Reduction in Bacterial Loading Using 2% Chlorhexidine Gluconate as an Irrigant in Pulpectomized Primary Teeth: A Preliminary Report

Abstract

Objective: The aim of this study was to evaluate the reduction in bacterial loading using 2% chlorhexidine gluconate as an irrigating solution in pulpectomized primary teeth. Study design: A randomized, controlled clinical trial was performed that included primary teeth with pulp necrosis. Forty necrotic teeth were included, 20 irrigated with 2% chlorhexidine gluconate (experimental group) and 20 with sterile saline solution (control group); in all cases, 2 microbiological samples from within the canals were taken with sterile paper points, the first after the canal opening and before the first irrigation, and the second after instrumentation and final irrigation, before filling. All samples were evaluated by McFarland's scale. Results: The results were statistically analyzed by the Mann-Whitney U test. After analyzing samples before and after irrigation in the control group (saline), we found a significant decrease of bacterial load (P <0.0002). The same occurred in the chlorhexidine group samples (P <0.0001). When both groups were compared postirrigation,a statistically significant difference was observed in favor of 2% chlorhexidine gluconate.Conclusion: Two percent chlorhexidine gluconate showed a greater reduction of intracanal bacterial loading compared with that observed with sterile saline solution. This irrigating solution is suggested as an alternative for pulpectomy of necrotic primary teeth.

Intracanal irrigants for pulpectomy in primary teeth: a systematic review and meta‐analysis

“…Three studies assessed the efficacy of 2% chlorhexidine gluconate compared with saline solution. Ruiz‐Esparza et al .…”

“…Three studies 32,33,35 assessed the efficacy of 2% chlorhexidine gluconate compared with saline solution. Ruiz-Esparza et al 32 and Jolly et al 35 both reported a significant decrease, in terms of CFU/mL, in favour of chlorhexidine, whereas Jolly et al 35 reported smaller values than the remaining studies included in the present review. Thus, it was decided not to include their study in the quantitative synthesis.…”

Optimal Irrigation and Debridement of Infected Total Joint Implants with Chlorhexidine Gluconate

“…Recent studies have demonstrated that when used in this manner, 2% CG yielded a substantial reduction in deep surgical site infections during both hip and knee arthroplasties [18][19][20][21]. Animal studies have also demonstrated effectiveness of 2% CG solution in eliminating bacteria from Achilles' tendons and in preventing bacterial growth on CG-coated tibial nails implanted in open fractures, though the effective dose and exposure time are not expanded upon in these studies [23,24].…”

Root Canal Irrigants in Primary Teeth

“…20 this is thus suggested as an alternative for pulpectomy of necrotic primary teeth. 21 though CHX as a root canal irrigant has not shown any long-term damage to host tissues, inflammatory responses were expressed from the host tissues when it was accidently injected beyond the root apex. though CHX is considered as a potent irrigating solution, its ineffectiveness on removal of necrotic remnants and limited action on Gram-negative organisms compared to Gram-positive bacteria it cannot be used as a final irrigant in endodontic cases.…”