Evaluation of the apical extrusion of sodium hypochlorite gel in immature permanent teeth: An in vitro study

Nesser, Salma Fuad Al; Bshara, Nada

doi:10.17219/dmp/103911

Cited by 12 publications

(15 citation statements)

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“…NaOCl gel has been suggested as an alternative endodontic irrigant because theoretically it has the same antimicrobial action of NaOCl solution, but with less apical extrusion and could thus be safer ( Nesser & Bshara, 2019 ). It is effective in reducing the microbial load, but has been shown to be less effective when compared to NaOCl solution of a lower concentration ( Poggio et al ., 2010 ; Zand et al ., 2016 ).…”

Section: Discussionmentioning

confidence: 99%

“…NaOCl is a cytotoxic substance ( Salazar-Mercado et al ., 2019 ); overflow during endodontic treatment can cause diverse exacerbations ( Goswami et al ., 2014 ). Thus, NaOCl gel may be safer due to its minor apical extrusion tendency ( Nesser & Bshara, 2019 ). Passive ultrasonic irrigation (PUI) improves RCS disinfection ( Plotino et al ., 2007 ), removing the smear layer and vapor lock during endodontic treatment ( Bueno et al ., 2019 ; Dioguardi et al ., 2019 ), and permits greater penetration of irrigants to the dentinal tubules ( Sáinz-Pardo et al ., 2014 ).…”

Section: Introductionmentioning

confidence: 99%

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Effect of sodium hypochlorite solution and gel with/without passive ultrasonic irrigation on Enterococcus faecalis, Escherichia coli and their endotoxins

et al. 2020

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Background: Sodium hypochlorite (NaOCl) is the most commonly used irrigant in endodontics. The purpose of this study was to evaluate the effect of NaOCl solution (2.5%) and gel (3%) with/without passive ultrasonic irrigation (PUI) on Enterococcus faecalis, Escherichia coli, and their endotoxins, lipopolysaccharide (LPS) and lipoteichoic acid (LTA). Methods: 40 human lower premolars were contaminated with E. coli (ATCC 25922) for 28 days and E. faecalis (ATCC 29212) for 21 days. Specimens were randomly divided into four groups: (1) 2.5% NaOCl irrigating the canals without PUI activation; (2) 2.5% NaOCl with PUI; (3) 3% NaOCl gel irrigating the canals without PUI; and (4) 3% NaOCl gel with PUI. 40 mL of irrigant was used for each group. PUI activation was carried out using E1-Irrisonic stainless-steel tip at 10% frequency. After treatment, all specimens were filled with 3mL of 17% ethylenediaminetetraacetic acid (EDTA) for 3min and then washed with nonpyrogenic saline solution. Three samples were collected from the canals: S1, at baseline to confirm biofilm formation; S2 after treatment; and S3 after EDTA. Samples were assessed for E. coli and E. faecalis colony forming units, and LPS and LTA were assessed using chromogenic kinetic LAL assay and ELISA, respectively. Data were analyzed by Kruskal-Wallis, Friedmann and Dunn tests with α≤0.05. Results: All groups were effective in reducing the microbial load of E. coli and E. faecalis after treatment without a significant difference among the groups. NaOCl and NaOCl gel groups had no significant difference in reducing LPS and LTA. Statistically increased reduction was seen for NaOCL + PUI and NaOCl gel + PUI compared for groups without PUI. Conclusions: NaOCl gel has the same antimicrobial action of NaOCl solution and can partially detoxify endotoxins. PUI improves NaOCl (gel or solution) action over E. faecalis and E. coli and their endotoxins.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effect of sodium hypochlorite solution and gel with/without passive ultrasonic irrigation on Enterococcus faecalis, Escherichia coli and their endotoxins

et al. 2020

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“…However, this solution is highly toxic at high concentrations if it is extruded apically [ 46 ]. The use of of NaOCl gel as an irrigating solution was suggested by some authors to overcome the problem of apical extrusion of its solution form [ 19 , 20 ]. To the best of our knowledge, no dental company produced NaOCl gel as a root canal medicament.…”

Section: Discussionmentioning

confidence: 99%

“…However, when apically extruded, this solution causes significant tissue toxicity [ 18 ]. As a result, using NaOCl in a gel form reduces the risk of apical extrusion and the unfavorable consequences of the solution form [ 19 , 20 ]. Sodium hypochlorite (NaOCl) gel is currently available under the name of bleaching pen (Clorox Bleach Pen, USA) to clean precisely the dirty white clothes.…”

