Girard S, Paqué F, Badertscher M, Sener B, Zehnder M. Assessment of a gel-type chelating preparation containing 1-hydroxyethylidene-1, 1-bisphosphonate. Int Endod J 2005; 38: 810-6
  • 28 Tasman F, Cehreli ZC, Ogan C, Etikan I. Surface tension of root canal irrigants. J Endod 2000; 26: 586-7
  • 29 Abou-Rass M, Patonai Jr FJ. The effects of decreasing surface tension on the flow of irrigating solutions in narrow root canals. Oral Surg Oral Med Oral Pathol 1982; 53: 524-6
  • 30 Giardino L, Ambu E, Becce C, Rimondini L, Morra M. Surface tension comparison of four common root canal irrigants and two new irrigants containing antibiotic. J Endod 2006; 32: 1091-3
  • 31 Grossman LI, Meiman BW. Solution of pulp tissue by chemical agents. J Am Dent Assoc 1941; 28: 223-5
  • 32 Zehnder M, Schicht O, Sener B, Schmidlin P. Reducing surface tension in endodontic chelator solutions has no effect on their ability to remove calcium from instrumented root canals. J Endod 2005; 31: 590-2
  • 33 Khedmat S, Shokouhinejad N. Comparison of the efficacy of three chelating agents in smear layer removal. J Endod 2008; 34: 599-602
  • 34 Krause TA, Liewehr FR, Hahn CL. The antimicrobial effect of MTAD, sodium hypochlorite, doxycycline, and citric acid on Enterococcus faecalis . J Endod 2007; 33: 28-30
  • 35 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: 334-7
  • 36 De-Deus G, Paciornik S, Pinho MauricioMH, Prioli R. Real-time atomic force microscopy of root dentine during demineralization when subjected to chelating agents. Int Endod J 2006; 39: 683-92