{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T11:52:57Z","timestamp":1791373977197,"version":"4.3.1"},"reference-count":41,"publisher":"Istanbul University","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["eor"],"accepted":{"date-parts":[[2026,8,22]]},"abstract":"<jats:p xml:lang=\"en\">PurposeThis in vitro study aimed to assess the penetration of root canal sealer (RCS) into dentinal tubules after the application of an intracanal medicament in hydrogel form (BA) and the effect of irrigation activation methods for its removal using a stereomicroscope.Materials and MethodsA total of 135 mandibular single-rooted premolars with round morphology were used. Root canals were instrumented and allocated into three main groups according to intracanal medicament: BA, calcium hydroxide (CH), and negative control with no medicament (NC). Subgroups were determined: sonic, passive ultrasonic activation (PUI), and conventional needle irrigation (needle). Medicaments were applied and removed using irrigation activation methods. Samples were filled using epoxy resin sealer\/gutta-percha, sectioned into apical, middle, and coronal parts in 1-mm thickness, and stereomicroscopic images were obtained. Maximum root canal sealer penetration and penetration area were analyzed using ImageJ. One-way ANOVA and intra-class correlation were used for statistical analysis.ResultsSonic and PUI presented higher RCS penetration in all root thirds. After using the BA in the middle and coronal thirds, irrigation activation showed better results (p&lt;0.05). After using the BA, root canal sealer penetration into dentinal tubules was higher than that of CH in all thirds (p&lt;0.05).ConclusionFollowing the use of the BA, greater RCS was observed compared with CH. These findings suggest that the BA did not adversely affect RCS penetration. The hydrogel may represent a promising vehicle material for intracanal medicament formulations. Sonic and PUI showed a similar effect for medicament removal. However, since residual intracanal medicament was not directly quantified, no conclusions regarding actual removal efficiency can be drawn.<\/jats:p>","DOI":"10.26650\/eor.20261854751","type":"journal-article","created":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T11:15:32Z","timestamp":1791371732000},"page":"364-374","update-policy":"https:\/\/doi.org\/10.26650\/iucrossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of boric acid intracanal medicament in hydrogel form on root canal sealer penetration"],"prefix":"10.26650","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5676-0293","authenticated-orcid":true,"given":"Deniz","family":"Yan\u0131k Nalbanto\u011flu","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04fjtte88","id-type":"ROR","asserted-by":"publisher"},{"id":"https:\/\/www.isni.org\/0000000121558589","id-type":"ISNI","asserted-by":"publisher"}],"name":"S\u00fcleyman Demirel \u00dcniversitesi","place":["Isparta Turkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0505-867X","authenticated-orcid":true,"given":"Ahmet Mert","family":"Nalbanto\u011flu","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04fjtte88","id-type":"ROR","asserted-by":"publisher"},{"id":"https:\/\/www.isni.org\/0000000121558589","id-type":"ISNI","asserted-by":"publisher"}],"name":"S\u00fcleyman Demirel \u00dcniversitesi","place":["Isparta Turkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-8789-5824","authenticated-orcid":true,"given":"Elif","family":"Bolat","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04fjtte88","id-type":"ROR","asserted-by":"publisher"},{"id":"https:\/\/www.isni.org\/0000000121558589","id-type":"ISNI","asserted-by":"publisher"}],"name":"S\u00fcleyman