Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

Users Online : 120464

AbstractMaterial and MethodsResultsDiscussionConclusionReferencesDOI and Others
Article in PDF How to Cite Citation Manager Readers' Comments (0) Audio Visual Article Statistics Link to PUBMED Print this Article Send to a Friend
Advertisers Access Statistics Resources

Dr Mohan Z Mani

"Thank you very much for having published my article in record time.I would like to compliment you and your entire staff for your promptness, courtesy, and willingness to be customer friendly, which is quite unusual.I was given your reference by a colleague in pathology,and was able to directly phone your editorial office for clarifications.I would particularly like to thank the publication managers and the Assistant Editor who were following up my article. I would also like to thank you for adjusting the money I paid initially into payment for my modified article,and refunding the balance.
I wish all success to your journal and look forward to sending you any suitable similar article in future"

Dr Mohan Z Mani,
Professor & Head,
Department of Dermatolgy,
Believers Church Medical College,
Thiruvalla, Kerala
On Sep 2018

Prof. Somashekhar Nimbalkar

"Over the last few years, we have published our research regularly in Journal of Clinical and Diagnostic Research. Having published in more than 20 high impact journals over the last five years including several high impact ones and reviewing articles for even more journals across my fields of interest, we value our published work in JCDR for their high standards in publishing scientific articles. The ease of submission, the rapid reviews in under a month, the high quality of their reviewers and keen attention to the final process of proofs and publication, ensure that there are no mistakes in the final article. We have been asked clarifications on several occasions and have been happy to provide them and it exemplifies the commitment to quality of the team at JCDR."

Prof. Somashekhar Nimbalkar
Head, Department of Pediatrics, Pramukhswami Medical College, Karamsad
Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
Ex-President - National Neonatology Forum Gujarat State Chapter
Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018

Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."

Dr Kalyani R
Professor and Head
Department of Pathology
Sri Devaraj Urs Medical College
Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
On Sep 2018

Dr. Saumya Navit

"As a peer-reviewed journal, the Journal of Clinical and Diagnostic Research provides an opportunity to researchers, scientists and budding professionals to explore the developments in the field of medicine and dentistry and their varied specialities, thus extending our view on biological diversities of living species in relation to medicine.
‘Knowledge is treasure of a wise man.’ The free access of this journal provides an immense scope of learning for the both the old and the young in field of medicine and dentistry as well. The multidisciplinary nature of the journal makes it a better platform to absorb all that is being researched and developed. The publication process is systematic and professional. Online submission, publication and peer reviewing makes it a user-friendly journal.
As an experienced dentist and an academician, I proudly recommend this journal to the dental fraternity as a good quality open access platform for rapid communication of their cutting-edge research progress and discovery.
I wish JCDR a great success and I hope that journal will soar higher with the passing time."

Dr Saumya Navit
Professor and Head
Department of Pediatric Dentistry
Saraswati Dental College
On Sep 2018

Dr. Arunava Biswas

"My sincere attachment with JCDR as an author as well as reviewer is a learning experience . Their systematic approach in publication of article in various categories is really praiseworthy.
Their prompt and timely response to review's query and the manner in which they have set the reviewing process helps in extracting the best possible scientific writings for publication.
It's a honour and pride to be a part of the JCDR team. My very best wishes to JCDR and hope it will sparkle up above the sky as a high indexed journal in near future."

Dr. Arunava Biswas
MD, DM (Clinical Pharmacology)
Assistant Professor
Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata

Dr. C.S. Ramesh Babu
" Journal of Clinical and Diagnostic Research (JCDR) is a multi-specialty medical and dental journal publishing high quality research articles in almost all branches of medicine. The quality of printing of figures and tables is excellent and comparable to any International journal. An added advantage is nominal publication charges and monthly issue of the journal and more chances of an article being accepted for publication. Moreover being a multi-specialty journal an article concerning a particular specialty has a wider reach of readers of other related specialties also. As an author and reviewer for several years I find this Journal most suitable and highly recommend this Journal."
Best regards,
C.S. Ramesh Babu,
Associate Professor of Anatomy,
Muzaffarnagar Medical College,
On Aug 2018

Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".

Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
On Aug 2018

Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".

Dr. Mamta Gupta
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018

Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.

Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."

Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
On May 11,2011

Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."

Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
On April 2011

Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.

Dr. Anuradha
On Jan 2020

Important Notice

Original article / research
Year : 2022 | Month : October | Volume : 16 | Issue : 10 | Page : ZC35 - ZC39 Full Version

Effect of Various Concentrations of Sodium Hypochlorite on the Microhardness of Bulkfill Restorative Composite Resin used as a Pre-endodontic Restoration

Published: October 1, 2022 | DOI:
Anuradha Patil, Priyanka Sangle, MV Sumanthini, Tanvi Satpute, Divya Naik, Antara Ghosh

1. Professor, Department of Conservative Dentistry and Endodontics, M.G.M Dental College and Hospital, Kamothe, Navi Mumbai, Mumbai, Maharashtra, India. 2. Former Fellowship Student, Department of Conservative Dentistry and Endodontics, M.G.M Dental College and Hospital, Kamothe, Navi Mumbai, Mumbai, Maharashtra, India. 3. Professor and Head, Department of Conservative Dentistry and Endodontics, M.G.M Dental College and Hospital, Kamothe, Navi Mumbai, Mumbai, Maharashtra, India. 4. Assistant Professor, Department of Conservative Dentistry and Endodontics, M.G.M Dental College and Hospital, Kamothe, Navi Mumbai, Mumbai, Maharashtra, India. 5. Associate Professor, Department of Conservative Dentistry and Endodontics, M.G.M Dental College and Hospital, Kamothe, Navi Mumbai, Mumbai, Maharashtra, India. 6. Assistant Professor, Department of Conservative Dentistry and Endodontics, M.G.M Dental College and Hospital, Kamothe, Navi Mumbai, Mumbai, Maharashtra, India.

Correspondence Address :
Anuradha Patil,
Junction of NH4 and, Sion - Panvel Expy, Sector 18, Navi Mumbai, Maharashtra 410209, Mumbai, Maharashtra, India.


Introduction: A four-walled access cavity plays a vital role in successful endodontic treatment. The materials used for preendodontic restoration are flowable composites, restorative composite resins, packable composite resins, silver amalgam, or glass ionomer cement. Researchers have claimed that exposure of composite resins to low pH liquids and root canal irrigants can have a deleterious effect on their physical and mechanical properties.

Aim: To evaluate the microhardness of a bulk-fill restorative composite resin material before and after being exposed to distilled water, 1% sodium hypochlorite, 3% sodium hypochlorite, and 5% sodium hypochlorite.

Materials and Methods: This was an in-vitro experimental study that was conducted at the Department of Conservative Dentistry and Endodontics, M.G.M Dental College and Hospital, Mumbai, Maharashtra, India, over a period of eight months from January 2021 till August 2021. Total 32 disc-shaped samples were made from a bulk-fill restorative composite resin, 3MTM Filtek Bulk fill posterior restorative composite resin (3MTM, St. Paul, MN, USA). Each disc was prepared using polytetrafluoroethylene (Teflon) molds of 10 mm inner diameter and 4 mm depth. The bulkfill composite resin discs were randomly divided into four main groups, group 1 (distilled water), group 2 (1% NaOCl), group 3 (3% NaOCl), and group 4 (5% NaOCl), with eight samples in each group. Baseline Vickers hardness testing was performed for each group using a 100 gram load and a dwell time of 10 seconds before being immersed in the irrigation solution. Pre and post immersion microhardness measurements were done on the same surface of each sample (top surface). Data obtained were subjected to normality tests. Further statistical analysis was done using one-way Analysis of Variance (ANOVA) followed by the Games-Howell test for pair-wise comparisons.

Results: Irrespective of the different concentrations of sodium hypochlorite irrigant, all samples showed a reduction in microhardness of bulk-fill composite restorative resin. The post immersion microhardness mean values were highest in group 1 (63.06) and lowest in group 4 (58.42), and the difference was statistically significant (p<0.001). No statistical difference was seen between group 3 and group 4. On intragroup comparison, all the groups show statistically highly significant difference between pre and post immersion microhardness values {Paired-t test (p<0.05)}.

Conclusion: Microhardness of bulk-fill composite restorative resin was lowered by different concentrations of sodium hypochlorite irrigant.


