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Printed in U.S.A.
VOL. 24, NO. 6, JUNE1998

JOURNAL OF ENDODONTICS

Copyright 1998 by The American Association of Endodontists

Chemical Stability of Heated Sodium Hypochlorite

Endodontic Irrigants
Gianluca Gambarini, MD, DDS, Massimo De Luca, MD, DDS, and Roberto Gerosa, MD, DDS

Several previous studies have investigated the advantage of temperature on tissue-dissolving and
antimicrobial properties of sodium hypochlorite.
However, it is known that the chemical stability of
sodium hypochiorite is adversely affected by exposure to high temperature. The purpose of this study
was to investigate the effect of heating sodium
hypochlorite to 50C on the stability of the solution.
An iodometric titration test was used to evaluate
the decomposition rates of heated and nonheated
solutions over 30 days. Results showed that all
specimens exhibited a minimal, gradual degradation versus time. However, no statistically significant difference (p < 0.05) was noted between the
two groups. After 30 days, both heated and nonheated solutions maintained high available chlorine content and pH values consistent with excellent tissue-dissolving and antibacterial properties.

dissolve necrotic tissue in rats. Abou-Rass and Oglesby (6) found

that the strongest effect was obtained on fresh tissues with 5.25%
NaOC1 at 60C. Berutti and Marini (7) compared the debridement
capability of 5% NaOCI at 21C and at 50C. Marked differences
observed in the smear layer indicated that NaOC1 heated to 50C
encouraged the formation of a thinner smear layer made up of finer
and less adherent particles.
Although the use of warmed NaOC1 solutions is becoming quite
popular in modern endodontic practice, a search of the literature
has failed to disclose information or guidelines for determining the
effective shelf-life of these solutions. The purpose of the present
study was to investigate the effect of heating NaOC1 to 50C on the
chemical stability of the irrigating solution,

M A T E R I A L S AND M E T H O D S
Four bottles of Niclor 5 (Ogna, Milan, Italy), an irrigating
solution especially prepared for endodontic use, were selected for
this study. All specimens supplied by the manufacturer had the
same production date and similar initial chlorine content.
Each bottle was opened only during sampling and was stored at
room temperature (20C) and protected from light. Approximately
every 12 h, two bottles (A and B) were heated for 30 min at 50C
(heated NaOCI). Samples were allowed to cool at room temperature and subjected to an iodometric titration test at precise intervals
(8). The other two bottles (C and D) served as a control group. No
heating was performed in these specimens.
Measurements of available chlorine content were taken at days
0, 3, 7, 14, 21, and 30. The density and pH of the four irrigating
solutions were also measured at the same intervals.
The results were evaluated statistically using A N O V A and the
paired t test.

The antibacterial properties and the ability of sodium hypochlorite

(NaOC1) to dissolve organic material and to remove loose debris
during chemicomechanical root preparation have been widely investigated. Hand et al. (1) showed that 5.25% NaOC1 was a potent
antimicrobical agent and an effective pulp tissue solvent. Harrison
and Hand (2) demonstrated that both the antibacterial and tissuedissolving capabilities of 5.25 NaOC1 decrease when the irrigant is
diluted.
Because NaOC1 is degraded by light, air, metals, and organic
contaminants, it is believed that the lack of chemical stability is an
important factor that may adversely affect cleaning properties (3).
The use of fresh stock solution is therefore recommended. Moreover, chlorine content of solutions tends to decrease after bottles
have been opened. Storage temperature and concentration of solutions are other important factors that may affect the decomposition rate. Piskin and Turkun (4) demonstrated that all solutions
showed degradation versus time and that a more rapid deterioration
in solutions containing 5% available chlorine occurred in those
stored at 24C than in those stored at 4C.
In contrast, temperature has a positive effect on the solvent
effects of NaOC1 irrigating solutions. Th6 (5) showed that raising
the temperature of the solution to 35.5C increased the power to

RESULTS
All specimens exhibited a minimal, gradual degradation versus
time (as shown in Table 1). Mean loss of available chlorine was
< 1%. Decomposition rate of heated and nonheated (control group)
solutions did not show a statistically significant difference (p <
0.05). None of the tested solutions showed a rapid degradation, and
chemical stability after 30 days was judged satisfactory.
A gradual decrease of pH values was noted over time, directly
related to the loss of available chlorine. Also, density of the
solutions tended to increase over time. These data are shown in
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Deterioration of Heated NaOCl

t/01.24, No. 6, June 1998

TABLE1. % available chlorine content of the four solutions
Day

Heated NaOCI
A
B
C0ntrolgroup
C
D

14

21

30

5.162
5.169

5.133
5.140

5.119
5.123

5.087
5.101

5.040
5.076

5.013
5.020

5.173
5.170

5.156
5.148

5.127
5.120

5.109
5.099

5.084
5.071

5.038
5.021

TABLE2. Density of NaOClsolutions versus time (g/ml)

