2012, Number 4
<< Back Next >>
Rev Odont Mex 2012; 16 (4)
Use of sodium hypochlorite in root canal irrigation. Opinion survey and concentration in commercial products
Cárdenas-Bahena Á, Sánchez-García S, Tinajero-Morales C, González-Rodríguez VM, Baires-Várguez L
Language: Spanish
References: 38
Page: 252-258
PDF size: 141.65 Kb.
ABSTRACT
Objective: To determine hypochlorite concentration of solutions used for root canal irrigation and compare them with concentrations deemed as «ideal» in scientific literature (5.25 and 2.5% (w/v)).
Methods: Opinion survey among endodontic specialists to ascertain sodium hypochlorite commercial brand most used in root canals irrigation. Iodometric titration to determine solution concentrations. Clorox Regular Bleach (Oakland, California) commercial brand most referred to in literature. Mean comparison of different commercial brands and lots. Concentrations deemed ideal 5.25 and 2.5% (w/v).
Results: Commercial brands of sodium hypochlorite most used by 192 endodontic specialists were as follows: Cloralex (43.2%), Concentrated Clorox (30.2%), Viarzoni-t (16.7%), Great Value (1.0%), «Los Patitos» (0.5%) and other brands (8.3%). Concentration (mean IC 95%) of Clorox Regular Bleach (6.34%, 6.32-6.36) Concentrated Clorox (5.43%, 5.42-5.45), Cloralex (5.40%, 5.38-5.41), Great Value (6.21% 6.19-6.23) and «Los Patitos» ( 5.82%, 5.80-5.83) exceeded a 5.25% sodium hypochlorite concentration. Viarzone-T (2.86%, 2.85-2.87) rated above the 2.5% hypochlorite concentration. There were statistically significant differences (p ≤ 0.001) among averages of different commercial brands and lots, with respect to concentrations deemed as ideal (5.25 and 2.5% (w/v).
Conclusion: Hypochlorite concentrations in commonly used commercial products are not the concentration recommended in scientific literature (5.25 w/v and 2.5% w/v). This can cause tissue damage in cases when hypochlorite solutions are improperly used without field isolation.
REFERENCES
Clarkson RM, Moule AJ. Sodium hypochlorite and its use as an endodontic irrigant. Aust Dent J 1998; 43: 250-256.
Rutala WA, Cole EC, Thomann CA et al. Stability and bactericidal activity of chlorine solutions. Infect Control Hosp Epidemiol 1998; 19: 323-327.
Rutala WA, Weber DJ. Uses of inorganic hypochlorite (bleach) in health care facilities. Clin Microbiol Rev 1997; 10: 597-610.
Best M, Springthorpe VS, Sattar SA. Feasibility of a combined carrier test for disinfectants: studies with a mixture of five types of microorganisms. Am J Infect Control 1994; 22: 152-162.
Piskin B, Turkun M. Stability of various sodium hypochlorite solutions. J Endodon 1995; 21: 253-255.
Glossary: American Association of Endodontics. Contemporary terminology for endodontics. 6th ed. Chicago, 1998.
Dakin HD. On the use of certain antiseptic substances in the treatment of infected wounds. Br Med J 1925a; 2: 318-320.
Dakin HD. The antiseptic action of hypochlorites: the ancient history of the “new antiseptic”. Br Med J 1915b; 2: 809-810.
Barret MT. The Dakin-carrel antiseptic solution. Dent Cosmos 1917; 59: 446-448.
Coolidge ED. The diagnosis and treatment of conditions from diseased dental pulps. J Ame Dent Assoc 1919; 6: 337-349.
Coolidge ED. Studies of germicides for the treatment of root canals. J Ame Dent Assoc 1929; 16: 698-712.
Walker A. A definite and dependable therapy for pulpless teeth. J Ame Dent Assoc 1936; 23: 1418-1425.
Lewis PR. Sodium hypochlorite in root canal therapy. Journal of the Florida Dental Society 1954; 24: 10-11.
Shih M, Marshall FJ, Rosen S. The bactericidal efficiency of sodium hypochlorite as an endodontic irrigant. Oral Surg Oral Med Oral Pathol 1970; 29: 613-619.
Trepagnier CM, Madden RM, Lazzari EP. Quantitative study of sodium hypochlorite as an in vitro endodontic irrigant. J Endod 1977; 3: 194-196.
Byström A, Sundqvist G. The antibacterial action of sodium hypochlorite and EDTA in 60 cases of endodontic therapy. Int Endod J. 1985; 18: 35-40.
Siqueira JF Jr, Rôças IN, Favieri A, Lima KC. Chemomechanical reduction of the bactericidal population in the root canal after instrumentation and irrigation with 1, 2.5, and 5.25% sodium hypochlorite. J Endod 2000; 26: 331-333.
