EFFECTIVENESS OF CHLORHEXIDINE AS A CAVITY DISINFECTANT IN ATRAUMATIC RESTORATIVE TREATMENT IN PRIMARY TEETH (RANDOMIZED CONTROLLED CLINICAL TRIAL)

Abstract

Introduction: Since the removal of caries in the Atraumatic restorative treatment (ART) is performed with hand excavation, its survival would increase if more bacteria could be inhibited under the restoration. The use of antibacterial agents such as Chlorhexidine gluconate (CHX) was found to hinder the growth of bacteria under restorations, reducing the risk of recurrent caries. Objective: Evaluate the effectiveness of CHX as a cavity disinfectant, on residual cariogenic bacteria, in ART restorations. Materials and methods: Atraumatic restorative treatment procedures were performed to the whole sample (N=40), with identical protocols except for the antibacterial agent used. Bacteriological samples from the center of the cavity were cultivated for Mutans streptococci (MS), Lactobacilli (LB) and total viable count (TVC). Chlorhexidine was applied onto the cavity floor in group I (N=20) and conventional ART without disinfectant was performed in group II (N=20). After 14 days, the restorations were removed and a second dentin sample was cultivated for bacteriologic assessment of the outcome. Results: After 14 days, Group I showed 22.17, 8.25, 6.88 mean percent reduction of MS, LB, and TVC, respectively whereas group II showed 12.67, 6.87, 6.11 mean percent reduction of MS, LB, TVC, respectively. MS and LB showed significantly higher percent reduction in group I compared to group II. Moreover, group I showed higher mean percent reduction in TVC than group II; however, it was not statistically significant. Conclusion: Chlorhexidine disinfection showed superior effectiveness in inhibiting residual bacteria under ART restoration compared to ART restorations using glass ionomer cement (GIC) alone.