PDF: Sodium Hypochlorite in Endodontics

The major objective in root canal treatment is to disinfect the entire root canal system. This requires that the pulpal contents be eliminated as sources of infection.


This goal may be accomplished using mechanical instrumentation and chemical irrigation, in conjunction with medication of the root canal between treatment sessions. Microorganisms and their by-products are considered to be the major cause of pulpal and periradicular pathosis. In order to reduce or eliminate bacteria and pulpal tissue remnants, various irrigation solutions have been suggested to be used during treatment. 

Read also: PDF: Endodontics: Obturation of Root Canal Systems

Sodium hypochlorite, an excellent non-specific proteolytic and antimicrobial agent, is the most common irrigation solution used during root canal therapy. The purpose of this paper was to review different aspects of sodium hypochlorite use in endodontics.

The essential role of microorganisms in development and perpetuation of pulpal and periapical diseases has been demonstrated clearly in animal models and human studies1-3. Elimination of microorganisms from infected root canals is a difficult task. Numerous measures have been described to reduce the numbers of root canal microorganisms, including the use of various instrumentation techniques, irrigation regimens and intra-canal medicaments. There is no evidence in the literature to show that mechanical instrumentation alone results in a bacteria-free root canal system4. Considering the complex anatomy of the root canal pulp space5, 6, this is not surprising. It is assumed, but not demonstrated, that any pulp tissue left in the root canals can serve as bacterial nutrient. 

Furthermore, tissue remnants also impede the antimicrobial effects of root canal irrigants and medicaments. Therefore some sort of irrigation / disinfection is necessary to remove tissue from the root canals and to kill microorganisms. Simply, chemical treatment of the root canal can be arbitrarily divided into irrigants, rinses, and inter-visit medicaments.

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