Dental resins, Materials testing, Permanent dental restorations, Root canal irrigants, Root canal therapy

Microorganisms primarily mediate endodontic disease. The primary endodontic treatment goal should be directed toward minimizing the critical concentration of microbial irritants (1). Thorough mechanical and chemical debridement of the root canal space results in successful endodontic outcomes. To preserve the functional integrity of teeth that have been destroyed by caries and require root canal treatment, a pre-endodontic buildup of the clinical crowns is often required (2). Investment of time in placing pre-endodontic restoration can provide ease in rubber dam placement, aid in containing root canal irrigants, ensure a low probability of losing the provisional restoration, and improve the endodontic treatment prognosis (3).

Chemical debridement is essential for teeth with complex internal anatomies such as fins, cul de sac, ramifications, lateral and accessory canals, and other irregularities which might be overlooked by instrumentation (4). By washing out debris, disintegrating tissue, and cleaning the root canal system, root canal irrigants can help with mechanical debridement (4),(5),(6). Because of its antimicrobial effect and high efficiency in dissolving necrotic tissue, NaOCl is the most commonly recommended irrigating solution. (4). Because of its proteolytic action, sodium hypochlorite can dissolve pulpal remnants (7),(8) and organic components of dentin (9). It can also partially neutralise necrotic tissues as well as any antigenic or microbial component left in the root canal space (10). Various concentrations of sodium hypochlorite ranging from 0.5-5.25% are widely used. Even though less concentrated solutions have shown antibacterial effectiveness, higher concentrations of NaOCl have a faster and more effective bactericidal effect. However, the higher the concentration of NaOCl, the greater the cytotoxic effect (11),(12).

The materials used for pre-endodontic restoration are flowable composites, restorative composite resins, packable composite resins, silver amalgam, or glass ionomer cement (13),(14). Bulkfill Resin Composite (BRCs) have been marketed with thickness of increments ranging from 4 to 10 mm (15). The use of larger increments of BRCs shortens the time required to place posterior restorations and thus reduces technique sensitivity (16). Resistance to wear and fracture is provided by the high filler loading (17),(18).

Despite advancements in the composition and properties of restorative materials, pre-endodontic restorations are subjected to numerous root canal irrigants that may result in changes in their physical and mechanical properties like bond strength, hardness, and fracture toughness [19-22]. Various studies have been performed to check for the effect of saliva, beverages, tea, coffee, and mouthwashes on the surface hardness of BRC’s (23),(24),(25),(26),(27),(28),(29),(30),(31). Researchers have claimed that exposure of composite resins to low pH liquids and root canal irrigants can have a deleterious effect on their properties (4). In addition, several studies have evaluated a high propensity of composite materials for alteration when exposed to chemical substances such as hydrogen peroxide, organic acids, or ethanol (32),(33),(34). To the best of our knowledge, no research has been done on how different sodium hypochlorite concentrations affect BRCs.

After completion of the endodontic treatment, the pre-endodontic restorations are often incorporated in the final post-endodontic restoration of the tooth (35). Because the strength of this restoration is critical to the long-term success of the permanent restoration (26), the current study sought to assess the effect of various concentrations of sodium hypochlorite irrigant on the microhardness of BRC. The null hypothesis was that there is no difference in the effect of different concentrations of sodium hypochlorite irrigant on the microhardness of BRC.

Material and Methods

This experimental in-vitro study was carried out at the Department of Conservative Dentistry and Endodontics, M.G.M Dental College and Hospital, Kamothe, Navi Mumbai, Maharashtra, India after obtaining the Institutional Ethics Committee approval (ethical clearance number: MGM/DCH/IRRC/6/2021). The study was conducted over a period of eight months (from January 2021 till August 2021).

Inclusion criteria: Samples prepared using 3MTM Filtek Bulk fill posterior restorative composite resin [3MTM Filtek, St. Paul, MN, USA] were included in the study.

Exclusion criteria: Samples that developed defects, errors during manipulation, or were damaged during finishing and polishing were excluded from the study.

Sample size calculation: Cochran’s formula was used for calculating the sample size with the value of standard deviation as 1.41, reliability coefficient as 1.96, and the power of study considered was 80 (36).

