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      Comparación de la Concentración de Hipoclorito de Sodio en la Atención Dental entre Dentistas Generales y Especialistas en Endodoncia Translated title: Comparison of the concentration of sodium hypochlorite used in dental care of general dentists and specialists in endodontics

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          Abstract

          RESUMEN Resumen: La vida útil de hipoclorito de sodio (NaOCl) es limitada, varios estudios señalan la posibilidad de discrepancias entre la concentración esperada y la concentración real en soluciones de NaOCl usadas como irrigantes endodónticos. El presente estudio investigó si existe alguna diferencia en la concentración usada por endodoncistas y dentistas generales. La solución de NaOCl es hasta la fecha, la solución de irrigación del canal radicular más utilizado, pero no existe un acuerdo general en cuanto a su concentración óptima, que varía desde 0,5 % a 5,25 %. Este estudio fue analítico experimental. El tamaño muestral fue por conveniencia. Los sujetos estudiados fueron especialistas en endodoncia y dentistas generales que se desempeñan tanto en la atención pública como privada, en la ciudad de Santiago de Chile. Participaron del estudio de manera voluntaria, para lo cual llenaron un consentimiento informado y completaron una encuesta previamente validada. Cada sujeto aportó una muestra de la solución de hipoclorito de sodio que utilizaba en su práctica clínica. Las muestras fueron recolectadas en recipientes plásticos oscuros y fueron almacenadas sin estar expuestas a la luz y refrigeradas hasta su análisis. Para el análisis de laboratorio se usó espectrofotometría, el análisis estadístico se emplearon los Test de Student y Fischer para medir si existían diferencias entre las concentraciones de hipoclorito de sodio utilizadas por endodoncistas y dentistas generales. Conclusiones: Existe diferencia en la concentración de hipoclorito de sodio en soluciones de hipoclorito de sodio usadas por endodoncistas y dentistas generales. Todas las muestras recolectadas poseen una concentración igual o mayor al 4,7% de hipoclorito. Existe diferencias entre la concentración real de hipoclorito de sodio en soluciones para la irrigación y la encuestada en el caso de dentistas generales. En este caso las concentraciones reales son más de dos veces mayores a las encuestadas. Existe diferencias entre la concentración real de hipoclorito de sodio en soluciones para la irrigación y la esperada en el caso de dentistas generales. Siendo incluso un poco mayores las reales a las encuestadas.

          Translated abstract

          ABSTRACT ABSTRACT: The shelf life of sodium hypochlorite (NaOCl) is limited, several studies point out the possibility of discrepancies between the expected concentration and the actual concentration in NaOCl solutions used as endodontic irrigants. The present study investigated whether there is any difference in the concentration used by endodontists and general dentists. NaOCl solution is to date the most widely used root canal irrigation solution, but there is no general agreement as to its optimal concentration, which varies from 0.5% to 5.25%. This study was analytical experimental. The sample size was for convenience. The subjects studied were specialists in endodontics and general dentists who work in both public and private care, in the city of Santiago de Chile. They participated in the study voluntarily, for which they filled out an informed consent and completed a previously validated survey. Each subject provided a sample of the sodium hypochlorite solution used in their clinical practice. The samples were collected in dark plastic containers and were stored without being exposed to light and refrigerated until analysis. For the laboratory analysis, spectrophotometry was used, for statistical analysis the Student and Fischer tests were used to measure whether there were differences between the concentrations of sodium hypochlorite used by endodontists and general dentists. Conclusions: There is a difference in the concentration of sodium hypochlorite in solutions of sodium hypochlorite used by endodontists and general dentists. All samples collected have a concentration equal to or greater than. to 4.7% hypochlorite. There are differences between the actual concentration of sodium hypochlorite in solutions for irrigation and that surveyed in the case of general dentists. In this case, the actual concentrations are more than twice as high as those surveyed. There are differences between the actual concentration of sodium hypochlorite in solutions for irrigation and that expected in the case of general dentists. The real ones are even slightly higher than those surveyed.

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          Most cited references22

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          Irrigation in endodontics.

          The success of endodontic treatment depends on the eradication of microbes from the root-canal system and prevention of reinfection. The root canal is shaped with hand and rotary instruments under constant irrigation to remove the inflamed and necrotic tissue, microbes/biofilms, and other debris from the root-canal space. Irrigants have traditionally been delivered into the root-canal space using syringes and metal needles of different size and tip design. Clinical experience and research have shown, however, that this classic approach typically results in ineffective irrigation. Many of the compounds used for irrigation have been chemically modified and several mechanical devices have been developed to improve the penetration and effectiveness of irrigation. This article summarizes the chemistry, biology, and procedures for safe and efficient irrigation and provides cutting-edge information on the most recent developments. Copyright 2010 Elsevier Inc. All rights reserved.
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            In vitro antimicrobial activity of several concentrations of sodium hypochlorite and chlorhexidine gluconate in the elimination of Enterococcus faecalis.

