Farklı Tiplerdeki Kök Kanal Yıkama Solüsyonlarının İnsan Osteoblastik Hücre Canlılığı Üzerine Etkileri

Hatice Büyüközer Özkan; Ayşe Canan Tutku Çelik; Hayriye Esra Ülker

doi:10.53394/akd.1058991

Research Article

Effects of Different Types of Root Canal Irrigation Solutions on the Viability of the Human Osteoblastic Cell Line

Year 2022, Volume: 8 Issue: 3, 236 - 243, 01.09.2022

Hatice Büyüközer Özkan Ayşe Canan Tutku Çelik Hayriye Esra Ülker

https://doi.org/10.53394/akd.1058991

Abstract

ABSTRACT
Objective: Root canal irrigation is very important for successful root canal treatment. During this procedure, root dentin and periapical tissues are in contact with irrigation solutions. These solutions should ideally remove pulpal tissues without damaging the oral tissues. The aim of this study was to evaluate the effects of 7 different irrigation solutions (Rocanal, BioPure MTAD, SmearClear, chlorhexidine gluconate, EDTA, hydrogen peroxide, NaOCl) on the viability of human osteoblastic cell lines (SaOS-2).
Methods: The tested solutions were diluted with culture medium and prepared in 6 different concentrations (1:2, 1:4, 1:8, 1:16, and 1:32). SaOS-2 cells were exposed to all concentrations of irrigation solutions, respectively (n = 12). Cell culture medium without test material was used as a control group. Cell viability was evaluated with the MTT cytotoxicity test. The cell viability of the control group was equal to 100%, and the data were statistically evaluated by One-way ANOVA and post-hoc Tukey's HSD tests.
Results: All tested solutions had cytotoxic effects on SaOS-2 cells at all concentrations (P < 0.05). There was difference in percentage between the cell viability values of the materials (P <0.05). No statistically difference between SmearClear and chlorhexidine gluconate groups. However, the difference between these groups and other groups (Rocanal, BioPure MTAD, hydrogen peroxide, EDTA, and NaOCl) was found to be significant. In group differences were detected in BioPure MTAD, hydrogen peroxide, EDTA groups at different concentrations.
Conclusion: According to the results of this study, all the tested solutions showed a cytotoxic effect on the selected cell culture.
Keywords: Biocompatibility, Irrigation solutions, Cytotoxicity, Osteoblastic cell

