Search Results (145)

Background: Periodontal disease is a chronic multifactorial inflammatory condition caused by dysbiosis of the dental biofilm, leading to destruction of the connective tissue attachment, alveolar bone resorption, and potentially tooth loss. Non-surgical periodontal therapy (NSPT), involving subgingival instrumentation, aims to restore periodontal health by reducing the probing pocket depth (PPD) and bleeding on probing (BOP) and by improving the clinical attachment level (CAL). The adjunctive use of chemical agents, such as sodium hypochlorite/amino acids (NaOCl) and cross-linked hyaluronic acid (xHyA) gels, has been proposed to enhance the efficacy of NSPT. Objective: This systematic review aimed to evaluate the clinical effectiveness of the subgingival application of NaOCl and xHyA gels as adjunctive therapies to NSPT in patients with periodontal disease. Materials and Methods: A comprehensive literature search was conducted in the MEDLINE (PubMed), Cochrane Library, Web of Science, and Scopus databases following PRISMA guidelines. The review was registered in PROSPERO (CRD420251074045). Randomized clinical trials (RCTs) in human subjects with a follow-up of at least 6 months were included if they assessed outcomes such as PPD, CAL, BOP, or radiographic bone loss (RBL). Studies involving the adjunctive use of NaOCl and xHyA gels were selected according to the PICOS strategy. Results: Two RCTs published between 2023 and 2024, with follow-ups ranging from 6 to 9 months and involving 48–50 patients, met the inclusion criteria. Both studies demonstrated significant improvements in clinical outcomes when sodium hypochlorite and hyaluronic acid were used adjunctively with NSPT compared to when NSPT was used alone. Sites treated with adjunctive therapy showed significantly greater reductions in PPD and greater CAL gains over time. Pocket closure rates were also markedly higher in deep sites (>7 mm) in the adjunctive group than in the control group, indicating a substantial regenerative potential and a possible reduction in the need for surgical intervention. Gingival recession exhibited more favorable recovery trends in the adjunctive group, while BOP frequency decreased in both groups without statistically significant differences. Conclusions: The adjunctive use of NaOCl and xHyA gels in non-surgical periodontal therapy significantly enhances clinical outcomes compared with the use of mechanical debridement alone. Full article

Eggs are nutrient-dense yet recognized vehicles for Salmonella transmission. Because eggshells are easily contaminated during production and handling, washing is critical to reduce microbial load. Here, we evaluated the bactericidal efficacy of 150 ppm sodium hypochlorite (NaOCl) against Salmonella enterica subsp. enterica serovar Enteritidis (S. Enteritidis), serovar Typhimurium (S. Typhimurium), and serovar Thompson (S. Thompson) across washing temperatures and exposure times. Eggs were inoculated by immersion in 100 mL of a Salmonella suspensions (approximately 8 log CFU/mL) prepared separately for each serovar, air-dried for 1 h, and subsequently washed in 150 ppm NaOCl for 35, 40, 45, or 50 °C. Following washing, eggs were transferred to buffered peptone water, homogenized, and plated on xylose lysine deoxycholate agar to quantify the residual Salmonella populations on the eggshells. Washing with 150 ppm NaOCl significantly reduced counts (3–5 log) under all conditions versus unwashed eggs (p < 0.001). Maximum inactivation for S. Enteritidis occurred at 35 °C for 45 s (4.95 log), whereas S. Typhimurium was greatest at 45 °C for 45 s (5.48 log). In contrast, S. Thompson showed a nonmonotonic, time-dependent pattern, with maximum inactivation occurring at 40 °C for 45 s (5.17 log). Overall, 150 ppm NaOCl effectively reduced S. Enteritidis, S. Typhimurium, and S. Thompson on eggshells. Efficacy appeared to be serovar dependent, with maximal reduction occurring at different temperatures for each serovar. These findings support standardized egg-washing guidelines to minimize Salmonella transmission across the food supply chain. Full article