Demirel \u00dcniversitesi","place":["Isparta Turkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"11192","published-online":{"date-parts":[[2026,10,7]]},"reference":[{"key":"1778951","doi-asserted-by":"crossref","unstructured":"Milojevic N, Krdzovic Lazic E, Lukic L, Puresevic D, Mirkovic M, Jakovljevic A. Inflammatory mediators\u2019 essence in apical periodontitis. Eur Oral Res 2024;58:160-8. [CrossRef ]","DOI":"10.26650\/eor.20241423117","type":"journal-article"},{"key":"1778952","doi-asserted-by":"crossref","unstructured":"Wong J, Manoil D, N\u00e4sman P, Belibasakis GN, Neelakantan P. Microbiological Aspects of Root Canal Infections and Disinfection Strategies: An Update Review on the Current Knowledge and Challenges. Front Oral Health 2021;2:672887. [CrossRef ]","DOI":"10.3389\/froh.2021.672887","type":"journal-article"},{"key":"1778953","doi-asserted-by":"crossref","unstructured":"Barbosa MA, Meyfarth SRS, Tomazinho FSF, Antunes LAA, Antunes LS, Gabardo MCL. Does calcium hydroxide interfere with root canal sealer penetration in dentinal tubules? A systematic review and metaanalysis. J Evid Based Dent Pract 2025;25:102046. [CrossRef ]","DOI":"10.1016\/j.jebdp.2024.102046","type":"journal-article"},{"key":"1778954","doi-asserted-by":"crossref","unstructured":"Dias-Junior LCL, Castro RF, Fernandes AD, Guerreiro MYR, Silva EJNL, Brand\u00e3o JMDS. Final endodontic irrigation with 70% ethanol enhanced calcium hydroxide removal from the apical third. J Endod 2021;47:105-11. [CrossRef ]","DOI":"10.1016\/j.joen.2020.09.017","type":"journal-article"},{"key":"1778955","doi-asserted-by":"crossref","unstructured":"Khan AA, Sun X, Hargreaves KM. Effect of calcium hydroxide on proinflammatory cytokines and neuropeptides. J Endod 2008;34:1360-3. [CrossRef ]","DOI":"10.1016\/j.joen.2008.08.020","type":"journal-article"},{"key":"1778956","doi-asserted-by":"crossref","unstructured":"Tavares WLF, de Brito LCN, Henriques LCF, Teles FRF, Teles RP, Vieira LQ, Sobrinho APR. Effects of calcium hydroxide on cytokine expression in endodontic infections. J Endod 2012;38:1368-71. [CrossRef ]","DOI":"10.1016\/j.joen.2012.06.036","type":"journal-article"},{"key":"1778957","doi-asserted-by":"crossref","unstructured":"Safavi KE, Nichols FC. Effect of calcium hydroxide on bacterial lipopolysaccharide. J Endod 1993;19:76-8. [CrossRef ]","DOI":"10.1016\/S0099-2399(06)81199-4","type":"journal-article"},{"key":"1778958","doi-asserted-by":"crossref","unstructured":"Fern\u00e1ndez R, Cardona JA, Cadavid D, \u00c1lvarez LG, Restrepo FA. Survival of endodontically treated roots\/teeth based on periapical health and retention: a 10-year retrospective cohort study. J Endod 2017;43:2001-8. [CrossRef ]","DOI":"10.1016\/j.joen.2017.08.003","type":"journal-article"},{"key":"1778959","doi-asserted-by":"crossref","unstructured":"Liang YH, Li G, Wesselink PR, Wu MK. Endodontic outcome predictors identified with periapical radiographs and cone-beam computed tomography scans. J Endod 2011;37:326-31. [CrossRef ]","DOI":"10.1016\/j.joen.2010.11.032","type":"journal-article"},{"key":"1778960","doi-asserted-by":"crossref","unstructured":"Bayir Y, Erkayman B, Albayrak A, Palabiyik-Y\u00fccelik \u015eS, Can S, Hanci H, Tun\u00e7 F, Halici H, Civelek MS, Sevim M, Yurdg\u00fcl\u00fc EE, Metin \u00d6. Boric acid and zinc borate doped graphene hydrogels designed for burn treatment: In vitro viability-biocompatibility tests and microbiological analysis. J Biomater Appl 2025;39:592-606. [CrossRef ]","DOI":"10.1177\/08853282241268673","type":"journal-article"},{"key":"1778961","doi-asserted-by":"crossref","unstructured":"Dornjak