|Year : 2022 | Volume
| Issue : 3 | Page : 297-301
Effect of different irrigation regimens on the wettability of Sealer Plus BC and AH Plus sealers on intraradicular dentin: An in vitro study
Archana Ambadas Chavan1, Tina Puthen Purayil1, Sajan Daniel George2, Nidambur Vasudev Ballal1
1 Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Manipal, Karnataka, India
2 Department of Atomic and Molecular Physics, Manipal Institute of Technololgy, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
|Date of Submission||31-Jan-2022|
|Date of Decision||08-Apr-2022|
|Date of Acceptance||11-Apr-2022|
|Date of Web Publication||1-Sep-2022|
Dr. Tina Puthen Purayil
Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Manipal-Manipal Academy of Higher Education, Manipal, Karnataka - 576 104
Source of Support: None, Conflict of Interest: None
Introduction: Irrigants play a major role in eliminating bacteria and modify the wettability of radicular dentin, thus impacting its interaction with restorative materials. Hence, the aim of the current research was to evaluate and compare the effect of 17% ethylenediaminetetraacetic acid (EDTA) and 7% maleic acid (MA) on the wettability of Sealer Plus BC and AH Plus sealers.
Materials and Methods: Thirty single-rooted premolars were decoronated and longitudinally sectioned to form 60 samples. The samples were then arbitrarily separated into three groups (n = 20) determined by the irrigation protocol: Group I (2.5% sodium hypochlorite [NaOCl] + 17% EDTA), Group II (2.5% NaOCl + 7% MA), and Group III (2.5% NaOCl + distilled water). Each group was then split into two subgroups (n = 10) based on the sealer utilized: Subgroup A (Sealer Plus BC sealer) and Subgroup B (AH Plus sealer). The sealers were mixed and placed on the samples. Contact angles of the sealers were determined with a goniometer. The intragroup and intergroup comparison was conducted by Two way-ANOVA test with a significance level of P < 0.01.
Results: The wettability of both sealers was favorably influenced by the final irrigant rinse with 7% MA and 17% EDTA, although there was no statistical difference between both sealers in the MA group (P > 0.01). AH Plus demonstrated a better wettability than Sealer Plus BC in the EDTA group (P < 0.001). Both Sealer Plus BC and AH Plus sealers demonstrated lower contact angles on final irrigation with 7% MA in comparison to 17% EDTA.
Conclusion: As a final irrigant, 7% MA increased the wettability of both Sealer Plus BC and AH Plus sealers compared to 17% EDTA.
Keywords: AH Plus, contact angle, maleic acid, Sealer Plus BC, wettability
|How to cite this article:|
Chavan AA, Purayil TP, George SD, Ballal NV. Effect of different irrigation regimens on the wettability of Sealer Plus BC and AH Plus sealers on intraradicular dentin: An in vitro study. Saudi Endod J 2022;12:297-301
|How to cite this URL:|
Chavan AA, Purayil TP, George SD, Ballal NV. Effect of different irrigation regimens on the wettability of Sealer Plus BC and AH Plus sealers on intraradicular dentin: An in vitro study. Saudi Endod J [serial online] 2022 [cited 2022 Oct 5];12:297-301. Available from: https://www.saudiendodj.com/text.asp?2022/12/3/297/354831
| Introduction|| |
Endodontic therapy targets the idea of bringing about a fluid-tight seal alongside the eradication of microorganisms through thorough irrigation during instrumentation. The production of a smear layer in the root canal is induced by mechanical instrumentation, which in turn alters the penetration of irrigants, medicaments, and sealers into the dentinal tubules. Irrigants play a role in lubricating the canals while simultaneously eradicating bacteria by debriding the inaccessible necrotic tissue by mechanical instrumentation.
Sodium hypochlorite (NaOCl) is an established irrigant owing to its capacity for organic tissue dissolution and potent antimicrobial properties. However, when apical tissues are subjected to NaOCl at higher concentrations, it acts as an irritant. Although the combination of NaOCl and ethylenediaminetetraacetic acid (EDTA) is the most employed irrigation regimen, EDTA is known to display a few disadvantageous properties such as cytotoxicity and a diminished smear layer removal efficacy in the apical third segment of the root canal. Maleic acid (MA) is one of the contemporary irrigants in the field of endodontics that has been established to be more efficacious in the smear layer removal of the apical third segment of the root canal, as opposed to 17% EDTA.
