Abstract
Effective shaping and cleaning of root canals are essential for the success of endodontic treatment. Due to the complex anatomy of root canal spaces, the use of various instrumentation techniques alone is not effective in producing bacteria-free root canal spaces. Irrigation, disinfectants, rinses, and intervisit medications are used in conjunction with the mechanical instrumentation to ensure the success of endodontic treatment. Sodium hypochlorite (NaOCl), a halogenated compound, is routinely used to irrigate the root canal during endodontic treatments. NaOCl has been known for its antibacterial action, proteolytic and dissolution capacity, and debridement properties. NaOCl, however, can alter the composition of dentin and hence its interaction with the adhesive resins used to bond the restorative materials to treated dentin. This review therefore covers in depth the action of NaOCl on dentin-adhesive resin bond strength including both enhancement and reduction, then mechanisms proposed for such action, and finally how the adverse action of NaOCl on dentin can be reversed.
Highlights
Effective shaping and cleaning of root canals are essential for the success of endodontic treatments
Large areas of root canal dentin could remain untouched by the instruments; this emphasizes the importance of chemical means of cleaning and disinfecting the root canal system [2]
The negative action of NaOCl on dentin bond strength can be reversed by some natural antioxidants, for example, ascorbic acid [30], sodium ascorbate [30, 39, 46], rosmarinic acid [46], green tea extracts [47], and proanthocyanidin [48]
Summary
Effective shaping and cleaning of root canals are essential for the success of endodontic treatments. Sodium hypochlorite (NaOCl), a halogenated compound, is routinely used to irrigate the root canal during endodontic treatments. It has antimicrobial action [5,6,7,8]; in water, sodium hypochlorite ionizes to Na and OCl. Between pH values 4 and 7, chlorine ion exists as hypochlorous acid (HClO) while, at pH above 9, OCl predominates. There are conflicting results on how the treatment of dentin with NaOCl affects the subsequent bond strength Such variation in response to sodium hypochlorite could be related to the variation in methodology, form (gel versus liquid) and concentration of sodium hypochlorite, time of application [19], and many other factors that will be discussed in detail in this review
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