Effectiveness of a calcium hydroxide and chlorhexidine digluconate mixture as disinfectant during retreatment of failed endodontic cases

Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005 Dec;100(6):756-61. doi: 10.1016/j.tripleo.2005.05.072. Epub 2005 Oct 12.

Abstract

Objective: The purpose of this in vivo investigation is to compare the effect of a slurry of Ca(OH)2 mixed in aqueous 2% chlorhexidine (CHX) versus aqueous Ca(OH)2 slurry alone on the disinfection of the pulp space of failed root-filled teeth during endodontic retreatment.

Study design: Forty single-rooted previously root-filled teeth with associated periradicular lesions were included. The teeth were nonsurgically retreated and medicated over 3 treatment visits with 7-10-day intervals with either Ca(OH)2 in water or Ca(OH)2 in 2% aqueous CHX. Root canal cultures were collected in fluid thioglycollate, and bacterial growth was assessed by turbidity daily for 1 week, then weekly for an additional 3 weeks. The presence of enterococci in the root canals at the initial treatment session was determined.

Results: Of the total sample population, 12 of 40 (30%) were positive for bacteria before root filling. The control medication disinfected 12 of 20 (60%) teeth including 2 of 4 teeth originally diagnosed with enterococci. The experimental medication resulted in disinfected 16 of 20 (80%) teeth at the beginning of the third appointment. None of the teeth originally containing enterococci showed remaining growth. This difference between the overall positive cultures was not statistically significant (P > .05).

Conclusions: Canal dressing with a mixture of 2% CHX and Ca(OH)2 slurry is as efficacious as aqueous Ca(OH)2 on the disinfection of failed root-filled teeth.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anti-Infective Agents, Local / pharmacology*
  • Calcium Hydroxide / pharmacology*
  • Chlorhexidine / analogs & derivatives*
  • Chlorhexidine / pharmacology
  • Dental Pulp Cavity / microbiology
  • Dental Restoration Failure*
  • Enterococcus faecalis / drug effects
  • Humans
  • Periapical Periodontitis / therapy
  • Retreatment
  • Root Canal Irrigants / pharmacology*
  • Root Canal Therapy*
  • Single-Blind Method

Substances

  • Anti-Infective Agents, Local
  • Root Canal Irrigants
  • chlorhexidine gluconate
  • Calcium Hydroxide
  • Chlorhexidine