The Effect of pH-regulated EDTA on Root Canal Dentin
Purpose: The purpose of this study was to evaluate the dentin demineralization and smear layer removal ability of 3% EDTA of pH 12.2 (pH 12.2 EDTA) as a root canal irrigant. Method: The demineralization effect of the pH 12.2 EDTA was analyzed using 10 human permanent teeth with a single root canal....
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| Published in | The Japanese Journal of Conservative Dentistry Vol. 63; no. 5; pp. 425 - 431 |
|---|---|
| Main Authors | , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
The Japanese Society of Conservative Dentistry
2020
特定非営利活動法人 日本歯科保存学会 |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0387-2343 2188-0808 |
| DOI | 10.11471/shikahozon.63.425 |
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| Abstract | Purpose: The purpose of this study was to evaluate the dentin demineralization and smear layer removal ability of 3% EDTA of pH 12.2 (pH 12.2 EDTA) as a root canal irrigant. Method: The demineralization effect of the pH 12.2 EDTA was analyzed using 10 human permanent teeth with a single root canal. The test samples were prepared by inducing a smear layer on the cross section of dentin after vertically cutting the teeth, and 3% EDTA of pH 9.0 was used as a control group. The pH 12.2 EDTA was used to irrigate the test samples for 1 to 60 minutes, and the surface hardness of the root canal dentin at each working time was measured by the indentation hardness test (HIT) and the indentation elastic modulus test (EIT). The effect of removing the smear layer was determined by observing the dentin surface by SEM after the pH 12.2 EDTA was applied for each irrigation time, and the state of the remaining smear layer was determined by the 5-step method according to the method of Hülsmann. Regarding the chemical stability analysis, the pH 12.2 EDTA solution was classified into storage groups at 25°C and 40°C, and the pH changes and changes of EDTA content were analyzed after storage for 6 months. Results: No statistically significant differences of dentin demineralization were found by measuring HIT and EIT. The residual smear layer in the test samples was not observed, and there was no significant difference compared with the pH 9.0 EDTA control group. Furthermore, no significant difference was found in change in dentin hardness after irrigation and the removing effect of the smear layer in the coronal, middle and apical of the root canal. Furthermore, no change was observed in color tone or properties for 6 months under the conditions of storage at 25°C and 40°C. Conclusion: The pH 12.2 EDTA solution was shown to have excellent smear layer removal effect and chemical stability as a root canal irrigant. |
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| AbstractList | Purpose: The purpose of this study was to evaluate the dentin demineralization and smear layer removal ability of 3% EDTA of pH 12.2 (pH 12.2 EDTA) as a root canal irrigant. Method: The demineralization effect of the pH 12.2 EDTA was analyzed using 10 human permanent teeth with a single root canal. The test samples were prepared by inducing a smear layer on the cross section of dentin after vertically cutting the teeth, and 3% EDTA of pH 9.0 was used