Abstract:
Sodium hypochlorite (NaOCl) cytotoxicity has been assessed using different methodologies, which has led to arbitrary interpretations. This scoping review aimed to discuss the different methodological protocols for assessing NaOCl cytotoxicity. A literature review performed in the PubMed and Embase databases up to July 2023 identified manuscripts reporting NaOCl cytotoxicity. The dataset identified 546 publications, further screened by 2 reviewers. Ninety studies were identified and mined methodologically to collect information on cell type, cytotoxicity assay, NaOCl dilution solutions, presence of fetal bovine serum (FBS), and NaOCl exposure time. The culture medium used in cytotoxicity assays contains buffering substances that neutralize the pH of NaOCl, thus reducing its cytotoxicity, an approach that may lead to bias when solutions with different pH are compared. For short exposure periods, as in simulations to evaluate the contact between irrigant and periapical tissue cells during chemo-mechanical preparation, NaOCl dilution should be performed with saline, which does not buffer the irrigant. For long exposure periods, as in simulations of irrigant extrusions, NaOCl should be diluted in the culture medium, to reproduce the expected buffering effect occurring in extrusions. The presence of FBS in culture medium can decrease NaOCl toxicity. There is no standardization of NaOCl cytotoxicity methodologies. This poses the risk of arriving at incorrect results and, therefore, pertinent tests must be refined.
摘要:
次氯酸钠(NaOCl)的细胞毒性已使用不同的方法进行了评估,这导致了任意解释。本范围审查旨在讨论评估NaOCl细胞毒性的不同方法学方案。截至2023年7月,在PubMed和Embase数据库中进行的文献综述确定了报告NaOCl细胞毒性的手稿。数据集确定了546种出版物,由2名审稿人进一步筛选。通过方法确定和挖掘了90项研究,以收集有关细胞类型的信息,细胞毒性试验,NaOCl稀释溶液,存在胎牛血清(FBS),和NaOCl暴露时间。细胞毒性测定中使用的培养基含有中和NaOClpH值的缓冲物质,从而降低其细胞毒性,当比较不同pH值的溶液时,这种方法可能会导致偏差。对于短暴露期,如在模拟中,以评估在化学机械制备期间冲洗液和根尖周组织细胞之间的接触,NaOCl稀释应用盐水进行,这不缓冲冲洗。对于长时间的暴露,就像模拟冲洗挤压一样,NaOCl应在培养基中稀释,再现挤出中发生的预期缓冲效果。培养基中FBS的存在可以降低NaOCl的毒性。没有NaOCl细胞毒性方法的标准化。这带来了得出不正确结果的风险,因此,相关测试必须完善。