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Kottathil H, Zehnder M, Gubler A, Attin T, Narkedamalli R, Ballal NV. Compatibility of Dual Rinse 1-Hydroxyethane-1,1-Diphosphonic Acid with Sodium Hypochlorite Solutions Containing Proprietary Additives. J Endod 2024; 50:1472-1477. [PMID: 39033801 DOI: 10.1016/j.joen.2024.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 06/18/2024] [Accepted: 07/09/2024] [Indexed: 07/23/2024]
Abstract
INTRODUCTION A salt of 1-hydroxyethylidene-1,1-diphosphonic acid (HEDP) was commercialized some years ago. This so-called Dual Rinse (DR) HEDP has been tested for its combined actions and interactions with pure sodium hypochlorite (NaOCl) solutions. The aim of this study was to assess DR interactions with NaOCl solutions containing proprietary additives. METHODS Designated endodontic NaOCl solutions that come at 2 different strengths (2% and 5.25%), and without or with additives (Chloraxid and Chloraxid Extra, respectively) were tested. Some of their key chemical and physical properties were determined in the presence or absence of HEDP (9%) in the solution. In addition, soft tissue dissolution efficacy of test and control solutions was assessed in extracted teeth (n = 10 per group, 90 teeth in total). RESULTS The NaOCl content in the 2% Chloraxid solutions was slightly above, that in the 5.25% solutions below the labeled concentration. The additives in the Chloraxid Extra solutions neither altered their surface tension nor their viscosity. The addition of HEDP to any of the tested NaOCl solutions reduced their pH, and increased their surface tension and viscosity. HEDP-induced available chlorine loss over the first hour was similar between all NaOCl solutions. Soft tissue dissolution in the root canals was affected by NaOCl concentration, but neither by any proprietary NaOCl additive in the Chloraxid solutions, nor the addition of DR HEDP. CONCLUSIONS Proprietary additives had no influence on any of the tested parameters, including surface tension of the "Extra" solutions. The increased viscosity of combined NaOCl/HEDP solutions deserves further attention.
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Affiliation(s)
- Honey Kottathil
- Clinic of Conservative and Preventive Dentistry, University of Zurich, Zurich, Switzerland
| | - Matthias Zehnder
- Clinic of Conservative and Preventive Dentistry, University of Zurich, Zurich, Switzerland.
| | - Andrea Gubler
- Clinic of Conservative and Preventive Dentistry, University of Zurich, Zurich, Switzerland
| | - Thomas Attin
- Clinic of Conservative and Preventive Dentistry, University of Zurich, Zurich, Switzerland
| | - Rajkumar Narkedamalli
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Nidambur Vasudev Ballal
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Novozhilova N, Babina K, Polyakova M, Sokhova I, Sherstneva V, Zaytsev A, Makeeva I, Mikheikina A. The Effect of Different Compositions and Concentrations of Etidronate-Containing Irrigants on the Antibacterial Activity of Sodium Hypochlorite against Enterococcus faecalis and Candida albicans. Dent J (Basel) 2024; 12:46. [PMID: 38534270 DOI: 10.3390/dj12030046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 02/12/2024] [Accepted: 02/19/2024] [Indexed: 03/28/2024] Open
Abstract
We assessed the effect of different compositions and concentrations of two etidronate-containing irrigants on the antibacterial activity of sodium hypochlorite (SH) against Enterococcus faecalis and Candida albicans in vitro. Pure cultures of C. albicans and E. faecalis were isolated from root canal samples. The disc diffusion method was used to compare the antibacterial effect of pure SH and SH mixed with 9%, 15%, and 18% etidronate of two manufactures (dual rinse (DR); IsraDent (ID)) and EDTA. The pH and temperature of the solutions were measured immediately after mixing and within 40 min. The ANOVA revealed a significant influence of the type of irrigating solution on the C. albicans and E. faecalis inhibition zone diameters that ranged from 6.6 to 51.6 mm and from 6.4 to 12.4 mm, respectively. SH with DR 9% exhibited the highest effect against C. albicans. The antifungal activity of the other irrigants was SH = SH + DR15% = SH + DR18% = SH + ID9% > SH + EDTA > SH + ID15% > SH + ID18%. No significant differences in the anti-E. faecalis effect were revealed between the tested solutions except for the mixtures of SH and 15% and 18% ID, which exhibited no antiseptic effect. There was a strong positive correlation between antiseptic activity against both microorganisms and the pH values of the tested solutions. In conclusion, most etidronate formulations did not significantly hamper sodium hypochlorite activity against C. albicans and E. faecalis. The effect was concentration- and manufacturer-dependent.
