ORIGINAL ARTICLE

 

Antimicrobial activity of chlorhexidine in root canals instrumented with the ProTaper Universal^TM System

 

 

Andréa Cruz Câmara^I; Miracy Muniz de Albuquerque^II; Carlos Menezes Aguiar^III; Ana Cristina Regis de Barros Correia^IV

^IPhD Student in Pharmaceutical Sciences, Department of Pharmaceutical Sciences, School of Pharmaceutical Sciences, Federal University of Pernambuco, Brazil
^IIAssociate Professor, Department of Pharmaceutical Sciences, School of Pharmaceutical Sciences, Federal University of Pernambuco, Brazil
^IIIAssociate Professor, Department of Prosthodontics and Oral and Maxillofacial Surgery, Dental School, Federal University of Pernambuco, Brazil
^IVMSc Student in Fungal Biology, Department of Pharmaceutical Sciences, Federal University of Pernambuco, Brazil

Correspondence to

 

 

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ABSTRACT

AIM: The purpose of the present study was to evaluate the antimicrobial activity of 0.2%, 1%, and 2% chlorhexidine in root canals instrumented with the ProTaper Universal^TM system.
METHODS: Fifty human mandibular premolar teeth were infected with a mixture of Candida albicans, Pseudomonas aeruginosa, Enterococcus faecalis and Staphylococcus aureus. The specimens were randomly divided into 5 groups with 10 root canals according to the irrigant used. All root canals were instrumented with the ProTaper Universal^TM system. Assessment of the antimicrobial action of the irrigant was performed before, during, and after instrumentation. Data were analyzed statistically by Chi-squared test and the Fisher exact test at 5% significance level.
RESULTS: The 0.2% chlorhexidine solution was ineffective against all test microorganisms. The 1% chlorhexidine solution was effective in eliminating P. aeruginosa and C. albicans after the use of the F1 and F3 instruments, respectively. The 2% chlorhexidine solution was effective at killing S. aureus, P. aeruginosa and C. albicans after the use of the S1 instrument. There were statistically significant differences (p<0.05) between the concentrations of chlorhexidine and the instruments used.
CONCLUSIONS: The 0.2% chlorhexidine solution in combination with rotary instrumentation was ineffective against all test microorganisms. The 1% chlorhexidine solution was ineffective against S. aureus and E. faecalis. The 2% chlorhexidine solution was not sufficient to inactivate E. faecalis.

Keywords: antimicrobial activity, chlorhexidine, ProTaper Universal^TM, root canal irrigant, rotary instrumentation.

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Acknowledgments

This study was supported by grants from Coordenação de Aperfeiçoamento de Pessoal de Nível Superior CAPES - Brazil.

 

References

1. Siqueira Júnior JF, Rôças IN. Clinical implications and microbiology of bacterial persistence after treatment procedures. J Endod. 2008; 34: 1291-1301.         [ Links ]

2. Vianna ME, Gomes BPFA. Efficacy of sodium hypochlorite combined with chlorhexidine against Enterococcus faecalis in vitro. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009; 107: 585-9.         [ Links ]

3. Tirali RE, Turan Y, Akal N, Karahan ZC. In vitro antimicrobial activity of several concentrations of NaOCl and Octenisept in elimination of endodontic pathogens. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009; 108: e117-20.         [ Links ]

4. Pelka M, Petschelt A. Permanent mimic musculature and nerve damage caused by sodium hypochlorite: a case report. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008; 106: e80-3.         [ Links ]

5. Lee JK, Baik JE, Yun CH, Lee K, Han SH, Lee W, et al. Chlorhexidine gluconate attenuates the ability of lipoteichoic acid from Enterococcus faecalis to stimulate toll-like receptor 2. J Endod. 2009; 35: 212-5.         [ Links ]

6. Williamson AE, Cardon JW, Drake DR. Antimicrobial susceptibility of monoculture biofilms of a clinical isolate of Enterococcus faecalis. J Endod. 2009; 35: 95-7.         [ Links ]

7. Athanassiadis B, Abbot PV, Walsh LJ. The use of calcium hydroxide, antibiotics and biocides as antimicrobial medicaments in endodontics. Aust Dent J. 2007; 52: S64-82.         [ Links ]

8. Câmara AC, Aguiar CM, Figueiredo JAP de. Assessment of the deviation after biomechanical preparation of the coronal, middle, and apical thirds of root canals instrumented with three Hero rotary systems. J Endod. 2007; 33: 1460-3.         [ Links ]

9. Aguiar CM, Câmara AC. Radiological evaluation of the morphological changes of root canals shaped with ProTaper^TM for hand use and the ProTaper^TM and RaCe^TM rotary instruments. Aust Endod J. 2008; 34: 115-9.         [ Links ]

10. Aguiar CM, Mendes D de A, Câmara AC, Figueiredo JAP de. Evaluation of the centreing ability of the ProTaper Universal? rotary system in curved roots in comparison to Nitiflex? files. Aust Endod J. 2009; 35: 174-9.         [ Links ]

11. Vaudt J, Bitter K, Neumann K, Kielbassa AM. Ex vivo study on root canal instrumentation of two rotary nickel-titanium systems in comparison to stainless steel hand instruments. Int Endod J. 2009; 42: 22-3.         [ Links ]

