Previous studies have demonstrated antimicrobial substantivity in root canal dentin up to 7 days after treatment with chlorhexidine. This in vitro study assessed the antimicrobial substantivity of chlorhexidine-treated bovine root dentin over a period of 21 days. Sixty standardized bovine root sections were randomly divided into three equal groups, and their canals immersed in one of the following solutions: (i) sterile saline; (ii) 2.5% NaOCl; or (iii) 0.2% chlorhexidine (CHX). Half the specimens in each group were treated with the solution for 5 min and the other half for 7 days. After solutions were removed, the specimens were incubated at 37 degrees C in Brain Heart Infusion broth containing Enterococcus faecalis (ATCC 29212). A fresh inoculum was added to the broth every other day over a 21-day period. The canals were then enlarged with sterile burs, and the dentin shavings collected and cultured for the presence of cultivable bacteria in the dentinal tubules. Specimens treated with CHX for 7 days demonstrated significantly less dentin colonization by E. faecalis than the other specimens. CHX has potential as an intracanal medicament, if it can be applied for a period of at least 7 days.

Electronic apex locators are frequently used attached to a small size endodontic file; however, the effect on the measurement of the relative diameters of the file and the root canal has not been clarified. In this study, the length of enlarged canals was measured using small size files and files matching the canal diameter to observe a possible discrepancy. The accuracy of electronic length control during canal preparation with rotary files was also assessed. The root canals in 21 extracted, single rooted teeth were accessed, and their actual length (AL) established by passing a size 10 file just through the minor apical foramen. The teeth were then embedded in an alginate mold. The initial canal length (IL) was measured with the Root ZX apex locator by negotiating a size 10 file to the apical constriction. The canal was enlarged to size 60 with rotary files while the length was continuously controlled with the apex locator. Then, the final length measurements were obtained with a size 10 file and a size 60 file (FL-10 and FL-60, respectively). The average values of IL, FL-10 and FL-60 were calculated and compared using Repeated Measures Analysis of Variance followed by Tukey's Studentized Range test (P < 0.05). Using composite resin, the size 60 files were secured at the FL-60 length, the teeth were removed from the alginate mold, stained with Picroformal DI Buoin stain and the position of the file tip was observed histomorphometrically after the apical 4 mm of the canal was exposed by grinding the buccal aspect of the root. The IL was 0.45 mm shorter than AL (P < 0.05). The differences between FL-10, FL-60 and IL were not statistically significant. Histomorphometrically, the apical constriction was absent in all the teeth, but the file tips were confined within the root. This study concluded that the Root ZX indicated the location of an apical constriction even when the anatomic constriction was eliminated. In the enlarged canals, length measurements obtained with small and large size files were comparable.

Root canal dentin acquires antimicrobial substantivity after exposure to chlorhexidine gluconate (CHX) for 1 wk. Therefore development of a vehicle for delivery of CHX as an intracanal medication is desirable. This in vitro study assessed the efficacy of two CHX delivery vehicles, a controlled-release device and a gel, to affect antimicrobial substantivity of bovine root dentin. Sixty bovine incisor root specimens were prepared with standardized length (10 mm) and canal diameter (3.3 mm), and coated externally with nail polish. Specimens were divided into four equal groups and their canals medicated for 7 days with either: (i) an experimental controlled-release device containing 25% CHX that was immersed in sterile saline; (ii) 2% CHX gel; or (iii) Ca(OH)2 paste. Sterile saline was used as the positive control. After medication, the canals of the specimens were inoculated with Enterococcus faecalis for 21 days. Root canal dentin samples ranging in depth from 0.1 to 0.45 mm were then obtained using sterile round burs of ascending diameter. Each dentin sample was placed in a separate test tube containing Brain Heart Infusion broth and incubated for 24 h. The optical density (OD) of the broth was then measured spectrophotometrically at 540 nm. The positive control showed significantly higher mean OD values (one-way ANOVA and Tukey's Studentized Range Test; p < 0.001) than the three test groups. The CHX controlled-release device group showed significantly lower OD values than the Ca(OH)2 group; however only at dentin depths up to 0.2 mm. In contrast, the CHX gel group consistently showed significantly lower OD values than both the CHX controlled-release device and Ca(OH)2 groups. These results suggest that bovine root canals medicated with 2% CHX gel for 7 days acquire antimicrobial properties for at least 21 days.

No abstract