International Journal of Scientific Research in Dental and Medical Sciences

International Journal of Scientific Research in Dental and Medical Sciences

Comparison of the Effect of Two Sodium Hypochlorite Concentrations on Micro-hardness of Butterfly-shaped Sclerotic Dentin in Single-rooted Premolar Teeth

Document Type : Original Article

Authors
Yasamin Roghaa
Parisa Ranjbarian
Mehrzad Moazzam
Department of Endodontics, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
10.30485/ijsrdms.2025.536625.1670
Abstract
Background and aim: Given the significance of the butterfly effect in premolars undergoing root canal treatment and their increased risk of vertical root fracture, it is important to investigate the impact of irrigation with different concentrations of sodium hypochlorite on premolar teeth with the butterfly effect.
Material and methods: This experimental study evaluated 30 single-rooted premolar teeth with butterfly-shaped sclerotic dentin. The teeth with circular root sections were selected to ensure an equal mesiodistal-to-buccolingual width ratio. The roots were sectioned into coronal, middle, and apical thirds. Microhardness measurements were conducted on the buccal and mesial sides at four points within the middle third of each root. After specimen preparation, the samples were allocated into three groups: 0.9% normal saline (control), 2.5%, and 5% concentration of sodium hypochlorite (intervention). Microhardness was assessed before and after the intervention; data were recorded in the checklist, and statistical analysis was performed at the 0.05 significance level using SPSS 26.
Results: The average microhardness of dentin with the butterfly effect in all groups, including 2.5% and 5% sodium hypochlorite and physiological saline, was less than before treatment. Sodium hypochlorite at the two investigated concentrations had a significantly greater effect than physiological saline (p<0.05), but there was no statistically significant difference between the two concentrations (p>0.05).
Conclusions: Sodium hypochlorite at both 2.5% and 5.25% concentrations reduces the microhardness of dentin with a butterfly effect. A 2.5% concentration is recommended to minimize potential side effects.
Keywords
Anatomy and Histology
Dentin
Root Canal Irrigants