as a control group. The pH 12.2 EDTA was used to irrigate the test samples for 1 to 60 minutes, and the surface hardness of the root canal dentin at each working time was measured by the indentation hardness test (HIT) and the indentation elastic modulus test (EIT). The effect of removing the smear layer was determined by observing the dentin surface by SEM after the pH 12.2 EDTA was applied for each irrigation time, and the state of the remaining smear layer was determined by the 5-step method according to the method of Hülsmann. Regarding the chemical stability analysis, the pH 12.2 EDTA solution was classified into storage groups at 25°C and 40°C, and the pH changes and changes of EDTA content were analyzed after storage for 6 months. Results: No statistically significant differences of dentin demineralization were found by measuring HIT and EIT. The residual smear layer in the test samples was not observed, and there was no significant difference compared with the pH 9.0 EDTA control group. Furthermore, no significant difference was found in change in dentin hardness after irrigation and the removing effect of the smear layer in the coronal, middle and apical of the root canal. Furthermore, no change was observed in color tone or properties for 6 months under the conditions of storage at 25°C and 40°C. Conclusion: The pH 12.2 EDTA solution was shown to have excellent smear layer removal effect and chemical stability as a root canal irrigant. Purpose: The purpose of this study was to evaluate the dentin demineralization and smear layer removal ability of 3% EDTA of pH 12.2 (pH 12.2 EDTA) as a root canal irrigant. Method: The demineralization effect of the pH 12.2 EDTA was analyzed using 10 human permanent teeth with a single root canal. The test samples were prepared by inducing a smear layer on the cross section of dentin after vertically cutting the teeth, and 3% EDTA of pH 9.0 was used as a control group. The pH 12.2 EDTA was used to irrigate the test samples for 1 to 60 minutes, and the surface hardness of the root canal dentin at each working time was measured by the indentation hardness test (HIT) and the indentation elastic modulus test (EIT). The effect of removing the smear layer was determined by observing the dentin surface by SEM after the pH 12.2 EDTA was applied for each irrigation time, and the state of the remaining smear layer was determined by the 5-step method according to the method of Hülsmann. Regarding the chemical stability analysis, the pH 12.2 EDTA solution was classified into storage groups at 25°C and 40°C, and the pH changes and changes of EDTA content were analyzed after storage for 6 months. Results: No statistically significant differences of dentin demineralization were found by measuring HIT and EIT. The residual smear layer in the test samples was not observed, and there was no significant difference compared with the pH 9.0 EDTA control group. Furthermore, no significant difference was found in change in dentin hardness after irrigation and the removing effect of the smear layer in the coronal, middle and apical of the root canal. Furthermore, no change was observed in color tone or properties for 6 months under the conditions of storage at 25°C and 40°C. Conclusion: The pH 12.2 EDTA solution was shown to have excellent smear layer removal effect and chemical stability as a root canal irrigant. 