            The aim of this study was to assess, in vitro, the effectiveness of several concentrations of NaOCl (0.5%, 1%, 2.5%, 4% and 5.25%) and two forms of chlorhexidine gluconate (gel and liquid) in three concentrations (0.2%, 1% and 2%) in the elimination of E. faecalis. A broth dilution test using 24-well cell culture plates was performed and the time taken for the irrigants to kill bacterial cells was recorded. Isolated 24 h colonies of pure cultures of E. faecalis grown on 10% sheep blood plus Brain Heart Infusion (BHI) agar plates were suspended in sterile 0.85% NaCI solution. The cell suspension was adjusted spectrophotometrically to match the turbidity of a McFarland 0.5 scale. One mL of each tested substance was placed on the bottom of wells of 24-well cell culture plates (Corning, NY), including the control group (sterile saline). Six wells were used for each time period and irrigant concentration. Two mL of the bacterial suspension were ultrasonically mixed for 10 s with the irrigants and placed in contact with them for 10, 30, and 45 s; 1, 3, 5, 10, 20, and 30 min; and 1 and 2 h. After each period of time, 1 mL from each well was transferred to tubes containing 2 mL of freshly prepared BHI + neutralizers in order to prevent a residual action of the irrigants. All tubes were incubated at 37 degrees C for 7 days. The tubes considered to have positive growth were those which presented medium turbidity during the incubation period. Data were analysed statistically by the Kruskal-Wallis test. with the level of significance set at P < 0.05. All irrigants were effective in killing E. faecalis. but at different times. Chlorhexidine in the liquid form at all concentrations tested (0.2%, 1% and 2%) and NaOCI (5.25%) were the most effective irrigants. However, the time required by 0.2% chlorhexidine liquid and 2% chlorhexidine gel to promote negative cultures was only 30 s and 1 min, respectively. Even though all tested irrigants possessed antibacterial activity, the time required to eliminate E. faecalis depended on the concentration and type of irrigant used.
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              Effect of sodium hypochlorite on mechanical properties of dentine and tooth surface strain.

              The aim of this study was to test the null hypothesis that sodium hypochlorite irrigation of root canals does not alter the properties of dentine and contribute to the weakening of root-treated teeth. The effect of two concentrations (0.5%, 5.25%) of sodium hypochlorite (NaOCl) and saline on (i) the elastic modulus and flexural strength of machined dentine bars, and (ii) changes in strain of 'whole' extracted human teeth were evaluated. One hundred standardized plano-parallel dentine bars (> 11.7 x 0.8 x 0.8 mm) were randomly divided into the three groups, immersed for 2 h in the respective solutions and then subjected to a three-point bend test. Changes in strain of each of 10 teeth on cyclical nondestructive occlusal loading were measured using electrical resistance strain gauges bonded to the cervical aspects. Each tooth had its crown and enamel reduced and root canal prepared. These were irrigated sequentially in a series of four separate, 30-minute regimes; initial-saline, 0.5% NaOCl, 5.25% NaOCl and final-saline. The changes in strains after each irrigation regime were compared. There was a significant decrease in elastic modulus of the dentine bars immersed in 5.25% NaOCl compared with the saline group (P < 0.01). There was also a significant decrease in flexural strength of the dentine bars in the 5.25% NaOCl group compared to both the saline and 0.5% NaOCl groups (P < 0.01). The strain data from the nondestructive tooth loading tests revealed significant increases in tensile strain between the initial-saline and the final-saline stages (P < 0.01). Significant increases in compressive strains were also found between initial-saline and 5.25% NaOCl; and between 0.5% NaOCl and 5.25% NaOCl stages (P < 0.01). The null hypothesis was rejected, 5.25% NaOCl reduced the elastic modulus and flexural strength of dentine. Irrigation of root canals of single, mature rooted premolars with 5.25% NaOCl affected their properties sufficiently to alter their strain characteristics when no enamel was present.
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                Author and article information

                Journal
                odonto
                Avances en Odontoestomatología
                Av Odontoestomatol
                Ediciones Avances, S.L. (Madrid, Madrid, Spain )
                0213-1285
                2340-3152
                September 2023
                : 39
                : 5
                : 230-240
                Affiliations
                [2] orgnameEndodoncista
                [1] orgnameCollected the data; Contributed data or analysis tools; Performed the analysis; Wrote the paper
                Article
                S0213-12852023000500005 S0213-1285(23)03900500005
                dd869c7b-203a-4126-a83d-c25de4697e2b

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 International License.

                History
                : 15 October 2022
                : 08 September 2022
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 22, Pages: 11
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                SciELO Spain

                Categories
                Artículos

                NaOCl,SCR,irrigation,general dentist,Endodontist
                NaOCl,SCR, irrigation, general dentist, Endodontist

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