The clinical toxicology of sodium hypochlorite

Slaughter, Robin J; Watts, Martin; Vale, J. A.; Grieve, Jacob R; Schep, Leo J.

doi:10.1080/15563650.2018.1543889

Cited by 138 publications

(102 citation statements)

References 94 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, these indications should be evaluated with caution. Firstly, if an adequate irrigation technique is used, the toxicity of NaOCl is controlled, even in adverse clinical conditions with higher chances of contact with periapical tissues (Zehnder , Slaughter et al ). Furthermore, other auxiliary chemical substances with lower cytotoxicity could be used for this reason, such as CHX, which has more evidence supporting its use than ozone (Ferraz et al , Gomes & Herrera , Neelakantan et al ).…”

Section: Discussionmentioning

confidence: 99%

The effect of ozone therapy in root canal disinfection: a systematic review

et al. 2019

View full text Add to dashboard Cite

Aim To answer the following focused question: ‘As regards microorganism load reduction for patients undergoing root canal treatment, is the use of ozone therapy comparable to conventional chemomechanical techniques using sodium hypochlorite (NaOCl)?’ Data sources A systematic review was conducted using controlled vocabulary and free‐text key words in the following databases: PubMed, Science Direct, Scopus, Web of Science and Open Grey until 2 November 2018. Additional studies were sought through hand searching of endodontic journals. Study eligibility criteria, participants and interventions The inclusion criteria comprised studies that compared microbial reduction in root canals after treatments with ozone and NaOCl in extracted mature human teeth or randomized clinical trials. Study appraisal and synthesis methods The quality assessment of included laboratory studies was performed with the following parameters: (i) sample size calculation, (ii) samples with similar dimensions, (iii) control group, (iv) standardization of procedures, (v) statistical analysis and (vi) other risk of bias. For randomized clinical trials, the qualitative analysis of the studies was performed from the bias risk assessment using the tool ‘Bias Risk Assessment of Randomized Controlled Studies’ Cochrane Handbook 5.0.2. Results The search resulted in 180 published studies. After removal of duplicate studies and full‐text analysis, eight studies were selected and seven were considered low risk of bias (seven ex vivo studies and one random clinical trial). Overall, the results demonstrated that ozone therapy provides significantly less microbial load reduction than NaOCl. As an adjunct in chemomechanical preparation, ozone was ineffective in increasing the antimicrobial effect of NaOCl. Ozone performance was strongly associated with the application protocol used: it is dose, time and bacterial strain dependent, besides the correlation with the use of complementary disinfection sources. Limitations A restricted number of randomized clinical trial was found, and the difference amongst the methodology of the studies did not allow a meta‐analysis to be performed. Conclusions and implications of key findings Although the selected studies had limitations, this review reached a satisfactory methodological and moderate evidence quality contributing to important preliminary information regarding ozone therapy. As regards load reduction of microorganisms for patients undergoing root canal treatment, ozone is not indicated neither to replace nor to complement the antimicrobial action of NaOCl.

show abstract

Section: Discussionmentioning

confidence: 99%

The effect of ozone therapy in root canal disinfection: a systematic review

et al. 2019

View full text Add to dashboard Cite

show abstract

“…In this context, the toxicity of NaOCl solutions varies with the concentration of NaOCl, in which a 0.1% NaOCl solution is the recommended concentration [ 38 ]. However, high concentrations of this disinfection agent can corrode mucous membranes (e.g., mouth, stomach, and respiratory tract), cause skin irritation, damage, and burn, gastrointestinal injury, and corneal epithelium burns [ 42 ]. Moreover, the dramatic increase in the use of disinfectants, including NaOCl and HOCl, due to the current pandemic, suggests an increase in resistance of bacteria present in the everyday human environment to these disinfectants.…”

Section: Hypochlorous Acid a Widely Used Disinfectantmentioning

confidence: 99%

Surviving Reactive Chlorine Stress: Responses of Gram-Negative Bacteria to Hypochlorous Acid

