|Year : 2015 | Volume
| Issue : 3 | Page : 166-170
Comparison of the effect of three different irrigants on the contact angle of an epoxy resin sealer with intraradicular dentin
Mamta Kaushik, Kitu Sheoran, Pallavi Reddy, Roshni, Poonam Narwal
Department of Conservative Dentistry and Endodontics, Army College of Dental Sciences, Secunderabad, Andhra Pradesh, India
|Date of Web Publication||26-Aug-2015|
Department of Conservative Dentistry and Endodontics, Army College of Dental Sciences, Secunderabad, Andhra Pradesh - 500 087
Source of Support: Nil., Conflict of Interest: None
Aim: To evaluate the contact angle between epoxy resin sealer and dentin treated with different irrigant solutions both in the presence and absence of smear layer.
Materials and Methods: Seventy human mandibularfirst premolars were used and 140 longitudinal dentin slices were obtained from them. Each sample was irrigated with of 3% sodium hypochlorite (NaOCl), simulating the irrigation used during the chemomechanical preparation and then washed with 10ml of distilled water (DW). The samples were then divided into seven groups of 20 samples each. Group 1:NaOCl + DW, Group 2: QMix + DW, Group 3: 0.1% octenidine hydrochloride + DW, Group 4:Ethylenediaminetetraacetic acid (EDTA) + DW + NaOCl + DW, Group 5: EDTA + DW + QMix + DW, Group 6: EDTA + DW + 0.1% Octenidine Hydrochloride + DW, and Group 7(control): DW. The contact angle between AH Plus and the samples was measured using Rame Hart Goniometer followed by statistical analysis of data.
Results: Values of contact angle was least when samples were treated with QMix followed by treatment with 0.1% Octenidine Hydrochloride followed by 3% NaOCl. Removal of smear layer reduced contact angles in all cases except when samples were treated with 3% NaOCl. Results were statistically significant when 3% NaOCl was compared to 0.1% Octenidine Hydrochloride and QMix (P = 0.034). Statistically significant difference was seen before and after removal of smear layer for 3% NaOCl and 0.1% Octenidine Hydrochloride. (P = 0.003).
Conclusion: Qmix is the irrigant of choice, but 0.1% octenidine hydrochloride may be recommended as a useful irrigant after further research.
Keywords: Contact angle, root canal irrigants, root canal sealer, wettability
|How to cite this article:|
Kaushik M, Sheoran K, Reddy P, Roshni, Narwal P. Comparison of the effect of three different irrigants on the contact angle of an epoxy resin sealer with intraradicular dentin. Saudi Endod J 2015;5:166-70
|How to cite this URL:|
Kaushik M, Sheoran K, Reddy P, Roshni, Narwal P. Comparison of the effect of three different irrigants on the contact angle of an epoxy resin sealer with intraradicular dentin. Saudi Endod J [serial online] 2015 [cited 2022 Aug 12];5:166-70. Available from: https://www.saudiendodj.com/text.asp?2015/5/3/166/163627
| Introduction|| |
Success in endodontics is achieved by the elimination of microorganisms, their byproducts, and a three-dimensional seal. Towards this objective, chemomechanical preparation of the root canal involves using various irrigants as necessary adjuncts that augment removal of necrotic tissue, microbes/biofilms, and other debris from root canal space.
Apart from being biocompatible, an irrigant should have a broad antimicrobial spectrum, ability to dissolve necrotic pulpal remnants, high efficacy against bacterial biofilms, ability to inactivate endotoxin, and remove smear layer formed during mechanical preparation of dentin. It is especially needed for teeth with complex internal anatomy which have canal walls that might be missed by instrumentation.