目的 : 本研究は, pH 12.2に調整した3%EDTA (以降pH 12.2 EDTA) 溶液の根管洗浄剤としての臨床応用を目的として, ヒト抜去歯根管象牙質に対する象牙質脱灰能とスミヤー層除去効果について解析した. 方法 : pH 12.2 EDTA溶液の無機質溶解作用は, ヒト単根抜去歯10本を使用して解析した. pH 9.0の3%EDTA溶液 (スメアクリーン) を対照群として比較した. 試料は歯根を垂直割断後, 象牙質断面にスミヤー層を実験的に誘導した. 象牙質脱灰能の解析には, pH 12.2 EDTA溶液を試料に対して1～60分間経時的に作用させ, 所定時間経過後の根管象牙質表面硬さについて, 超微小押込み硬さ試験機にて, 押込み硬さ (HIT), 押込み弾性率 (EIT) を測定した. スミヤー層除去効果は, pH 12.2 EDTA溶液を経時的に作用後, 根管象牙質表面をSEMにて観察し, スミヤー層残存状態をHülsmannの方法に従って5段階法で判定した. 化学的安定性は, pH 12.2 EDTA溶液を25°C, 40°C保管群に分類し1, 6カ月間保管後にpH変動およびEDTA含有量の変化を解析した. 結果 : 象牙質脱灰能をHIT, EITの測定によって評価した結果, いずれの測定値も作用前と比較して統計学的有意差を認めなかった. pH 12.2 EDTA溶液による根管洗浄後にスミヤー層の残存は認められず, 対照群と比較して, スミヤー層除去効果に有意差は認められなかった. さらに, 根管歯冠部, 中央部および根尖部において, 洗浄後の根管象牙質表面硬さとスミヤー層除去効果に有意差は認められなかった. pH 12.2 EDTA溶液を6カ月間保存後, いずれの保存条件においてもpHの変化, およびEDTA含有量に変化は認められなかった. 結論 : pH 12.2 EDTA溶液は適切なスミヤー層除去効果を有し, 60分間作用後にも過剰脱灰を示さなかった. さらに, 25°C, 40°Cの保管条件で6カ月間, 色調・性状に変化は認められなかった. |
| Author | Nobuyuki, TANI-ISHII Jiro, SUZUKI Ryuji, FUJIMAKI |
| Author_FL | 藤巻 龍治 石井 信之 鈴木 二郎 |
| Author_FL_xml | – sequence: 1 fullname: 藤巻 龍治 – sequence: 2 fullname: 鈴木 二郎 – sequence: 3 fullname: 石井 信之 |
| Author_xml | – sequence: 1 fullname: Ryuji, FUJIMAKI organization: Division of Pulp Biology and Endodontics, Department of Oral Interdisciplinary Medicine, Graduate School of Dentistry, Kanagawa Dental University – sequence: 1 fullname: Jiro, SUZUKI organization: Division of Pulp Biology and Endodontics, Department of Oral Interdisciplinary Medicine, Graduate School of Dentistry, Kanagawa Dental University – sequence: 1 fullname: Nobuyuki, TANI-ISHII organization: Division of Pulp Biology and Endodontics, Department of Oral Interdisciplinary Medicine, Graduate School of Dentistry, Kanagawa Dental University |
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| References | 22) 片岡博樹, 須田英明. スメア層・根管治療における臨床的意義. QE 1996 ; 15 : 446-448. 23) 吉岡隆知, 片岡博樹, 須田英明. EDTAを用いた根管洗浄. 歯科評論 1998 ; 669 : 175-180. 6) Sirtes G, Waltimo T, Schaetzle M, Zehnder M. The effects of temperature on sodium hypochlorite short-term stability, pulp dissolution capacity, and antimicrobial efficacy. J Endod 2005; 31: 669-671. 4) Dotto L, Sarkis Onofre R, RoCha Pereira GK. Effect of root canal irrigants on the mechanical properties of endodontically treated teeth: A scoping review. J Endod 2020; 5: 596-604. 9) Lottanti S, Gautschi H, Sener B, Zehnder M. Effects of ethylenediaminetetraacetic, etidronic and peracetic acid irrigation on human root dentine and the smear layer. Int Endod J 2009; 42: 335-343. 26) 中島 薫, 寺田林太郎, 久保田 捻, 常川勝由. pH調整EDTA水溶液による根管壁スメア層の除去効果. 日本臨床歯内療法学会. 2001別冊the Quintessence エンドドンティックス 21世紀への展望. クインテッセンス. 東京. 2001. 155-158. 14) 小澤寿子, 越野孝行, 新井 髙. 弱アルカリ性3%EDTA液の根管壁スミヤー層除去効果. 日歯保存誌 2003 ; 46 : 435-438. 15) 川島伸之, 戸村淳嗣, 横田兼欣, 興地隆史. 低濃度EDTA溶液のスミヤー層除去効果と象牙質脱灰に対する影響. 日歯保存誌 2017 ; 60 : 32-39. 27) 佐藤武則, 鈴木二郎, 藤巻龍治, 石井信之, 合田征司, 浜田信城. アルカリ性根管洗浄液がE. faecalisバイオフィルムに与える影響. 第60回歯科基礎医学会学術大会抄録集, 福岡, 2018. p1-91. 12) 長谷川誠実, 日生下剛一, 常深伸介, 本田公亮, 清水明彦, 吉岡 済. 根管象牙質の硬さと根管の封鎖性に及ぼすNaOClおよびEDTAの影響. 日歯保存誌 1989 ; 32 : 1646-1652. 24) Jamleh A, Suda H, Adorno CG. Irrigation effectiveness of continuous ultrasonic irrigation system: An ex vivo study. Dent Mater J 2018; 37: 1-5. 