Mechanism of action of sodium hypochlorite

TLDR

Effective root‑canal irrigation requires knowledge of the infecting microorganisms, the canal’s complex anatomy, and the irrigant’s antimicrobial and tissue‑dissolving properties. The study aims to discuss the mechanism of action of sodium hypochlorite based on its antimicrobial and physico‑chemical properties. Sodium hypochlorite exerts its antimicrobial effect by disrupting bacterial phospholipids, generating chloramines that interfere with metabolism, inducing oxidative damage that irreversibly inactivates enzymes, and degrading lipids and fatty acids.

Abstract

The choice of an irrigating solution for use in infected root canals requires previous knowledge of the microorganisms responsible for the infectious process as well as the properties of different irrigating solutions. Complex internal anatomy, host defenses and microorganism virulence are important factors in the treatment of teeth with asymptomatic apical periodontitis. Irrigating solutions must have expressive antimicrobial action and tissue dissolution capacity. Sodium hypochlorite is the most used irrigating solution in endodontics, because its mechanism of action causes biosynthetic alterations in cellular metabolism and phospholipid destruction, formation of chloramines that interfere in cellular metabolism, oxidative action with irreversible enzymatic inactivation in bacteria, and lipid and fatty acid degradation. The aim of this work is to discuss the mechanism of action of sodium hypochlorite based on its antimicrobial and physico-chemical properties.