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Research methods assessing sodium hypochlorite cytotoxicity: A scoping review
Hernán Coaguila-Llerena1, Luana Raphael da Silva1, Gisele Faria1
1Department of Restorative Dentistry, Araraquara School of Dentistry, São Paulo State University -UNESP, Araraquara, São Paulo, Brazil.
Heliyon
|January 9, 2024
Summary
Standardizing sodium hypochlorite (NaOCl) cytotoxicity testing is crucial. Methodological variations, like dilution fluids and exposure times, significantly impact results, necessitating refined protocols for accurate cytotoxicity assessment.
Area of Science:
- Biomaterials Science
- Dental Materials
- Toxicology
Background:
- Sodium hypochlorite (NaOCl) is a widely used irrigant in endodontics.
- Varied methodologies for assessing NaOCl cytotoxicity lead to inconsistent and arbitrary interpretations.
- Lack of standardization hinders reliable comparison of cytotoxicity data.
Purpose of the Study:
- To critically review and discuss diverse methodological protocols for evaluating NaOCl cytotoxicity.
- To identify key variables influencing NaOCl cytotoxicity assessments.
- To highlight the need for standardized testing procedures.
Main Methods:
- A comprehensive scoping review of literature from PubMed and Embase databases up to July 2023.
- Identification and methodological mining of 90 relevant studies.
- Data extraction focused on cell type, cytotoxicity assay, NaOCl dilution, presence of fetal bovine serum (FBS), and exposure duration.
Main Results:
- Culture media buffering substances neutralize NaOCl pH, potentially biasing cytotoxicity results.
- Saline dilution is recommended for short exposures simulating chemo-mechanical preparation.
- Culture medium dilution is advised for long exposures simulating irrigant extrusion.
- Fetal bovine serum (FBS) presence can reduce NaOCl toxicity.
Conclusions:
- Significant variability exists in NaOCl cytotoxicity testing methodologies.
- Inconsistent protocols risk generating inaccurate results.
- Refinement and standardization of cytotoxicity assays are essential for reliable scientific conclusions.