L, Bazina I, Ljubi\u010di\u0107 I, Protrka M, Anga\u00efts A, Szpunar J, Rogina A. Bioactive composite scaffolds for antitumour drug delivery: a dual-functional approach through the combination of chitosan, calcium phosphate, and boric acid. J Drug Deliv Sci Technol 2025;115:107836. [CrossRef ]","DOI":"10.1016\/j.jddst.2025.107836","type":"journal-article"},{"key":"1778962","unstructured":"Zan R, Hubbezoglu I, Ozdem\u0131r A, Tunc T, Sumer Z, Al\u0131c\u0131 O. Antibacterial Effect of Different Concentration of Boric Acid against Enterococcus Faecalis Biofilms in Root Canal. Marmara Dent J 2014;1:76-80.","type":"journal-article"},{"key":"1778963","doi-asserted-by":"crossref","unstructured":"Sa\u011flam M, Arslan U, Buket Bozkurt \u015e, Hakk\u0131 SS. Boric acid irrigation as an adjunct to mechanical periodontal therapy in patients with chronic periodontitis: a randomized clinical trial. J Periodontol 2013;84:1297-308. [CrossRef ]","DOI":"10.1902\/jop.2012.120467","type":"journal-article"},{"key":"1778964","doi-asserted-by":"crossref","unstructured":"Fava LRG, Saunders WP. Calcium hydroxide pastes: classification and clinical indications. Int Endod J 1999;32:257-82. [CrossRef ]","DOI":"10.1046\/j.1365-2591.1999.00232.x","type":"journal-article"},{"key":"1778965","doi-asserted-by":"crossref","unstructured":"Athanassiadis B, Abbott PV, Walsh LJ. The use of calcium hydroxide, antibiotics and biocides as antimicrobial medicaments in endodontics. Aust Dent J 2007;52:64-82. [CrossRef ]","DOI":"10.1111\/j.1834-7819.2007.tb00527.x","type":"journal-article"},{"key":"1778966","doi-asserted-by":"crossref","unstructured":"Gomes BPFDA, Ferraz CCR, Vianna ME, Rosalen PL, Zaia AA, Teixeira FB, Souza-Filho FJD. In vitro antimicrobial activity of calcium hydroxide pastes and their vehicles against selected microorganisms. Braz Dent J 2002;13:155-61. [CrossRef ]","DOI":"10.1590\/S0103-64402002000300002","type":"journal-article"},{"key":"1778967","doi-asserted-by":"crossref","unstructured":"Farasati Far B, Safaei M, Nahavandi R, Gholami A, Naimi-Jamal MR, Tamang S, Ahn JE, Ramezani Farani M, Huh YS. Hydrogel Encapsulation Techniques and Its Clinical Applications in Drug Delivery and Regenerative Medicine: A Systematic Review. ACS Omega 2024;9:29139-58. [CrossRef ]","DOI":"10.1021\/acsomega.3c10102","type":"journal-article"},{"key":"1778968","doi-asserted-by":"crossref","unstructured":"Ruiz-Linares M, Monroy-Rojas JF, Solana C, Baca P, Aguado B, Soriano-Lerma A, vd. Antimicrobial potential of new diclofenac hydrogels for disinfection in regenerative endodontics: An in vitro and ex vivo study. Int Endod J 2023;56:103-17. [CrossRef ]","DOI":"10.1111\/iej.13840","type":"journal-article"},{"key":"1778969","doi-asserted-by":"crossref","unstructured":"Reis-Prado AHD, Rahimnejad M, Dal-Fabbro R, Toledo PTA de, Anselmi C, de Oliveira PHC, Bottino MC. Injectable thermosensitive antibiotic-laden chitosan hydrogel for regenerative endodontics. Bioact Mater 2025;46:406-22. [CrossRef ]","DOI":"10.1016\/j.bioactmat.2024.12.026","type":"journal-article"},{"key":"1778970","doi-asserted-by":"crossref","unstructured":"Harzivartyan S, Hazar AB, Kartal N, Cimilli ZH. Evaluation of different irrigation solutions and activation methods on removing calcium hydroxide. J Dent Sci 2021;16:700-5 [CrossRef ]","DOI":"10.1016\/j.jds.2020.09.003","type":"journal-article"},{"key":"1778971","doi-asserted-by":"crossref","unstructured":"Wiseman A, Cox TC, Paranjpe A, Flake NM, Cohenca N, Johnson JD. Efficacy of sonic and ultrasonic activation for removal of calcium hydroxide from mesial canals of mandibular molars: a