Endodontology

ORIGINAL ARTICLE
Year
: 2019  |  Volume : 31  |  Issue : 1  |  Page : 17--20

Effectiveness of three chemical solutions on gutta-percha cones by rapid sterilization technique: A scanning electron microscope study


S Anitha Rao, Muppala Nikhitha Chowdary, CS Soonu, T Muralidhar 
 Department of Conservative Dentistry and Endodontics, Mamata Dental College, Khammam, Telangana, India

Correspondence Address:
Dr. Muppala Nikhitha Chowdary
Department of Conservative Dentistry and Endodontics, Mamata Dental College, Giri Prasad Nagar, Khammam - 507 002, Telangana
India

Abstract

Objectives: It is prudent to produce most sterile root canal system and to maximize the most hermetical seal so gutta percha cones are used gutta-percha (GP) cones are used to obliterate the root canal space, prevention of contamination becomes a problem. Hence, the aim of this study was to identify the presence of surface topography, crystallization, and subsequent removal of sodium hypochlorite, glutaraldehyde, and aloe vera crystals on GP cones after rapid sterilization technique – this was a scanning electron microscope (SEM) study. Materials and Methods: GP points of size 80 and 2% taper were divided into four groups depending on the type of agents used for sterilization. Four groups were as follows: Group 1 – control group, Group 2 – aloe vera, Group 3 – glutaraldehyde, and Group 4 – NaOCL. About 10 GP points of each group were immersed for 2 min in different concentrations and observed under SEM to evaluate surface topography and presence of chloride crystals. Statistical analysis was carried out using Chi-square test, Kruskal–Wallis test and Mann–Whitney U-test to compare the results between the groups. All the data were expressed as mean ± standard deviation, and the difference of P < 0.05 or more was considered significant. Results: Aloe vera found to be an effective medium in decontaminating GP cones compared to glutaraldehyde and NaOCL (sodium hypochlorite). Conclusion: The use of sterile GP cones for the obliteration of root canals is of prime importance, and aloe vera group shows no changes in surface topography and the presence of chloride crystal formation compared to the control group. Hence, it is prudent to produce the most sterile root canal system, maximizing most hermetical seal possible.



How to cite this article:
Rao S A, Chowdary MN, Soonu C S, Muralidhar T. Effectiveness of three chemical solutions on gutta-percha cones by rapid sterilization technique: A scanning electron microscope study.Endodontology 2019;31:17-20


How to cite this URL:
Rao S A, Chowdary MN, Soonu C S, Muralidhar T. Effectiveness of three chemical solutions on gutta-percha cones by rapid sterilization technique: A scanning electron microscope study. Endodontology [serial online] 2019 [cited 2019 Sep 15 ];31:17-20
Available from: http://www.endodontologyonweb.org/text.asp?2019/31/1/17/260530


Full Text

 Introduction



Eliminating flare-ups is very important in maintaining the chain of aseptic condition. The most commonly used endodontic filling materials are gutta-percha (GP) points which should be free of contamination.[1],[2] Dentist must be apprehensive with both endogenous microbial flora and exogenous bacterial pestilence organisms such as cocci, rods and yeasts present in air that may cause potential contamination to GP points once exposed to chair-side clinical environment.[3],[4]

Sterilization of GP cone plays a crucial role during root canal obturation.[5] Chemical and physical properties of GP points are not suitable for usual methods of sterilization such as autoclave or hot air oven. Chemical sterilization can be an effective method, and selection of disinfectant plays an important role, because it may affect surface texture and mechanical properties of GP cones.[6],[7]

Chemical agents which are readily available in dental operatory can be used to produce an effective surface sterilization of GP points.[8] Senia et al. stated that the most effectual, definitive, appropriate, and inexpensive used method for sterilization of GP is rapid sterilization technique.[4]

Sodium hypochlorite, a commonly used disinfecting agent for root canal irrigation, can be used for disinfection of GP cones as well.[9] Kumar R et al. stated that 5% of NaOCL provides excellent antibacterial activity in 6 and 3 weeks.[9] Antimicrobial effect of NaOCL is directly proportional to its concentration.[10] Da Motta et al. stated that 5.25% NaOCL plays a major role in surface alterations of GP cones.[10]

 Materials and Methods



The present study was conducted in the Department of Conservative Dentistry and Endodontics, Mamata Dental College, Khammam, Telangana, India.

Eighty standardized GP cones were randomly selected from new boxes and divided into four groups based on the type of agents used for sterilization and observed under scanning electron microscope (SEM) to evaluate surface topography. Four groups include Group 1 – control, Group 2 – aloe vera, Group 3 – glutaraldehyde, and Group 4 – NaOCL. From each group, 10 GP points were selected and perceived under SEM to assess surface topography and the presence of chloride crystals.

In Group 1 (control), 10 GP points were directly taken from the sealed pack with the help of locking tweezer and pictures are captured under SEM.

