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 »  Home  »  Endodontic Articles 9  »  Inflammatory response to different endodontic irrigating solutions
Inflammatory response to different endodontic irrigating solutions
Discussion - References.



Discussion.
The migration of inflammatory cells into the peritoneal cavity of mice has been used to evaluate inflammatory response caused by endodontic materials (Silva et al. 1997) and calcium hydroxide dressings (Nelson Filho et al.1999). In this study, the solutions did not cause a significant increase in neutrophils or mononuclear cells in the peritoneal cavity at 4 and 24 h (P > 0.05). However, at 48-168 h, the 0.5% sodium hypochlorite solution caused a greater increase in the number of neutrophils in the peritoneal cavity (P < 0.05). This response is probably due to tissue irritation caused by the capacity of sodium hypochlorite to dissolve organic tissue (Grossman & Meiman 1941, Gordon et al. 1981), and is increased at higher concentrations. Yesilsoy et al. (1995) and Spangberg (1973) reported the irritating effect of sodium hypochlorite, particularly at high concentrations. Leonardo et al. (1984) observed periapical and apical tissue irritation after biomechanical preparation of dog’s teeth using 4% sodium hypochlorite solution.
Two percent chlorhexidine solution has a wide spectrum of antibacterial effect as well as prolonged residual effect (Jeansonne & White 1994,White et al. 1997, Leonardo et al.1999), suggesting its use as an irrigating solution in infected root canals. This solution has also shown to be non-irritating to tissue. The use of 2% chlorhexidine as a periodontal irrigant did not cause obvious toxic effect son gingival tissue (Loe&Schiott1970, Southard et al.1989).
At all experimental periods, chlorhexidine was statistically similar to the control group (P > 0.05). The absence of oedema observed by protein leakage suggested no significant tissue damage, indicating biocompatibility of chlorhexidine (Yesilsoy et al.1995).
Jimenes-Rubio et al. (1997) reported that5.25%sodium hypochlorite and 1% glutaraldehyde significantly decreased macrophage adhesion capacity, an important factor during inflammation. Segura et al. (1999) observed that0.12%chlorhexidine solution inhibited macrophage adherence, however, at lower intensity than 5.25% sodium hypochlorite.
Although chlorhexidine had better biological results compared to sodium hypochlorite, it does not dissolve tissue or inactivate bacterial LPS. Therefore its use has been recommended as an alternative to sodium hypochlorite in patients who are allergic to hypochlorite or in teeth with incomplete roots (Jeansonne & White 1994). Fuss & Trope (1996) have recommended its use in crestal perforations because a biocompatible medicament is essential to prevent inflammatory response in proximity to the epithelial attachment. It can also be used for final irrigation due to its broad spectrum of antimicrobial activity (Delany et al. 1982, Ohara et al. 1993, Jeansonne &White1994).

References.

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