Self-perceived pain levels following irrigation with various concentrations of sodium hypochlorite solution and gels: A systematic review of randomized clinical studies


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Published: Mar 30, 2024
DOI: https://doi.org/10.37983/IJDM.2024.6105
Keywords:
Root canal treatment, Irrigation, Sodium hypochlorite, Postoperative pain, endodontic
Section
Systematic Reviews
Statistic

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Maryam Altuhafy
Eastman Institute for Oral Health
Ghida Askar
Eastman Institute for Oral Health
Luay Jabr
Eastman Institute for Oral Health
Zegar Zegar
Loma Linda University
https://orcid.org/0009-0008-7992-5239
Junad Khan
Eastman Institute for Oral Health
https://orcid.org/0000-0002-3107-6118

Abstract

Background: Sodium hypochlorite, a prevalent root canal irrigation solution, valued for its antibacterial properties and tissue-dissolving abilities, varies in concentration (0.5% to 8.25%). However, its efficacy across formulations awaits systematic evaluation.
Aim: To evaluate self-perceived post-operative pain levels in a 5.25% concentration of NaOCl in gel or solution form.
Materials and Methods: An unrestricted search of indexed databases (PubMed, Embase, Scopus, Web of Science, and Cochrane) and a manual search were performed up to April 2023. Three randomized controlled trials (RCTs) compared a solution form of 5.25% NaOCl to other solution concentrations, whereas 2 RCTs compared a gel form of 5.25% NaOCl concentration to 5.25% NaOCl solution form. The risk of Bias (RoB) assessment was conducted using the Cochrane tool.
Results: A total of 5 RCTs met the inclusion criteria and were included in the review. Four RCTs used the visual analog scale (VAS), whereas 1 RCT used the numeric rating scale (NRS) to assess post-operative pain. Three RCTs had a moderate Risk of Bias (RoB), whereas 1 had a low and 1 had a high RoB.
Conclusion: Based on the current evidence the concentration of NaOCl used during irrigation did not have any effect on the post-operative pain developed regardless of the use of a gel or solution forms. Future randomized studies with standardized protocols are needed to further investigate the efficacy of NaOCl concentration on postoperative pain in endodontic treatment.

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How to Cite
Altuhafy, M., Askar, G., Jabr, L., Zegar, Z., & Khan, J. (2024). Self-perceived pain levels following irrigation with various concentrations of sodium hypochlorite solution and gels: A systematic review of randomized clinical studies. International Journal of Dental Materials, 6(1), 22–31. https://doi.org/10.37983/IJDM.2024.6105
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This work is licensed under a Creative Commons Attribution 4.0 International License.

This work is licensed under a Creative Commons Attribution 4.0 International License.

Author Biographies

Maryam Altuhafy, Eastman Institute for Oral Health

Assistant Professor of Clinical Dentistry, Orofacial Pain and TMJD, Eastman Institute for Oral Health, Rochester, NY, USA.

Ghida Askar, Eastman Institute for Oral Health

Resident, Orofacial Pain and TMJD, Eastman Institute for Oral Health, Rochester, NY, USA.

Luay Jabr, Eastman Institute for Oral Health

Resident, Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, Rochester, NY, USA.

Zegar Zegar, Loma Linda University

Assistant Professor of Clinical Dentistry, Endodontics, Loma Linda University, School of Dentistry, Loma Linda, CA, USA.

Junad Khan, Eastman Institute for Oral Health

5Director and Associate Professor, Orofacial Pain and TMJD, Eastman Institute for Oral Health, Rochester, NY, USA.

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