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Combined and independent cytotoxicity of sodium hypochlorite, ethylenediaminetetraacetic acid and chlorhexidine
Author(s) -
Vouzara T.,
Koulaouzidou E.,
Ziouti F.,
Economides N.
Publication year - 2016
Publication title -
international endodontic journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.988
H-Index - 119
eISSN - 1365-2591
pISSN - 0143-2885
DOI - 10.1111/iej.12517
Subject(s) - sodium hypochlorite , chlorhexidine , ethylenediaminetetraacetic acid , benzalkonium chloride , chemistry , serial dilution , cytotoxicity , cytotoxic t cell , pharmacology , nuclear chemistry , dentistry , chromatography , medicine , in vitro , chelation , biochemistry , alternative medicine , organic chemistry , pathology
Aim To evaluate the capacity of commonly used root canal irrigants to induce cytotoxic effects, when applied singly or in combination. The hypothesis tested was that the irrigants were less cytotoxic when applied in combination than independently. Methodology MRC 5 cells were grown as monolayer cultures at 37 °C in an atmosphere containing 5% CO 2 in air and 100% relative humidity. Cells were exposed to sodium hypochlorite (Na OC l), ethylenediaminetetraacetic acid ( EDTA ), chlorhexidine ( CHX ) and their combinations (Na OC l/ EDTA , Na OC l/ CHX , EDTA / CHX ) in serial dilutions. Growth medium was Dulbecco's modified Eagle's medium supplemented with 10% foetal bovine serum and antibiotics and was used as control. The effect on cell survival was estimated after 6 and 24 h of exposure by means of the sulforhodamine B assay, in reference to controls. Dose–response curves were plotted, and 50% inhibitory doses ( IC 50 ) were subjected to statistical analysis ( anova and post hoc comparison test; P < 0.05). Analysis of cell survival and interaction of the irrigants was performed using CalcuSyn dose effect analyzer software to calculate a combination index ( CI ). Results The tested irrigants were cytotoxic in dose‐ and time‐dependent manner. CHX was the most cytotoxic irrigant tested, followed by Na OC l, whilst EDTA was the least cytotoxic irrigant tested. The difference between CHX and Na OC l was significant ( P < 0.05) as well as between Na OC l and EDTA ( P < 0.05). Based on CalcuSyn modelling, a mainly antagonistic effect was recorded with Na OC l/ CHX and Na OC l/ EDTA combinations. The combination EDTA / CHX had an additive to antagonistic effect. Conclusions CHX was significantly more cytotoxic than Na OC l and EDTA . Na OC l was significantly more cytotoxic than EDTA . The combined action of irrigants did not produce a significant increase in their cytotoxicity.