Background:chronic apical periodontitis is a common pathology in dentistry, especially in endodontics. It is necessary to systematize data concerning commonly used irrigation solutions. The development of new protocols for endodontic treatment is a very promising direction. The use of a polyhexanide-based antiseptic can positively affect the results of endodontic treatment. Methods: the review was carried out involving the search for English language research and meta-analyses in the Google Scholar and PubMed databases. Results: the number of literary sources that were identified during the literature review is 180. After excluding publications that did not match the search criteria, the total number of articles included in the systematic review was determined to be 68. Conclusions: polyhexanide is a promising solution for infected root canal irrigation. The antibacterial activity of this substance is suitable for the elimination of pathogens responsible for the appearance of apical periodontitis.

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 purpose of this systematic review of the literature is to detail the main physical, chemical, biological, operational, and other significant properties of bioceramic materials used in endodontic practice ю Фccording to the studied literature, we can say that bioceramic endodontic materials have satisfactory performance properties, are characterized by antimicrobial action and alkaline pH, have optimal biocompatibility and bioactivity, which indicates the feasibility of their use in the clinical practice of a dentist-endodontist.

The purpose of this reviewarticle is to analyze the current data on the use of antiseptics in the treatment of periodontitis, development of resistance of periodontopathogens to antiseptic agents using the example of chlorhexidine, cetylpyridinium chloride and hexetidine. Periodontal pathogens are an integral part of the commensal microflora of the oral cavity, but under certain conditions and under the influence of etiological factors, their number begins to progressively grow, which increases the risk of initiation of periodontal diseases through the formation of aggressive biofilm on the teeth.Materials and methods. Тhe study of publications was produced in the electronic databases such as PubMed and Google Scholar in the course of a systematic review of the literature. Included articles contain information about antiseptic agents which are chlorhexidine, cetylpyridinium chloride and hexetidine, as well as their effect on periodontopathogens and the possibility of developing resistance in them against these antiseptics.Results. 127 articles were viewed during the review. After analyzing the literature for inclusion criteria, the total number of publications has become 94.Conclusions. Аccording to the analyzed data, we have found that antiseptic treatment of the oral cavity and lesions in periodontitis is an integral part of the treatment of this inflammatory disease, as an addition to the mechanical treatment protocol. Chlorhexidine in local forms of delivery has shown particular activity against periodontopathogens.

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.

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.