Sodium hypochlorite 0.05% solution

IntroductionThe bond strength (BS) between composite resin and dentin is a crucial factor determining the long-term success of restorations. Sodium hypochlorite (NaOCl), a frequently used root canal irrigating agent, has been demonstrated to notably influence the properties of dentin, thereby affecting the BS. Moreover, the application of collagen crosslinkers has become a potential approach to improve the stability of the resin-dentin bond. Nevertheless, the effect of collagen crosslinkers on the bond strength (BS) between sodium hypochlorite (NaOCl) treated dentin and composite resin remains a topic of contention, and there is a lack of in-depth understanding in the existing literature. The purpose of this systematic review and meta-analysis was to analyze the current literature on the effect of collagen crosslinkers on the BS between sodium hypochlorite treated dentin and composite resin.MethodsDatabases including PubMed, EMBASE, Cochrane library, Scopus, Web of Science and SinoMed were searched. In vitro studies reported the effect of crosslinking agents on NaOCl-treated dentin BS were included. The reference lists of studies included via databases were manually searched for more studies that fulfilled the inclusion criteria. The initial search yielded 1,538 studies, and subsequent screening resulted in the inclusion of 14 studies. Most of studies (78.6%, 11/14) were categorized as having a "low" risk of bias. The studies included in the meta-analysis employed a range of cross-linking agents, including ethylenediaminetetraacetic acid (EDTA), phytic acid (IP6), proanthocyanidin (PA), rosmarinic acid (RA) and sodium ascorbate (SA). Subgroup comparisons were performed according to NaOCl exposure duration. Studies treated with different concentration of NaOCl were analyzed separately.ResultsFor dentin exposed less than 1 min or NaOCl at lower concentration, significant positive effect cannot be observed when using collagen crosslinkers. For dentin exposed more than 1 min in NaOCl at concentrations greater than 2.5%, EDTA, PA and SA were observed to significantly improve the BS. RA is proved effective in improving the BS of dentin exposed to high concentrations NaOCl within a shorter duration. Current evidence is insufficient to conclude that IP6 has a positive effect in NaOCl-treated dentin bonding performance.ConclusionThe effect of collagen crosslinkers on the BS of NaOCl treated dentin was influenced by the concentration of NaOCl and the duration of exposure.

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ObjectiveThe aim of the present systematic review and meta-analysis was to evaluate the effect of different concentrations of sodium hypochlorite (NaOCl) on post-operative pain following root canal treatment.Material and methodsThe current study was conducted according to PRISMA guidelines and registered on PROSPERO (CRD42023451576). The research question was formulated according to PICO strategy and aimed at determining if different concentrations of NaOCl would have influenced post-operative pain in adults following endodontic treatments. A comprehensive literature search was performed manually and through multiple electronic databases, using predefined keywords and MeSH terms. Randomized controlled trials (RCTs) comparing different NaOCl concentrations (ResultsSeven RCTs met the inclusion criteria and were included in the systematic review; moreover, four studies underwent quantitative evaluation (meta-analysis). The results showed no statistically significant difference in post-operative pain between low (ConclusionWithin the limitations of the present study, no significant differences in post-endodontic pain were found between high and low NaOCl concentrations. However, concentrations < 5% might be associated with less pain incidence. Further well-designed clinical trials with standardized methodologies are needed to provide more conclusive evidence.

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This systematic review aims to compare the efficacy of sodium hypochlorite (NaOCl) and chlorhexidine digluconate (CHX) in decontaminating gutta-percha (GP) cones against endodontic pathogens-Enterococcus faecalis (E. faecalis), Staphylococcus aureus (S. aureus), and Candida albicans (C. albicans)-within 0-10 min. A systematic search was conducted in six databases (PubMed, Web of Science, Cochrane Library, SCIELO, Scopus, and LILACS), supplemented by manual searches performed independently by three reviewers. No publication year restrictions were applied, and only English-language studies were included. This review followed the PRISMA statement (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). The risk of bias was assessed using six parameters with a modified Cochrane risk of bias tool. Out of 309 potentially eligible studies, 216 were screened by title and abstract, 32 were selected for full-text assessments, and 7 were included. All studies had a moderate or high risk of bias. The majority of the included studies showed that higher NaOCl concentrations effectively eliminate E. faecalis and S. aureus within 1-5 min. However, data on CHX's antimicrobial effect on C. albicans were limited. The qualitative analysis suggests that NaOCl remains the most effective agent for GP decontamination, while CHX with additives shows potential against fungal species.

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