All irrigants currently in use have their limitations and the search for an ideal root canal irrigant continues. Sodium hypochlorite (NaOCl; Prime Dental, India) is the most widely used irrigating solution due to its solvent action on pulp tissues, marked bactericidal activity, and effectiveness as a lubricant. QMix (Dentsply Tulsa Dental, Tulsa, OK), constitutes a mixture of a bisguanide antimicrobial agent, a polyaminocarboxylic acid calcium chelating agent, saline, and surfactant. It is effective against bacterial biofilms and removes smear layer equivalent to 17% ethylenediaminetetraacetic acid (EDTA). Octenidine hydrochloride (Schulke and Mayers, Germany) is a cationic surfactant that has been recently suggested as an alternative endodontic irrigant based on its antimicrobial effects and low cytotoxicity. Various concentrations of octenidine hydrochloride ranging from 0.03 to 0.1% exhibit antimicrobial effects equivalent to 5.25% NaOCl. It is also more effective than chlorhexidine because of its prolonged antibacterial property. However, no study in the past has evaluated the effect of octenidine hydrochloride on the surface characteristics of dentin.
It has been seen in the past that surface treatment of dentin causes a change in its structural and chemical characteristics, thereby affecting the wettability of various substances to dentin. Wettability is expressed in terms of contact angle which is the angle of intersection between the tangent to the liquid drop and the plane solid surface on which it rests. Contact angle shares an inverse relationship with wettability and surface free energy. A surface with low contact angle has higher wettability compared to a substance with higher contact angle. Contact angle measurements also indicate spreading and adsorption of liquids. Lower the contact angle greater the adhesion to dentin surface.
A sealer with optimum wettability will adapt well to dentin and provide a good seal., However, the contact angle and wettability of a sealer to dentin surface might get altered by the surface treatment of dentin with various irrigants. AH Plus (De Trey- Dentsply, Konstanz, Germany) is a popular epoxy resin amine sealer with satisfactory physicochemical and biological properties, low solubility and disintegration, good sealability, and adhesion. A recent study showed that AH Plus sealer has better wettability to root dentin compared to zinc oxide eugenol and GuttaFlow sealers because of its ability to penetrate into micro irregularities.,,
The aim of the present study was to evaluate the wettability of AH Plus sealer with dentin surface treated with 3% NaOCl, QMix, and 0.1% octenidine hydrochloride in the presence and absence a of smear layer.
| Materials and Methods|| |
Seventy extracted single rooted human mandibularfirst premolars were used in this study. Following extraction the teeth were scaled with ultrasonic and washed with distilled water (DW) to remove calculus and soft tissue debris. Criteria for tooth selection included: A single root canal, no visible root caries, fractures or cracks on examination, no signs of internal or external resorption or calcification, and a completely formed apex. Radiographs were taken for all the samples to confirm that the teeth met the selection criteria. The teeth were decoronated with low speed diamond disc under water coolant. Roots were then split longitudinally to yield 140 sections. The sections were flattened with the help of sandpaper (100 grit) to obtain smooth flat surface for analysis. For standardization they were cut with a diamond disc to obtain segments of 10 mm. This method of sample preparation was earlier used by de Assis et al.
Each sample was irrigated with 25 ml 3% NaOCl for 5 min simulating the irrigation used during root canal chemomechanical preparation and then washed with 10ml of DW. The capacity of NaOCl to remove smear layer from the instrumented root canal walls has been found to be lacking. Thus, samples were treated with 17% EDTA for 5 min to remove smear layer in the present study. Comparative evaluation of wettability was done before and after removal of smear layer.
The samples were divided into seven groups of 20 samples each and irrigated as shown in [Table 1]. The samples were dried with nitrogen gas and attached to a glass base for contact angle measurement.
