OBJECTIVES: The aim of this systematic review was to critically analyze previously published studies of the effects of dentin surface pretreatment with deproteinizing agents on the bonding of self-etch (SE) adhesives to dentin. Additionally, a meta-analysis was conducted to quantify the effects of the above-mentioned surface pretreatment methods on the bonding of SE adhesives to dentin. MATERIALS AND METHODS: An electronic search was performed using the following databases: Scopus, PubMed and ScienceDirect. The online search was performed using the following keywords: ‘dentin’ or ‘hypochlorous acid’ or ‘sodium hypochlorite’ and ‘self-etch adhesive.’ The following categories were excluded during the assessment process: non-English articles, randomized clinical trials, case reports, animal studies, and review articles. The reviewed studies were subjected to meta-analysis to quantify the effect of the application time and concentration of sodium hypochlorite (NaOCl) and hypochlorous acid (HOCl) deproteinizing agents on bonding to dentin. RESULTS: Only 9 laboratory studies fit the inclusion criteria of this systematic review. The results of the meta-analysis revealed that the pooled average microtensile bond strength values to dentin pre-treated with deproteinizing agents (15.71 MPa) was significantly lower than those of the non-treated control group (20.94 MPa). CONCLUSIONS: In light of the currently available scientific evidence, dentin surface pretreatment with deproteinizing agents does not enhance the bonding of SE adhesives to dentin. The HOCl deproteinizing agent exhibited minimal adverse effects on bonding to dentin in comparison with NaOCl solutions.
Adhesives* ; Animals ; Dentin* ; Hypochlorous Acid ; Smear Layer* ; Sodium Hypochlorite

The use of the mineral trioxide aggregate (MTA) has been expanded as the material can be applied on various treatment of endodontic care, which also has many advantages including bioactivity. Still, the discolorations of the materials have been presented as a concern related to esthetic appearances, which is caused by the presence of radiopacifiers. Therefore, the aim of this study was to investigate the color stability and radiopacity of white MTA with various radiopacifiers. Four different radiopacifiers [bismuth oxide (BM), calcium tungstate (CT), barium oxide (BO), and zirconium oxide (ZO)] were used. The radiopacity was tested according to ISO 6876, and the color change before and after immersing in a 5% hypochlorite solution was tested using a spectrophotometer. The group with no radiopacifier (NR) was used as a negative control and ProRoot MTA (PR) was used as the commercial control. The immersion of the PR and BM in sodium hypochlorite resulted in a dark brown discoloration, in which the values were higher than the rest of the group (p<0.05). No change was observed in the NR. Moreover, the CT and ZO showed no color change compared to the NR (p>0.05). In terms of the radiopacity, the NR showed the lowest value as expected (p<0.05). Meanwhile, the BM showed the highest value (p<0.05), followed by PR and BO (p<0.05). The NR showed the lowest radiopacity values. The result of this study will be useful for future development of MTA that would have clinically adequate radiopacity with minimum discoloration.
Barium ; Calcium ; Hypochlorous Acid ; Immersion ; Miners ; Pemetrexed ; Sodium Hypochlorite ; Zirconium

OBJECTIVES: To evaluate the effects of copolymer of acrylic acid and maleic acid (Poly[AA-co-MA]) and calcium hypochlorite (Ca(OCl)2) on root canal dentin using scanning electron microscope (SEM). MATERIALS AND METHODS: Twenty-four single-rooted teeth were instrumented and the apical and coronal thirds of each root were removed, leaving the 5 mm middle thirds, which were then separated into two pieces longitudinally. The specimens were randomly divided into six groups and subjected to each irrigant for 5 min as follows: G1, Ca(OCl)2; G2, Poly(AA-co-MA); G3, Ca(OCl)2 + Poly(AA-co-MA); G4, sodium hypochlorite (NaOCl); G5, ethylenediaminetetraacetic acid (EDTA); G6, NaOCl+EDTA. The specimens were prepared for SEM evaluation. Smear layer, debris and erosion scores were recorded by two blinded examiners. One image from G3 was analyzed with energy dispersive spectroscopy (EDS) on suspicion of precipitate formation. Data were analyzed using the Kruskal-Wallis and Dunn tests. RESULTS: G1 and G4 showed the presence of debris and smear layer and they were statistically different from G2, G3, G5 and G6 where debris and smear layer were totally removed (p < 0.05). In G1 and G4, erosion evaluation could not be done because of debris and smear layer. G2, G3 and G5 showed no erosion, and there was no significant difference between them. G6 showed severe erosion and was statistically different from G2, G3 and G5 (p < 0.05). EDS microanalysis showed the presence of Na, P, and Ca elements on the surface. CONCLUSIONS: Poly(AA-co-MA) is effective in removing the smear layer and debris without causing erosion either alone or with Ca(OCl)2.
Calcium ; Dental Pulp Cavity ; Dentin* ; Edetic Acid ; Hypochlorous Acid ; Smear Layer* ; Sodium Hypochlorite ; Spectrum Analysis ; Tooth

