Assessment of the Antibacterial Activity of Calcium Hydroxide Combined with Chlorhexidine Paste and Other Intracanal Medications against Bacterial Pathogens (original) (raw)
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Antimicrobial Effects of Calcium Hydroxide and Chlorhexidine on Enterococcus faecalis
Journal of Endodontics, 2010
Introduction: Endodontic treatment is commonly based on nonspecific elimination of intraradicular microorganisms. Although some authors prefer single-visit root canal operations for endodontic treatment, several studies have shown the importance of intracanal medication between sessions to kill microorganisms that biomechanical preparations alone cannot achieve. The purpose of this study was to evaluate the efficacy of calcium hydroxide Ca(OH) 2 and chlorhexidine gel on the elimination of intratubular Enterococcus faecalis. Methods: Human uniradicular teeth contaminated with E. faecalis were treated with Ca(OH) 2 , 2% chlorhexidine gel, Ca(OH) 2 plus 2% chlorhexidine gel, or saline (0.9% NaCl) as a negative control. Samples obtained at a depth of 0 to 100 mm and 100 to 200 mm from these root canal preparations were analyzed for bacterial load by counting the number of colonyforming units (CFUs) and bacterial viability using fluorescence microscopy. Results: A significant decrease in the number of CFUs and the percentage of viable E. faecalis was observed after treatment with either Ca(OH) 2 or chlorhexidine when compared with the control group. Additionally, chlorhexidine gel had a significantly higher antimicrobial efficacy as measured by the number of CFUs and the percentage of viable cells than Ca(OH) 2 . No differences were observed between the antimicrobial properties of chlorhexidine gel with and without the addition of Ca(OH) 2 . Conclusion: Both Ca(OH) 2 and chlorhexidine have antimicrobial effects on E. faecalis. Chlorhexidine had increased antimicrobial activity when compared with Ca(OH) 2. Ca(OH) 2 combined with chlorhexidine showed similar antimicrobial activity to chlorhexidine alone. (J Endod 2010;36:1389-1393
Oral Surgery Oral Medicine Oral Pathology Oral Radiology and Endodontology, 2003
Objective. We sought to assess the efficacy of chlorhexidine (CHX) and calcium hydroxide, Ca(OH) 2 , against Enterococcus faecalis in vitro. Study design. The effect of CHX (0.2% and 2% in gel or solution) and Ca(OH) 2 (alone or with 0.2% CHX gel) was evaluated by using the agar diffusion test and an in vitro human root inoculation method, to measure zone of inhibition or bacterial growth with optical density analysis, respectively. For optical density analysis, samples from infected root canals were collected after 7 days of medication and were cultured for 24 hours in brain-heart infusion to detect viable bacteria. Results. In the agar diffusion test, CHX was effective against E faecalis in a concentration-dependent fashion, but Ca(OH) 2 alone had no effect. In the root canal inoculation test, CHX was significantly more effective against E faecalis than Ca(OH) 2 was (P Ͻ .05), but there were no significant differences between the modes of medication or concentrations of CHX. Conclusions. CHX is effective against E faecalis in vitro. Further in vivo studies are needed to confirm the value of CHX in clinical treatment.
Iranian Endodontic Journal, 2008
INTRODUCTION: The aim of this in vitro study was to compare the effectiveness of three intracanal medicaments in disinfecting the root canal and dentin of experimentally infected human teeth with Enterococcus faecalis (EF). MATERIALS AND METHODS: One hundred extracted human single-rooted teeth were used. After root canal preparation, teeth were mounted in epoxy resin. Following sterilization, the teeth were infected for 28 days with EF. Then root canals were filled with one of three different disinfectants: viscous 2% Chlorhexidine (CHX), calcium hydroxide paste (CH) or a mixture of CH and CHX (n=30 in each group). Antimicrobial assessments were performed at 1, 3 and 7 days (n=10 in each time period). Microbial samples were obtained from root canals before and after the experiment. Also dentin samples were examined. The data was analyzed using Two- Way ANOVA test. RESULTS: The findings showed that there was no difference between experimental groups at different time periods. The mix...
