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

Introduction: The 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. Methods: Eight 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 (alpha = 0.05). Results: The 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). Conclusions: Periapical tissue dissolution occurred in all groups, with a greater impact observed with 2.5% NaOCl with or without ultrasonic activation.

Automated summary

This study evaluated the impact of different sodium hypochlorite irrigation protocols on organic tissue dissolution in the periapical region of simulated immature permanent teeth. The results showed that 2.5% NaOCl with ultrasonic activation had the greatest dissolution effect.