microtomographic study. J Endod 2011;37:235-8. [CrossRef ]","DOI":"10.1016\/j.joen.2010.11.019","type":"journal-article"},{"key":"1778972","doi-asserted-by":"crossref","unstructured":"Sah S, Mangat P, Kumar A, Sah N, Shivakumar GC, Di Blasio M, Minervini G. Stereomicroscopic evaluation of sealing ability of four different root canal sealers: an in-vitro study. BMC Oral Health 2024;24:258. [CrossRef ]","DOI":"10.1186\/s12903-024-03913-7","type":"journal-article"},{"key":"1778973","doi-asserted-by":"crossref","unstructured":"\u00c7alt S, Serper A. Dentinal tubule penetration of root canal sealers after root canal dressing with calcium hydroxide. J Endod 1999;25:431-3. [CrossRef ]","DOI":"10.1016\/S0099-2399(99)80273-8","type":"journal-article"},{"key":"1778974","doi-asserted-by":"crossref","unstructured":"Ok\u015fan T, Aktener BO, Sen BH, Tezel H. The penetration of root canal sealers into dentinal tubules. Int Endod J 1993;26:301-5 [CrossRef ]","DOI":"10.1111\/j.1365-2591.1993.tb00575.x","type":"journal-article"},{"key":"1778975","doi-asserted-by":"crossref","unstructured":"Russell A, Friedlander L, Chandler N. Sealer penetration and adaptation in root canals with the butterfly effect. Aust Endod J 2018;44:225-34. [CrossRef ]","DOI":"10.1111\/aej.12238","type":"journal-article"},{"key":"1778976","doi-asserted-by":"crossref","unstructured":"Yan\u0131k D, \u00d6zel \u015e. Shaping ability of three instrumentation system in moderately curved canals: A micro-CT study. Microsc Res Tech 2024;87:2399-407. [CrossRef ]","DOI":"10.1002\/jemt.24613","type":"journal-article"},{"key":"1778977","doi-asserted-by":"crossref","unstructured":"Pereira RD, Brito-J\u00fanior M, Leoni GB, Estrela C, de Sousa-Neto MD. Evaluation of bond strength in single-cone fillings of canals with different cross-sections. Int Endod J 2017;50:177-83. [CrossRef ]","DOI":"10.1111\/iej.12607","type":"journal-article"},{"key":"1778978","doi-asserted-by":"crossref","unstructured":"Yan\u0131k D, Turker N. Glycolic acid on push-out bond strength of fiber post and smear removal: an in vitro study. Odontology 2024;112:739-50. [CrossRef ]","DOI":"10.1007\/s10266-024-00928-y","type":"journal-article"},{"key":"1778979","doi-asserted-by":"crossref","unstructured":"Yan\u0131k D, \u00d6zel \u015e, Da\u011fl\u0131 Ta\u015fman C\u00f6mert F. Brushing motion caused no microcracks: a micro-computed tomography study. Clin Oral Investig 2025;29:173. [CrossRef ]","DOI":"10.1007\/s00784-025-06253-0","type":"journal-article"},{"key":"1778980","doi-asserted-by":"crossref","unstructured":"Safavi K, Nakayama TA. Influence of Mixing Vehicle on Dissociation of Calcium Hydroxide in Solution. J Endod 2000;26:649-51. [CrossRef ]","DOI":"10.1097\/00004770-200011000-00004","type":"journal-article"},{"key":"1778981","doi-asserted-by":"crossref","unstructured":"Park E, Shen YA, Haapasalo M. Irrigation of the apical root canal. Endod Topics 2012;27:54-3. [CrossRef ]","DOI":"10.1111\/etp.12028","type":"journal-article"},{"key":"1778982","doi-asserted-by":"crossref","unstructured":"Boutsioukis C, Lambrianidis T, Kastrinakis E. Irrigant flow within a prepared root canal using various flow rates: a computational fluid dynamics study. Int Endod J 2009;42:144-55. [CrossRef ]","DOI":"10.1111\/j.1365-2591.2008.01503.x","type":"journal-article"},{"key":"1778983","doi-asserted-by":"crossref","unstructured":"Mancini M, Cerroni L, Iorio L, Armellin E, Conte G, Cianconi L. Smear layer removal and canal cleanliness using different irrigation systems (EndoActivator, EndoVac, and passive ultrasonic irrigation): field emission scanning electron microscopic evaluation in an in vitro study. J