Section: Introductionmentioning

confidence: 99%

Comparing the Antifungal Effect of Sodium Hypochlorite Gel versus Different Types of Root Canal Medicaments at Different Time Intervals Using the Agar Diffusion Test: An In Vitro Study

Sayed

Ghanerad

Shabanpour

et al. 2021

International Journal of Dentistry

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Aims. The purpose of this study was to compare the antifungal activity of sodium hypochlorite gel to those of four intracanal medicaments at various time intervals. Materials and Methods. The agar well diffusion technique was utilized to test the antifungal activity of the following medicaments against Candida albinans (C. albicans): sodium hypochlorite gel, chlorhexidine gel, calcium hydroxide paste, Ledermix, and Diapex Plus. The inhibition zone related to each medicine was measured in millimeter after 24, 48, and 72 hours of incubation at 37°C. The data were analyzed using one-way ANOVA and Games–Howell tests, at a significance level of P < 0.05 . Results. Except for Ledermix and Diapex Plus, which had no antifungal action, all of the medicaments showed varied inhibitory zones for C. albicans. At all periods, the NaOCl gel had the most significant inhibition zones, followed by the CHX gel and calcium hydroxide. At all time intervals, the NaOCl gel demonstrated comparable antifungal efficacy. When compared to a 24-hour time interval, the CHX gel showed an increased antifungal activity at the 48-hour and 72-hour intervals. Calcium hydroxide, on the other hand, showed a decrease in its antifungal activity at the 72-hour interval. Conclusion. The antifungal activity of sodium hypochlorite gel was the highest among the investigated medicaments. Chlorhexidine gel's antifungal activity improved over time, whereas calcium hydroxide's antifungal activity declined. Diapex Plus and Ledermix did not have any antifungal properties.

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“…Zand et al suggested that the adverse effects of sodium hypochlorite solution can be prevented by using NaOCl gel [9]. In addition, NaOCl solution cannot be used as an irrigant in immature teeth, thus gel form was a safe alternative for immature teeth irrigation with an open apex up to 2.5 mm [16]. Furthermore, gel form demonstrated better behavior than solution form on deciduous molars dentin [17].…”

mentioning

confidence: 99%

Comparative evaluation of apical extrusion of sodium hypochlorite gel and solution in primary molars using two different instrumentation techniques: an in-vitro study

Karkoutly¹,

Bshara²

2022

jos

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Introduction: Sodium hypochlorite solution apical extrusion leads to life-threatening sequelae. Gel-type has been suggested as a safer alternative during intra-canal irrigation due to its' higher viscosity. Objectives: To compare the apical extrusion of three sodium hypochlorite viscosities in primary molars prepared with two different instrumentation techniques. Material and methods: This was an in-vitro crossover study. Sixty human primary molar roots were divided into two groups (n = 30), depending on physiological root resorption, and each group was further divided into two sub-groups (n = 15) based on instrumentation technique. Manual instruments (K-file) and rotary files (ProTaper) were used for root canal instrumentation. Each group was irrigated with 5 ml of sodium hypochlorite solution and two different viscosities of sodium hypochlorite gel after preparation. The extruded volume was collected and calculated using Myers and Montgomery model. Statistical analysis was performed by applying Kolmogorov-Smirnov test and Kruskal-Wallis test. Results: A statistically significant difference was found between sodium hypochlorite solution and gel in manual instrumentation groups. No statistically significant difference was observed between the extruded volumes in the rotary instrumentation groups. Conclusions: Sodium hypochlorite gel is a safer alternative for primary molars prepared by stainless steel K-file. Preparation technique used in primary molars affects extruded irrigant volume more compared with physiologic root resorption.

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Evaluation of the apical extrusion of sodium hypochlorite gel in immature permanent teeth: An in vitro study

Abstract: , which deserves a great appreciation for all academic and financial support.

Cited by 12 publications

References 12 publications

Effect of sodium hypochlorite solution and gel with/without passive ultrasonic irrigation on Enterococcus faecalis, Escherichia coli and their endotoxins

Effect of sodium hypochlorite solution and gel with/without passive ultrasonic irrigation on Enterococcus faecalis, Escherichia coli and their endotoxins

Comparing the Antifungal Effect of Sodium Hypochlorite Gel versus Different Types of Root Canal Medicaments at Different Time Intervals Using the Agar Diffusion Test: An In Vitro Study

Comparative evaluation of apical extrusion of sodium hypochlorite gel and solution in primary molars using two different instrumentation techniques: an in-vitro study

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