School of Dentistry, University of Queensland, Brisbane, Australia.
School of Dentistry, Kuwait University, Jabriya, Kuwait.
J Endod. 2017 Aug;43(8):1354-1359. doi: 10.1016/j.joen.2017.03.034. Epub 2017 May 31.
The therapeutic effects of sodium hypochlorite (NaOCl) solutions are dependent on the levels of free available chlorine (FAC). Mixing these solutions with irrigants can result in significant reductions in FAC. Although the effect of some irrigants on FAC is known, the effect of other commonly used irrigants is not. Thus, the therapeutic ramifications of the concurrent use of these on the efficiency of NaOCl solutions is not known.
Aliquots of 5.2% (w/v) NaOCl solutions were admixed in proportions of 90:10, 80:20, and 50:50 with the following irrigants: octenidine dihydrochloride (OCT); SmearOFF (Vista Dental Products, Racine, WI), 17% EDTA; and 0.2%, 2%, and 5% chlorhexidine (CHX) solutions. Changes in FAC were measured by iodometric titration. Statistical differences between means were determined using a post hoc Tukey analysis test after an analysis of variance.
OCT appeared not to affect FAC and was significantly different than all other irrigants, except for 90:10 and 80:20 mixtures of low concentration (0.2%) CHX. CHX solutions showed a marked concentration- and mixture proportion-dependent detrimental effect on FAC. The reduction of FAC between different concentrations of CHX was statistically significant in 80:20 and 50:50 proportions, with 50:50 mixtures of 5% CHX having the greatest influence. Mixtures containing even small proportions of SmearOFF or EDTA exhibited significant losses in FAC.
OCT has little effect on FAC and can be used concurrently with NaOCl solutions. Higher concentrations of CHX significantly affect FAC. Their combined use with NaOCl solutions should be avoided. EDTA and SmearOFF should not be mixed with NaOCl solutions.
次氯酸钠(NaOCl)溶液的治疗效果取决于游离有效氯(FAC)的水平。将这些溶液与冲洗剂混合会导致 FAC 显著降低。虽然一些冲洗剂对 FAC 的影响是已知的,但其他常用冲洗剂的影响则不然。因此,同时使用这些冲洗剂对 NaOCl 溶液效率的治疗影响尚不清楚。
将 5.2%(w/v)的 NaOCl 溶液与以下冲洗剂以 90:10、80:20 和 50:50 的比例混合:双氯苯双胍己烷(OCT);SmearOFF(Vista Dental Products,Racine,WI),17% EDTA;以及 0.2%、2%和 5%的洗必泰(CHX)溶液。通过碘量滴定法测量 FAC 的变化。在方差分析后,使用事后 Tukey 分析测试确定均值之间的统计差异。
OCT 似乎不会影响 FAC,与除 OCT 以外的所有冲洗剂均有显著差异,除了低浓度(0.2%)CHX 的 90:10 和 80:20 混合物。CHX 溶液对 FAC 表现出明显的浓度和混合比例依赖性的有害影响。不同浓度 CHX 之间 FAC 的减少在 80:20 和 50:50 比例中具有统计学意义,50:50 混合物中 5%CHX 的影响最大。含有少量 SmearOFF 或 EDTA 的混合物会显著损失 FAC。
OCT 对 FAC 的影响很小,可以与 NaOCl 溶液同时使用。更高浓度的 CHX 会显著影响 FAC。应避免将它们与 NaOCl 溶液一起使用。EDTA 和 SmearOFF 不应与 NaOCl 溶液混合。