Preparation of Composite Resin Samples

Samples were made using Teflon molds of 10 mm diameter and 4 mm height. Molds were placed on mylar strips placed on a glass slab and were filled with 3MTM Filtek Bulk fill posterior restorative composite resin [3MTM Filtek, St. Paul, MN, USA] according to the manufacturer's instructions. A mylar strip was placed on the upper surface of the mold, and the material was flattened with a microscope glass slide to achieve a standardised surface finishing and remove any excess material. After removing excess material, the glass microscope slide was removed, leaving the mylar strip. The Light Emitting Diode (LED) curing light (Ivoclar Vivadent AG, FL-9494 Schaan, Liechtenstein, Austria) was used to cure the samples for 40 seconds at an intensity of 1200 mW/cm2, with the tip kept at a distance of 1 mm. An external handheld radiometer checked the intensity of the light curing unit before curing each sample.

After curing, the cured samples were separated from the molds. Samples were polished with Shofu Composite polishing kit (San Marcos, California, USA) using a low-speed handpiece with coolant according to the manufacturer’s instructions. To achieve complete polymerisation, the samples were kept in an incubator at 37°C, 100% humidity in a lightproof container for 24 hours.

A total of 32 samples of BRC were prepared. The samples were randomly divided into four groups of eight samples each (n=08) as follows: group 1 [distilled water], group 2 [1% NaOCl], group 3 [3% NaOCl], group 4 [5% NaOCl].

Pre immersion Microhardness Testing

The baseline microhardness values of the samples were recorded using Vicker’s microhardness tester (Microhardness tester, Reichert Austria Make, Sr.No.363798, Reference Standard: ISO 6507) for specimen indentation with a load of 100 g and a dwell time of 10 s. For each microhardness test, three indentations were made randomly on the top surfaces of each sample which were not closer than 1 mm to the adjacent ones. The average of the three readings was taken, and microhardness values were calculated. All hardness values were expressed in Vickers Hardness Number (VHN), where 1 VHN=1.854 P/d2, with P being the indentation load and d being the diagonal length (37).

Post immersion Microhardness Testing

The immersion procedure was carried out by immersing the samples in test solutions and replenishing the solution every five minutes for 40 minutes. The most effective irrigation regimen to disinfect dentin was seen at 40 minutes, hence the samples were immersed in the test solutions for 40 minutes (38). The samples were then rinsed with distilled water and dried using blotting/tissue paper. The post immersion microhardness was checked in the same manner as the baseline VHN determination. Pre and post immersion microhardness measurements were done on the same surface of each sample (top surface). Data were tabulated and statistically analysed.

Statistical Analysis

The data obtained were subjected to statistical analysis using MS Office Excel Sheet (v 2019, Microsoft Redmond Campus, Redmond, Washington, United States). First, the normality of data was tested using the Shapiro-Wilk test and was normally distributed (p>0.05); hence parametric test (one-way ANOVA) was used for comparison followed by Games-Howell post hoc test Statistical Package for the Social Sciences software (SPSS v 26.0, IBM). An intra group comparison was made using paired t-test. The level of significance was set at 5% and keeping α error at 5% and β error at 20%, thus giving power to the study as 80%.


The control group, group 1 (Distilled water), had the highest mean microhardness values, and group 4 had the lowest mean microhardness values (NaOCl 5%) post immersion. All four groups' microhardness decreased upon immersion when compared to pre immersion values. Descriptive statistics of surface microhardness measurements for each experimental group are shown in (Table/Fig 1).

The mean values of post immersion microhardness were higher in group I (63.06) followed by group 2 (59.96), group 3 (58.43) and least in group 4 (58.42). The ANOVA test showed a statistically highly significant difference in post immersion microhardness between the groups with p<0.01 (Table/Fig 1).

Due to the non-homogeneity of variances (p<0.05) (Table/Fig 2), Games-Howell post hoc test was applied. There was a significant difference in post immersion when group 1 was compared with group 3 (p=0.016) and group 4 (p=0.008) respectively. Also, statistical significance was seen when mean difference of group 2 was compared with group 3 (p=0.043) and 4 (p=0.003). However, no statistically significant differences were seen between group 3 and group 4 (p=0.114) (Table/Fig 3).

An intra group comparison was made using paired t-test which showed statistically highly significant (p<0.01) difference in the pre and post immersion microhardness values of all the four groups (Table/Fig 4).


