Skip to main content

Advertisement

SpringerLink
Log in

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

  • Original Article
  • Published:
Odontology Aims and scope Submit manuscript

Abstract

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. European Society of Endodontology. Quality guidelines for endodontic treatment: consensus report of the European Society of Endodontology. Int Endod J. 2006;39:921–30.

    Article  Google Scholar 

  2. Siqueira JF, Rôças IN. Clinical implications and microbiology of bacterial persistence after treatment procedures. J Endod. 2008;34:1291–301.

    Article  Google Scholar 

  3. Vertucci FJ. Root canal morphology and its relationship to endodontic procedures. Endod Topics. 2005;10:3–29.

    Article  Google Scholar 

  4. Paquè F, Peters OA. Micro-computed tomography evaluation of the preparation of long oval root canals in mandibular molars with the self-adjusting file. J Endod. 2011;37:517–21.

    Article  PubMed  Google Scholar 

  5. Peters OA, Arias A, Paqué F. A micro-computed tomographic assessment of root canal preparation with a novel instrument, TRUShape, in mesial roots of mandibular molars. J Endod. 2015;41:1545–50.

    Article  Google Scholar 

  6. Nair PNR, Henry S, Cano V, Vera J. Microbial status of apical root canal system of human mandibular first molars with primary apical periodontitis after “one-visit” endodontic treatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005;99:231–52.

    Article  PubMed  Google Scholar 

  7. Jr Siqueira J F, Pérez AR, Marceliano-Alves MF, Provenzano JC, Silva SG, Pires FR, Vieira GCS, Rôças IN, Alves FRF. What happens to unprepared root canal walls: a correlative analysis using micro-computed tomography and histology/scanning electron microscopy. Int Endod J. 2018;51:501–8.

    Article  Google Scholar 

  8. Haapasalo M, Endal U, Zandi H, Coil J. Eradication of endodontic infection by instrumentation and irrigation solutions. Endod Topics. 2005;10:77–102.

    Article  Google Scholar 

  9. Baker NA, Eleazer PD, Averbach RE, Seltzer S. Scanning electron microscopic study of the efficacy of various irrigation solutions. J Endod. 1975;1:127–35.

    Article  PubMed  Google Scholar 

  10. Giardino L, Ambu E, Becce C, Rimondini L, Morra M. Surface tension comparison of four common root canal irrigants and two new irrigants containing antibiotic. J Endod. 2006;32:1091–3.

    Article  PubMed  Google Scholar 

  11. Mohammadi Z, Giardino L, Mombeinipour A. Antibacterial substantivity of a new antibiotic-based endodontic irrigation solution. Aust Endod J. 2012;38:26–30.

    Article  PubMed  Google Scholar 

  12. Arias-Moliz MT, Ferrer-Luque CM, Espigares-Rodríguez E, Liébana-Ureña J, Espigares-García M. Bactericidal activity of phosphoric acid, citric acid, and EDTA solutions against Enterococcus faecalis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008;106:84–9.

    Article  Google Scholar 

  13. Giardino L, Del Fabbro M, Cesario F, Fernandes FS, Andrade FB. Antimicrobial effectiveness of oxidant and chelating agents combination in infected dentine: an ex vivo confocal laser scanning microscopy study. Int Endod J. 2018;51:448–56.

    Article  PubMed  Google Scholar 

  14. Clarkson RM, Podlich HM, Moule AJ. Influence of ethylenediaminetetraacetic acid on the active chlorine content of sodium hypochlorite solutions when mixed in various proportions. J Endod. 2011;37:538–43.

    Article  PubMed  Google Scholar 

  15. Zollinger A, Mohn D, Zeltner M, Zehnder M. Short-term storage stability of NaOCl solutions when combined with Dual Rinse HEDP. Int Endod J. 2018;51:691–6.

    Article  PubMed  Google Scholar 

  16. Zehnder M, Schmidlin P, Sener B, Waltimo T. Chelation in root canal therapy reconsidered. J Endod. 2005;31:817–20.

    Article  PubMed  Google Scholar 

  17. 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;42:335–43.

    Article  PubMed  Google Scholar 

  18. Arias-Moliz MT, Ordinola-Zapata R, Baca P, Ruiz-Linares M, Ferrer-Luque CM. Antimicrobial activity of a sodium hypochlorite/etidronic acid irrigant solution. J Endod. 2014;40:1999–2002.

    Article  PubMed  Google Scholar 

  19. Morago A, Ordinola-Zapata R, Ferrer-Luque CM, Baca P, Ruiz-Linares M, Arias-Moliz MT. Influence of smear layer on the antimicrobial activity of a sodium hypochlorite/etidronic acid irrigating solution in infected dentin. J Endod. 2016;42:1647–50.

    Article  PubMed  Google Scholar 

  20. Giardino L, Andrade FB, Beltrami R. Antimicrobial effect and surface tension of some chelating solutions with added surfactants. Braz Dent J. 2016;27:584–8.

    Article  PubMed  Google Scholar 

  21. Morago A, Ruiz-Linares M, Ferrer-Luque CM, Baca P, Rodríguez Archilla A, Arias-Moliz MT. Dentine tubule disinfection by different irrigation protocols. Microsc Res Tech. 2019. https://doi.org/10.1002/jemt.23200.