2) Paque F, Balmer M, Attin T. Preparation of oval-shaped root canals in mandibular molars using nickel-titanium rotary instruments: a micro-computed tomography study. J Endod 2010; 36: 703-707. 5) Okiji T. Controversies in endodontics: Etiology and clinical management of treatment-resistant apical periodontitis. Niigata Dent J 2006; 36: 1-15. 7) Maurer JK, Molai AL, Parker RD, Li L, Carr GJ, Petroll WM, Cavanagh HD, Jester JV. Pathology of ocular irritation with bleaching agents in the rabbit low-volume eye test. Toxicol Pathol 2001; 29: 308-319. 21) 中村 洋, 須田英明, 勝海一郎, 興地隆史. 歯内療法学. 4版. 医歯薬出版 : 東京 ; 2012. 134-135. 16) 山口博康, 矢作保澄, 新井 髙, 髙水正明. EDTA水溶液の有機質除去への影響. 第132回日本歯科保存学会春季学術大会抄録集 2010 ; 48 : A16. 18) Hülsmann M. Dens invaginatus: aetiology, classification, prevalence, diagnosis, and treatment considerations. J Endod 1997; 30: 79-90. 11) 石井隆資, 勝海一郎, 中村恭政. ラテラル・コンデンセーション法による根管充塡時の歯根破折に関する研究. 日歯保存誌 1991 ; 34 : 1252-1267. 13) Qian W, Shen Y, Haapasalo M. Quantitative analysis of the effect of irrigant solution sequences on dentin erosion. J Endod 2011; 37: 1437-1441. 19) Violich DR, Chandler NP. The smear layer in endodontics―a review. Int Endod J 2010; 43: 2-15. 3) Shahravan A, Haghdoost AA, Adl A, Rahimi H, Shadifar F. Effect of smear layer on sealing ability of canal obturation: a systematic review and meta-analysis. J Endod 2007; 33: 96-105. 8) Gokan Y, Mizukami E, Tani C, Manabe A. Evaluation of EDTA conditioners of various pHs on dentin surfaces. Jpn J Conserv Dent 2014; 57: 137-144. 25) İriboz E, Bayraktar K, Türkaydın D, Tarçın B. Comparison of apical extrusion of sodium hypochlorite using 4 different root canal irrigation techniques. J Endod 2015; 41: 380-384. 1) 和達礼子. 根管洗浄のコンセプトの変遷とテクニックの進化. 日歯内療誌 2016 ; 37 : 144-149. 10) Poggio C, Dagna A, Vinci A, Beltrami R, Cucca L, Giardino L. Decalcifying capability of irrigating solutions on root canal dentin mineral content. Contemp Clin Dent 2015; 6: 201-205. 17) 木田 中, 田口文章. 細菌とキレート剤. 防菌防黴 2007 ; 35 : 567-581. 20) 石井信之. 第12章 根管形成, 3 根管の化学的清掃. 興地隆史, 石井信之, 小木曽文内. エンドドンティクス. 5版. 永末書店 : 京都 : 2018. 134-136. 28) 木津純子, 高木 奏, 黒田裕子, 前澤佳代子, 松本一明, 堀 誠治. 複合塩素系除菌・洗浄製剤の安定性と色調の変化. 環境感染誌 2014 ; 29 : 411-416. |
| References_xml | – reference: 24) Jamleh A, Suda H, Adorno CG. Irrigation effectiveness of continuous ultrasonic irrigation system: An ex vivo study. Dent Mater J 2018; 37: 1-5. – reference: 4) Dotto L, Sarkis Onofre R, RoCha Pereira GK. Effect of root canal irrigants on the mechanical properties of endodontically treated teeth: A scoping review. J Endod 2020; 5: 596-604. – reference: 8) Gokan Y, Mizukami E, Tani C, Manabe A. Evaluation of EDTA conditioners of various pHs on dentin surfaces. Jpn J Conserv Dent 2014; 57: 137-144. – reference: 21) 中村 洋, 須田英明, 勝海一郎, 興地隆史. 歯内療法学. 4版. 医歯薬出版 : 東京 ; 2012. 134-135. – reference: 10) Poggio C, Dagna A, Vinci A, Beltrami R, Cucca L, Giardino L. Decalcifying capability of irrigating solutions on root canal dentin mineral content. Contemp Clin Dent 2015; 6: 201-205. – reference: 6) Sirtes G, Waltimo T, Schaetzle M, Zehnder M. The effects of temperature on sodium hypochlorite short-term stability, pulp dissolution capacity, and antimicrobial efficacy. J Endod 2005; 31: 669-671. – reference: 18) Hülsmann M. Dens invaginatus: aetiology, classification, prevalence, diagnosis, and treatment considerations. J Endod 1997; 30: 79-90. – reference: 11) 石井隆資, 勝海一郎, 中村恭政. ラテラル・コンデンセーション法による根管充塡時の歯根破折に関する研究. 