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Effect of ionizing radiation on the microstructure and physical properties of endodontic gutta-percha points

Year 2024, Volume: 58 Issue: 3, 139 - 144, 20.09.2024
https://doi.org/10.26650/eor.20241355944

Abstract

Purpose: Patients undergoing radiotherapy for head or neck cancer often require root canal treatments, which can be compromised by the effects of radiation. This investigation aimed to determine whether ionizing radiation (IR), in doses similar to those used in conventional therapy, affects the surface and physicomechanical properties of various brands of endodontic gutta-percha points (EGPs).

Materials and Methods: One hundred and twenty-three EGPs from three brands (Meta-Biomed, Dentsply, and Hygenic) were divided into groups and either exposed or not exposed to IR at a total dose of 50 Gy, divided into 25 fractions. Tensile strength and microhardness tests were performed on all EGPs. Scanning electron microscopy was utilized to identify possible microstructural surface changes due to IR exposure. The proportion of organic to inorganic components in each brand was also determined.

Results: Exposure to IR resulted in significant changes only in the EGPs from the Meta-Biomed brand, including a notable decrease in tensile strength and an increase in microhardness. Furthermore, the surface microstructure of these EGPs displayed dark lines and striations over a large area, with some lines deeply embedded in the center and cavities of variable depths and extensions observed, leading to irregular and non-smooth surfaces. This brand had the highest proportion of organic components.

Conclusion: The physicomechanical properties and surface microstructure of Meta-Biomed brand EGPs were significantly affected by IR at doses used in conventional therapy for head or neck cancer, while the other brands were less affected or unaffected.