12. Câmara AC, Albuquerque MM de, Aguiar CA, Correia ACR de B. In Vitro Antimicrobial Activity of 0.5%, 1%, and 2.5% sodium hypochlorite in Root Canals Instrumented with the ProTaper Universal^TM System. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009; 108: e55-61.         [ Links ]

13. Mercade M, Duran-Sindreu F, Kuttler S, Roig M, Durany N. Antimicrobial efficacy of 4.2% sodium hypochlorite adjusted to pH 12, 7.5, and 6.5 in infected human root canals. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009; 107: 295-8.         [ Links ]

14. Paz LEC de, Bergenholtz G, Svensäter G. The effects of antimicrobials on endodontic biofilm bacteria. J Endod. 2010; 36: 70-7.         [ Links ]

15. Prabhakar J, Senthilkumar M, Priya MS, Mahalakshmi K, Sehgal PK, Sukumaran VG. Evaluation of antimicrobial efficacy of herbal alternatives (triphala and green tea polyphenols), MTAD, and 5% sodium hypochlorite against Enterococcus faecalis biofilm formed on tooth substrate: an in vitro study. J Endod. 2010; 36: 83-6.         [ Links ]

16. Arias-Moliz MT, Ferrer-Luque CM, González-Rodríguez MP, Valderrama MJ, Baca P. Eradication of Enterococcus faecalis biofilms by cetrimide and Chlorhexidine. J Endod. 2010; 36: 87-90.         [ Links ]

17. Aubut V, Pommel L, Verhille B, Orsière T, Garcia S, About I, Camps J. Biological properties of a neutralized 2.5% sodium hypochlorite solution. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010; 109: e120-5.         [ Links ]

18. Zehnder M. Root canal irrigants. J Endod 2006; 32: 389-98.         [ Links ]

19. Siqueira Júnior JF, Rôças IN, Paiva SSM, Guimarães-Pinto T, Magalhães KM, Lima KC. Bacteriologic investigation of the effects of sodium hypochlorite and chlorhexidine during the endodontic treatment of teeth with apical periodontitis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007; 104: 122-30.         [ Links ]

20. Vianna ME, Gomes BPFA, Berber VB, Zaia, AA, Ferraz CCR, Souza-Filho FJ de. In vitro evaluation of the antimicrobial activity of chlorhexidine and sodium hypochlorite. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004; 97: 79-84.         [ Links ]

21. Ohara P, Torabinejad M, Kettenring JD. Antibacterial effects of various endodontic irrigants on selected anaerobic bacteria. Endod Dent Traumatol. 1993; 9: 95-100.         [ Links ]

22. D'Arcangelo C, Varvara G, De Fazio P. An evaluation of the action of different root canal irrigants on facultative aerobic-anaerobic, obligate anaerobic, and microaerophilic bacteria. J Endod. 1999; 253: 351-3.         [ Links ]

23. Sassone LM, Fidel R, Fidel S, Vieira M, Hirata Júnior R. The influence of organic load on the antimicrobial activity of different concentrations of NaOCl and chlorhexidine in vitro. Int Endod J. 2003; 36: 848-52.         [ Links ]

24. Ruff ML, McClanahan SB, Babel BS. In vitro antifungal efficacy of four irrigants as a final rinse. J Endod. 2006; 32: 331-3.         [ Links ]

25. Huth KC, Quirling M, Maier S, Kamereck K, Alkhayer M, Paschos E, et al. Effectiveness of ozone against endodontopathogenic microorganisms in a root canal biofilm model. Int Endod J. 2009; 42: 3-13.         [ Links ]

26. Gomes BPFA, Ferraz CCR, Vianna ME, Berber VB, Teixeira FB, Souza-Filho FJ. In vitro antimicrobial activity of several concentrations of sodium hypochlorite and chlorhexidine gluconate in the elimination of Enterococcus faecalis. Int Endod J. 2001; 34: 424-8.         [ Links ]

27. Berber VB, Gomes BPFA, Sena NT, Vianna ME, Ferraz CCR, Zaia AA, et al. Efficacy of various concentrations of NaOCl and instrumentation techniques in reducing Enterococcus faecalis within root canals and dentinal tubules Int Endod J. 2006; 39: 10-7.         [ Links ]

28. Rollison S, Barnett F, Stevens RH. Efficacy of bacterial removal from instrumented root canal in vitro related to instrumentation technique and size. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002; 94: 366-71.         [ Links ]

29. Chuste-Guillot MP, Badet C, Peli JF, Perez F. Effect of three nickel-titanium rotary file techniques on infected root dentin reduction. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006; 102: 254-8.         [ Links ]

30. Khademi A, Yazdizadeh M, Feizianfard M. Determination of the minimum instrumentation size for penetration of irrigants to the apical third of root canal systems. J Endod. 2006; 32: 417-20.         [ Links ]

 

 

Correspondence to:
Andréa Cruz Câmara
Rua Nadir de Medeiros, 51, Piedade, Jaboatão dos Guararapes PE 54410-110 Brasil.
Phone: (+55) 81 3361 5269.
E-mail: andreaccam@yahoo.com.br

Received for publication: May 26, 2010
Accepted: August 27, 2010