pp 1–9 | Cite as

Dual Rinse® HEDP increases the surface tension of NaOCl but may increase its dentin disinfection efficacy

  • Luciano Giardino
  • Massimo Del FabbroEmail author
  • Marco Morra
  • Thais Pereira
  • Flaviana Bombarda de Andrade
  • Paolo Savadori
  • Luigi Generali
Original Article


The aim of this study was to evaluate the surface tension and the antimicrobial activity in infected dentin of a NaOCl solution combined with an etidronate powder (Dual Rinse® HEDP), compared to pure NaOCl and the classic NaOCl + EDTA irrigating sequence, respectively. The surface tension of three irrigants was measured by Wilhelmy technique. To evaluate the antimicrobial activity of the solutions, 26 human teeth were contaminated for 5 days with E. faecalis. After bacterial contamination, ten samples were irrigated with NaOCl followed by EDTA, another ten with NaOCl/Dual Rinse® HEDP, and four were used as positive controls. Two specimens not contaminated were used as negative controls. After live/dead BacLight staining, samples were examined by CLSM for analyzing % of residual live and dead cells. Comparison of bacterial viability between and within groups was performed using the Mann–Whitney test for independent samples and the Wilcoxon signed-rank test, respectively. The mean surface tension of EDTA was significantly lower than that of the other irrigants tested (p < 0.001). Conversely, the surface tension of NaOCl/Dual Rinse® HEDP solution was significantly higher than that of all the other solutions (p < 0.001). Residual bacterial viability in the NaOCl/Dual Rinse® HEDP (1.71%) was significantly lower (p = 0.019) than in the NaOCl + EDTA group (3.77%). All of the experimental groups showed significantly lower proportion of viable bacterial cells than the positive control group (p < 0.01). Clinical relevance adding etidronate to NaOCl increases its antimicrobial effect in dentinal tubules even though increases its surface tension.


Antimicrobial activity Confocal laser scanning microscopy Etidronic acid Root canal irrigants Surface tension 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© The Society of The Nippon Dental University 2019

Authors and Affiliations

  1. 1.Freelance ResearcherCrotoneItaly
  2. 2.Department of Biomedical, Surgical and Dental SciencesUniversità degli Studi di MilanoMilanItaly
  3. 3.IRCCS Orthopedic Institute GaleazziMilanItaly
  4. 4.NobilBio RicerchePortacomaroItaly
  5. 5.Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of DentistryUniversity of São PauloBauruBrazil
  6. 6.Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance (CHIMOMO)University of Modena and Reggio EmiliaModenaItaly

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