Interactions Between Calcium Hypochlorite and Irrigants Commonly Used in Endodontic Practice: A Chemical Analysis

J Endod. 2023 Jul;49(7):894-900. doi: 10.1016/j.joen.2023.05.003. Epub 2023 May 12.

Abstract

Introduction: This study aimed to identify possible products resulting from chemical interactions between calcium hypochlorite (Ca[OCl]2) and other irrigants for endodontic use using electrospray ionization quadrupole time-of-flight mass spectrometry.

Methods: The 5.25% Ca(OCl)2 was associated with either 70% ethanol solution, distilled water, saline solution (0.9% sodium chloride), 5% sodium thiosulfate, 10% citric acid, 17% ethylenediaminetetraacetic acid (EDTA), or 2% chlorhexidine (CHX). The reaction ratio was 1:1 and the products obtained were analyzed by electrospray ionization quadrupole time-of-flight mass spectrometry.

Results: The interactions between Ca(OCl)2 and CHX generated an orange-brown precipitate, without identification of para-chloroaniline and between Ca(OCl)2 and sodium thiosulfate, a milky-white precipitate. Furthermore, when the oxidizing agent was associated with EDTA and citric acid, chlorine gas was released. As for the other associations, 70% ethanol, distilled water, and saline solution, no precipitation or gas release occurred.

Conclusions: The orange-brown precipitate occurs due to the chlorination of guanidine nitrogens, and the milky-white precipitate is due to the partial neutralization of the oxidizing agent. The release of chlorine gas occurs due to the low pH of the mixture, which results in the rapid formation and decomposition of chlorine. In this context, an intermediate rinsed with distilled water, saline solution, and ethanol between Ca(OCl)2 and CHX, citric acid, and EDTA seems to be appropriate to prevent the formation of by-products when these irrigants need to be used in the canal. Furthermore, if it is necessary to use sodium thiosulfate, a larger volume of the solution must be used compared to that used for the oxidizing solution.

Keywords: Calcium hypochlorite; chemical interactions; endodontic irrigants; mass spectrometry.

MeSH terms

  • Chemical Precipitation
  • Chlorhexidine / chemistry
  • Chlorine*
  • Citric Acid / chemistry
  • Edetic Acid / chemistry
  • Ethanol
  • Oxidants
  • Root Canal Irrigants / chemistry
  • Saline Solution*
  • Sodium Chloride
  • Sodium Hypochlorite / chemistry
  • Water

Substances

  • sodium thiosulfate
  • calcium hypochlorite
  • Edetic Acid
  • Saline Solution
  • Chlorine
  • Root Canal Irrigants
  • Chlorhexidine
  • Ethanol
  • Sodium Chloride
  • Oxidants
  • Water
  • Citric Acid
  • Sodium Hypochlorite