Irrigation plays a crucial role in the success of root canal treatment; however, currently, no standardized irrigation protocols exist, particularly regarding the optimal sequence for smear layer removal. This systematic review aimed to determine which irrigation protocol achieves superior smear layer removal: traditional sequential irrigation with sodium hypochlorite (NaOCl) followed by ethylenediaminetetraacetic acid (EDTA), or irrigation with etidronic acid, either combined with NaOCl in continuous chelation or used as a final irrigant. Continuous chelation with etidronic acid may be clinically advantageous in daily practice, as it would facilitate workflow by using a single irrigating solution without compromising the efficacy of the irrigation process. A comprehensive electronic search was conducted in Medline, Embase, Cochrane, Scopus, and Web of Science, last updated in August 2025. In vitro studies were selected according to predefined PICO-based criteria. Two reviewers independently screened the studies and extracted data, with an inter-rater agreement of 0.92 using the Kappa index. Risk of bias was evaluated using a modified CONSORT checklist for in vitro studies on dental materials. The average item compliance of the included studies was 58%. The maximum score was 73% and the minimum was 47%. Twenty studies met the inclusion criteria. Etidronic acid used in continuous chelation showed equal or superior smear layer removal compared with sequential irrigation in nine of ten studies. Conversely, when used as a final irrigant, etidronic acid demonstrated inferior performance in more than half of the studies, particularly in the apical third. Based on the available evidence, etidronic acid in continuous chelation appears as effective as, or more effective than, traditional NaOCl–EDTA sequential irrigation. Full article

Microwave radiation is a potential alternative to conventional disinfection of acrylic resin, but exposure time must be minimized, e.g., by combining it with chemical agents, due to its effects on material properties. This study aimed to microbiologically evaluate the antifungal activity of microwave disinfection performed in distilled water, sodium hypochlorite (NaOCl), chlorhexidine (CHX), hydrogen peroxide (H₂O₂), or without immersion. Thermally polymerized PMMA samples colonized with Candida albicans ATCC 14053 were exposed to microwaves for 1 or 3 min in an unmodified microwave oven. Disinfection effectiveness was assessed by colony counting after 48 h of culture and absorbance after crystal violet staining. All microwave treatments significantly reduced fungal counts compared with the control (5360.00 ± 1663.09 CFU/mL). Complete inhibition of colony growth occurred only after 3 min exposure in distilled water, NaOCl, or CHX. One-minute exposure in these liquids reduced but did not eliminate fungi. The least effective method was disinfection without immersion, yielding 1040.00 ± 169.71 CFU/mL after 1 min and 560.00 ± 108.32 CFU/mL after 3 min. None of the tested conditions fully removed biofilms, although microwaves combined with NaOCl produced the best results. Overall, it was found that the presence of a liquid itself, rather than the type of chemical used, was the key factor in effective microwave-assisted disinfection. Microwave disinfection without the addition of chemicals does not remove biofilms. Full article

Due to the limitations of SRP, new methods are being sought to support non-surgical periodontal therapy. One of them is the use of antiseptics such as low-concentration sodium hypochlorite gel buffered with amino acids (NaOCl/AA). The aim of the study was to evaluate periodontal parameters and the concentration of metalloproteinase 8 (MMP-8) and interleukin 8 (IL-8) in the gingival crevicular fluid (GCF) after SRP with or without NaOCL/AA gel. The study included 40 periodontal patients randomized to study and control groups. Before SRP, the study group had a gel introduced into pockets with PD ≥ 5 mm. After treatment in both groups, the pocket depth (PD) decreased, there was a CAL gain, and unnoticeable changes in the gingival recession (GR). In the study group, deep pockets accounted for 25% of the sites examined prior to therapy, whereas after therapy, they decreased to 12%. In the control group, the proportion of deep periodontal pockets (PD ≥ 5 mm) fell from 17.46% to 9.05%. No differences were noted between groups. In the study group, there was a significant reduction in the amount of MMP-8 in GCF from 8.32 ng/mL to 5.14 ng/mL after 3 months. No statistically significant difference was observed in the control group. The concentration of IL-8 decreased significantly over time in both groups without differences between them. A single application of the NaOCl/AA gel in deep periodontal pockets does not affect clinical results and IL-8 levels. However, it had a significant effect on the amount of MMP-8. Full article

Background: Porphyromonas gingivalis is one of the most prevalent periodontal pathogens, involved in the development of periodontitis, deep caries, pulpitis, endodontic infections, and peri-implantitis. Antiseptics are commonly used in the treatment of oral diseases, but their effectiveness against P. gingivalis remains only partially understood. This preliminary study investigated antimicrobial and antibiofilm activity of eight pure antiseptics: boric acid (BA), chlorhexidine (CHX), ethacridine lactate (ET), hydrogen peroxide (H₂O₂), octenidine (OCT), polyhexanide (PHMB), potassium permanganate (KMnO₄), and sodium hypochlorite (NaOCl), as well as five commercial rinses containing these agents, against periopathogen P. gingivalis ATCC 33277. Methods: Minimal inhibitory concentrations (MICs) were determined using the broth microdilution method. The Clinical Efficiency of MIC (CEMIC) was subsequently calculated. Antibiofilm activity was evaluated using the crystal violet method, LIVE/DEAD fluorescence assay and by measuring biofilm thickness with digital microscopy in combination with the author’s Python-based application Biofilm Thickness Analyzer. Results: OCT, CHX, PHMB and ET showed the strongest activity against P. gingivalis, in both its planktonic and biofilm forms. H₂O₂ and BA had variable MIC efficacy and moderate antibiofilm activity. In contrast, NaOCl and KMnO₄ demonstrated the weakest activity or no significant effect against P. gingivalis. Conclusions: The results have a translational dimension, supporting the potential clinical relevance of the selected compounds. However, this study was conducted strictly in vitro on a single strain under monomicrobial biofilm conditions. Therefore, while the findings suggest that mouthwashes containing OCT, CHX, and PHMB may be effective against P. gingivalis, their actual clinical efficacy in the treatment and prevention of oral diseases remains to be confirmed in in vivo studies. Full article

