Department of Endodontics, Faculty of Dental Medicine, Saint- Joseph University, Beirut, Lebanon.
Department of Conservative and Preventive Dentistry, Periodontology and Cariology, University of Zurich, Zurich, Switzerland.
Eur Endod J. 2023 Mar;8(2):162-169. doi: 10.14744/eej.2022.93064.
This study aimed to assess the effect of sodium hypochlorite (NaOCl) combined with a novel chelating agent DualRinse HEDP (Medcem GmbH, Weinfelden, Switzerland), a product consisting of 0.9 g of 1-hydroxyethylidene-1,1-diphosphonic acid (HEDP) powder, with or without high-power sonic activation on debris and smear layer removal.
Seventy-five mandibular premolars were divided into 5 groups (n=15) and treated with different irrigation protocols: group 1 (D3N), DualRinse HEDP+3% NaOCl without activation; group 2 (D3NA), DualRinse HEDP+3% NaOCl with activation (EDDY, VDW, Munich, Germany) during the final irrigation; group 3 (3NE), 3% NaOCl+17% Ethylenediaminetetracetic acid (EDTA)+3% NaOCl without activation; group 4 (3NEA), 3% NaOCl+17% EDTA+3% NaOCl with activation during the final irrigation; group 5 (NC), negative control group, 0.9% saline. Samples were analysed by scanning electron microscopy (SEM) to evaluate residual debris and smear layer at 3 levels of the root canal: coronal, middle, and apical. Statistical analysis was performed with a level of significance set at p<0.05. The normality distribution of scores within each group was assessed using Kolmogorov-Smirnov and Shapiro-Wilk tests. A Kruskal-Wallis test followed by multiple comparison tests was used to compare scores among the 5 groups on the apical, middle, and coronal levels of the root canal. A Friedman test followed by multiple comparison tests was used to compare scores within the apical, middle, and coronal levels for each treatment group.
Debris score was significantly the lowest for D3NA, followed by D3N, 3NEA and 3NE at all root levels (p<0.05). The smear layer score was significantly the lowest for D3NA, followed by D3N, 3NEA and 3NE only at the apical level, while no significant difference was found in the middle and coronal levels between the groups (p<0.05). DualRinse HEDP resulted in less debris and smear layer compared to the classic approach of NaOCl without activation. Implementing sonic activation further improved debris and smear layer removal.
DualRinse HEDP+3% NaOCl improved debris removal at all levels and smear layer elimination at the apical level of the root canal. These results were further enhanced when adding high-power sonic activation. (EEJ-2022-09-116).
本研究旨在评估次氯酸钠（NaOCl）与新型螯合剂 DualRinse HEDP（Medcem GmbH，Weinfelden，瑞士）联合应用，该产品由 0.9 克 1-羟乙基二膦酸（HEDP）粉末组成，是否会对根管内的残屑和玷污层去除产生影响。
75 颗下颌前磨牙分为 5 组（n=15），采用不同的冲洗方案进行处理：组 1（D3N），DualRinse HEDP+3% NaOCl 无激活；组 2（D3NA），DualRinse HEDP+3% NaOCl 激活（EDDY，VDW，慕尼黑，德国）在最终冲洗期间；组 3（3NE），3% NaOCl+17%乙二胺四乙酸（EDTA）+3% NaOCl 无激活；组 4（3NEA），3% NaOCl+17% EDTA+3% NaOCl 激活在最终冲洗期间；组 5（NC），阴性对照组，0.9%生理盐水。采用扫描电子显微镜（SEM）分析样本，以评估根管内 3 个水平（冠、中、根尖）的残留残屑和玷污层。使用显著性水平 p<0.05 进行统计分析。使用 Kolmogorov-Smirnov 和 Shapiro-Wilk 检验评估每组内评分的正态分布。使用 Kruskal-Wallis 检验和多个比较检验比较 5 个组在根管根尖、中部和冠部的评分。使用 Friedman 检验和多个比较检验比较每个处理组的根尖、中部和冠部的评分。
在所有根管水平上，D3NA 的残屑评分最低，其次是 D3N、3NEA 和 3NE（p<0.05）。D3NA 的玷污层评分最低，其次是 D3N、3NEA 和 3NE，仅在根尖水平，而各组在中部和冠部水平之间无显著差异（p<0.05）。与无激活的经典 NaOCl 方法相比，DualRinse HEDP 可减少残屑和玷污层。实施超声激活进一步改善了残屑和玷污层的去除。
DualRinse HEDP+3% NaOCl 可提高根管内各水平的残屑去除率和根尖水平的玷污层消除率。当添加高功率超声激活时，这些结果得到进一步增强。（EEJ-2022-09-116）。
