Sodium Hypochlorite Irrigation Research Articles

Dens invaginatus Type II in an Immature Lateral Incisor With Apical Periodontitis Treated With Regenerative and Strategic Antimicrobial Procedures: A Case Report

Dens invaginatus is a developmental dental anomaly that can predispose the tooth to pulp and periradicular disease. Management of this condition can be challenging because of anatomic and microbiologic issues. This case report describes the regenerative endodontic treatment (REP) using a strategic antimicrobial protocol for management of an immature maxillary lateral incisor with type-II dens invaginatus associated with apical periodontitis in a 13-year-old patient. The tooth presented with a complex anatomy and was associated with an active sinus tract. Because the true root canal was not negotiable in its coronal part due to the presence of the dens invaginatus, the closed end of the invagination (pseudocanal) was perforated to permit access to the apical segment of the true root canal for cleaning and disinfection. Both the invagination and the true canal were treated using an antimicrobial regimen based on chemomechanical preparation with sodium hypochlorite irrigation, supplementary disinfection with passive ultrasonic irrigation and interappointment calcium hydroxide medication. After 2 exchanges of calcium hydroxide medication, the sinus tract did not disappear, then the antimicrobial protocol was changed to include an antibiotic solution for irrigation and antibiotic paste for intracanal medication. After signs and symptoms disappeared, regenerative endodontic treatment was performed by inducing blood clot formation within the root canal. The coronal canal segment including the invagination was filled with Biodentine. Follow-up including cone-beam computed tomography examination showed complete healing of the apical periodontitis lesion and mineralized tissue formation at the apical portion of the true root canal.

Does increase in temperature of sodium hypochlorite have enhanced antimicrobial efficacy and tissue dissolution property? – A systematic review and meta-regression

Objectives: The objective of this study was to analyze the available evidence on the performance of increase in temperature of sodium hypochlorite on its antimicrobial efficacy and tissue dissolution property. Materials and Methods: The study was conducted according to PRISMA guidelines, and a modified Joanna Briggs Institute (JBI) tool was used for quality assessment of the included studies. Two reviewers independently performed an electronic search in four databases along with the reference lists of the included articles. Results: This systematic review included a total of 12 studies: antimicrobial efficacy (n = 6) and tissue dissolution property (n = 6). For the studies that were chosen, the overall risk of bias was moderate. Quantitative assessment through meta-regression was performed for tissue dissolution property. Low-concentration sodium hypochlorite irrigant (≤3%) shows a 0.13-unit times increase in tissue dissolution ability with a degree rise in temperature although not statistically significant. Conclusion: Due to inconsistency in the study parameters, results pertaining to the exclusive effect of increase in the temperature of sodium hypochlorite remain inconclusive.

Does increase in temperature of sodium hypochlorite have enhanced antimicrobial efficacy and tissue dissolution property? – A systematic review and meta-regression

Objectives: The objective of this study was to analyze the available evidence on the performance of increase in temperature of sodium hypochlorite on its antimicrobial efficacy and tissue dissolution property. Materials and Methods: The study was conducted according to PRISMA guidelines, and a modified Joanna Briggs Institute (JBI) tool was used for quality assessment of the included studies. Two reviewers independently performed an electronic search in four databases along with the reference lists of the included articles. Results: This systematic review included a total of 12 studies: antimicrobial efficacy (n = 6) and tissue dissolution property (n = 6). For the studies that were chosen, the overall risk of bias was moderate. Quantitative assessment through meta-regression was performed for tissue dissolution property. Low-concentration sodium hypochlorite irrigant (≤3%) shows a 0.13-unit times increase in tissue dissolution ability with a degree rise in temperature although not statistically significant. Conclusion: Due to inconsistency in the study parameters, results pertaining to the exclusive effect of increase in the temperature of sodium hypochlorite remain inconclusive.

Comparing the EdgeFile X3, GenEndo, HeroGold, and ProTaper Gold Rotary Instruments Regarding the Effect of Different Concentrations and Temperature of NaOCl on Cyclic Fatigue Resistance.