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Affiliation(s)
- Nina Novozhilova
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Ksenia Babina
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Maria Polyakova
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Inna Sokhova
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Valeria Sherstneva
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Alexandr Zaytsev
- Institute of Linguistics and Intercultural Communication, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Irina Makeeva
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Anna Mikheikina
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
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Aldoski MRN, Selivany BJ, Sulaiman T. Bromelain-based endodontic irrigant: preparation, properties, and biocompatibility: An in-vitro study. AUST ENDOD J 2023; 49 Suppl 1:146-155. [PMID: 36305605 DOI: 10.1111/aej.12704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 09/24/2022] [Accepted: 10/09/2022] [Indexed: 11/26/2022]
Abstract
The aim of the study was to determine the properties, efficacy and biocompatibility of combining bromelain enzyme, chlorohexidine and EDTA (BCE) to create a novel endodontic irrigant. Fourier transform infrared spectrometry was performed to confirm the stability of the BCE and direct contact inhibition test was performed to determine antibacterial action. Baseline pH and surface tension of irrigants was compared with determine stability. Subcutaneous injection to dorsal skin of rabbits was graded for presence of inflammation, oedema, granulation and fibrosis. BCE caused less overall irritation, less oedematous and was earlier to heal than 2.5% NaOCl. The pH stability of BCE was also superior to 2.5% NaOCl. A one-way ANOVA test was performed for the direct contact inhibition and microleakage test. A significant difference was determined (p ≤ 0.05) between BCE and 2.5% NaOCl for antibacterial action. BCE irrigant is effective in preparing dentinal surfaces for root canal without adverse effects and promising longevity.
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Affiliation(s)
| | - Bahar Jaafar Selivany
- Department of Conservative Dentistry, College of Dentistry, University of Duhok, Iraq
| | - Taiseer Sulaiman
- Division of Comprehensive Oral Health, University of North Carolina at Chapel Hill Adams School of Dentistry, Chapel Hill, North Carolina, USA
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Advances in the Role of Sodium Hypochlorite Irrigant in Chemical Preparation of Root Canal Treatment. BIOMED RESEARCH INTERNATIONAL 2023; 2023:8858283. [PMID: 36685672 PMCID: PMC9859704 DOI: 10.1155/2023/8858283] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 01/06/2023] [Accepted: 01/07/2023] [Indexed: 01/15/2023]
Abstract
Irrigation of root canal system is of great significance to the success of endodontic treatment, where sodium hypochlorite (NaOCl) is the most widely used irrigant in chemical preparation. NaOCl functions by eliminating bacterial biofilms and dissolving organic tissue, which may vary according to several factors such as the microbiology of root canal infection and the concentration of the irrigant. It has been proposed that the effectiveness of NaOCl could be enhanced via several methods, including heating the irrigant, applying in conjunction with certain reagents, or activating by agitation techniques. Despite its antibacterial and tissue-dissolving capacities, NaOCl should be used with caution to avoid detrimental effect due to its cytotoxicity and negative effect on dentin properties. In this narrative review, we discussed the factors that affect the properties of NaOCl, the methods to improve its efficacy, and the side effects that might occur in clinical practice.
