In vitro assessment of dentinal permeability after the use of ultrasonic-activated irrigants in the pulp chamber before internal dental bleaching.

This in vitro study aimed to assess dentin permeability quantitatively after the use of different irrigants into the pulp chamber, with or without ultrasonic activation, before the application of an internal bleaching agent. Thirty maxillary anterior teeth, treated endodontically, were randomly assigned to six groups, according to the irrigant used: group I, distilled water; group II, 17% EDTA; group III, 1% sodium hypochlorite; for groups IV, V, and VI, respectively, the same solutions were used, but were ultrasonicated. In groups I, II, and III, the irrigant that filled the pulp chamber was left undisturbed for 15 s and was then aspirated; in groups IV, V, and IV, the irrigants were placed into the pulp chamber, ultrasonic-activated for 15 s, and were then aspirated. This sequence was repeated three times for all groups. Afterwards, for all groups, the pulp chamber was dried, filled with a bleaching agent, and sealed with glass ionomer cement. At each change of the whitening agent, these procedures were repeated. Then, the temporary restorations were removed, access cavities were cleaned, and teeth were immersed in a 10% copper sulfate aqueous solution, submitted to vacuum and immersed in a 1% rubianic acid alcohol solution. Copper ion penetration was revealed by the rubianic acid. After staining, roots were removed at the cemento-enamel junction (CEJ) and sectioned in a mesiodistal direction starting from the cervical plug level. The sections were thinned, observed under an optical microscope, the images were digitized, and copper ion penetration was measured in each section using a specific software. Means and SD were: group I, 2.41 (+/-1.45); group II, 5.22 (+/-1.79); group III, 8.32 (+/-2.55); group IV, 3.73 (+/-0.89); group V, 14.83 (+/-4.99); and group VI, 10.51 (+/-2.65). Statistical analysis using two-way anova and Tukey test showed that, regardless of the irrigant, ultrasonication increased dentinal permeability (P < 0.01). Comparing the overall effectiveness of the tested solutions, EDTA yielded the greatest increase in dentinal permeability (P < 0.01). Based on these results, it may be concluded that use of ultrasonic-activated irrigants in the pulp chamber, before the accomplishment of internal dental bleaching procedures, may result in a remarkable increase of dentin permeability, which may enhance the efficiency of the whitening agent.