日歯保存誌 1991 ; 34 : 1252-1267. – reference: 26) 中島 薫, 寺田林太郎, 久保田 捻, 常川勝由. pH調整EDTA水溶液による根管壁スメア層の除去効果. 日本臨床歯内療法学会. 2001別冊the Quintessence エンドドンティックス 21世紀への展望. クインテッセンス. 東京. 2001. 155-158. – reference: 13) Qian W, Shen Y, Haapasalo M. Quantitative analysis of the effect of irrigant solution sequences on dentin erosion. J Endod 2011; 37: 1437-1441. – reference: 14) 小澤寿子, 越野孝行, 新井 髙. 弱アルカリ性3%EDTA液の根管壁スミヤー層除去効果. 日歯保存誌 2003 ; 46 : 435-438. – reference: 7) Maurer JK, Molai AL, Parker RD, Li L, Carr GJ, Petroll WM, Cavanagh HD, Jester JV. Pathology of ocular irritation with bleaching agents in the rabbit low-volume eye test. Toxicol Pathol 2001; 29: 308-319. – reference: 19) Violich DR, Chandler NP. The smear layer in endodontics―a review. Int Endod J 2010; 43: 2-15. – reference: 28) 木津純子, 高木 奏, 黒田裕子, 前澤佳代子, 松本一明, 堀 誠治. 複合塩素系除菌・洗浄製剤の安定性と色調の変化. 環境感染誌 2014 ; 29 : 411-416. – reference: 15) 川島伸之, 戸村淳嗣, 横田兼欣, 興地隆史. 低濃度EDTA溶液のスミヤー層除去効果と象牙質脱灰に対する影響. 日歯保存誌 2017 ; 60 : 32-39. – reference: 22) 片岡博樹, 須田英明. スメア層・根管治療における臨床的意義. QE 1996 ; 15 : 446-448. – reference: 16) 山口博康, 矢作保澄, 新井 髙, 髙水正明. EDTA水溶液の有機質除去への影響. 第132回日本歯科保存学会春季学術大会抄録集 2010 ; 48 : A16. – reference: 23) 吉岡隆知, 片岡博樹, 須田英明. EDTAを用いた根管洗浄. 歯科評論 1998 ; 669 : 175-180. – reference: 1) 和達礼子. 根管洗浄のコンセプトの変遷とテクニックの進化. 日歯内療誌 2016 ; 37 : 144-149. – reference: 12) 長谷川誠実, 日生下剛一, 常深伸介, 本田公亮, 清水明彦, 吉岡 済. 根管象牙質の硬さと根管の封鎖性に及ぼすNaOClおよびEDTAの影響. 日歯保存誌 1989 ; 32 : 1646-1652. – reference: 20) 石井信之. 第12章 根管形成, 3 根管の化学的清掃. 興地隆史, 石井信之, 小木曽文内. エンドドンティクス. 5版. 永末書店 : 京都 : 2018. 134-136. – reference: 25) İriboz E, Bayraktar K, Türkaydın D, Tarçın B. Comparison of apical extrusion of sodium hypochlorite using 4 different root canal irrigation techniques. J Endod 2015; 41: 380-384. – reference: 9) Lottanti S, Gautschi H, Sener B, Zehnder M. Effects of ethylenediaminetetraacetic, etidronic and peracetic acid irrigation on human root dentine and the smear layer. Int Endod J 2009; 42: 335-343. – reference: 5) Okiji T. Controversies in endodontics: Etiology and clinical management of treatment-resistant apical periodontitis. Niigata Dent J 2006; 36: 1-15. – reference: 3) Shahravan A, Haghdoost AA, Adl A, Rahimi H, Shadifar F. Effect of smear layer on sealing ability of canal obturation: a systematic review and meta-analysis. J Endod 2007; 33: 96-105. – reference: 17) 木田 中, 田口文章. 細菌とキレート剤. 防菌防黴 2007 ; 35 : 567-581. – reference: 27) 佐藤武則, 鈴木二郎, 藤巻龍治, 石井信之, 合田征司, 浜田信城. アルカリ性根管洗浄液がE. faecalisバイオフィルムに与える影響. 第60回歯科基礎医学会学術大会抄録集, 福岡, 2018. p1-91. – reference: 2) Paque F, Balmer M, Attin T. Preparation of oval-shaped root canals in mandibular molars using nickel-titanium rotary instruments: a micro-computed tomography study. J Endod 2010; 36: 703-707. |
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| SubjectTerms | dentin demineralization EDTA EDTA溶液 root canal irrigant smear layer removal スミヤー層除去効果 根管洗浄剤 象牙質脱灰能 |
| Title | The Effect of pH-regulated EDTA on Root Canal Dentin |
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| ispartofPNX | The Japanese Journal of Conservative Dentistry, 2020, Vol.63(5), pp.425-431 |
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