Antimicrobial and toxic effects of established and potential root canal irrigants

Yesilsoy, Cemil; Whitaker, Eugene J.; Cleveland, Deborah B.; Phillips, Eric M.; Trope, Martin

doi:10.1016/s0099-2399(06)80524-8

Cited by 178 publications

(162 citation statements)

References 16 publications

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“…CHX is less cytotoxic to the periapical tissues than NaOCL; however as an antimicrobial it is highly effective against a range of Gram-positive and Gramnegative oral bacterial species (33). The substantivity of CHX in dentin seems to be an advantage over NaOCl (34).…”

Section: Discussionmentioning

confidence: 99%

The Effect of Sodium Hypochlorite and Chlorhexidine as Irrigant Solutions for Root Canal Disinfection: A Systematic Review of Clinical Trials

Gonçalves

Rodrigues

Andrade

et al. 2016

Journal of Endodontics

136

100

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Aims: This systematic review aimed to compare the effectiveness of sodium hypochlorite and chlorhexidine for root canal disinfection during root canal therapy. Methods:A literature search for clinical trials was made on the PUBMED (Medline), Web of Knowledge, SCOPUS, and Science Direct databases and in the reference lists of the identified articles up to January 2015. Quality assessment of the selected studies was carried out according to the CONSORT statement. Results:One clinical trial and four randomized clinical trials (RCTs) were selected from the 172 papers initially identified. There was heterogeneity in the laboratory methods used to assess the root canal disinfection as well as in the concentrations of the irrigants used. Therefore, meta-analysis was not performed. Two studies reported effective and similar reductions in bacterial levels for both irrigants. Sodium hypochlorite was more effective than chlorhexidine to reduce microorganisms in one study and another reported opposite findings. Both root irrigants were ineffective in eliminating endotoxins from necrotic pulp root canals in one study. Trial design and information regarding randomization procedures were not clearly described in the clinical trials. No study compared laboratory results with clinical outcomes. Conclusions:The available evidence on this topic is scarce and the findings of studies were not consistent. Additional RCTs using clinical outcomes to compare the use of sodium hypochlorite and chlorhexidine during root canal therapy are needed.

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Section: Discussionmentioning

confidence: 99%

The Effect of Sodium Hypochlorite and Chlorhexidine as Irrigant Solutions for Root Canal Disinfection: A Systematic Review of Clinical Trials

Gonçalves

Rodrigues

Andrade

et al. 2016

Journal of Endodontics

136

100

View full text Add to dashboard Cite

show abstract

“…In an in vitro evaluation of the antimicrobial activity of chlorhexidine and sodium hypochlorite, it has been found that the timing required for 1.0% and 2.0% chlorhexidine liquid to eliminate all microorganisms was the same as that required for 5.25% NaOCl. 34 Similarly, Gomes et al 35 found chlorhexidine in the liquid form at all concentrations tested (0.2%, 1%, and 2%) was as effective as 5.2% NaOCl in killing E faecalis, and Yesilsoy et al 22 found 2.0% chlorhexidine to be as effective as 5.2% NaOCl in a Petri dish test using S mutans, Peptostreptococcus micros, Prevotellaintermedia, and Porphyromonas gingivalis. On the other hand, 4% NaOCl was found to be statistically better than 0.2% and 2% chlorhexidine against 4 blackpigmented gram-negative anaerobes and 4 facultative anaerobes.…”

mentioning

confidence: 92%

“…Higher concentrations have been reported to be more effective by using agar diffusion tests. [21][22][23] However, direct extrapolation to the clinical situation of agar diffusion test should be treated with caution. When used in contaminated canals of extracted teeth, Siqueira et al 24 found no difference in the antibacterial effect of 1%, 2.5%, and 5.2% NaOCl.…”

mentioning

confidence: 99%

The antimicrobial effects of root canal irrigation and medication

Karim

Kennedy

Hussey

2007

Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, an

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“…Furthermore, there is evidence that hypochlorite is not effective against all pathogenic bacteria specifically Enterococcus faecalis which is associated with recalcitrant canals. 14 Further complications of conventional disinfecting agents are toxicity and microbial resistance [15][16][17] since most which have effective bactericidal activity are used at concentrations where normal tissue toxicity is becoming a significant factor. This can lead to adverse tissue reactions.…”

Section: Introductionmentioning

confidence: 99%

An alternative regimen for root canal disinfection

et al. 2006

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Objective To compare the effect of a combination of 20% citric acid solution and photo-activated disinfection with the use of 20% citric acid and 2.25% sodium hypochlorite solutions on bacterial load on the dentine walls in prepared canals in vivo. Subjects and methods Sixty-four randomly selected cases were evaluated and allocated to one of two groups. In Group 1, after gaining access to the root canal, bacterial load on the canal walls was sampled using endodontic files. A further sample was taken after apex location and initial widening of the canal had been completed and the photoactivated disinfection process carried out. A final sample was taken after completion of the canal preparation using citric acid and sodium hypochlorite solutions. In Group 2, the initial sample was taken as described previously. A second sample was taken after conventional preparation using 20% citric acid and sodium hypochlorite solutions as co-irrigants. A final sample was then taken after a subsequent PAD treatment. All samples were cultured for facultative anaerobic bacteria. Results Of the canals treated in Group 1 only two of the 23 canals infected showed culturable bacteria after the use of citric acid and photo-activated disinfection. Of these two canals, one was free of culturable bacteria on completion of conventional treatment but the other still contained culturable bacteria. In Group 2, four canals of the 23 infected initially, remained contaminated after conventional treatment. After subsequent photo-activated disinfection three of these four canals were free of culturable bacteria. Conclusion Results indicate that the use of a chelating agent acting as a cleaner and disrupter of the biofilm and photo-activated disinfection to kill bacteria is an effective alternative to the use of hypochlorite as a root canal cleaning system.

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Antimicrobial and toxic effects of established and potential root canal irrigants

Cited by 178 publications

References 16 publications

The Effect of Sodium Hypochlorite and Chlorhexidine as Irrigant Solutions for Root Canal Disinfection: A Systematic Review of Clinical Trials

The Effect of Sodium Hypochlorite and Chlorhexidine as Irrigant Solutions for Root Canal Disinfection: A Systematic Review of Clinical Trials

The antimicrobial effects of root canal irrigation and medication

An alternative regimen for root canal disinfection

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