Abstract
The purpose of this study was to investigate the influence of serum and necrotic soft tissue on the antimicrobial activity of intracanal medicaments. The medicaments tested were: calcium hydroxyde/glycerin paste, calcium hydroxide/chlorhexidine paste, calcium hydroxide/camphorated paramonochlorophenol/glycerin paste, and chlorhexidine/zinc oxide paste. Survival of Enterococcus faecalis and Candida albicans exposed to the medicaments tested in the presence or absence of serum or necrotic tissue was monitored in three in vitro experiments where samples for culturing were taken at different time periods. The overall results demonstrated that the antimicrobial activity of all intracanal medicaments tested was slowed down in the presence of necrotic tissue. Calcium hydroxide pastes in glycerin or chlorhexidine were significantly affected by serum. Of the medicaments tested in this study, the least affected was the calcium hydroxide/camphorated paramonochlorophenol/glycerin paste.
Highlights
The rationale for treatment of any infectious diseases is elimination of causative microorganisms
The following agents were tested in the present study: calcium hydroxide/glycerin paste (CHG), CH/ camphorated paramonochlorophenol (CPMC)/glycerin paste (CHPG), CH/0.2% chlorhexidine gluconate paste (CHCx), 0.2% chlorhexidine gluconate/zinc oxide paste (CxZO)
In the presence of necrotic tissue, all medicaments succeeded in eliminating E. faecalis cells after 1 day, except for CxZO, which reduced the number of bacterial cells, but was clearly negatively affected by necrotic tissue (Table 1)
Summary
The rationale for treatment of any infectious diseases is elimination of causative microorganisms. Chemomechanical procedures are highly effective in reducing bacterial populations within the main root canal [2,3], bacteria located in some areas of the root canal system, such as untouched canal walls, dentin tubules, isthmuses, lateral canals and apical ramifications, may still remain unaffected by instruments and irrigants and jeopardize the treatment outcome [4]. This is a result of the physical limitations of endodontic instruments and the short time irrigants remain in the root canal during instrumentation/ irrigation procedures. It has been demonstrated that irrigation with NaOCl in different concentrations is not sufficient to render root canals free of bacteria in about one half of the cases [2,3]
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