Effect of a Polyhexanide-Based Antiseptic Composition on Dentin Microhardness and Mechanical Properties: An In Vitro Study Zurab Khabadze, Yulia Generalova, Oleg Mordanov Materials, 2025 The effect of root canal irrigants on the mechanical properties of dentin is crucial in endodontic treatment planning. While antiseptics such as sodium hypochlorite and EDTA are widely used, their potential to weaken dentin structure remains a concern. Polyhexanide-based formulations may offer a safer alternative. To assess the impact of a polyhexanide-based antiseptic composition, compared to standard irrigants, on the microhardness, Young’s modulus, and elastic deformation energy of dentin. Sixty extracted human teeth were sectioned and polished to prepare dentin samples. Baseline measurements of Vickers microhardness, Young’s modulus, and elastic deformation work were performed using a Microhardness Tester (CSM Instruments, Switzerland) with a Berkovich indenter. Samples were then divided into six groups (n = 10 per group) and exposed to different irrigants (NaCl 0.9%, NaOCl 3%, chlorhexidine 2%, EDTA 17%, and polyhexanide-based solutions—0.1% and 0.2% Lavasept). Post-treatment measurements were performed. Statistical analysis was conducted using non-parametric tests with Bonferroni correction. Sodium hypochlorite (3%) caused the most pronounced reduction in dentin microhardness and mechanical strength, though not always statistically significant. Polyhexanide-based solutions (0.1% and 0.2% Lavasept) showed a milder effect, with statistically significant changes observed only in elastic deformation energy for 0.2% polyhexanide. EDTA treatment led to severe surface destruction, precluding reliable post-treatment measurements. Polyhexanide-based irrigants demonstrated a more favorable impact on dentin mechanical properties compared to traditional irrigants, supporting their potential use in endodontic protocols aimed at preserving dentin integrity.
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Clinical assessment of polyhexanide as an endodontic irrigant in the management of chronic apical periodontitis Yu. A. Generalova, A. Yu. Umarov, A. Wehbe, M. Yu. Dashtieva, I. V. Bagdasarova Endodontics Today, 2025 INTRODUCTION. Chronic forms of apical periodontitis remain a relevant challenge in endodontic practice. The effectiveness of treatment largely depends on the quality of root canal irrigation. Polyhexamethylene guanidine (polyhexanide) is considered a promising alternative to sodium hypochlorite, offering antimicrobial activity with low cytotoxicity. MATERIALS AND METHODS. The study included 49 patients with chronic apical periodontitis, divided into two groups. In the first group, a 0.2% polyhexanide solution was used as the primary irrigant, while the second group received a standard protocol with 3% sodium hypochlorite (NaOCl) and 17% EDTA. Treatment efficacy was evaluated based on clinical symptoms and radiographic changes at 6 and 12 months. The Mann–Whitney U test and Pearson’s chi-squared (χ²) test were used for statistical analysis. RESULTS. The treatment success rate was 98% in the polyhexanide group and 93.6% in the control group. After 12 months, patients in the experimental group showed a lower incidence of persistent periapical lesions. Although the differences did not reach statistical significance (p > 0.05), there was a trend toward a more favorable healing process with polyhexanide use. CONCLUSIONS. The use of a 0.2% polyhexanide solution as an irrigant demonstrated clinical efficacy comparable to the traditional protocol, with a potential reduction in the risk of adverse effects on hard tissues and surrounding structures. Further studies with larger sample sizes and longer follow-up periods are needed to definitively assess the advantages of this approach.
The Analisys of Polyhexanide-Based Antiseptis Solution Cytotoxicity on Multipotent Mesenchymal Stromal Cells Journal of International Dental and Medical Research, 2025
DETERMINATION OF ROOT CANAL MICROBIOTA IN CHRONIC APICAL PERIODONTITIS AND EVALUATION OF THE MICROBIOLOGICAL ACTIVITY SPECTRUM OF POLYHEXANIDE AGAINST THE IDENTIFIED MICROBIAL FLORA Georgian Medical News, 2025
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The investigation of endodontic irrigants and polyhexanide-based solution action on smear layer Z. S. Khabadze, Yu. A. Generalova, A. A. Kulikova Endodontics Today, 2024 AIM. The effect of irrigants on the smear layer on the intracanalicular dentin surface is one of the important issues in endodontics. The objective of this article is to determine the effect of different concentrations of polyhexanide-based solutions and standard irrigants on the smear layer using scanning electron microscopy (SEM).MATERIALS AND METHODS. The present study was conducted on 42 extracted teeth (third molars, first and second premolars) with formed apices that had been extracted for orthodontic indications. The teeth were decoronated and samples were prepared. In order to create a smear layer, the lumen of the canals was instrumented with H-file #40 throughout. A simulation of root canal irrigation was conducted by immersing the specimens in a 5-ml container filled with the proper solution for 1 hour: group 1 – no treatment (n = 6); group 2 – saline (n = 6); group 3 – 2% chlorhexidine (n = 6); group 4 – 3% sodium hypochlorite (n = 6); group 5 – 17% EDTA; group 6 – polyhexanide 0.1% (n = 6); group 7 – polyhexanide 0.2% (n = 6). A ~30 nm thick platinum film was sputtered onto the surface of each sample using a magnetron deposition technique. SEM microphotos were acquired on a Vega3 TESCAN scanning electron microscope (SEM) with an SE secondary electron detector, which enables imaging with high topographic contrast. The initial detector (incamera) was employed for image acquisition, with an electron energy of 30 keV. Images were acquired at magnifications of x20 (overview image), x150, x250, x500, x1000, x2500, x7500 for each sample.RESULTS. The samples from groups 1 and 5 demonstrated the absence of a smear layer on the dentin surface and the absence of smear plugs in the dentinal tubules. Groups 2 and 3 are distinguished by the deposition of a pronounced amorphous smear layer and the obturation of all dentinal tubules. Groups 4, 6, and 7 are distinguished by the deposition of a smaller volume of smear layer on the dentin surface, as well as the presence of semi-open or completely open entrances to the dentinal tubules.CONCLUSION. The data obtained indicates that antiseptic compositions based on polyhexanide in concentrations of 0.1 and 0.2% do not have a pronounced effect on the smear layer. However, in visual evaluation of SEM micrographs, their effect is comparable to that of 3% sodium hypochlorite. In instances where enhanced dissolution of the smear layer and smear plugs from the tubules is necessary to facilitate decontamination of the wall dentin, the combination of antiseptics with chelate compounds, such as 17% EDTA, may be employed.
