A matched irrigation and obturation strategy for root canal therapy

Area of Science:

• Endodontics
• Dental Materials Science
• Biomaterials

Background:

• Root canal therapy relies on irrigating solutions to eliminate bacteria and prepare dentin for sealers.
• Understanding the impact of irrigation sequences on dentin is crucial for optimizing root canal treatment outcomes.

Purpose of the Study:

• To evaluate the effects of different irrigating solution sequences on tooth structure.
• To determine the optimal irrigation strategy for hydraulic calcium silicate cement (HCSC) sealer obturation.
• To guide clinicians in matching irrigation protocols with obturation materials for enhanced root canal therapy.

Main Methods:

• Assessed changes in dentin microhardness, ultrastructure, mineral content, organic/inorganic matter, surface roughness, and Young's modulus.
• Analyzed the interaction between four root canal sealers and dentin using microhardness testing, scanning electron microscopy, and confocal laser microscopy.

Main Results:

• Irrigating solutions, individually and in combination, caused irreversible dentin damage.
• An optimal sequence involved sodium hypochlorite, followed by a chelator, and a final sodium hypochlorite rinse.
• This sequence, combined with HCSC sealers, restored dentin properties.
• HCSC sealers demonstrated good dentin adaptation without reliance on chelator irrigating solutions.

Conclusions:

• The choice and sequence of irrigating solutions significantly impact dentin integrity.
• A specific irrigation protocol using sodium hypochlorite and chelator can mitigate damage and prepare dentin for HCSC sealers.
• HCSC sealers offer effective dentin bonding, independent of chelator use in the final irrigation steps.