References

  • Rosales AC de MN, Esteves SCB, Jorge J, de Almeida OP, Lopes MA. Dental needs in brazilian patients subjected to head and neck radiotherapy. Braz Dent J 2009;20:74-7. google scholar
  • Sygula M, Skladowski K, Pilecki B, Wygoda A, Hutnik M, Sasiadek W. Efficacy of primary and combined radiotherapy in locally advanced cancer of oropharynx and nasopharynx in III and IV stage. Otolaryngol Pol Polish Otolaryngol 2005;59:229-34. google scholar
  • Epstein JB, Robertson M, Emerton S, Phillips N, Stevenson-Moore P. Quality of life and oral function in patients treated with radiation therapy for head and neck cancer. Head Neck 2001;23:389-98. google scholar
  • Naidu MUR, Ramana GV, Rani PU, Suman A, Roy P. Chemotherapy-induced and/or radiation therapy-induced oral mucositis-complicating the treatment of cancer. Neoplasia 2004;6:423-31. google scholar
  • Nabil S, Samman N. Incidence and prevention of osteoradionecrosis after dental extraction in irradiated patients: a systematic review. Int J Oral Maxillofac Surg 2011;40:229-43. google scholar
  • Cardoso M de FA, Novikoff S, Tresso A, Segreto RA, Cervantes O. Prevention and control of sequels in the mouth of patients treated with radiation therapy for head and neck tumors. Radiol Bras 2005;38:107-15. google scholar
  • Hegde MN, John A. Radiation induced caries: An overview. J Heal Allied Sci NU 2018;08:028-33. google scholar
  • de Goes Paiola F, Lopes FC, Mazzi-Chaves JF, Pereira RD, Oliveira HF, de Queiroz AM, et al. How to improve root canal filling in teeth subjected to radiation therapy for cancer. Braz Oral Res 2018;32:1-9. google scholar
  • Hideaki W, Kobayashi-Velasco S, Gialain IO, Caldeira CL, Cavalcanti MGP. Endodontic treatment in patients previously subjected to head and neck radiotherapy : a literatüre review. J Oral Diagnosis 2019;4:1-6. google scholar
  • Bodrumlu EH, Bodrumlu E, Avşar A, Meydan AD. Effect of radiotherapy on the sealing ability of temporary filling materials. Eur J Gen Dent 2015;4:8-11. google scholar
  • Bodrumlu E, Avsar A, Meydan AD, Tuloglu N. Can radiotherapy affect the apical sealing ability of resin-based root canal sealers? J Am Dent Assoc 2009;140:326-30. google scholar
  • 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;46:1-12. doi:10.5395/rde.2021.46.e22 google scholar
  • Dobrzanska J, Dobrzanski LB, Dobrzanski LA, Golombek K, Dobrzanska-Danikiewicz AD. Is gutta-percha still the “gold standard” among filling materials in endodontic treatment? Processes 2021;9:1-51. google scholar
  • Marciano J, Michailesco P, Abadie MJ. Stereochemical structure characterization of dental gutta-percha. J Endod 1993;19:31-4. google scholar
  • Gurgel-Filho ED, Feitosa JPA, Teixeira FB, De Paula RCM, Silva JBA, Souza-Filho FJ. Chemical and X-ray analyses of five brands of dental gutta-percha cone. Int Endod J 2003;36:302-07. google scholar
  • Maniglia-Ferreira C, Silva Jr JBA, Paula RCM de, Feitosa JPA, Cortez DGN, Zaia AA, et al. Brazilian gutta-percha points: Part I: chemical composition and X-ray diffraction analysis. Braz Oral Res 2005;19:193-7. google scholar
  • Lieshout HFJ, Bots CP. The effect of radiotherapy on dental hard tissue—a systematic review. Clin Oral Investig 2014;18:17-24. google scholar
  • de Siqueira Mellara T, Palma-Dibb RG, de Oliveira HF, Garcia Paula-Silva FW, Nelson-Filho P, da Silva RAB, et al. The effect of radiation therapy on the mechanical and morphological properties of the enamel and dentin of deciduous teeth—an in vitro study. Radiat Oncol 2014;9:1-7. google scholar
  • Friedman CE, Sandrik JL, Heuer MA, Rapp GW. Composition and physical properties of gutta-percha endodontic filling materials. J Endod 1977;3:304-8. google scholar
  • Otmani N. Oral and maxillofacial side effects of radiation therapy on children. J Can Dent Assoc (Tor) 2007;73:256-61. google scholar
  • Bonan PRF, Lopes MA, Pires FR, Almeida OP de. Dental management of low socioeconomic level patients before radiotherapy of the head and neck with special emphasis on the prevention of osteoradionecrosis. Braz Dent J 2006;17:336-42. google scholar
  • Whitmyer CC, Waskowski JC, Iffland HA. Radiotherapy and oral sequelae: preventive and management protocols. J Dent Hyg JDH. 1997;71:23-9. google scholar
  • Schilder H. Filling root canals in three dimensions. Dent Clin North Am 1967;11:723-44. google scholar
  • Komabayashi T, Colmenar D, Cvach N, Bhat A, Primus C, Imai Y. Comprehensive review of current endodontic sealers. Dent Mater J 2020;39:703-20. google scholar
  • Kielbassa AM, Wrbas KT, Schulte-Mönting J, Hellwig E. Correlation of transversal microradiography and microhardness on in situ-induced demineralization in irradiated and nonirradiated human dental enamel. Arch Oral Biol 1999;44:243-51. google scholar
  • Pioch T, Golfels D, Staehle HJ. An experimental study of the stability of irradiated teeth in the region of the dentinoenamel junction. Dent Traumatol 1992;8:241-44. google scholar
  • Kielbassa AM, Beetz I, Schendera A, Hellwig E. Irradiation effects on microhardness of fluoridated and non-fluoridated bovine dentin. Eur J Oral Sci 1997;105:444-47. google scholar
  • Friedman CM, Sandrik JL, Heuer MA, Rapp GW. Composition and mechanical properties of gutta-percha endodontic points. J Dent Res 1975;54:921-25. google scholar
  • Moorer WR, Genet JM. Antibacterial activity of gutta-percha cones attributed to the zinc oxide component. Oral surgery, oral Med oral Pathol 1982;53:508-17. google scholar
  • Schilder H, Goodman A, Aldrich W. The thermomechanical properties of gutta-percha: III. Determination of phase transition temperatures for gutta-percha. Oral Surgery, Oral Med Oral Pathol 1974;38:109-14. google scholar
  • Rootare HM, Powers JM, Smith RL. Thermal analysis of experimental and commercial gutta-percha. J Endod 1976;2:244-49. google scholar
  • Soares CJ, Castro CG, Neiva NA, Soares P V, Santos-Filho PCF, Naves LZ, et al. Effect of gamma irradiation on ultimate tensile strength of enamel and dentin. J Dent Res 2010;89:159-64. google scholar
  • Joyston-Bechal S. The effect of X-radiation on the susceptibility of enamel to an artificial caries-like attack in vitro. J Dent 1985;13:41-4. google scholar
  • Aktemur Türker S, Kaşıkçı S, Uzunoğlu Özyürek E, Olcay K, Elmas Ö. The effect of radiotherapy delivery time and obturation materials on the fracture resistance of mandibular premolars. Clin Oral Investig 2021;25:901-5. google scholar

