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Biomedical subjects

Mahmoud Torabinejad

Publications and source records attributed to Mahmoud Torabinejad.

34 records · Page 2Linked to original sources

Quantitative analysis of the solubilizing action of MTAD, sodium hypochlorite, and EDTA on bovine pulp and dentin.

Necrotic bovine pulp and dentin were used in this study as model tissues to represent the organic and inorganic components of the smear layer present in instrumented root canals. The capabilities of endodontic irrigants to dissolve pulverized forms of these tissues were compared. Lyophilized tissue samples were mixed for 2 h at 37 degrees C with MTAD, three concentrations of sodium hypochlorite (NaOCl), 17% EDTA, or isotonic saline. Undissolved tissues were rinsed with water and lyophilized. The change in tissue weight after exposure to an irrigant was measured to quantify solubilization. The results showed that various concentrations of NaOCl removed organic components of pulp and dentin effectively. As pulp solubilizers 5.25% and 2.60% NaOCl were equal (>90%), and 5.25% NaOCl was capable of dissolving virtually the entire organic component of dentin. EDTA was capable of solubilizing inorganic material in dentin and organic material in pulp and likely also in dentin. It dissolved >70% of the dentin and >51% of the pulp. The solubilizing effects of MTAD on pulp and dentin were somewhat similar to those of EDTA. The major difference between the actions of these solutions was a high binding affinity of doxycycline present in MTAD for the dentin.

Animals↗

The antimicrobial effect of MTAD: an in vitro investigation.

Pulp and periradicular diseases are of microbial origin. To effectively clean the root canal system a disinfecting agent must be able to penetrate into difficult-to-reach areas and kill microorganisms with minimal damage to the host tissues. The purpose of this investigation was to test the ability of a mixture of a tetracycline isomer, an acid, and a detergent (MTAD) to kill Enterococcus faecalis and compare its efficacy to that of sodium hypochlorite (NaOCl) and ethylene diamine tetraacetic acid (EDTA). The zones of inhibition and minimum inhibitory concentrations were measured for these solutions. Measurement of zones of inhibition and determination of the minimum inhibitory concentrations showed that MTAD is as effective as 5.25% NaOCl and significantly more effective than EDTA (p < 0.0001). Furthermore, MTAD is significantly more effective in killing E. faecalis than NaOCl when the solutions are diluted (p < 0.0001). Measurement of the minimum inhibitory concentrations demonstrated that although MTAD is still effective in killing E. faecalis at 200x dilution, NaOCl ceases to exert its antibacterial activity beyond 32x dilution. EDTA did not exhibit any antibacterial activity. Based on the results of this study, it seems that MTAD is an effective solution in eradicating E. faecalis.

Chelating Agents↗

In vitro antimicrobial efficacy of MTAD and sodium hypochlorite.

The purpose of this study was to compare the ability of a mixture of a tetracycline isomer, an acid, and a detergent (MTAD) with that of sodium hypochlorite (NaOCI) to disinfect human root canals that had been contaminated with whole saliva. One hundred and thirty-two root canals of extracted human teeth were cleaned and shaped using the passive step-back technique and rotary NiTi files. The smear layer was removed, and the teeth were autoclaved. Six autoclaved samples were transferred to sterile broth without contamination with saliva to serve as negative controls. Whole saliva was used to contaminate the root canals of the rest of the samples for 48 h. Six of these contaminated samples were irrigated with Brain Heart Infusion (BHI) broth and served as positive controls. The rest of the contaminated specimens were then divided into two experimental groups of 60 teeth each. In one group, the canals were irrigated with 1 ml MTAD, and the samples were immersed in 2 ml of the same solution for 5 min. In the second group, the specimens were similarly treated with 5.25% NaOCl. All samples were washed in BHI broth and then placed in another tube containing BHI broth and incubated for 96 h. Disinfection of the samples was determined based on presence or absence of turbidity in the broth 96 h later. Twenty-three of 60 teeth treated with NaOCl remained infected. Only one of 60 teeth treated with MTAD remained infected. Statistical analysis of the data using the Chi-square test showed a significant difference between the two groups (p < 0.0001).

Bacteria↗

Effect of MTAD on Enterococcus faecalis-contaminated root canals of extracted human teeth.

