Intracanal use of heated rinsing solutions: A pilot study

Objective: The tissue-dissolving and bactericidal activity of sodium hypochlorite (NaOCl) can be increased by warming the NaOCl solution without concurrently increasing its toxicity. The present study was set up to determine if and to what extent a heated liquid reaches the apical region. Method and Materials: A temperature sensor was introduced from the apical aspect into a human canine 22 mm in length prepared to size 40.04. At 37°C in the incubator the canal was irrigated with water 10 times each at temperatures of 10°C, 21°C, 45°C, 60°C, and 37°C (control group). The apical temperature curve was recorded with a one-second resolution from the time the irrigation started until at least 2 minutes after its end. Results: None of the measurements yielded the same temperature in the apical region as that of the coronally introduced liquid. At 60°C, a maximum value of 52.2°C ± 1.39°C, and at 10°C, a minimum value of 16.09°C ± 0.39°C, was achieved apically. At 1 minute after the end of active rinse cycle, the temperature at the apical probe differed only 4.8°C to 0.9°C ± 1.41°C from the initial value (about 37°C). Only with the cold 10°C solution was the temperature difference higher, at 7.5°C ± 2.14°C. Conclusion: The benefit of heating irrigants accrues primarily during the period of active rinsing; immediately after the end of the rinsing cycle, body temperature is reached again. A positive aspect to be noted is that an irrigant stored at room temperature is quickly warmed to 37°C in the root canal by the temperature of the body. Keywords: disinfection, heating, irrigation, rinsing, root canal, sodium hypochlorite, temperature, tissue dissolution