In Vitro Assessment of the Antimicrobial Action and the Mechanical Ability of Chlorhexidine Gel as an Endodontic Irrigant (original) (raw)
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Brazilian Dental Journal, 2007
The purpose of this study was to assess the in vitro the antimicrobial efficacy of chlorhexidine gluconate gel as an endodontic auxiliary chemical substance compared to sodium hypochlorite (NaOCl) and chlorhexidine gluconate solution. The antimicrobial efficacy of the tested substances was evaluated using the agar diffusion test. The growth inhibition zones produced by 0.2%, 1% and 2% chlorhexidine gel were evaluated against 5 facultative anaerobic bacteria and 4 pigmented Gram-negative anaerobes, and compared to the results obtained by NaOCl and chlorhexidine solution. The largest growth inhibition zones were produced when the test bacteria were in contact with 2% chlorhexidine gluconate gel (11.79 mm), being significantly different (p<0.05) from the growth inhibition zones produced by all NaOClconcentrations, including 5.25% (9.54 mm). However, there was no statistically significant difference (p>0.05) between the growth inhibition zones obtained with equal concentrations of chlorhexidine solution and gel. The results of this study indicate that, as far as its antimicrobial properties are concerned, chlorhexidine gel has a great potential to be used as an endodontic auxiliary chemical substance.
Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, 2005
The aim of this study was to assess in vitro the antimicrobial activity of 2% chlorhexidine gel against Enterococcus faecalis, comparing it to other endodontic irrigants (2% chlorhexidine liquid and 5.25% sodium hypochlorite). Study design. Eighty roots of human mandibular premolars were prepared by serial instrumentation technique, autoclaved, and contaminated for 7 days with E faecalis monocultures. The roots were then divided into 5 groups according to the irrigant substance used during the standardized biomechanical preparation. In order to evaluate the antimicrobial action of the irrigant substances, 3 microbial samples were taken: initial (before the biomechanical preparation); post-treatment (immediately after the biomechanical preparation), and final (7 days after the biomechanical preparation). The microbiological samples were plated to count the colony-forming units (CFU). Results. The 2% chlorhexidine gel and 2% chlorhexidine liquid significantly reduced the E faecalis CFU in the post-treatment and final microbiological samples. The 5.25% sodium hypochlorite also reduced the E faecalis CFU immediately after the root canal instrumentation, but it was not able to keep the root canal free of detectable E faecalis in the final sample. Conclusions. The 2% chlorhexidine gluconate (gel and liquid) antimicrobial ability was more effective than 5.25% sodium hypochlorite in keeping low CFU of E faecalis for 7 days after the biomechanical preparation.
The effect of chlorhexidine as an endodontic disinfectant
Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, 2003
Objective. The purpose of this study was to establish whether addition of a 2% chlorhexidine rinse to a conventional treatment protocol enhances the rate of the successful disinfection of the root canal system in vivo. Study design. Twenty-four teeth with infected necrotic pulps and resorbing apical periodontitis were treated with a conventional technique in which 1% NaOCl as irrigant was used. Half of the cases received an additional rinse with 2% chlorhexidine. Prereduced thioglycollate medium was used to take cultures that were incubated for 4 weeks. Results. Cultivable bacteria were retrieved at the conclusion of the first visit in 1 out of 12 chlorhexidine cases whereas in the control group 7 out of 12 cases showed growth. This difference was significant (P Ͻ .05). Conclusion. The findings are clinically important.