The purpose of this investigation was to compare the antimicrobial effect of MTAD (a mixture of a tetracycline isomer, an acid, and a detergent) with that of NaOCl with and without EDTA. Eighty-five extracted human teeth were contaminated with Enterococcus faecalis for 4 weeks. After biomechanical instrumentation using 1.3% or 5.25% NaOCl as root canal irrigant, the root canal and the external surface of each tooth were exposed to a 5-min application of MTAD, 1.3% NaOCl, 5.25% NaOCl or a 1-min application of EDTA followed by irrigation with 5 ml of 1.3% NaOCl or 5.25% NaOCl. Teeth or dentin shavings were cultured to determine presence or absence of the test bacteria. Fisher's exact test showed that the combination of 1.3% NaOCl as a root canal irrigant and MTAD as a final rinse was significantly more effective against E. faecalis than the other regimens. The chi2 test showed no difference between the other regimens.

Anti-Bacterial Agents↗

Identification of hard tissue after experimental pulp capping using dentin sialoprotein (DSP) as a marker.

The purpose of this study was to identify the hard tissue formed early in experimental pulp exposures capped with mineral trioxide aggregate (MTA) or bone morphogenetic protein (BMP)-7 using dentin sialoprotein (DSP) as a marker. The pulps of 35 maxillary first, second, and third molar teeth from 10 male rats were experimentally exposed. The pulps were capped with MTA alone as a pulp-capping agent and final restoration or with BMP-7 followed by restoration with MTA. Five teeth with class I occlusal preparations, no exposure, and no restoration served as positive controls. Five teeth that received pulp exposures and no restoration served as negative controls. Five untreated third molars served as additional controls. The animals were killed at 2 weeks. The specimens were prepared and evaluated histologically and with immunohistochemistry using polyclonal antibodies raised against rat DSP. Pulps capped with MTA formed hard tissue that demonstrated significantly more immunostaining for DSP compared with BMP-7 (p = 0.0031). MTA-capped pulps also showed significantly more complete bridge formation compared with BMP-7 (p = 0.0008). Pulps capped with BMP-7 demonstrated a hard tissue that was bone-like in appearance and devoid of DSP staining.

Aluminum Compounds↗

Evaluation of cytotoxicity of MTAD using the MTT-tetrazolium method.

Previous studies have shown that MTAD (a mixture of a tetracycline isomer, an acid, and a detergent) is an effective antibacterial irrigant as a final rinse to remove the smear layer from the instrumented surface of root canals. In this investigation we examined the cytotoxicity of MTAD compared with that of commonly used irrigants and medications. L929 fibroblasts were grown on cell culture plates and were placed in contact with various concentrations of test irrigants and medications. The cytotoxicity of these materials was evaluated 24 h after incubation using MTT assay. Means and standard deviations of absorbance were calculated for each group and statistically analyzed to determine presence or absence of significant difference between the means. The 50% inhibitory dose values were calculated, ranked, and statistically analyzed using the sign interval for median. Based on our results it seems that MTAD is less cytotoxic than eugenol, 3% H2O2, Ca(OH)2 paste, 5.25% NaOCl, Peridex, and EDTA and more cytotoxic than 2.63%, 1.31%, and 0.66% NaOCl.

Animals↗

Effect of MTAD on flexural strength and modulus of elasticity of dentin.

The purpose of this study was to evaluate the effect of MTAD on the flexural strength and modulus of elasticity of dentin. Dentin bars were randomly assigned to eight groups treated with various concentrations of NaOCl (5.25%, 2.65%, 1.31%, 0.66%), 17% EDTA, MTAD, saline, or according to a clinical protocol with 1.3% NaOCl and then 5 min of MTAD. Specimens were subjected to flexural strength and modulus of elasticity tests. Two-sample t test (alpha = 0.05) showed no statistically significant differences between various groups except for a reduction in flexural strength for the 2-h MTAD group (p = 0.002) and the EDTA group (p = 0.002). A significant reduction of modulus of elasticity for the 2-h MTAD group (p < 0.001), EDTA group (p < 0.001), and 0.6% NaOCl (p < 0.002) also was noted. There was no significant difference in flexural strength and modulus of elasticity between the dentin bars exposed to saline or MTAD when applied according to the clinical protocol (p > 0.05). These results indicate that MTAD can be used as prescribed for clinical use without affecting the physical properties of the dentin.

Analysis of Variance↗

Effect of MTAD on the bond strength to enamel and dentin.

