Cytotoxic effect of sodium hypochlorite (Lavanox 0.08%) and chlorhexidine gluconate (Irrisept 0.05%) on human osteoblasts.

PURPOSE: Soft tissue, bone and joint infections are severe complications in orthopedic and traumatological surgery. Lavanox (0.08% NaOCl) and Irrisept (0.05% chlorhexidine gluconate, CHG) are industrially produced antiseptic solutions commonly used in infection treatment. Regarding this clinical indication, the microbicidal effect is often investigated, but toxicity to osteoblasts has rarely been examined. This is important to decide whether these solutions should be used in septic situations in which bone healing must take place. The hypothesis of the present study is that NaOCl and CHG are cytotoxic to osteoblasts even after a short exposure time. METHODS: Human osteoblasts were isolated from donors with osteoarthritis during total knee and hip arthroplasty. Cells were cultivated and treated with both antiseptic solutions for 2, 5 and 10 min in different dilutions. Toxicity was quantified by counting cells, lactate dehydrogenase (LDH) expression, spectrophotometric quantification via XTT assay and FDA/PI fluorescence microscopy. RESULTS: Analyzing viable cells after treatment with both antiseptics showed a significant decrease in viable cells through LDH expression test, XTT assay, fluorescence microscopy and light microscopy, depending on concentration. The time dependence showed a trend to more cell death at longer exposure times, without significance. CONCLUSION: Toxic effects on osteoblasts were shown after treatment with 0.08% NaOCl and 0.05% CHG after an exposure time of 2 min which also was concentration dependent. There was no difference in cytotoxicity between both antiseptics. In conclusion, these antiseptic solutions may be used with caution in situations requiring bone healing. Trial registration number Local ethics committee registration number: 5176-07/16.

The cytotoxic effects of various endodontic irrigants on the viability of dental mesenchymal stem cells.

This study aimed to evaluate cytotoxic effects of various irrigation solutions used in regenerative endodontic treatments (RETs) on mesenchymal stem cells, and further examine the long-term effect of hypochlorous acid (HOCl) on the cell viability and alkaline phosphatase (ALP) activity. Stem cells were exposed to various concentrations of NaOCl, EDTA, chlorhexidine (CHX), etidronic acid (HEDP)/NaOCl combination and HOCl. HOCl was tested for its effects on ALP activity up to 21 days. Additionally, cell viability was measured fluorescently using calcein AM. The most cytotoxic irrigant was CHX even with the lowest concentration. NaOCl and HEDP/NaOCl with 1:100 dilution decreased viability to around 40%. HOCl showed the lowest cytotoxicity among all tested irrigants. HOCl also showed no significant reduction in ALP activity compared with the controls. The cytotoxicity of endodontic irrigants was time and concentration dependent. HOCl demonstrated promising results regarding viability and ALP activity, since RETs require host stem cell survival.

Assessment of the cytotoxic effects and chemical composition of the insoluble precipitate formed from sodium hypochlorite and chlorhexidine gluconate.

AIM: To investigate (1) the cytotoxic potential of the brown precipitate (BP) formed with sodium hypochlorite (NaOCl) and chlorhexidine gluconate (CHX), using both a small animal model of Caenorhabditis elegans (C. elegans) and cultured human gingival fibroblasts; and (2) the chemical composition of BP using Time-of-Flight Secondary Ion Mass Spectrometry (ToF-SIMS). METHODOLOGY: Brown precipitate was obtained by mixing equal volumes of 6% NaOCl and 2% CHX and separating the BP from clear supernatant by centrifugation. The brown precipitate was weighed and solubilized in dimethyl sulfoxide for cytotoxicity experiments. The cytotoxic effect of BP was assessed using C. elegans larvae and primary immortalized human gingival fibroblasts-hTERT (hTERT-hNOF) cells. Various dilutions of BP (25 ng/µL-150 ng/µL), supernatant (0.15% v/v), NaOCl (1:100-1:1000 dilutions of 6% NaOCl) or CHX (1:500-1:1000 dilutions of 2% CHX) along with vehicle control (0.5% v/v ethanol and 0.15% v/v DMSO) or untreated control (growth medium) were tested on C. elegans larvae and hTERT-hNOF cells. Viability was assessed in C. elegans larvae using stereomicroscopy and in hTERT-hNOF cells using dehydrogenase-based colorimetric assay. ToF-SIMS was used to assess the chemical composition of BP in comparison with CHX and para-chloroaniline (PCA). The C. elegans and cell line data were analysed using Log-Rank test and Student's t-test, respectively (p < .05). RESULTS: BP-75 ng/µL and BP-150 ng/µL were significantly more toxic to C. elegans larvae than the untreated, vehicle, supernatant or CHX treatment groups (p < .0001). Similarly, in hTERT-hNOF cells, BP-50 ng/µL, BP-75 ng/µL and BP-150 ng/µL induced significant cytotoxicity within 2 h compared with untreated, vehicle, supernatant and CHX treatments (p < .05). ToF-SIMS analysis of BP revealed ion composition characteristic of both CHX and the carcinogen PCA. CONCLUSIONS: Brown precipitate was toxic in both C. elegans larvae and hTERT-hNOF cells. The ToF-SIMS analysis of BP revealed ions characteristic of CHX and PCA that could account for the toxicities observed in C. elegans larvae and human gingival fibroblasts. Because of the insoluble and toxic nature of BP, consecutive use of CHX and NaOCl irrigants should be avoided in root canal treatment.