Keywords

Biocompatibility, Irrigation solutions, Cytotoxicity, Osteoblastic cell

References

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2. Bystrom A, Sundqvist G. Bacteriologic evaluation of the efficacy of mechanical root-canal instrumentation in endodontic therapy. Scand J Dent Res 1981; 89(4): 321-28.
3. Abou-Rass M, Piccinino MV. The effectiveness of four clinical irrigation methods on the removal of root canal debris. Oral Surg Oral Med Oral Pathol. 1982; 54(3):323-8.
4. Peters LB, Wesselink PR, Buijs JF, van Winkelhoff AJ. Viable bacteria in root dentinal tubules of teeth with apical periodontitis. J Endod. 2001; 27(2):76-81.
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6. Mohammadi Z, Abbott PV. The properties and applications of chlorhexidine in endodontics. Int Endod J. 2009; 42(4): 288-302.
7. Zehnder M. Root canal irrigants. J Endod. 2006 ;32(5): 389-98.
8. Murray PE, Farber RM, Namerow KN, Kuttler S, Garcia-Godoy F. Evaluation of Morinda citrifolia as an endodontic irrigant. J Endod. 2008; 34(1): 66-70.
9.Eddy RS, Joyce AP, Roberts S, Buxton TB, Liewehr F. An in vitro evaluation of the antibacterial efficacy of chlorine dioxide on E. faecalis in bovine incisors. J Endod. 2005; 31(9): 672-5.
10.Dunavant TR, Regan JD, Glickman GN, Solomon ES, Honeyman AL. Comparative evaluation of endodontic irrigants against Enterococcus faecalis biofilms. J Endod. 2006; 32(6):527-31.
11.Vahabi S, Najafi E, Alizadeh S. In vitro antimicrobial effects of some herbal essences against oral pathogens. J Med Plants Res, 2011; 5(19): 4870-8.
12.Pinheiro ET, Karygianni L, Attin T, Thurnheer T. Antibacterial Effect of Sodium Hypochlorite and EDTA in Combination with High-Purity Nisin on an Endodontic-like Biofilm Model. Antibiotics. 2021; 10(9):1141
13.Dioguardi M, Gioia GD, Illuzzi G, Laneve E, Cocco A, Troiano G. Endodontic irrigants: Different methods to improve efficacy and related problems. Eur J Dent. 2018;12(3):459-466.
14. Garcez AS, Hamblin MR. Methylene Blue and Hydrogen Peroxide for Photodynamic Inactivation in Root Canal- A New Protocol for Use in Endodontics. Eur Endod J. 2017;20;2(1):1-7.
15. Torabinejad M, Khademi AA, Babagoli J, Cho Y, Johnson WB, Bozhilov K, Kim J, Shabahang S. A new solution for the removal of the smear layer. J Endod. 2003 ;29(3):170-5.
16. Torabinejad M, Cho Y, Khademi AA, Bakland LK, Shabahang S. The effect of various concentrations of sodium hypochlorite on the ability of MTAD to remove the smear layer. J Endod. 2003; 29(4):233-9.
17. Lui JN, Kuah HG, Chen NN. Effect of EDTA with and without surfactants or ultrasonics on removal of smear layer. J Endod. 2007; 33(4):472-5.
18. Khedmat S, Shokouhinejad N. Comparison of the efficacy of three chelating agents in smear layer removal. J Endod. 2008; 34(5):599-602.
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21. Sen BH, Akdeniz BG, Denizci AA. The effect of ethylenediamine-tetraacetic acid on Candida albicans. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000; 90(5):651-5.
