In Situ Antimicrobial Effectiveness of Chlorhexidine and Calcium Hydroxide: Gel and Paste Versus Gutta-Percha Points

Abstract

The aim of this study was to determine the antibacterial effectiveness of either chlorhexidine or calcium hydroxide integrated in gutta-percha points compared with chlorhexidine or calcium hydroxide delivered as gel or paste, respectively. A total of 70 initially sterile roots with open accesses were carried for 1 week in the oral cavities of two volunteers. The roots were then removed, and samples were taken from the root canals for microbial analysis. The roots were medicated with calcium hydroxide paste, 5% chlorhexidine gel, or a chlorhexidine- or calcium hydroxide-containing gutta-percha point. The accesses were closed with bonding material, and the roots incubated for 1 week. After removal of the antimicrobial agents, roots were again checked for bacterial growth. One thioglycolate-soaked paper point was then introduced into each canal, and roots were incubated for 1 week more to observe bacterial regrowth. After 1 week of medication, the absolute bacterial count revealed significant differences compared with the controls. However, only the chlorhexidine-gel and the calcium hydroxide paste group showed no microbial colonization in a considerable number of samples after 1 and 2 weeks.

Microbiological Analysis of Teeth with Chronic Apical Periodontitis and the Outcome of Treatment by Gutta Percha Points Impregnated with Either Calcium Hydroxide or Chlorhexidine as Intra Canal Medicament

“…This finding was compatible with that obtained by others [22][23][24] who reported that CHX showed complete elimination of bacteria especially Enterococcus faecalis. Opposite to our finding, Barthel et al [36] reported only bacterial reduction after application of CHX points. Different methodologies might be the cause of difference in results, beside what they reported about the rigidity for the points that might restrict the release of CHX.…”

“…Different methodologies might be the cause of difference in results, beside what they reported about the rigidity for the points that might restrict the release of CHX. Still, their results resembled the present study in that CHX points produced better action than that of Ca(OH) 2 [36]. Two out of fifteen cases treated by CHX revealed positive cultures.…”

Effect of rotary instrumentation and of the association of calcium hydroxide and chlorhexidine on the antisepsis of the root canal system in dogs

“…The action of files and irrigation solutions have only a partial and temporary effect upon microorganisms limited to the principal root canal 2,3,18 . Consequently, after adequate cleaning and shaping of the root canals, the application of dressings is recommended, usually with calcium hydroxide 1,2,[5][6][7][8][9][10][11]13,18,22 , which has a complementary antiseptic action on the microorganisms remaining in the root canal system and apical cement lacunae.…”

“…Vehicles used with the calcium hydroxide paste may be water soluble, aqueous 2,17,23 viscous [11][12][13] , inert or with an antiseptic action 1,2,13,21,22,24 . Endodontic infection diffuses through the root canal system and is polymicrobial 5,15 .…”

Resposta celular e molecular do tecido conjuntivo de camundongos e medicações intracanal

“…A principal vantagem da CHX é a substantividade, que permite efeito residual prolongado e não promove resistência microbiana Roshental et al, 2004;Anthanassiadis et al, 2007;Neelakantan et al, 2007). A CHX, na forma de gel ou associada ao Ca(OH) 2 , tem sido investigada como medicação intracanal em estudos in vitro (Lenet et al, 2000;Lima et al 2001;Barthel et al, 2002;Basrani et al, 2003;Evans et al, 2003;Haenni et al, 2003;Gomes et al, 2003;Basrani et al, 2004;Rosenthal et al, 2004;Schäfer e Bössmann, 2005;Gomes et al, 2006;Ercan et al, 2006;Ballal et al, 2007;Krithikadatta et al, 2007;Neelakantan et al, 2007;Souza-Filho et al, 2008;Delgado et al, 2010;Kandaswamy et al, 2010;Lima et al, 2011;Vaghela et al, 2011) e in vivo (Wuerch et al, 2004;Dammaschke et al, 2005;De Rossi et al, 2005;Soares et al, 2006a;Manzur et al, 2007;Vianna et al, 2007;Wang et al, 2007;Semenoff et al, 2008;Silva et al, 2009;Gondim et al, 2011;Martinho et al, 2011), sendo escassas e controversas as análises da reação tecidual a estas medicações (Dammaschke et al, 2005;De Rossi et al, 2005;Gomes-Filho et al, 2008;...…”