The Influence of Nano Chitosan as Final Irrigation on Push-Out Bond Strength of Different Endodontic Sealers

Section: Research Paper
Issue
Vol. 26 No. 2 (2026): Volume 26 Issue 2
Pages
458-481

Abstract

Aims: The present study aimed to evaluate the influence of Chitosan nanoparticle irrigants at two concentrations (0.2% and 0.5%) and compare them with other irrigants on the push-out bond strength of obturation endodontic sealers.


Materials and Methods: Fifty-four human lower premolar teeth with single, straight roots were extracted and utilized. Teeth were prepared to a 12 mm length. Biomechanical preparation of the canal was carried out through the ProTaper universal system. Six Groups were developed depending on the final irrigation. GI: 0.2% Chitosan nanoparticles (CNPs), GII:0.5% Chitosan nanoparticles (CNPs), GIII: 17% Ethylenediaminetetraacetic acid (EDTA), GIV: 3% Sodium hypochlorite (NaOCl), GV: 2% Chlorohexidine (CHX), and GVI: Distilled water as the control group. Afterward, the groups were subdivided into 3 subgroups (n=3) based on the sealer used: (A) AH Plus sealer, (B) MTA Fillapex sealer, (C) EndoFill sealer. F3 gutta-percha cone and a single cone procedure were used to fill all samples with sealer. From each sample, three slices, 2 mm thick, were cut at 3, 7, and 11 mm from the apex. They were labeled coronal, middle, and apical in that order. A universal testing machine was used to analyze push-out bond strength (POBS), and a stereomicroscope with a 40X magnification was utilized to examine the mode of failure. Then, the data were collected and analyzed statistically.


Results: The highest mean Push-out bond strength (POBS) at the apical third is Chitosan nanoparticles (CNP), followed by Ethylenediaminetetraacetic acid (EDTA), then Sodium hypochlorite (NaOCl), 0.5% Chitosan nanoparticles (CNP) significantly differs from 0.2% Chitosan nanoparticles (CNP). Chlorohexidine (CHX) increased Push-out bond strength POBS of AH Plus sealer and MTA Fillapex at coronal and middle, respectively. The lowest mean Push-out bond strength (POBS) is Sodium hypochlorite (NaOCl) and distilled water   


Conclusion: Chitosan nanoparticles (CNPs) are a new final washing improve bond strength of resin-based and MTA-based sealers better than 17% Ethylenediaminetetraacetic acid (EDTA). And 2% Chlorohexidine (CHX) is as effective as chitosan nanoparticles (CNPs) in improving bond strength of resin-based AH Plus, MTA Fillapex and EndoFill sealers.

Keywords:

