Abstract
One of the primary objectives of endodontic treatment of teeth with pulp necrosis is the elimination of microorganisms from the root canal system, as effectively as possible, especially in cases with chronic periapical lesions. AIM: The purpose of this study was to analyze the response of the periapical tissue of dogs' teeth with chronic periapical lesions to endodontic treatment performed with utilization of metronidazole, calcium hydroxide, and an association of both as root canal dressings. METHODOLOGY: Forty root canals were submitted to pulpectomy and the root canals were kept exposed to the oral environment for 6 months. Then, they were submitted to biomechanical preparation and divided into 4 study groups with 10 specimens: group I – no root canal dressing; group II – calcium hydroxide; group III – metronidazole; group IV – calcium hydroxide associated to metronidazole. After 15 days, the root canals were filled with Fill Canal sealer. After 90 days, the animals were killed and the especimens processed for histological analysis. RESULTS: Calcium hydroxide dressing provided a significantly better outcome compared to other experimental groups (α = 0.01). Also, the results of the association of metronidazole and calcium hydroxide were similar to those observed for the metronidazole group. The worst results were obtained by the no root canal dressing group. CONCLUSION: The use of metronidazole alone or associated with Calcium hydroxide, did not improve periapical healing when compared to Calcium hydroxide dressing.
Highlights
One of the primary objectives of endodontic treatment of teeth with pulp necrosis is the elimination of microorganisms from the root canal system, as effectively as possible, especially in cases with chronic periapical lesions
The effectiveness of intracanal medication can only be helpful if the drug employed is a germicide, since chronic periapical lesions are related to the presence of bacteria, especially anaerobes[18,27,29]
In an attempt to increase the antimicrobial activity of root canal dressing, with possible improvement of the final outcome of treatment, the aim of the present study was to analyze the response of the periapical tissue of dogs’ teeth with experimentally induced chronic periapical lesions to the endodontic treatment performed with utilization of metronidazole, calcium hydroxide, and an association of both as root canal dressings
Summary
One of the primary objectives of endodontic treatment of teeth with pulp necrosis is the elimination of microorganisms from the root canal system, as effectively as possible, especially in cases with chronic periapical lesions. The effectiveness of intracanal medication can only be helpful if the drug employed is a germicide, since chronic periapical lesions are related to the presence of bacteria, especially anaerobes[18,27,29]. Metronidazole is a synthetic antimicrobial agent, which is bactericidal and exceptionally effective against anaerobes. Even though it is not the drug of choice for dental infections, it has been largely employed as a coadjuvant in the treatment of periodontal diseases and anaerobic infections in general, when other antibiotics are not effective or are contraindicated. In Endodontics procedures, this drug has been empirically used but a scientific base is required despite the in vitro effectiveness against bacterias[22,30]
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