Abstract
Aims:To compare the antibacterial activity of alexidine (ALX) alone or as a final irrigant in combination with sodium hypochlorite (NaOCl), with the most common canal irrigants, NaOCl and chlorhexidine (CHX).Materials and methods:Ninety-four root fragments from extracted human teeth were infected with Enterococcus faecalis for 24 h and then distributed into 4 groups of 20 fragments each. The NaOCl, CHX and ALX groups were immersed in 1 ml of 2.5% NaOCl, 2% CHX, and 1% ALX for 10 min, respectively. The samples of the NaOCl+ALX group were immersed in 1 ml of 2.5% NaOCl for 10 min followed by 1% ALX for 10 min. Bacteriological samples were taken, cultured, and the colony-forming units were counted.Results:There was no significant differences among the experimental groups (P>0.05) except for the comparisons CHX versus ALX and NaOCl+ALX versus ALX (P=0.004). ALX alone was the worst irrigant. CHX and NaOCl+ALX eradicated all bacteria. All experimental groups were significantly more effective than the control group immersed in saline (P<0.05).Conclusions:The antibacterial effect of ALX alone was inferior to 2% CHX and 2.5% NaOCl. However, the combination of NaOCl with ALX as a final irrigant eradicated the biofilms.
Highlights
The aim of treatment in infected root canals is to eliminate microorganisms from the root canal system and to prevent its reinfection
Intergroup analysis revealed no significant difference among the experimental groups (P40.05) except for the comparisons chlorhexidine digluconate (CHX) versus ALX, and NaOCl+ALX versus ALX (P = 0.004)
CHX and NaOCl+ALX eradicated all bacterial cells in all samples
Summary
The aim of treatment in infected root canals is to eliminate microorganisms from the root canal system and to prevent its reinfection. Studies have demonstrated that instrumentation and irrigation are effective in substantially reducing the number of bacteria in infected canals, in many cases bacteria remain in the main root canal even when sodium hypochlorite (NaOCl) is used as the irrigant.[5] NaOCl is the most common root canal irrigant due to its tissue-dissolving capability, its broad antimicrobial action, as well as its ability to neutralize toxic products.[6,7] NaOCl has many disadvantages, including cytotoxicity, reduced efficacy in the presence of organic matter, and interference with pulp regeneration procedures.[8,9,10] These limitations stimulate the search for safer and more effective irrigants. An alternative to NaOCl is chlorhexidine digluconate (CHX) This irrigant is a bisbiguanide disinfectant that has high antimicrobial activity, substantivity, and biocompatibility. CHX has been shown to have no tissue-dissolving activity and, when combined with NaOCl, produces parachloroaniline, a toxic precipitate.[11,12,13]
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