Contact angle measurement
A Rame Hart Goniometer was used to measure the contact angle between AH Plus and dentin samples treated with different irrigant solutions. The AH Plus sealer was manipulated according to manufacturer's instructions and a drop (0.1 ml) was deposited on the dentin surface using a 0.5 ml ultrafine syringe. In each sample, one drop of sealer was measured. Images of the drop were immediately analyzed to provide the values of contact angle [Figure 1]. Data was analyzed statistically (IBM Statistical Package for Social Sciences (SPSS) Statistics for Windows, Version 22.0. Armonk, NY: IBM Corp) using one-way analysis of variance (ANOVA) and post-hoctests. The significance level was set at 0.05.
|Figure 1: >Different groups showing contact angles of sealer with dentin samples treated with different irrigant solutions in the presence and absence of smear layer. (a) 3% NaOCl, (b) QMix, (c) 0.1% octenidinehydrochloride, (d) 17%EDTA+3%NaOCl, (e) 17%EDTA+QMix, (f) 17%EDTA+0.1% octenidine hydrochloride, and (g) control. EDTA = Ethylenediaminetetraacetic acid|
Click here to view
| Results|| |
On evaluating the contact angle between AH Plus and the treated dentin surface, least value of contact angle was seen in the samples treated with QMix followed by 0.1% octenidine hydrochloride and maximum value was observed in samples treated with 3% NaOCl [Figure 1].
[Table 2] lists the mean and standard deviation values of contact angles between sealer and treated dentin surface. When smear layer was removed with 17% EDTA, contact angle values were lower in all cases except when the samples were treated with 3% NaOCl. Thus, 3% NaOCl did not promote wettability of AH Plus even after the samples were treated with 17% EDTA. Results were statistically significant when 3% NaOCl was compared to 0.1% octenidine hydrochloride and QMix (P = 0.034). Also, statistically significant difference was seen in groups before and after removal of smear layer for samples treated with 3% NaOCl and 0.1% octenidine hydrochloride (P = 0.003).
|Table 2: Mean and standard deviation values of contact angle between AH Plus and treated dentin surface|
Click here to view
| Discussion|| |
During the obturation of root canals, a root canal sealer promotes sealing of root canal wall irregularities and spaces where the primary root canal filling material fails to reach. It acts as a binding agent between root canal walls and the main root filling material, thereby contributing to attainment of fluid tight seal., Thus, adequate flow and wetting are important physicochemical properties of a sealer during root canal obturation. Wettability is a measure of affinity of a liquid to a surface of solid as indicated by spreading of a drop. In the present study a drop of AH plus sealer is employed and its contact angle on the dentin surface is analyzed after various surface treatments of dentin.
The study was carried out under standard environmental conditions because surface tension coefficient of liquids is influenced by temperature change and humidity. A controlled volume of sealer (0.1 ml) was used as any volumetric change could affect the value of contact angle. The samples were treated with 25 ml 3% NaOCl for 5 min, thereby simulating normal irrigation protocol.
In the present study, it was seen that the contact angle values were least when samples were treated with QMix. This was in accordance with a recent study conducted by Ballal et al. It could be due to the presence of chlorhexidine, EDTA, and detergent (surface active agent: N-Cetyl-N, N, N-trimethylammonium bromide) in its composition. The rationale of adding a surface active agent in QMix is to lower surface tension and increase wettability, which also enables better penetration of irrigant into the root canal. Chlorhexidine also has a surfactant molecule which increases the dentin surface free energy. Smear layer tends to act as a barrier preventing diffusion of sealer into the dentinal tubule. The presence of EDTA in QMix improves wettability of sealer by removing smear layer and exposing dentinal tubules. Comparative evaluation of the contact angle values clearly indicates that contact angle reduces after removal with 17% EDTA. Hence, it is mandatory to treat root canal wall with chelating agent during chemomechanical preparation. This was in accordance with a previous study done by de Assis et al. However, removal of smear layer by treating the samples with EDTA prior to treatment with QMix did not significantly reduce the contact angle further (P > 0.05).
When samples were treated with 0.1% octenidine hydrochloride, the values of contact angles were low compared to the samples treated with NaOCl; but more than those treated with QMix. Octenidine hydrochloride is a dicationic surfactant, and hence it increases the surface free energy of dentin, thereby improving the wettability of the sealer. Also when the samples were treated with EDTA prior to treatment with octenidine hydrochloride, the contact angle values further reduced for the reason already discussed. Wettability of various sealers to dentin after irrigating with octenidine hydrochloride shows promising results.
