Applicability of three rinse solutions in root canal therapy of pulpitis

GONG Wenting; HONG Lilin; LIU Shouhong; HAN Licun

doi:10.3969/j.issn.2097-1753.2025.04.015

Abstract：Objective To explore the applicability of three types of irrigations in the root canal therapy of pulpitis.Methods Ninety-three patients with pulpitis treated in the Department of Stomatology,North District of the First Affiliated Hospital of Anhui Medical University,between January 2021 and June 2023 were selected as the subjects,who were randomized into the observation group A(n=31),observation group B(n=31)and control group(n=31)using the random number table method.During root canal preparation,patients in group A were given 3%sodium hypochlorite irrigation,those in group B 1%sodium hypochlorite irrigation,and those in group C 3%hydrogen peroxide irrigation.The number of root canal bacterial colonies and the endotoxin contentin the affected teethbefore and after root canal preparationusingt heirrigationsolutions,the levels of matrix metalloproteinase(MMP)-2,MMP-8 and MMP-9 levels in root canal exudates.Inflammatory cytokines(IL-8,TNF-α)in gingival crevicular fluidbefore using theirrigationsolutionsandat 1-weekafter using theirrigationsolutions.Occlusal pain(VAS scores)before using the irrigationsolutions and at 24 h,48 h,and 1-week after using the irrigationsolutions.Treatment success rates were assessed after 1-year follow-up.Results After using the flushing solution,the bacterial count and endotoxin content in the root canal of Group A were lower than those of Group B and Group C.The levels of MMP-2 and MMP-8 in Group A were lower than those in Group B and Group C.The levels of MMP-9 in Group A were lower than those in Group B and Group C,and the differences were statistically significant(all P＜0.001);After using the flushing solution for one week,the IL-8 level in group A was lower than that in group C(P=0.007),and the TNF-α level was lower in group A than in group B than in group C,with statistically significant differences(P＜0.05);After using the flushing solution for 24 hours,48 hours,and 1 week,Group A＜Group B＜Group C,and the differences were statistically significant(P＜0.01).After a one-year follow-up,the success rates of Group A,Group B,and Group C were 96.55%(28/29),76.92%(20/26),and 75.00%(18/24),respectively,with no statistically significant difference between the groups(P=0.079).Conclusion In root canal therapy of pulpitis,sodium hypochlorite irrigations can more effectively reduce the number of root canal bacterial colonies and lower the endotoxin content.Meanwhile,3%sodium hypochlorite irrigation can inhibit the expressions of matrix metalloproteinases and inflammatory factors,relieve pain after treatment and enhance the success rate of treatment,making it the preferred option for root canal irrigations.The overall curative effect can help optimize the treatment process of pulpitis.Future research can explore the concentration gradient effect and the association with long-term prognosis.