This research was carried out with the objective of comparison between GenEndo, Protaper Gold, Hero Gold and EdgeFile X3 regarding the effect of different concentrations of NaOCl. About 720 study specimens were included in the study. They were divided into four groups. Each group consisted of 180 files. Group A: GenEndo, Group B: Protaper Gold, Group C: Hero Gold, Group D: EdgeFile X3. Each group of instruments were further subdivided into nine subgroups (n = 20 for each subgroup). Testing of the cyclic fatigue was carried out in artificial canals which were prepared inside the blocks of stainless steel. The stainless steel blocks with artificial canals were established in a receiver that was packed with experimental solutions like distilled water, 5.25% NaOCl and 2.5% NaOCl. The adjustment of temperature was done at 25, 37, and 60°C. The rotation of the instrument was carried out inside the artificial canal as per the instructions of the manufacturer. The instrument was rotated until it got fractured. The time taken by the instrument to fracture was recorded in seconds. The number of cycles to fracture (NCF) was analyzed with the help of the equation (NCF = time to fracture × rpm/60). Surfaces at the site of fracture were examined with the help of a scanning electron microscope (EVOLS10, ZEISS) at magnification (300x and 2000x). It was noticed that there was a statistically significant increase in cyclic fatigue when sodium chloride was used as an endodontic irrigant instead of distilled water. The increase in cyclic fatigue was also observed when 5.25% sodium chloride was used instead of 2.5% sodium hypochlorite. Cyclic fatigue increased on change in temperature from 25 to 37°C and from 37 to 60°C. The difference was statistically significant (p < 0.05). It was observed that resistance against cyclic fatigue on treatment with different irrigation solutions at different temperatures was in the order of GenEndo > Protaper Gold > Hero Gold > EdgeFile X3. The resistance against cyclic fatigue in new NiTi rotary files can be affected significantly by different concentrations of sodium hypochlorite irrigant solution and the GenEndo rotary endodontic instrument has the maximum resistance against cyclic fatigue. Irrigation of the root canal with irrigants, such as sodium hypochlorite (NaOCl) has been recommended strongly. NaOCl is used in the range of 0.5 and 6.5% concentration owing to its antimicrobial activity and tissue dissolution activities, particularly at higher temperatures. It has been postulated that fatigue of rotary endodontic instruments can be influenced by adjoining medium and their concentration.

Assessment of Penetrability for Different Endodontic Irrigation Activating Techniques Using Cone-Beam Computed Tomography and Periapical Digital Radiography—An In Vitro Study

The elimination of necrotic and inflamed pulp tissue, dentin debris, and microorganisms is essential for the success of endodontic treatment. However, the root canal’s complexity has led to incomplete cleaning and disinfection. This study aims to compare the efficacy of the penetrability of three different irrigation activating techniques to the apical third of the root canal. Sixty sound single-rooted human mandibular premolars are prepared with rotary instrumentation under continuous sodium hypochlorite irrigation. Three irrigation activation techniques are utilized: group 1 (n = 20), conventional needle irrigation (CN); group 2 (n = 20), side-vented endodontic needle irrigation (EN); and group 3 (n = 20), manual activation irrigation with gutta-percha cone (MA). The penetrability is assessed with the aid of a radiopaque irrigation solution using digital radiography in conjunction with cone-beam computed tomographic (CBCT) measurements. Data are analyzed using a statistical package for social sciences (SPSS), using multiple comparisons to compare the baseline and test values. One-way analysis of variance with post hoc analysis (Tukey honestly significant difference) is performed to detect the statistically significant differences between groups. Manual activation (MA) shows effective delivery of the irrigant into full WL, followed by endodontic needle (EN) and conventional (CN) methods of activation (p &lt; 0.001). The results of the present study show that maximum penetrability of the irrigant is observed with manual activation (MA) using a gutta cone in comparison with the conventional needle (CN).

Effect of Heated Sodium Hypochlorite Irrigant on Structural Changes and Microhardness of Radicular Dentin: An In Vitro Study.

This study is aimed to evaluate the combined effect of sodium hypochlorite at varied concentrations and temperatures on radicular dentin microhardness along with its surface structural changes using an FTIR spectrometer. Mandibular premolars were cleaned and shaped up to F3 Protaper gold rotary files, after which they were subjected to five experimental conditions - group I - neutral saline as negative control, group II - 3% NaOCl solution, group III - 5% NaOCl solution, group IV - 3% intracanal-heated NaOCl solution, and group V - 5% intracanal-heated NaOCl solution. Following this, the microhardness of radicular dentin at 100 µm and 300 µm from the canal lumen and Fourier-transform infrared (FTIR) spectroscopic analysis were performed. The results showed that intracanal-heated sodium hypochlorite group reduced root dentin microhardness at 300 µm than its nonheated counterpart. No difference in microhardness values was observed between 3% intracanal-heated and room-temperature sodium hypochlorite groups at 100 µm. Reduction in amide/phosphate ratio was noted in all the groups treated with sodium hypochlorite irrespective of temperature and concentration. Thus, considering that the level of alteration in physical and structural changes of root dentin with or without heating is insignificant, intracanal-heated low-concentration sodium hypochlorite solutions could be used as an alternative to high-concentration sodium hypochlorite. Intracanal-heated low-concentration sodium hypochlorite enables the clinicians to achieve maximum disinfection while keeping the structural and physical properties of the dentin similar to room-temperature sodium hypochlorite.