İyonlaştırıcı radyasyonun endodontik güta-perkaların mikro yapısı ve fiziksel özellikleri üzerine etkisi

Year 2024, Volume: 58 Issue: 3, 139 - 144, 20.09.2024
https://doi.org/10.26650/eor.20241355944

Abstract

Amaç: Baş veya boyun kanserinde radyoterapi gören hastalar genellikle radyasyon etkileri nedeniyle kök kanal tedavilerine ihtiyaç duyarlar. Geleneksel tedavi sırasında kullanılanlara benzer dozlardaki iyonlaştırıcı radyasyonun (IR), farklı markalardaki endodontik güta-perka noktalarının (EGP’ler) yüzeyini ve fizikomekanik özelliklerini etkileyip etkilemediğinin belirlenmesi son derece önemlidir ve bu çalışmanın amacını oluşturmaktadır.

Gereç ve Yöntem: Üç markaya (Meta-Biomed, Dentsply ve Hygenic) ait 123 EGP, gruplara ayrılarak 25 fraksiyona bölünmüş toplam 50 Gy dozda IR’ye maruz bırakılıp bırakılmadı. Tüm EGP’lere çekme mukavemeti ve mikrosertlik testleri yapıldı. IR’ye maruz kalma nedeniyle olası mikroyapısal yüzey değişikliklerini tanımlamak için taramalı elektron mikroskobu gözlemleri kullanıldı. Her markanın organik-inorganik oranı belirlendi.

Bulgular: IR’ye maruz kaldıktan sonra yalnızca Meta-Biomed markasının EGP’leri önemli değişiklikler yaşadı, çekme mukavemetinde önemli bir azalma ve mikro sertlik arttı. Ayrıca yüzey mikro yapısında geniş bir yüzey alanını etkileyen koyu çizgiler görülüyordu; bu çizgilerden bazıları merkezde derindi ve düzensiz ve pürüzsüz olmayan yüzeyler oluşturan, değişken derinlik ve uzantılara sahip boşluklar gözlemlendi. Organik bileşen oranı en yüksek markaydı.

Sonuç: Test edilen markalardan biri olan Meta-Biomed’in fiziko-mekanik özellikleri ve yüzey mikro yapısı, konvansiyonel baş veya boyun kanseri tedavisi sırasında kullanılan dozlarda IR’den önemli ölçüde etkilenirken, diğer markalar daha az etkilendi veya hiç etkilenmedi.

