AquatineEC Hypochlorous Acid - A Safe Alternative to Sodium Hydrochlorite

Thorough disinfection and cleaning of the root canal is key to successful endodontic therapy.  Sodium hypochlorite (NaOCl), the most commonly used endodontic disinfectant, is highly caustic and causes severe burns if accidentally leaked.  AquatineEC, a new, biocompatible, hypochlorous acid irrigant, offers a safe alternative to NaOCl.  Objectives: To compare, in root canals, the disinfecting and cleaning activity of AquatineEC (Sterilox Dental, Malvern, PA) with 6% NaOCl (Clorox, Oakland, CA.).  Methods: Forty premolar single rooted teeth were inoculated with E. faecalis at 37 ^oC in 5% CO₂ for 28 days. Teeth were randomly divided into groups.  Canals were sampled for the presence of viable microorganisms then cleaned and shaped using ProTaper rotary instrumentation.  The treatments evaluated were: AquatineEC, 6 % NaOCl with 17% EDTA and AquatineEC with 17 % EDTA.  To measure disinfection, root canal shavings were cultured in BHI broth for seven days. The presence or absence of smear layer was examined using scanning electron microscopy (SEM).  After drying and gold sputter-coating, x2000 magnification micrographs were scored blind for smear layer removal on the surface of the root canal, coronal, middle and apical portion of each canal (JEOL JSM-840 SEM).  Data were analyzed using Chi-square statistical tests.  Results: No microorganism growth was observed from root canal shavings treated with AquatineEC.  SEM images confirmed these findings.  Additionally, SEM data demonstrated that smear layer removal was dependent on the use of EDTA (P<0.0001).  AquatineEC in combination with EDTA was substantially equivalent to 6% NaOCl and EDTA in the cleaning and disinfecting of root canal systems during endodontic instrumentation. Conclusion: AquatineEC disinfects root canals.  Furthermore, in combination with EDTA, AquatineEC, effectively disinfects and removes the smear layer from the root canal system.  In summary, AquatineEC provides a safe, biocompatible alternative to NaOCl disinfection in endodontic therapy.