Assessment of toxicity and oxidative DNA damage of sodium hypochlorite, chitosan and propolis on fibroblast cells

Abstract The objective of this study was to evaluate and compare the cytotoxicity and genotoxicity on human fibroblast cell lines of sodium hypochlorite (NaOCl), chitosan and propolis as root canal irrigating solutions. Human fibroblast cells were exposed to chitosan, propolis and NaOCl for 4 and 24 h. Cell viability was assessed by 2,3-bis-(2-methoxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxanilide, and oxidative DNA damage was assessed by determination of 8-hydroxydeoxyguanosine (8-OHdG) level with an ELISA kit. The data of cell cytotoxicity were analysed statistically using a test of one-way analysis of variance at a significance level of p < 0.05. In the NaOCI group, the 8-OHdG level was higher than in the chitosan group, but there was no statistical difference when compared with the other groups (p < 0.05). It was determined that the irrigation solutions were cytotoxic, depending on the dose and time. NaOCl was the most toxic solution after both 4 and 24 h of exposure (p < 0.05). Chitosan and propolis may be alternatives to NaOCl for irrigation solutions, because they are both less toxic and produce less oxidative DNA damage.

Determination of mutagenicity of the precipitate formed by sodium hypochlorite and chlorhexidine using the Ames test.

The aim of this study was to determine the direct mutagenic potential of any precipitate formed by combining sodium hypochlorite (NaOCl) and chlorhexidine (CHX). The precipitates formed by NaOCl and CHX were dissolved in 100% dimethyl sulfoxide and cultured with mutant Salmonella Typhimurium strains. The cells were observed for reverse mutation. The numbers of positive/mutated wells were statistically compared with those in the background plates using the two-sample proportion independent t-test. The precipitates were not found to be significantly more mutagenic than the background plates. Within the limitations of this study, the results suggest that the precipitates formed when sodium hypochlorite and chlorhexidine contact did not show mutagenic (and are therefore carcinogenic) potential.

Quantification of thiazolidine-4-carboxylic acid in toxicant-exposed cells by isotope-dilution liquid chromatography-mass spectrometry reveals an intrinsic antagonistic response to oxidative stress-induced toxicity.

Carcinogenic formaldehyde is produced by endogenous protein oxidation and various exogenous sources. With formaldehyde being both ubiquitous in the ambient environment and one of the most common reactive carbonyls produced from endogenous metabolism, quantifying formaldehyde exposure is an essential step in risk assessments. We present in this study an approach to assess the risk of exposure to oxidative stress by quantifying thiazolidine-4-carboxylic acid (TA), a cysteine-conjugated metabolite of formaldehyde in toxicant-exposed Escherichia coli. The method entails TA derivatization with ethyl chloroformate, addition of isotope-labeled TA derivatives as internal standards, solid-phase extraction of the derivatives, and quantification by liquid chromatography-mass spectrometry (LC-MS). After validating for accuracy and precision, the developed method was used to detect TA in oxidizing agent-exposed E. coli samples. Dose-dependent TA formation was observed in E. coli exposed to hydroxyl radical mediators Fe(2+)-EDTA, H2O2, and NaOCl, indicating the potential use of TA as a biomarker of exposure to oxidative stress and disease risk.

Cytotoxicity of QMix™ endodontic irrigating solution on human bone marrow mesenchymal stem cells.