This study investigated a plasma-sonic treatment that combines plasma-activated water (PAW) and ultrasound (US) as an alternative to conventional sodium hypochlorite (NaOCl), which may leave harmful chlorine residues and generate toxic by-products in fresh produce. The treatment was applied to kale to evaluate its decontamination efficiency and storage stability during 7 days at 4 °C. PAW was generated at 52 W and 14.4 kHz for 624 s, and US was applied at 20 kHz and 250 W for 624 s. The plasma-sonic treatment achieved microbial inactivation of indigenous bacteria by 3.2 log CFU/g, which is comparable to the 3.0 log CFU/g reduction achieved by NaOCl treatment. Moreover, the plasma-sonic treatment group exhibited the highest initial moisture content (89.42%) and maintained higher firmness during storage than the NaOCl-washed and untreated groups. Collectively, these findings indicate that the combined PAW and US washing method constitutes a promising non-chlorine-based intervention that enhances microbial stability while maintaining the physicochemical quality of fresh leafy vegetables. Full article

Background: Irrigation is a key strategy in reducing bioburden, disrupting biofilms, and supporting wound healing. While saline is the standard for its safety and availability, antiseptic and antibiotic solutions are often used in clinical scenarios that require infection control. However, the rise in antibiotic stewardship and concerns regarding cytotoxicity are reshaping current practices. This review identifies recent trends, current controversies, and persistent gaps in knowledge that warrant further investigation and regulatory attention. Methods: A literature review identified irrigation solutions commonly used in plastic surgery; labeling and concentrations were obtained from Devices@FDA, Drugs@FDA, and DailyMed, and PubMed, Cochrane Central, and Embase were searched (January 2022–July 2025) for human studies on acute wounds, chronic wounds, and implant-based breast surgery. Results: In acute wounds, saline and potable tap water effectively prevent infection. In chronic wounds, such as diabetic foot ulcers and pressure injuries, antiseptic agents, including hypochlorous acid, sodium hypochlorite, polyhexanide, and citrate-based solutions, have shown promise in improving healing and reducing infection. In implant-based breast reconstruction and augmentation, data on antiseptics, such as chlorhexidine, and changes in FDA guidance for povidone–iodine and bacitracin have prompted a reevaluation of intraoperative irrigation practices. Conclusion: Despite widespread use, many antiseptics remain off-label, and high-quality clinical studies comparing efficacy and safety are lacking. Full article

The aim of this study was to find a way to remove persistent bacteria inhabiting in vitro shoot cultures of raspberry. Often, decontamination treatments fail to reach bacteria residing in internal tissues, leading to contaminated cultures later. Three raspberry cultivars, each harboring a unique bacterial contaminant, were used in this study. Experiments were conducted to assess the potential for eliminating these bacteria using biocide infiltration at 30 mbar. The following biocides were used: mercuric chloride (HgCl₂ at 0.05 and 0.1%), Plant Preservative Mixture (PPM^TM 0.2–4%), rifampicin (50–200 mg L⁻¹), and sodium hypochlorite (NaOCl 0.1–60%). Only 0.05 or 0.1% HgCl₂ applied via infiltration successfully eliminated all of the bacteria from the shoots, which remained bacteria-free for several years, as confirmed by indexing explants on bacterial media at each subculture. While most treated shoots became necrotic and died due to infiltration, the surviving shoots remained vital and provided bacteria-free material for long-term propagation. Results from experiments comparing micropropagation potential in bacteria-contaminated and bacteria-free cultures showed that bacteria-free shoots produced longer shoots, and the total number of shoots did not differ, except for ‘Norna’/Curtobacbacteria-free cultures, which were more productive. Bacteria-contaminated shoots rooted at higher percentages, but roots were much shorter, and plantlets initiated growth during acclimatization later. Cultures that were contaminated did not survive storage at 4 °C in the dark for 4–6 months. Full article