Irrigants may modify the root dentin wettability by removing the smear layer, in turn influencing the bacterial adhesion to the root dentin, along with its interaction with restorative materials. The wettability of the root dentinal surface governs the adaptation of a root canal sealer to the surface,, which helps in creating an impervious seal along with the obturation material, which makes it imperative to study the effect of different irrigants on the wetting ability of root canal sealers. However, no study has evaluated the effect of 17% EDTA and 7% MA on the wettability of Sealer Plus BC sealer on root canal dentin. Hence, this study aims to evaluate the contact angle of Sealer Plus BC on the root dentin following treatment with 17% EDTA and 7% MA.
| Materials and Methods|| |
Ethical clearance was acquired from the Institutional Review Board (IEC: 812/2019).
Sample size calculation was done using the following formula:
Where Zα = 1.96 at 95% confidence level, Zβ = 1.28 at 90% power, S = 9.367 (combined standard deviation), and d = 9.596 (mean difference).
Sample size was calculated to a minimum of 20 in each group, 10 in each subgroup.
Thirty intact human single-rooted premolars, each having a single canal and fully formed apex, were collected and cleaned using ultrasonics for the removal of debris and calculus. The exclusion criteria consisted of teeth with fractures, caries, resorptions, and calcifications.
The collected teeth were subjected to 0.2% sodium azide (Sigma-Aldrich, Germany) for disinfection and stored at 4°C until sample preparation to prevent dehydration of teeth. These samples were then decoronated with a low-speed diamond disc (Frank Dental GmbH, Bavaria, Germany) using water as a coolant. Following this, the teeth were split longitudinally into 60 sections, which were flattened and polished with 100-grit silicon carbide paper (30 strokes per specimen) to obtain a fine surface for the analysis.
The specimens were arbitrarily separated into three groups (n = 20) based on the irrigation protocol to be followed:
- Group I: 2.5% NaOCl (1 min) + 17% EDTA (1 min)
- Group II: 2.5% NaOCl (1 min) + 7% MA (1 min)
- Group III: 2.5% NaOCl (1 min) + distilled water (1 min).
After the irrigation procedure, each sample was washed with 5-mL deionized water for 1 min to eliminate any precipitation and blot dried using blotting paper. Depending on the sealer to be used for contact angle measurement, each group of specimens was split into two subgroups (n = 10): Subgroup A – Sealer Plus BC (MK Life, Rio Grande do Sul, Brazil) and Subgroup B – AH Plus (Dentsply DE Trey, Konstanz, Germany). The summary of the sample divisions based on the irrigation regimen and sealers used is specified in [Table 1].
|Table 1: Grouping of samples based on irrigation regimen and sealer used|
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Contact angle measurement
Contact angle measurement was done with the Ramé-hart contact angle goniometer (RCAG) (Ramé-hart Instrument Co., Succasunna, NJ, USA). The RCAG equipment comprises a horizontal stage for the installation of a solid/liquid sample, an illuminant, and an inbuilt camera. The prepared specimens from each group were individually placed on the horizontal stage. Each sealer was prepared in abiding by the manufacturer's instructions and applied on the surface of the selected specimen as a controlled volume droplet (0.1 mL), using a micropipette. For each irrigation regimen group, three drops of the same sealer were analyzed. After recording the sealer spreading process for 60s, the static contact angles produced by the sealers on root canal dentin were determined by taking pictures of the droplets with the camera, followed by their measurement with the Contact Angle Meter software (Version 126.96.36.199, Kyowa Interface Science Co., Ltd., Niiza, Saitama, Japan).
Statistical analysis was carried out with IBM SPSS statistics version 20.0 software (IBM Corp., Armonk, NY, USA). The normality of the data was assessed using Kolmogorov–Smirnov test. The intragroup comparison among irrigants and intergroup comparison between sealers were conducted by means of two-way ANOVA test with a significance level of P < 0.01 [Table 2] and [Table 3] and [Figure 1].
|Table 2: Intergroup comparison of irrigants tested for Sealer Plus BC and AH Plus sealers|
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|Table 3: Intragroup comparison of wettability between Sealer Plus BC and AH Plus sealers|
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|Figure 1: Contact angles made by Sealer Plus BC and AH Plus sealer when subjected to various irrigants|
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| Results|| |
[Figure 1] depicts the mean contact angles made by Sealer Plus BC and AH Plus sealers on root canal dentin subjected to various irrigants. The wettability of both Sealer Plus BC and AH Plus sealers on root canal dentin was favorably influenced by the final irrigant rinse (P < 0.001).
