Safety assessment of an etidronate in a sodium hypochlorite solution: randomized double-blind trial

N. V. Ballal, P. Gandhi, P. A. Shenoy, V. Shenoy Belle, V. Bhat, D. K. Rechenberg, M. Zehnder

Research output: Contribution to journalArticle

Abstract

Aim: To assess whether Dual Rinse HEDP, an etidronate that can be combined with NaOCl to create an endodontic irrigating solution containing both hypochlorite and a chelator in the form of 1-hydroxyethane 1,1-diphosphonic acid (HEDP), alters the clinical efficacy of NaOCl or adds any untoward clinical effects. Methodology: In this randomized controlled double-blind single-centre trial, a pure NaOCl solution was compared to a HEDP-containing counterpart regarding antimicrobial efficacy, postoperative pain, and the host response by means of changes in MMP-9 levels in periapical fluid. Sixty patients presenting with asymptomatic apical periodontitis (one tooth each) were randomly divided into two groups (N = 30) based on irrigation regime. Pre- and post-treatment microbial aerobic and anaerobic cultures and MMP-9/total protein (TP) periapical fluid samples were collected. Postoperative pain levels were assessed 24 h after treatment. Categorical data were compared between groups using the Fisher's exact test, continuous data using the Wilcoxon signed-rank test, α = 0.05. Results: Irrigation with pure NaOCl rendered 40% canals free of culturable microorganisms, compared to 50% with the NaOCl/HEDP mixture (P = 0.60). As assessed by matrix-assisted laser desorption/ionization-time-of-flight analysis (MALDI-TOF), no apparent selection of aerobic or anaerobic taxa occurred in either group. One patient in the NaOCl group experienced moderate pain, whilst two patients in the NaOCl/HEDP group experienced mild postoperative pain. MMP-9/TP levels in periapical fluid declined significantly (P < 0.001) after 1 week with no medication in the root canal, without significant difference between treatment groups (P > 0.05). Conclusions: This trial found no influence of HEDP on clinical NaOCl effects.

Original languageEnglish
Pages (from-to)1274-1282
Number of pages9
JournalInternational Endodontic Journal
Volume52
Issue number9
DOIs
Publication statusPublished - 01-01-2019

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Etidronic Acid
Sodium Hypochlorite
Safety
Acids
Postoperative Pain
Matrix Metalloproteinases
Periapical Periodontitis
Hypochlorous Acid
Endodontics
Chelating Agents
Nonparametric Statistics
Tooth
Proteins
Lasers
Therapeutics
Pain

All Science Journal Classification (ASJC) codes

  • Dentistry(all)

Cite this

Ballal, N. V. ; Gandhi, P. ; Shenoy, P. A. ; Shenoy Belle, V. ; Bhat, V. ; Rechenberg, D. K. ; Zehnder, M. / Safety assessment of an etidronate in a sodium hypochlorite solution : randomized double-blind trial. In: International Endodontic Journal. 2019 ; Vol. 52, No. 9. pp. 1274-1282.
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title = "Safety assessment of an etidronate in a sodium hypochlorite solution: randomized double-blind trial",
abstract = "Aim: To assess whether Dual Rinse HEDP, an etidronate that can be combined with NaOCl to create an endodontic irrigating solution containing both hypochlorite and a chelator in the form of 1-hydroxyethane 1,1-diphosphonic acid (HEDP), alters the clinical efficacy of NaOCl or adds any untoward clinical effects. Methodology: In this randomized controlled double-blind single-centre trial, a pure NaOCl solution was compared to a HEDP-containing counterpart regarding antimicrobial efficacy, postoperative pain, and the host response by means of changes in MMP-9 levels in periapical fluid. Sixty patients presenting with asymptomatic apical periodontitis (one tooth each) were randomly divided into two groups (N = 30) based on irrigation regime. Pre- and post-treatment microbial aerobic and anaerobic cultures and MMP-9/total protein (TP) periapical fluid samples were collected. Postoperative pain levels were assessed 24 h after treatment. Categorical data were compared between groups using the Fisher's exact test, continuous data using the Wilcoxon signed-rank test, α = 0.05. Results: Irrigation with pure NaOCl rendered 40{\%} canals free of culturable microorganisms, compared to 50{\%} with the NaOCl/HEDP mixture (P = 0.60). As assessed by matrix-assisted laser desorption/ionization-time-of-flight analysis (MALDI-TOF), no apparent selection of aerobic or anaerobic taxa occurred in either group. One patient in the NaOCl group experienced moderate pain, whilst two patients in the NaOCl/HEDP group experienced mild postoperative pain. MMP-9/TP levels in periapical fluid declined significantly (P < 0.001) after 1 week with no medication in the root canal, without significant difference between treatment groups (P > 0.05). Conclusions: This trial found no influence of HEDP on clinical NaOCl effects.",
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Safety assessment of an etidronate in a sodium hypochlorite solution : randomized double-blind trial. / Ballal, N. V.; Gandhi, P.; Shenoy, P. A.; Shenoy Belle, V.; Bhat, V.; Rechenberg, D. K.; Zehnder, M.

