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The use of NaOCl in combination with CHX produces cytotoxic product

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Abstract

Objectives

The combination of sodium hypochlorite (NaOCl) and chlorhexidine (CHX) yields a “precipitate potentially toxic” (PPT). The aim of this study was to evaluate the tissue response to implanted polyethylene tubes filled with PPT-soaked fibrin sponge.

Methods

Forty rats received four polyethylene tubes each; each tube was filled with fibrin sponge soaked by 2.5 % NaOCl, 2.0 % CHX, PPT (2.5 % NaOCl plus 2.0 % CHX), or not soaked (control). The observation time points were 7, 15, 30, 60, and 90 days. At each time point, eight animals were killed, and the tubes and surrounding tissues were removed, fixed, and prepared for light microscopic analysis by performing glycol methacrylate embedding, serial cutting into 3-μm sections, and hematoxylin–eosin staining. Qualitative and quantitative evaluations of the reactions were performed. Results were statistically analyzed by Kruskal–Wallis test (p < 0.05).

Results

All chemical solutions caused moderate reactions at 7 days. On day 30, PPT group was more cytotoxic than the control group and the CHX group (p < 0.05). On days 15 and 60, PPT group was more cytotoxic than the control group (p < 0.05). On day 90, there was no statistically significant difference between the different groups.

Conclusion

PPT is more cytotoxic than NaOCl and CHX alone, particularly in the short term.

Clinical significance

Protocols which suggest the use of CHX and NaOCl must be revised because this mixture produces cytotoxic product.

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Endodontics, Araçatuba Dental School, UNESP—Universidade Estadual Paulista, R. José Bonifácio, 1193, Araçatuba, São Paulo, Brazil

    Luciano Tavares Angelo Cintra, Simone Watanabe, Renata Oliveira Samuel, Aguinaldo Cândido da Silva Facundo, Índia Olinta de Azevedo Queiroz, Eloi Dezan-Júnior & João Eduardo Gomes-Filho

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  1. Luciano Tavares Angelo Cintra
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  2. Simone Watanabe
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  3. Renata Oliveira Samuel
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  4. Aguinaldo Cândido da Silva Facundo
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  5. Índia Olinta de Azevedo Queiroz
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  6. Eloi Dezan-Júnior
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  7. João Eduardo Gomes-Filho
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Correspondence to Luciano Tavares Angelo Cintra.

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Cintra, L.T.A., Watanabe, S., Samuel, R.O. et al. The use of NaOCl in combination with CHX produces cytotoxic product. Clin Oral Invest 18, 935–940 (2014). https://doi.org/10.1007/s00784-013-1049-5

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  • DOI: https://doi.org/10.1007/s00784-013-1049-5

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