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A chitosan-based irrigant improves the dislocation resistance of a mineral trioxide aggregate-resin hybrid root canal sealer

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Clinical Oral Investigations Aims and scope Submit manuscript

Abstract

Objectives

To investigate the effectiveness of root canal irrigation with chitosan on the dislocation resistance of a root canal sealer (MTA Fillapex) in vitro, measured by the push-out bond strength test.

Materials and methods

Root canals of mandibular premolars (n = 57) were prepared using rotary files with 5.25% sodium hypochlorite as the irrigant during instrumentation. Following this, the specimens were randomly divided into three groups (n = 19) based on the final irrigant: group 1, 0.2% chitosan solution; group 2, 17% EDTA solution; group 3, saline. Three specimens from each group were analyzed using scanning electron microscopy-energy dispersive spectroscopy (SEM-EDS). The remaining specimens of each group were divided into two subgroups (n = 8) based on the method of agitation of the final irrigants (chitosan/EDTA/saline): subgroup A, sonic (Endoactivator, Dentsply Maillefer); subgroup B, no activation (control). After irrigation, all specimens obturated with a commercial mineral trioxide aggregate-resin hybrid sealer (MTA Fillapex, Angelus, Londrina, Brazil). Dislocation resistance was measured using the push-out bond strength test after 3 weeks. The data were analyzed using Kruskal-Wallis test (P = 0.05).

Results

Immaterial of the irrigant agitation, groups irrigated with chitosan showed significantly higher bond strength values than those irrigated with EDTA (P < 0.05). Groups irrigated with saline showed the least bond strength values (P < 0.05). When EDTA was used, sonic agitation significantly improved the bond strength of the sealer, compared to the control (P < 0.05). There was no significant difference between sonic agitation and the control when chitosan solution was used as the final irrigant (P > 0.05). The nitrogen/carbon ratio was significantly higher in chitosan groups compared to the control group (P < 0.05).

Conclusion

This study provides the first evidence that chitosan irrigation improves the dislocation resistance of MTA-resin hybrid root canal sealer, compared to EDTA and saline irrigation.

Clinical relevance

Chitosan-based irrigation has been previously shown to demonstrate anti-biofilm properties in the root canal. The present study demonstrates that chitosan can improve the bond strength of a root filling material, which may contribute to better sealing of the root canal system.

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Author information

Authors and Affiliations

  1. Department of Endodontics, Faculty of Dentistry, The University of Yuzuncu Yil, Van, Turkey

    Esin Ozlek

  2. Discipline of Endodontology, Faculty of Dentistry, The Prince Philip Dental Hospital, The University of Hong Kong, 34, Hospital Road, Sai Ying Pun, Hong Kong SAR

    Priti Pragati Rath & Prasanna Neelakantan

  3. Faculty of Dentistry, The University of Toronto, Toronto, Canada

    Anil Kishen

Authors
  1. Esin Ozlek
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  2. Priti Pragati Rath
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  3. Anil Kishen
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  4. Prasanna Neelakantan
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Corresponding author

Correspondence to Prasanna Neelakantan.

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Conflict of interest

Esin Ozlek declares that she has no conflict of interest. Priti Pragati Rath declares that she has no conflict of interest. Anil Kishen declares that he has no conflict of interest. Prasanna Neelakantan declares that he has no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The use of extracted teeth was approved by the Institutional Review Board and Ethics committee of The University of Yuzuncu Yil.

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Ozlek, E., Rath, P.P., Kishen, A. et al. A chitosan-based irrigant improves the dislocation resistance of a mineral trioxide aggregate-resin hybrid root canal sealer. Clin Oral Invest 24, 151–156 (2020). https://doi.org/10.1007/s00784-019-02916-x

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  • DOI: https://doi.org/10.1007/s00784-019-02916-x

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