Antibacterial effects of chemomechanical instrumentation and calcium hydroxide in primary teeth with pulp necrosis

Pediatr Dent. 2011 Jul-Aug;33(4):307-11.

Abstract

Purpose: This study's purposes were to: evaluate the antibacterial effect of chemomechanical instrumentation and a calcium hydroxide-based dressing in primary teeth with pulp necrosis secondary to trauma; and detect the presence of Fusobacterium nucleatum and black-pigmented rods in the canals of these teeth.

Methods: Microbiological sample collections (MSCs) were obtained: after coronal access to the canals of primary incisors (in 18 teeth; MSC 1); after chemomechanical instrumentation (in 10 teeth; MSC 2); and 72 hours after removal of intracanal medication (in 18 teeth; MSC 3). These samples were sent for microbiological processing. The results were analyzed statistically via chi-square, analysis of variance, and Games-Howell tests (P<.05).

Results: Micro-organisms were isolated in approximately 94%, 10%, and 83% of canals, respectively, in MSCs 1, 2, and 3. There was a statistically significant difference only between MSCs 1 and 2 (P<.03). F nucleatum and black-pigmented rods were detected in approximately 56% and 11% of canals in MSC 1, respectively.

Conclusion: Chemomechanical instrumentation and calcium hydroxide-based dressing have an anti-bacterial effect by significantly reducing the number of micro-organisms in the main root canal. They showed a limited efficacy, however, and did not prevent bacterial regrowth after endodontic therapy in primary teeth with pulp necrosis secondary to trauma.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Analysis of Variance
  • Anti-Infective Agents, Local / pharmacology*
  • Calcium Hydroxide / pharmacology*
  • Child
  • Child, Preschool
  • Chlorhexidine / pharmacology
  • Cross-Sectional Studies
  • Dental Pulp Necrosis / etiology
  • Dental Pulp Necrosis / microbiology*
  • Dental Pulp Necrosis / therapy
  • Female
  • Fusobacterium nucleatum / drug effects*
  • Gram-Negative Anaerobic Straight, Curved, and Helical Rods / drug effects*
  • Humans
  • Male
  • Root Canal Irrigants / pharmacology*
  • Root Canal Preparation / instrumentation
  • Root Canal Preparation / methods*
  • Sodium Hypochlorite / pharmacology
  • Statistics, Nonparametric
  • Tooth Injuries / complications
  • Tooth, Deciduous

Substances

  • Anti-Infective Agents, Local
  • Root Canal Irrigants
  • Sodium Hypochlorite
  • Calcium Hydroxide
  • Chlorhexidine