Advances in the Role of Sodium Hypochlorite Irrigant in Chemical Preparation of Root Canal Treatment.

Irrigation of root canal system is of great significance to the success of endodontic treatment, where sodium hypochlorite (NaOCl) is the most widely used irrigant in chemical preparation. NaOCl functions by eliminating bacterial biofilms and dissolving organic tissue, which may vary according to several factors such as the microbiology of root canal infection and the concentration of the irrigant. It has been proposed that the effectiveness of NaOCl could be enhanced via several methods, including heating the irrigant, applying in conjunction with certain reagents, or activating by agitation techniques. Despite its antibacterial and tissue-dissolving capacities, NaOCl should be used with caution to avoid detrimental effect due to its cytotoxicity and negative effect on dentin properties. In this narrative review, we discussed the factors that affect the properties of NaOCl, the methods to improve its efficacy, and the side effects that might occur in clinical practice.

Assessment of Irrigant Agitation Devices in Simulated Closed and Open Root Canal Systems

IntroductionThe in vitro efficacy of irrigant activation devices has not been contrasted to their safety. This was attempted in this study using apically closed versus patent simulated root canal systems in epoxy resin models, with the latter featuring a simulated periapical lesion. MethodsAll 72 models had 2 joining canals connected by an isthmus, which was filled with dentin debris. The simulated periapical lesion was filled with colored gelatin in the 36 respective models. Canals were irrigated with 1.3% sodium hypochlorite. Samples were divided into 4 subgroups per system (n = 9): conventional irrigation, sonic low (EndoActivator; Dentsply Sirona, Charlotte, NC) and high frequency (EDDY; VDW, Munich, Germany), and ultrasonic agitation of the irrigant (always applying 3 cycles of 20 seconds). The total cleared surface areas (mm2) in the simulated isthmus and periapical lesion were compared between systems and devices using parametric tests (P < .05). ResultsThe cleaning of the isthmus was more effective in the apically open compared with the closed systems and was also significantly influenced by the agitation method (P < .001). In the closed systems, EDDY and ultrasonic agitation achieved the significantly (P < .05) best cleaning of the isthmus. In the open systems, ultrasonic agitation showed the single best result (P < .05). EDDY caused by far the highest and ultrasonic agitation the lowest dissolution of the gelatin in the simulated periapical lesion. ConclusionsUnder the conditions of this study, ultrasonic agitation of a previously administered sodium hypochlorite irrigant was more laterally targeted and thus safer and more effective than sonic agitation methods.

Microbiological evaluation of the disinfection of the root canal system using different irrigation protocol – An interventional study

ABSTRACT Aim: The focus of the present research is to analyze the potential role of irrigants along with the activation system in the disinfection of the root canal space. Methods: Ninety root canals were randomly divided into two experimental groups based on the irrigants: Group I (n = 45) – Sodium hypochlorite irrigant and Group II (n = 45) –Chlorhexidine irrigant. The two groups are further subdivided into three subgroups base on the activation devices, i.e., passive ultrasonic irrigation, endoactivator, and laser. The first sample as a baseline, and the second sample was collected after the disinfection procedure. All the samples were streaked in brain − heart infusion agar plate to analyze the bacterial colony growth. The confirmatory analysis for the presence of Enterococcus faecalis was done using gram staining, biochemical analysis, and polymerase chain reaction. The nonparametric analysis was done using Kruskal–Wallis, Mann–Whitney U, and Wilcoxon signed-rank test and P &lt; 0.05 was considered to be statistically significant. Results: The mean colony-forming unit was significantly reduced and there exhibited a statistically significant difference in pretreatment and posttreatment irrigated with sodium hypochlorite and chlorhexidine activated with passive ultrasonic activation with (P = 0.001), endoactivator with (P = 0.001), and laser with (P = 0.001). Conclusion: In consideration with advantage of the properties of both irrigants, the present study concludes a combined use with sodium hypochlorite during instrumentation followed by laser activation and a final rinse with chlorhexidine for a better eradication of the microbes from the root canal system thus preventing re-infection.

