sodium-hypochlorite and 4-chloroaniline

To determine if the formation of para-chloroaniline (PCA) can be avoided by using an alternative irrigant following sodium hypochlorite but before chlorhexidine.. Fifty-five single-rooted teeth were decoronated, instrumented to size 40, .06 taper whilst being irrigated with 14% ethylene-diamine-tetra-acetic acid (EDTA) and 6% NaOCl. Samples were then randomly divided into three experimental and two control groups. Group 1 was irrigated with saline followed by 2% chlorhexidine gluconate (CHX). Group 2 was irrigated with 50% citric acid (CA) followed by 2% CHX. Group 3 was irrigated with 14% EDTA followed by 2% CHX. The chemical identity and quantification of the PCA in the formed precipitate was determined using gas chromatography/mass spectrometry (GC/MS).. All experimental groups contained PCA. The mean level of PCA for group 1 (sterile saline) was 229 ng mL(-1), group 2 (citric acid) 72 ng mL(-1) and group 3 (EDTA) 400 ng mL(-1), respectively. A significant difference was found between the saline and EDTA groups and the negative control (P < 0.05). Although no statistical significance was found between the negative control and citric acid group, PCA was still present in this experimental group.. Citric acid used as the intermittent irrigant had the least amount of PCA formation in the canal system. Until the threshold required to cause biological damage in humans is determined, the combination of NaOCl and CHX in root canal treatment should be avoided.

Topics: Aniline Compounds; Anti-Infective Agents, Local; Chemical Precipitation; Chlorhexidine; Citric Acid; Dental Pulp Cavity; Edetic Acid; Gas Chromatography-Mass Spectrometry; Humans; Materials Testing; Root Canal Irrigants; Root Canal Preparation; Sodium Chloride; Sodium Hypochlorite; Tryptophan Hydroxylase

To evaluate intermediate treatments between sodium hypochlorite and chlorhexidine gluconate irrigations for the prevention of a toxic brown precipitate in root canal therapy.. Thirty-nine premolars were irrigated with 6% sodium hypochlorite and divided into either: No intermediate treatment; Dry paper points; three different irrigations with 17% ethylenediaminetetraacetic acid, deionized water, or 5% sodium thiosulfate. 2% chlorhexidine gluconate was the final irrigant in all groups. Sectioned teeth were analyzed for brown precipitate intensity and area using stereomicroscopy and components related to para-chloroaniline using Time-of-Flight Secondary Ion Mass Spectrometry (ToF-SIMS).. Stereomicroscopy showed that 5% STS significantly reduced brown precipitate intensity and area as compared with no intermediate irrigation (p < .05, Chi-square, generalized linear model, and Tukey's multiple comparison tests). Utilizing ToF-SIMS, 5% sodium thiosulfate was most effective in reducing the components representing para-chloroaniline and chlorhexidine gluconate.. The 5% sodium thiosulfate was most effective among other intermediate treatments, assessed by stereomicroscopy and ToF-SIMS.

Topics: Chemical Precipitation; Root Canal Irrigants; Sodium Hypochlorite

Topics: Aniline Compounds; Anti-Infective Agents, Local; Chlorhexidine; Lasers, Solid-State; Low-Level Light Therapy; Oxidants; Photoacoustic Techniques; Proton Magnetic Resonance Spectroscopy; Root Canal Irrigants; Root Canal Preparation; Sodium Hypochlorite

The literature reveals controversies regarding the formation of para-chloroaniline (PCA) when chlorhexidine (CHX) is mixed with sodium hypochlorite (NaOCl). This study aimed to investigate the stability of PCA in the presence of NaOCl and to examine the in vitro cytotoxic effects of CHX/NaOCl reaction mixtures.. Different volumes of NaOCl were added to CHX (mix 1) or PCA (mix 2). Upon centrifugation, the supernatant and precipitate fractions collected from samples were analyzed using high-performance liquid chromatography. The cytotoxic effects of both fractions were examined on human periodontal ligament and 3T3 fibroblast cell lines.. High-performance liquid chromatographic analysis showed no PCA signal when NaOCl was mixed with CHX (mix 1). In mix 2, the intensity of PCA was decreased when NaOCl was added to PCA, and chromatographic signals, similar to that of CHX/NaOCl, were also observed. The mortality of precipitates exerted on both cell lines was lower compared with that of supernatants.. The discrepancy in the data from the literature could be caused by the instability of the PCA in the presence of NaOCl. The CHX/NaOCl reaction mixture exhibits a wide range of cytotoxic effects.

