Discipline of Endodontology, Department of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region.
Discipline of Pediatric Dentistry, Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region.
Dent Mater. 2020 Dec;36(12):1655-1665. doi: 10.1016/j.dental.2020.10.010. Epub 2020 Nov 5.
Proteolytic and demineralizing agents have a profound influence on the dentin ultrastructure, which plays a key role in the mechanical integrity of the tooth and integrity of dentin-biomaterial interfaces. In-depth characterization of dentin treated with a novel root canal irrigation protocol comprising sodium hypochlorite (NaOCl) and etidronate (HEDP) is lacking. This study comprehensively characterized and compared the effects of the continuous chelation (NaOCl/HEDP) and sequential chelation (NaOCl/EDTA) protocols on dentin.
Dentin blocks, dentin powder and root canals of mandibular premolars were distributed into Group 1, Saline (control); Group 2, NaOCl/EDTA; and Group 3, NaOCl/HEDP. Ultrastructural characteristics of the treated dentin were investigated using electron microscopy and light microscopy, while the surface roughness was analyzed using atomic force microscopy. Chemical compositional changes were characterized using Fourier transform infrared spectroscopy (FTIR) and energy-dispersive-X-ray spectroscopy (EDS), while collagen degradation was determined using ninhydrin assay. Data were statistically analyzed using multiple-factor one-way ANOVA and Tukey HSD tests (P = 0.05).
NaOCl/HEDP resulted in partially degraded, yet mineralized collagen fibers, with minimal alteration to the subsurface matrix. Conversely, NaOCl/EDTA dissolved the hydroxyapaptite encapsulation, exposing collagen fibre bundles. There was no significant difference in the surface roughness between the two protocols (P > 0.05). NaOCl/HEDP resulted in homogenous distribution of organic and inorganic components on the treated surface.
This study highlighted that continuous chelation (NaOCl/HEDP) resulted in a frail surface collagen layer while sequential chelation (NaOCl/EDTA) exposed bare collagen fibres. These surface and sub-surface effects potentially contribute to structural failures of dentin and/or dentin-biomaterial interfacial failures.
蛋白水解和脱矿物质剂对牙本质超微结构有深远影响,而牙本质超微结构对牙齿的机械完整性和牙本质-生物材料界面的完整性起着关键作用。目前缺乏对采用新型根管冲洗方案(包含次氯酸钠(NaOCl)和依替膦酸(HEDP))处理的牙本质进行深入表征。本研究全面表征和比较了连续螯合(NaOCl/HEDP)和顺序螯合(NaOCl/EDTA)方案对牙本质的影响。
将牙本质块、牙本质粉末和下颌前磨牙根管分别分配到第 1 组(生理盐水对照)、第 2 组(NaOCl/EDTA)和第 3 组(NaOCl/HEDP)。采用电子显微镜和光学显微镜观察处理后牙本质的超微结构特征,原子力显微镜分析表面粗糙度。采用傅里叶变换红外光谱(FTIR)和能谱(EDS)分析化学组成变化,采用茚三酮法测定胶原蛋白降解情况。采用多因素方差分析和 Tukey HSD 检验对数据进行统计学分析(P = 0.05)。
NaOCl/HEDP 导致部分降解但矿化的胶原蛋白纤维,对亚表面基质的改变最小。相反,NaOCl/EDTA 溶解了羟基磷灰石的包裹,暴露出胶原纤维束。两种方案的表面粗糙度无显著差异(P > 0.05)。NaOCl/HEDP 导致处理表面有机和无机成分均匀分布。
本研究表明,连续螯合(NaOCl/HEDP)导致牙本质表面胶原蛋白层脆弱,而顺序螯合(NaOCl/EDTA)则暴露出裸露的胶原纤维。这些表面和亚表面的影响可能导致牙本质结构失效和/或牙本质-生物材料界面失效。