BACKGROUND: Debridement and disinfection of the root canal system is a crucial step in endodontic procedures. The effectiveness of irrigation relies on both the mechanical flushing action and the ability of irrigants to dissolve tissue and kill bacteria. The objective of the present study is to evaluate and compare the cytotoxicity of QMix™ root canal irrigating solution on immortalized human bone marrow mesenchymal stem cells (hTERT-MSC-C1) and to compare it with that of sodium hypochlorite (NaOCl). METHODS: Immortalized human bone marrow mesenchymal stem cells (hTERT-MSCs) were exposed to QMix™ and NaOCl. Cell viability was assessed by 3-(4, 5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) and alamarBlue assays. The cell morphology was studied after two hours of exposure to QMix™ and NaOCl. Scanning electron microscopy (SEM) analyses were performed after 2- and 4-hour incubation periods. Finally, ethidium bromide/acridine orange (EB/AO) fluorescent stain was applied to the cells in the 8-chamber slides after they were incubated with the testing agents for 2 hours to detect live and dead cells. The observations were tabulated and analyzed statistically. RESULTS: QMix™ exposure resulted in a significantly higher percentage of cell viability than NaOCl in the MTT and alamarBlue assays at three time points compared to the control. The SEM analysis demonstrated minimal morphological changes associated with cells that were exposed to the QMix™ solution, with little shrinkage and fragmentation of the cell wall. The live/dead analysis showed that the number of live cells after exposure to QMix™ was similar to that of the untreated control. No cell structure could be observed with the NaOCl group, indicating cell lysis. CONCLUSION: Both the QMix™ and NaOCl solutions were toxic to human bone marrow MSCs. Each solution might have induced cell death in a different way as evidenced in the cell viability, SEM and fluorescent studies. The slower cell death induced by QMix™ might therefore be less aggressive and more acceptable to living tissues.

An in vitro evaluation of the cytotoxicity of varying concentrations of sodium hypochlorite on human mesenchymal stem cells.

AIM: To evaluate and compare the cytotoxicity of various concentrations of sodium hypochlorite on immortalized human bone marrow mesenchymal stem cells (MSCs). MATERIALS AND METHODS: The 5.25 percent sodium hypochlo-rite (NaOCl) at concentrations of 0.5, 0.1, 0.025, 0.0125, and 0.005 mg/ml were used to assess the cytotoxic effect on MSCs. Immortalized human bone marrow mesenchymal stem cells (hTERT-MSCs) were exposed to NaOCl at 5 different concentrations. Cell viability was assessed by 3-(4, 5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) and alamarBlue assays. The cell morphology changes were assessed with scanning electron microscopy (SEM) after exposure to 2, 4, and 24 hour incubation. The ethidium bromide/acridine orange (EB/ AO) fuorescent stain was applied to the cells in the 8-chamber slides after they were incubated with the testing agents for 2 and 4 hours to detect live and dead cells. The observations were quantitatively and qualitatively analyzed. RESULTS: The cell viability study using MTT assay and AB assay showed significant reduction with varying concentration at 2 and 4 hours incubation period. The cell viability decreased with the higher percentage of NaOCl. The exposure time also revealed an inverse relation to the cell viability. The SEM analysis showed reduction in the number of cells and morphological alterations with 0.5 mg/ml at 2 and 4 hours compared to 0.025 mg/ml NaOCl. Destruction of the cells with structural alterations and lysis was evident under fuorescence microscope when the cells were exposed to 0.5 mg/ml NaOCl. CONCLUSION: Within the limitations of this in vitro study it can be concluded that NaOCl is toxic to the human bone marrow MSCs. The cell lysis was evident with higher concentration of sodium hypochlorite. From the observations, it can be concluded that a lower concentration of NaOCl may be used as endodontic irrigant due to its cytotoxic properties. Further studies are mandatory to evolve a consensus on the optimal concentration of sodium hypochlorite to be used as endodontic irrigant.

Bactericidia de hipoclorito de sodio sobre Staphylococcus cohnii productor de biofilm en una fabrica / Bactericidal activity of sodium hypochlorite against biofilm-producing Staphylococcus cohnii in a factory / Atividade bactericida de hipoclorito de sodio sobre Staphylococcus cohnii produtor de biofilme numa fabrica

