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Efficacy of glycolic acid for the removal of calcium hydroxide from simulated internal Resorption cavities

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Abstract

Objectives

This study evaluated the efficacy of 5% and 10% glycolic acid solutions for the removal of calcium hydroxide medicament from artificial internal resorption cavities.

Materials and methods

A total of 170 human maxillary premolars were selected and artificial internal resorption cavities were prepared using round burs and 37% orthophosphoric acid in the apical third of the root halves. Entire canal and resorption cavity were filled with calcium hydroxide paste. Then, the specimens were assigned to 2 control groups or ten experimental groups according to the irrigating solutions used for medicament removal with and without activation with ultrasonic energy as following: 5% glycolic acid, 10% glycolic acid, 17% EDTA, and 10% citric acid and distilled water. The resorption cavities were examined under different magnifications using stereomicroscopy and scanning electron microscopy (SEM). The calcium hydroxide remnants in the resorption cavity were scored by 2 evaluators using a 4-scoring scale. The data were analyzed with Kruskal-Wallis H tests with 5% significance threshold.

Results

There was no significant difference regarding the distribution of removal scores among non-activated solutions (P > 0.05). In activated groups, 10% glycolic acid irrigation removed significantly more amount of calcium hydroxide than EDTA and distilled water (P < 0.05). No significant difference was found between the efficacy of 10% glycolic and citric acid (P > 0.05). Citric acid, 5% glycolic acid, and EDTA showed similar removal scores (P > 0.05). Passive ultrasonic irrigation significantly improved calcium hydroxide removal scores in 10% glycolic acid, citric acid, and EDTA groups (P < 0.05). The SEM examination revealed that the specimens that were scored 0 are not entirely free of calcium hydroxide remnants.

Conclusion

Concentration of 10% glycolic acid removed significantly more calcium hydroxide paste from resorption cavities than EDTA when used with passive ultrasonic irrigation. Although passive ultrasonic irrigation favored medicament removal in all irrigating solutions, complete elimination of medicament remnants was unattainable.

Clinical relevance

This study showed the improved efficacy of ultrasonically activated 10% glycolic acid in removing the calcium hydroxide medicament from the internal resorption cavity.

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References

  1. Patel S, Ricucci D, Durak C, Tay F (2010) Internal root resorption: a review. J Endod 36(7):1107–1121

    Article  Google Scholar 

  2. Nilsson E, Bonte E, Bayet F, Lasfargues JJ (2013) Management of internal root resorption on permanent teeth. Int J Dent:929486

  3. Bhuva B, Barnes J, Patel S (2011) The use of limited cone beam computed tomography in the diagnosis and management of a case of perforating internal root resorption. Int Endod J 44(8):777–786

    Article  Google Scholar 

  4. Çalt S, Serper A (1999) Dentinal tubule penetration of root canal sealers after root canal dressing with calcium hydroxide. J Endod 25(6):431–433

    Article  Google Scholar 

  5. Hosoya N, Kurayama H, Iino F, Arai T (2004) Effects of calcium hydroxide on physical and sealing properties of canal sealers. Int Endod J 37(3):178–184

    Article  Google Scholar 

  6. Uzunoglu E, Eymirli A, Uyanik MÖ, Çalt S, Nagas E (2015) Calcium hydroxide dressing residues after different removal techniques affect the accuracy of Root-ZX apex locator. Res Dent Endod 40(1):44–49

    Article  Google Scholar 

  7. da Silva JM, Silveira A, Santos E, Prado L, Pessoa OF (2011) Efficacy of sodium hypochlorite, ethylenediaminetetraacetic acid, citric acid and phosphoric acid in calcium hydroxide removal from the root canal: a microscopic cleanliness evaluation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 112(6):820–824

    Article  Google Scholar 

  8. Lambrianidis T, Margelos J, Beltes P (1999) Removal efficiency of calcium hydroxide dressing from the root canal. J Endod 25(2):85–88

    Article  Google Scholar 

  9. Ballal N, Kumar S, Laxmikanth H, Saraswathi M (2012) Comparative evaluation of different chelators in removal of calcium hydroxide preparations from root canals. Aust Dent J 57(3):344–348

    Article  Google Scholar 

  10. Qian W, Shen Y, Haapasalo M (2011) Quantitative analysis of the effect of irrigant solution sequences on dentin erosion. J Endod 37(10):1437–1441