The quality of the instrumentation, irrigation, disinfection, obturation, and lastly the coronal seal of the root canal system completely determines the long-term prognosis of endodontic treatment. The significance of the coronal seal has been increasingly recognized in the dental literature. In more recent times, it has been proposed that coronal leakage is much more likely to be the key determinant of clinical success or failure than apical leakage (39). Amalgam, glass ionomers, and composites are commonly used pre-endodontic build-up materials in today’s practice (40). The use of composites as build-up materials should be favored due to the known drawbacks of amalgam as a build-up material (corrosion and staining of the remaining tooth structure) and the low mechanical properties of glass ionomers in comparison to composites (2),(3),(5),(6).

The effect of irrigating solutions on the pre-endodontic restoration during irrigation may change the physical and chemical properties of the restorative material, including hardness (41),(42). Hence, the present study was carried out to evaluate the effect of various concentrations of NaOCl endodontic irrigating solutions, i.e., distilled water, 1% NaOCl, 3% NaOCl, and 5% NaOCl on the microhardness of a BRC. Contact with sodium hypochlorite on build-up materials has previously been shown to reduce their microhardness.

The softening can be found in deeper layers of build-up materials and not only limited to the surface (43). Microhardness of bulk-fill composites is also altered after exposure to various agents like bleaching agents (44). Microhardness of bulk-fill composites has also been shown to be affected after immersion in different solutions like coffee, cola, red wine, and distilled water (45). The BRC was chosen for this study since the material simplifies the clinical procedure and randomized controlled studies have proven them to be successful (46),(47) however, information with regards to their performance in restoring root-filled teeth is inadequate.

Micro hardness testing is one of the most simple and non destructive methods for studying fine-scale changes in a material's hardness (48). The Vickers hardness test is one method for measuring micro hardness. The Vickers hardness test was used in this study because it is an appropriate and practical method for evaluating changes on the surface and in deeper hard tissue structures (49). Furthermore, this test is widely accepted due to its highly accurate readings and the fact that only one type of indentation is used in this method for all types of surface treatment (50).

In the present study, the samples were polished and finished with Shofu [San Marcos, California, USA] to remove any surface imperfections and achieve a mirror-like quality. When using the VHN testing equipment, the glossy surface promotes light reflection so that indentations may be seen clearly. To achieve maximum polymerization, the specimens were stored in an incubator for 24 hours immediately after fabrication before being immersed in the experimental solution.

For standardisation, all samples were immersed for 40 mins in the selected irrigating solutions and the solution was replenished every 5 min to mimic the clinical scenario.

An excellent restorative material should exhibit good mechanical properties to replace natural tooth tissue. During endodontic treatment, dental composites are exposed intermittently or continuously to chemical agents, which could cause chemical degradation and loss of many dental properties (22).

In the present study, it was observed that the microhardness of BRC is inversely proportional to the concentration of the irrigants, thus rejecting the null hypothesis. An alteration in the composition of the restorative material may be responsible for the decrease in microhardness. Hypochlorite and hypochlorous acid, the reactive chlorine derivatives of sodium hypochlorite, exhibit significant oxidizing potential (51). It is seen that substrates with oxidative capabilities may break polymer chains, leading to the decomposition of resin-based materials thus affecting their properties (32). Oxidative substrates may also have an impact on the hardness of composites by contributing to debonding of the filler matrix (51). Therefore, before the final prosthetic restoration, it appears that alteration of the composite brought on by contact with NaOCl necessitates a total replacement of the build-up.


The in-vitro environment does not accurately represent the natural conditions of the oral cavity. As a result, future research should test more experimental designs that can depict the clinical behaviour of the restorative material in-vitro.


It can be concluded that contact of sodium hypochlorite with bulkfill restorative composite resin causes a reduction in microhardness. Alteration in the properties of the BRC can compromise the coronal seal along with the ability to sustain the masticatory forces directed towards the endodontically treated tooth to achieve the desired outcome of the restorative treatment. Therefore it is deemed necessary to completely replace the pre-endodontic restoration prior to the definitive prosthetic restoration for its longevity. Future studies have to be done with different irrigating solutions with different core build-up materials and various material properties such as sorption, solubility, and nanoleakage should be checked. Furthermore, to overcome the limitations, further advances are to be made in materials to enhance the physical and mechanical properties of the pre-endodontic restoration material.