Endod 2013;39:1456-60. [CrossRef ]","DOI":"10.1016\/j.joen.2013.07.028","type":"journal-article"},{"key":"1778984","doi-asserted-by":"crossref","unstructured":"McGillivray A, Dutta A. The influence of laser-activated irrigation on post-operative pain following root canal treatment: A systematic review. J Dent 2024;144:104928. [CrossRef ]","DOI":"10.1016\/j.jdent.2024.104928","type":"journal-article"},{"key":"1778985","doi-asserted-by":"crossref","unstructured":"Iandolo A, Amato M, Abdellatif D, Barbosa AFA, Pantaleo G, Blasi A, Franco V, Silva EJNL. Effect of different final irrigation protocols on pulp tissue dissolution from an isthmus model. Aust Endod J 2021;47:538-43. [CrossRef ]","DOI":"10.1111\/aej.12518","type":"journal-article"},{"key":"1778986","doi-asserted-by":"crossref","unstructured":"Galler KM, Grubm\u00fcller V, Schlichting R, Widbiller M, Eidt A, Schuller C, Buchalla W. Penetration depth of irrigants into root dentine after sonic, ultrasonic and photoacoustic activation. Int Endod J 2019;52:1210-7. [CrossRef ]","DOI":"10.1111\/iej.13108","type":"journal-article"},{"key":"1778987","doi-asserted-by":"crossref","unstructured":"Nalbanto\u011flu DY, Yagmur B, Bolat E. Ethylenediaminedisuccinic Acid: A Bio\u2010Friendly Chelating Agent for Smear Layer Removal, Dentine Integrity, and Sealer Penetration. Australian Endod J 2026. [CrossRef ]","DOI":"10.1111\/aej.70099","type":"journal-article"},{"key":"1778988","doi-asserted-by":"crossref","unstructured":"de Almeida Barbosa M, de Oliveira KV, Dos Santos VR, da Silva WJ, Tomazinho FSF, Baratto-Filho F, Gabardo MCL. Effect of vehicle and agitation methods on the penetration of calcium hydroxide paste in the dentinal tubules. J Endod 2020;46:980-6. [CrossRef ]","DOI":"10.1016\/j.joen.2020.03.026","type":"journal-article"},{"key":"1778989","doi-asserted-by":"crossref","unstructured":"Donnermeyer D, Schmidt S, Rohrbach A, Berlandi J, B\u00fcrklein S, Sch\u00e4fer E. Debunking the concept of dentinal tubule penetration of endodontic sealers: sealer staining with rhodamine B fluorescent dye is an inadequate method. Materials (Basel) 2021;14:3211. [CrossRef ]","DOI":"10.3390\/ma14123211","type":"journal-article"},{"key":"1778990","doi-asserted-by":"crossref","unstructured":"Tedesco M, Vitali FC, Bortoluzzi EA, Garcia LDFR, Teixeira CDS. Analysis of physicochemical properties of endodontic sealers containing rhodamine B. J Mech Behav Biomed Mater 2023;140:105699. [CrossRef ]","DOI":"10.1016\/j.jmbbm.2023.105699","type":"journal-article"},{"key":"1778991","unstructured":"Ratih DN, Fajrianti H, Purwanti N, Aspriyanti SE. Effects of three final irrigation solutions with chelation properties on the erosion and mineral content of root canal dentin. Eur Oral Res 2026;60:38-44. [CrossRef ]","type":"journal-article"}],"container-title":["European Oral Research"],"original-title":[],"language":"en","deposited":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T11:15:43Z","timestamp":1791371743000},"score":1,"resource":{"primary":{"URL":"https:\/\/iupress.istanbul.edu.tr\/en\/journal\/eor\/article\/effect-of-boric-acid-intracanal-medicament-in-hydrogel-form-on-root-canal-sealer-penetration"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,7]]},"references-count":41,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1,22]]}},"URL":"https:\/\/doi.org\/10.26650\/eor.20261854751","relation":{},"ISSN":["2651-2823"],"issn-type":[{"value":"2651-2823","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,7]]},"assertion":[{"value":"2026-01-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-22","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"1778938"}}