In Group 2 (aloe vera), 10 GP points were selected and were immersed and soaked in 100% aloe vera juice for 2 min using locking tweezer and the cone was transferred to a sterile 4-inch × 4-inch gauze pads and allowed to air dry for 30 min. Gutta percha cones are mounted on aluminium studs individually and gold sputtering done. They were analyzed under SEM to observe surface topography and crystal formation.

In Group 3 (glutaraldehyde), 10 GP points were selected and were immersed and soaked in 2% solution of glutaraldehyde for 2 min using locking tweezer, and the cone was transferred to a sterile 4-inch × 4-inch gauze pads and allowed to air dry for 30 min. GP points are mounted on aluminium studs individually and gold sputtering done and they were analyzed under SEM to observe surface topography and crystal formation.

In Group 4 (NaOCL), 10 GP points were selected and were immersed and soaked in 5% NaOCL for 2 min using locking tweezer and cone was transferred to a sterile 4-inch × 4-inch gauze pads and allowed to air dry for 30 min. GP points were mounted on aluminum studs individually, gold sputtering was done and they were analyzed under SEM to observe surface topography and crystal formation.

Finally, GP cones from all groups were selected and mounted on aluminum studs followed by gold sputtering and pictures were captured under SEM.

Statistical analysis was done using Chi-square test, Kruskal–Wallis test, and Mann–Whitney U-test. Difference of P ≤ 0.05 or more was considered statistically significant, and data obtained were expressed as mean ± standard deviation. On comparing four groups, Group 4 (NaOCL) shows severe changes in surface topography and crystal formation on the surface of GP points when compared to the remaining groups [Table 1] and [Graph 1].{Table 1}[INLINE:1]

 Results



SEM picture reveals the following: Group 1 (control) – mild changes in surface topography and chloride crystal formation [Figure 1] and Group 2 (aloe vera) – no changes in surface topography and chloride crystal formation [Figure 2].{Figure 1}{Figure 2}

Group 3 (glutaraldehyde) – moderate changes in surface topography and chloride crystal formation [Figure 3], and Group 4 (NaOCL) – severe changes in surface topography and chloride crystal formation [Figure 4].{Figure 3}{Figure 4}

 Discussion



During endodontic procedures, extensive effort is concerned to the removal of microorganisms within the root canal.[11] Vivek V et al. stated that risk of contamination may occur mainly at the time of opening the fresh GP cones in a dental clinic.[11] Dental professionals face many problems after filling of root canals, due to emplacement of GP points into the canal.[12] Commercially available GP cones have several advantages, Several advantages which include biocompatible, radiopaque, dimensionally stable, easily removed from root canal, antibacterial, and also do not stain tooth structure.[13]

Antimicrobial properties of GP are mainly due to the zinc oxide component. Gp produced under septic conditions they can be still contaminated by aerosols and handling during storage process. One of the most common frequent contaminations of GP cones is by operator's fingers.[14]

Depletion or clearance of microorganisms within root canal is a major goal in endodontic therapy for achieving success.[14] Cardoso et al. stated that utmost care must be taken to prevent contamination of filling materials to avoid cross-infection of root canal.[14] Alpha-phase GP is more commonly employed in thermoplasticized techniques, while beta-phase GP is more popular in lateral condensation techniques.[15]

Ingle stated that decontamination through wiping technique has disadvantages relying mainly on physical contact for removal of the organisms and not permitting chemical solution to contact microorganisms for an effective time period. Dropping a clear cone into a good germicidal solution for an adequate period of time will effectively decontaminate the cone.[16]

This study reveals that chloride crystals are present in control, glutaraldehyde (2%), and aloe vera 100% groups. NaOCL (5%) group shows no chloride crystal formation and surface topography.

Suchde et al. stated that contamination of GP cones with different bacteria can be decontaminated when treated with 2% of glutaraldehyde for 30 s, and 2-min immersion time is more effective for decontamination.[17] Glutaraldehyde can sterilize GP cones because of its sporicidal activity and avoid root canal cross-infection.[18],[19] It is used as preservative and sterilization agent, and it also helps in killing microorganisms as well as endospores.[20]

Aloe vera (100%) was selected because of antimicrobial properties, and it is bacteriostatic against Staphylococcus aureus and Streptococcus pyogenes.[20],[21] Its antimicrobial activity is due to p-coumaric acid, ascorbic acid, and cinnamic acid. Aloe vera is efficient in decontaminating GP cones within 1 min.[22]

NaOCL (5%) is known to its antibacterial activity due to hypochlorous acid (HCLO) in solution. NaOCL is a strong disinfectant that can cause utmost topographic change and hostile deterioration. During endodontic practice, NaOCL was used routinely as an irrigating solution and 5.25% NaOCL was used as disinfectant for GP cones for 30 s.[23]

Statistically significant differences seen among all groups and aloe vera group show better results on surface topography and chloride crystal formation compared to the control group.

 Conclusion



Sterility of GP cones is very important for the obliteration of root canal. Hence, the study was undertaken in an attempt to develop a clinically effective and rapid procedure for sterilization. Hence, aloe vera acts as a best disinfectant for decontamination of GP points.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

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