En equipamientos industriales la persistencia de las bacterias se debe al desarrollo de biofilms. El hipoclorito de sodio (NaClO) es usado rutinariamente como desinfectante. El objetivo del trabajo fue determinar el efecto inhibitorio del NaClO sobre S. cohnii productoras y no productoras de biofilms aisladas de una fabrica de pastas a partir de maquinarias de un establecimiento de Tucuman, Argentina. Se estudio produccion de biofilm, concentracion inhibitoria minima (CIM), concentracion bactericida minima (CBM) y curva de tiempo de muerte con NaClO frente a S. cohnii productora y no productora de biofilm. Los resultados obtenidos demostraron que de los ocho cocos grampositivos aislados, cuatro correspondieron a S. cohnii. Los valores CIM y CBM para S. cohnii productoras y no productoras de biofilm resultaron entre 0,05 y 0,2 g/dL. Mediante la curva de muerte se determino efecto bactericida observando una disminucion de ≥4 log de ufc (1h) tratado con 0,2 y 0,4% de NaClO. La formacion de biofilm para la cepa no tratada fue de DO: 0,12 y para la cepa tratada DO: 0,07 a las 18 h. Aplicar desinfectantes con amplio espectro de accion es importante, debido a que la eliminacion de bacterias puede prevenir su diseminacion y evitar la formacion de biofilms.

Persistence of bacteria in industrial equipment is favoured by biofilm formation. Sodium hypochlorite (NaClO) is routinely used as a disinfectant. The objective of the current study was to determine the inhibitory effect of NaClO on biofilm-producing and non-biofilm-producing S. cohnii strains, isolated from equipment in a fresh pasta factory in Tucuman, Argentina. The following parameters were assayed: production of biofilm, minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC) and NaClO death curves for both biofilm-producing and non-biofilm-producing S. cohnii strains. Four of the eight isolated Gram-positive cocci corresponded to S. cohnii. MIC and MBC values for biofilm-producing and non-biofilm-producing S. cohnii strains were between 0.05 and 0.2 g/dL. A bactericidal effect of 0.2 and 0.4% NaClO for 1 h was established with the death curve, showing a decrease in cfu of ≥4 log units. Biofilm production after 18 h for untreated strains gave an OD of 0.12, whereas the OD of treated strains was 0.07. The use of broad spectrum disinfectants is important, because elimination of bacteria helps prevent their propagation and avoid the formation of biofilms.

A persistência da bactéria em equipamento industrial e resultado do desenvolvimento de biofilmes. O hipoclorito de sodio (NaOCl) e rotineiramente utilizado como desinfetante. O objetivo do trabalho foi determinar o efeito inibitorio do NaClO sobre S. cohnii produtoras e nao produtoras de biofilmes isoladas de uma fabrica de massas frescas a partir de maquinarias de um estabelecimento de Tucuman, Argentina. Foram estudados: producao de biofilme, concentracao inibitoria minima (CIM), concentracao bactericida minima (CBM) e curva de tempo de morte com NaClO perante S. cohnii produtora e naoprodutora de biofilme. Os resultados obtidos demonstraram que quatro dos oito cocos Gram-positivos isolados corresponderam a S. cohnii. Os valores CIM e CBM para S. cohnii produtoras e nao produtoras de biofilme foram entre 0,05 e 0,2 g/dL. Atraves da curva de morte foi determinado um efeito bactericida observando uma diminuicao de ≥ 4 log de ufc (1h) tratado com 0,2 e 0,4% de NaClO. A formacao de biofilme, apos 18 h, para a cepa nao tratada foi de DO: 0,12, ao passo que para a cepa tratada foi de 0,07. A utilizacao de desinfetantes de amplo espectro de acao e importante, visto que a eliminação de bacterias pode prevenir sua propagação e evitar a formacao de biofilmes.

Sanitizer residues in the milk of cows which had passed through footbaths / Resíduos de sanitizantes em vacas de leite após passagem por pedilúvio

Copper sulfate and sodium hypochlorite are used in footbath solutions for the prevention and treatment of bovine digital diseases; however, data on the residues of such elements in milk are sparse in Brazil. This study evaluated the cost of applying the footbath treatment and the total amount of copper and chlorite residues in the milk of healthy cows after they had passed through these footbath solutions. Two groups of 7 cows each (GI and GII) were studied. In the case of GI, 1% sodium hypochlorite was used and for GII 5% copper sulfate was employed in the footbath. The milk samples were collected before the 7-day footbath treatment period (M0) and 24 h (M1), 48 h (M2), 72 h (M3) and 15 days (M15) after the last footbath. Statistical analysis to compare the different samples within each group was carried out by applying Friedman's test, followed by Dunn's test (p<0.05). It was concluded that the amount of total chlorites and copper in the milk of healthy cattle after routine daily footbaths for a period of 7 days presented some variations. However, the concentrations observed were considered insufficient to represent a risk to human health. The cost of the footbath solutions was found to be reasonable.