Tonini R, Salvadori M, Audino E, Sauro S, Garo ML, Salgarello S. Irrigating solutions and activation methods used in clinical endodontics: A systematic review. Front Oral Health. 2022;3:838043. [crossref] [PubMed]
Kshirsagar S, Aggarwal S, Mukhtar A, Gupta P, Rai V, Chawla M, et al. Pre endodontic build-up of a grossly destructed tooth: A case report. Int J Sci Stud. 2015;2(11):225-29.
DMG. Pre-Endodontic Build-Up- An Essential Component of Endodontic Therapy [Internet]. New Jersey (USA): DMG Connect;2022 Available at: https://dmgconnect. com/user-reports/pre-endodontic-build-up-an-essential-componentof- endodontic-therapy/.
Wegehaupt FJ, Betschart J, Attin T. Effect of sodium hypochlorite contamination on microhardness of dental core build-up materials. Dent Mater J. 2010;29(4):469-74. [crossref]
Rao S, Ballal NV. Endodontic buildups - A case series. The Journal of Dentists. 2017;5(1):06-12.
Kandaswamy D, Venkateshbabu N. Root canal irrigants. J Conserv Dent. 2010;13(4):256-64. [crossref] [PubMed]
Reis So MV, Vier-Pelisser FV, Darcie MS, Smaniotto DGR, Montagner F. Pulp tissue dissolution when the use of sodium hypochlorite and EDTA alone or associated. Revista Odonto Ciencia. 2011;26(2):156-60. [crossref]
Taneja S, Mishra N, Malik S. Comparative evaluation of human pulp tissue dissolution by different concentrations of chlorine dioxide, calcium hypochlorite and sodium hypochlorite: An in-vitro study. J Conserv Dent. 2014;17(6):541-45. [crossref] [PubMed]
Mohammadi Z. Sodium hypochlorite in endodontics: an update review. Int Dent J. 2008;58(6):329-41. [crossref] [PubMed]
Andersen M, Lund A, Andreasen JO, Andreasen FM. In-vitro solubility of human pulp tissue in calcium hydroxide and sodium hypochlorite. Endod Dent Traumatol. 1992;8(3):104-08. [crossref] [PubMed]
Shih M, Marshall FJ, Rosen S. The bactericidal efficiency of sodium hypochlorite as an endodontic irrigant. Oral Surg Oral Med Oral Pathol. 1970;29(4):613-19. [crossref] [PubMed]
Marion JJC, Manhaes FC, Bajo H, Duque TM. Efficiency of different concentrations of sodium hypochlorite during endodontic treatment. Literature review. Dental Press Endod. 2012;2(4):32-37.
Yanikog? lu N, Duymus, ZY, Yilmaz B. Effects of different solutions on the surface hardness of composite resin materials. Dent Mater J. 2009;28(3):344-51. [crossref]
Awliya WY, Al-Alwani DJ, Gashmer ES, Al-Mandil HB. The effect of commonly used types of coffee on surface microhardness and colour stability of resinbased composite restorations. Saudi Dent J. 2010;22(4):177-81. [crossref] [PubMed]
Fatima N, Abidi SY, Qazi FU, Jat SA. Effect of different tetra pack juices on microhardness of direct tooth coloured-restorative materials. Saudi Dent J. 2013;25(1):29-32. [crossref] [PubMed]
Tanthanuch S, Kukiattrakoon B, Siriporananon C, Ornprasert N, Mettasitthikorn W, Likhitpreeda S, et al. The effect of different beverages on surface hardness of nanohybrid resin composite and giomer. J Conserv Dent. 2014;17(3):261-65. [crossref] [PubMed]
Khan AA, Siddiqui AZ, Al-Kheraif AA, Zahid AA, Divakar DD. Effect of different pH solvents on micro-hardness and surface topography of dental nano-composite: An in-vitro analysis. Pak J Med Sci. 2015;31(4):854-59. [crossref] [PubMed]
Dionysopoulos D, Papadopoulos C, Koliniotou-Koumpia E. Effect of temperature, curing time, and filler composition on surface microhardness of composite resins. J Conserv Dent. 2015;18(2):114-18. [crossref] [PubMed]
Gharatkar AA, Irani R, Shiraguppi V, Hegde V. Effect of cola, orange juice, and wine on surface microhardness of nano-composites: An in-vitro study. J Dent Orofac Res. 2014; 10(1):16-20.
