Effect of Different Root Canal Irrigant Solutions on the Release of Dentin-Growth Factors: A Systematic Review and Meta-Analysis
Abstract
:1. Introduction
2. Materials and Methods
2.1. Eligibility Criteria
2.2. Information Sources
2.3. Search Strategy
2.4. Selection Process
2.5. Data Collection Process and Data Items
2.6. Studies Risk of Bias Assessment
2.7. Synthesis Methods and Effect Measures
2.8. Certainty of Evidence Assessment
3. Results
3.1. Study Selection
3.2. Characteristics of the Included Studies
3.3. Risk of Bias in Studies
3.4. Results of Synthesis, Meta-Analyses, and Certainty of Evidence
3.4.1. 10% EDTA Versus 10% Citric Acid
3.4.2. 17% EDTA Versus Other Irrigants
3.4.3. Detection of TGF-β1 by the Immunogold Method
4. Discussion
4.1. Regenerative Endodontics
4.2. Methodological Issues
4.3. The Action of Irrigants in the Release of Dentin-Growth Factors
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Study (Year) | Type of Sample | Root Canal Irrigant | Growth Factors | Evaluation Method |
---|---|---|---|---|
Kucukkaya Eren et al., 2021 [22] | Dentin slices | 17% EDTA and 17% EDTA + 0.008% benzalkonium chloride | TGF-β1 | ELISA |
Khan et al., 2021 [23] | Dentin slices and Root canal segment | 17% EDTA, 9% etidronic acid, and 1% phytic acid | VEGF | ELISA |
Hancerliogullari et al., 2021 [24] | Root canal segment | 17% EDTA, 10% citric acid (break)Both irrigants was tested with follow irrigation activation technique (conventional syringe irrigation, passive ultrasonic irrigation, PUI, and Er:YAG laser activation | TGF-β1, IGF-I, BMP-7 and VEGF-A | ELISA |
Ferreira et al., 2020 [25] | Root canal segment | 2.5% NaOCl, 2% chlorhexidine, and 10% EDTA | TGF-β1 and VEGF | ELISA |
Aksel et al., 2020 [26] | Dentin slices | 1.5% NaOCl + PBS + 17% EDTA + PBS, 17% EDTA with Nanobubble water, 17% EDTA activated with ultrasonic, 17% EDTA with Nanobubble water activated with ultrasonic, and phosphate-buffered saline (PBS) | TGF-β | ELISA |
Atesci et al., 2020 [27] | Dentin slices and Powdered dentine * | 17% EDTA, 10% citric acid, 1% phytic acid, 37% phosphoric acid, distilled water | TGF-β1, BMP-2, FGF-2 and VEGF | ELISA |
Ivica et al., 2019 [28] | Dentin slices | 10% Citric Acid, 17% EDTA and phosphate-buffered saline | TGF-β1 | Slot blot |
Deniz Sungur et al., 2019 [29] | Dentin slices | 17% EDTA, 1% phytic acid, 9% etidronic acid, and distilled water | TGF-β | ELISA |
Chae et al., 2018 [13] | Root canal segment | Saline, 17% EDTA, 10% citric acid, 10% phosphoric acid, and 37% phosphoric acid | TGF-β1 | ELISA |
Duncan et al., 2017 [30] | Powdered dentine | 10% EDTA, valproic acid, trichostatin A and suberoylanilide hydroxamic acid | TGF-β1 | ELISA |
Gonçalves et al., 2016 [31] | Dentin slices | EDTA 10%, NaOCl 2,5% and phosphate-buffered saline | TGF-β1 | ELISA |
Sadaghiani et al., 2016 [32] | Dentin slices | 10% EDTA, 37% phosphoric acid, 10% citric acid, 25% polyacrylic acid, buffered saline, and calcium hydroxide | TGF-β1, BMP-2 and VEGF | ELISA and Immunogold method |
Zeng et al., 2016 [33] | Root canal segment | 1.5% NaOCl + 17% EDTA, 2.5% NaOCl + 17% EDTA, 17% EDTA, and deionized water | TGF-β1 and bFGF | ELISA |
Galler et al., 2015 [10] | Dentin slices | 10% EDTA, 17% EDTA, 10% citric acid, citrate buffer, and citric acid phosphate buffer | TGF-β1 | ELISA |
Graham et al., 2006 [34] | Powdered dentine | 10% EDTA and calcium hydroxide | TGF-β1 | ELISA |
Zhao et al., 2000 [35] | Dentin slices | 3% NaOCl, 17% EDTA, 10% citric acid, and phosphate-buffered saline | TGF-β1 TGF-β2 TGF-β3 | Immunogold method |
Study (Year) | Main Conclusions |
---|---|
Kucukkaya Eren et al., 2021 [22] | Both 17% EDTA and 17% EDTA + 0.008% benzalkonium chloride were similar in the amount of TGF-β1 released by dentin. |
Khan et al., 2021 [23] | VEGF release by 9% etidronic acid was greater in dentin cylinders than 17% EDTA and 1% phytic acid, however similar between irrigants groups.in the dentin discs analysis. |
Hancerliogullari et al., 2021 [24] | The 17% EDTA caused significantly more IGF-I release than 10% citric acid, while for TGF-β1, BMP-7, and VEGF-A, both irrigants were equally effective. |
Ferreira et al., 2020 [25] | The 2% chlorhexidine and 10% EDTA irrigants released significantly more TGF- β1 than 2.5% NaOCl. No VEGF release was detected for any group. |
Aksel et al., 2020 [26] | Although there is no significant difference between the groups of irrigants used, the ultrasonic activation enhanced the TGF- β release. |
Atesci et al., 2020 [27] | For TGF- β1, 10% citric acid was responsible for releasing significantly more than EDTA, IP6, and with no statistically significant difference when compared to 37% phosphoric acid. For VEGF, there was a very minor release with no significant difference, while for BMP-2 and FGF-2, the release was similar to all irrigants. |
