Concentration-dependent effect of sodium hypochlorite on stem cells of apical papilla survival and differentiation

David E. Martin, Jose Flavio A De Almeida, Michael A. Henry, Zin Z. Khaing, Christine E. Schmidt, Fabricio B. Teixeira, Anibal Diogenes

Research output: Contribution to journalArticle

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Abstract

Introduction Intracanal disinfection is a crucial step in regenerative endodontic procedures. Most published cases suggest the use of sodium hypochlorite (NaOCl) as the primary irrigant. However, the effect of clinically used concentrations of NaOCl on the survival and differentiation of stem cells is largely unknown. In this study, we tested the effect of various concentrations of NaOCl on the stem cells of the apical papilla (SCAPs) survival and dentin sialophosphoprotein (DSPP) expression. Methods Standardized root canals were created in extracted human teeth and irrigated with NaOCl (0.5%, 1.5%, 3%, or 6%) followed by 17% EDTA or sterile saline. SCAPs in a hyaluronic acid-based scaffold were seeded into the canals and cultured for 7 days. Next, viable cells were quantified using a luminescence assay, and DSPP expression was evaluated using quantitative real-time polymerase chain reaction. Results There was a significant reduction in survival and DSPP expression in the group treated with 6% NaOCl compared with the untreated control group. Comparable survival was observed in the groups treated with the lower concentrations of NaOCl, but greater DSPP expression was observed in the 1.5% NaOCl group. In addition, 17% EDTA resulted in increased survival and DSPP expression partially reversing the deleterious effects of NaOCl. Conclusions Collectively, the results suggest that dentin conditioning with high concentrations of NaOCl has a profound negative effect on the survival and differentiation of SCAPs. However, this effect can be prevented with the use of 1.5% NaOCl followed by 17% EDTA. The inclusion of this irrigation regimen might be beneficial in regenerative endodontic procedures. © 2014 American Association of Endodontists.

Original languageEnglish (US)
Pages (from-to)51-55
Number of pages5
JournalJournal of Endodontics
Volume40
Issue number1
DOIs
StatePublished - Jan 2014

Fingerprint

Sodium Hypochlorite
Dentin
Stem Cells
Edetic Acid
Endodontics
Dental Pulp Cavity
Disinfection
Hyaluronic Acid
Luminescence
Real-Time Polymerase Chain Reaction
Tooth

Keywords

  • Dentin conditioning
  • dentin sialophosphoprotein
  • EDTA
  • gene expression
  • irrigant
  • regenerative endodontics
  • sodium hypochlorite
  • stem cells of apical papilla
  • survival
  • viability

ASJC Scopus subject areas

  • Dentistry(all)

Cite this

Concentration-dependent effect of sodium hypochlorite on stem cells of apical papilla survival and differentiation. / Martin, David E.; De Almeida, Jose Flavio A; Henry, Michael A.; Khaing, Zin Z.; Schmidt, Christine E.; Teixeira, Fabricio B.; Diogenes, Anibal.

In: Journal of Endodontics, Vol. 40, No. 1, 01.2014, p. 51-55.

Research output: Contribution to journalArticle

Martin DE, De Almeida JFA, Henry MA, Khaing ZZ, Schmidt CE, Teixeira FB et al. Concentration-dependent effect of sodium hypochlorite on stem cells of apical papilla survival and differentiation. Journal of Endodontics. 2014 Jan;40(1):51-55. Available from, DOI: 10.1016/j.joen.2013.07.026

Martin, David E.; De Almeida, Jose Flavio A; Henry, Michael A.; Khaing, Zin Z.; Schmidt, Christine E.; Teixeira, Fabricio B.; Diogenes, Anibal / Concentration-dependent effect of sodium hypochlorite on stem cells of apical papilla survival and differentiation.

In: Journal of Endodontics, Vol. 40, No. 1, 01.2014, p. 51-55.