Day
0
He~ed NaOCI
A

B
Control group
C
D

14

21

30

1.0940 1.0943 1.0958 1.0975 1.0998 1.1009

1.0938 1.0940 1.0947 1.0959 1.0978 1.0995
1.0937 1.0936 1.0939 1.0945 1.0949 1.0955
1.0932 1.0933 1.0943 1.0950 1.0958 1.0964

TABLE 3. pH values of NaOCI solutions versus time

Day

Heated NaOCI
A
B
Control group
C
D

14

21

30

12.97
12.88

12.96
12.86

12.93
12.81

12.90
12.78

12.86
12.73

12.82
12.69

12.85
12.89

12.82
12.88

12.81
12.84

12.78
12.81

12.73
12.77

12.68
12.72

Tables 2 and 3. No significant difference was noted among the four

specimens for both density and pH values (p < 0.05).

DISCUSSION
There is an increasing discussion concerning the chemical stability of NaOC1 solutions after bottles have been opened. Some
published reports showed high decomposition rates, up to a 70%
loss of available chlorine (9). On the contrary, other studies have
shown that NaOC1 solutions are stable over long periods (3, 10). It
is suggested that a more rapid degradation occurs in solutions
stored at 24C. Moreover, a higher concentration of solutions
seems to be another important factor that may adversely affect the
decomposition rate (3, 4).
The results of the present study are consistent with data from
previous researchers (4, 8, 11) that showed a minimal, gradual
decrease of chlorine content and pH over time. After bottles had
been opened, all of the tested solutions (heated and nonheated
specimens) kept an excellent chemical stability. Storage temperature and heating procedures did not adversely affect chemical
stability over a short period of time. Mean loss of available chlorine after 30 days was < 1% for both groups, despite the fact that
all solutions were kept at the storage temperature of 20C. These
data support the findings of Johnson and Remeikis (11), who
reported that the tissue-dissolving ability of 5.25% NaOC1 remained stable for at least 10 wk, when stored in translucent,
air-tight, nonreactive bottles. Martin (12) found that the bacterial

433

effectiveness of 5% NaOC1 decreased over time and suggested a

storage shelf-life of 3 months for undiluted solutions.
Because root canal morphological complexities tend to impede
the delivery of irrigants and the efficacy of chemical reactions, a
great effort has been placed on improving irrigation materials and
techniques (13). Some studies (7, 14) indicated that raising the
temperature of the irrigating solution increased the debridement
capability of NaOC1. The findings of the present study show that
heating NaOC1 to 50C has no adverse effect on the chemical
stability of the solutions. There is no significant difference in
decomposition rates and pH decreases versus time between heated
and nonheated 5% solutions. These results are not consistent with
a previous report by Cunningham and Balekjian (15), who noted
deterioration of the warmed solutions at 24 h, when tested at 37C.
pH values of tested solutions showed a minimal decrease versus
time. These findings may explain the good chemical stability,
because decomposition rate increases when pH of solutions decreases. Both heated and nonheated solutions maintained high
available chlorine content and pH values, consistent with excellent
tissue-dissolving and antimicrobial capabilities. A minimal increase of density was noted over time, although the significance of
this finding remains unknown and does not seem related to clinical
activity.
Therefore, the use of warmed NaOC1 solutions seems to be a
safe and simple procedures that may lead to a better debridement
of the canals. However, the destructive nature of NaOC1 on periapical tissue is well documented. Severe sequelae have been reported (16) when nonheated 5.25% NaOC1 is injected into human
periapical tissue. Whether the heat generated by warmed NaOC1
solutions within the canal could have a deleterious effect on the
periodontal tissues remains controversial. In any case, any method
of irrigation delivery that reduces or prevent apical extrusion of
wanned NaOC1 solutions during endodontic canal preparation (17)
would be of great benefit.

Dr. Gambarini is professor and Dr. De Luca is head and professor, Department of Dental Materials, University of Siena, Dental School, Siena, Italy.
Dr. Gerosa is professor, Department of Restorative Dentistry, University of
Ferrara, Ferrara, Italy. Address requests for reprints to Dr. Gianluca Gambarini, Circonvallazione Casilina 124, 00176 Rome, Italy.

References
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the necrotic tissue dissolution property of sodium hypochlorite. J Endodon
1978;4:60-4.
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1981:77-83.
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J o u r n a l of E n d o d o n t i c s

14. Cameron JA. The use of ultrasonics in the removal of the smear layer:
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J Endodon 1995;21:587-91.

T h e W a y It W a s
One facet of present day gender equality initiatives that appears to be achieving reasonable success is the
advancement of women to positions of authority in business and finance. Surely, it is an expression of equality
of opportunity that is appropriate. But women have had success in such areas in the past, too . . . consider
Hettie Green. A business wizard, she increased her inheritance over 25 times by shrewd investing and
manipulation of financial instruments. Known as the "Witch of Wall Street" because she habitually dressed
all in black, she was worth perhaps $100 million at her death in 1916 (Audac 1996;4:40), which would likely
have placed her among the 20 wealthiest persons in the world at that time.

Ann Wiley