Detoxification of Endotoxin by Endodontic Irrigants and Calcium Hydroxide

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The effects of endodontic irrigants and calcium hydroxide on lipopolysaccharide (LPS; endotoxin) were analyzed using the highly selective technique of mass spectrometry/gas chromatography with selected ion monitoring. An aqueous solution of LPS was mixed with one of a variety of endodontic irrigants for 30 min. Because it is a commonly used interappointment dressing, calcium hydroxide was also applied to LPS for 1, 2, or 5 days. LPS inactivation was measured by quantitation of free fatty acid release. Water, EDTA, ethanol, 0.12% chlorhexidine, chlorhexidine + sodium hypochlorite, and sodium hypochlorite alone showed little breakdown of LPS. Long-term calcium hydroxide—as well as 30-min exposure to an alkaline mixture of chlorhexidine, ethanol, and sodium hypochlorite—did detoxify LPS molecules by hydrolysis of ester bonds in the fatty acid chains of the lipid A moiety.

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