Effect of EDTA and QMIX Ultrasonic Activation on the Reduction of Microorganisms and Endotoxins in Ex Vivo Human Root Canals

Abstract

The present study aimed to compare the effectiveness of QMiX and 17% EDTA associated to passive ultrasonic irrigation (PUI) or manual agitation (MA) on the reduction of E. faecalis, E. coli and LPS from root canals. Forty single rooted human teeth were randomly divided into four groups (n=10), according to the final irrigation protocol: EDTA+MA, QMiX+MA, EDTA+PUI, QMiX+PUI. Sample collections were obtained from the root canal content immediately before preparation (baseline-S1), after instrumentation (S2), after final irrigation protocol (S3) and 7 days after instrumentation and final irrigation (S4). The antimicrobial effectivity and on endotoxin content were analyzed by culture procedure (CFU/mL) and LAL assay (EU/mL), respectively. The results were statistically analyzed by Kruskal-Wallis and Friedman test (α=5%). QMiX+MA and QMiX+PUI reduced 100% of E. coli and E. faecalis bacteria and also prevented E. faecalisregrowth at S4. EDTA significantly reduced E. coli, but it was not effective in reducing E. faecalis. All protocols reduced EU/mL when compared to S1, however at S4 there was a significant reduction of EU/mL only in the QMiX+MA and QMiX+PUI groups in relation to S3 and S2, respectively. Final irrigation with QMiX associated with MA or PUI had superior antibacterial efficacy compared to EDTA, eliminating 100% of E. coli and E. faecalis strains. In addition, QMiX+PUI reduced 97.61% of the initial content of LPS.

The effect of 17% EDTA and QMiX ultrasonic activation on smear layer removal and sealer penetration: ex vivo study

“…To remove debris and smear layer and improve the permeability of the RCS, final irrigation with ethylenediaminetetraacetic acid (EDTA) is recommended as a prerequisite for a satisfactory sealing of the dentinal canaliculi 5 . More recently, the final irrigant QMiX has gained special attention for presenting a chelating effect similar or superior to EDTA, besides antimicrobial activity [6][7][8][9] . The QMiX promotes a superior sealer penetration to that achieved by other chelating solutions such as BioPure MTAD 10 .…”

Effectiveness of grape seed extract-based intracanal dressings against Enterococcus Faecalis and its influence on dentin microhardness and bond strength of filling material

“…The use of intracanal dressings results in improved microbiological and structural status of the root canal system (VERA et al, 2012), and adequate tests are necessary to evaluate their properties. The counting of CFUs provides bacterial quantification of root canals in an acceptable way, allowing calculating the E. faecalis percentage reduction (PETERS;WESSELINK;MOORER, 1995;MATOS et al, 2019). The Knoop test is more sensitive to surface conditions and, due to its longer diagonals, it is less sensitive to measure errors when equal loads are applied (LYSAGHT; DEBELLIS, 1969).…”

Cytotoxicity and Efficacy in Debris and Smear Layer Removal of HOCl-Based Irrigating Solution: An In Vitro Study

“…Failure of endodontic treatment is mostly related to the remaining microorganisms and their products within the root canal system [ 1 ]. Attempts to reduce the microbial load below a critical threshold, which can be subsequently controlled by the immune system [ 2 ], usually rely on a combination of mechanical root canal preparation and chemical disinfection [ 3 ].…”

“…Sodium hypochlorite (NaOCl) is generally assumed to be a benchmark for root canal irrigation due to its exceptional antimicrobial activity, tissue-dissolving properties, low cost and wide availability [ 1 ]. Traditionally, the use of NaOCl is followed by the use of calcium chelating agents, such as ethylenediaminetetraacetic acid (EDTA), which dissolve the inorganic part of the smear layer and result in a wider range of open dentinal tubules, thus contributing to the superior debridement and disinfection of the root canal system [ 10 ].…”