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Boutsioukis C, Arias‐Moliz MT, Chávez de Paz LE. A critical analysis of research methods and experimental models to study irrigants and irrigation systems. Int Endod J 2022; 55 Suppl 2:295-329. [PMID: 35171506 PMCID: PMC9314845 DOI: 10.1111/iej.13710] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 02/07/2022] [Accepted: 02/08/2022] [Indexed: 11/28/2022]
Abstract
Irrigation plays an essential role in root canal treatment. The purpose of this narrative review was to critically appraise the experimental methods and models used to study irrigants and irrigation systems and to provide directions for future research. Studies on the antimicrobial effect of irrigants should use mature multispecies biofilms grown on dentine or inside root canals and should combine at least two complementary evaluation methods. Dissolution of pulp tissue remnants should be examined in the presence of dentine and, preferably, inside human root canals. Micro-computed tomography is currently the method of choice for the assessment of accumulated dentine debris and their removal. A combination of experiments in transparent root canals and numerical modeling is needed to address irrigant penetration. Finally, models to evaluate irrigant extrusion through the apical foramen should simulate the periapical tissues and provide quantitative data on the amount of extruded irrigant. Mimicking the in vivo conditions as close as possible and standardization of the specimens and experimental protocols are universal requirements irrespective of the surrogate endpoint studied. Obsolete and unrealistic models must be abandoned in favour of more appropriate and valid ones that have more direct application and translation to clinical Endodontics.
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Affiliation(s)
- Christos Boutsioukis
- Department of EndodontologyAcademic Centre for Dentistry Amsterdam (ACTA)University of Amsterdam and Vrije Universiteit AmsterdamAmsterdamThe Netherlands
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Gow CK, Weinhouse C, Johnson GO, Saunders KE. Stability of Free Available Chlorine Levels in Dilute Sodium Hypochlorite Solutions over a 6-Week Period. JOURNAL OF THE AMERICAN ASSOCIATION FOR LABORATORY ANIMAL SCIENCE : JAALAS 2022; 61:181-187. [PMID: 35109965 PMCID: PMC8956213 DOI: 10.30802/aalas-jaalas-21-000080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 08/11/2021] [Accepted: 11/15/2021] [Indexed: 06/14/2023]
Abstract
Animal care and use programs commonly use chlorine and chlorine-based disinfectants to help prevent facility acquired infections in animals. The Department of Comparative Medicine (DCM) at Oregon Health and Science University (OHSU) follows the Centers for Disease Control and Prevention (CDC) disinfection guidelines for preparing and storing these disinfectants. DCM prepares bottles of dilute solutions of sodium hypochlorite (that is, commercial bleach) daily. In this study, we tested whether dilute bleach solutions, as prepared following the DCM protocol, remained stable under real-world practice conditions for up to 6 wk. We tested 4 groups of spray bottles filled with 0.5% bleach solutions in these experiments. Specifically, we sprayed 2 groups of bottles daily to mimic use while 2 other groups of bottles were not sprayed. We then measured free available chlorine (FAC) using 2 methods, spectrophotometry and colorimetric strips. All 4 test groups showed stable maintenance of FAC concentration for the length of the experiment. Mean FAC loss from baseline levels was not significantly different in the group of bottles not sprayed daily (6% for group 2 at week 5 compared with 7% for Group 4 at week 6). All bottles in Groups 1 and 3 measured by colorimetric strips showed concentrations at or near 5000 mg/L at all weekly time points throughout the experiment. This study shows that 0.5% sodium hypochlorite solutions stored and used in a standard rodent housing room and sprayed daily will maintain acceptable FAC concentrations for at least 5 to 6 wk, perhaps longer. In addition, we report that colorimetric strips may be a useful and accessible quality control tool for testing freshly prepared solutions at regular intervals. We conclude that sodium hypochlorite solutions can be prepared on a weekly, biweekly, or monthly basis with no loss in disinfection effectiveness.