In the present study, 3% NaOCl has been used as an irrigant because it is a broad spectrum antimicrobial agent with vital tissue dissolving capacity. Being a Predentin solvent, it increases dentin permeability by opening up dentinal tubules, thereby improving adhesion of sealers to dentin. We observed that when smear layer was removed, use of NaOCl did not favor the spread of AH Plus sealer. AH Plus is a hydrophobic sealer. After removal of smear layer, use of NaOCl causes deproteinization that leads to a hydrophilic surface, which does not promote spreading of hydrophobic sealer. Similar effect was seen in a previous study done by de Assis et al.
Each irrigant brings about a change in the surface characteristics of the dentin, thereby affecting spread of sealer on the dentin. However, future studies should focus on comparison of contact angles of different sealers and sealers other than AH Plus may be used.
Octenidine hydrochloride can serve as an alternate irrigant not only based on its antimicrobial effects and low cytotoxicity but also because of its ability to promote sealer wettability on the dentin surface which is an important aspect of endodontic therapy.
| Conclusion|| |
QMix irrigated samples show least values of contact angle, and thus maximum wettability of the sealer followed by 0.1% octenidine hydrochloride followed by 3% NaOCl.
The removal of smear layer using EDTA further reduced contact angle of AH Plus in samples treated with 0.1% octenidine hydrochloride. Based on this study, QMix should be the irrigant of choice. However, 0.1% octenidine hydrochloride may be recommended as a useful endodontic irrigant after further research. Thus, within the limitations of this in vitro study, the results showed that wettability of sealer on dentin is affected by various irrigating solutions.
| References|| |
Haapasalo M, Shen Y, Qian W, Gao Y. Irrigation in endodontics. Dent Clin North Am 2010;54:291-312.
Zehnder M. Root canal irrigants. J Endod 2006;32:389-98.
Baker NA, Eleazer PD, Averbach RE, Seltzer S. Scanning electron microscopic study of the efficacy of various irrigation solutions. J Endod 1975;1:127-35.
Garg P, Tyagi PS, Sinha DJ, Singh UP, Malik V, Maccune ER. Comparison of antimicrobial efficacy of propolis, Morinda citrifolia, Azadirachta indica, triphala, green tea polyphenols and 5.25% sodium hypochlorite against Enterococcus fecalis biofilm. Saudi Endod J 2014;4:122-7.
Dai L, Khechen K, Khan S, Gillen B, Loushine BA, Wimmer CE, et al.
The Effect of QMix, an experimental antibacterial root canal irrigant, on removal of canal wall smear layer and debris. J Endod 2011;37:80-4.
Stojicic S, Shen Y, Qian W, Johnson B, Haapasalo M. Antibacterial and smear layer removal ability of a novel irritant: QMix. Int Endod J 2009;45:363-71.
Tirali R, Turan Y, Akal N, Karahan ZC.In vitro
antimicrobial activity of several concentrations of Sodium Hypochlorite and Octenisept in elimination of endodontic pathogens. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009;108:117-20.
Tirali RE, Bodur H, Sipahi B, Sungurtekin E. Evaluation of antimicrobial activities of chlorhexidine gluconate, Sodium Hypochlorite and octenidine hypochlorite in vitro.
Aust Endod J 2013;39:15-8.
Decker EM, Weiger R, Wiech I, Heide PE, Brecx M. Comparison of antiadhesive and antibacterial effects of antiseptics on Streptococcus sanguinis. Eur J Oral Sci 2003;111:144-8.
Al-Omari WM, Mitchell CA, Cunningham JL. Surface roughness and wettability of enamel and dentin surfaces prepared with different dental burs. J Oral Rehabil 2001;28:645-50.
