Dual Rinse® HEDP
One capsule of Dual Rinse®HEDP contains about 0.9 g of HEDP powder.
No. The capsule needs to be opened and then the powder that is contained therein can then be dissolved in a sodium hypochlorite (10 ml). To do that, fill the solution into the measuring cup, add the powder, and stir using a sterile spatula. This combined solution can then be drawn back into a 10-mL syringe.
The solution with the added powder should be stirred using a spatula. After less than 2 min, the powder should be completely dissolved, and the mixed solution can be drawn back into a 10-ml syringe.
No. Sodium hypochlorite is highly reactive. We did everything to not interfere with the NaOCl. However, after one hour NaOCl starts to react with HEDP. Hence DualRinse® HEDP has to be mixed freshly before each individual treatment, and the resulting combined solution must not be used for more than one root canal treatment.
Exception: if you use an NaOCl solution of less than 3%, then the combined solutions can be prepared with a cooled NaOCl solution from the refrigerator, and filled syringes can be stored for the course of one working day in the refrigerator.
First, Dual Rinse® HEDP saves time, because the irrigant does not have to be changed. And time, as we all know, is money. Then, by not having to use a second irrigant, I save one syringe (retail price approx. 20 cents) and one irrigating tip (retail price approx. 70 cents) and the EDTA (retail price approx 70 cents per 5 mL).
HEDP is an abbreviation for 1-hydroxyethane 1,1-diphosphonate. The abbreviation HEBP and the term etidronate are also used to refer to the same molecule. However, HEDP is the most common designation.
HEDP is a mild decalcifying and stabilizing agent, which is commonly used in food hygiene, water cleaning, cosmetics, and in dishwashing tablets. HEDP is a chelator that binds calcium and other divalent metal ions.
No. The mixture of Dual Rinse® HEDP and sodium hypochlorite can be used during instrumentation and as a final irrigant. Exception: before a revascularization procedure, the canal should still be rinsed using 17% EDTA. Studies on this topic using HEDP instead of EDTA are about to be performed.
Basically yes. However, NaOCl is a proteolytic agent. It destroys tissue factors that are necessary for the homing (attraction and differentiation) of pluripotent cells in the root canal system. It is thus still indicated to apply 17% EDTA for this purpose. Alternatively, the Dual Rinse® HEDP powder can be mixed with sterile physiological saline solution. However, this approach needs to be substantiated by studies. Soon we will know more.
No! Chlorhexidine (CHX) is a biguanide, which precipitates at high pH. Dual Rinse® HEDP was specifically designed to be used in conjunction with a sodium hypochlorite (NaOCl) solution. If you are looking for a mild disinfecting solution, it is better to use a diluted sodium hypochlorite rather than a CHX solution. Just add pure water to your NaOCl solution. NaOCl is a better disinfectant than CHX, especially against micro-organisms organized in biofilms. In addition, sodium hypochlorite solutions dissolve necrotic tissue remnants and the biofilm matrix.
Theoretically yes. However, this is unnecessary, as HEDP replaces EDTA.
Quite the contrary. HEDP is stable in an alkaline environment and binds calcium. In the presence of HEDP, more hydroxyl ions are liberated from the calcium hydroxide in aqueous suspension. Hence, the effect of calcium hydroxide is sped up. Furthermore, a solution containing Dual Rinse® HEDP can be used to rinse the root canal system after a calcium hydroxide dressing in order to get a clean canal.
In principle yes. When 10 mL of a sodium hypochlorite (NaOCl) irrigant are added, the resulting combined solution will then have a slightly stronger demineralizing effect. We recommend using 2 capsules per 20 mL of NaOCl solution (indicated in the measuring cup) in case it is intended to irrigate with higher volumes.
The more concentrated the NaOCl solution, the more aggressive it becomes. In endodontics, solutions in the range of 0.5% and 2.5% are recommended. Anything more concentrated is not supported by the current literature. However, interactions between NaOCl solutions of up to 5 wt% with Dual Rinse® HEDP have been investigated, and no negative (chemical) effects have been found.