Antibacterial Effect of Metronidazole vs Chlorhexidine Solutions in Treatment of Root Canals of Primary Anterior Teeth
Ibrahim Barakat, Mohamed A Elpatal, AlWaleed Abushanan, Bahaa Eldin Anwar Abd elrady
Chlorhexidine, Dental caries, E. faecalis, Metronidazole, Pulpectomy
Citation Information :
Barakat I, Elpatal MA, Abushanan A, Abd elrady BE. Antibacterial Effect of Metronidazole vs Chlorhexidine Solutions in Treatment of Root Canals of Primary Anterior Teeth. J Contemp Dent Pract 2020; 21 (4):396-399.
The aim of this study was to evaluate and compare the antibacterial effect of 0.5% metronidazole, 2% chlorhexidine, and normal saline irrigant solutions against Enterococcus faecalis bacteria in the treatment of root canals of primary anterior teeth. Materials and methods: This study was carried out on sixty nonvital primary anterior teeth of Egyptian children diagnosed with ECC. These teeth were classified equally into three groups according to irrigation materials. A fresh sample was collected from each root canal after access opening before and 3 days after irrigation with the help of a paper point. The number of organisms (E. faecalis) before and after irrigation was compared for each group. Results: The bacterial count of E. faecalis was decreased in all groups however, these differences were statistically insignificant where (p <0.05). Conclusion: Both 0.5% metronidazole and 2.0% chlorhexidine appeared to be superior against E. faecalis bacteria as endodontic irrigants in pulpectomy anterior primary teeth with higher antibacterial efficacy compared to saline. Clinical significance: The success of endodontic treatment depends on the removal of microbes, from the root canals and avoidance of reinfection thus; this study provides an insight on the effects of different irrigant solutions to further help dental practitioners in the endodontic management of primary dentition.
Schilder H. Cleaning and shaping the root canal. Dent Clin North Am 1974;18:269–296.
Gao Y, Fan B, Cheung GS, et al. C-shaped canal system in mandibular second molars part IV: 3-D morphological analysis and transverse measurement. J Endod 2006;32(11):1062–1065. DOI: 10.1016/j.joen.2006.05.014.
Leonardo M, Tanomaru Filho M, Nelson Filho P, et al. In vivo antimicrobial activity of 2% chlorhexidine used as a root canal irrigating solution. J Endod 1999;25(3):167–171. DOI: 10.1016/S0099-2399(99)80135-6.
Peters OA, Roehlike JO, Baumann MA. Effect of immersion in sodium hypochlorite on torque and fatigue resistance of nickeltitanium instruments. J Endod 2007;33(5):589–593. DOI: 10.1016/j.joen.2007.01.007.
Hong S-T, Bae K-S, Baek S-H, et al. Effects of root canal irrigants on the push-out strength and hydration behavior of accelerated mineral trioxide aggregate in its early setting phase. J Endod 2010;36(12):1995–1999. DOI: 10.1016/j.joen.2010.08.039.
Mitchell D. Metronidazole: Its use in clinical dentistry. J Clin Periodontol 1984;11(3):145–158. DOI: 10.1111/j.1600-051X.1984. tb01318.x.
Marsh P, Martin M. Oral Microbiology 1999 4th ed., Oxford: Wright; 1999.
Anargyros P, Astill D, Lim I. Comparison of improved BACTEC and Lowenstein-Jensen media for culture of mycobacteria fromclinical specimens. J Clin Microbiol 1990 Jun;28(6):1288–1291.
Dentistry AAOP. Symposium on the prevention of oral disease in children and adolescents. Chicago, Ill; November 11-12, 2005: conference papers. Pediatr Dent 2006;28(2):96–198.
DiAngelis AJ, Andreasen JO, Ebeleseder KA, et al. International association of dental traumatology guidelines for the management of traumatic dental injuries: 1. Fractures and luxations of permanent teeth. Dent Traumatol 2012;28(1):2–12. DOI: 10.1111/j.1600-9657.2011.01103.x.
Zamany A, Safavi K, Spångberg LS. The effect of chlorhexidine as an endodontic disinfectant. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2003;96(5):578–581. DOI: 10.1016/S1079-2104(03) 00168-9.
Knöfler G, Purschwitz R, Jentsch H, et al. Gingival crevicular fluid levels of aspartate aminotransferase and alpha 2 macroglobulin before and after topical application of metronidazole or scaling and root planing. Quintessence Int 2008;39(5):381–389.
Keller U, Hibst R. Wirkungsweise und indikationen des er: YAG lasers in der Zahn-Mund-und Kieferheilkunde. Magazin für ZMK 1992;4: 6–10.
Önçağ Ö, Hoşgör M, Hilmioğlu S, et al. Comparison of antibacterial and toxic effects of various root canal irrigants. Int Endod J 2003;36(6):423–432. DOI: 10.1046/j.1365-2591.2003.00673.x.
Gardner TB, Hill DR. Treatment of giardiasis. Clin Microbiol Rev 2001;14(1):114–128. DOI: 10.1128/CMR.14.1.114-128.2001.
Gaetti-Jardim EC, Marqueti AC, Faverani LP, et al. Antimicrobial resistance of aerobes and facultative anaerobes isolated from the oral cavity. J Appl Oral Sci 2010;18(6):551–559. DOI: 10.1590/S1678-77572010000600004.
Andrade C, Bustamante D, Cabrera OFG, et al. Comparación entre clorhexidina e hipoclorito de sodio como soluciones desinfectantes en la práctica endodóntica. Revista Kiru 2017;14(1).
Mohammadi Z, Abbott PV. Antimicrobial substantivity of root canal irrigants and medicaments: A review. Aust Endod J 2009;35(3): 131–139. DOI: 10.1111/j.1747-4477.2009.00164.x.
Sassone LM, Fidel RAS, Fidel SR, et al. Antimicrobial activity of different concentrations of NaOCl and chlorhexidine using a contact test. Braz Dent J 2003;14(2):99–102. DOI: 10.1590/S0103-64402003000200005.
Menezes M, Valera M, Jorge A, et al. In vitro evaluation of the effectiveness of irrigants and intracanal medicaments on microorganisms within root canals. Int Endod J 2004;37(5):311–319. DOI: 10.1111/j.0143-2885.2004.00799.x.
Siqueira JF, Paiva SS, Rôças IN. Reduction in the cultivable bacterial populations in infected root canals by a chlorhexidine-based antimicrobial protocol. J Endod 2007;33(5):541–547. DOI: 10.1016/j.joen.2007.01.008.
Shen Y, Stojicic S, Haapasalo M. Antimicrobial efficacy of chlorhexidine against bacteria in biofilms at different stages of development. J Endod 2011;37(5):657–661. DOI: 10.1016/j.joen.2011.02.007.
Hoshino E, Iwaku M, Sato M, et al. Bactericidal efficacy of metronidazole against bacteria of human carious dentin in vivo. Caries Res 1989;23(2):78–80. DOI: 10.1159/000261161.
Sato T, Hoshino E, Uematsu H, et al. Bactericidal efficacy of a mixture of ciprofloxacin, metronidazole, minocycline and rifampicin against bacteria of carious and endodontic lesions of human deciduous teeth in vitro. Microb Ecol Health Dis 1992;5(4):171–177. DOI: 10.3109/08910609209141583.
Gajan EB, Aghazadeh M, Abashov R, et al. Microbial flora of root canals of pulpally-infected teeth: enterococcus faecalis a Prevalent species. J Dent Res Dent Clin Dent Prospects 2009;3(1):24–27. DOI: 10.5681/joddd.2009.007.