Chitosan nanoparticles (CNPs), EDTA, POBS, Sealer

References

  1. Antunes PVS, Flamini LES, Chaves JFM, Silva RG, Cruz Filho AM. Comparative effects of final canal irrigation with chitosan and EDTA. J Appl Oral Sci. 2020;28:e20190005. https://doi.org/10.1590/1678-7757-2019-0005.
  2. Çakır A, Şahin TN, Kahveci Ö. Assessing the efficacy of various irrigation solutions in dissolving organic tissue. Sci Rep. 2024;14:13861. https://doi.org/10.1038/s41598-024-64904-w.
  3. Martins CM, da Silva Machado NE, Giopatto BV, de Souza Batista VE, Marsicano JA, Mori GG. Post-operative pain after using sodium hypochlorite and chlorhexidine as irrigation solutions in endodontics: systematic review and meta-analysis of randomised clinical trials. Indian J Dent Res. 2020;31(5):774–781.
  4. Pivatto K, Pedro FLM, Guedes OA, Silva AFD, Piva E, Pereira TM, Borges AH. Cytotoxicity of chelating agents used in endodontics and their influence on MMPs of cell membranes. Braz Dent J. 2020;31(1):32–36.
  5. Subhashree P, Sumit M, Monalisa M. Nanoparticles used in dentistry. J Oral Biol Craniofac Res. 2018;8(1):58–67.
  6. Amin D, Elfaramawy M, Abdelrahman TY. Effect of addition of chitosan nanoparticles on film thickness of different root canal sealers. J Endod. 2022;68(3):2851–2854.
  7. Mohammed RR, Rafeeq RA. An in vitro study of the cytotoxicity of chitosan nanoparticles-containing orthodontic primer. Tikrit J Dent Sci. 2024;12(1):47–57.
  8. Abdul-Shafi HAW, Aziz HK. Evaluation of the antifungal activity of heat-cured soft denture liner impregnated with chitosan nanoparticles. Tikrit J Dent Sci. 2021;9(2):104–112.
  9. Mikusova V, Mikus P. Advances in chitosan-based nanoparticles for drug delivery. Int J Mol Sci. 2021;22(17):9652. https://doi.org/10.3390/ijms22179652
  10. Janini ACP, Pelepenko LE, Gomes BPFA, Marciano MA. Physico-chemical properties of calcium silicate-based sealers in powder/liquid and ready-to-use forms. Braz Dent J. 2022;33(5):18–25.
  11. Galledar S, Farhang R, Abazari M, Negahdar P. Evaluation of the apical microleakage of MTA Fillapex, AH26, and Endofill sealers. Braz Dent Sci. 2020;23(3):1–8.
  12. Verma D, Taneja S, Kumari M. Efficacy of different irrigation regimes on the push-out bond strength of various resin-based sealers at different root levels: An in vitro study. J Conserv Dent. 2018;21(2):125–129. https://doi.org/10.4103/JCD.JCD_67_17.
  13. Sharma D, Worlikar N, Shah K, Sharma Y. Recent advancements in root canal sealers: An overview. J Adv Med Dent Res. 2023;11(4):82–91.
  14. Ghouchani TZ, Farhadpour H, Mohammadi N. Effect of root canal filling materials and pretreatment with solvents on the shear bond strength of composite resin with primary tooth dentin. Biomed Res Int. 2021;2021:66404. https://doi.org/10.1155/2021/6640403.
  15. Mohamed Nour ElDeen S, Rokaya M, Aly Sherif M. Evaluation of antimicrobial efficacy of nano chitosan and chlorhexidine versus sodium hypochlorite as final rinse against Enterococcus faecalis. Alex Dent J Girls. 2023;10(1):11–17.
  16. Mohamed AM, Nabih SM, Wakwak MA. Effect of chitosan nanoparticles on microtensile bond strength of resin composite to dentin: An in vitro study. Braz Dent Sci. 2020;23(2):1–10.
  17. Attash IM, Al-Ashou WM. Push-out bond strength evaluation for different endodontic sealers: A comparative study. Al-Rafidain Dent J. 2022;22(2):301–312.
  18. Naeem AM, Al-Zaka IM. The influence of different root canal irrigants on the push-out bond strength of AH Plus and bioceramic sealers. J Bagh Coll Dent. 2021;33(2):21–29.
  19. Yaduka P, Kataki R, Roy D, Das L, Goswami S. Effects of radiation therapy on the dislocation resistance of root canal sealers applied to dentin and the sealer-dentin interface: A pilot study. Restor Dent Endod. 2021;46(2):e22. https://doi.org/10.5395/rde.2021.46.e22.
  20. Aydın ZU, Özyürek T, Keskin B, Baran T. Effect of chitosan nanoparticle, QMix, and EDTA on TotalFill BC sealer dentinal tubule penetration: A confocal laser scanning microscopy study. Odontology. 2019;107(1):64–71. https://doi.org/10.1007/s10266-018-0364-5.
  21. Abidin T, Susilo D, Gani BA. The effectiveness of 0.2% high-molecular-weight nano-chitosan as an irrigant agent against Enterococcus faecalis with passive ultrasonic irrigation. J Conserv Dent. 2022;25(1):37–41. https://doi.org/10.4103/jcd.jcd_340_21.
  22. Ratih DN, Enggardipta RA, Kartikaningtyas AT. The effect of chitosan nanoparticle as a final irrigation solution on smear layer removal, microhardness, and surface roughness of root canal dentin. Open Dent J. 2020;14(1):19–26. https://doi.org/10.2174/1874210602014010019.