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Iglesias JE, Pinheiro LS, Weibel DE, Montagner F, Grecca FS. Influence of surfactants addition on the properties of calcium hypochlorite solutions. J Appl Oral Sci 2019; 27:e20180157. [PMID: 30624467 PMCID: PMC6322640 DOI: 10.1590/1678-7757-2018-0157] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2018] [Accepted: 08/21/2018] [Indexed: 11/25/2022] Open
Abstract
Objectives The aim of this study was to evaluate the influence of surfactants 0.2% or 0.1% cetrimide (Cet) or 0.008% benzalkonium chloride (BAK) on 2.5% calcium hypochlorite (Ca(OCl)2), and compare to sodium hypochlorite (NaOCl), regarding the properties of pH, free chlorine content, surface tension, contact angle, pulp dissolution and antimicrobial activity. Material and Methods The pH and free chlorine content were evaluated by digital pHmeter and by titration, respectively. Surface tension was measured by the platinum ring technique with a Du Noüy tensiometer. The solution's contact angle in human dentin surfaces was checked by Drop Shape Analyzer software. Bovine pulps were used for pulp dissolution analysis and the dissolving capacity was expressed by percent weight loss. Antimicrobial activity over Enterococcus faecalis was evaluated by the agar diffusion method. Results Surfactants addition to Ca(OCl)2 and NaOCl did not alter the pH, free chlorine content and pulp dissolution properties. Ca(OCl)2 had the highest surface tension among all tested solutions. When surfactants were added to Ca(OCl)2 and NaOCl, there was a significant reduction of surface tension and contact angle values. The addition of 0.2% or 0.1% Cet enhanced antimicrobial activity of both Ca(OCl)2 and NaOCl. Conclusion Surfactant addition to 2.5% Ca(OCl)2 has shown acceptable outcomes for pH, free chlorine content, surface tension, contact angle, pulp dissolution and antimicrobial activity. Furthermore, the addition of 0.2% Cet showed better results for all tested properties.
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Affiliation(s)
- Júlia Eick Iglesias
- Universidade Federal do Rio Grande do Sul, Faculdade de Odontologia, Departamento de Odontologia Conservadora, Porto Alegre, Rio Grande do Sul, Brasil
| | - Lucas Siqueira Pinheiro
- Universidade Federal do Rio Grande do Sul, Faculdade de Odontologia, Departamento de Odontologia Conservadora, Porto Alegre, Rio Grande do Sul, Brasil
| | - Daniel Eduardo Weibel
- Universidade Federal do Rio Grande do Sul, Instituto de Química, Departamento de Físico-Química, Porto Alegre, Rio Grande do Sul, Brasil
| | - Francisco Montagner
- Universidade Federal do Rio Grande do Sul, Faculdade de Odontologia, Departamento de Odontologia Conservadora, Porto Alegre, Rio Grande do Sul, Brasil
| | - Fabiana Soares Grecca
- Universidade Federal do Rio Grande do Sul, Faculdade de Odontologia, Departamento de Odontologia Conservadora, Porto Alegre, Rio Grande do Sul, Brasil
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Lee LW, Hsiao SH, Lin YH, Chen PY, Lee YL, Hung WC. Outcomes of necrotic immature open-apex central incisors treated by MTA apexification using poly(ε-caprolactone) fiber mesh as an apical barrier. J Formos Med Assoc 2018; 118:362-370. [PMID: 29937322 DOI: 10.1016/j.jfma.2018.06.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 05/30/2018] [Accepted: 06/05/2018] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND/PURPOSE Although unset mineral trioxide aggregate (MTA) has some cytotoxicity, MTA is still a biocompatible material suitable for doing apexification. This study assessed the outcomes for 8 necrotic immature open-apex permanent maxillary central incisors treated by MTA apexification using poly(ε-caprolactone) fiber mesh (PCL-FM) as an apical barrier (so-called PCL-FM/MTA apexification) to prevent extrusion of MTA materials into the periapical tissues of open-apex teeth. METHODS Eight necrotic immature open-apex permanent maxillary central incisors with the open apices measuring 2.5 mm-3.5 mm in diameter in 8 patients (6 boys and 2 girls; age range, 8-10 years) were first cleaned using ultrasonic activated irrigation with 2.5% sodium hypochlorite solution and then treated by PCL-FM/MTA apexification procedure. RESULTS All the 8 permanent maxillary central incisors showed successful outcomes after PCL-FM/MTA apexification procedure. The mean duration for apical hard tissue barrier formation of the 8 incisors was 6.8 ± 0.5 weeks (range 6-7 weeks). The mean increased root length was 1.8 ± 0.7 mm (range 1-3 mm) at 7 weeks and 3.1 ± 0.6 mm (range 2-4 mm) at 3 months. The mean increased dentinal wall thickness at the most apical portion of the root was 1.3 ± 0.5 mm (range 1-2 mm) at 7 weeks and 2.4 ± 0.6 mm (range 1.5-3 mm) at 3 months. None of the teeth treated by PCL-FM/MTA apexification showed tooth discoloration after a follow-up period of 3 months. CONCLUSION PCL-FM/MTA apexification is an excellent technique for treatment of necrotic immature open-apex permanent maxillary central incisors.