Topics: Aniline Compounds; Cell Line; Chlorhexidine; Chromatography, High Pressure Liquid; Humans; Sodium Hypochlorite; Toxicity Tests

Mixing sodium hypochlorite (NaOCl) with chlorhexidine (CHX) forms a brown-colored precipitate. Previous studies are not in agreement whether this precipitate contains para-chloroaniline (PCA). Tests used for analysis may demonstrate different outcomes. Purpose of this study was to determine whether PCA is formed through the reaction of mixing NaOCl and CHX by using high performance liquid chromatography, proton nuclear magnetic resonance spectroscopy, gas chromatography, thin layer chromatography, infrared spectroscopy, and gas chromatography/mass spectrometry.. To obtain a brown precipitate, 4.99% NaOCl was mixed with 2.0% CHX. This brown precipitate was analyzed and compared with signals obtained from commercially available 4.99% NaOCl, 2% solutions, and 98% PCA in powder form.. Chromatographic and spectroscopic analyses showed that brown precipitate does not contain free PCA.. This study will be a cutoff proof for the argument on PCA formation from reaction of CHX and NaOCl.

Topics: Aniline Compounds; Chemical Precipitation; Chlorhexidine; Chromatography, High Pressure Liquid; Drug Interactions; Gas Chromatography-Mass Spectrometry; Magnetic Resonance Spectroscopy; Root Canal Irrigants; Sodium Hypochlorite

(i) To compare chlorhexidine and QMix(TM) in terms of orange-brown precipitate generation in root canals and (ii) to analyse the precipitate produced by mixing chlorhexidine and QMix(™) with NaOCl to determine whether para-chloroaniline was produced.. The root canals of 57 single-rooted anterior teeth were prepared using ProTaper Universal rotary instruments up to size F4. Two millilitres of 2.5% NaOCl was used between each instrument change. The specimens were then divided randomly into three groups (n = 19) and irrigated as follows: group 1, 5 mL of distilled water (control group) for 60 s; group 2, 5 mL of 2% chlorhexidine for 60 s; and group 3, 5 mL of QMix for 60 s. The roots were split longitudinally, and one of the halves was photographed using a stereomicroscope. The amount of orange-brown precipitate was evaluated using a four-grade scoring system. The data were analysed statistically using the Kruskal-Wallis and Mann-Whitney U-tests (P = 0.05). To evaluate whether the precipitates included para-chloroaniline, 5 mL of 2% chlorhexidine and 5 mL QMix were separately mixed with 5 mL of 2.5% NaOCl in two flasks. After centrifugation, precipitates were obtained and analysed using (1) H NMR spectra. The data were subjected to statistical analysis using the Kruskal-Wallis and Mann-Whitney tests at a 95% confidence level (P = 0.05).. Chlorhexidine had significantly higher scores than QMix(™) in terms of orange-brown precipitate formed in the root canals (P < 0.001). According to the 1H NMR spectra, para-chloroaniline was present in the mixture of chlorhexidine and NaOCl. However, the mixture of QMix(™) and NaOCl did not result in para-chloroaniline formation.. QMix(™) does not form para-chloroaniline when associated with NaOCl.

Topics: Aniline Compounds; Biguanides; Chemical Precipitation; Chlorhexidine; Dental Pulp Cavity; Humans; In Vitro Techniques; Polymers; Root Canal Irrigants; Sodium Hypochlorite

