Effect of Irrigation Time of Antiseptic Solutions on Bone Cell Viability and Growth Factor Release

Abstract

Antiseptic solutions are commonly utilized to treat local infection in the oral and maxillofacial region. However, surrounding vital bone is also exposed to antiseptic agents during irrigation and may have a potential negative impact on bone survival. The aim of the present study was therefore to investigate the effect of rinsing time with various antiseptic solutions on bone cell viability, as well as their subsequent release of growth factors important for bone regeneration. The bone samples collected from porcine mandible were rinsed in the following commonly utilized antiseptic solutions; povidone-iodine (0.5%), chlorhexidine digluconate (CHX, 0.2%), hydrogen peroxide (1%), and sodium hypochlorite (0.25%) for 1, 5, 10, 20, 30, or 60 minutes and assessed for cell viability and release of growth factors including vascular endothelial growth factor, transforming growth factor beta 1, bone morphogenetic protein 2, receptor activator of nuclear factor kappa-B ligand, and interleukin-1 beta by enzyme-linked immunosorbent assay. It was found in all the tested groups that the long exposure of any of the tested antiseptic solutions drastically promoted higher cell death. Sodium hypochlorite demonstrated the significantly highest cell death and at all time points. Interestingly, bone cell viability was highest in the CHX group post short-term rinsing of 1, 5, or 10 minutes when compared with the other 4 tested groups. A similar trend was also observed in subsequent growth factor release. The present study demonstrated that of the 4 tested antiseptic solutions, short-term CHX rinsing (ideally within 1 minute) favored bone cell viability and growth factor release. Clinical protocols should be adapted accordingly.

Cytotoxicity and Gene Expression Changes of a Novel Homeopathic Antiseptic Oral Rinse in Comparison to Chlorhexidine in Gingival Fibroblasts

“…Previously, our research team investigated four commonly utilized antiseptic solutions, including (1) povidone-iodine (PI, 0.5%), (2) CHX (0.2%), (3) hydrogen peroxide (H 2 O 2 , 1%), and (4) sodium hypochlorite (HYP, 0.25%) on bone chip cell viability and growth factor release of VEGF, TGFB1, BMP2, RANKL, and IL1β [ 20 ]. It was actually reported following antiseptic rinsing that the CHX-rinsed bone chips demonstrated the highest cellular viability between all the antiseptic solutions however nearly 50% of the cells underwent dead [ 20 , 21 ].…”

Cytotoxic effect of sodium hypochlorite (Lavanox 0.08%) and chlorhexidine gluconate (Irrisept 0.05%) on human osteoblasts

“…These effects seem to be concentration dependent according to the data of Kozol et al, who investigated neutrophil, fibroblast and endothelial cell viability after treatment with 0.025-0.0025% NaOCl for an exposure time of 30 min and reported cytoplasmic vacuolation, swollen mitochondria and dilated endoplasmic reticulum in fibroblasts and endothelial cells, but no cell deaths [14]. Sawada et al showed a decrease in viable cells after 10-min rinsing with 0.25% NaOCl [11]. Vouzara et al reported a cytotoxic effect of NaOCl on MRC5 cells (human lung fibroblasts) [12] and Hidalgo et al on dermal fibroblasts, depending on concentration and exposure time [10].…”

“…Comparing CHG to NaOCl, Sawada et al reported a higher cytotoxic effect of NaOCl than CHG after investigating antiseptic solution in dentistry bone samples. They showed higher cell viability after rinsing with 0.2% CHG than 0.25% NaOCl for different exposure times [4,11]. On the other hand, Vouzara et al reported a higher cytotoxic effect of CHG than NaOCl on MRC5 cell samples at different concentrations of the solutions after 6 and 24 h [12].…”

“…The microbicidal effect of both antiseptic solutions has been investigated extensively [4,7,8]. A cytotoxic time-dependent effect on fibroblasts (e.g., dermal and lung fibroblasts) in higher concentrations has also been described for both solutions [9][10][11][12][13][14][15].…”

“…To prevent tissue damage in our setting, the exposure time is limited to a few minutes, followed by irrigation with saline solution [16,17], although most investigations about the bactericidal effect were performed using longer exposure times [4,[6][7][8][9][10][11][12]18]. Nonetheless, there is a lack of knowledge about the effect of industrially solutions like Lavanox® or Irrisept® on osteoblasts, even after a shorter exposure time of just a few minutes.…”