Detailed studies were conducted on the photooxidation of salicylic acid (SA) in the presence of sodium hypochlorite (NaOCl), which is important in the context of water disinfection processes. It was shown that NaOCl alone causes slow degradation of SA (<10% after 60 min), while its combination with UV radiation significantly increases the efficiency of the process, especially at pH 7.5–10 (up to 30% degradation in 60 min). Eleven chlorinated transformation products have been identified, including 2,6-dichlorophenol and 2,4,6-trichlorophenol, which are characterized by high environmental persistence (>96 days) and the ability to travel distances exceeding 4000 km. QSAR analyses and ecotoxicological tests (Microtox^®, Daphtoxkit F^®, Lemna sp.) confirmed the significant toxicity of some compounds to fish, daphnia, and algae. It was found that the post-reaction mixture after the NaOCl/UV process exhibits higher toxicity than SA photolysis alone, indicating a significant contribution of chlorinated intermediates to environmental risk. The results highlight the need to develop alternative methods for removing pharmaceuticals that minimize the formation of persistent and toxic by-products, and indicate directions for further research on their monitoring in the aquatic environment. Full article

Background: Adhesion to enamel is influenced by surface preparation, which affects the micromechanical retention of resin-based materials. Sodium hypochlorite (NaOCl) deproteinization has been proposed as a pretreatment to improve acid etching efficacy, but the optimal application time remains unclear. Methods: This in vitro study evaluated the effect of 5% NaOCl pretreatment at three exposure times (15, 30, and 60 s) on shear bond strength (SBS), the adhesive remnant index (ARI), and enamel etching patterns. Extracted human premolars (n = 140) were divided into four groups: the control (acid etching only) and three experimental groups. SBS was tested per ISO 11405, while ARI scores were assessed under stereomicroscopy, and surface morphology was examined by scanning electron microscopy (SEM). Results: The 30-s NaOCl group exhibited the highest SBS (20.9 MPa) compared with the control (15.9 MPa, p < 0.05) and 15-s (14.9 MPa, p < 0.05) groups. SEM analysis showed predominantly Type I–II etching patterns for the 30-s group, irregular Type III for 15 s, and overetched Type IV with loss of prism definition for 60 s, compromising the adhesive interface. ARI scores indicated 86.7% of samples in the 30-s group retained all adhesive on enamel (score 3). Conclusions: A 30-s 5% NaOCl pretreatment before acid etching improved enamel micromorphology and bonding performance compared to shorter or longer exposures. The intermediate duration provided effective deproteinization without structural damage, whereas prolonged exposure degraded the enamel microstructure. This protocol may offer a simple, cost-effective method to enhance clinical adhesive procedures, though prolonged exposure (60 s) should be avoided due to structural degradation of the enamel microstructure. Full article

Background/Objectives: The objective of this in vitro study was to compare and evaluate the in vitro antimicrobial effectiveness of Endosal, Octenisolv, and Endoxal against intracanal Enterococcus faecalis. Methods: The study sample consisted of 84 extracted single-rooted human teeth, which were divided into seven groups (12 roots in each group): Group 1—Endoxal, Group 2—Octenisolv, Group 3—Endosal, Group 4—15% ethylenediaminetetraacetic acid (EDTA), Group 5—2% sodium hypochlorite (NaOCl), Group 6—0.9% sterile saline solution (NaCl), and one positive control group where no irrigant was used. The roots were sterilized within an autoclave for 30 min at 121 °C and then contaminated with E. faecalis bacteria, after instrumentation and removing the smear layer from canals. The root canals were irrigated using a side-vented needle, and then ISO size 40 H-file was used to obtain fine dentine chips. Aliquots taken from the canals were plated on blood agar broth and the plates were incubated for 36 h. Results: In this study, significant differences were observed between the antimicrobial activity of Endoxal, Octenisolv, Endosal, 2% NaOCl, and sterile saline solution. Conclusions: The compound irrigants Endosal, Endoxal, and a novel irrigant containing disodium edetate and octenidine, which were evaluated in this study, exhibited relatively good antimicrobial properties against Enterococcus faecalis. The use of Endosal, Octenisolv or Endoxal appears promising, yet their clinical efficacy remains to be confirmed through further studies. Full article