The purpose of this study was to compare the effect of MTAD (a mixture of a tetracycline isomer [doxycycline], an acid [citric acid], and a detergent [Tween 80]) and phosphoric acid on the bond strength to enamel and dentin using a conventional OptiBond Solo Plus dentin adhesive system. One hundred flat surfaces (50 enamel/50 dentin) were prepared for bonding. Specimens were embedded in acrylic with the flat surface exposed. One of the following surface treatments was applied before bonding composite with Optibond Solo Plus (Kerr Corp): 1 min NaOCl/1 min EDTA; 1 min NaOCl/1 min MTAD; 30 s etch with H3PO4 (positive control), 2 min saline (negative control), or 20 min NaOCl/5 min MTAD (clinical protocol for MTAD). Shear bond strength was tested 30 min after bonding. Data were analyzed using a one-way ANOVA followed by the Student-Newman-Keuls multiple comparison method. Surface pretreatment with acid etch resulted in the greatest enamel bond strengths (p < 0.05). All surface pretreatments were superior to saline for dentinal bonding (p < 0.05). On the basis of our findings, it appears that teeth endodontically treated with the MTAD protocol for clinical use (20 min 1.3% NaOCl/5 min MTAD) may not need any additional dentin conditioning before the application of the dental adhesive.

Analysis of Variance↗

Clinical implications of the smear layer in endodontics: a review.

It has been recognized for many years that root canal instrumentation produces a smear layer that covers the surfaces of prepared canal walls. This layer contains inorganic and organic substances such as fragments of odontoblastic processes and necrotic debris. There is a lack of agreement regarding the effect of the smear layer on the quality of instrumentation and obturation, but the smear layer itself may be infected and may protect the bacteria within the dentinal tubules. Various methods have been used to remove the smear layer. Conflicting results have been obtained from numerous in vitro studies regarding the significance of the presence or the removal of the smear layer.

Dental Leakage↗

Leakage evaluation of root end filling materials using endotoxin.

Mineral trioxide aggregate (MTA) has been shown to possess excellent sealing ability when tested with dye, bacteria, and a fluid filtration technique. Endotoxin, a component of the cell wall of Gram-negative bacteria, has been proposed to play a role in the pathogenesis of periradicular lesions. This study used a modified Limulus Amebocyte Lysate test for the presence of endotoxin as a tracer and compared the sealing ability of Super-EBA, IRM, amalgam, and MTA. The results showed that MTA permitted less endotoxin leakage than IRM and amalgam at 1, 2, 6, and 12 wk (p < 0.05), and leaked less than Super-EBA at 2 and 12 wk (p < 0.05).

Aluminum Compounds↗

The effect of preflaring on the rates of separation for 0.04 taper nickel titanium rotary instruments.

The purpose of this study was to compare the rates of separation of 0.04 taper nickel titanium (NiTi) rotary instruments using two different instrumentation techniques. Twenty sets of 0.04 taper Profile Series 29 rotary instruments, sizes 2 to 6 were used in the mesial (mandibular) or buccal (maxillary) canals of extracted human molars with a 20 to 30 degree root curvature according to the Schneider classification. The rotary instruments were used up to 20 times either with the crown-down technique recommended by the manufacturer or with a combination of preflaring with hand files in a passive step-back technique followed by rotary instrumentation. Statistical analysis of the data showed that the combination technique allowed more uses before separation compared with the crown-down technique recommended by the manufacturer p < 0.0001.

Dental Instruments↗

Microleakage of resected MTA.

Forty-six single rooted extracted human teeth were used in this study. After cleaning and shaping, twenty canals were randomly selected for obturation with MTA placed in an orthograde manor (Group 1). Another twenty roots were obturated with gutta-percha and Kerr EWT sealer, using warm vertical compaction (Group 2). The apical 3 mm of each root in both groups were resected at approximately 45 degrees to its long axis. The teeth were aged for 48 h in a humidor. The root-ends of the teeth in Group 2 were then prepared and received MTA as a root-end filling material to a depth of 3 mm. Six roots were used as positive and negative controls. The roots of all teeth were placed in contact with India ink for 48 h. The roots were split and examined for dye leakage. There was no discernible leakage in teeth with resected MTA or those with MTA placed as a retrograde root-end filling material. We found no significant difference in dye leakage between resected MTA (Group 1) and non-resected MTA (Group 2). Based on these results it appears that the resection of set MTA does not affect its sealing ability.

Aluminum Compounds↗