OBJECTIVE: Disinfection/sterilization of hospital devices prevents the occurrence of several infections; therefore, disinfectants are essential for public health. The purpose of this study was to evaluate the biocidal effect of a hypochlorous acid solution. METHODS: Hypochlorous acid solution, Neolox (Neo Chemical, Paju, Korea) obtained from Purester (Morinaga Engineering, Tokyo, Japan) was used. Antimicrobial activity of the solution against bacteria, yeasts, and mycobacteria at different exposure times (0.5, 1, 2, 5, 10, 15, and 30 minutes) was evaluated. RESULTS: All strains of bacteria and yeasts showed a 5-log10 reduction within 30 seconds of exposure to the solution, and mycobacteria showed the same reduction within 2 minutes. CONCLUSION: Hypochlorous acid solution has been widely used as a disinfectant in recent years. Neolox can be used as an effective intermediate- to high-level disinfectant for hospital infection control.
Bacteria ; Cross Infection ; Disinfectants ; Hypochlorous Acid* ; Public Health ; Yeasts

BACKGROUND AND OBJECTIVES: Low concentration hypochlorous acid is known for being an endogenous anti-bacterial and anti-viral agent. Saline irrigation has been used as an adjunctive treatment for patients with chronic sinusitis. In this study, we tried to compare the effectiveness of hypochlorous acid and saline nasal irrigation to patients with intractable sinusitis after surgery. SUBJECTS AND METHOD: A total of 35 patients who had a frequent relapse of chronic sinusitis or had persisting symptoms post-surgically were recruited. The experimental group was given hypochlorous acid and saline nasal irrigation, while the control group was given saline nasal irrigation for eight weeks. The curative effects were assessed on the basis of the symptom score, nasal endoscopic score, bacterial culture, and inflammatory cytokines on the first day, fourth week, and eighth week after treatment. RESULTS: A total of 26 participants were assessed. The study finally consisted of 15 patients in experimental group and 11 in the control group. The symptom scores in the experimental group were substantially lower before, and after four and eight weeks of treatment. However, there was no specific difference in symptom score improvement between the two groups. The endoscopic score improved in experimental group (p<0.01). Similar tendencies were shown in the bacterial culture test of both groups. In the experimental group, the values of TNF-alpha, IL-8, and IL-1beta decreased in the fourth week, whereas they increased in the eighth week. CONCLUSION: Hypochlorous acid nasal irrigation may be to used as an alternative adjunctive treatment in addition to saline irrigation.
Cytokines ; Humans ; Hypochlorous Acid ; Interleukin-8 ; Nasal Cavity ; Nasal Lavage ; Recurrence ; Sinusitis ; Tumor Necrosis Factor-alpha

This study examined the disinfection conditions (exposure time, 0–30 min; exposure temperature, 4℃–65℃) of hypochlorous acid water (HOCl) in automobile disinfection equipment. The study tested poliovirus type 1 (PV1), low pathogenic avian influenza virus (AIV, H9N2), and foot and mouth disease virus (FMDV, O type). As a result, the PV1 and FMD viruses were inactivated easily (virus titer 4 log value) by HOCl (> 100 ppm) but the AIV required higher exposure temperatures (> 55℃). In conclusion, the exposure temperature and time are important factors in deactivating AIV and FMDV.
Animals ; Automobiles ; Disinfection ; Foot-and-Mouth Disease Virus ; Foot-and-Mouth Disease ; Hypochlorous Acid ; Influenza in Birds ; Poliovirus ; Water

BACKGROUND: Bacteriokiller system(BKS) produces disinfectant which is generated by the mixture of active oxygen and hypochlorous acid with tap water. Previous studies showed that BKS disinfectant is highly bacteridal against clinical isolates in in vitro testings and more effective than general soap and water for the disinfecttion of contaminated handa. This study was performed to evaluate ling-trem effects of BKS as a handwasing agent in clinical settings. METHODS: Five BKS were installed for the 9-month period from June 1995 to February 1996 in 16-bed Neurosurgery Intensive Care Unit. Handwashing was frequency was observed after 1, 6, and 8 month of BKS use. Six-month incidences of nosocomial infecrion before and after BKS installation were compared to evaluate the possible effect of handwashings on nosocomial infection rates. A self-administered questionaire was used to collect data on handwashing frequency and their opinions of the BKS disinfectant at 2 and 8 months after the installation. RESULTS: Handwashing frequency of healthcare workers(HCWs) before and after patient contacts was increased from 34.1%(137/402) to 50.3%(193/384) (p<0.00001). At the same time, the 6-month nosocomial infection rate was down to 10.5%(43/411) from the pre-BKS rate of 13.0%( 51/431) and the patient-day rate was also decreased from 18.3(56/3068) to 15.1(43/2,844). Most (80.5%) of HCWs thought that BKS promote handwashing and "convenience" was the main reason for more frequent handwashing. Ninety three percent of HCWs would recommend the replacement of tne existing sinks and handwashing disinfectants with BKS. NO adverse skin reaction were reported after 8 months. Conclusions: BKS appears to promote handwashing because it is easy to use with no skin irritation and may contribute toward the prevention of nosocomial infections.
Cross Infection ; Delivery of Health Care ; Disinfectants ; Hand Disinfection ; Humans ; Hypochlorous Acid ; Incidence ; Intensive Care Units ; Neurosurgery ; Reactive Oxygen Species ; Skin ; Soaps