Interaction of sodium hypochlorite (NaOCl) mixed with chlorhexidine (CHX) produces a brown precipitate containing para-chloroaniline (PCA). When QMiX is mixed with NaOCl, no precipitate forms, but color change occurs. The aim of this study was to qualitatively assess the formation of precipitate and PCA on the surface and in the tubules of dentin irrigated with NaOCl, followed either by EDTA, NaOCl, and CHX or by saline and QMiX by using time-of-flight secondary ion mass spectrometry (TOF-SIMS).. Dentin blocks were obtained from human maxillary molars, embedded in resin, and cross-sectioned to expose dentin. Specimens in group 1 were immersed in 2.5% NaOCl, followed by 17% EDTA, 2.5% NaOCl, and 2% CHX. Specimens in group 2 were immersed in 2.5% NaOCl, followed by saline and QMiX. The dentin surfaces were subjected to TOF-SIMS spectra analysis. Longitudinal sections of dentin blocks were then exposed and subjected to TOF-SIMS analysis. All samples and analysis were performed in triplicate for confirmation.. TOF-SIMS analysis of group 1 revealed an irregular precipitate, containing PCA and CHX breakdown products, on the dentin surfaces, occluding and extending into the tubules. In TOF-SIMS analysis of group 2, no precipitates, including PCA, were detected on the dentin surface or in the tubules.. Within the limitations of this study, precipitate containing PCA was formed in the tubules of dentin irrigated with NaOCl followed by CHX. No precipitates or PCA were detected in the tubules of dentin irrigated with NaOCl followed by saline and QMiX.

Topics: Aniline Compounds; Biguanides; Chemical Precipitation; Chlorhexidine; Color; Dentin; Edetic Acid; Humans; Materials Testing; Polymers; Root Canal Irrigants; Sodium Chloride; Sodium Hypochlorite; Spectrometry, Mass, Secondary Ion

Recent studies have reported the color change and formation of precipitates containing para-chloroaniline (PCA) after a reaction of sodium hypochlorite (NaOCl) and chlorhexidine (CHX). Alexidine (ALX), a biguanide disinfectant similar to CHX, has greater affinity for bacterial virulence factors than CHX. This study determined by electrospray ionization mass spectrometry (ESI-MS) and scanning electron microscopy (SEM) whether the chemical interaction between ALX and NaOCl results in PCA or precipitates.. ESI-MS was performed on 4 different concentrations of ALX (1%, 0.5%, 0.25%, and 0.125%) with 4% NaOCl to detect the presence of PCA. As control groups, 1% ALX, 0.5% PCA, and a mixture of 2% CHX and 4% NaOCl were analyzed. The formation of precipitates on the dentinal surfaces of premolar root canals treated with the solutions of ALX and NaOCl (AN) or CHX and NaOCl (CN) was observed by SEM and the color change in the reaction solutions was also analyzed.. ESI-MS showed that the peak (mass/charge ratio = 128.026) in the PCA spectrum was not detected in any of the 4 AN solutions, whereas the peak was found in the CN solution. SEM revealed precipitates covering dentinal surfaces in the CN solution. The AN solutions produced no precipitate. The AN solutions changed in color from light yellow to transparent with decreasing ALX concentration, whereas peach-brown discoloration was observed in the CN solution.. The interaction of ALX and NaOCl did not produce PCA or precipitates, and the color of the reacted solution changed transparent with decreasing ALX concentration.

Topics: Aniline Compounds; Bicuspid; Biguanides; Chemical Precipitation; Chlorhexidine; Color; Dental Disinfectants; Dental Pulp Cavity; Dentin; Humans; Materials Testing; Microscopy, Electron, Scanning; Root Canal Irrigants; Sodium Hypochlorite; Spectrometry, Mass, Electrospray Ionization

The combination of sodium hypochlorite (NaOCl) and chlorhexidine (CHX) results in the formation of a precipitate. In a previous study, we demonstrated the formation of 4-chloroaniline (PCA) in the precipitate by using x-ray photon spectroscopy (XPS) and time of flight secondary ion mass spectrometry (TOF-SIMS). The TOF-SIMS results showed a peak at 127 amu, which is characteristic of 4-chloroaniline. However, this could also be characteristic of other isomers of 4-chloroaniline such as 2-chloroaniline and 3-chloroaniline.. The aim of this study was to further identify the precipitate by using gas chromatography-mass spectrometry (GC-MS).. The results showed an absence of other aniline derivatives in the precipitate. Only PCA was found.. Further investigations of the precipitate should address the bioavailability of PCA leaching out from dentin and its cytotoxicity. Until the precipitate is studied further, it would appear prudent to minimize its formation by avoiding the use of CHX together with NaOCl.