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29. Alaçam T. Endodonti, 2. Baskı: Ankara, Barış Yayınları Fakülteler Kitabevi, 2000.
30. Wesselink P, Bergenholtz G. Treatment of the necrotic pulp. In: Bergenholtz G, Reit C, eds. Textbook of Endodontology. Wiley, 2003: 352.
31. Ruksakiet K, Hanák L, Farkas N, Hegyi P, Sadaeng W, Czumbel LM, Sang-Ngoen T, Garami A, Mikó A, Varga G, Lohinai Z. Antimicrobial Efficacy of Chlorhexidine and Sodium Hypochlorite in Root Canal Disinfection: A Systematic Review and Meta-analysis of Randomized Controlled Trials. J Endod. 2020; 46(8):1032-1041.e7.
32. Sassone LM, Fidel R, Fidel S, Vieira M, Hirata R Jr. The influence of organic load on the antimicrobial activity of different concentrations of NaOCl and chlorhexidine in vitro. Int Endod J. 2003; 36(12):848-52.
33. Haapasalo M, Endal U, Zandi H, Coil JM. Eradication of endodontic infection by instrumentation and irrigation solutions. Endodontic Topics. 2005; 10(1): 77-102.
34. Wong DT, Cheung GS. Extension of bactericidal effect of sodium hypochlorite into dentinal tubules. J Endod. 2014; 40(6):825-9.
35. Rôças IN, Siqueira JF Jr. Identification of bacteria enduring endodontic treatment procedures by a combined reverse transcriptase-polymerase chain reaction and reverse-capture checkerboard approach. J Endod. 2010; 36(1):45-52.
36. Zhang W, Torabinejad M, Li Y. Evaluation of cytotoxicity of MTAD using the MTT-tetrazolium method. J Endod. 2003; 29(10):654-7.
37. Ercan E, Ozekinci T, Atakul F, Gül K. Antibacterial activity of 2% chlorhexidine gluconate and 5.25% sodium hypochlorite in infected root canal: in vivo study. J Endod. 2004; 30(2):84-7.
38. Slaughter RJ, Watts M, Vale JA, Grieve JR, Schep LJ. The clinical toxicology of sodium hypochlorite. Clin Toxicol (Phila). 2019; 57(5):303-311.
39. Türkün M, Gökay N, Özdemir N. Farklı Endodontik Yıkama Solüsyonlarının Toksik ve Nekrotik Doku Çözücü Etkilerinin Karşılaştırmalı Olarak İncelenmesi-Comparative Investigation of the Toxic and Necrotic Tissue-Dissolving Effects of Different Endodontic Irrigants. İ Ü Diş Hek Fak Der. 1998; 32(2):87-94.
40. Hülsmann M, Hahn W. Complications during root canal irrigation--literature review and case reports. Int Endod J. 2000; 33(3):186-93.
41. de Arruda JAA, Schuch LF, Pereira A, Monteiro JLGC, Melo-Juinor PMR, Mesquita RA, Moreno A, Callou G. Investigation of different sodium hypochlorite volumes, concentrations and times of irrigation in endodontic therapy: a systematic review. Arch Health Invest. 2019; 8(4): 185-91.
42. Martin DE, De Almeida JF, Henry MA, Khaing ZZ, Schmidt CE, Teixeira FB, Diogenes A. Concentration-dependent effect of sodium hypochlorite on stem cells of apical papilla survival and differentiation. J Endod. 2014; 40(1):51-5.
43.Serper A, Calt S, Dogan AL, Guc D, Ozçelik B, Kuraner T. Comparison of the cytotoxic effects and smear layer removing capacity of oxidative potential water, NaOCl and EDTA. J Oral Sci. 2001; 43(4):233-8.
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Farklı Tiplerdeki Kök Kanal Yıkama Solüsyonlarının İnsan Osteoblastik Hücre Canlılığı Üzerine Etkileri

