Sodium hypochlorite in endodontics: an update review

Abstract

The major objective in root canal treatment is to disinfect the entire root canal system. This requires that the pulpal contents be eliminated as sources of infection. This goal may be accomplished using mechanical instrumentation and chemical irrigation, in conjunction with medication of the root canal between treatment sessions. Microorganisms and their by-products are considered to be the major cause of pulpal and periradicular pathosis. In order to reduce or eliminate bacteria and pulpal tissue remnants, various irrigation solutions have been suggested to be used during treatment. Sodium hypochlorite, an excellent non-specific proteolytic and antimicrobial agent, is the most common irrigation solution used during root canal therapy. The purpose of this paper was to review different aspects of sodium hypochlorite use in endodontics.

Bovine Pulp Tissue Dissolution Ability of Irrigants Associated or Not to Ultrasonic Agitation

“…Sodium hypochlorite is used worldwide as the main endodontic irrigant, in concentrations ranging from 0.5% to 6% due to its antimicrobial and tissue-dissolving properties (2). An increase in NaOCl concentration may facilitate pulp tissue dissolution (3), but at the same time, it increases the cytotoxic effect (2,17).…”

“…It has been shown that NaOCl solutions with higher concentration dissolve more easily vital and necrotic remnants of pulp, but at the same time, increase the risk of damage to the periradicular tissues and oral mucosa (2,3).…”

“…An endodontic irrigating solution must have four main properties: antimicrobial activity, water solubility, low toxicity to periradicular tissues and tissue dissolution ability (2). Sodium hypochlorite (NaOCl) is the most commonly used root canal irrigant, since it is able to kill a wide range of pathogens and dissolve pulp tissue (1,2).…”

“…Sodium hypochlorite (NaOCl) is the most commonly used root canal irrigant, since it is able to kill a wide range of pathogens and dissolve pulp tissue (1,2).…”

In-vitro activity of sodium-hypochlorite gel on bacteria associated with periodontitis

“…Already in 1918 it was published that sodium hypochlorite has a higher dissolving effect on necrotic tissue than on vital one [10]. However its use on everyday basis in dentistry is known basically in endodontics as one of the main canal irrigants [11]. Activity of sodium hypochlorite is depending on pH.…”