    Article  Google Scholar 

  11. Zhang K, Kim YK, Cadenaro M, Bryan TE, Sidow SJ, Loushine RJ, Ling JQ, Pashley DH, Tay FR (2010) Effects of different exposure times and concentrations of sodium hypochlorite/ethylenediaminetetraacetic acid on the structural integrity of mineralized dentin. J Endod 36(1):105–109

    Article  Google Scholar 

  12. Segura JJ, Calvo JR, Guerrero JM, Sampedro C, Jimenez A, Llamas R (1996) The disodium salt of EDTA inhibits the binding of vasoactive intestinal peptide to macrophage membranes: endodontic implications. J Endod 22(7):337–340

    Article  Google Scholar 

  13. Chaudhary AJ, Donaldson JD, Grimes SM, ul- Hassan M, Spencer RJ (2000) Simultaneous recovery of heavy metals and degradation of organic species–copper and ethylenediaminetetra-acetic acid (EDTA). J Chem Technol Biotechnol 75(5):353–358

    Article  Google Scholar 

  14. Hua X, Cao R, Zhou X, Xu Y (2019) One-step continuous/semi-continuous whole-cell catalysis production of glycolic acid by a combining bioprocess with in-situ cell recycling and electrodialysis. Bioresour Technol 273(2):515–520

    Article  Google Scholar 

  15. Dal Bello Y, Porsch HF, Farina AP et al (2019) Glycolic acid as the final irrigant in endodontics: mechanical and cytotoxic effects. Mater Sci Eng C 100(7):323–329

    Article  Google Scholar 

  16. Cecchin D, Farina AP, Vidal CMP, Bedran-Russo AK (2018) A novel enamel and dentin etching protocol using a-hydroxy glycolic acid: surface property, etching pattern, and bond strength studies. Oper Dent 43(1):101–110

    Article  Google Scholar 

  17. Dal Bello Y, Farina AP, Souza MA, Cecchin D (2020) Glycolic acid: characterization of a new final irrigant and effects on flexural strength and structural integrity of dentin. Mater Sci Eng C 106(1):110283

    Article  Google Scholar 

  18. Gambin DJ, Leal LO, Farina AP, Souza MA, Cecchin D (2020) Antimicrobial activity of glycolic acid as a final irrigant solution for root canal preparation. Gen Dent 68(1):41–44

    PubMed  Google Scholar 

  19. Keskin C, Sariyilmaz E, Sariyilmaz Ö (2017) Efficacy of XP-endo finisher file in removing calcium hydroxide from simulated internal resorption cavity. J Endod 43(1):126–130

    Article  Google Scholar 

  20. Van der Sluis LWM, Wu M, Wesselink P (2007) The evaluation of removal of calcium hydroxide paste from an artificial standardized groove in the apical root canal using different irrigation methodologies. Int Endod J 40(1):52–57

    Article  Google Scholar 

  21. Capar ID, Ozcan E, Arslan H, Ertas H, Aydinbelge HA (2014) Effect of different final irrigation methods on the removal of calcium hydroxide from an artificial standardized groove in the apical third of root canals. J Endod 40(3):451–454

    Article  Google Scholar 

  22. Donnermeyer D, Wyrsch H, Bürklein S, Schäfer E (2019) Removal of calcium hydroxide from artificial grooves in straight root canals: sonic activation using EDDY versus passive ultrasonic irrigation and XPendo Finisher. J Endod 45(3):322–326

    Article  Google Scholar 

  23. Marques-da-Silva B, Alberton C, Tomazinho F et al (2020) Effectiveness of five instruments when removing calcium hydroxide paste from simulated internal root resorption cavities in extracted maxillary central incisors. Int Endod J 53(3):366–375

    Article  Google Scholar 

  24. Topçuoğlu H, Düzgün S, Ceyhanlı K et al (2015) Efficacy of different irrigation techniques in the removal of calcium hydroxide from a simulated internal root resorption cavity. Int Endod J 48(4):309–316

    Article  Google Scholar 

  25. Van der Sluis LWM, Versluis M, Wu MK, Wesselink PR (2007) Passive ultrasonic irrigation of the root canal: a review of the literature. Int Endod J 40(6):415–426