Year 2022, Volume: 8 Issue: 3, 236 - 243, 01.09.2022

Hatice Büyüközer Özkan Ayşe Canan Tutku Çelik Hayriye Esra Ülker

https://doi.org/10.53394/akd.1058991

Abstract

ÖZ
Giriş/Amaç: Kök kanallarının yıkanması, kanal tedavisinin başarılı olabilmesi için uygulanan en önemli basamaklardan biridir. Uygulanan bu işlem sırasında kök dentini ve dişin periapikal dokuları yıkama solüsyonlarıyla sürekli temas halindedirler. Bu solüsyonların içindeki ajanların ideal olarak oral dokulara zarar vermeyerek pulpal dokuları uzaklaştırması gerekmektedir. Bu çalışmanın amacı, 7 farklı yıkama solüsyonunun (Rocanal, BioPure MTAD, SmearClear, klorheksidin glukonat, EDTA, hidrojen peroksit, NaOCl) insan osteoblastik hücre dizisinin (SaOS-2) canlılıkları üzerine etkilerini değerlendirmektir.
Gereç ve Yöntemler:Test edilen solüsyonlar kültür ortamı ile seyreltilerek 6 farklı konsantrasyonda (1:2, 1:4, 1:8, 1:16 ve 1:32) hazırlandı. SaOS-2 hücreleri yıkama solüsyonlarının tüm konsantrasyonlarına sırasıyla maruz bırakıldı (n = 12). Kontrol grubu olarak test materyali içermeyen hücre kültür ortamı kullanıldı. Hücre canlılığı MTT sitotoksisite testi ile değerlendirildi. Kontrol grubunun hücre canlılığı %100’e eşitlendi, veriler istatistiksel olarak One-way ANOVA ve post-hoc Tukey’s HSD testleri ile değerlendirildi.
Bulgular: Test edilen yıkama solüsyonlarının tüm konsantrasyolarda kontrol grubu ile karşılaştırıldığında SaOS-2 hücreleri üzerine sitotoksik etkileri olduğu gözlenmiştir (P <0.05). Materyallerin hücre canlılık değerleri arasında yüzdesel olarak anlamlı bir fark olduğu görülmüştür (P <0.05). SmearClear ve klorheksidin glukonat grupları arasında istatistiksel olarak bir fark gözlenmemiştir. Ancak, bu gruplar ile diğer gruplar (Rocanal, BioPure MTAD, hidrojen peroksit, EDTA ve NaOCl) arasındaki fark önemli bulunmuştur. BioPure MTAD, hidrojen peroksit, EDTA gruplarında farklı konsantrasyonlarda grup içi farklılıklar tespit edilmiştir.
Sonuç: Bu çalışmanın sonuçlarına göre test edilen yıkama solüsyonlarının hepsi seçilen hücre kültürü üzerinde sitotoksik etki göstermiştir.
Anahtar Sözcükler: Biyouyumluluk, Yıkama solüsyonları, Sitotoksisite, Osteoblastik hücre.