Identifying The Superior Root Canal Irrigant Between Hydrogen Peroxide And Sodium Hypochlorite In Post Endodontic Pain Management

Place of Study: THQ Thal Hospital LayyahStudy Design: Randomized control trialDuration of Study: January 2022 to July 2022Methodology: 104 subjects were selected by non-probability non purposive sampling technique. Informed consent was taken from the patients and they were randomly allocated to 2 study groups i.e. Group A (Sodium Hypochlorite) and Group B (Hydrogen Peroxide). Mechanical preparation of root canals for the lower first molar was done in the first appointment. In Group A, a 2.5 % Sodium Hypochlorite (NaOCl) irrigant was used, while in Group B, a 3% Hydrogen Peroxide (H O ) irrigant was used. 2 The patients were followed up after 10 days. The frequency of endodontic pain on the follow-up visit was evaluated by Visual Analogue Scale (VAS). Statistical Package for Social Science (version 23.0) (SPSS) was used to analyze the data. The frequency of endodontic pain was compared between the study arms with a chi-square test.Results: A total of 104 participants were placed into 2 groups, 52 cases in each group. 56/104 (54.30%) were males while 48/104 (45.70%) were females. In Group “A” endodontic pain on 10-day follow-up visit was present in 18/52 (34.6%) patients, while in Group “B” endodontic pain on 10-day follow-up visits were present in 35/52 (68%) patients. By using the chi-square test it was observed that there was a significant association between groups and the presence of endodontic pain having p-value = 0.001Conclusion: Sodium Hypochlorite was much better than Hydrogen Peroxide in the management of endodontic pain in terms of incidence.

Effects of Calcium Hydroxide Paste in Different Vehicles on Bacterial Reduction during Treatment of Teeth with Apical Periodontitis

IntroductionThis clinical study evaluated the antibacterial effects of calcium hydroxide associated with different vehicles during the treatment of infected teeth with apical periodontitis. MethodsBacteriologic samples were taken from 90 necrotic root canals of teeth with apical periodontitis before (S1) and after preparation with a rotary nickel-titanium instrument system and 2.5% sodium hypochlorite irrigation (S2). The teeth were distributed in 3 groups according to the intracanal medication used, which consisted of a calcium hydroxide paste in glycerin, camphorated paramonochlorophenol/glycerin (CHPG), or 2% chlorhexidine for 1 week, and then another sample was taken (S3). The frequency of bacteria-positive cases and the reduction of bacterial counts were evaluated by quantitative real-time polymerase chain reaction. ResultsSubstantial intracanal bacterial reduction was observed after preparation in the 3 groups (P < .001). After calcium hydroxide paste in glycerin medication, the number of bacteria-positive cases decreased from 20/29 (69%) to 17/29 (59%); however, the mean bacterial counts increased 8.4% from S2 to S3. Medication with CHPG reduced the number of bacteria-positive cases from 17/29 (59%) to 15/29 (52%), with a significant mean S2–S3 reduction of 71% (P < .05). In the chlorhexidine group, the number of bacteria-positive cases decreased from 21/30 (70%) to 17/30 (57%) after medication, with a mean S2–S3 reduction of 55%, which, however, was not statistically significant (P > .05). Intergroup comparisons showed no significant differences (P > .05). ConclusionComparison between the 3 calcium hydroxide pastes showed no significant differences in antibacterial effectiveness in the main root canal. However, only the CHPG paste showed a significant reduction in bacterial counts when postpreparation and postmedication samples were compared.

Knowledge of Female Dental Students of KKU Regarding Pulp Revascularization Treatment

Aim: To assess the knowledge of female dental students of KKU about pulp revascularization procedure. Methods: A self-administered questionnaire was distributed to female students of 5th and 6th year and to dental interns. Collected data were analysed with descriptive statistics using SPSS (V19). Results: 137 contributors filled the proforma. Highest percentage of students (35%) considered pulp revascularization as the best treatment for immature necrotic permanent teeth in terms of tooth survival and 45.3% believed to have strongest tooth structure with this procedure as compared to other options. 68.6% of the participants had never attempted this procedure. 53.3% of the students were not sure about the outcome of the treatment. Only 31.4% of the students were aware of need of post and core as a contraindication forprocedure. 52.6% participants chose the option of little instrumentation with sodium hypochlorite irrigation for canal cleaning and 27.7% considered CaOH as a best intracanal medicament. According to majority of students (44.5%) continued root development with absence of signs and symptoms were the best indications of successful treatment. Conclusion: Majority of the students had the knowledge of regenerative endodontics as a viable treatment option for immature permanent teeth with necrotic pulps but were unaware of the details of the procedure and case selection criterion. Students should be given detailed clinical knowledge of this procedure so that in their future clinical practice they consider it among other options either for treatment or do case selection for referrals to specialists. Keywords: pulp revascularization; knowledge; dental students.