Research output: Contribution to journalArticle

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abstract = "Introduction Intracanal disinfection is a crucial step in regenerative endodontic procedures. Most published cases suggest the use of sodium hypochlorite (NaOCl) as the primary irrigant. However, the effect of clinically used concentrations of NaOCl on the survival and differentiation of stem cells is largely unknown. In this study, we tested the effect of various concentrations of NaOCl on the stem cells of the apical papilla (SCAPs) survival and dentin sialophosphoprotein (DSPP) expression. Methods Standardized root canals were created in extracted human teeth and irrigated with NaOCl (0.5%, 1.5%, 3%, or 6%) followed by 17% EDTA or sterile saline. SCAPs in a hyaluronic acid-based scaffold were seeded into the canals and cultured for 7 days. Next, viable cells were quantified using a luminescence assay, and DSPP expression was evaluated using quantitative real-time polymerase chain reaction. Results There was a significant reduction in survival and DSPP expression in the group treated with 6% NaOCl compared with the untreated control group. Comparable survival was observed in the groups treated with the lower concentrations of NaOCl, but greater DSPP expression was observed in the 1.5% NaOCl group. In addition, 17% EDTA resulted in increased survival and DSPP expression partially reversing the deleterious effects of NaOCl. Conclusions Collectively, the results suggest that dentin conditioning with high concentrations of NaOCl has a profound negative effect on the survival and differentiation of SCAPs. However, this effect can be prevented with the use of 1.5% NaOCl followed by 17% EDTA. The inclusion of this irrigation regimen might be beneficial in regenerative endodontic procedures. © 2014 American Association of Endodontists.",
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AU - Schmidt,Christine E.

AU - Teixeira,Fabricio B.

AU - Diogenes,Anibal

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N2 - Introduction Intracanal disinfection is a crucial step in regenerative endodontic procedures. Most published cases suggest the use of sodium hypochlorite (NaOCl) as the primary irrigant. However, the effect of clinically used concentrations of NaOCl on the survival and differentiation of stem cells is largely unknown. In this study, we tested the effect of various concentrations of NaOCl on the stem cells of the apical papilla (SCAPs) survival and dentin sialophosphoprotein (DSPP) expression. Methods Standardized root canals were created in extracted human teeth and irrigated with NaOCl (0.5%, 1.5%, 3%, or 6%) followed by 17% EDTA or sterile saline. SCAPs in a hyaluronic acid-based scaffold were seeded into the canals and cultured for 7 days. Next, viable cells were quantified using a luminescence assay, and DSPP expression was evaluated using quantitative real-time polymerase chain reaction. Results There was a significant reduction in survival and DSPP expression in the group treated with 6% NaOCl compared with the untreated control group. Comparable survival was observed in the groups treated with the lower concentrations of NaOCl, but greater DSPP expression was observed in the 1.5% NaOCl group. In addition, 17% EDTA resulted in increased survival and DSPP expression partially reversing the deleterious effects of NaOCl. Conclusions Collectively, the results suggest that dentin conditioning with high concentrations of NaOCl has a profound negative effect on the survival and differentiation of SCAPs. However, this effect can be prevented with the use of 1.5% NaOCl followed by 17% EDTA. The inclusion of this irrigation regimen might be beneficial in regenerative endodontic procedures. © 2014 American Association of Endodontists.

AB - Introduction Intracanal disinfection is a crucial step in regenerative endodontic procedures. Most published cases suggest the use of sodium hypochlorite (NaOCl) as the primary irrigant. However, the effect of clinically used concentrations of NaOCl on the survival and differentiation of stem cells is largely unknown. In this study, we tested the effect of various concentrations of NaOCl on the stem cells of the apical papilla (SCAPs) survival and dentin sialophosphoprotein (DSPP) expression. Methods Standardized root canals were created in extracted human teeth and irrigated with NaOCl (0.5%, 1.5%, 3%, or 6%) followed by 17% EDTA or sterile saline. SCAPs in a hyaluronic acid-based scaffold were seeded into the canals and cultured for 7 days. Next, viable cells were quantified using a luminescence assay, and DSPP expression was evaluated using quantitative real-time polymerase chain reaction. Results There was a significant reduction in survival and DSPP expression in the group treated with 6% NaOCl compared with the untreated control group. Comparable survival was observed in the groups treated with the lower concentrations of NaOCl, but greater DSPP expression was observed in the 1.5% NaOCl group. In addition, 17% EDTA resulted in increased survival and DSPP expression partially reversing the deleterious effects of NaOCl. Conclusions Collectively, the results suggest that dentin conditioning with high concentrations of NaOCl has a profound negative effect on the survival and differentiation of SCAPs. However, this effect can be prevented with the use of 1.5% NaOCl followed by 17% EDTA. The inclusion of this irrigation regimen might be beneficial in regenerative endodontic procedures. © 2014 American Association of Endodontists.

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