Abstract
Therapeutic success in endodontic treatment depends on successful infection control. Alexidine dihydrochloride (ALX) was recently proposed as a potential alternative to 2% chlorhexidine (CHX) as it possesses similar antimicrobial properties, expresses substantivity and does not produce p-chloroaniline (PCA) when mixed with sodium hypochlorite (NaOCl). However, the products released in this reaction have not been described to date. The aim of this study was to identify detected chemical compounds formed in the reaction of ALX and NaOCl with the ultra-high-performance liquid chromatography–mass spectrophotometry (UHPLC-MS) method and assess whether precipitates and PCA are formed in this reaction. Solutions of ALX were mixed with the equivalent volume of 2% and 5.25% (w/v) NaOCl solutions. As control, 2% (w/v) CHX was mixed with 2% and 5.25% (w/v) NaOCl. Samples were subjected to the UHPLC-MS analysis. The mixture of ALX and NaOCl resulted in a yellowish precipitate formation, the amount of which depended on NaOCl concentration. Interaction of ALX and NaOCl resulted in the production of aliphatic amines. No PCA was formed when NaOCl was mixed with ALX. However, for the first time, we identified the possible products of the interaction. The interaction between NaOCl and ALX results in the formation of aliphatic amines; therefore, these compounds should not be mixed during endodontic treatment.
Highlights
One of the main objectives of endodontic treatment is the eradication of infection from root canal systems by chemical and mechanical preparation
Sodium hypochlorite (NaOCl), a basic solution used in irrigation protocol due to its unique tissue-dissolving capacities and broad antimicrobial spectrum, is not able to fulfill all criteria of effective chemical preparation, especially regarding smear layer removal and total eradication of microbiota
The precipitate formed in each mixture (Figure 1) was dissolved in methanol examined by means of UHPLCMS
Summary
One of the main objectives of endodontic treatment is the eradication of infection from root canal systems by chemical and mechanical preparation. It has been widely proved that microbial reduction improves the prognosis of root canal treatment and is the key to achieving endodontic success, as no apical periodontitis will develop without the presence of bacteria [1]. Sodium hypochlorite (NaOCl), a basic solution used in irrigation protocol due to its unique tissue-dissolving capacities and broad antimicrobial spectrum, is not able to fulfill all criteria of effective chemical preparation, especially regarding smear layer removal and total eradication of microbiota. One-third to one-half of treated root canals remain infected when irrigated with 5.25% NaOCl only [3]. It is suggested that adjunctive chemical solutions be used
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