Comparison of the sealers
There was a substantial statistical difference in the contact angles made by Sealer Plus BC and AH Plus sealers when 17% EDTA was used as a final irrigant (P < 0.001), with AH Plus demonstrating superior wettability than the Sealer Plus BC. When 7% MA was employed, the wettability of Sealer Plus BC did not differ significantly from the wettability of AH Plus.
Comparison of the irrigants
Sealer Plus BC showed better wettability when the root canal dentin was treated with 17% EDTA and 7% MA in comparison to distilled water. MA significantly reduced the contact angle of Sealer Plus BC than EDTA.
Both 17% EDTA and 7% MA had a beneficial effect on the wetting ability of AH Plus sealer, in comparison to distilled water. Although, the use of 7% MA as a final irrigant on radicular dentin improved the wettability of AH Plus when compared to 17% EDTA.
| Discussion|| |
The results of this research demonstrated that both Sealer Plus BC and AH Plus sealers showed the best wettability when MA was used to treat the root canal dentin.
Erickson stated that the contact angle of a sealer is affected by the wettability of the dentinal surface. Another factor that affects the contact angle of the sealer is the surface tension that is caused by the intermolecular attraction of a liquid interacting with a solid surface. It reduces as the intermolecular attraction weakens. In addition, the presence of heat or surfactant may reduce the surface tension. The liquid should have the lowest feasible contact angle with the surface for optimal wettability.
The contact angle is also found to be affected by the state of hydration of the dentinal surface. In the current study, the dentin surface was polished to diminish the influence of roughness on the surface energy of the radicular dentin wall and thus on the contact angle measurement. The volume of the sealer was quantified with a micropipette for all static contact angle measurements. This was done to minimize the influence of volume change on the value of contact angle measurement. Furthermore, as the surface tension coefficient of a liquid is influenced by temperature and humidity, the complete experiment was carried out under conventional climatic conditions.
When the irrigants were compared, it was inferred that both sealers showed better wettability with 7% MA than 17% EDTA, which was consistent with previous studies., This could be attributed to the better chelating action of MA when compared to 17% EDTA., Another cause for the decrease in the contact angle of both the sealers on irrigation with MA could be the positive association between surface roughness and wettability of a sealer, which results in a decrease in the contact angle of a sealer as surface roughness increases.
17% EDTA performed poorly considering the wettability of both sealers as compared to 7% MA. Owing to the high pH of EDTA, there are more OH ions (hydroxyl) present, which leads to less hydroxyapatite dissociation in the smear layer. As a result of this occurrence, the number of calcium ions that may be chelated by EDTA is reduced, resulting in EDTA's limited efficiency in reducing sealer wettability.
Sealer Plus BC had a poorer wettability than AH Plus sealer in this study, which could be due to lower intermolecular attraction and surface tension than AH Plus. The enhanced wetting of AH Plus on the radicular dentin may be due to the sealer's close contact with the dentinal surface and its superior penetration capacity into micro-irregularities and dentinal tubules when the smear layer is removed.
A limitation of this study is that in the clinical scenario, the surface roughness of the instrumented canal and the method of the placement of the sealer in the canal will differ from the experimental methodology used in this study, which may affect the contact angle values of the sealers.
As it promotes sealer penetration into the micro-irregularities, good wetting is a requisite to improve adhesion between the canal wall and the sealer. Good wetting, on the other hand, does not always imply good adhesion. Associated with the formation of a mineral infiltration zone, bioceramic sealers have been shown to have improved adhesion to root canal dentin. Hence, more research needs to be done to assess Sealer Plus BC's dentinal penetration and three-dimensional obturation.
| Conclusion|| |
As a final irrigant, 7% MA increased the wettability of both Sealer Plus BC and AH Plus sealers to root canal dentin compared to 17% EDTA.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Siqueira JF Jr., Rôças IN. Optimising single-visit disinfection with supplementary approaches: A quest for predictability. Aust Endod J 2011;37:92-8.
White RR, Goldman M, Lin PS. The influence of the smeared layer upon dentinal tubule penetration by endodontic filling materials. Part II. J Endod 1987;13:369-74.
