Department of Restorative Dentistry, Dental Materials and Endodontics, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil.
School of Dentistry, Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.
Sci Rep. 2021 Feb 25;11(1):4666. doi: 10.1038/s41598-021-83849-y.
In root canal therapy, irrigating solutions are employed to eliminate the bacterial load and also prepare dentin for sealer interaction. The aim of this research was to assess how irrigating solutions employed on their own or in sequence affected the tooth structure. The best way to prepare the tooth for obturation using hydraulic calcium silicate cement (HCSC) sealers and gutta-percha, thus guiding clinicians on a matched irrigation-obturation strategy for optimized root canal treatment was investigated. The effect of irrigating solutions on dentine was investigated by assessing changes in dentin microhardness, ultrastructure and mineral content, organic/inorganic matter, surface roughness and Young's modulus. The interaction of four root canal sealers with the dentin was analysed by assessing the changes in microhardness of the dentin after sealer placement and also the sealer to dentin interface by scanning electron and confocal laser microscopy. The irrigating solutions damaged the dentin irreversibly both when used on their own and in combination. The best sequence involved sodium hypochlorite followed by chelator and a final rinse with sodium hypochlorite and obturation using HCSC sealers that enabled the restoration of dentin properties. The HCSC sealers did not rely on chelator irrigating solutions for a good material adaptation to dentin.
在根管治疗中，冲洗液用于消除细菌负荷并为密封剂与牙本质的相互作用做准备。本研究旨在评估单独或连续使用冲洗液对牙体结构的影响。研究使用液压硅酸钙水泥（HCSC）密封剂和牙胶对牙齿进行最佳填充，从而为临床医生提供匹配的冲洗-填充策略，以优化根管治疗，探讨了这种方法。通过评估牙本质微硬度、超微结构和矿物质含量、有机/无机物质、表面粗糙度和杨氏模量的变化，研究了冲洗液对牙本质的影响。通过评估密封剂放置后牙本质微硬度的变化以及扫描电子显微镜和共聚焦激光显微镜下的密封剂-牙本质界面，分析了四种根管密封剂与牙本质的相互作用。单独使用和联合使用冲洗液都会对牙本质造成不可逆的损伤。最佳的冲洗顺序为次氯酸钠-螯合剂-次氯酸钠最后冲洗，并用 HCSC 密封剂进行填充，从而恢复牙本质的特性。HCSC 密封剂不需要依赖螯合剂冲洗液来实现与牙本质的良好材料适应性。