EVALUATION OF THE DENTINAL TUBULE PENETRATION OF AN ENDODONTIC BIOCERAMIC SEALER AFTER THREE FINAL IRRIGATION PROTOCOLS

Introduction: This study aimed to evaluate the dentinal tubule penetration of an endodontic bioceramic sealer, Sealer Plus BC, after three final irrigation protocols. Methods: Thirty distobuccal roots of maxillary molars were selected. Root canal preparation was performed up to an #40.06 instrument (X1 Blue) under 2.5% sodium hypochlorite irrigation. Specimens were randomly divided into three groups (n=10), according to the final irrigation protocol: G-NaOCl (2.5% sodium hypochlorite + PUI), G-SS (0.9% saline solution + PUI) and G-H20 (Deionized water + PUI). After final irrigation protocols, all specimens were irrigated with phosphate buffer solution. Root canal obturation was performed using the single cone technique and Sealer Plus BC, stained with a specific fluorophore. Specimens were transversely sectioned and each root third was evaluated in a confocal scanning laser microscopy. Images obtained were analyzed for sealer penetration in the dentinal tubules. Results: Dentinal tubule penetration of Sealer Plus BC was not observed in any root third, regardless of the final irrigation protocol investigated. Conclusions: Sealer Plus BC dentinal tubule penetration was not observed after none of the protocols tested. Dentinal tubule penetrability of Sealer Plus BC may be related to other factors rather than the final irrigation protocol.

Evaluation of Antimicrobial Efficacy of Punica Granatum, Green Tea, Chitosan and Sodium Hypochlorite Irrigants Against E. faecalis

Evaluation of Antimicrobial Efficacy of Punica Granatum, Green Tea, Chitosan and Sodium Hypochlorite Irrigants Against E. faecalis

Influence of Needle Design and Irrigant Flow Rate on the Removal of Enterococcus faecalis Biofilms In Vitro.

This study aimed to evaluate the influence of needle design and irrigant flow rate on the removal of Enterococcus faecalis mature biofilms during sodium hypochlorite irrigation. Forty-eight single-rooted human teeth were instrumented (ProTaper F3), autoclaved and inoculated with Enterococcus faecalis to establish a two-week-old biofilm. E. faecalis biofilms were treated with Sodium hypochlorite that was injected in the root canals using three types of needles (NaviTip, ProRinse, IrriFlex). For the IrriFlex needle, one, two, or four bars of pressure was applied to the irrigating solution to increase flow rates. Bacteria were labeled with the LIVE/DEAD BacLight Bacterial Viability kit, and viability was assessed by flow cytometry (FCM). Results were statistically analyzed using one-way ANOVA and Tukey multiple comparison intervals (α = 0.05). Bacterial viability was significantly reduced after sodium hypochlorite passive irrigation but the number of viable bacteria retrieved from root canal specimens irrigated with the Pro-Rinse needle was significantly higher compared to NaviTip and IrriFlex needles (p < 0.05). When the irrigant flow rate was increased, the viability of bacterial biofilms was significantly reduced compared to passive irrigation using the IrriFlex needle (p < 0.05). Applying higher flow rates during irrigation using the IrriFlex needle did not further reduce bacterial viability.

The Products of Probiotic Bacteria Effectively Treat Persistent Enterococcus faecalis Biofilms.

