Abstract
Aim: The purpose of study was to evaluate, in vitro, the effectiveness of intracanal dressing protocols in root canals infected with E.faecalis. Methods: Eighty eight bovine incisors were contaminated with E. faecalis, remaining in culture for 30 days for biofilm formation. The teeth were divided into ten groups according to presence of disinfectant penetration (DP), intracanal dressing and medication placement site: G1 (CHX gel) – 2% chlorhexidine (CHX) gel (cervical third), G2 (CHX liq) – 2% CHX liquid (cervical third), G3 (TC) – tricresol formalin (canal entrance). In these groups (n=10), DP was not performed. G4 (DP+CHX gel) – 2% CHX gel (all thirds), G5 (DP+CHX liq) – 2% CHX liquid (all thirds), G6 (DP+TC) – tricresol formalin (canal entrance), G7 (DP+Ca(OH)2) – calcium hydroxide paste (all thirds). In these groups (n=10) DP with 2% NaOCl was performed. Groups G8 (DP NaOCl) – DP with 2% NaOCl, G9 (DP H2O) – DP with distilled water, and G10 – (no treatment) were considered controls (n=6). Microbiological test (CFUs counting) and scanning electron microscopy (SEM) were performed to evaluate and illustrate respectively the effectiveness of proposed treatments. Results: Microbiological test demonstrated that groups G4 (DP+CHX gel), G5 (DP+CHX liq), G6 (DP+TC) and G7 (DP+Ca(OH)2) showed no bacterial growth, being statistically different from all other groups (p<0.05). Conclusion: 2% chlorhexidine gel, 2% chlorhexidine liquid and calcium hydroxide paste in all root canal thirds, as well as tricresol formalin on root canal entrance, are effective intracanal dressings against E. faecalis, when associated to previous DP with 2% NaOCl.
Highlights
Most pathological changes affecting pulp and periradicular tissues have microbial etiology
scanning electron microscopy (SEM) revealed that root canal walls of samples from group 10 were densely colonized by Enterococcus faecalis (Fig 2 – A and B)
One of the most important factors of endodontic success is an effective decontamination of root canal system
Summary
Most pathological changes affecting pulp and periradicular tissues have microbial etiology. Studies have reported that bacteria found in endodontic microbiota can be removed using sodium hypochlorite in chemomechanical preparation [3,4] Some bacteria such as Enterococcus faecalis possess resistance to endodontic treatment and remain viable into dentinal tubules even after root canal preparation [5]. Calcium hydroxide has been recommended as intracanal dressing due to some properties such as antibacterial activity, endotoxin neutralization and inducement of hard tissue formation [7,8]. Microorganisms such as Enterococcus faecalis may persist [9] and its antimicrobial activity may vary depending on the location into root canal [10]
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