  23. Patih DN, Sari NI, Santosa P, Kaswati NMN. Time-dependent effect of chitosan nanoparticles as final irrigation on the apical sealing ability and push-out bond strength of root canal obturation. Int J Dent. 2020;2020:8885804. https://doi.org/10.1155/2020/8885804.
  24. Mohamed AM, Ghoneim AG, Roshdy NN. Evaluation of the effect of final rinse with chitosan nanoparticles and EDTA on the push-out bond strength of resin-based and bioceramic-based root canal sealers. Alexandria Sci Dent Stud. 2021;5(4):66–75.
  25. Türker SA, Uzunoğlu V, Puralı N. Evaluation of dentinal tubule penetration depth and push-out bond strength of AH 26, BioRoot RCS, and MTA Plus root canal sealers in the presence or absence of smear layer. J Dent Res Dent Clin Dent Prospects. 2018;12(4):294–298. https://doi.org/10.15171/joddd.2018.046.
  26. Mathew SP, Pai VS, Usha G, Nadig RR, et al. Comparative evaluation of smear layer removal by chitosan and ethylenediaminetetraacetic acid when used as irrigants and its effect on root dentin: An in vitro atomic force microscopic and energy-dispersive X-ray analysis. J Conserv Dent. 2017;20(4):245–250. https://doi.org/10.4103/JCD.JCD_114_17.
  27. Chaves JF, Martins CV, Gabriel AE. Effect of a chitosan final rinse on the bond strength of root canal fillings. Gen Dent. 2019;67(5):54–57.
  28. 28. Geogi CC, Dubey S, Singh P, Rajkumar B, Samant P, Rawat A. A comparative evaluation of the effect of different endodontic irrigating solutions on microhardness of root canal dentin: An in vitro study. J Dent (Shiraz). 2023;24(4):1–7.
  29. Gu LS, Cai X, Guo JM, Pashley DH, Breschi L, Xu HHK, Wang XY, Tay FR, Niu LN. Chitosan-based extrafibrillar demineralization for dentin bonding. J Dent Res. 2019;98(2):186–193. https://doi.org/10.1177/0022034518809967.
  30. Özlek E, Rath PP, Kishen A, Neelakantan P. A chitosan-based irrigant improves the dislocation resistance of a mineral trioxide aggregate–resin hybrid root canal sealer. Clin Oral Investig. 2020;24(1):151–156. https://doi.org/10.1007/s00784-019-02916-9
  31. Kaki GD, Genç Şen O. The effects of chelation on the adhesion of two different root canal sealers. J Evol Med Dent Sci. 2018;7(32):3595–3603. https://doi.org/10.14260/jemds/2018/809.
  32. Hashem SS, Fawzy MI, Bastawy HA. Effectiveness of chitosan as final irrigating solution on bond strength of resin-based sealer to radicular dentin. Alex Dent J Girls. 2019;6(2):137–146.
  33. Rifaat S, Rahoma A, Alkhalifa F, AlQuraini G, Alsalman Z, Alwesaibi Z, Taymour N. Push-out bond strength of EndoSeal mineral trioxide aggregate and AH Plus sealers after using three different irrigation protocols. Eur J Dent. 2023;17(1):76–81. https://doi.org/10.1055/s-0042-1755615.
  34. Bayram H, Bayram E, Kanber M, Celikten B, Şaklar F. Effect of different chelating solutions on the push-out bond strength of various root canal sealers. Biomed Res. 2017;28:8418–8423.
  35. Khanvilkar U, Patil H, Bandekar S, Kshirsagar S, Pawar AM, Wahjuningrum DA, Pagnoni F, Reda R, Zanza A, Testarelli L. Push-out bond strength of root fillings after irrigation of root canals utilizing sodium hypochlorite, chlorhexidine, and homeopathic mother tincture (Arnica montana). Clin Pract. 2023;13(1):305–314. https://doi.org/10.3390/clinpract13010028.
  36. Hassoon S, Al-Sabawi NA, Al-Shamaa RM. Effect of irrigation with different solutions on push-out bond strength of root canal obturation materials. Tikrit J Dent Sci. 2023;11(1):31–40.
  37. Trindade TF, Barbosa AFS, Castro-Raucci LMS, Silva-Sousa YTC, Colucci V, Raucci-Neto W. Chlorhexidine and proanthocyanidin enhance the long-term bond strength of resin-based endodontic sealer. Braz Oral Res. 2018;32:e44. https://doi.org/10.1590/1807-3107BOR-2018.vol32.0044.
  38. Coelho A, Amaro I, Rascão B, Marcelino I, Paula A, Saraiva J, et al. Effect of cavity disinfectants on dentin bond strength and clinical success of composite restorations: A systematic review of in vitro, in situ, and clinical studies. Int J Mol Sci. 2021;22(1):353. https://doi.org/10.3390/ijms22010353.
  39. Abdollahi AA, Seyyedi SA, Khodaie A, Najm Afshar N. Push-out bond strength of a new bioceramic-based root canal sealer. J Dent Mater Tech. 2024;13(1):26–32. https://doi.org/10.22038/JDMT.2024.76417.1633.
  40. Sfeir G, Bukiet F, Hage W, El Hachem R, Zogheib C. Impact of final irrigation protocol on the push-out bond strength of two types of endodontic sealers. Materials (Basel). 2023;16(5):1761. https://doi.org/10.3390/ma16051761

Authors

Fatimah Shamil Al-Hashimy

Ministry of Health, Left Mosul Specialized Dental Center, Mosul, Iraq

Fanar Turki abdulhammed Al-Jadwaa

Department of Conservative Dentistry, College of Dentistry, University of Mosul, Mosul, Iraq

Identifiers

DOI: 10.33899/0fhgb105

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