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Interactions between Irrigants Commonly Used in Endodontic Practice: A Chemical Analysis

Published:January 31, 2013DOI:https://doi.org/10.1016/j.joen.2012.11.050

      Abstract

      Introduction

      The aim of this work was to characterize the by-products formed in the associations between the most commonly used irrigants in endodontic practice through electrospray ionization quadrupole time-of-flight mass spectrometry analyses.

      Methods

      Sodium hypochlorite (NaOCl) (0.16%, 1%, 2.5%, and 5.25%) was associated with 2% chlorhexidine (CHX) solution and gel, 17% EDTA, 10% citric acid, 37% phosphoric acid, saline solution, ethanol, and distilled water. CHX solution and gel were also associated with all above mentioned irrigants. The solutions were mixed in a 1:1 ratio, and electrospray ionization quadrupole time-of-flight mass spectrometry was used to characterize the precipitates when formed.

      Results

      CHX produced an orange-brown precipitate when associated with NaOCl from 1%–5.25% and an orange-white precipitate when associated with 0.16% NaOCl. When associated with EDTA, CHX produced a white milky precipitate, and when associated with saline solution and ethanol, a salt precipitation was produced. No precipitation was observed when CHX was associated with citric acid, phosphoric acid, or distilled water. In the NaOCl associations, precipitation occurred only when CHX was present.

      Conclusion

      The orange-brown precipitate observed in the association between CHX and NaOCl occurs because of the presence of NaOCl, an oxidizing agent causing chlorination of the guanidino nitrogens of the CHX. The precipitates formed in the reaction of CHX with EDTA, saline solution, and ethanol were associated with acid-base reactions, salting-out process, and lower solubility, respectively. NaOCl associated with EDTA, citric acid, and phosphoric acid leads mainly to chlorine gas formation. Intermediate flushes with distilled water seem to be appropriate to prevent or at least reduce formation of by-products.

