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Decoding the perplexing mystery of para-chloroaniline formation: A systemic review

1 Department of Conservative Dentistry and Endodontics, Dr. Syamala Reddy Dental College Hospital and Research Centre, Bangalore, India
2 SJM Dental College and Hospital, Chitradurga, India
3 KLE Viswanath Katti Institute of Dental Sciences, Belgaum, Karnataka, India
4 Apollo White Dental Clinic, Mumbai, Maharashtra, India

Correspondence Address:
Mohd. Sibghatullah Khatib,
Department of Conservative Dentistry and Endodontics, Dr. Syamala Reddy Dental College Hospital and Research Centre, Bangalore 560037, Karnataka.
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jispcd.JISPCD_488_19

Objective: The objective of this article was to understand and decode the mystery of the formation of para-chloroaniline (PCA). The ingredient of the brown precipitate after mixing sodium hypochlorite (NaOCl) and chlorhexidine gluconate (CHX) is still in debate. Materials and Methods: Various studies adopt a different methodology to substantiate that it may contain PCA, which is a carcinogenic agent. The purpose of this systematic review is to evaluate the relationship between PCA and brown precipitate. Two reviewers independently conducted a comprehensive literature search. The MEDLINE, Embase, Cochrane, and PubMed databases were searched. In addition, the bibliographies were manually searched. There was no disagreement between the two reviewers. This review was reported and conducted in step with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results: Of 233 articles, only 13 articles met the inclusion criteria. Available scientific evidence was more supportive that the brown precipitate form after mixing NaOCl and CHX may form para-chloroamide moiety rather than free PCA, and PCA may be the by-product of CHX degradation. Conclusion: On the basis of the current evidence and data extracted from the various databases, it can be concluded that the mixture of sodium hypochlorite and chlorhexidine does not form PCA, and PCA may be the by-product of high concentrated chlorhexidine. Further studies are required to substantiate the evidence.

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  Search Pubmed for
    -  Khatib MS
    -  Ameer B
    -  Ajit Mannur N
    -  Madi Ramalingaiahsetty A
    -  Peerzade SM
    -  Bambawale A
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