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Affiliation(s)
- Li-Wan Lee
- Department of Dentistry, Taipei City Hospital, Renai Branch, Taipei, Taiwan
| | - Sheng-Huang Hsiao
- Department of Neurosurgery, Taipei City Hospital, Renai Branch, Taipei, Taiwan; Department of Psychology, National Chengchi University, Taipei, Taiwan
| | - Yun-Ho Lin
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan; Division of Oral Pathology, Department of Dentistry, Taipei Medical University Hospital, Taipei, Taiwan
| | - Po-Yu Chen
- Institute of Polymer Science and Engineering, National Taiwan University, Taipei, Taiwan
| | - Ya-Ling Lee
- Department of Dentistry, Taipei City Hospital, Heping Fuyou Branch, Taipei, Taiwan; Department of Dentistry, School of Dentistry, National Yang-Ming University, Taipei, Taiwan
| | - Wei-Chiang Hung
- School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan.
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Atasoy Ulusoy Öİ, Savur İG, Çelik B. Etilendiamin tetraasetik asit, perasetik asit ve etidronik asitin sodyum hipokloritin doku çözme kapasitesi üzerine etkisi: in vitro. ACTA ODONTOLOGICA TURCICA 2016. [DOI: 10.17214/gaziaot.277456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Leonardo NGES, Carlotto IB, Luisi SB, Kopper PMP, Grecca FS, Montagner F. Calcium Hypochlorite Solutions: Evaluation of Surface Tension and Effect of Different Storage Conditions and Time Periods over pH and Available Chlorine Content. J Endod 2016; 42:641-5. [DOI: 10.1016/j.joen.2016.01.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Revised: 01/11/2016] [Accepted: 01/12/2016] [Indexed: 11/27/2022]
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Arias-Moliz MT, Morago A, Ordinola-Zapata R, Ferrer-Luque CM, Ruiz-Linares M, Baca P. Effects of Dentin Debris on the Antimicrobial Properties of Sodium Hypochlorite and Etidronic Acid. J Endod 2016; 42:771-5. [PMID: 26951957 DOI: 10.1016/j.joen.2016.01.021] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2015] [Revised: 12/28/2015] [Accepted: 01/11/2016] [Indexed: 10/22/2022]
Abstract
INTRODUCTION The purpose of this study was to determine the influence of dentin powder on the concentration, pH, and antimicrobial activity of sodium hypochlorite (NaOCl) alone and combined with etidronic acid (HEBP). METHODS Biofilms of Enterococcus faecalis were grown on the surface of dentin blocks for 5 days and then exposed to 1% and 2.5% NaOCl alone or combined with 9% HEBP for 3 minutes in the absence and presence of dentin powder. The biovolumes of the biofilm were measured using confocal microscopy and the live/dead technique. The available chlorine and pH of the solutions were also measured. Nonparametric tests were used to determine statistical differences (P < .05). RESULTS The presence of dentin powder resulted in a reduction of the free available chlorine and pH in all the irrigating solutions; 1% NaOCl lost its antimicrobial activity completely in the presence of dentin powder. The antimicrobial activity was significantly reduced in the 2.5% NaOCl and 1% NaOCl/HEBP groups, and it was not affected in the 2.5% NaOCl/HEBP group. CONCLUSIONS The presence of dentin powder significantly decreased the available chlorine and antimicrobial activity of 1% NaOCl, 2.5% NaOCl, and 1% NaOCl/HEBP irrigating solutions. The antimicrobial activity of 2.5% NaOCl/HEBP was not affected by the dentin powder after a 3-minute contact time against E. faecalis biofilms.