Tammineedi S, Kakollu S, Thota MM, Basam LC, Basam RC, Chinthamreddy S. Comparison of the effect of sodium hypochlorite, EDTA, and etidronic acid on wettability of root canal sealers using contact angle goniometer: An in vitro
study. J Dr NTR Univ Health Sci 2020;9:178-82.
Ruddle CJ. Endodontic disinfection: Tsunami irrigation. Saudi Endod J 2015;5:1-12. [Full text]
de Sermeño RF, da Silva LA, Herrera H, Herrera H, Silva RA, Leonardo MR. Tissue damage after sodium hypochlorite extrusion during root canal treatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009;108:e46-9.
Ballal NV, Kundabala M, Bhat S, Rao N, Rao BS. A comparative in vitro
evaluation of cytotoxic effects of EDTA and maleic acid: Root canal irrigants. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009;108:633-8.
Ballal NV, Kandian S, Mala K, Bhat KS, Acharya S. Comparison of the efficacy of maleic acid and ethylenediaminetetraacetic acid in smear layer removal from instrumented human root canal: A scanning electron microscopic study. J Endod 2009;35:1573-6.
Pringle JH, Fletcher M. Influence of substratum wettability on attachment of freshwater bacteria to solid surfaces. Appl Environ Microbiol 1983;45:811-7.
Baier RE. Principles of adhesion. Oper Dent 1992;Suppl 5:1-9.
Erickson RL. Surface interactions of dentin adhesive materials. Oper Dent 1992;Suppl 5:81-94.
Eick JD, Gwinnett AJ, Pashley DH, Robinson SJ. Current concepts on adhesion to dentin. Crit Rev Oral Biol Med 1997;8:306-35.
Abou-Rass M, Patonai FJ Jr. 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.
Cameron JA. The effect of a fluorocarbon surfactant on the surface tension of the endodontic irrigant, sodium hypochlorite. A preliminary report. Aust Dent J 1986;31:364-8.
Attal JP, Asmussen E, Degrange M. Effects of surface treatment on the free surface energy of dentin. Dent Mater 1994;10:259-64.
Rosales JI, Marshall GW, Marshall SJ, Watanabe LG, Toledano M, Cabrerizo MA, et al.
Acid-etching and hydration influence on dentin roughness and wettability. J Dent Res 1999;78:1554-9.
Good RJ, Koo MN. The effect of drop size on contact angle. J Colloid Interface Sci 1979;71:283-92.
Neumann AW, Good RJ, Hope CJ, Sejpal M. An equation-of-state approach to determine surface tensions of low-energy solids from contact angles. J Colloid Interface Sci 1974;49:291-304.
Ballal NV, Tweeny A, Khechen K, Prabhu KN, Satyanarayan, Tay FR. Wettability of root canal sealers on intraradicular dentine treated with different irrigating solutions. J Dent 2013;41:556-60.
Gandhi P, Ballal NV, George JE, George SD, Narkedamalli RK. Effect of chelating agents on the wettability of BioRoot RCS and AH Plus sealers. Saudi Endod J 2020;10:100-5. [Full text]
Kuruvilla A, Jaganath BM, Krishnegowda SC, Ramachandra PK, Johns DA, Abraham A. A comparative evaluation of smear layer removal by using edta, etidronic acid, and maleic acid as root canal irrigants: An in vitro
scanning electron microscopic study. J Conserv Dent 2015;18:247-51.
] [Full text]
Wenzel RN. Resistance of solid surfaces to wetting by water. J Ind Eng Chem 1936;28:988-94.
Nikiforuk G, Sreebny L. Demineralization of hard tissues by organic chelating agents at neutral pH. J Dent Res 1953;32:859-67.
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.
Grégoire G, Dabsie F, Dieng-Sarr F, Akon B, Sharrock P. Solvent composition of one-step self-etch adhesives and dentine wettability. J Dent 2011;39:30-9.
Samuel B, Zhao H, Law KY. Study of wetting and adhesion interactions between water and various polymer and superhydrophobic surfaces. J Phys Chem C 2011;115:14852-61.
Han L, Okiji T. Uptake of calcium and silicon released from calcium silicate-based endodontic materials into root canal dentine. Int Endod J 2011;44:1081-7.
[Table 1], [Table 2], [Table 3]