    Article  PubMed  Google Scholar 

  22. Andrade FB, Arias MP, Maliza AG, Duarte MA, Graeff MS, Amoroso-Silva PA, Midena RZ, Moraes IG. A new improved protocol for in vitro intratubular dentinal bacterial contamination for antimicrobial endodontic tests: standardization and validation by confocal laser scanning microscopy. J Appl Oral Sci. 2015;23:591–8.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Ma J, Wang Z, Shen Y, Haapasalo M. A new noninvasive model to study the effectiveness of dentin disinfection by using confocal laser scanning microscopy. J Endod. 2011;37:1380–5.

    Article  PubMed  Google Scholar 

  24. Generali L, Campolongo E, Consolo U, Bertoldi C, Giardino L, Cavani F. Sodium hypochlorite penetration into dentinal tubules after manual dynamic agitation and ultrasonic activation: a histochemical evaluation. Odontology. 2018;106:454–9.

    Article  PubMed  Google Scholar 

  25. Chávez de Paz LE. Image analysis software based on color segmentation for characterization of viability and physiological activity of biofilms. Appl Environ Microbiol. 2009;75:1734–9.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Tartari T, Guimarães BM, Amoras LS, Duarte MA, Silva e Souza PA, Bramante CM. Etidronate causes minimal changes in the sodium hypochlorite ability to dissolve organic matter. Int Endod J. 2014;48:399–404.

    Article  PubMed  Google Scholar 

  27. Hsin WL, Sheng YJ, Lin SY, Tsao HK. Surface tension increment due to solute addition. Phys Rev E Stat Nonlinear Soft Matter Phys. 2004;69:031605. https://doi.org/10.1103/physreve.69.031605.

    Article  Google Scholar 

  28. Giardino L, Estrela C, Mohammadi Z, Generali L, Asgary S. The in vitro effect of irrigants with low surface tension on Enterococcus faecalis. Iran Endod J. 2015;10:174–8.

    PubMed  PubMed Central  Google Scholar 

  29. Wang Z, Shen Y, Ma J, Haapasalo M. The effect of detergents on the antibacterial activity of disinfecting solutions in dentin. J Endod. 2012;38:948–53.

    Article  PubMed  Google Scholar 

  30. Farrugia C, Baca P, Camilleri J, Moliz AMT. Antimicrobial activity of ProRoot MTA in contact with blood. Sci Rep. 2017;7:41359. https://doi.org/10.1038/srep41359.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Sundqvist G, Figdor D, Persson S, Sjogren U. Microbiologic analysis of teeth with failed endodontic treatment and the outcome of conservative re-treatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998;85:86–93.

    Article  PubMed  Google Scholar 

  32. Rôças IN, Siqueira JF Jr, Santos KR. Association of Enterococcus faecalis with different forms of periradicular diseases. J Endod. 2004;30:315–20.

    Article  PubMed  Google Scholar 

  33. Tzanetakis GN, Azcarate-Peril MA, Zachaki S, Panopoulos P, Kontakiotis EG, Madianos PN, Divaris K. Comparison of bacterial community composition of primary and persistent endodontic infections using pyrosequencing. J Endod. 2015;41:1226–33.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Giardino L, Cavani F, Generali L. Sodium hypochlorite solution penetration into human dentine: a histochemical evaluation. Int Endod J. 2017;50:492–8.

    Article  PubMed  Google Scholar 

  35. Biel P, Mohn D, Attin T, Zehnder M. Interactions between the tetrasodium salts of EDTA and 1-hydroxyethane 1,1-diphosphonic acid with sodium hypochlorite irrigants. J Endod. 2017;43:657–61.

    Article  PubMed  Google Scholar 

  36. Tawakoli PN, Ragnarsson KT, Rechenberg DK, Mohn D, Zehnder M. Effect of endodontic irrigants on biofilm matrix polysaccharides. Int Endod J. 2017;50:153–60.

    Article  PubMed  Google Scholar 

  37. de Almeida J, Hoogenkamp M, Felippe WT, Crielaard W, van der Waal SV. Effectiveness of EDTA and modified salt solution to detach and kill cells from Enterococcus faecalis biofilm. J Endod. 2016;42:320–3.

    Article  PubMed  Google Scholar 

  38. van der Waal SV, van der Sluis LW, Özok AR, Exterkate RA, van Marle J, Wesselink PR, de Soet JJ. The effects of hyperosmosis or high pH on a dual-species biofilm of Enterococcus faecalis and Pseudomonas aeruginosa: an in vitro study. Int Endod J. 2011;44:1110–7.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Freelance Researcher, Crotone, Italy

    Luciano Giardino

  2. Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy

    Massimo Del Fabbro

  3. IRCCS Orthopedic Institute Galeazzi, Milan, Italy

    Massimo Del Fabbro & Paolo Savadori

  4. NobilBio Ricerche, Portacomaro, AT, Italy

    Marco Morra

  5. Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil

    Thais Pereira & Flaviana Bombarda de Andrade

  6. Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance (CHIMOMO), University of Modena and Reggio Emilia, Modena, Italy

    Luigi Generali

Authors
  1. Luciano Giardino
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Massimo Del Fabbro
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Marco Morra
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Thais Pereira
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Flaviana Bombarda de Andrade
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Paolo Savadori
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Luigi Generali
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Massimo Del Fabbro.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Giardino, L., Del Fabbro, M., Morra, M. et al. Dual Rinse® HEDP increases the surface tension of NaOCl but may increase its dentin disinfection efficacy. Odontology 107, 521–529 (2019). https://doi.org/10.1007/s10266-019-00436-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10266-019-00436-4

Keywords

Search

Navigation