ArticleEuropean endodontic journal2023
Effect of Continuous Chelation Irrigation Using DualRinse HEDP+3% NaOCl with or without High-power Sonic Activation on Debris and Smear Layer Removal.
Article in European endodontic journal, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- Evaluation of the effect of different irrigation solutions used in regenerative endodontic treatment of necrotic molar teeth with open apex on postoperative pain- randomized clinical trial.Clinical oral investigations · 2025Trial
- Etidronate-enhanced sodium hypochlorite irrigation in root canal therapy: A scoping review of efficacy and safety.Journal of clinical and experimental dentistry · 2026Article
- Effect of different irrigation regimen on sealability and push-out bond strength of biodentine when used for repair of furcal perforation in mandibular permanent molars: AnJournal of conservative dentistry and endodontics · 2026Article
- Efficacy of Etidronic Acid for Smear Layer Removal: A Systematic Review of In Vitro Studies.Journal of functional biomaterials · 2026Review
- Impact of Apical Shaping Diameter on Bacterial Load Reduction in Multispecies Infected Root Canals.International journal of dentistry · 2026Article
- Effect of ultrasonic versus laser-activated irrigation on smear layer removal - AnBioinformation · 2026Article
- Is continuous soft chelation protocol more efficacious than conventional irrigation protocol in removing the smear layer? - A systematic review.Journal of conservative dentistry and endodontics · 2026Review
- In Vitro Evaluation of Bovine Pulp Dissolution Using Dual Rinse HEDP at Different Temperatures.European endodontic journal · 2025Article
- Tissue-friendly dentin treatments as a potential element in revascularization protocol (ex-vivo study).BMC oral health · 2025Article
- Evaluation of the efficiency of smear layer removal during endodontic treatment using scanning electron microscopy: an in vitro study.BMC oral health · 2025Article
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Authors and funding
6 authors.
Funding
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Abstract
objectiveThis study aimed to assess the effect of sodium hypochlorite (NaOCl) combined with a novel chelating agent DualRinse HEDP (Medcem GmbH, Weinfelden, Switzerland), a product consisting of 0.9 g of 1-hydroxyethylidene-1,1-diphosphonic acid (HEDP) powder, with or without high-power sonic activation on debris and smear layer removal.
methodsSeventy-five mandibular premolars were divided into 5 groups (n=15) and treated with different irrigation protocols: group 1 (D3N), DualRinse HEDP+3% NaOCl without activation; group 2 (D3NA), DualRinse HEDP+3% NaOCl with activation (EDDY, VDW, Munich, Germany) during the final irrigation; group 3 (3NE), 3% NaOCl+17% Ethylenediaminetetracetic acid (EDTA)+3% NaOCl without activation; group 4 (3NEA), 3% NaOCl+17% EDTA+3% NaOCl with activation during the final irrigation; group 5 (NC), negative control group, 0.9% saline. Samples were analysed by scanning electron microscopy (SEM) to evaluate residual debris and smear layer at 3 levels of the root canal: coronal, middle, and apical. Statistical analysis was performed with a level of significance set at p<0.05. The normality distribution of scores within each group was assessed using Kolmogorov-Smirnov and Shapiro-Wilk tests. A Kruskal-Wallis test followed by multiple comparison tests was used to compare scores among the 5 groups on the apical, middle, and coronal levels of the root canal. A Friedman test followed by multiple comparison tests was used to compare scores within the apical, middle, and coronal levels for each treatment group.
resultsDebris score was significantly the lowest for D3NA, followed by D3N, 3NEA and 3NE at all root levels (p<0.05). The smear layer score was significantly the lowest for D3NA, followed by D3N, 3NEA and 3NE only at the apical level, while no significant difference was found in the middle and coronal levels between the groups (p<0.05). DualRinse HEDP resulted in less debris and smear layer compared to the classic approach of NaOCl without activation. Implementing sonic activation further improved debris and smear layer removal.
conclusionDualRinse HEDP+3% NaOCl improved debris removal at all levels and smear layer elimination at the apical level of the root canal. These results were further enhanced when adding high-power sonic activation. (EEJ-2022-09-116).
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