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Affiliation(s)
| | - Ana Morago
- Department of Microbiology, School of Dentistry, University of Granada, Spain
| | - Ronald Ordinola-Zapata
- Department of Endodontics, Bauru Dental School, University of São Paulo, São Paulo, Brazil
| | | | | | - Pilar Baca
- Department of Stomatology, School of Dentistry, University of Granada, Spain
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Tanomaru-Filho M, Silveira BRF, Martelo RB, Guerreiro-Tanomaru JM. Influence of Concentration and Agitation of Sodium Hypochlorite and Peracetic Acid Solutions on Tissue Dissolution. J Contemp Dent Pract 2015; 16:876-879. [PMID: 26718295 DOI: 10.5005/jp-journals-10024-1775] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
AIM AND OBJECTIVE To evaluated the tissue dissolution of sodium hypochlorite (NaOCl) and peracetic acid (PA) solutions at different concentrations, with or without ultrasonic agitation. MATERIALS AND METHODS The following solutions were analyzed: 2.5% NaOCl, 0.5, 1 and 2% PA, 1% PA associated with 6.5% hydrogen peroxide (HP) and saline. Fragments of bovine pulp tissue with 25 ± 2g mg were immersed into test tubes containing 4 mL of the solutions for 10 minutes. In the groups with agitation, pulp tissues were submitted to 2 cycles of 1 minute of ultrasonic agitation. The specimens were weighed after the removal from the solutions. The percentage of mass loss was calculated according to the difference of mass before and after exposure to solutions. Data were submitted to ANOVA and Tukey tests (p < 0.05). RESULTS A total of 2.5% NaOCl with or without agitation showed the higher tissue dissolution (between 64.5 and 67% of mass reduction) (p < 0.005). By comparing the PA solutions, the concentrations of 1 and 2% with or without agitation and the concentration of 0.5% with agitation showed similar dissolution activity (between 35.4 and 44% of mass reduction). The use of the ultrasonic agitation promoted an increase of the dissolution ability only for 0.5% PA. CONCLUSION Peracetic acid solution has pulp tissue dissolution. However, this ability is lower than 2.5% NaOCl solution. CLINICAL SIGNIFICANCE The sodium hypochlorite solution shows higher ability to dissolve tissue than PA.