Dental Research Journal, 2012
Introduction: Antimicrobial activity of interappointment intracanal medications is an important consideration in endodontics. Considering the fact that calcium hydroxide (CH) cannot sterilize the root canal system, completing its antimicrobial spectrum seems necessary. The aim of this study was to compare the antibacterial activity of CH combined with three different vehicles in root canal system. Materials and Methods: In this in vitro experimental study, 61 freshly extracted human single rooted teeth were used. After chemo-mechanical preparation, the teeth were dressed with CH in combination with: G1: Distilled water (DW); G2: 5.25% sodium hypochlorite; G3: 0.2% chlorhexidine solution. All teeth were mounted in a 2-chamber apparatus. After sterilization, the coronal chamber was exposed to bacteria and the apical chamber was filled with broth for 90 days. Leakage was recorded when turbidity was observed in broth. Mean times of leakage and turbidity percentage were recorded for each group. Data were analyzed by One Way ANOVA test (a=0.005). Results: The highest mean time of contamination was for chorhexidine/CH combination (M=66.76 days), and the lowest was for DW/CH combination (M=40.29 days). Statistically significant difference was observed between G3 and G1 (P=0.042), but the difference between G2 and G3 (P=0.76) or G1 and G2 (P=0.18) were not significant. 88.23% of the samples of G1, 70.58% of G2, and 64.70% of G3 were contaminated after 3 months. Conclusion: As an intracanal medication, the chlorhexidine/CH combination had significantly more antibacterial activity than DW/CH combination.
Brazilian Dental Journal, 2008
The purposes of this study were to evaluate the effectiveness of 2% chlorhexidine (CHX) gluconate gel, calcium hydroxide [Ca(OH)2] and their combination with iodoform and zinc oxide powder as intracanal medications against select microorganisms, and to measure the pH changes caused by these medications. Antimicrobial activity was determined by the agar diffusion method. The zones of growth inhibition were measured and the results were analyzed statistically by Kruskal-Wallis test (p<0.05). The pH of the pastes was measured right after preparation, after 24 h and 1 week later. The largest mean zones of microbial inhibition were produced by 2% CHX gel, followed by Ca(OH)2 + 2% CHX gel + iodoform, Ca(OH)2 + 2% CHX gel, Ca(OH)2 + 2% CHX gel + zinc oxide, and Ca(OH)2 + water. The mean pH of all medications stayed above 12.0 during the whole experiment, except for CHX gel (pH=7.0). The results of this study showed that all medications had antimicrobial activity, but the most effective against the tested microorganisms were 2% CHX gel, followed by its combination with Ca(OH)2 and iodoform.
Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, 2006
The purpose of this study was to compare the effectiveness of various medicaments, including Ca(OH) 2 / 2% chlorhexidine, 2% chlorhexidine gel, and Ca(OH) 2 alone, against Enterococcus faecalis and Candid albicans in vitro. Study design. Eighty extracted single-rooted human maxillary teeth were used. After removing the crown, each root was instrumented up to size 50 by using a conventional technique. The root canal was irrigated with ethylenediamine tetra-acetic acid (EDTA) solution to remove smear layer. Then, roots were infected with E faecalis and C albicans. Subsequently, the roots were divided into 4 treatment groups: group 1 was treated with calcium powder hydroxide in distilled water, group 2 was treated with calcium hydroxide powder in 2% chlorhexidine, group 3 was treated with 2% chlorhexidine gel, and group 4 was treated with 0.9% sterile saline serving as negative control. Microbial samples were taken after 7, 15, and 30 days. After incubation, dentine chips were obtained form each root canal and examined microbiologically. The microbiological samples were plated to count colony-forming units in per milligram of dentin. Results. The results showed that the 2% chlorhexidine gel was significantly more effective than calcium hydroxide with 2% chlorhexidine, calcium hydroxide, and control saline solution (P Ͻ .05). Conlusion. Under the conditions of this study, 2% chlorhexidine gel is effective in the elimination of E faecalis and C albicans from the root canal system. However, to support this in vitro observation, further in vivo studies are needed. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006;102:e27-e31) MATERIAL AND METHODS Eighty freshly extracted human upper anterior teeth were placed in 2.5% sodium hypochlorite for 5 hours, after which any bone, calculus, or soft tissues on the root surfaces were removed with curettes.