    Article  Google Scholar 

  26. Jeong SK, Ko JY, Seo JT, Ahn SK, Lee CW, Lee SH (2005) Stimulation of epidermal calcium gradient loss and increase in TNF-α and IL-1α expressions by glycolic acid in murine epidermis. Exp Dermatol 14(8):571–579

    Article  Google Scholar 

  27. Yaylali IE, Kececi AD, Ureyen Kaya B (2015) Ultrasonically activated irrigation to remove calcium hydroxide from apical third of human root canal system: a systematic review of in vitro studies. J Endod 41(10):1589–1599

    Article  Google Scholar 

  28. Hülsmann M, Heckendorff M, Lennon A (2003) Chelating agents in root canal treatment: mode of action and indications for their use. Int Endod J 36(12):810–830

    Article  Google Scholar 

  29. Zorzin J, Wießner J, Wießner T, Lohbauer U, Petschelt A, Ebert J (2016) Removal of radioactively marked calcium hydroxide from the root canal: influence of volume of irrigation and activation. J Endod 42(4):637–640

    Article  Google Scholar 

  30. Silva LJM, Pessoa OF, Teixeira MBG et al (2015) Micro-CT evaluation of calcium hydroxide removal through passive ultrasonic irrigation associated with or without an additional instrument. Int Endod J 48(8):768–773

    Article  Google Scholar 

  31. Çalt S, Serper A (2000) Smear layer removal by EGTA. J Endod 26(8):459–461

    Article  Google Scholar 

  32. Zehnder M, Schmidlin P, Sener B, Waltimo T (2005) Chelation in root canal therapy reconsidered. J Endod 31(11):817–820

    Article  Google Scholar 

  33. De-Deus G, Paciornik S, Pinho Mauricio M, Prioli R (2006) Real-time atomic force microscopy of root dentine during demineralization when subjected to chelating agents. Int Endod J 39(9):683–692

    Article  Google Scholar 

  34. De-Deus G, Reis C, Fidel S et al (2008) Longitudinal and quantitative evaluation of dentin demineralization when subjected to EDTA, EDTAC, and citric acid: a co-site digital optical microscopy study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 105(3):391–397

    Article  Google Scholar 

  35. Rödig T, Vogel S, Zapf A, Hülsmann M (2010) Efficacy of different irrigants in the removal of calcium hydroxide from root canals. Int Endod J 43(6):519–527

    Article  Google Scholar 

  36. Kabir SMM, Koh J (2017) Effect of chelating agent in disperse dye dyeing on polyester fabric. Fiber Polym 18(12):2315–2321

    Article  Google Scholar 

  37. Dias-Junior LCL, Castro RF, Fernandes AD et al (2020) Final endodontic irrigation with 70% ethanol enhanced calcium hydroxide removal from the apical third. J Endod S0099-2399(20):30756–30751. https://doi.org/10.1016/j.joen.2020.09.017

    Article  Google Scholar 

  38. Kato AS, Cunha RS, da Silveira Bueno CE, Pelegrine RA, Fontana CE, de Martin AS (2016) Investigation of the efficacy of passive ultrasonic irrigation versus irrigation with reciprocating activation: an environmental scanning electron microscopic study. J Endod 42(4):659–663

    Article  Google Scholar 

  39. Ahmetoğlu F, Şimşek N, Keleş A et al (2013) Efficacy of self-adjusting file and passive ultrasonic irrigation on removing calcium hydroxide from root canals. Dent Mater J 32(6):1005–1010

    Article  Google Scholar 

Download references

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Authors and Affiliations

  1. Department of Endodontics, Faculty of Dentistry, Ondokuz Mayis University, 55200, Samsun, Turkey

    Cangül Keskin & Ali Keleş

  2. Ordu Oral and Dental Health Center, Ordu, Turkey

    Öznur Sarıyılmaz

Authors
  1. Cangül Keskin
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  2. Ali Keleş
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  3. Öznur Sarıyılmaz
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Correspondence to Cangül Keskin.

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The authors declare that they have no conflict of interest.

Ethical approval

The study protocol was approved by the local university clinical research ethical board with the approval number KAEK 2020/322.

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Informed consent was obtained from each patient.

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Keskin, C., Keleş, A. & Sarıyılmaz, Ö. Efficacy of glycolic acid for the removal of calcium hydroxide from simulated internal Resorption cavities. Clin Oral Invest 25, 4407–4413 (2021). https://doi.org/10.1007/s00784-020-03753-z

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