Objectives: Enterococcus faecalis is a Gram-positive commensal bacterium that possesses various survival and virulence factors, including the ability to compete with other microorganisms, invade dentinal tubules, and resist nutritional deprivation. E. faecalis is associated with persistent endodontic infections where biofilms formed by this bacterium in the root canal frequently resist dental therapies. Aseptic techniques, such as the inclusion of sodium hypochlorite, are the most commonly used methods to treat E. faecalis infections within the root canal system. In this work, we assess the effectiveness of probiotic strains to prevent the regrowth of E. faecalis biofilm cells treated by sodium hypochlorite irrigation. Methods: First, methods are presented that evaluate the effects of short-term exposure to sodium-hypochlorite on established E. faecalis. Next, we evaluate the effects of the secreted products of probiotic strains on biofilm cells and planktonic cells. Results: Sodium hypochlorite, the treatment conventionally used to decontaminate infected root canal systems, was extremely toxic to planktonic bacteria but did not fully eradicate biofilm cells. Furthermore, low concentrations of sodium hypochlorite induced eDNA dependent biofilms. Strikingly, conditioned medium from the probiotic bacteria Lactobacillus plantarum and Lactobacillus casei was sufficient to fully prevent the regrowth of treated biofilms while showing reduced potency towards planktonic cells. Conclusion: Sodium hypochlorite irrigations may contribute to the persistence of biofilm cells if used at concentrations lower than 3%. Probiotic strains and their products represent a new reservoir of biofilm therapies for E. faecalis infections formed in the root canal system.

Effect of Sodium Hypochlorite Concentration on Electronic Apex Locator Reliability.

This ex vivo study aimed to measure the performance of an electronic apex locator (EAL) in the presence of sodium hypochlorite irrigants with different concentrations. Two EALs (Root ZX Mini and Locapex 6) were used to locate the apical foramen in 10 extracted single-rooted teeth in the presence of 0.5%, 2.5% and 5% sodium hypochlorite. Visual working lengths were also determined using #10 K-file under a microscope before the electronic measurements were made. The performance of both EALs was compared for the electronic working lengths determined under the different concentrations of sodium hypochlorite. A multiple-way ANOVA and PLSD Fisher’s test with an α risk fixed at 5% were conducted. There were no statistical differences in the working lengths determined by both EALs between the three groups with different concentrations of sodium hypochlorite and their visual control measurements. When a ± 0.5 mm margin was applied, the Root ZX Mini and the Locapex 6 presented 88% and 83% accuracy, respectively. Sodium hypochlorite concentration in irrigants does not affect the accuracy and reliability of either the Root ZX Mini or the Locapex 6. Electronic apex locators are reliable with any concentration of sodium hypochlorite irrigants.

Impact of Sodium Hypochlorite on Organic Tissue Dissolution in the Periapical Region of Immature Permanent Teeth: An Ex Vivo Study

IntroductionThe purpose of this study was to evaluate the impact of different sodium hypochlorite (NaOCl) irrigation protocols on organic tissue dissolution in the periapical region of simulated immature permanent teeth. MethodsEight single-rooted premolars and 48 samples of porcine palatal mucosa were used. Acrylic resin prototypes were constructed, placing the tissue in close contact with the dental apices. Specimens were then divided into 6 groups (n = 8): 2 control groups of normal saline irrigation with (NS/WA) or without (NS/NA) ultrasonic activation and 4 experimental groups of 1.5% and 2.5% NaOCl irrigation with (NaOCl 1.5%/WA and NaOCl 2.5%/WA) or without (NaOCl 1.5%/NA and NaOCl 2.5%/NA) activation. Root canals were irrigated with 20 mL of the solution for 5 minutes distributed over 4 irrigation cycles. In each cycle, after irrigation, the solution was either kept stagnant or activated for 30 seconds and then replaced. Specimens were weighed on a precision balance before and after the irrigation protocols. Tissue dissolution was measured by the difference between the initial and final weights. One-way analysis of variance was applied followed by the Tukey honestly significant difference test (α = 0.05). ResultsThe NS/NA and NS/WA groups had mean weight reductions similar to the 1.5% NaOCl/NA group (P > .05) and lower than the others (P < .05). The 2.5% NaOCl/NA and 2.5% NaOCl/WA groups had the highest mean weight loss (P < .05), whereas the 1.5% NaOCl/WA group had intermediate values (P < .05). ConclusionsPeriapical tissue dissolution occurred in all groups, with a greater impact observed with 2.5% NaOCl with or without ultrasonic activation.

Effect of two different sonic activation techniques on organic tissue dissolution efficacy of sodium hypochlorite irrigation solution: EndoActivator / Eddystrength

Effect of two different sonic activation techniques on organic tissue dissolution efficacy of sodium hypochlorite irrigation solution: EndoActivator / Eddystrength

Evaluation of the antibacterial effect of apple cider vinegar, black tea and sodium hypochlorite irrigant solutions on infected root canal microorganisms of primary teeth: An invitro study

Evaluation of the antibacterial effect of apple cider vinegar, black tea and sodium hypochlorite irrigant solutions on infected root canal microorganisms of primary teeth: An invitro study