Topics: Aniline Compounds; Chemical Precipitation; Chlorhexidine; Drug Interactions; Gas Chromatography-Mass Spectrometry; Root Canal Irrigants; Sodium Hypochlorite

The purpose of this in vitro study was to determine whether para-chloroaniline (PCA) is formed through the reaction of mixing sodium hypochlorite (NaOCl) and chlorhexidine (CHX).. Initially, commercially available samples of chlorhexidine acetate (CHXa) and PCA were analyzed with 1H nuclear magnetic resonance (NMR) spectroscopy. Two solutions, NaOCl and CHXa, were warmed to 37 degrees C, and when mixed they produced a brown precipitate. This precipitate was separated in half, and pure PCA was added to 1 of the samples for comparison before they were each analyzed with 1H NMR spectroscopy.. The peaks in the 1H NMR spectra of CHXa and PCA were assigned to specific protons of the molecules, and the location of the aromatic peaks in the PCA spectrum defined the PCA doublet region. Although the spectrum of the precipitate alone resulted in a complex combination of peaks, on magnification there were no peaks in the PCA doublet region that were intense enough to be quantified. In the spectrum of the precipitate to which PCA was added, 2 peaks do appear in the PCA doublet region. Comparing this spectrum with that of precipitate alone, the peaks in the PCA doublet region are not visible before the addition of PCA.. On the basis of this in vitro study, the reaction mixture of NaOCl and CHXa does not produce PCA at any measurable quantity, and further investigation is needed to determine the chemical composition of the brown precipitate.

Topics: Aniline Compounds; Chemical Precipitation; Chlorhexidine; Drug Interactions; Magnetic Resonance Spectroscopy; Root Canal Irrigants; Sodium Hypochlorite

The purpose of this study was (1) to evaluate maximum thickness the and chemical composition of the precipitate formed between sodium hypochlorite (NaOCl) and chlorhexidine (CHX) and (2) to evaluate effectiveness of absolute alcohol to remove residual NaOCl and thereby prevent the formation of the precipitate.. Forty extracted single-rooted human teeth were decoronated, and the canals were instrumented. In the test group (Ts group), canals were irrigated with 17% EDTA and 2.5% NaOCl followed by 2% CHX. In the absolute alcohol (Aba), saline (Sa), and distilled water (Dw) groups, intermediate flushes of absolute alcohol, saline, and distilled water were used between the last two irrigants. Teeth were sectioned longitudinally and subjected to stereomicroscopic examination.. The Ts group samples showed orange-brown precipitate, concentrated more in the coronal and middle thirds, whereas the Aba group showed no evidence of precipitate. The Sal and Dw groups showed minimal precipitate in the coronal and middle thirds. The thickness of the precipitate was measured using the ProgRes computer software (Olympus, Hamburg, Germany). The chemical composition of the precipitate was confirmed by Beilstein and HCl tests, and the nuclear magnetic resonance imaging technique confirmed chlorine in the para position of the benzene ring.. The interaction between NaOCl and CHX resulted in an insoluble neutral salt as a precipitate that can be prevented using absolute alcohol and minimized using saline and distilled water as intermediate flushes.

Topics: Aniline Compounds; Chelating Agents; Chemical Precipitation; Chlorhexidine; Color; Dental Pulp Cavity; Edetic Acid; Ethanol; Humans; Materials Testing; Root Canal Irrigants; Root Canal Preparation; Sodium Chloride; Sodium Hypochlorite; Surface Properties; Water

The combination of sodium hypochlorite (NaOCl) and chlorhexidine (CHX) results in the formation of a precipitate. The aim of this study was to determine the minimum concentration of NaOCl required to form a precipitate with 2.0% CHX. This was accomplished with a serial dilution technique. X-ray photon spectroscopy (XPS) and time-of-flight secondary ion mass spectrometry (TOF-SIMS) were used to qualify and quantify the precipitate. A color change and precipitate were induced in 2.0% CHX by 0.023% and 0.19% NaOCl, respectively. Both XPS and TOF-SIMS showed the presence of para-chloroaniline in an amount directly related to the concentration of NaOCl used. Until this precipitate is studied further, its formation should be avoided by removing the NaOCl before placing CHX into the canal.

Topics: Aniline Compounds; Chemical Precipitation; Chlorhexidine; Color; Dose-Response Relationship, Drug; Drug Interactions; Dye Dilution Technique; Root Canal Irrigants; Sodium Hypochlorite; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization; Spectrometry, X-Ray Emission