Gonçalves Lucio Souza, Rodrigues Renata Costa Val, Andrade Junior Carlos Vieira, Soares Renata G, Vettore Mario Vianna
Faculty of Dentistry, Estácio de Sá University, Rio de Janeiro, Rio de Janeiro, Brazil.
Faculty of Dentistry, Estácio de Sá University, Rio de Janeiro, Rio de Janeiro, Brazil; Department of Endodontics, Faculty of Dentistry, Veiga de Almeida University, Rio de Janeiro, Rio de Janeiro, Brazil.
J Endod. 2016 Apr;42(4):527-32. doi: 10.1016/j.joen.2015.12.021. Epub 2016 Feb 4.
This systematic review aimed to compare the effectiveness of sodium hypochlorite and chlorhexidine for root canal disinfection during root canal therapy.
A literature search for clinical trials was made on the PubMed (MEDLINE), Web of Knowledge, SCOPUS, and Science Direct databases and in the reference lists of the identified articles up to January 2015. Quality assessment of the selected studies was performed according to the Consolidated Standards of Reporting Trials statement.
One clinical trial and 4 randomized clinical trials were selected from the 172 articles initially identified. There was heterogeneity in the laboratory methods used to assess the root canal disinfection as well as in the concentrations of the irrigants used. Therefore, meta-analysis was not performed. Two studies reported effective and similar reductions in bacterial levels for both irrigants. Sodium hypochlorite was more effective than chlorhexidine in reducing microorganisms in 1 study, and another reported opposite findings. Both root irrigants were ineffective in eliminating endotoxins from necrotic pulp root canals in 1 study. Trial design and information regarding randomization procedures were not clearly described in the clinical trials. No study compared laboratory results with clinical outcomes.
The available evidence on this topic is scarce, and the findings of studies were not consistent. Additional randomized clinical trials using clinical outcomes to compare the use of sodium hypochlorite and chlorhexidine during root canal therapy are needed.
本系统评价旨在比较次氯酸钠和氯己定在根管治疗期间用于根管消毒的有效性。
在PubMed（MEDLINE）、Web of Knowledge、SCOPUS和Science Direct数据库以及截至2015年1月已识别文章的参考文献列表中进行了临床试验的文献检索。根据报告试验的统一标准声明对所选研究进行质量评估。
从最初识别的172篇文章中选择了1项临床试验和4项随机临床试验。用于评估根管消毒的实验室方法以及所用冲洗剂的浓度存在异质性。因此，未进行荟萃分析。两项研究报告了两种冲洗剂在细菌水平降低方面均有效且相似。在1项研究中，次氯酸钠在减少微生物方面比氯己定更有效，而另一项研究报告了相反的结果。在1项研究中，两种根管冲洗剂在消除坏死牙髓根管内的内毒素方面均无效。临床试验中未清楚描述试验设计和随机程序的相关信息。没有研究将实验室结果与临床结果进行比较。
关于该主题的现有证据很少，且研究结果不一致。需要更多使用临床结果来比较根管治疗期间次氯酸钠和氯己定使用情况的随机临床试验。