Foodborne illness outbreaks from fresh produce underscore the urgent demand for sanitizing strategies that ensure safety while minimizing harmful by-products from high-dose chemical disinfectants such as sodium hypochlorite (NaOCl). Low-concentration combinations of organic acids and washing sanitizers were systematically evaluated to identify synergistic antibacterial effects, and citric acid (CA) was found to markedly potentiate the activity of NaOCl against Salmonella Typhimurium through a sequential assault on the cell envelope. A low-dose combination of sub-inhibitory concentrations (1/2 MIC of CA and 1/4 MIC of NaOCl) exhibited robust synergy, achieving a >6 log CFU/cm² reduction in the pathogen on a cherry tomato model within 3 min. Moreover, this synergistic entry leads to profound disruption of membrane integrity, resulting in leakage of nucleic acids and proteins, extensive oxidative damage, hyperpolarization, and cell lysis, as confirmed by electron and confocal microscopy together with physicochemical assays. Mechanistic investigation revealed that oxidative damage from NaOCl amplified CA-induced membrane acidification and permeability, facilitating deeper sanitizer penetration and accelerating envelope destruction. Collectively, these findings uncover a membrane-targeted synergistic mechanism, providing a solid scientific basis for the development of novel, low-residue, and high-efficacy food safety interventions. Full article

Background/Objectives: Periradicular disease is largely microbial in origin. Even gutta-percha (GP) cones manufactured under aseptic conditions can acquire contaminants during handling or storage, undermining otherwise adequate canal preparation. To assess residual antimicrobial activity on GP cones after brief exposure to five endodontic disinfectants: sodium hypochlorite (NaOCl) 1%, 2.5%, 5.25%; chlorhexidine (CHX) 2%; and glutaraldehyde 2% against Enterococcus faecalis and Candida albicans. Methods: Standardized GP cones were dipped for 5–120 s, blotted on neutralizing gauze, and placed on agar inoculated with either organism. Using an agar diffusion approach, inhibition-zone diameters were recorded at 0, 24, and 48 h. Data were summarized using descriptive statistics (means, standard deviations, and 95% confidence intervals) for each disinfectant–dip-time combination. Results: By 24 h, inhibition zones were observed for most disinfectants; for C. albicans, glutaraldehyde 2% showed no measurable effect. At later time points, performance depended on both disinfectant and contact time. For E. faecalis, NaOCl 2.5% and 5.25% yielded the largest zones at 48 h (20–21 mm at 120 s), whereas NaOCl 1% was smaller (10 mm) and glutaraldehyde 2% modest (9 mm). For C. albicans, NaOCl 2.5% and CHX 2% were most effective at 48 h (17–19 mm at 120 s); NaOCl 5.25% was intermediate, NaOCl 1% weak, and glutaraldehyde 2% showed no measurable antifungal effect. Longer immersions (≥45 s) consistently increased inhibition zone diameters. Conclusions: Residual antimicrobial activity on GP cones depends on both the agent and the immersion time. For E. faecalis, higher concentration NaOCl produced the largest zones at short contact time, whereas for C. albicans, CHX 2% and NaOCl 2.5% provided the most reliable carryover. Selecting an appropriate concentration and allowing sufficient dip time may reduce reinfection risk at obturation. Full article

Background/Objectives: Root canal therapy (RCT) aims to eliminate intracanal infection and promote periapical healing through mechanical instrumentation and chemical disinfection. Conventional irrigants, such as sodium hypochlorite (NaOCl), are effective but may exhibit limited penetration into anatomically complex root canal systems and carry the risks of cytotoxicity if extruded beyond the apical foramen or into surrounding periodontal tissues. In this pilot study, we evaluated the clinical effectiveness and safety of underwater discharge plasma (UDP) as a biocompatible alternative to NaOCl for root canal irrigation. Methods: A prospective, randomized clinical trial was conducted involving 30 patients who required root canal treatment. Patients were randomly allocated to the UDP (n = 15) or NaOCl (n = 15) group. All treatments were performed by a single operator following standardized protocols. Pain was assessed using the visual analog scale (VAS), and periapical healing was evaluated using the Periapical Index (PAI) at baseline, 2 months, and 4 months. Statistical analyses included the Friedman test, Mann–Whitney U test, and Fisher’s exact test. Interobserver agreement for radiographic readings was evaluated using quadratic-weighted Cohen’s kappa coefficient. Results: A total of 28 patients completed the study. VAS scores significantly decreased over time in both groups (p < 0.05), with no significant difference between the groups at any time point (p > 0.05). At 4 months, radiographic healing was observed in 71.4% and 92.9% of patients in the UDP and NaOCl groups, respectively (p > 0.05). PAI score changes and clinical success rates were comparable between groups. No adverse effects or thermal damage was reported when using UDP. Conclusions: UDP demonstrated short-term clinical efficacy and safety comparable to that of NaOCl. Thus, UDP may serve as a biocompatible alternative for root canal disinfection. Further large-scale and long-term studies are warranted to confirm its clinical utility. Full article