Of all toxic inhalant exposures, chlorine is one of the most common toxic chemical inhalants. When acutely inhaled, it can be responsible for symptoms ranging from upper air way irritation to more serious respiratory effects. It can also deteriorate lung function and lead to death. Chlorine and its compounds such as chlorinated cyanurates and hypochlorites are commonly used in water disinfection. The chemical agents discussed in this article are sodium dichloroiso cyanurate and calcium hypochlorite which are the two most popular products for swimming pool chlorination. They are both strong oxidizing agents which are soluble in water. Between the above two alkali agents, acid-base interaction occurred and generated heat. And the acid drove the combination of hypochlorous and chloride ions to form chlorine gas. We have experienced, two boys who had inhalation injuries caused by an accidental explosion which occurred in a swimming pool by mixing two different chlorinating agents : sodium dichloroiso cyanurate and calcium hypochlorite. The children suffered from respiratory difficulties after the exposure. They both required intensive care management and one needed the support of mechanical ventilation
Alkalies ; Calcium* ; Child ; Chlorine ; Disinfection ; Explosions* ; Halogenation ; Hot Temperature ; Humans ; Hypochlorous Acid ; Inhalation* ; Critical Care ; Ions ; Lung ; Oxidants ; Respiration, Artificial ; Sodium ; Swimming Pools* ; Swimming* ; Water

Helicobacter pylori are a capnophilic bacterium, which colonize gastric mucosa and are resistant to acidic and oxidative damage. Thiol-active proteins subserve redox functions in tolerating oxidative stress and environmental toxicants, such as hydrogen peroxide and hypochlorous acid. We analyzed disulfide-containing proteins of H. pylori strain 26695. Active disulfide-containing proteins were separated by thiol-affinity chromatography, displayed with two-dimensional electrophoresis (2-DE), and identified by MALDI-TOF-MS. Thirty-five putative disulfide proteins, including AhpC (HP1563), GroEL (HP0011), and FrdB (HP0191), were identified in this study. In addition, 4 disulfide proteins of HypB, FusA, TufB, and AhpC showed enhanced intensities in the periplasmic space when compared with the pellet, suggesting that these proteins might play roles in the first redox system against environmental oxidative stresses. Disulfide-containing proteins identified in this study will provide the standard landscape for constructing the proteome components responsible for redox regulation of H. pylori.
Chromatography ; Colon ; Electrophoresis ; Gastric Mucosa ; Helicobacter ; Helicobacter pylori ; Hydrogen Peroxide ; Hypochlorous Acid ; Oxidation-Reduction ; Oxidative Stress ; Periplasm ; Proteins ; Proteome ; Sprains and Strains

BACKGROUND AND OBJECTIVES: The authors aimed to evaluate the safety of low concentration hypochlorous acid as an oral gargle solution. To do this, we carried out in vitro and in vivo experiments and evaluated its efficacy by compared with normal saline and chlorhexidine gargle using throat culture before and after gargling. MATERIALS AND METHOD: The authors treated oral mucosal epithelial cell with 3.5 ppm hypochlorous acid and evaluated cytotoxicity. For evaluation of morphological change, oral mucosa specimens were obtained during surgery before 30 minutes and 2 hours after treatment with hypochlorous acid. The specimens were evaluated with light microscopy. For evaluation of efficacy, we performed oral gargle with normal saline, chlorhexidine and hypochlorous acid in 10 healthy volunteers. The throat cultures were performed before and after each gargling. Staphylococcus aureus, Streptococcus pneumoniae, Streptococcus pyogenes, Haemophilus influenzae, Klebsiella pneumoniae, Aspergillus fumigatus, Rhizopus oryzae were evaluated semi-quantitatively (Grade 0 to 4). RESULTS: There was no cellular toxicity in MTT assay and the morphological changes were not observed. Both chlorhexidine and hypochlorous acid showed significant decrease of microbes (chlorhexidine: p=0.036, hypochlorous acid: p=0.031). There was no significant differences between them (p=0.217). CONCLUSION: Low concentration hypochlorous acid is safe for the oral mucosal epithelium and has antimicrobial efficacy similar to that of chlorhexidine.
Anti-Infective Agents ; Aspergillus fumigatus ; Chlorhexidine ; Epithelial Cells ; Epithelium ; Haemophilus influenzae ; Hypochlorous Acid ; Klebsiella pneumoniae ; Light ; Microscopy ; Mouth Mucosa ; Oryza ; Pharynx ; Rhizopus ; Staphylococcus aureus ; Streptococcus pneumoniae ; Streptococcus pyogenes