Effectiveness of 2% chlorhexidine on Enterococcus Faecalis in Root Canal Treatment
Root canal treatment plays an important role in saving the tooth. In Endodontics it is a routine treatment that involves removing the contaminated dentine, infected pulp, inflamed and dead pulp tissue by cleaning and shaping the canal with intracanal medication, disinfecting with irrigants to eliminate the all causative microorganisms. For the long-standing success of the endodontically treated tooth, it is necessary to eliminate persistent bacteria, such as Enterococcus faecalis. The ruinous components of Enterococcus Faecalis, including its capacity to tackle diverse microorganisms, attack dentinal tubules, and contradict nutritional difficulty. Using a good aseptic debridement procedure of diseased pulp and contaminated dentin with a combination of 2% chlorhexidine is the best way to eliminate E. faecalis in root canal procedure. Following a systematic review and metanalysis, the efficacy of 2% chlorhexidine (CHX) on Enterococcus faecalis was evaluated. Aim: The goal of this review was to determine and compare the efficacies of root canal disinfectant 2% chlorhexidine with 5.25% sodium hypochlorite (NaOCl), Calcium hydroxide (Ca(OH) 2),17% EDTA, MDTA. Materials and Methods: Literature research is performed in sources of data like MEDLINE, online library journal PubMed NIH, NCBI, WILEY ONLINE LIBRARY, ORAL HEALTH GROUP, Scopus ETC. Electronic information bases had been looked through utilizing the resulting keywords: Root canal irrigants, 2% chlorhexidine, Enterococcus faecalis, Calcium hydroxide NaOCl Root canal irrigation medicine. Our search was done on articles distributed to date. Results: After reviewing the titles and abstracts, many articles met the eligibility. The use of chemical agents with 5.25 percent sodium hypochlorite and 2 percent chlorhexidine resulted in microbial eradication at 100 percent compared to using only 5.25% sodium hypochlorite alone or calcium hydroxide alone which decreased by 97.7 percent compared to baseline microbial count and reduced by 68.42 percent at the same dilutions after mechanical cleaning respectively.. Conclusion: In this review study,2% Chlorhexidine has greater disinfection than calcium hydroxide and 5.25% sodium hypochlorite.
Chlorhexidine gluconate, its properties and applications in endodontics
Iranian endodontic journal, 2008
The major objective in endodontic therapy is to disinfect the entire root canal system. This requires that the pulpal content be eliminated as sources of infection. This goal may be accomplished by mechanical instrumentation and chemical irrigation, in conjunction with medication of the root canal between treatment sessions. Microorganisms and their by-products are considered to be the major cause of pulpal and periradicular pathosis. In order to reduce or eliminate bacteria from the root canal system, various irrigants have been used during treatment. Chlorhexidine is a cationic solution which can be used during treatment. It has a wide range of antimicrobial activity. Furthermore, because of its cationic structure, chlorhexidine has a unique property named substantivity. The purpose of this paper is to review different aspects of chlorhexidine in endodontics.
European Journal of Molecular & Clinical Medicine, 2021
Background: Irrigants and intracanal medicaments form a necessary adjunct that enhances the antimicrobial effect of mechanical cleansing and thus augments overall clinical efficacy. Hence; the present study was undertaken for analyzing and comparing the efficacy of three endodontic irrigating solutions against Enterococcus Faecalis. Materials & methods: A total of thirty single rooted mandibular first premolar specimens were included. Sectioning of the specimens was done at cement-enamel junction level. Instrumentation of the root canals was done with rotary instruments to an apical size of ProTaper F3. Vertical sectioning of all the specimens was done along the mid-sagittal plane into two halves. All the specimens were divided into following study groups: Group A: 5% Sodium hypochlorite, Group B: 0.2% Chitosan and Group C: Saline. Inoculation of the bacterium was done in the broth in all the tissue culture wells. The biofilm on root canal surface was taken with a sterile scalpel and inoculated on agar plates and incubated. Colony forming units were then analyzed. Analysis of all the results was done using SPSS software. Results: Mean CFU among specimens of group A, group B and group C were found to be 0.59, 2.118 and 90.184 respectively. While analyzing the results statistically, significant results were obtained. Conclusion: Sodium hypochlorite exhibited maximum efficacy against Enterococcus Faecalis.