Harrison JW, Wagner GW, Henry CA. Comparison of the antimicrobiol effectiveness of regular and fresh scent Clorox. J Endod 1990; 16: 328-330.
Norma Mexicana NMX-K-620-NORMEX-2008, Productos de aseo-desinfectante y blanqueador liquido concentrado, formulado con hipoclorito de sodio a una concentración del 6.0% de cloro activo-especificaciones y métodos de prueba. Diario Oficial de la Federación (México), 02 de abril de 2009.
USP31–NF26 Page 3251 Pharmacopeial Forum: Volume No. 28 (2) Page 366.
Hand RE, Smith ML, Harrison JW. Analysis on the necrotic tissue dissolution property of sodium hypochlorite. Journal of Endodontics 1978; 4: 60-64.
Cunningham WT, Balekjian A. Effect of temperature on collagen-dissolving ability of sodium hypochlorite endodontic irrigant. Oral Surgery, Oral Medicine and Oral Pathology 1980; 49: 175-177.
Moorer WR, Wesselink PR. Factors promoting the tissue dissolving capability of sodium hypochlorite. Int Endo Jour 1982; 15: 187-196.
Norma Oficial Mexicana NOM-189-SSA1/SCFI-2002, Productos y servicios. Etiquetado y envasado para productos de aseo de uso doméstico. Diario Oficial de la Federación (México), 2 de diciembre de 2002.
Norma Mexicana NMX-K-621-NORMEX-2008, Productos de aseo-blanqueador líquido concentrado, formulado con hipoclorito de sodio a una concentración de 13.0% de cloro activo-especificaciones y métodos de prueba. Diario Oficial de la Federación (México), 02 de abril de 2009.
Radcliffe CE, Potouridou L, Qureshi R, Habahbeh N, Qualtrough A, Worthington H, Drucker DB. Antimicrobial activity of varying concentrations of sodium hypochlorite on the endodontic microorganisms Actinomyces israelii, A. naeslundii, Candida albicans and Enterococcus faecalis. Int Endod J 2004; 37: 438-446.
Izu KH, Thomas SJ, Zhang P, Izu E, Michalek S. Effectiveness of sodium hypochlorite in preventing inoculation of periapical tissues with contaminated patency files. J Endod 2004; 30: 92-94.
Weber CD, McClanahan SB, Miller GA, Diener-West M, Johnson JD. The effect of passive ultrasonic activation of 2 chlorhexidine or 5.25% sodium hypochlorite irrigant on residual antimicrobial activity in root canals. J Endod 2003; 29: 562-564.
Ercan E, Özekinci T, Atakul F, Gül K. Antibacterial activity of 2% chlorhexidine gluconate and 5.25% sodium hypochlorite in infected root canal: in vivo study. J Endod 2004; 30: 84-87.
Shabahang S, Pouresmail M, Torabinejad M. In vitro antimicrobial efficacy of MTAD and sodium hypochlorite. J Endod 2003; 29: 450-452.
Berber VB, Gomes BPFA, Sena NT, Vianna ME, Ferraz CCR, Zaia AA, Souza-Filho FJ. Efficacy of various concentrations of NaOCl and instrumentation techniques in reducing Enterococcus faecalis within root canals and dentinal tubules. Int Endod Jour 2006; 39: 10-17.
Vianna ME, Gomes BPFA, Berber VB, Zaia AA, Ferraz CCR, Souza-Filho FJ. In vitro evaluation of antimicrobial activity of chlorhexidine and sodium hypochlorite. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2004; 97: 79-84.
Torabinejad M, Cho Y, Khademi AA, Bakland LF, Shabahang S. The effect of various concentrations of sodium hypochlorite on the ability on MTAD to remove the smear layer. J Endod 2003; 29: 233-239.
Koshinen KP, Stenvall H. Uitto V. Dissolution of bovine pulp tissue by endodontic solutions. Scandinavian Journal of Dental Research 1980; 88: 406-411.
Guerisoli DMZ, Sousa Neto MD, Pécora JD. Ação do hipoclorito de sódio em diversas concentrações sobre a estrutura dentinária. Rev Odont UNAERP1998; 1: 7-11.
Spangberg L, Engström B, Langeland K. Biologic effects of dental materials toxicity and antimicrobial effect of endodontic antiseptics in vitro. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1973; 36: 856-871.
Yuan-Ling NG, Spratt D, Sriskantharajah S, Gualabivala K. Evaluation of protocols for field decontamination before bacterial sampling of root canals for contemporany microbiology techniques. J Endod. 2003; 29: 317-20.
Calcium Hypochlorite (CaCl2O2)/sodium hypochlorite (NaOCl) http://www.atsdr.cdc.gov/MHMI/mmg184.pdf (revisado 22 de abril del 2010).