Keywords

Biyouyumluluk, Yıkama solüsyonları, Sitotoksisite, Osteoblastik hücre

References

1. Ricucci D, Siqueira JF. Biofilms and apical periodontitis: study of prevalence and association with clinical and histopathologic findings. J Endod 2010; 36(8): 1277-88.
2. Bystrom A, Sundqvist G. Bacteriologic evaluation of the efficacy of mechanical root-canal instrumentation in endodontic therapy. Scand J Dent Res 1981; 89(4): 321-28.
3. Abou-Rass M, Piccinino MV. The effectiveness of four clinical irrigation methods on the removal of root canal debris. Oral Surg Oral Med Oral Pathol. 1982; 54(3):323-8.
4. Peters LB, Wesselink PR, Buijs JF, van Winkelhoff AJ. Viable bacteria in root dentinal tubules of teeth with apical periodontitis. J Endod. 2001; 27(2):76-81.
5. Nair PN, 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(2): 231-52.
6. Mohammadi Z, Abbott PV. The properties and applications of chlorhexidine in endodontics. Int Endod J. 2009; 42(4): 288-302.
7. Zehnder M. Root canal irrigants. J Endod. 2006 ;32(5): 389-98.
8. Murray PE, Farber RM, Namerow KN, Kuttler S, Garcia-Godoy F. Evaluation of Morinda citrifolia as an endodontic irrigant. J Endod. 2008; 34(1): 66-70.
9.Eddy RS, Joyce AP, Roberts S, Buxton TB, Liewehr F. An in vitro evaluation of the antibacterial efficacy of chlorine dioxide on E. faecalis in bovine incisors. J Endod. 2005; 31(9): 672-5.
10.Dunavant TR, Regan JD, Glickman GN, Solomon ES, Honeyman AL. Comparative evaluation of endodontic irrigants against Enterococcus faecalis biofilms. J Endod. 2006; 32(6):527-31.
11.Vahabi S, Najafi E, Alizadeh S. In vitro antimicrobial effects of some herbal essences against oral pathogens. J Med Plants Res, 2011; 5(19): 4870-8.
12.Pinheiro ET, Karygianni L, Attin T, Thurnheer T. Antibacterial Effect of Sodium Hypochlorite and EDTA in Combination with High-Purity Nisin on an Endodontic-like Biofilm Model. Antibiotics. 2021; 10(9):1141
13.Dioguardi M, Gioia GD, Illuzzi G, Laneve E, Cocco A, Troiano G. Endodontic irrigants: Different methods to improve efficacy and related problems. Eur J Dent. 2018;12(3):459-466.
14. Garcez AS, Hamblin MR. Methylene Blue and Hydrogen Peroxide for Photodynamic Inactivation in Root Canal- A New Protocol for Use in Endodontics. Eur Endod J. 2017;20;2(1):1-7.
15. Torabinejad M, Khademi AA, Babagoli J, Cho Y, Johnson WB, Bozhilov K, Kim J, Shabahang S. A new solution for the removal of the smear layer. J Endod. 2003 ;29(3):170-5.
16. Torabinejad M, Cho Y, Khademi AA, Bakland LK, Shabahang S. The effect of various concentrations of sodium hypochlorite on the ability of MTAD to remove the smear layer. J Endod. 2003; 29(4):233-9.
17. Lui JN, Kuah HG, Chen NN. Effect of EDTA with and without surfactants or ultrasonics on removal of smear layer. J Endod. 2007; 33(4):472-5.
18. Khedmat S, Shokouhinejad N. Comparison of the efficacy of three chelating agents in smear layer removal. J Endod. 2008; 34(5):599-602.
19. Gainor BJ, Hockman DE, Anglen JO, Christensen G, Simpson WA. Benzalkonium chloride: a potential disinfecting irrigation solution. J Orthop Trauma. 1997 Feb; 11(2):121-5.
20. Perotti S, Bin P, Cecchi R. Hypochlorite accident during endodontic therapy with nerve damage - A case report. Acta Biomed. 2018 Mar; 89(1):104-108.
21. Sen BH, Akdeniz BG, Denizci AA. The effect of ethylenediamine-tetraacetic acid on Candida albicans. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000; 90(5):651-5.
22. Schmalz G. Concepts in biocompatibility testing of dental restorative materials. Clin Oral Invest.1997; 1:154-62.
23. Schmalz G. Use of cell cultures for toxicity testing of dental materials-advantages and limitations. J Dent. 1994; 22 Suppl 2: S6-11.
24. Wataha JC, Hanks CT, Sun Z. Effect of cell line on in vitro metal ion cytotoxicity. Dent Mater. 1994; 10:156-61.
25. Geurtsen W, Lehmann F, Spahl W, Leyhausen G. Cytotoxicity of 35 dental resin composite monomers/additives in permanent 3T3 and three human primary fibroblast cultures. J Biomed Mater Res. 1998; 41:474-80.
26. van Meerloo J, Kaspers GJ, Cloos J. Cell sensitivity assays: the MTT assay. Methods Mol Biol. 2011; 731:237-45.
27. Parboosing R, Mzobe G, Chonco L, Moodley I. Cell-based Assays for Assessing Toxicity: A Basic Guide. Med Chem. 2016;13(1):13-21.
28. Sundqvist G, Figdor D. Endodontic treatment of apical periodontitis. Essential endodontology. Oxford: Blackwell, 1998: 242-69.
29. Alaçam T. Endodonti, 2. Baskı: Ankara, Barış Yayınları Fakülteler Kitabevi, 2000.