In: International Endodontic Journal, Vol. 52, No. 9, 01.01.2019, p. 1274-1282.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Safety assessment of an etidronate in a sodium hypochlorite solution

T2 - randomized double-blind trial

AU - Ballal, N. V.

AU - Gandhi, P.

AU - Shenoy, P. A.

AU - Shenoy Belle, V.

AU - Bhat, V.

AU - Rechenberg, D. K.

AU - Zehnder, M.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Aim: To assess whether Dual Rinse HEDP, an etidronate that can be combined with NaOCl to create an endodontic irrigating solution containing both hypochlorite and a chelator in the form of 1-hydroxyethane 1,1-diphosphonic acid (HEDP), alters the clinical efficacy of NaOCl or adds any untoward clinical effects. Methodology: In this randomized controlled double-blind single-centre trial, a pure NaOCl solution was compared to a HEDP-containing counterpart regarding antimicrobial efficacy, postoperative pain, and the host response by means of changes in MMP-9 levels in periapical fluid. Sixty patients presenting with asymptomatic apical periodontitis (one tooth each) were randomly divided into two groups (N = 30) based on irrigation regime. Pre- and post-treatment microbial aerobic and anaerobic cultures and MMP-9/total protein (TP) periapical fluid samples were collected. Postoperative pain levels were assessed 24 h after treatment. Categorical data were compared between groups using the Fisher's exact test, continuous data using the Wilcoxon signed-rank test, α = 0.05. Results: Irrigation with pure NaOCl rendered 40% canals free of culturable microorganisms, compared to 50% with the NaOCl/HEDP mixture (P = 0.60). As assessed by matrix-assisted laser desorption/ionization-time-of-flight analysis (MALDI-TOF), no apparent selection of aerobic or anaerobic taxa occurred in either group. One patient in the NaOCl group experienced moderate pain, whilst two patients in the NaOCl/HEDP group experienced mild postoperative pain. MMP-9/TP levels in periapical fluid declined significantly (P < 0.001) after 1 week with no medication in the root canal, without significant difference between treatment groups (P > 0.05). Conclusions: This trial found no influence of HEDP on clinical NaOCl effects.

AB - Aim: To assess whether Dual Rinse HEDP, an etidronate that can be combined with NaOCl to create an endodontic irrigating solution containing both hypochlorite and a chelator in the form of 1-hydroxyethane 1,1-diphosphonic acid (HEDP), alters the clinical efficacy of NaOCl or adds any untoward clinical effects. Methodology: In this randomized controlled double-blind single-centre trial, a pure NaOCl solution was compared to a HEDP-containing counterpart regarding antimicrobial efficacy, postoperative pain, and the host response by means of changes in MMP-9 levels in periapical fluid. Sixty patients presenting with asymptomatic apical periodontitis (one tooth each) were randomly divided into two groups (N = 30) based on irrigation regime. Pre- and post-treatment microbial aerobic and anaerobic cultures and MMP-9/total protein (TP) periapical fluid samples were collected. Postoperative pain levels were assessed 24 h after treatment. Categorical data were compared between groups using the Fisher's exact test, continuous data using the Wilcoxon signed-rank test, α = 0.05. Results: Irrigation with pure NaOCl rendered 40% canals free of culturable microorganisms, compared to 50% with the NaOCl/HEDP mixture (P = 0.60). As assessed by matrix-assisted laser desorption/ionization-time-of-flight analysis (MALDI-TOF), no apparent selection of aerobic or anaerobic taxa occurred in either group. One patient in the NaOCl group experienced moderate pain, whilst two patients in the NaOCl/HEDP group experienced mild postoperative pain. MMP-9/TP levels in periapical fluid declined significantly (P < 0.001) after 1 week with no medication in the root canal, without significant difference between treatment groups (P > 0.05). Conclusions: This trial found no influence of HEDP on clinical NaOCl effects.

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