Okada K, Tosaki S, Hirota K, Hume WR. Surface hardness change of restorative filling materials stored in saliva. Dent Mater. 2001;17(1):34-39. [crossref] [PubMed]
Fennis WMM, Ray NJ, Creugers NHJ, Kreulen CM. Microhardness of resin composite materials light-cured through fiber reinforced composite. Dent Mater. 2009;25(8):947-51. [crossref] [PubMed]
Espindola-Castro LF, Durao MA, Pereira TV, Cordeiro AB, Monteiro GM. Evaluation of microhardness, sorption, solubility, and colour stability of bulk fill resins: A comparative study. J Clin Exp Dent. 2020;12(11):e1033-e1038. [crossref] [PubMed]
Jyothi K, Crasta S, Venugopal P. Effect of five commercial mouth rinses on the microhardness of a nanofilled resin composite restorative material: An in-vitro study. J Conserv Dent. 2012;15(3):214-17. [crossref] [PubMed]
Antony Fernandez R, El Araby M, Siblini M, Al-Shehri A. The effect of different types of oral mouth rinses on the hardness of Silorane-based and Nano-hybrid composites. Saudi J Oral Sci. 2014;1(2):105. [crossref]
Sadat Hashemi Kamangar S, Ghavam M, Mirkhezri Z, Karazifard MJ. Comparison of the effects of two different drinks on microhardness of a silorane-based composite resin. J Dent Shiraz Univ Med Sci. 2015;16(0):260-66.
Kelic´ K, Matic S, Marovic´ D, Klaric´ E, Tarle Z. Microhardness of bulk-fill composite materials. Acta Clin Croat. 2016;55(4):607-14. [crossref] [PubMed]
Son SA, Park JK, Seo DG, Ko CC, Kwon YH. How light attenuation and filler content affect the microhardness and polymerization shrinkage and translucency of bulk-fill composites? Clin Oral Investig. 2017;21(2):559-65. [crossref] [PubMed]
Themudo B, Annapoorna BM. Effect of toothbrush mouthrinse cycling on surface roughness and microhardness of nanohybrid composite resin and giomer. International Journal of Current Research. 2017;9(7):54745-50.
Eliguzeloglu Dalkilic E, Donmez N, Kazak M, Duc B, Aslantas A. Microhardness and water solubility of expired and non-expired shelf-life composites. Int J Artif Organs. 2019;42(1):25-30. [crossref] [PubMed]
Rizzante FAP, Duque JA, Duarte MAH, Mondelli RFL, Mendonca G, Ishikiriama SK, et al. Polymerization shrinkage, microhardness and depth of cure of bulk fill resin composites. Dent Mater J. 2019;38(3):403-10. [crossref] [PubMed]
Haapasalo M, Qian W, Portenier I, Waltimo T. Effects of dentin on the antimicrobial properties of endodontic medicaments. J Endod. 2007;33(8):917-25. [crossref] [PubMed]
Hannig C, Duong S, Becker K, Brunner E, Kahler E, Attin T, et al. Effect of bleaching on subsurface micro-hardness of composite and a polyacid modified composite. Dent Mater. 2007;23(2):198-03. [crossref] [PubMed]
Gurdal P, Akdeniz BG, S, en BH. The effects of mouthrinses on microhardness and colour stability of aesthetic restorative materials. J Oral Rehabil. 2002;29:895-01. [crossref] [PubMed]
Gurgan S, Onen A, Koprulu H. In-vitro effects of alcohol-containing and alcoholfree mouthrinses on microhardness of some restorative materials. J Ora Rehabil. 1997;24:244-46. [crossref]
Gavriil D, Kakka A, Myers P, O Connor CJ. Pre-endodontic restoration of structurally compromised teeth: Current concepts. Br Dent J. 2021;231(6):343-49. [crossref] [PubMed]
Uakarn C, Chaokromthong K, Sintao N. Sample size estimation using Yamane and Cochran and Krejcie and Morgan and Green Formulas and Cohen statistical power analysis by G*Power and comparisons. APHEIT Int. J. 2021;10(2):76-88.
Chuenarrom C, Benjakul P, Daosodsai P: Effect of indentation load and time on knoop and Vickers microhardness tests for enamel and dentin. Mater Res. 2009;12(4):473-76. [crossref]