O sulfato de cobre e o hipoclorito de sódio são empregados na prevenção e tratamento das enfermidades digitais dos bovinos, mas os valores residuais desses elementos foram pouco estudados. Neste estudo, avaliou-se a presença de resíduos de cobre e cloretos totais no leite de vacas saudáveis após passagens dos animais em pedilúvio contendo soluções formuladas com estas substâncias e estimou-se os custos das soluções. Utilizou-se 14 vacas saudáveis distribuídas em dois grupos (GI e GII) de sete animais cada. Em GI, empregou-se solução de hipoclorito de sódio a 1% e, em GII, sulfato de cobre a 5%. As amostras de leite foram colhidas antes da passagem pelo pedilúvio (M0), após 24 (M1), 48 (M2) e 72 (M3) horas, além de 15 dias (M15) subsequentes à última passagem. Na análise estatística, a comparação entre momentos dentro de cada grupo foi realizada com teste de Friedman, seguido pelo teste de Dunn's (p<0,05). Concluiu-se que os valores de cloretos totais e de cobre no leite de bovinos saudáveis, após passagens diárias dos animais em pedilúvio por um período de sete dias, apresentaram algumas variações consideradas insuficientes para provocarem danos à saúde humana e as soluções medicamentosas não apresentaram custos exorbitantes.

In vitro toxicity and activity of Dakin's solution, mafenide acetate, and amphotericin B on filamentous fungi and human cells.

OBJECTIVES: Posttraumatic invasive fungal infections threaten critically injured combat-related injuries and require a combination of extensive surgery and systemic antifungal therapy, along with topical antimicrobials used adjunctively to control the infection. We evaluated the in vitro activity of topical agents in varying combinations and concentrations against molds from patients that were responsible for wound invasive fungal infections and the topical agents' toxicity to human cells. METHODS: Mafenide acetate solutions (2.5%, 5%, and 7.5%), amphotericin B solutions (2 µg/mL, 2 mg/mL, and 20 mg/mL), SMAT (5% mafenide acetate in combination with 2 µg/mL, 2 mg/mL, and 20 mg/mL amphotericin B), and Dakin's solutions (buffered sodium hypochlorite) (0.5%, 0.25%, and 0.125% and 10-fold serial dilutions of 0.25%-0.00000025%) were evaluated for antifungal activity against 4 molds using a time-kill assay using standard conidial suspensions of 5 × 10(4) colony-forming units per milliliter. To assess cellular toxicity, confluent monolayers of human keratinocytes, dermal fibroblasts, and osteoblasts were exposed to these topical agents. Based upon efficacy and toxicity ratios, an additional 10 molds were screened with selected concentrations of the topical agents for antifungal activity and toxicity. RESULTS: All the topical agents seemed to have a dose-dependent killing with only mafenide acetate showing time killing associated with prolonged contact. There was overall evidence of dose-dependent cytotoxicity of the various topical agents against the various cell lines tested, but there did not seem to be increased cell death with continued exposure to the agents over time. Dakin's solution exhibited dose-dependent toxicity and efficacy with 0.00025% appearing to optimize those parameters. CONCLUSIONS: Mafenide acetate and amphotericin B did not seem to persistently meet the toxicity and efficacy balance as consistently as Dakin's solution.

In vitro genotoxicity and cytotoxicity in murine fibroblasts exposed to EDTA, NaOCl, MTAD and citric acid

The aim of the present study was to evaluate the capacity of some root canal irrigants to induce genetic damage and/or cellular death in vitro. Murine fibroblast cells were exposed to ethylenediaminetetraacetic acid (EDTA), sodium hypochlorite (NaOCl), MTAD™ and citric acid in increasing concentrations for 3 h at 37ºC. The negative control group was treated with vehicle control (phosphate buffer solution - PBS) for 3 h at 37°C, and the positive control group was treated with methylmetanesulfonate, 1 μM. for 3 h at 37°C. Cytotoxicity was assessed by the trypan blue test and genotoxicity was evaluated by the single cell gel (comet) assay. The results showed that exposure to 2.5% and 5% NaOCl and 8.5% citric acid resulted in a significant cytotoxic effect. NaOCl, EDTA and citric acid did not produce genotoxic effects with respect to the comet assay data for all evaluated concentrations. Although MTAD was not a cytotoxic agent, it showed significant genotoxic effects at all tested concentrations (ANOVA and Tukey's test; p<0.05). NaOCl, EDTA and citric acid were found to be cytotoxic in a dose-dependent manner, but they were not genotoxic. MTAD did not cause cell death, but presented genotoxic effects.

