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Interaction between sodium hypochlorite and chlorhexidine gluconate.

Bettina R Basrani¹, Sheela Manek, Rana N S Sodhi

¹Department of Endodontics University of Toronto, Toronto, Ontario, Canada. bettina.basrani@dentistry.utoronto.ca

Journal of Endodontics

|September 20, 2007

Summary

Mixing sodium hypochlorite (NaOCl) with chlorhexidine (CHX) creates a precipitate. This study found the minimum NaOCl concentration to form this precipitate with 2.0% CHX, identifying para-chloroaniline as a component.

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Area of Science:

Dental materials science
Biochemistry
Analytical chemistry

Background:

Sodium hypochlorite (NaOCl) and chlorhexidine (CHX) are widely used in endodontics.
Their combination can lead to an undesirable precipitate formation.
Understanding the interaction is crucial for clinical safety and efficacy.

Purpose of the Study:

To determine the minimum concentration of sodium hypochlorite (NaOCl) that precipitates with 2.0% chlorhexidine (CHX).
To characterize the chemical composition of the precipitate formed.
To provide guidance on avoiding adverse chemical interactions in clinical practice.

Main Methods:

Serial dilution technique to establish minimum precipitating concentrations.
X-ray photon spectroscopy (XPS) for elemental analysis.
Time-of-flight secondary ion mass spectrometry (TOF-SIMS) for surface chemical characterization.

Main Results:

A color change was observed with NaOCl concentrations as low as 0.023%.
A visible precipitate formed at 0.19% NaOCl.
XPS and TOF-SIMS confirmed the presence of para-chloroaniline, with amounts correlating to NaOCl concentration.

Conclusions:

The interaction between NaOCl and CHX produces a precipitate containing para-chloroaniline.
The concentration of NaOCl significantly influences precipitate formation.
Clinicians should avoid irrigating with NaOCl and CHX sequentially without intermediate flushing to prevent precipitate generation.