Huntsberger JR. Surface energy, wetting and adhesion. Adhesion 1981;12:3-12.
Kontakiotis EG, Tzanetakis GN, Loizides AL. A comparative study of contact angles of four different root canal sealers. J Endod 2007;33:299-302.
Milosevic A. The influence of surface finish and in vitro
pellicle on contact angle measurements and surface morphology of three commercially available composite restoratives. J Oral Rehabil 1992;19:85-97.
Saleh IM, Ruyter IE, Haapasalo M, Ørstavik D. The effects of dentin pre-treatment on the adhesion of root canal sealers. Int Endod J 2002;35:859-66.
Kokkas AB, Boutsioukis Ach, Vassiliadis LP, Stavrianos CK. The influence of the smear layer on dentinal tubule penetration depth by three different root canal sealers: An in vitro
study. J Endod 2004;30:100-2.
Schafer E, Zandbiglari T. Solubility of root-canal sealers in water and artificial saliva. Int Endod J 2003;36:660-9.
Eldeniz AU, Erdenir A, Belli S. Shear bond strength of three resin based sealer to dentin with and without the smear layer. J Endod 2005;3:293-6.
Willershausen B, Marroquin BB, Schafer D, Schulze R. Cytotoxicity of root canal filling materials to three different human cell lines. J Endod 2000;26:703-7.
Tummala M, Chandrasekhar V, Rashmi AS, Kundabala M, Ballal V. Assessment of the wetting behavior of three different root canal sealers on root canal dentin. J Conserv Dent 2012;15:109-12.
Nunes VH, Silva RG, Alfredo E, Sousa-Neto MD, Silva-Sousa YT. Adhesion of Epiphany and AH Plus sealers to human root dentin treated with different solutions. Braz Dent J 2008;19:46-50.
de Assis DF, Prado Md, Simão RA. Evaluation of interaction between endodontic sealers and dentin treated with different irrigant solutions. J Endod 2011;37:1550-2.
Violich DR, Chandler NP. The smear layer in endodontics-A review. Int Endod J 2010;43:2-15.
Iqbal MK, Sijiny R, Al-Zaidan H. A comparison of sealing ability of four sealer cements in apically perforated root canals. Saudi Endod J 2011;1:12-8.
Wennberg A, Ørstavik D. Adhesion of root canal sealers to bovine dentine and gutta-percha. Int Endod J 1990;23:13-9.
Siqueira JF Jr, Favieri A, Gahyva SM, Moraes SR, Lima KC, Lopes HP. Antimicrobial activity and flow rate of newer and established root canal sealers. J Endod 2000;26:274-7.
Newmann AW. Contact angles and their temperature dependence. Adv Colloid Interace Sci 1974;4:105-91.
Vafai S, Podowski MZ. Analysis of the relationship between liquid droplet size and contact angle. Adv Colloid Interface Sci 2005;113:133-46.
Ballal NV, Tweeny A, Khechen K, Prabhu KN, Satyanarayan, Tay FR. Wettability of root canal sealers on intraradicular dentine treated with different irrigating solutions 2013;41:556-60.
Giardino L, Ambu E, Becce C, Rimondini L, Morra M. Surafce tension comparison of four common root canal irrigants and two new irrigants containing antibiotic. J Endod 2006;32:1091-3.
Hu X, Ling J, Gao Y. Effects of irrigation solutions on dentin wettability and roughness. J Endod 2010;36:1064-7.
Karale R, Thakore A, Shetty VK. An evaluation of antibacterial efficacy of 3% Sodium Hypochlorite, high frequency alternating current and 2% Chlorhexidine on Enterococcus faecalis: An in vitro
study. J Conserv Dent 2011;14:2-5.
Attal JP, Asmussen E, Degrange M. Effect of surface treatment on the free surface energy of dentin. Dent Mater 1994;10:259-64.
[Table 1], [Table 2]