O objetivo do presente estudo foi avaliar a capacidade de alguns irrigantes endodônticos em induzir danos genéticos e/ou morte celular in vitro. Células de fibroblastos murinos foram expostas ao ácido etilenodiaminotetracético (EDTA), hipoclorito de sódio (NaOCl), MTAD™ e ácido cítrico em concentrações crescentes durante 3 h a 37°C. O grupo controle negativo foi tratado com solução tampão fosfato - PBS por 3 h a 37° C e o grupo controle positivo foi tratado com metilmetanesulfonato a 1 μM por 3 h a 37° C. A citotoxicidade foi testada pelo azul de tripan e a genotoxicidade foi avaliada pelo teste do cometa. Os resultados apontaram que a exposição ao NaOCl a 2,5% e 5%, e ácido cítrico a 21% resultou em efeitos citotóxicos significativos. O NaOCl, EDTA e o ácido cítrico não produziram efeitos genotóxicos no que diz respeito aos dados obtidos pelo ensaio do Cometa em todas as concentrações testadas. Embora o MTAD não tenha sido um agente citotóxico, mostrou efeitos genotóxicos significativos em todas as concentrações testadas (ANOVA e teste de Tuckey; p<0,05). O NaOCl, o EDTA e o ácido cítrico mostraram-se citotóxicos de maneira dose-dependente, mas não genotóxicos. Por outro lado, apesar do MTAD não ter causado a morte celular, foi genotóxico em todas as concentrações testadas.

Modulation of cytochrome P450 and induction of DNA damage in Cyprinus carpio exposed in situ to surface water treated with chlorine or alternative disinfectants in different seasons.

Epidemiological studies have shown an association between consumption of disinfected drinking water and adverse health outcomes. The chemicals used to disinfect water react with occurring organic matter and anthropogenic contaminants in the source water, resulting in the formation of disinfection by-products (DBPs). The observations that some DBPs are carcinogenic in animal models have raised public concern over the possible adverse health effects for humans. Here, the modulation of liver cytochrome P450-linked monooxygenases (MFO) and the genotoxic effects in erythrocytes of Cyprinus carpio fish exposed in situ to surface drinking water in the presence of disinfectants, such as sodium hypochlorite (NaClO), chlorine dioxide (ClO(2)) and peracetic acid (PAA), were investigated in winter and summer. A complex induction/suppression pattern of CYP-associated MFOs in winter was observed for all disinfectants. For example, a 3.4- to 15-fold increase was recorded of the CYP2B1/2-linked dealkylation of penthoxyresorufin with NaClO (10 days) and PAA (20 days). In contrast, ClO(2) generated the most notable inactivation, the CYP2E1-supported hydroxylation of p-nitrophenol being decreased up to 71% after 10 days' treatment. In summer, the degree of modulation was modest, with the exception of CYP3A1/2 and CYP1A1 supported MFOs (62% loss after 20 days PAA). The micronucleus (MN) induction in fish circulating erythrocytes was also analysed as an endpoint of genotoxic potential in the same fish population. Significant increases of MN induction were detected at the latest sampling time on fish exposed to surface water treated with chlorinate-disinfectants, both in winter (NaClO) and summer (NaClO and ClO(2)), while no effect was observed in fish exposed to PAA-treated water. These results show that water disinfection may be responsible for harmful outcomes in terms of MFO perturbation and DNA damage; if extrapolated to humans, they ultimately offer a possible rationale for the increased urinary cancer risk recorded in regular drinking water consumers.

Effect of irrigants on the survival of human stem cells of the apical papilla in a platelet-rich plasma scaffold in human root tips.