Evaluation of different pH levels of calcium hydroxide on Enterococcus faecalis: an in vitro study
Microbiology Research, 2012
The aim of the study was to determine the effective pH of calcium hydroxide Ca(OH) 2 against Enterococcus faecalis, the most frequently isolated bacterial species in endodontic failure. Solutions of Ca(OH) 2 with different pH values of 9, 11 and 12.5 were prepared by dissolving 1 mg of Ca(OH) 2 in distilled water. The test solutions were grouped as follows: Group I, vials containing phosphate buffered saline pH of 7.2 as control; Group II, aqueous calcium hydroxide with pH of 9; Group III, aqueous calcium hydroxide with pH of 11; Group IV, aqueous calcium hydroxide of pH 12.5.Forty sterile paper points were transferred to Trypticase Soy Agar broth containing Enterococcus faecalis for a period of 10 min, then transferred to vials containing 1 mL of the test solutions and incubated for 1 h at 37 o C. The paper points were then transferred to neutralizing broth with glass beads to resuspend the microorganisms. Ten-fold serial dilutions were performed using aliquots of 250 µL from the broth and the same amount was plated onto blood agar plates. The plates were incubated anaerobically at 37 o C for 24 h. The number of colony forming units for each dilution was counted using the colony counter. The inhibitory effects of different pH groups on the bacteria were as follows: Group IV > Group III > Group II > Group I in an ascending order. This study revealed that Ca(OH) 2 at a pH 12.5 was effective in complete elimination of Enterococcus faecalis.
Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, 2009
The aim of this study was to investigate in vitro the antimicrobial activity of calcium hydroxide in combination with several vehicles against some microorganisms commonly isolated from root canals. Antimicrobial activity was determined by the agar diffusion method. Stainless-steel cylinders were placed on each inoculated agar medium. The test medicaments and their controls were placed inside the cylinders. The zones of growth inhibition were measured and recorded after incubation for each plate and the results were analyzed statistically (ANOVA). The in vitro antimicrobial effects of the medications were ranked from strongest to weakest as follows: Ca(OH) 2 + CMCP + glycerine, Ca(OH) 2 + CMCP, Ca(OH) 2 + glycerine, Ca(OH) 2 + anesthetic, Ca(OH) 2 + saline, Ca(OH) 2 + H 2 O, Ca(OH) 2 + polyethyleneglycol. The pastes with oily vehicles showed significantly larger mean zones of inhibition compared to those with aqueous or viscous vehicles. It was concluded that diffusion and antimicrobial activity of calcium hydroxide were affected by the type of vehicle used.
International journal of health sciences
Aim: Antimicrobial effectiveness of calcium hydroxide against E. faecalis is the primary goal of this research, which aims to compare the effects of calcium hydroxide with and without the addition of turmeric and ocimum tenuiflorum extract. Ingredients and Procedure: Using calcium hydroxide and herbal extracts, the samples were divided into six groups. Normal saline, turmeric extract, and tulsi extract are in groups A1, B1, and C1 respectively. Calcium hydroxide and saline are in Group A; calcium hydroxide and turmeric extract are in Group B; and basil extract is in Group C. Enterococcus faecalis may be grown in brain heart infusion broth (BHI). Three equal-sized sets of media are placed in each of three wells with a diameter of 4 mm on each media plate. A sliding calliper is used to identify inhibitory zones after 1-2 days of incubation at 37°Celsius. Results: This study's statistical findings were generated entirely with SPSS version 18. P values of less than 0.04 were deemed ...