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Affiliation(s)
- Mário Tanomaru-Filho
- Professor, Department of Restorative Dentistry, Araraquara Dental School, Sao Paulo State University, Rua Humaita, 1680 CEP: 14801903, Araraquara, Sao Paulo, Brazil, Phone: +55-16-3301-6390 e-mail:
| | - Bruna Ramos Franco Silveira
- Department of Restorative Dentistry, Araraquara Dental School, Sao Paulo State University, Araraquara, Sao Paulo, Brazil
| | - Roberta Bosso Martelo
- Department of Restorative Dentistry, Araraquara Dental School, Sao Paulo State University, Araraquara, Sao Paulo, Brazil
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del Carpio-Perochena A, Bramante CM, de Andrade FB, Maliza AGA, Cavenago BC, Marciano MA, Amoroso-Silva P, Duarte MH. Antibacterial and dissolution ability of sodium hypochlorite in different pHs on multi-species biofilms. Clin Oral Investig 2015; 19:2067-73. [DOI: 10.1007/s00784-015-1431-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2014] [Accepted: 02/10/2015] [Indexed: 11/29/2022]
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14
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Lee LW, Hsieh SC, Lin YH, Huang CF, Hsiao SH, Hung WC. Comparison of clinical outcomes for 40 necrotic immature permanent incisors treated with calcium hydroxide or mineral trioxide aggregate apexification/apexogenesis. J Formos Med Assoc 2015; 114:139-46. [DOI: 10.1016/j.jfma.2014.06.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Revised: 06/23/2014] [Accepted: 06/23/2014] [Indexed: 01/09/2023] Open
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van der Waal SV, van Dusseldorp NE, de Soet JJ. An Evaluation of the Accuracy of Labeling of Percent Sodium Hypochlorite on Various Commercial and Professional Sources: Is Sodium Hypochlorite from These Sources Equally Suitable for Endodontic Irrigation? J Endod 2014; 40:2049-52. [DOI: 10.1016/j.joen.2014.08.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Revised: 08/05/2014] [Accepted: 08/26/2014] [Indexed: 10/24/2022]
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Similar Influence of Stabilized Alkaline and Neutral Sodium Hypochlorite Solutions on the Fracture Resistance of Root Canal–treated Bovine Teeth. J Endod 2014; 40:1600-3. [DOI: 10.1016/j.joen.2014.02.028] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2013] [Revised: 02/21/2014] [Accepted: 02/25/2014] [Indexed: 11/19/2022]
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Clarkson RM, Smith TK, Kidd BA, Evans GE, Moule AJ. Assessment of residual active chlorine in sodium hypochlorite solutions after dissolution of porcine incisor pulpal tissue. Aust Dent J 2013; 58:428-33. [DOI: 10.1111/adj.12115] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2012] [Revised: 02/22/2013] [Accepted: 03/13/2013] [Indexed: 11/30/2022]
Affiliation(s)
- R M Clarkson
- School of Dentistry, The University of Queensland
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Gjorgievska E, Apostolska S, Dimkov A, Nicholson J, Kaftandzieva A. Incorporation of antimicrobial agents can be used to enhance the antibacterial effect of endodontic sealers. Dent Mater 2013; 29:e29-34. [DOI: 10.1016/j.dental.2012.10.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2012] [Revised: 06/15/2012] [Accepted: 10/02/2012] [Indexed: 10/27/2022]
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Clarkson RM, Kidd B, Evans GE, Moule AJ. The Effect of Surfactant on the Dissolution of Porcine Pulpal Tissue by Sodium Hypochlorite Solutions. J Endod 2012; 38:1257-60. [DOI: 10.1016/j.joen.2012.05.013] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2012] [Revised: 05/12/2012] [Accepted: 05/17/2012] [Indexed: 10/28/2022]
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Jungbluth H, Peters C, Peters O, Sener B, Zehnder M. Physicochemical and Pulp Tissue Dissolution Properties of Some Household Bleach Brands Compared with a Dental Sodium Hypochlorite Solution. J Endod 2012; 38:372-5. [DOI: 10.1016/j.joen.2011.12.013] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2011] [Revised: 12/06/2011] [Accepted: 12/08/2011] [Indexed: 11/28/2022]
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Rossi-Fedele G, Doğramaci EJ, Guastalli AR, Steier L, de Figueiredo JAP. Antagonistic interactions between sodium hypochlorite, chlorhexidine, EDTA, and citric acid. J Endod 2012; 38:426-31. [PMID: 22414823 DOI: 10.1016/j.joen.2012.01.006] [Citation(s) in RCA: 87] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2011] [Revised: 12/29/2011] [Accepted: 01/08/2012] [Indexed: 10/14/2022]
Abstract
INTRODUCTION Root canal irrigants play a significant role in the elimination of microorganisms, tissue dissolution, and the removal of debris and smear layer. No single solution is able to fulfill these actions completely; therefore, their association is required. The aim of this investigation was to review the antagonistic interactions occurring when sodium hypochlorite (NaOCl), chlorhexidine (CHX), EDTA, and citric acid (CA) are used together during endodontic treatment. METHODS A search was performed in the electronic database Medline (articles published through 2011; English language; and the following search terms or combinations: "interaction AND root canal irrigant or endodontic irrigant or sodium hypochlorite or chlorhexidine," "sodium hypochlorite AND EDTA or ethylenediaminetetraacetic acid or citric acid or chelating agent or chlorhexidine," and "chlorhexidine AND EDTA or ethylenediaminetetraacetic acid or citric acid or chelating agent") to identify publications that studied unwanted chemical interactions between NaOCl, CHX, and EDTA and CA. RESULTS The search identified 1,285 publications; 19 fulfilled the inclusion/exclusion criteria of the review. Their research methodology was classified as either in vitro or ex vivo. CONCLUSIONS Antagonistic interactions included the loss of free available chlorine for NaOCl when in contact with chelators, which consequently reduced the tissue dissolution capability and to a lesser extent antimicrobial activities. When CHX and NaOCl are mixed, a precipitate forms that can present detrimental consequences for endodontic treatment, including a risk of discoloration and potential leaching of unidentified chemicals into the periradicular tissues. CHX and EDTA mixtures cause a precipitate, whereas CHX and CA do not exhibit interaction.