INTRODUCTION: Intracanal disinfection is a crucial step in regenerative endodontic procedures. However, this novel endodontic treatment lacks standardization, and numerous treatment protocols have been reported without knowledge of the effect of disinfection protocols on the survival of stem cells. The aim of this study was to test the hypothesis that different root canal irrigation protocols alter survival of stem cells from the apical papilla (SCAP). METHODS: SCAP were isolated from immature human third molars, and a subpopulation of STRO-1 expressing cells was selected and expanded in vitro. Standardized human root segments (n = 5/group) were irrigated with 1 of 4 protocols: (1) 17% ethylenediaminetetraacetic acid (EDTA), (2) 6% NaOCl/17% EDTA/6% NaOCl, (3) 17% EDTA/2% chlorhexidine (CHX), or (4) 6% NaOCl/17% EDTA/6% NaOCl/isopropyl alcohol/2% CHX. Subsequently, STRO-1-enriched SCAP were mixed with platelet-rich-plasma, seeded into the root tips, and cultured for 21 days. Roots were then decalcified, processed for immunohistochemistry, and stained for vimentin and TO-PRO-3. The proportion of viable (vimentin-positive) cells was calculated on the basis of the total cell counts (TO-PRO-3) for each group. RESULTS: Irrigation with 17% EDTA best supported cell survival (89% viability; P < .001 versus all other groups), followed by irrigation with 6% NaOCl/17% EDTA/6% NaOCl (74%; P < .001 versus the 2 groups containing 2% CHX). Conversely, protocols that included 2% CHX lacked any viable cells. CONCLUSIONS: Collectively, the results suggest that irrigants alone greatly affect the survivability of STRO-1-enriched SCAP within the root canal environment and that inclusion of EDTA in irrigation protocols might be beneficial in regenerative procedures.

A protocol for the evaluation of genotoxicity in bile of carp (Cyprinus carpio) exposed to lake water treated with different disinfectants.

A sensitive and rapid method to evaluate toxic and genotoxic properties of drinking water supplied from Lake Trasimeno (Umbria, Central Italy) was worked out analysing bile in Cyprinus carpio exposed for 20 d to lake water treated with 3 different disinfectants, sodium hypochlorite (NaClO), chlorine dioxide (ClO(2)) and peracetic acid (PAA). Fish were sacrificed at 0, 10 and 20 d in order to investigate the time course of these endpoints. An aliquot of bile samples was fractionated by adsorption on C(18) silica cartridges and the genotoxic potential of whole bile and of bile fractions was evaluated by the single-cell microgel-electrophoresis (comet) assay on human colonic adenocarcinoma cells (Caco-2). Bile (both whole and fractionated) from specimens exposed to the three disinfectants always showed a genotoxic activity as compared to the control group. The results of this study provide evidence that all three disinfectants cause an increase in bile genotoxicity of chronically exposed fish.

Tissue reaction to silver nanoparticles dispersion as an alternative irrigating solution.

INTRODUCTION: Nanomaterials have been used to create new consumer products as well as applications for life sciences and biotechnology. The aim of this study was to evaluate the tissue response to implanted polyethylene tubes filled with fibrin sponge embedded with silver nanoparticles dispersion. METHODS: Thirty rats received individually 4 polyethylene tubes filled with sponge embedded in 47 ppm, 23 ppm silver nanoparticles dispersion, 2.5% sodium hypochlorite, or with no embedding as control. The observation periods were 7, 15, 30, 60, and 90 days. After each period of time, 6 animals were killed, and the tubes and surrounding tissue were removed, fixed, and prepared to be analyzed in light microscope with glycol methacrylate embedding, 3-µm serial cutting, and hematoxylin-eosin stain. Qualitative and quantitative evaluations of the reactions were performed. RESULTS: Both materials caused moderate reactions at 7 days. The response was similar to the control on the 15th day with 23 ppm silver nanoparticles dispersion and 2.5% sodium hypochlorite and on the 30th day with 47 ppm silver nanoparticles dispersion. CONCLUSIONS: It was possible to conclude that silver nanoparticles dispersion was biocompatible especially in a lower concentration.

Cytotoxicity and genotoxicity of endodontic irrigants on human cells / Citotoxicidade e genotoxicidade de irrigantes endodônticos em células humanas

OBJECTIVE: Endodontic irrigants solutions with antibacterial activity have been used in treatment of teeth with infected root canals; however, these solutions can irritate periapical tissues. The aim of this study was to evaluate the cytotoxity and genotoxicity of different endodontic irrigants solutions – sodium hypochlorite (1% and 2%), calcium hydroxide (0.2%), and HCT20 in human KB cells. MATERIAL AND METHOD: Cells were incubated with solutions for 2 and 24 hours. The cell viability was assessed after the trypan blue exclusion and the frequency of cell death mechanism (apoptotic or necrotic) was determined by acridine orange/ethidium bromide fluorescent dyeing test. The genotoxicity effects were assessed by the micronucleus assays. RESULTS AND DISCUSSION: The results showed that Ca(OH)2 alone or in combination with tergentol (HCT20), and NaOCl induced cytotoxicity in KB causing death cells by apoptosis. The micronuclei test showed that KB treated with NaOCl (1%) present an increase in the frequency of micronucleus compared to the control group.