The effect of the irrigation solutions on dentin organic components: Pilot study Z. S. Khabadze, Yu. A. Generalova, Yu. A. Taptun, L. A. Kozhevnikova, F. Ya. Gadzhiev, M. Yu. Dashtieva Endodontics Today, 2024 INTRODUCTION. Tooth decay and its complications are prevalent dental issues among adults. Endodontic treatment is the standard of care for complicated caries, specifically pulpitis and periodontitis. Endodontic irrigants, which are placed in the root canal lumen for a specific duration, can affect the intracanal dentin structure (organic and inorganic substances) in various ways. The use of polyhexanide-based antiseptic products in endodontics is a promising idea to overcome microbial resistance and minimize microbial-related endodontic treatment failures.AIM. The aim of this study is to investigate the qualitative impact of standard irrigation solutions and a polyhexanide-based composition on the collagen matrix of dentin.MATERIALS AND METHODS. The study investigated the effect of nine solutions on the dentin of the tooth root. Twelve intact maxillary third molars extracted for orthodontic reasons were taken for the study. The teeth were fixed in a 10% neutral formalin solution for at least one day and were decalcinated. 5–10 μm thick sample sections were made and stained with picrosirius (Picrosirius Red, Biovitrum, Russia) before being examined under polarized light. The histological slice was analyzed using a Carl Zeiss (Germany) software and hardware complex based on ZEN v3.0 and light microscope Axioimager M.1. All microphotos were loaded into the Fiji distribution program of ImageJ for microscopy pixel classification.RESULTS. Upon analysis of the diagrams, it appears that there is a lower amount and density of stained dentin collagen array after exposure to sodium hypochlorite solutions of 3% and 1.5%, as well as polyhexanide.CONCLUSIONS. The data obtained from the histogram analyzer of samples stained with picrosirius suggests that polyhexanide may have a qualitative effect on the organic structure of hard tissues, particularly collagen.
The Analisys of Polyhexanide-Based Endodontic Irrigant Cytotoxicity on Multipotent Mesenchymal Stromal Cells Journal of International Dental and Medical Research, 2024
Analysis of the chemical interaction of polyhexanide with endodontic irrigants Z. S. Zurab, Yu. A. Generalova, A. A. Kulikova, A. Yu. Umarov, F. V. Badalov, A. Wehbe, E. M. Kakabadze Endodontics Today, 2024 INTRODUCTION. Chronic apical periodontitis (CAP) poses significant challenges in endodontics due to microbial resistance and inadequate disinfection protocols. Polyhexanide (PHMB) is a promising irrigant due to its antimicrobial properties. However, its interactions with other commonly used endodontic irrigants require further investigation to establish effective and safe clinical protocols. AIM. To evaluate the chemical interactions of PHMB with sodium hypochlorite (NaOCl), hydrogen peroxide (H2O2), EDTA, and chlorhexidine and identify optimal irrigation protocols.MATERIALS AND METHODS. The study utilized high-performance liquid chromatography (HPLC) to monitor reactions of PHMB with NaOCl, H2O2, EDTA, and chlorhexidine at intervals of 30 minutes, 1 hour, and 3 days. The analysis focused on detecting reaction products and assessing chemical stability.RESULTS. PHMB formed a precipitate when combined with NaOCl, leading to its complete depletion in the solution. Reaction with H2O2 produced new chemical compounds, while EDTA demonstrated no significant negative reactions. Mixtures with chlorhexidine generated new products and precipitates. Sequential use of EDTA and PHMB showed compatibility and potential for effective irrigation.CONCLUSIONS. Polyhexanide is a valuable irrigant for endodontics, particularly in combination with EDTA, as it provides smear layer removal and antimicrobial action without adverse interactions. Sodium hypochlorite and hydrogen peroxide require careful protocol adjustments to avoid chemical incompatibility. Further studies are necessary to confirm the clinical outcomes and refine protocols for safe and effective endodontic treatments.
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