Evaluation of the Effect of Casein Phosphopeptide-Amorphous Calcium Phosphate (Cpp-Acp)
on Edta Treated Root Dentin Microhardness when used as Final Irrigant in Single Rooted Teeth - An Invitro Study
Majd Abedrabbo1*, Heba El Asfouri2 and Dina Ahmed Ali Morsy3
1Master’s degree candidate, Department of Endodontics, Faculty of Dentistry, Cairo University, Egypt
2Associate Professor of Endodontics, Department of Endodontics, Faculty of Dentistry, Cairo University, Egypt
3Lecturer of Endodontics, Department of Endodontics, Faculty of Dentistry, Cairo
*Corresponding Author:Majd Abedrabbo, Master’s degree candidate, Department of Endodontics, Faculty of Dentistry, Cairo University, Egypt.
Received: December 22, 2022; Published: January 11, 2023
Aim: The aim of this study was to evaluate the effect of irrigation with CPP-ACP solution on EDTA treated root dentin microhardness when used as a final irrigant in single rooted teeth.
Methodology: Twenty one extracted human single rooted teeth with single canals were used. All teeth were decoronated at 12mm length from the apex.
Complete chemo-mechanical preparation was done using NaOCl as conventional irrigation protocol. Teeth were randomly divided into 3 groups (n = 7 in each) according to the final irrigation protocol as follows: Group (A) final irrigation with 17% EDTA for 5 minutes followed by CPP-ACP remineralizing solution for 10 minutes, Group (B) final irrigation with 17% EDTA for 5 minutes, and Group (C) final irrigation with normal saline for 5 minutes. Each root specimen was cut horizontally at 3 different levels (coronal, middle, apical). Vicker’s Microhardness Testing was done at three different horizontal depths from the canal lumen (25μm, 50μm, 100μm).
Results: The results showed the highest values of microhardness for group A, followed by group C and B respectively. There was a significant difference in microhardness values between group A and the other groups at the middle third of the root, whereas the difference at coronal and apical thirds was insignificant. In addition, the values of microhardness increased significantly at deeper depths of dentin away from the canal lumen towards cementum in all groups.
Conclusion: Final irrigation with CPP-ACP remineralizing solution may improve mechanical properties of dentin including microhardness, especially after EDTA irrigation for smear layer removal.
Keywords:Smear Layer; Demineralization; Remineralization; Mechanical Properties; Microhardness; Endodontic Irrigation
- Violich DR and Chandler NP. “The smear layer in endodontics - A review”. International Endodontic Journal 43 (2010): 2-15.
- Tsenova-ilieva I and Karova E. “Effect of Endodontic Irrigants on Root Dentin Microhardness : A Systematic Review”. International Journal of Science and Research 9 (2020): 491-496.
- Baldasso FER., et al. “Effect of final irrigation protocols on microhardness reduction and erosion of root canal dentin”. Brazilian Oral Research 31 (2017): 1-8.
- Abd-Elgawad R and Fayyad D. “Comparative evaluation of smear layer removal, calcium ions loss and dentin microhardness after different final irrigation solutions”. Egyptian Dental Journal 63 (2017): 3551-3562.
- Uzunoglu E., et al. “Effect of ethylenediaminetetraacetic acid on root fracture with respect to concentration at different time exposures”. Journal of Endodontics 38 (2012): 1110-1113.
- Karova E., et al. “The Ability of Root Canal Cleaning and Shaping Procedures to Initiate Dentinal Radicular Microcracks”. International Journal of Science and Research 7 (2018): 1558-1565.
- Arifa MK., et al. “Recent Advances in Dental Hard Tissue Remineralization: A Review of Literature”. International Journal of Clinical Pediatric Dentistry 12 (2019): 139-144.
- Garg P., et al. “An update on remineralizing agents”. Journal of Interdisciplinary Dentistry 3 (2013): 151-158.
- Abdel Hamid DM. “Effect of different remineralizing agents on the microhardness of therapeutic gamma irradiated human dentin”. Egyptian Dental Journal 59 (2013): 2367-2376.
