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VOLUME 15 , ISSUE 5 ( September-October, 2014 ) > List of Articles


In vitro Assessment of Tooth Color Alteration by Two Different Types of Endodontic Irrigants

Anastasios Dimitrios Koursoumis, Nikolaos P Kerezoudis, Afrodite Kakaboura

Citation Information : Koursoumis AD, Kerezoudis NP, Kakaboura A. In vitro Assessment of Tooth Color Alteration by Two Different Types of Endodontic Irrigants. J Contemp Dent Pract 2014; 15 (5):529-533.

DOI: 10.5005/jp-journals-10024-1574

Published Online: 01-02-2015

Copyright Statement:  Copyright © 2014; The Author(s).



The purpose of this study was to assess in vitro the tooth color alterations associated with two commonly used endodontic irrigants, the chlorhexidine gluconate (CHX) and the sodium hypochlorite (NaOCl) up to 15 days post-treatment. Additionally, the possible influence of endodontic access preparation on tooth color was investigated.

Materials and methods

Thirty intact human anterior teeth were used. Black adhesive tape with a 4 mm diameter window was used to standardize the enamel surface intended for color analysis. After the access cavity, preparation and the initial root canal negotiation with stainless steel hand files, the root canal shaping was completed with rotary nickel-titanium files. The teeth were divided into three groups (n = 10). Conventional syringe irrigation was performed with one irrigant for each group. The enamel surfaces were colorimetrically evaluated before access cavity, after cavity preparation and at 1, 3, 7 and 15 days post-treatment. The CIE color parameters (L*, a*, b*) were recorded and averaged for each material and the corresponding color differences (ΔE) were calculated and statistically analyzed.


The most significant factor in tooth color alteration, during the endodontic treatment, was the access preparation. CHX and NaOCl caused tooth color changes comparable with the saline. CHX and NaOCl did not increase the tooth color changes relative to the values induced by the access preparation.


The two endodontic irrigants were not able to induce tooth color alteration to a greater extent than the access preparation.

Clinical significance

Chlorhexidine and NaOCl cannot be considered as discoloring endodontic materials. The most contributing factor in tooth color alteration during endodontic treatment in the anterior teeth is access preparation.

How to cite this article

Koursoumis AD, Kerezoudis NP, Kakaboura A. In vitro Assessment of Tooth Color Alteration by Two Different Types of Endodontic Irrigants. J Contemp Dent Pract 2014;15(5):529-533.

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  1. Tooth discoloration induced by endodontic sealers. Oral Surg Oral Med Oral Pathol 1986 Jan;61(1):84-89.
  2. In vitro longitudinal assessment of coronal discoloration from endodontic sealers. J Endod 2001 Nov;27(11):699-702.
  3. Tooth discoloration and staining: a review of the literature. Br Dent J 2001 Mar 24;190(6):309-316.
  4. Discoloration potential of endodontic procedures and materials: a review. Int Endod J 2012 Oct;45(10):883-877.
  5. Tooth discoloration induced by dental materials. Oral Surg Oral Med Oral Pathol 1985 Dec;60(6):666-669.
  6. Current challenges and concepts in the preparation of root canal systems: a review. J Endod 2004 Aug;30(8):559-567.
  7. Root canal irrigants. J Endod 2006 May;32(5):389-398.
  8. Sodium hypochlorite in endodontics: an update review. Int Dent J 2008 Dec;58(6):329-341.
  9. In vitro antibacterial efficacy of endodontic irrigants against Enterococcus faecalis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007 May;103(5):702-706.
  10. The properties and applications of chlorhexidine in endodontics. Int Endod J 2009 Apr;42(4):288-302.
  11. Scanning electron microscope evaluation of chlorhexidine gel and liquid associated with sodium hypochlorite cleaning on the root canal walls. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010 Nov;110(5):82-87.
  12. In vitro assessment of the immediate and prolonged antimicrobial action of chlorhexidine gel as an endodontic irrigant against Enterococcus faecalis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2005 Jan;99(6):768-772.
  13. In vivo antimicrobial activity of 2% chlorhexidine used as a root canal irrigating solution. J Endod 1999 Mar;25(3):167-171.
  14. Influence of irrigants on the coronal microleakage of laterally condensed gutta-percha root fillings. Int Endod J 2002 Sep;35(9):791-795.
  15. Potential iatrogenic tetracycline staining of endodontically treated teeth via NaOCl/MTAD irrigation: a preliminary report. J Endod 2006 Apr;32(4):354-358.
  16. Interaction between chlorhexidine digluconate and EDTA. J Endod 2008 Dec;34(12):1521-1523.
  17. Interaction between sodium hypochlorite and chlorhexidine gluconate. J Endod 2007 Aug;33(8):966-969.
  18. Evaluation of the interaction between sodium hypochlorite and chlorhexidine gluconate and its effect on root dentin. J Endod 2008 Feb;34(2):181-185.
  19. J Endod 2010 May;36(5):847-850.
  20. Evaluation and prevention of the precipitate formed on interaction between sodium hypochlorite and chlorhexidine. J Endod 2010 Jul;36(7):1154-1157.
  21. Evaluation of the colour change in enamel and dentine promoted by the interaction between 2% chlorhexidine and auxiliary chemical solutions. Aust Endod J 2013 Dec;39(3):107-111.
  22. An in vitro model of chlorhexidine-induced tooth staining. J Periodont Res 2005 Jun;40(3):225-230.
  23. Efficacy of several concentrations of sodium hypochlorite for root canal irrigation. J Endod 1992 Dec;18(12):605-612.
  24. Clinical efficacy of 5% sodium hypochlorite for removal of stains caused by dental fluorosis. J Clin Pediatr Dent 2009;33(3):187-191.
  25. Effect of sodium hypochlorite on dentine mechanical properties: a review. J Dent 2009 Dec;37(12):903-908.
  26. Inactivation of local root canal medicaments by dentine: an in vitro study. Int Endod J 2000 Mar;33(2):126-131.
  27. Mechanism of action of sodium hypochlorite. Braz Dent J 2002;13(2):113-117.
  28. Penetration of sodium hypochlorite into dentin. J Endod 2010 May;36(5):793-796.
  29. Tooth colour: a review of the literature. J Dent 2004;32:3-12.
  30. The principles of visual perception and their clinical application to denture esthetics. J Prosthet Dent 1973 Apr;29(4):358-382.
  31. Color and translucency of in vivo natural central incisors. J Prosthet Dent 2000 Apr;83(4):418-423.
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