![]() The literature shows that the combination of these substances leads to the formation of a brownish precipitate, but does not reveal measurements of the intensity of this precipitate and its consequences. Seeking to increase the efficiency of endodontic irrigation, the association of different solutions as final irrigant has been investigated, such as sodium hypochlorite with chlorhexidine. Peracetic acid is more effective to remove the chemical smear layer. Ethanol is not capable to remove the chemical smear layer. RESEARCH HIGHLIGHTS: The post-space irrigation with chlorhexidine results in the formation of chemical smear layer. ![]() The use of 1% PA prior the post-space irrigation with CHX decrease the incidence of CSL. No difference on the incidence of open dentin tubules was found for any irrigation protocol and post-space third (p >. DW and CHX-PA showed similar incidence of CSL (p >. Moreover, CHX and CHX-ET showed the highest incidence of CSL (p. Cl, Bi, and Si were the chemical elements most found over the dentin after the irrigation with CHX and CHX-ET. Data from chemical composition of CSL were descriptively analyzed, while the incidence of open dentin tubules was evaluated by scores and submitted to Kruskal-Wallis and Dunn test (p =. The chemical composition of CSL and the incidence of open dentin tubules at the post-space thirds were evaluated by EDS (500× magnification) and SEM (2000× magnification) images, respectively. After, post-space preparation was performed and the roots were randomized in four groups (n = 10) according to the irrigation protocol: DW, CHX, CHX-ET and CHX-PA. Forty bovine roots were endodontically treated. Scanning electron microscopy (SEM) and electron dispersive spectroscopy (EDS) images were used. This study evaluated the effect of irrigation protocols using 95% ethanol (ET) or 1% peracetic acid (PA) prior the use of 2% chlorhexidine (CHX) compared to distilled water (DW) on the chemical smear layer (CSL) formation and incidence of open dentin tubules at the apical, medium, and cervical third of the post-space dentin. The 5% sodium thiosulfate was most effective among other intermediate treatments, assessed by stereomicroscopy and ToF-SIMS. Utilizing ToF-SIMS, 5% sodium thiosulfate was most effective in reducing the components representing para-chloroaniline and chlorhexidine gluconate. 05, Chi-square, generalized linear model, and Tukey's multiple comparison tests). Stereomicroscopy showed that 5% STS significantly reduced brown precipitate intensity and area as compared with no intermediate irrigation (p <. Sectioned teeth were analyzed for brown precipitate intensity and area using stereomicroscopy and components related to para-chloroaniline using Time-of-Flight Secondary Ion Mass Spectrometry (ToF-SIMS). 2% chlorhexidine gluconate was the final irrigant in all groups. Thirty-nine premolars were irrigated with 6% sodium hypochlorite and divided into either: No intermediate treatment Dry paper points three different irrigations with 17% ethylenediaminetetraacetic acid, deionized water, or 5% sodium thiosulfate. To evaluate intermediate treatments between sodium hypochlorite and chlorhexidine gluconate irrigations for the prevention of a toxic brown precipitate in root canal therapy. The interaction between NaOCl and CHX resulted in an insoluble neutral salt as a precipitate that can be prevented using absolute alcohol and minimized using saline and distilled water as intermediate flushes. The chemical composition of the precipitate was confirmed by Beilstein and HCl tests, and the nuclear magnetic resonance imaging technique confirmed chlorine in the para position of the benzene ring. The thickness of the precipitate was measured using the ProgRes computer software (Olympus, Hamburg, Germany). The Sal and Dw groups showed minimal precipitate in the coronal and middle thirds. The Ts group samples showed orange-brown precipitate, concentrated more in the coronal and middle thirds, whereas the Aba group showed no evidence of precipitate. Teeth were sectioned longitudinally and subjected to stereomicroscopic examination. In the absolute alcohol (Aba), saline (Sa), and distilled water (Dw) groups, intermediate flushes of absolute alcohol, saline, and distilled water were used between the last two irrigants. In the test group (Ts group), canals were irrigated with 17% EDTA and 2.5% NaOCl followed by 2% CHX. The purpose of this study was (1) to evaluate maximum thickness the and chemical composition of the precipitate formed between sodium hypochlorite (NaOCl) and chlorhexidine (CHX) and (2) to evaluate effectiveness of absolute alcohol to remove residual NaOCl and thereby prevent the formation of the precipitate.įorty extracted single-rooted human teeth were decoronated, and the canals were instrumented.
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