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Kuga MC, Gouveia-Jorge É, Tanomaru-Filho M, Guerreiro-Tanomaru JM, Bonetti-Filho I, Faria G. Penetration into dentin of sodium hypochlorite associated with acid solutions. ACTA ACUST UNITED AC 2011; 112:e155-9. [DOI: 10.1016/j.tripleo.2011.05.040] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2011] [Accepted: 05/19/2011] [Indexed: 10/16/2022]
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Dornelles-Morgental R, Guerreiro-Tanomaru JM, de Faria-Júnior NB, Hungaro-Duarte MA, Kuga MC, Tanomaru-Filho M. Antibacterial efficacy of endodontic irrigating solutions and their combinations in root canals contaminated with Enterococcus faecalis. ACTA ACUST UNITED AC 2011; 112:396-400. [DOI: 10.1016/j.tripleo.2011.02.004] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2010] [Accepted: 02/03/2011] [Indexed: 02/03/2023]
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Evaluation of pH, available chlorine content, and antibacterial activity of endodontic irrigants and their combinations against Enterococcus faecalis. ACTA ACUST UNITED AC 2011; 112:132-5. [DOI: 10.1016/j.tripleo.2011.01.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2010] [Revised: 12/05/2010] [Accepted: 01/06/2011] [Indexed: 11/21/2022]
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Rossi-Fedele G, Guastalli AR, Doğramacı EJ, Steier L, De Figueiredo JAP. Influence of pH changes on chlorine-containing endodontic irrigating solutions. Int Endod J 2011; 44:792-9. [DOI: 10.1111/j.1365-2591.2011.01911.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Jungbluth H, Marending M, De-Deus G, Sener B, Zehnder M. Stabilizing Sodium Hypochlorite at High pH: Effects on Soft Tissue and Dentin. J Endod 2011; 37:693-6. [DOI: 10.1016/j.joen.2011.02.019] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2010] [Revised: 01/20/2011] [Accepted: 02/03/2011] [Indexed: 11/25/2022]
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Monteiro-Jardel C, Alves FR. Type III dens invaginatus in a mandibular incisor: a case report of a conventional endodontic treatment. ACTA ACUST UNITED AC 2011; 111:e29-32. [PMID: 21420629 DOI: 10.1016/j.tripleo.2010.11.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2010] [Revised: 11/03/2010] [Accepted: 11/19/2010] [Indexed: 10/18/2022]
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Aubut V, Pommel L, Verhille B, Orsière T, Garcia S, About I, Camps J. Biological properties of a neutralized 2.5% sodium hypochlorite solution. ACTA ACUST UNITED AC 2010; 109:e120-5. [DOI: 10.1016/j.tripleo.2009.09.022] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2009] [Revised: 09/01/2009] [Accepted: 09/10/2009] [Indexed: 11/25/2022]
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