References

  • Rosales AC de MN, Esteves SCB, Jorge J, de Almeida OP, Lopes MA. Dental needs in brazilian patients subjected to head and neck radiotherapy. Braz Dent J 2009;20:74-7. google scholar
  • Sygula M, Skladowski K, Pilecki B, Wygoda A, Hutnik M, Sasiadek W. Efficacy of primary and combined radiotherapy in locally advanced cancer of oropharynx and nasopharynx in III and IV stage. Otolaryngol Pol Polish Otolaryngol 2005;59:229-34. google scholar
  • Epstein JB, Robertson M, Emerton S, Phillips N, Stevenson-Moore P. Quality of life and oral function in patients treated with radiation therapy for head and neck cancer. Head Neck 2001;23:389-98. google scholar
  • Naidu MUR, Ramana GV, Rani PU, Suman A, Roy P. Chemotherapy-induced and/or radiation therapy-induced oral mucositis-complicating the treatment of cancer. Neoplasia 2004;6:423-31. google scholar
  • Nabil S, Samman N. Incidence and prevention of osteoradionecrosis after dental extraction in irradiated patients: a systematic review. Int J Oral Maxillofac Surg 2011;40:229-43. google scholar
  • Cardoso M de FA, Novikoff S, Tresso A, Segreto RA, Cervantes O. Prevention and control of sequels in the mouth of patients treated with radiation therapy for head and neck tumors. Radiol Bras 2005;38:107-15. google scholar
  • Hegde MN, John A. Radiation induced caries: An overview. J Heal Allied Sci NU 2018;08:028-33. google scholar
  • de Goes Paiola F, Lopes FC, Mazzi-Chaves JF, Pereira RD, Oliveira HF, de Queiroz AM, et al. How to improve root canal filling in teeth subjected to radiation therapy for cancer. Braz Oral Res 2018;32:1-9. google scholar
  • Hideaki W, Kobayashi-Velasco S, Gialain IO, Caldeira CL, Cavalcanti MGP. Endodontic treatment in patients previously subjected to head and neck radiotherapy : a literatüre review. J Oral Diagnosis 2019;4:1-6. google scholar
  • Bodrumlu EH, Bodrumlu E, Avşar A, Meydan AD. Effect of radiotherapy on the sealing ability of temporary filling materials. Eur J Gen Dent 2015;4:8-11. google scholar
  • Bodrumlu E, Avsar A, Meydan AD, Tuloglu N. Can radiotherapy affect the apical sealing ability of resin-based root canal sealers? J Am Dent Assoc 2009;140:326-30. google scholar
  • 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;46:1-12. doi:10.5395/rde.2021.46.e22 google scholar
  • Dobrzanska J, Dobrzanski LB, Dobrzanski LA, Golombek K, Dobrzanska-Danikiewicz AD. Is gutta-percha still the “gold standard” among filling materials in endodontic treatment? Processes 2021;9:1-51. google scholar
  • Marciano J, Michailesco P, Abadie MJ. Stereochemical structure characterization of dental gutta-percha. J Endod 1993;19:31-4. google scholar
  • Gurgel-Filho ED, Feitosa JPA, Teixeira FB, De Paula RCM, Silva JBA, Souza-Filho FJ. Chemical and X-ray analyses of five brands of dental gutta-percha cone. Int Endod J 2003;36:302-07. google scholar
  • Maniglia-Ferreira C, Silva Jr JBA, Paula RCM de, Feitosa JPA, Cortez DGN, Zaia AA, et al. Brazilian gutta-percha points: Part I: chemical composition and X-ray diffraction analysis. Braz Oral Res 2005;19:193-7. google scholar
  • Lieshout HFJ, Bots CP. The effect of radiotherapy on dental hard tissue—a systematic review. Clin Oral Investig 2014;18:17-24. google scholar
  • de Siqueira Mellara T, Palma-Dibb RG, de Oliveira HF, Garcia Paula-Silva FW, Nelson-Filho P, da Silva RAB, et al. The effect of radiation therapy on the mechanical and morphological properties of the enamel and dentin of deciduous teeth—an in vitro study. Radiat Oncol 2014;9:1-7. google scholar
  • Friedman CE, Sandrik JL, Heuer MA, Rapp GW. Composition and physical properties of gutta-percha endodontic filling materials. J Endod 1977;3:304-8. google scholar