Ivica et al., 2019 [28] | The 17% EDTA released a 5-fold higher concentration of TGF- β1 than 10% citric acid. |
Deniz Sungur et al., 2019 [29] | The greatest release of TGF-β1 was obtained in the 9% etidronic acid group, whilethe lowest in the 1% phytic acid group, with no significant difference between groups. |
Chae et al., 2018 [13] | The use of 10% citric acid released significantly more TGF- β1 than 17% EDTA and 10% phosphoric acid, while 37% phosphoric acid and saline released the least amount. |
Ducan et al., 2017 [30] | The 10% EDTA promoted significantly greater release of TGF- β1 than valproic acid, trichostatin A, and suberoylanilide hydroxamic acid. |
Gonçalves et al., 2016 [31] | The 10% EDTA released significantly more TGF- β1of dentin matrix than 2.5% NaOCl or PBS. |
Sadaghiani et al., 2016 [32] | Under the immunogold method, calcium hydroxide significantly increased the release of TGF-β1 within 5 min of conditioning, BMP-2 and VEGF within 10 min. The 10% EDTA, 10% citric acid, and 37% phosphoric acid showed intermediate values for TGF-β1 release, while for BMP-2 and VEGF, the phosphoric acid was lower in the time of 10 min. In the ELISA method, only 17% EDTA detected TGF-β1 release, whereas for BMP-2 and VEGF the most effective irrigant was 10% citric acid. |
Zeng et al., 2016 [33] | The groups with 1.5% NaOCl + 17% EDTA and 2.5% NaOCl + 17% EDTA had significantly higher release of TGF- β1 than 17% EDTA, with a peak release at day 1. The release of bFGF was detected at a low level in all irrigants. |
Galler et al., 2015 [10] | Conditioning with 10% EDTA resulted in the release of the highest amounts of TGF- β1, while 17% EDTA was less effective. The release after treatment with citric acid and its variations was significantly smaller than EDTA. |
Graham et al., 2006 [34] | The 10% EDTA released higher concentrations of TGF- β1 from dentin than calcium hydroxide. |
Zhao et al., 2000 [35] | Conditioning with 17% EDTA generated a greater release of TGF-β1 while treatments with 10% citric acid and 3% NaOCl revealed smaller amounts of this isoform. TGF-β2 and -β3 isoforms could not be detected in samples with any of the irrigants. |
Study (Year) | Reporting Quality | Methodological Quality | Relevance | Quality Rating |
---|---|---|---|---|
Kucukkaya Eren et al., 2021 [22] | 97.73 | 100 | Directly relevant | Low risk |
Khan et al., 2021 [23] | 93.75 | 100 | Directly relevant | Low risk |
Hancerliogullari et al., 2021 [24] | 90 | 91.67 | Directly relevant | Low risk |
Ferreira et al., 2020 [25] | 93.75 | 91.67 | Directly relevant | Low risk |
Aksel et al., 2020 [26] | 90.48 | 96.43 | Directly relevant | Low risk |
Atesci et al., 2019 [27] | 83.33 | 92.31 | Directly relevant | Low risk |
Ivica et al., 2019 [28] | 88.1 | 96.43 | Directly relevant | Low risk |
Sungur et al., 2019 [29] | 97.62 | 100 | Directly relevant | Low risk |
Chae et al., 2018 [13] | 78.57 | 78.57 | Directly relevant | Low risk |
Duncan et al., 2016 [30] | 92.86 | 95.83 | Directly relevant | Low risk |
Gonçalves et al., 2016 [31] | 90.48 | 92.31 | Directly relevant | Low risk |
Sadaghiani et al., 2016 [32] | 88.1 | 92.31 | Directly relevant | Low risk |
Zeng et al., 2016 [33] | 92.86 | 92.31 | Directly relevant | Low risk |
Galler et al., 2015 [10] | 78.13 | 95.83 | Directly relevant | Low risk |
Graham et al., 2006 [34] | 80.95 | 92.31 | Directly relevant | Low risk |
Zhao et al., 2000 [35] | 71.88 | 79.17 | Directly relevant | Low risk |
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Tavares, S.; Pintor, A.; Mourão, C.F.d.A.B.; Magno, M.; Montemezzi, P.; Sacco, R.; Alves, G.; Scelza, M.Z. Effect of Different Root Canal Irrigant Solutions on the Release of Dentin-Growth Factors: A Systematic Review and Meta-Analysis. Materials 2021, 14, 5829. https://doi.org/10.3390/ma14195829
Tavares S, Pintor A, Mourão CFdAB, Magno M, Montemezzi P, Sacco R, Alves G, Scelza MZ. Effect of Different Root Canal Irrigant Solutions on the Release of Dentin-Growth Factors: A Systematic Review and Meta-Analysis. Materials. 2021; 14(19):5829. https://doi.org/10.3390/ma14195829
Chicago/Turabian StyleTavares, Sandro, Andrea Pintor, Carlos Fernando de Almeida Barros Mourão, Marcela Magno, Pietro Montemezzi, Roberto Sacco, Gutemberg Alves, and Miriam Zaccaro Scelza. 2021. "Effect of Different Root Canal Irrigant Solutions on the Release of Dentin-Growth Factors: A Systematic Review and Meta-Analysis" Materials 14, no. 19: 5829. https://doi.org/10.3390/ma14195829