      Key Words

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      References

        • Byström A.
        • Sundqvist G.
        Bacteriologic evaluation of the efficacy of mechanical root canal instrumentation in endodontic therapy.
        Scand J Dent Res. 1981; 89: 321-328
        • Zehnder M.
        Root canal irrigants.
        J Endod. 2006; 32: 389-398
        • Prado M.
        • Gusman H.
        • Gomes B.P.
        • Simão R.A.
        Scanning electron microscopic investigation of the effectiveness of phosphoric acid in smear layer removal when compared with EDTA and citric acid.
        J Endod. 2011; 37: 255-258
        • Basrani B.R.
        • Manek S.
        • Sodhi R.N.
        • et al.
        Interaction between sodium hypochlorite and chlorhexidine gluconate.
        J Endod. 2007; 33: 966-969
        • Rasimick B.J.
        • Nekich M.
        • Hladek M.M.
        Interaction between chlorhexidine gluconate and EDTA.
        J Endod. 2008; 34: 1521-1523
        • Akisue E.
        • Tomita V.S.
        • Gavini G.
        • Poli de Figueiredo J.A.
        Effect of the combination of sodium hypochlorite and chlorhexidine on dentinal permeability and scanning electron microscopy precipitate observation.
        J Endod. 2010; 36: 847-850
        • Bui T.
        • Baumgartner J.
        • Mitchell J.
        Evaluation of the interaction between sodium hypochlorite and chlorhexidine gluconate and its effect on root dentin.
        J Endod. 2008; 34: 181-185
        • Vivacqua-Gomes N.
        • Ferraz C.C.
        • Gomes B.P.
        • et al.
        Influence of irrigants on the coronal microleakage of laterally condensed gutta-percha root fillings.
        Int Endod J. 2002; 35: 791-795
        • Baumgartner J.C.
        • Ibay A.C.
        The chemical reactions of irrigants used for root canal debridement.
        J Endod. 1987; 13: 47-51
        • Krishnamurthy S.
        • Sudhakaran S.
        Evaluation and prevention of the precipitate formed on interaction between sodium hypochlorite and chlorhexidine.
        J Endod. 2010; 36: 1154-1157
        • Thomas J.E.
        • Sem D.S.
        An in vitro spectroscopic analysis to determine whether para-chloroaniline is produced from mixing sodium hypochlorite and chlorhexidine.
        J Endod. 2010; 36: 315-317
        • Nowicki J.B.
        • Sem D.S.
        An in vitro spectroscopic analysis to determine the chemical composition of the precipitate formed by mixing sodium hypochlorite and chlorhexidine.
        J Endod. 2011; 37: 983-988
        • Araujo A.S.
        • Rocha L.L.
        • Tomazela D.M.
        • et al.
        Electrospray ionization mass spectrometry fingerprinting of beer.
        Analyst. 2005; 130: 884-889
        • Catharino R.
        • Haddad R.
        • Cabrini L.G.
        • et al.
        Characterization of vegetable oils by electrospray ionization mass spectrometry fingerprinting: classification, quality, adulteration, and aging.
        Anal Chem. 2005; 77: 7429-7433
        • Souza G.H.M.F.
        • Catharino R.R.
        • Ifa D.R.
        • et al.
        Peptide fingerprinting of snake venoms by direct infusion nano-electrospray ionization mass spectrometry: potential use in venom identification and taxonomy.
        J Mass Spectrom. 2008; 43: 594-599
        • Basrani B.R.
        • Manek S.
        • Mathers D.
        • et al.
        Determination of 4-chloroaniline and its derivatives formed in the interaction of sodium hypochlorite and chlorhexidine by using gas chromatography.
        J Endod. 2010; 36: 312-314
        • Kind T.
        • Fiehn O.
        Advances in structure elucidation of small molecules using mass spectrometry.
        Bioanal Rev. 2010; 2: 23-60
        • Rockwood A.L.
        • Haimi P.
        Efficient calculation of accurate masses of isotopic peaks.
        J Am Soc Mass Spectrom. 2006; 17: 415-419
        • Kind T.
        • Fiehn O.
        Seven Golden Rules for heuristic filtering of molecular formulas obtained by accurate mass spectrometry.
        BMC Bioinformatics. 2007; 8: 105
        • Zhang C.
        • Reiter C.
        • Eiserich J.P.
        • et al.
        L-Arginine chlorination products inhibit endothelial nitric oxide production.
        J Biol Chem. 2001; 29: 27159-27165
        • Thomas E.L.
        • Jefferson M.M.
        • Grisham M.B.
        Myeloperoxidase-catalyzed incorporation of amines into proteins: role of hypochlorous acid and dichloramines.
        Biochemistry. 1982; 21: 6299-6308
        • Grisham M.B.
        • Jefferson M.M.
        • Melton D.F.
        • Thomas E.L.
        Chlorination of endogenous amines by isolated neutrophils: ammonia-dependent bactericidal, cytotoxic, and cytolytic activities of the chloramines.
        J Biol Chem. 1984; 259: 10404-10413
        • Micklus M.J.
        • Stein I.M.
        The colorimetric determination of mono- and disubstituted guanidines.
        Anal Biochem. 1973; 54: 545-553
      1. Hammock BD, Morisseau CH, Zheng J, et al. Preparation of ureas and related compounds as soluble epoxide hydrolase inhibitors. Patent US6150415 (A) – 2000-11-21.

        • Albright P.S.
        Experimental tests of recent theories descriptive of the salting-out effect.
        J Am Chem Soc. 1937; 59: 2098-2104
        • Grawehr M.
        • Sener B.
        • Waltimo T.
        • Zehnder M.
        Interactions of ethylenediamine tetraacetic acid with sodium hypochlorite in aqueous solutions.
        Int Endod J. 2003; 36: 411-415
        • Mrvos R.
        • Dean B.S.
        • Krenzelok E.P.
        Home exposures to chlorine/chloramine gas: review of 216 cases.
        South Med J. 1993; 86: 654-657
        • Wang T.X.
        • Margerum D.W.
        Kinetics of reversible chlorine hydrolysis: temperature dependence and general-acid/base-assisted mechanisms.
        Inorg Chem. 1994; 33: 1050-1055
        • Nicoson J.S.
        • Perrone T.F.
        • Huff Hartz K.E.
        • et al.
        Kinetics and mechanisms of the reactions of hypochlorous acid, chlorine, and chlorine monoxide with bromite ion.
        Inorg Chem. 2003; 42: 5818-5824
      2. Bard A.J. Parsons R. Jordan J. Standard Potentials in Aqueous Solution. Marcel Dekker, New York1985