OBJETIVO: Soluções irrigadoras com atividade antibacteriana têm sido usadas no tratamento de dentes com canais radiculares infectados; entretanto, essas soluções podem irritar os tecidos periapicais. O objetivo deste estudo foi avaliar a citotoxicidade e genotoxicidade de diferentes soluções irrigadoras – hipoclorito de sódio (1% e 2%), hidróxidode cálcio (0,2 %) e HCT em células humanas KB. MATERIAL E MÉTODO: As células foram incubadas em soluções por 2 e 24 horas. A viabilidade celular foi determinada após exclusão do tripan blue e a frequência de mecanismo de morte celular (apoptótica ou necrótica) foi determinada pelo teste acridine Orange/ethidium bromide fluorescen dyeing. Os efeitos de genotoxicidade foram determinados pelo ensaio de micronúcleos. RESULTADOS E DISCUSSÃO: Os resultados demonstraram que o Ca(OH2), isoladamente ou em combinação com Tergentol™ (HCT20) e NaOCl, induziram citotoxicidade em KB, causando morte celular por apoptose. O teste de micronúcleos demonstrou que KB tratado codm NaOCl (1%) apresentou aumento na frequência de microdnúcleos quando comparadocom o grupo controle.

Estado actual del hipoclorito de sodio en endodoncia. 1: propiedades biológicas / Sodium hypochlorite in Endodontics: an update. 1: biologic properties

La solución de hipoclorito de sodio en diferentes concentraciones es uno de los agentes irrigantes más utilizados en endodoncia. El hipoclorito de sodio es un agente antibacteriano efectivo, tiene la capacidad de desintegrar el tejido pulpar vital o necrótico infectado y la propiedad de desnaturalizar las toxinas, actuando además como lubricante durante la preparación del sistema de conductos radiculares. A pesar de la conveniencia de estas características, el hipoclorito de sodio en altas concentraciones se ha manifestado como producto sumamente tóxico tanto in vitro como in vivo. El objetivo de este trabajo fue actualizar la información pertinente a las propiedades biológicas del hipoclorito de sodio utilizado como solución irrigante en endodoncia.

[Case of alkaline esophagitis due to sodium hypochlorite ingestion].

The severity of alkaline esophagitis due to sodium hypochlorite ingestion is variable and the findings of endoscope within 48 hours of ingestion are reported to be associated with its prognosis. We report a good recovery case of grade 2B of alkaline esophagitis, which was treated with close observation. The patient was 59-year old man. He was found lying on the bed by his wife, after drinking bactericidal agents (Jianok) and kitchen cleaner (Magiclean) for suicide attempt. After his trachea was intubated, he underwent upper gastrointestinal scope, which displayed circumferential ulcers at the lower esophagus. He was diagnosed as having a Grade 2B alkaline esophagitis, which was associated with a higher probability of stricture or perforation. On the 14th day of the admission, the 2nd endoscope was performed and no esophageal strictures were detected. He was extubated and started oral feeding on the 15th day. After that, his hospital course was uneventful and was discharged on the 18th day. 6 months have passed since he left hospital. No esophageal strictures were detected so far.

Biological properties of a neutralized 2.5% sodium hypochlorite solution.

OBJECTIVES: The objective of this study was to evaluate the influence of neutralizing a 2.5% NaOCl solution on its cytotoxicity, genotoxicity, and tissue-dissolving potential. STUDY DESIGN: The cytotoxicity and the genotoxicity of Dakin, a 2.5% NaOCl solution, and a neutralized 2.5% NaOCl solution were assessed according to ISO 10993 standards. The weight of palatal mucosa samples placed in neutralized 2.5% NaOCl, 2.5% NaOCl was recorded over time as well as the pH of the solutions. RESULTS: The neutralized 2.5% NaOCl solution was 10-fold more cytotoxic than the 2.5% NaOCl solution. None of the solutions was genotoxic. The 2.5% NaOCl solution had a better tissue-dissolving capacity than the neutralized 2.5% NaOCl solution. The pH of the 2.5% NaOCl solution and neutralized 2.5% NaOCl solution decreased from 12 to 9 and from 7.5 to 5.6, respectively. CONCLUSION: Neutralizing a 2.5% NaOCl solution increased its cytotoxicity, did not induce any genotoxic effect, and reduced its tissue-dissolving ability.