International Journal of Advanced Research, 2017
Microorganisms play an important role in the etiology of pulpal and periapical lesions and various studies have clearly demonstrated it. 1 The main goal of root canal treatment is the complete eradication of microorganisms and their by-products from the root canal system, though not always achieved. 1 After root canal treatment, if Secondary infection occurs, it is caused by microorganisms and their by-products that resisted intracanal antimicrobial procedures and periods of deprivation, in treated canals. 2,3 Hence, the use of an effective irrigant is necessary for effective removal of microorganisms from areas that are not accessible to instruments. 4 Numbers of root canal irrigants have been developed in an attempt to reduce or eliminate the bacteria from the root canal system. The root canal irrigant at the very least should have antibacterial activity and a capacity to dissolve tissues. 4 Such solutions should also be compatible with periradicular tissues, and capable of maintaining their therapeutic effect for a long period of time. Sodium hypochlorite is the most commonly used irrigant, its tissue-dissolving and antibacterial properties have been well proven. However, it is not substantive and is highly irritating to periradicular tissues at higher concentrations. 5 In addition; factors such as concentration 6, temperature 7, and pH 8 greatly affect its efficacy. Chlorhexidine has recently been introduced as an alternative irrigating solution. Chlorhexidine (CHX) is a broad spectrum antimicrobial agent active against aerobic and anaerobic bacteria. 9 Chlorhexidine is a cationic molecule, which can be used during treatment.Furthermore, because of its cationic structure, chlorhexidine has a unique property named substantivity. CHX has strong binding affinity to the hydroxyapatite in dentin, enamel and cementum, and can be slowly released. 10 This property gives CHX more longer-lasting bacteriostatic activity and the antibacterial efficacy of CHX has been shown to continue for up to 72 h after instrumentation. 11 On the other hand, CHX lacks the ability to dissolve organic matter, which negatively affects its cleaning capacity. Enterococcus faecalis (E. faecalis), a persistent organism that can survive as a monoculture in root canals. 12 Its high prevalence in cases with post-treatment disease associated with virulence factors (aggregation substance,
Journal of Oral Biology and Craniofacial Research, 2014
Introduction: The aim of this in vitro study was to evaluate and compare the antimicrobial substantivity of different concentrations of chlorohexidine as root canal irrigant by microbiological assay using mitis salivarius bacitracin streptomycin, MSBS agar plate. Methods: Extracted single rooted permanent human teeth were selected as samples and randomly divided into four groups (three experimental, one control). The samples of the three experimental groups used different concentration of chlorhexidine, CHX (0.1%, 1% and 2%), deionized water used as an irrigant served as control. In each group the apices of teeth were sealed with composite and mounted on plaster blocks. Root canals were prepared using step back technique and enlarged upto no 80. With each change in the file size the corresponding irrigant was used and final irrigation was done with deionized water. Samples were taken with paper points at 12 h, 1 day, 2 days and 3 days respectively and stored in sterile phials which were then arranged on MSBS agar plates for microbiological assay. Results and conclusion: Results were analysed by ANOVA and Tukey's HSD test showed that antibacterial substantivity of 2% CHX was best followed by 1% CHX and 0.1% CHX in decreasing order respectively.
Journal of Conservative Dentistry, 2013
Complete debridement and disinfection of the root canal system are fundamental requirements for successful endodontic treatment. Despite the morphological challenges of the internal root anatomy, root canal irrigants play an important role in the optimization of the root canal preparation, which is essentially a chemo-mechanical procedure. Enterococcus faecalis is one of the most resistant microorganisms that dominants the microbial ecosystem of persistent periradicular lesions in retreatment cases. For that reason, many in vitro and in vivo studies evaluated and compared the antibacterial activity of sodium hypochlorite and chlorhexidine at varying concentrations using different experimental models against this microorganism. However, many controversies with regard to the ideal irrigant and concentration do in fact exist. Hence, this review aims to discuss the antibacterial activity of these two main root canal irrigants against Enterococcus faecalis using the agar diffusion and direct contact methods and the possible modulating factors responsible for inconsistent findings among different studies. In addition, the disinfection potential of both chemical agents on gutta percha and Resilon cones are also discussed. The source of this review was conducted through an electronic literature search using PubMed database from December 1997 until December 2011, which analyze the related laboratory investigations of both irrigants, published in major endodontic journals.
Journal of Pure and Applied Microbiology, 2019
The complete microfloral debriment of the root canal is possible only through successful endodontic treatment. Due to complexicity constraints of root canal system complete microfloral removal by simply mechanical instruments is not sufficient. Therefore we aim to evaluate the antimicrobial efficacy of five different intracanal medicaments such as calcium hydroxide, chlorhexidiene, octenidol, endosepton and calcium hydroxide and chlorhexidine against Enterococcus faecalis. The Antibacterial activity of aforesaid medicaments was done against Enterococcus feacalis using agar disk diffusion method, over a period of 24 hrs and 72 hrs. The samples were divided into 6 groups. The zone of inhibition was measured after 24 and 72 hrs and were recorded in millimeters and compared with respect to control. There was a significant difference in the mean zone of inhibition at 24 and 72 hrs between calcium hydroxide, endoseptone, octenidol, calcium hydroxide and chlorohexidine combination, chlorohexidine and control group. Chlorohexidine was found to have maximum inhibitory efficacy followed by calcium hydroxide and chlorohexidine combination. Within the limitations of this study it may be concluded that Chlorhexidine can be used as an efficient intracanal medicament.