Efficacy of various intracanal medicaments against Enterococcus faecalis in primary teeth: An in vivo study

The aim of this study was to evaluate the in vivo efficacy of three intracanal medicaments (Ca(OH)2, 1% chlorhexidine gel and 1% chlorhexidine gel with Ca(OH)2 against Enterococcus faecalis in necrotic primary teeth.

As a conclusion, chlorhexidine gel with or without Ca(OH)2 was more effective than Ca(OH)2 alone against Enterococcus faecalis.

1. Engström B. The significance of enterococci in root canal treat-ment. Odontol Revy 15: 87–105, 1964.

2. Gomes BPFA, Pinheiro ET, Gade-Neto CR, Sousa ELR, Ferraz CCR, Zaia AA, Teixeira FB, Souza-Filho FJ. Microbiological examination of infected dental root canals. Oral Microbiol Immunol 19: 71–6, 2004.

3 Ohara PK,Torabinejad M, Kettering JD. Antibacterial effects of various endodontic irrigants on selected anaerobic bacteria. Endod Dent Traumatol 9: 95–100, 1993.

4. Marsh SJ, Largent MD. A bacteriologic study of the pulp canals of infected primary molars. J Dent Child 37: 460–70, 1967

5. Tomic-Karovic K, Jelinek E. Comparative study of the bacterial flora in the surroundings the root canals and socked of decidu-ous molars. Int Dent J 21: 375–388.

6. Sundqvist G. Ecology of the root canal flora. J Endod 18: 427–30, 1992.

7. Tronstad L. Root resorption-etiology, terminology and clinical manifestations. Endod Dent Traumatol 4: 241–52, 1988.

8. Buijs JF,Wesselink PR. Effects of instrumentation, irrigation and dressing with calcium hydroxide on infection in pulpless teeth with periapical bone lesions. Int Endod J. 35: 13–21, 2002.

9. Byström A, Claesson R, Sundqvist G. The antibacterial effect of camphorated paramonochlorophenol, camphorated phenol and calcium hydroxide in the treatment of infected root canals. Endod Dent Traumatol 1: 170–5,1985.

10. Sjögren U, Figdor D, Spangberg L, Sundqvist G. The antibacteri-al effect of calcium hydroxide as a short-term intracanal dressing. Int Endod J 24: 119–25, 1991.

11. Estrela C, Pimenta FC, Ito IY, Bammann L. In vitro determina-tion of direct antimicrobial effect of calcium hydroxide. J Endod 24: 15–7, 1998.

12. Dahlen G, Samuelsson W, Molander A, Reit C. Identification and antimicrobial susceptibility of enterococci isolated from the root canal. Oral Microbiol Immunol 15: 309–12, 2000.

13. Heiling M, Sommer D, Steinberg M, Friedman M, Sela MN. Microbiological evaluation of the efficacy of chlorhexidine in a sustained-release device for dentine sterilisation. Int Endod J 25: 15–9, 1992.

14. Siqueira JF jr, de Uzeda M. Intracanal medicaments: Evaluation of the antibacterial effects of chlorhexidine, metronidazole, and calcium hydroxide associated with three vehicles. J Endod 23: 167–9, 1997.

15. Siqueira JF Jr, Lopes HP. Mechanisms of antimicrobial activity of calcium hydroxide: a critical review. Int Endod J 32: 361–9, 1999.

16. Gomes BPFA, Souza SFC, Ferraz CCR, Teixeira FB, Zaia AA, Valdrighi L et al. Effectiveness of 2% chlorhexidine gel and cal-cium hydroxide against Enterococcus faecalis in bovine root dentine in vitro. Int Endod J 36: 267–75, 2003.

17. Lui JN, Sae-Lim K, Song KP, Chen NN. In vitro antimicrobial effect of chlorhexidine impregnated gutta percha points on Enterococcus faecalis. Int Endod J 37: 105–13, 2004.

18. Ferraz CC, Gomes BPFA, Zaia AA, Teiveira FB, Souza-Filho FJ. In vitro assessment of the antimicrobial action and the mechani-cal ability of chlorhexidine gel as an endodontic irrigant. J Endod 27: 452–5, 2001.

19. Lindskog S, Pierce AM, Blomlof L. Chlorhexidine as a root canal medicament for treating inflammatory lesions in the periodontal space. Endod Dent Traumatol 14: 186–90, 1998.

20. Almyroudi A, Mackenzie D, McHugh S, Saunders WP. The effec-tiveness of various disinfectants used as endodontic intracanal medications: an in vitro study. J Endod 28: 163–7, 2002.

