Evaluation of Sodium Dichloroisocyanurate as a root canal irrigation solution; Cl-concentration, pH, Cytotoxicity and Antimicrobial effect in vitro

Abstract

【The purpose of this study was to evaluate the clinical applications of the Sodium Dichloroisocyanurate effervescent tablet as a routine root canal irrigant by performing several in vitro tests such as $Cl^{-}$ content. cytotoxicity. antimicrobial effect as well as its pH level compared to the equivalent concentration of sodium hypochlorite solution. 1. Sodium Dichloroisocyanurate demonstrated lower level of $Cl^{-}$ concentration than each dilution of sodium hypochlorite solution. Both solution has increased level of $Cl^{-}$ as the concentration of each solution increased. There was no significant change of $Cl^{-}$ concentration in sodium hypochlorite as time goes by. However. $Cl^{-}$ concentration in Sodium Dichloroisocyanurate was increased. 2. The antimicrobial effects of both solutions were increased when their concentrations were increased. One day after dilution. antimicrobial effect of Sodium Dichloroisocyanurate was slightly higher than sodium hypochlorite. however. there was no difference in 1 week dilution solution. One month dilution solution of sodium hypochlorite still retain its activity. but antimicrobial effect of Sodium Dichloroisocyanurate was drastically decreased 1 month after dilution. 3. The cytotoxicity of Sodium Dichloroisocyanurate was rather higher than same concentration of sodium hypochlorite solution until 1 week after dilution. Then in 1 month. cytotoxicity of Sodium Dichloroisocyanurate was decreased than that of 1 week dilution solution. especially 4% Sodium Dichloroisocyanurate solution has almost no toxicity. However. 1% and 2% sodium hypochlorite solution has unchanged moderate degree of cytotoxicity after the dilution. Furthermore. 4% sodium hypochlorite solution showed high level of toxicity. 4. The pH level of Sodium Dichloroisocyanurate showed that the solution was weak acid (pH5). On the other hand. sodium hypochlorite was revealed as a strong alkaline solution (pH12). There was no change in pH following the dilution of each solution. As results. Sodium Dichloroisocyanurate solution fully satisfy the basic requirements as a root canal irrigation solution. However. we strongly recommend to use this solution clinically in low concentration and try to apply into the root canal within 1 week after dilution.】