Cytotoxicity and Genotoxicity of Triton All-In-One Irrigation Solution: An InVitro Study

Successful endodontic therapy depends on effective microbial control and the biocompatibility of irrigants. While sodium hypochlorite (NaOCl) and ethylenediaminetetraacetic acid (EDTA) are widely used, concerns regarding their cytotoxic and genotoxic potential remain. Triton, a novel all-in-one irrigant, combines NaOCl with chelators and surfactants, potentially simplifying irrigation. This study aimed to evaluate the cytotoxicity and genotoxicity of Triton compared with NaOCl and EDTA in human periodontal ligament fibroblasts.

Human periodontal ligament fibroblasts were exposed to 4% NaOCl, 6% NaOCl, 17% EDTA, and Triton for 1 and 10 minutes. Cytotoxicity was assessed using the Cell Counting Kit-8 assay. Genotoxicity was evaluated via immunofluorescence staining for γH2AX and 53BP1, markers of DNA double-strand breaks. A total of 0.9% sodium chloride and phosphate-buffered saline served as the negative controls, while lysis buffer and hydrogen peroxide served as positive controls in respective studies.

Triton exhibited cytotoxicity comparable to 4% and 6% NaOCl but significantly lower than 17% EDTA. Immunofluorescence analysis showed no genotoxicity with Triton or NaOCl at either concentration or time point. In contrast, 17% EDTA induced a time-dependent increase in γH2AX/53BP1 colocalized foci, indicating DNA damage.

Triton has shown cytotoxicity and genotoxicity levels comparable to those of NaOCl while demonstrating significantly lower toxicity than 17% EDTA in both assays. These findings suggest that Triton may serve as a beneficial addition to the current endodontic irrigation armamentarium, offering a simplified protocol.