30. Wesselink P, Bergenholtz G. Treatment of the necrotic pulp. In: Bergenholtz G, Reit C, eds. Textbook of Endodontology. Wiley, 2003: 352.
31. Ruksakiet K, Hanák L, Farkas N, Hegyi P, Sadaeng W, Czumbel LM, Sang-Ngoen T, Garami A, Mikó A, Varga G, Lohinai Z. Antimicrobial Efficacy of Chlorhexidine and Sodium Hypochlorite in Root Canal Disinfection: A Systematic Review and Meta-analysis of Randomized Controlled Trials. J Endod. 2020; 46(8):1032-1041.e7.
32. Sassone LM, Fidel R, Fidel S, Vieira M, Hirata R Jr. The influence of organic load on the antimicrobial activity of different concentrations of NaOCl and chlorhexidine in vitro. Int Endod J. 2003; 36(12):848-52.
33. Haapasalo M, Endal U, Zandi H, Coil JM. Eradication of endodontic infection by instrumentation and irrigation solutions. Endodontic Topics. 2005; 10(1): 77-102.
34. Wong DT, Cheung GS. Extension of bactericidal effect of sodium hypochlorite into dentinal tubules. J Endod. 2014; 40(6):825-9.
35. Rôças IN, Siqueira JF Jr. Identification of bacteria enduring endodontic treatment procedures by a combined reverse transcriptase-polymerase chain reaction and reverse-capture checkerboard approach. J Endod. 2010; 36(1):45-52.
36. Zhang W, Torabinejad M, Li Y. Evaluation of cytotoxicity of MTAD using the MTT-tetrazolium method. J Endod. 2003; 29(10):654-7.
37. Ercan E, Ozekinci T, Atakul F, Gül K. Antibacterial activity of 2% chlorhexidine gluconate and 5.25% sodium hypochlorite in infected root canal: in vivo study. J Endod. 2004; 30(2):84-7.
38. Slaughter RJ, Watts M, Vale JA, Grieve JR, Schep LJ. The clinical toxicology of sodium hypochlorite. Clin Toxicol (Phila). 2019; 57(5):303-311.
39. Türkün M, Gökay N, Özdemir N. Farklı Endodontik Yıkama Solüsyonlarının Toksik ve Nekrotik Doku Çözücü Etkilerinin Karşılaştırmalı Olarak İncelenmesi-Comparative Investigation of the Toxic and Necrotic Tissue-Dissolving Effects of Different Endodontic Irrigants. İ Ü Diş Hek Fak Der. 1998; 32(2):87-94.
40. Hülsmann M, Hahn W. Complications during root canal irrigation--literature review and case reports. Int Endod J. 2000; 33(3):186-93.
41. de Arruda JAA, Schuch LF, Pereira A, Monteiro JLGC, Melo-Juinor PMR, Mesquita RA, Moreno A, Callou G. Investigation of different sodium hypochlorite volumes, concentrations and times of irrigation in endodontic therapy: a systematic review. Arch Health Invest. 2019; 8(4): 185-91.
42. Martin DE, De Almeida JF, Henry MA, Khaing ZZ, Schmidt CE, Teixeira FB, Diogenes A. Concentration-dependent effect of sodium hypochlorite on stem cells of apical papilla survival and differentiation. J Endod. 2014; 40(1):51-5.
43.Serper A, Calt S, Dogan AL, Guc D, Ozçelik B, Kuraner T. Comparison of the cytotoxic effects and smear layer removing capacity of oxidative potential water, NaOCl and EDTA. J Oral Sci. 2001; 43(4):233-8.
44. Aldemir AB. Farklı irrigasyon solüsyonlarının sitotoksisitelerinin hücre kültürü yöntemi ile karşılaştırılmalı olarak incelenmesi. Doktora tezi. Ankara Üniversitesi Sağlık Bilimleri Enstitüsü, Endodonti Anabilim Dalı. 2009
45. Tanaka T, Masako O, Masayuki O. The relationship between the preservative efficacy and cytotoxicity of two common preservatives used in cosmetics. J Oral Tissue Engin. 2018; 15(3): 186-92.
46. Sreevidya VS, Lenz KA, Svoboda KR, Ma H. Benzalkonium chloride, benzethonium chloride, and chloroxylenol - Three replacement antimicrobials are more toxic than triclosan and triclocarban in two model organisms. Environ Pollut. 2018; 235:814-24.
47. Pappen FG, Souza EM, Giardino L, Carlos IZ, Leonardo MR, de Toledo Leonardo R. Endodontic chelators induce nitric oxide expression by murine-cultured macrophages. J Endod. 2009; 35(6):824-8.
48. Zhang W, Torabinejad M, Li Y. Evaluation of cytotoxicity of MTAD using the MTT-tetrazolium method. J Endod. 2003; 29(10):654-7.
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Details

Primary Language	Turkish
Subjects	Clinical Sciences
Journal Section	Research Article
Authors	Hatice Büyüközer Özkan This is me 0000-0003-4419-1518 Ayşe Canan Tutku Çelik This is me 0000-0001-6680-0236 Hayriye Esra Ülker This is me 0000-0002-2967-5680
Publication Date	September 1, 2022
Submission Date	April 10, 2021
Published in Issue	Year 2022 Volume: 8 Issue: 3

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Vancouver	Büyüközer Özkan H, Çelik ACT, Ülker HE. Farklı Tiplerdeki Kök Kanal Yıkama Solüsyonlarının İnsan Osteoblastik Hücre Canlılığı Üzerine Etkileri. Akd Med J. 2022;8(3):236-43.

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