  • Otmani N. Oral and maxillofacial side effects of radiation therapy on children. J Can Dent Assoc (Tor) 2007;73:256-61. google scholar
  • Bonan PRF, Lopes MA, Pires FR, Almeida OP de. Dental management of low socioeconomic level patients before radiotherapy of the head and neck with special emphasis on the prevention of osteoradionecrosis. Braz Dent J 2006;17:336-42. google scholar
  • Whitmyer CC, Waskowski JC, Iffland HA. Radiotherapy and oral sequelae: preventive and management protocols. J Dent Hyg JDH. 1997;71:23-9. google scholar
  • Schilder H. Filling root canals in three dimensions. Dent Clin North Am 1967;11:723-44. google scholar
  • Komabayashi T, Colmenar D, Cvach N, Bhat A, Primus C, Imai Y. Comprehensive review of current endodontic sealers. Dent Mater J 2020;39:703-20. google scholar
  • Kielbassa AM, Wrbas KT, Schulte-Mönting J, Hellwig E. Correlation of transversal microradiography and microhardness on in situ-induced demineralization in irradiated and nonirradiated human dental enamel. Arch Oral Biol 1999;44:243-51. google scholar
  • Pioch T, Golfels D, Staehle HJ. An experimental study of the stability of irradiated teeth in the region of the dentinoenamel junction. Dent Traumatol 1992;8:241-44. google scholar
  • Kielbassa AM, Beetz I, Schendera A, Hellwig E. Irradiation effects on microhardness of fluoridated and non-fluoridated bovine dentin. Eur J Oral Sci 1997;105:444-47. google scholar
  • Friedman CM, Sandrik JL, Heuer MA, Rapp GW. Composition and mechanical properties of gutta-percha endodontic points. J Dent Res 1975;54:921-25. google scholar
  • Moorer WR, Genet JM. Antibacterial activity of gutta-percha cones attributed to the zinc oxide component. Oral surgery, oral Med oral Pathol 1982;53:508-17. google scholar
  • Schilder H, Goodman A, Aldrich W. The thermomechanical properties of gutta-percha: III. Determination of phase transition temperatures for gutta-percha. Oral Surgery, Oral Med Oral Pathol 1974;38:109-14. google scholar
  • Rootare HM, Powers JM, Smith RL. Thermal analysis of experimental and commercial gutta-percha. J Endod 1976;2:244-49. google scholar
  • Soares CJ, Castro CG, Neiva NA, Soares P V, Santos-Filho PCF, Naves LZ, et al. Effect of gamma irradiation on ultimate tensile strength of enamel and dentin. J Dent Res 2010;89:159-64. google scholar
  • Joyston-Bechal S. The effect of X-radiation on the susceptibility of enamel to an artificial caries-like attack in vitro. J Dent 1985;13:41-4. google scholar
  • Aktemur Türker S, Kaşıkçı S, Uzunoğlu Özyürek E, Olcay K, Elmas Ö. The effect of radiotherapy delivery time and obturation materials on the fracture resistance of mandibular premolars. Clin Oral Investig 2021;25:901-5. google scholar
There are 34 citations in total.

Details

Primary Language English
Subjects Dentistry (Other)
Journal Section Original Research Articles
Authors

María Alejandra Narváez Rodríguez 0009-0000-2551-8162

Marina Vega González 0000-0002-9465-1271

Rafael Alberto Pedraza Neiza 0009-0006-7944-8108

Cesar López Cruz 0009-0008-7322-1337

León Francisco Espinosa Cristóbal 0000-0002-9295-6928

Rubén Abraham Domínguez Pérez 0000-0001-8979-8394

Publication Date September 20, 2024
Submission Date September 7, 2023
Published in Issue Year 2024 Volume: 58 Issue: 3

Cite

EndNote Narváez Rodríguez MA, Vega González M, Pedraza Neiza RA, López Cruz C, Espinosa Cristóbal LF, Domínguez Pérez RA (September 1, 2024) Effect of ionizing radiation on the microstructure and physical properties of endodontic gutta-percha points. European Oral Research 58 3 139–144.