Abstract

This study aimed at evaluating the antisepsis of the root canal system (RCS) and periapical region (PR) provided by rotary instrumentation associated with chlorhexidine + calcium hydroxide as intracanal medicament. Chronic periapical lesions were induced in 26 pre-molar roots in two dogs. After microbiological sampling, automatic instrumentation using the Profile system and irrigation with 5.25% sodium hypochlorite solution, with a final rinse of 14.3% EDTA followed by profuse irrigation with physiological saline were carried out in 18 root canals. After drying the canals, a paste based on calcium hydroxide associated with a 2% chlorhexidine digluconate solution was placed inside them. After 21 days, the medication was removed, leaving the root canals empty and coronally sealed. After 96 hours, a final microbiological sample was obtained, followed by histomicrobiological processing by the Brown & Brenn method. Eight untreated root canals represented the control group (C-G). Based on the Mann-Whitney test at a confidence level of 5% (p < 0.05), the procedures of antisepsis used offered significant efficacy (p < 0.05) resulting in 100.0% of the canals free of microorganisms. In the C-G, an elevated incidence of various microbial morphotypes was confirmed in all sites of the RCS, with the presence of microbial colonies in the periapical region. In contrast, the experimental group showed a similar pattern of infection in the RCS, although less intense and a reduced level of periapical infection (p < 0.05). It was concluded that adequate instrumentation followed by the application of calcium hydroxide + chlorhexidine offered significant elimination of microorganisms.

Highlights

  • The response of the immunological system to infection of the root canal system and of the tissues adjacent to the apical foramen results in the formation and perpetuation of periapical pathology[2,11,15,18,19]

  • 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

  • The objective of this study was to evaluate the antiseptic effect of rotary instrumentation followed by the action of a paste based on calcium hydroxide associated with a solution of 2% chlorhexidine digluconate in dog teeth with experimentally induced periapical lesions

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Summary

Introduction

The response of the immunological system to infection of the root canal system and of the tissues adjacent to the apical foramen results in the formation and perpetuation of periapical pathology[2,11,15,18,19]. Chlorhexidine has been used as vehicle for Ca(OH)[25,6,21] It is a biguanide used for irrigation of the root canals[5,6,14], irrigation of the operating field in periodontal and periapical surgery[4,10]. It has been used for supra- and sub-gingival biofilm control in the form of mouthwashes, irrigation solutions or sustained release devices[7,9,14]. Its concentrations vary between 0.12 and 2.0%, and it is effective against gram-positive and gram-negative obligate anaerobic and facultative microorganisms[8,14,24]

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