Biological and chemical properties of new multi-functional root canal irrigants

Nidambur Vasudev Ballal; Rajkumar Narkedamalli; Padmaja A Shenoy; Shubhankar Das; Saravana Karthikeyan Balasubramanian; Jothi Varghese; Herman Sunil Dsouza; Kevin Epps; Theodroe Ravenel; Franklin R Tay

doi:10.1016/j.jdent.2024.105551

Biological and chemical properties of new multi-functional root canal irrigants

J Dent. 2024 Dec 27:105551. doi: 10.1016/j.jdent.2024.105551. Online ahead of print.

Affiliations

¹ Department of Conservative Dentistry & Endodontics, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India. Electronic address: [email protected].
² Department of Conservative Dentistry & Endodontics, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India.
³ Department of Microbiology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India.
⁴ Thumbay Research Institute for Precision Medicine, Gulf Medical University, Ajman, UAE; Department of Radiation Biology and Toxicology, Manipal School of Life Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India.
⁵ Department of Conservative Dentistry and Endodontics, SRM Dental College, Bharathi Salai, SRM Institute of Science and Technology, Chennai, Tamil Nadu, India.
⁶ Department of Periodontology, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India.
⁷ Department of Radiation Biology and Toxicology, Manipal School of Life Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India.
⁸ Dental College of Georgia, Augusta University, Augusta, GA, USA.
⁹ Dental College of Georgia, Augusta University, Augusta, GA, USA. Electronic address: [email protected].

PMID: 39733816
DOI: 10.1016/j.jdent.2024.105551

Abstract

Objectives: To evaluate the efficacy of multi-functional root canal irrigating solutions in the removal of canal wall smear layers, antibacterial activity, cytotoxicity, and tissue dissolution efficacy.

Methods: Forty single-rooted teeth were mechanically instrumented and irrigated with Triton, EndoJuice™, EDTA, and 0.9% saline. Each tooth was evaluated for smear layer removal using scanning electron microscopy. Antibacterial activity of the irrigants was assessed against Enterococcus faecalis biofilms using colony-forming unit analysis. Neutral red, clonogenic, and cytokinesis-block micronucleus assays were performed on Chinese hamster V79 cells to evaluate the short-term and long-term cytotoxicity and genotoxicity of the irrigants. Tissue dissolution efficacy was tested on shrimp meat placed in resorptive cavities prepared in root canals.

Results: EndoJuice™ and EDTA showed better smear layer removal than Triton in the coronal-third and middle-third of the canal walls. There was no significant difference between EndoJuice™ and EDTA. In the apical-third, EndoJuice™ removed the smear layer more effectively than EDTA and Triton. Specimens treated with saline were heavily smeared. Triton and sodium hypochlorite were similar in reducing intracanal E. faecalis counts, while specimens treated with EndoJuice™ had higher colony-forming units compared to Triton or sodium hypochlorite. EndoJuice™ was less cytotoxic and genotoxic compared to Triton. Sodium hypochlorite dissolved the most soft tissue, followed by Triton and EndoJuice™.

Conclusion: EndoJuice™ was less toxic and more effective in smear layer removal. Triton demonstrated better antimicrobial activity and tissue dissolution efficacy.

Clinical significance: Evaluating the smear layer removal, antibacterial activity, toxicity, and tissue dissolution abilities of multi-functional root canal irrigants is essential to ensure their effectiveness and safety for clinical use in root canal treatment.

Keywords: EndoJuice; Triton; irrigation; smear layer; tissue dissolution; toxicity.