21. Basrani B, Santos JM, Tjörderhane L, Grad H, Gorduysus O, Huang J. Substantive antimicrobial activity in Chlorhexidine-treated human root dentin. Oral Surg Oral Med Oral Pathol 94: 240–5, 2002.

22. Sukawat C, Srisuwan T. A comparison of the antimicrobial effic-cy of three calcium hydroxide formulations on human dentin infected with Enterococcus faecalis. J Endod 28: 102–4, 2002.

23. Moller AJ. Microbial examination of root canals and periapical tissues of human teeth. Methodological studies. Odontol Tridskr 74: Suppl: 1–380, 1966.

24. Lui JN, Sae-Lim K, Song P, Chen NN. In vitro antimicrobial effect of chlorhexidine-impagnated gutta percha points on Enterococcus faecalis. Int Endod J 37: 105–13, 2004.

25. Saleh IM, Ruyter IE, Haapasalo M, Østravik D. Survival of Enterococcus faecalis in infected dentinal tubules after canal fill-ing with different root canal sealers in vitro. Int Endod J 37: 193–8, 2004.

26. Byström A, Sundqvist G. Bacteriologic evaluation of the efficacy of mechanical root canal instrumentation in endodontic therapy. Scand J Dent Res 89: 321–8, 1981.

27. Gomes BPFA, Lilley JD, Drucker DB. Variations in the suscepti-bilities of components of the endodontic microflora to biome-chanical procedures. Int Endod J 29: 235–41, 1996.

28. Safavi KE, Spangberg LSW, Largeland K. Root canal dentine tubule desinfection. J Dent 16: 207–10, 1990.

29. Byström A, Sundqvist G. Bacteriologic evaluation of the effect of 0.5% percent sodium hypochlorite in endodontic therapy. Oral Surg Oral Med Oral Pathol 53: 307–12, 1983.

30. Byström A, Sundqvist G. The antibacterial action of sodium hypochlorite and EDTA in 60 cases of endodontic therapy. Int Endod J 18: 35–40, 1985.

31. Siqueira JF Jr, Machado AG, Silveira RM, Lopes HP, Uzeda M. Evaluation of effectiveness of sodium hypochlorite used with three irrigation methods in the elimination of Enterococcus fae-calis from the root canal, in vitro. Int Endod J 30: 279–82, 1997.

32. Molander A, Reit C, Dahlen G, Kvist T. Microbiological status of root-filled teeth with apical periodontitis. Int Endod J 31: 1–7, 1998.

33. Sundqvist G. Associations between microbial species in dental root canal infections. Oral Microbiol Immunol 7: 257–262, 1992.

34. Sundqvist G, Figdor D, Persson S, Sjögren U. Microbiologic analysis of teeth with failed endodontic treatment and the out-come of conservative re-treatment. Oral Surg Oral Med Oral Pathol 85: 86–93, 1998.

35. Haapasalo M, Østravik D. In vitro infection and disinfection of dentinal tubules. J Dent Res 66: 1375–9, 1987.

36. Heiling I, Steinberg D, Kenig S, Gavrilovich I, Sela MN, Friedman M. Efficacy of a sustained-release device containing chlorhexidine and Ca(OH)2 in preventing secondary infection of dentinal tubules. Int Endod J 25: 20–4, 1992.

37. Basrani B, Tjäderhane L, Santos JM, Pascon E, Grad H, Lawrence HP, et al. Efficacy of chlorhexidine-and calcium hydroxide-containing medicaments against Enterococcus fae-calis in vitro. Oral Surg Oral Med Oral Pathol 96: 618–24, 2003.

38. Haapasalo HK, Siren EK, Waltimo TMT, Østravik D, Haapasalo MPP. Inactivation of local root canal medicaments by dentine: an in vitro study. Int Endod J 33: 126–31, 2000.

39. Delany GM, Patterson SS, Miller CH, Newton CW. The effect of chlorhexidine gluconate irrigation on the root canal flora of freshly extracted necrotic teeth. Oral Surg Oral Med Oral Pathol 53: 518–23, 1982.

40. Barbosa CAM, Gonc˛ alves RB, Siqueira FE jr, Uzeda M. Evaluation of the antibacterial activities of calcium hydroxide antibacterial, chlorhexidine, and camphorated paramono-chlorophenol as intracanal medicament. A clinical and laborato-ry study. J Endod 23: 297–300, 1997.