Influence of Intracanal Irrigants on Coronal Fracture Resistance of Endodontically Treated and Bleached Teeth: An In vitro Study

Abstract

Background: Irrigation has a key role in the success of endodontic treatment. Intracanal irrigant solutions have adverse effects on the physical properties of dentin. Aim: The present study aimed to evaluate the effect of different irrigation protocols on coronal fracture resistance of endodontically treated teeth undergoing bleaching treatment. Design and Materials and Methods: Access cavities were prepared in 120 maxillary premolars which were divided into two groups (n = 60) - Group A: nonbleached, Group B: bleached ( B). Each group was subdivided into five subgroups based on irrigation protocol (n = 12); G1: normal saline (NS), G2: 2.5 sodium hypochlorite (NaOCl), G3: 10 citric acid (CA), G4: 17 ethylene diamine tetra acetic acid, and G5: NaOCl plus CA. In Group B, the teeth were bleached using 38 hydrogen peroxide and 20 carbamide peroxide gels as in-office and at-home bleaching techniques for 3 weeks. All the teeth were restored with composite resin, thermocycled, and incubated for 24 h. The specimens underwent fracture resistance tests. Data were analyzed with ANOVA, Tukey honestly significant difference test, t-test, and Chi-squared test (alpha = 0.05). Results: T-test showed significant differences between each two corresponding subgroups (P < 0.0001). In Group A, NS demonstrated significantly higher fracture resistance compared to others; however, minimum fracture resistance recorded in G2. In Group B, the maximum fracture resistance was recorded in G1, with the minimum being recorded in G5. Samples irrigated with NaOCl and NaOCl plus CA exhibited significantly lower fracture resistance compared to NS subgroup (P < 0.05). Conclusions: Within the limitations of this study, it can be concluded that the irrigation protocol used during endodontic treatment with/without bleaching can affect the coronal fracture resistance.