Department of Dental Research, Faculty of Dentistry, Iguaçu University (UNIG), Nova Iguaçu, RJ, Brazil; Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, RJ, Brazil.
Department of Dental Research, Faculty of Dentistry, Iguaçu University (UNIG), Nova Iguaçu, RJ, Brazil; Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, RJ, Brazil.
J Endod. 2023 Jan;49(1):55-61. doi: 10.1016/j.joen.2022.10.008. Epub 2022 Oct 26.
This clinical study evaluated the antibacterial effects of calcium hydroxide associated with different vehicles during the treatment of infected teeth with apical periodontitis.
Bacteriologic samples were taken from 90 necrotic root canals of teeth with apical periodontitis before (S1) and after preparation with a rotary nickel-titanium instrument system and 2.5% sodium hypochlorite irrigation (S2). The teeth were distributed in 3 groups according to the intracanal medication used, which consisted of a calcium hydroxide paste in glycerin, camphorated paramonochlorophenol/glycerin (CHPG), or 2% chlorhexidine for 1 week, and then another sample was taken (S3). The frequency of bacteria-positive cases and the reduction of bacterial counts were evaluated by quantitative real-time polymerase chain reaction.
Substantial intracanal bacterial reduction was observed after preparation in the 3 groups (P < .001). After calcium hydroxide paste in glycerin medication, the number of bacteria-positive cases decreased from 20/29 (69%) to 17/29 (59%); however, the mean bacterial counts increased 8.4% from S2 to S3. Medication with CHPG reduced the number of bacteria-positive cases from 17/29 (59%) to 15/29 (52%), with a significant mean S2-S3 reduction of 71% (P < .05). In the chlorhexidine group, the number of bacteria-positive cases decreased from 21/30 (70%) to 17/30 (57%) after medication, with a mean S2-S3 reduction of 55%, which, however, was not statistically significant (P > .05). Intergroup comparisons showed no significant differences (P > .05).
Comparison between the 3 calcium hydroxide pastes showed no significant differences in antibacterial effectiveness in the main root canal. However, only the CHPG paste showed a significant reduction in bacterial counts when postpreparation and postmedication samples were compared.
本临床研究评估了氢氧化钙在治疗伴有根尖周炎的感染牙齿时，与不同载体联合使用的抗菌效果。
在使用旋转镍钛器械系统和 2.5%次氯酸钠冲洗根管预备后（S1），从 90 颗患有根尖周炎的坏死根管中采集细菌样本，然后在根管内使用氢氧化钙糊剂（CHPG）、樟脑对氯苯酚/甘油（CHPG）或 2%氯己定进行 1 周治疗，然后再次采集样本（S2）。采用实时定量聚合酶链反应（PCR）评估细菌阳性病例的频率和细菌计数的减少情况。
3 组根管预备后均观察到大量的根管内细菌减少（P <.001）。在使用甘油氢氧化钙糊剂治疗后，细菌阳性病例数量从 20/29（69%）减少至 17/29（59%）；然而，从 S2 到 S3，细菌计数增加了 8.4%。使用 CHPG 治疗后，细菌阳性病例数量从 17/29（59%）减少至 15/29（52%），S2-S3 减少的平均值具有统计学意义（71%）（P <.05）。在氯己定组中，用药后细菌阳性病例数量从 21/30（70%）减少至 17/30（57%），S2-S3 减少的平均值为 55%，但无统计学意义（P >.05）。组间比较无统计学差异（P >.05）。
3 种氢氧化钙糊剂之间的比较显示，在主根管内抗菌效果没有显著差异。然而，只有 CHPG 糊剂在比较预备后和用药后样本时显示出细菌计数的显著减少。