Retamozo B, Shabahang S, Johnson N, Aprecio RM, Torabinejad M. Minimum contact time and concentration of sodium hypochlorite required to eliminate Enterococcus faecalis. J Endod. 2010;36(3):520-23. [crossref] [PubMed]
Chesterman J, Jowett A, Gallacher A, Nixon P. Bulk-fill resin-based composite restorative materials: a review. Br Dent J. 2017;222(5):337-44. [crossref] [PubMed]
Smidt A, Venezia E. Techniques for immediate core buildup of endodontically treated teeth. Quintessence International. 2003;34(4):258-68.
Sritharan A. Discuss that the coronal seal is more important than the apical seal for endodontic success. Aust Endod J. 2002;28(3):112-15. [crossref] [PubMed]
Badr RM Al, Hassan HA. Effect of immersion in different media on the mechanical properties of dental composite resins. Int J Appl Dent Sci. 2017;3(1):81-88.
Wegehaupt FJ, Betschart J, Attin T. Effect of sodium hypochlorite contamination on microhardness of dental core build-up materials. Dent Mater J. 2010;29(4):469-74. [crossref] [PubMed]
Ozduman ZC, Kazak M, Fildisi MA, Ozlen RH, Dalkilic E, D1nmez N, et al. Effect of polymerization time and home bleaching agent on the microhardness and surface roughness of bulk-fill composites: A scanning electron microscopy study. Scanning. 2019;2019:2307305. [crossref] [PubMed]
Bilgili Can D, Ozarslan M. Evaluation of colour stability and microhardness of contemporary bulk-fill composite resins with different polymerization properties. J Esthet Restor Dent. 2022. Doi: 10.1111/jerd.12879. Epub ahead of print. [crossref] [PubMed]
Manhart J, Chen HY, Hickel R. Clinical evaluation of the posterior composite Quixfil in class I and II cavities: 4-year follow-up of a randomized controlled trial. J Adhes Dent. 2010;12(3):237-43.
van Dijken JW, Pallesen U. A randomized controlled three-year evaluation of “bulk-filled” posterior resin restorations based on stress decreasing resin technology. Dent Mater. 2014;30(9):e245-51. [crossref] [PubMed]
Voort GFV, Lucas GM. Microindentation hardness testing. Adv Mater Proc. 1998;154:21-25
Scougall-Vilchis RJ, Hotta Y, Hotta M, Idono T, Yamamoto K. Examination of composite resins with electron microscopy, microhardness tester and energy dispersive X-ray microanalyzer. Dent Mater J. 2009;28(1):102-12. [crossref] [PubMed]
El-Sherbiny M, Hegazy R, Ibrahim M, Abuelezz A. The Influence of geometrical tolerances of vickers indenter on the accuracy of measured hardness. Int J Metrol Qual Eng. 2012;3:01-06. [crossref]
Wattanapayungkul P, Yap AU. Effects of in-office bleaching products on surface finish of tooth-coloured restorations. Oper Dent. 2003;28(1):15-19.

DOI and Others

DOI: 10.7860/JCDR/2022/57498.17040

Date of Submission: May 02, 2022
Date of Peer Review: May 28, 2022
Date of Acceptance: Aug 09, 2022
Date of Publishing: Oct 01, 2022

• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? No
• For any images presented appropriate consent has been obtained from the subjects. NA

• Plagiarism X-checker: May 05, 2022
• Manual Googling: Aug 05, 2022
• iThenticate Software: Aug 08, 2022 (22%)

ETYMOLOGY: Author Origin

JCDR is now Monthly and more widely Indexed .
  • Emerging Sources Citation Index (Web of Science, thomsonreuters)
  • Index Copernicus ICV 2017: 134.54
  • Academic Search Complete Database
  • Directory of Open Access Journals (DOAJ)
  • Embase
  • EBSCOhost
  • Google Scholar
  • HINARI Access to Research in Health Programme
  • Indian Science Abstracts (ISA)
  • Journal seek Database
  • Google
  • Popline (reproductive health literature)