2020

View full text Add to dashboard Cite

Sodium hypochlorite (NaOCl) and its active ingredient, hypochlorous acid (HOCl), are the most commonly used chlorine-based disinfectants. HOCl is a fast-acting and potent antimicrobial agent that interacts with several biomolecules, such as sulfur-containing amino acids, lipids, nucleic acids, and membrane components, causing severe cellular damage. It is also produced by the immune system as a first-line of defense against invading pathogens. In this review, we summarize the adaptive responses of Gram-negative bacteria to HOCl-induced stress and highlight the role of chaperone holdases (Hsp33, RidA, Cnox, and polyP) as an immediate response to HOCl stress. We also describe the three identified transcriptional regulators (HypT, RclR, and NemR) that specifically respond to HOCl. Besides the activation of chaperones and transcriptional regulators, the formation of biofilms has been described as an important adaptive response to several stressors, including HOCl. Although the knowledge on the molecular mechanisms involved in HOCl biofilm stimulation is limited, studies have shown that HOCl induces the formation of biofilms by causing conformational changes in membrane properties, overproducing the extracellular polymeric substance (EPS) matrix, and increasing the intracellular concentration of cyclic-di-GMP. In addition, acquisition and expression of antibiotic resistance genes, secretion of virulence factors and induction of the viable but nonculturable (VBNC) state has also been described as an adaptive response to HOCl. In general, the knowledge of how bacteria respond to HOCl stress has increased over time; however, the molecular mechanisms involved in this stress response is still in its infancy. A better understanding of these mechanisms could help understand host-pathogen interactions and target specific genes and molecules to control bacterial spread and colonization.

show abstract

“…24 However, if the prosthesis is not well rinsed, its intake can produce side effects such as nausea and vomiting. 25 When using 0.12% chlorhexidine, 0.5% sodium hypochlorite and 100000UI nystatin, complete inhibition of Candida albicans growth on Sabouraud agar surface is observed, presenting a statistically significant difference in the reduction in the growth of Candida albicans with respect to the control group.…”

Section: Discussionmentioning

confidence: 96%

Efficacy of copper sulphate on Candida albicans on heat-polymerized acrylic resin

et al. 2020

View full text Add to dashboard Cite

The ageing of population is increasing, and a great percentage of these patients wear removable prostheses, and can suffer denture stomatitis, a condition that has been associated with candidiasis. Aims: To evaluate in vitro the effectiveness of Copper Sulfate against Candida albicans in samples of heat-polymerized acrylic resin, compared to nystatin, sodium hypochlorite and chlorhexidine. Materials and Methods: Initially, the minimum inhibitory concentration (MIC) of copper sulfate for Candida albicans was determined by microdilution. Then, 54 resin samples were divided into 6 treatment groups corresponding to Nystatin 100.000 UI, Sodium Hypochlorite 0.5%, chlorhexidine 0.12%, Copper Sulfate 4.7µg/ml, Copper Sulfate 9.4µg/ml and physiological saline solution, in which samples were submerged for 6 hours. Resin samples were then washed and cultured on solid media at 37°C for 72 hours. The number of colony-forming units was determined using a Quebec colony counter. The statistical analysis was performed using the Kruskal-Wallis test and the Mann-Whitney U test. Results: Copper sulfate at a concentration of 9.4μg/ml presented a similar effectiveness as the other control products regarding the reduction in the number of colonies of Candida albicans post-treatment. Conclusion: The effectiveness of copper sulfate against Candida albicans on acrylic resin was similar to that of nystatin, sodium hypochlorite and chlorhexidine.Abstract: En las últimas décadas se ha observado un aumento de la población de adultos mayores, de los cuales un gran porcentaje es portador de prótesis removible, y dos tercios pueden sufrir estomatitis subprotésica, enfermedad que es asociada a infecciones como candidiasis. Objetivo: Evaluar la efectividad antimicótica in vitro del sulfato de cobre en placas de resinas acrílicas de termocurado inoculadas con Candida albicans, frente a Nistatina, Hipoclorito de Sodio y Clorhexidina. Material y Métodos: Inicialmente, y mediante microdilución del sulfato de cobre, se determinó la concentración mínima inhibitoria (CMI) para Candida albicans. En la fase experimental, 54 muestras de resina se dividieron en 6 grupos correspondientes a Nistatina 100.000 UI, Hipoclorito 0.5%, Clorhexidina 0.12%, Sulfato de Cu 4.7µg/ml, Sufato de Cu 9.4 µg/ml y suero fisiológico. Las muestras fueron sumergidas en estos agentes por 6 horas, para posteriormente ser lavadas y cultivada en medios solidos a 37°C por 72 horas. Luego se realizó el conteo de unidades formadoras de colonias mediante contador tipo Quebec. El análisis estadístico se realizó mediante la prueba de Kruskal-Wallis y la prueba U de Mann-Whitney. Resultado: El sulfato de cobre a una concentración de 9.4μg/

show abstract

The clinical toxicology of sodium hypochlorite

Cited by 138 publications

References 94 publications

The effect of ozone therapy in root canal disinfection: a systematic review

The effect of ozone therapy in root canal disinfection: a systematic review

Surviving Reactive Chlorine Stress: Responses of Gram-Negative Bacteria to Hypochlorous Acid

Efficacy of copper sulphate on Candida albicans on heat-polymerized acrylic resin

Contact Info

Product

Resources

About