- Bertassoni LE., et al. “Mechanical recovery of dentin following remineralization in vitro - An indentation study”. Journal of Biomechanics 44 (2011): 176-181.
- Gandolfi MG., et al. “Demineralization, collagen modification and remineralization degree of human dentin after EDTA and citric acid treatments”. Materials (Basel) 12 (2018): 25-34.
- Gandhi B., et al. “Evaluating the effect of CPP-ACP as a final irrigant in improving the micro-hardness of erosive root dentin and its influence on the bond strength of self etch resin sealer - An in-vitro study”. Journal of Clinical and Diagnostic Research 10 (2016): 53-56.
- Fuentes V., et al. “Microhardness of superficial and deep sound human dentin”. Journal of Biomedical Materials Research Part A 66 (2003): 850-853.
- Pashley D., et al. “The relationship between dentin microhardness and tubule density”. Endodontics and Dental Traumatology 1 (1985): 176-179.
- Wei S., et al. “Effect of caries-affected dentin hardness on the shear bond strength of current adhesives”. Journal of Adhesive Dentistry 10 (2008): 431-440.
- Lo Giudice G., et al. “Dentin morphology of root canal surface: A quantitative evaluation based on a scanning electronic microscopy study”. BioMed Research International (2015): 1640-1665.
- Pashley DH. “Dentin-predentin complex and its permeability: physiologic overview”. Journal of Dental Research 6491985): 613-620.
- Liu J., et al. “Effect of Tubule Orientation and Dentin Location on the Microtensile Strength of Bovine Root Dentin”. Dental Materials Journal 21 (2002): 73-82.
- Chandra SS., et al. “Depth of penetration of four resin sealers into radicular dentinal tubules: A confocal microscopic study”. Journal of Endodontics 38 (2012): 1412-1416.
- Kinney JH., et al. “Hardness and young’s modulus of human peritubular and intertubular dentine”. Archives of Oral Biology 41 (1996): 9-13.
- Gilboe DB., et al. “Dentinal smearing: An investigation of the phenomenon”. Journal of Prosthetic Dentistry 44 (1980): 310-316.
- Çalt S and Serper A. “Time-dependent effects of EDTA on dentin structures”. Journal of Endodontics 28 (2002): 17-19.
- Taneja S., et al. “Effect of QMix, peracetic acid and ethylenediaminetetraacetic acid on calcium loss and microhardness of root dentine”. Journal of Conservative Dentistry 17 (2014): 155-158.
- Ballal NV., et al. “Evaluation of the smear layer removal and decalcification effect of QMix, maleic acid and EDTA on root canal dentine”. Journal of Dental Sciences 51 (2016): 62-68.
- Ballal NV., et al. “Evaluation of SmearOFF, maleic acid and two EDTA preparations in smear layer removal from root canal dentin”. Acta Odontologica Scandinavica 77 (2019): 28-32.
- Rath PP., et al. “The effect of root canal irrigants on dentin: a focused review”. Journal of Restorative Dentistry and Endodontics 45 (2020): 39-48.
- Mjör IA. “Dentin permeability: The basis for understanding pulp reactions and adhesive technology”. Brazilian Dental Journal 20 (2009): 3-16.
- Urban, K., et al. “Canal cleanliness using different irrigation activation systems: a SEM evaluation”. Clinical Oral Investigations 21 (2017): 2681-2687.
- De Gregorio C., et al. “Effect of apical size and taper on volume of irrigant delivered at working length with apical negative pressure at different root curvatures”. Journal of Endodontics 39 (2013): 119-124.
- Gu L sha., et al. “Changes in stiffness of resin-infiltrated demineralized dentin after remineralization by a bottom-up biomimetic approach”. Acta Biomaterialia 6 (2010): 1453-1461.
- Toledano M., et al. “Early dentine remineralisation: Morpho-mechanical assessment”. Journal of Dentistry 42 (2014): 384-394.