Subjects

[1] Carvalho TS, Lussi A. Age‐related morphological, histological and functional changes in teeth. Journal of oral rehabilitation. 2017;44(4):291-8. https://doi.org/10.1111/joor.12474.
[2] Kabartai F, Hoffmann T, Hannig C. The physiologic sclerotic dentin: A literature-based hypothesis. Medical hypotheses. 2015;85(6):887-90. https://doi.org/10.1016/j.mehy.2015.09.016.
[3] Vasiliadis L, Stavrianos C, Dagkalis P, Parisi K, Pantelidou O, Samara E. Root dentine translucency of human teeth: Factors affecting formation and deposition. Res J Biol Sci. 2011;6(2):82-8.
[4] Yan W, Jiang E, Renteria C, Paranjpe A, Arola DD, Liao L, et al. Odontoblast apoptosis and intratubular mineralization of sclerotic dentin with aging. Archives of Oral Biology. 2022;136:105371. https://doi.org/10.1016/j.archoralbio.2022.105371.
[5] Goldberg M, Kulkarni AB, Young M, Boskey A. Dentin: Structure, Composition and Mineralization: The role of dentin ECM in dentin formation and mineralization. Frontiers in bioscience (Elite edition). 2011;3:711-35. https://doi.org/10.2741/e281.
[6] Sodvadiya UB, Bhat GS, Shetty A, Hegde MN, Shetty P. The “Butterfly Effect” and its correlation to the direction of the fracture line in root dentin. Journal of Endodontics. 2021;47(5):787-92. https://doi.org/10.1016/j.joen.2021.01.011.
[7] Russell AA, Chandler NP, Hauman C, Siddiqui AY, Tompkins GR. The butterfly effect: an investigation of sectioned roots. Journal of endodontics. 2013;39(2):208-10. https://doi.org/10.1016/j.joen.2012.09.016.
[8] von Arx T, Bosshardt D. Vertical root fractures of endodontically treated posterior teeth: A histologic analysis with clinical and radiographic correlates. SWISS DENTAL JOURNAL SSO–Science and Clinical Topics. 2017;127(1):14-23. https://doi.org/10.61872/sdj-2017-01-233.
[9] Rao MS, Sekhar VS, Kumar CK, Rathod RT. Comparative evaluation of presence of butterfly effect in transverse sections of incisors, canines and premolars–an in-vitro study. Indian Journal of Mednodent and Allied Sciences. 2016;4(2):71-5.
[10] Harrison JW. Irrigation of the root canal system. Dental Clinics of North America. 1984;28(4):797-808. https://doi.org/10.1016/S0011-8532(22)02205-4.
[11] Verma N, Sangwan P, Tewari S, Duhan J. Effect of different concentrations of sodium hypochlorite on outcome of primary root canal treatment: a randomized controlled trial. Journal of endodontics. 2019;45(4):357-63. https://doi.org/10.1016/j.joen.2019.01.003.
[12] Zehnder M. Root canal irrigants. Journal of endodontics. 2006;32(5):389-98. https://doi.org/10.1016/j.joen.2005.09.014.
[13] Slaughter RJ, Watts M, Vale JA, Grieve JR, Schep LJ. The clinical toxicology of sodium hypochlorite. Clinical toxicology. 2019;57(5):303-11. https://doi.org/10.1080/15563650.2018.1543889.
[14] Ruksakiet K, Hanák L, Farkas N, Hegyi P, Sadaeng W, Czumbel LM, et al. Antimicrobial efficacy of chlorhexidine and sodium hypochlorite in root canal disinfection: a systematic review and meta-analysis of randomized controlled trials. Journal of endodontics. 2020;46(8):1032-41. https://doi.org/10.1016/j.joen.2020.05.002.
[15] Oncu A, Celikten B, Aydın B, Amasya G, Tuncay E, Eskiler GG, et al. Antibacterial efficacy of silver nanoparticles, sodium hypochlorite, chlorhexidine, and hypochlorous acid on dentinal surfaces infected with Enterococcus faecalis. Microscopy Research and Technique. 2024;87(9):2094-102. https://doi.org/10.1002/jemt.24590.
[16] del Carpio-Perochena A, Bramante CM, de Andrade FB, Maliza AG, Cavenago BC, Marciano MA, et al. Antibacterial and dissolution ability of sodium hypochlorite in different pHs on multi-species biofilms. Clinical Oral Investigations. 2015;19(8):2067-73. https://doi.org/10.1007/s00784-015-1431-6.
[17] Briseño-Marroquín B, Callaway A, Shalamzari NG, Wolf TG. Antibacterial efficacy of peracetic acid in comparison with sodium hypochlorite or chlorhexidine against Enterococcus faecalis and Parvimonas micra. BMC oral health. 2022;22(1):119. https://doi.org/10.1186/s12903-022-02148-8.
[18] Ma J, Wang Z, Shen Y, Haapasalo M. A new noninvasive model to study the effectiveness of dentin disinfection by using confocal laser scanning microscopy. Journal of endodontics. 2011;37(10):1380-5. https://doi.org/10.1016/j.joen.2011.06.018.
[19] Khademi A, Feizianfard M. The effect of EDTA and citric acid on smear layer removal of mesial canals of first mandibular molars, a scanning electron microscopic study. J Res Med Sci. 2004;9(2):27-35.
[20] Zehnder M, Kosicki D, Luder H, Sener B, Waltimo T. Tissue-dissolving capacity and antibacterial effect of buffered and unbuffered hypochlorite solutions. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 2002;94(6):756-62. https://doi.org/10.1067/moe.2002.128961.
[21] Lin GS, Ghani NR, Noorani TY. The existence of butterfly effect and its impact on the dentinal microhardness and crack formation after root canal instrumentation. Odontology. 2021;109(3):672-8. https://doi.org/10.1007/s10266-021-00589-1.
[22] Russell AA, He LH, Chandler NP. Investigation of dentin hardness in roots exhibiting the butterfly effect. Journal of endodontics. 2014;40(6):842-4. https://doi.org/10.1016/j.joen.2013.11.005.
[23] Slutzky-Goldberg I, Maree M, Liberman R, Heling I. Effect of sodium hypochlorite on dentin microhardness. Journal of endodontics. 2004;30(12):880-2. https://doi.org/10.1097/01.DON.0000128748.05148.1E.
[24] Pascon FM, Kantovitz KR, Sacramento PA, Nobre-dos-Santos M, Puppin-Rontani RM. Effect of sodium hypochlorite on dentine mechanical properties. A review. Journal of dentistry. 2009;37(12):903-8. https://doi.org/10.1016/j.jdent.2009.07.004.
[25] Cáceres CH, Griffiths JR, Pakdel AR, Davidson CJ. Microhardness mapping and the hardness-yield strength relationship in high-pressure diecast magnesium alloy AZ91. Materials Science and Engineering: A. 2005;402(1-2):258-68. https://doi.org/10.1016/j.msea.2005.04.042.
[26] Giardino L, Del Fabbro M, Cesario F, Fernandes FS, Andrade FB. Antimicrobial effectiveness of combinations of oxidant and chelating agents in infected dentine: an ex vivo confocal laser scanning microscopy study. International Endodontic Journal. 2018;51(4):448-56. https://doi.org/10.1111/iej.12863.
International Journal of Scientific Research in Dental and Medical Sciences
Volume 7, Issue 3
Summer 2025
Pages 101-105

  • Receive Date 20 July 2025
  • Revise Date 22 August 2025
  • Accept Date 28 August 2025
  • Publish Date 01 September 2025