It’s that sticky, collagenous mass that can be in a fin, a lateral canal, an apical bifidity, anastomoses… and it’s very difficult to get this tissue out in a reasonable amount of clinical time. You know, what we’re trying to do here is digest collagen. He reported in the Triple O (currently Oral Surg Oral Med Oral Pathol Oral Radiol Endod), 49(2), 1980, that sodium hypochlorite was a potent adjunct to disinfection because it could sharply reduce digestion times. Cunningham, you know, talked about the effects of temperature on collagen dissolving abilities of sodium hypochlorite. Obviously it was reported much, much earlier. This is a very interesting article and is really one of the groundwork articles in ’96 to support this. My good friend, Elio Berutti, and Marini in 1996, in the Journal of Endodontics, I think it was 22(9), Volume 22, Number 9… They talked about the capabilities of sodium hypochlorite to de-bride pulp tissue at different temperatures. Well, I’ll give some papers because some of you are going to want to go back, obviously, to PubMed, punch in the key words, you know, such as sodium hypochlorite, heated, disinfection and things like that and authors names in journals and you can go find the very evidence that I’m going to now talk about that supports heating sodium hypochlorite up. Today, we’re just talking about should we heat it, should we not heat it. So, is there any evidence, has there been any research generated, to even support heating sodium hypochlorite up to 60☌? In another blog I’ll talk about ways to heat it up and the actual clinical technical support on how that might happen. In fact, even though I’ve taught it for 30 years, I would say there are some that do it, but most don’t. I am oftentimes asked, well is this like a mainstream protocol that most clinicians in the United States use? A lot of times international dentists want to know that, and I would have to characterize heating sodium hypochlorite as absolutely not mainstream. For your information, 60☌ is about equivalent to the temperature of a cup of hot coffee and when warmed the irrigant is confined to the endodontic space which is surrounded by a non-conducting dentin so it is perfectly safe. My idea arose from a well-known fact that virtually all laboratory reactions are accelerated in the presence of heat. I was one of the first educators to advocate heating 6% concentrations of sodium hypochlorite to 60☌. Do I believe in heating sodium hypochlorite to a higher temperature and what would be the rationale for that? Is there any evidence to support this and what is the outcome if we did heat up our sodium hypochlorite? I am frequently asked questions regarding sodium hypochlorite, disinfection, how to use active irrigation, which method, but today I’m going to focus on the question relating to what should be the ideal optimal temperature of sodium hypochlorite.
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