Yi Luo, Runze Liu, Pei Liu, Mengting Duan, Wei Fan, Bing Fan
{"title":"Effects of penetration enhancers on the performance of irrigants for root canal disinfection.","authors":"Yi Luo, Runze Liu, Pei Liu, Mengting Duan, Wei Fan, Bing Fan","doi":"10.1007/s00784-025-06557-1","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the effects of penetration enhancers on the physicochemical properties, dentinal tubule penetration, tissue dissolution, and antimicrobial efficacy of root canal irrigants.</p><p><strong>Materials and methods: </strong>Azone, Triton X-100, or iso-octyl polyoxyethylene ether (JFC-E) (0.1%-5%) were individually added to sodium hypochlorite (NaOCl) or chlorhexidine (CHX) to assess the influence of penetration enhancers. Surface tension, contact angle, viscosity and free available chlorine (FAC) were measured. Dentinal penetration of NaOCl was assessed via discolored area and depth under stereomicroscopy. Soft tissue dissolution was evaluated by changes in bovine pulp tissue weight and volume. The inhibition of protease activity was examined by monitoring matrix metalloproteinase (MMP) gelatinolytic activity via in situ zymography in radicular dentin. Confocal laser scanning microscope (CLSM) was used to analyze multispecies biofilms clearance and bacterial viability.</p><p><strong>Results: </strong> 0.5% Azone significantly enhanced NaOCl penetration into dentinal tubules (p < 0.05) while maintaining chlorine stability over 90 days. Although tissue dissolution was not significantly improved (p > 0.05), azone-supplemented NaOCl provided deeper infiltration and greater collagen disruption. In situ zymography revealed lower gelatinolytic activity in dentin treated with azone-supplemented NaOCl or CHX (p < 0.05). In biofilm models, azone-supplemented irrigants showed superior bactericidal effects and biofilm reduction compared to irrigants alone (p < 0.05).</p><p><strong>Conclusions: </strong>Penetration enhancers, particularly azone, effectively enhance the dentinal tubule penetration and antimicrobial performance of endodontic irrigants without negatively affecting their chemical stability.</p><p><strong>Clinical relevance: </strong>The irrigants supplemented with penetration enhancers may improve disinfection of complex root canal anatomies, contributing to more predictable endodontic outcomes.</p>","PeriodicalId":10461,"journal":{"name":"Clinical Oral Investigations","volume":"29 10","pages":"471"},"PeriodicalIF":3.1000,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Oral Investigations","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00784-025-06557-1","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"DENTISTRY, ORAL SURGERY & MEDICINE","Score":null,"Total":0}
引用次数: 0
Abstract
Objectives: To evaluate the effects of penetration enhancers on the physicochemical properties, dentinal tubule penetration, tissue dissolution, and antimicrobial efficacy of root canal irrigants.
Materials and methods: Azone, Triton X-100, or iso-octyl polyoxyethylene ether (JFC-E) (0.1%-5%) were individually added to sodium hypochlorite (NaOCl) or chlorhexidine (CHX) to assess the influence of penetration enhancers. Surface tension, contact angle, viscosity and free available chlorine (FAC) were measured. Dentinal penetration of NaOCl was assessed via discolored area and depth under stereomicroscopy. Soft tissue dissolution was evaluated by changes in bovine pulp tissue weight and volume. The inhibition of protease activity was examined by monitoring matrix metalloproteinase (MMP) gelatinolytic activity via in situ zymography in radicular dentin. Confocal laser scanning microscope (CLSM) was used to analyze multispecies biofilms clearance and bacterial viability.
Results: 0.5% Azone significantly enhanced NaOCl penetration into dentinal tubules (p < 0.05) while maintaining chlorine stability over 90 days. Although tissue dissolution was not significantly improved (p > 0.05), azone-supplemented NaOCl provided deeper infiltration and greater collagen disruption. In situ zymography revealed lower gelatinolytic activity in dentin treated with azone-supplemented NaOCl or CHX (p < 0.05). In biofilm models, azone-supplemented irrigants showed superior bactericidal effects and biofilm reduction compared to irrigants alone (p < 0.05).
Conclusions: Penetration enhancers, particularly azone, effectively enhance the dentinal tubule penetration and antimicrobial performance of endodontic irrigants without negatively affecting their chemical stability.
Clinical relevance: The irrigants supplemented with penetration enhancers may improve disinfection of complex root canal anatomies, contributing to more predictable endodontic outcomes.
期刊介绍:
The journal Clinical Oral Investigations is a multidisciplinary, international forum for publication of research from all fields of oral medicine. The journal publishes original scientific articles and invited reviews which provide up-to-date results of basic and clinical studies in oral and maxillofacial science and medicine. The aim is to clarify the relevance of new results to modern practice, for an international readership. Coverage includes maxillofacial and oral surgery, prosthetics and restorative dentistry, operative dentistry, endodontics, periodontology, orthodontics, dental materials science, clinical trials, epidemiology, pedodontics, oral implant, preventive dentistiry, oral pathology, oral basic sciences and more.