Exploring calcium hypochlorite: A promising alternative to sodium hypochlorite for enhanced pulp tissue dissolution

Abstract

Objective: This study aimed to evaluate and compare the pulp tissue dissolution efficacy of three endodontic irrigants-Sodium Hypochlorite (NaOCl), Calcium Hypochlorite (Ca(OCl)₂), and Chlorhexidine (CHX)-when used with different irrigation techniques: conventional syringe irrigation, sonic activation, and laser-activated irrigation. Materials and Methods: Human vital premolar teeth extracted for orthodontic reasons were used to harvest pulp tissue. Standardized tissue samples (3 ± 1 mg) were subjected to one of the three irrigants i.e NaOCl, CaOCl2 and CHX and activated using one of the three techniques: Conventional Syringe Irrigation, Sonic and Laser activated irrigation. Weight loss of the tissue post-irrigation was measured to determine dissolution efficacy. Irrigation protocols were standardized across all groups for time, volume, and activation cycles. Results: NaOCl and Ca(OCl)₂ exhibited similar levels of tissue dissolution when used with the same activation technique. Laser-activated irrigation significantly enhanced the efficacy of both NaOCl and Ca(OCl)₂ compared to sonic and conventional syringe methods. CHX, while antimicrobial, showed minimal tissue-dissolving capacity regardless of activation method. Conclusion: Laser activation was the most effective method for enhancing the tissue-dissolving properties of NaOCl and Ca(OCl)₂. Calcium Hypochlorite appears to be a promising alternative to NaOCl due to its comparable efficacy, higher chemical stability, and lower cytotoxicity. Chlorhexidine, lacking tissue-dissolving properties, should not be used as a primary irrigant in root canal disinfection.