Sodium Hypochlorite Accident: A Systematic Review.

AIM To assess the penetration of sodium hypochlorite (NaOCl) gel or NaOCl solutions with surfactants, and the effect of passive ultrasonic irrigation (PUI) on penetration into dentinal tubules. METHODOLOGY Bovine incisor root canals were instrumented, the roots sectioned and the dentine blocks obtained were stained with crystal violet. Dentine blocks (n = 10 per group) were exposed to 3% NaOCl gel or 3% NaOCl solution for 10 and 20 min. Other dentine blocks (n = 10 per group) were exposed to Chlor-Extra (6% NaOCl + surfactant), 6% NaOCl, 2.5% NaOCl with 0.2% cetrimide and 2.5% NaOCl for 10 and 20 min. The penetration depth of irrigants into dentinal tubules was measured in micrometres by viewing the bleached crystal violet under a stereomicroscope. Additionally, bovine incisor root canals, instrumented and stained with crystal violet, were distributed into two groups (n = 10) and irrigated with 2.5% NaOCl with PUI or conventional syringe irrigation (CSI). The penetration depth of irrigants into dentinal tubules was assessed 3 and 7 mm from the apex. Statistical analysis was performed by ANOVA and Tukey tests (α = 0.05). RESULTS There was significantly greater penetration of 3% NaOCl solution into dentinal tubules compared with the gel form (P   0.05) between 6% NaOCl and Chlor-Extra, and between 2.5% NaOCl and 2.5% NaOCl + cetrimide. PUI significantly increased the penetration depth of NaOCl into dentinal tubules when compared with CSI (P < 0.05). CONCLUSIONS In extracted bovine incisors, NaOCl gel penetrated less into dentinal tubules than NaOCl solution. The addition of surfactants did not increase the penetration depth. The use of PUI significantly increased NaOCl penetration into dentinal tubules.

Penetration of sodium hypochlorite into root canal dentine: effect of surfactants, gel form and passive ultrasonic irrigation

Aim
To evaluate the cytotoxicity and the mechanism of cell aggression of peracetic acid (PA) in comparison with sodium hypochlorite (NaOCl).

Methodology
L929 fibroblasts were exposed to 1% PA and 2.5% NaOCl, in different dilutions for 10 minutes. The following parameters were evaluated: cell metabolism by methylthiazol tetrazolium assay (MTT), external morphology by scanning electron microscopy, ultrastructure by transmission electron microscopy, the cytoskeleton by means of actin and α-tubulin labeling, and the type of cell death by flow cytometry (apoptosis/necrosis). The data were analyzed by two-way ANOVA and the Bonferroni post-test (α=0.05).

Results
The PA group had lower cell viability and a higher percentage of necrotic cells than the NaOCl group (P < 0.05). Both solutions diminished cell metabolism, led to destructuring of the cytoskeleton, created changes in the external morphology, resulted in the accumulation of proteins in the rough endoplasmic reticulum, and induced cell death predominantly by necrosis. However, these changes were observed in lower doses of PA when compared with NaOCl.

Conclusions
Although they had the same mechanism of cytotoxicity, 1% PA had greater cytotoxic potential than 2.5% NaOCl.

This article is protected by copyright. All rights reserved

https://onlinelibrary.wiley.com/doi/pdf/10.1111/iej.12750

Cytotoxicity of peracetic acid: evaluation of effects on metabolism, structure and cell death.

Activity of sol-gel derived nanocrystalline WO3 films in photoelectrochemical generation of reactive chlorine species

Accidental Extrusion of Sodium Hypochlorite in a Patient Taking Alendronate: A Case Report With an 8-Year Follow-up.

Sodium hypochlorite (NaOCl) is the most common irrigant used in modern endodontics. It is highly effective at dissolving organic debris and disinfecting the root canal system due to the high pH. Extravasation of NaOCl into intra-oral and extra-oral tissues can lead to devastating outcomes leading to long-term functional and aesthetic deficits. Currently no clear guidelines are available which has caused confusion among the dental and oral and maxillofacial (OMFS) surgical community how best to manage these patients. Following a literature review and considering our own experience we have formulated clear and precise guidelines to manage patients with NaOCl injury.

/pdf/guidelines-for-management-of-sodium-hypochlorite-extrusion-1hqjmjz2yz.pdf

Guidelines for management of sodium hypochlorite extrusion injuries

Corrigendum. Practice article (BDJ 2014; 217: 679-684). Guidelines for management of sodium hypochlorite extrusion injuries.

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Guidelines for management of sodium hypochlorite extrusion injuries

Corrigendum. Practice article (BDJ 2014; 217: 679-684). Guidelines for management of sodium hypochlorite extrusion injuries.