Does increase in temperature of sodium hypochlorite have enhanced antimicrobial efficacy and tissue dissolution property? – A systematic review and meta-regression

The objective of this study was to analyze the available evidence on the performance of increase in temperature of sodium hypochlorite on its antimicrobial efficacy and tissue dissolution property. The study was conducted according to PRISMA guidelines, and a modified Joanna Briggs Institute (JBI) tool was used for quality assessment of the included studies. Two reviewers independently performed an electronic search in four databases along with the reference lists of the included articles. This systematic review included a total of 12 studies: antimicrobial efficacy (n = 6) and tissue dissolution property (n = 6). For the studies that were chosen, the overall risk of bias was moderate. Quantitative assessment through meta-regression was performed for tissue dissolution property. Low-concentration sodium hypochlorite irrigant (≤3%) shows a 0.13-unit times increase in tissue dissolution ability with a degree rise in temperature although not statistically significant. Due to inconsistency in the study parameters, results pertaining to the exclusive effect of increase in the temperature of sodium hypochlorite remain inconclusive.