Effectiveness of Root Canal Debris Removal Using Passive Ultrasound Irrigation with Chlorhexidine Digluconate or Sodium Hypochlorite Individually or in Combination as Irrigants
Citation Information :
Ferreira RB, Marchesan MA, Silva-Sousa YT, Sousa-Neto M. Effectiveness of Root Canal Debris Removal Using Passive Ultrasound Irrigation with Chlorhexidine Digluconate or Sodium Hypochlorite Individually or in Combination as Irrigants. J Contemp Dent Pract 2008; 9 (5):68-75.
The aim of this in vitro study was to evaluate the cleaning capacity of different auxiliary chemical substances energized with ultrasound in radicular dentin using morphologic analysis.
Methods and Materials
Twenty-eight single-canal, mandibular incisors were prepared with the Hero 642 canal preparation system following the sequence: 25/12, 30/06, 35/02, and 40/02, 1 mm from the apex. The specimens were then divided into four groups of seven teeth. During biomechanical preparation the teeth were irrigated with 2 ml of distilled water between files. Each group of specimens (n=7) received a final irrigation with 100 ml of the following irrigants that were activated with ultrasound for 3 minutes: Group 1- distilled water; Group 2- 0.2% chlorhexidine digluconate (CHX); Group 3- 2.5% sodium hypochlorite (NaOCl); and Group 4-the filtrate obtained after combining 0.2% CHX and 2.5% NaOCl. The apical portions of the root canals from each group were then submitted to histological processing and analyzed using optical microscopy.
Results
Results showed statistical differences between the groups (p<0.01). Groups 1 and 2 (distilled water and 0.2% CHX respectively) were statistically similar in terms of a greater amount of debris, whereas 2.5% NaOCl and the filtrate were more efficient in removal of debris.
Conclusion
There is no additional benefit in terms of debris removal from root canal walls by irrigating with the filtrate obtained from the combination of NaOCl and CHX when compared to using NaOCl alone.
Clinical Significance
The findings of this study suggest the time and expense of preparing and using a combination of NaOCl and CHX is not warranted compared to using NaOCl alone for root canal irrigation.
Citation
Ferreira RB, Marchesan MA, Silva-Sousa YT, Sousa-Neto M. Effectiveness of Root Canal Debris Removal Using Passive Ultrasound Irrigation with Chlorhexidine Digluconate or Sodium Hypochlorite Individually or in Combination as Irrigants. J Contemp Dent Pract 2008 July; (9)5:068-075.
Effects of mechanical and chemical procedures on root canal surfaces. Endod Topics. 2005 10:103-22.
Solvent action of sodium hypochlorite on bovine pulp and physico-chemical properties of resulting liquid. Braz Dent J. 2001 12:154-7.
The effects of temperature on sodium hypochlorite short-term stability, pulp dissolution capacity, and antimicrobial efficacy. J Endod. 2005 31:669-71.
Review: the use of sodium hypochlorite in endodontics- potential complications and their management Brit Dent J. 2007 9(12):555-59.
The importance of irrigation in endodontics. Contemp Endod. 2004 1:3-7.
In vitro evaluation of the antimicrobial activity of chlorhexidine and sodium hypochlorite. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004 97:79-84.
In vitro assessment of the immediate and prolonged antimicrobial action of chlorhexidine gel as an endodontic irrigant against Enterococcus faecalis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005 99:768-72.
Root canal irrigants. J Endod. 2006 32:389-98.
The effect of chlorhexidine as an endodontic disinfectant. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003 96:578-81.
Antibacterial effects of various endodontic medicaments on selected anaerobic bacteria. J Endod. 1993 19:498-500.
Antimicrobial and toxic effects of established and potential root canal irrigants. J Endod. 1995 21:513-5.
Intracanal medicaments: evaluation of the antibacterial effects of chlorhexidine, metronidazole, and calcium hydroxide associated with three vehicles. J Endod. 1997 23:167-9.
Chlorhexidine gluconate. Aust Endod J. 2005 31:48-52.
Efficacy of chlorhexidine in disinfecting dentinal tubules in vitro. Endod Dent Traumatol. 1993 9:243-8.
Antimicrobial effect of irrigant combinations within dentinal tubules. Int Endod J. 1998 31:8-14.
Antimicrobial activity of 2.5% sodium hypochlorite and 0.2% chlorhexidine gluconate separately and combined, endodontic irrigants. J Endod. 1998 24:472-76.
A comparison of the cleaning efficacy of short-term sonic and ultrasonic passive irrigation after hand instrumentation in mesio root canals. J Endod. 2003 29(10):674-78.
In vivo debridament efficacy of ultrasonic irrigation following hand-rotary instrumentation in human mandibular molars. J Endod. 2005 31(3):166-70.
A scanning electron microscope evaluation of root canal debriment with the endosonic ultrasonic synergistic system. Oral Surg Oral Med Oral Pathol. 1982 53(1):527-31.
Passive ultrasonic irrigation of the root canal: a review of the literature. Int Endod J. 2007 40(6):415-26.
Comparison of passive ultrasonic debridement between fluted and nonfluted instruments in root canals. J Endod. 2007 33(5):578-80.
Effectiveness of manual and rotatory instrumentation techniques for cleaning flattened root canals. J Endod. 2002 28(5):365-66.
The Effectiveness of Three Instrumentation Techniques on the Elimination of Enterococcus Faecalis from a Root Canal: An In Vitro Study. J Contemp Dent Pract. 2005 (6)1:94-106.
Effects of various irrigating solutions on the cleaning of root canal with ultrasonic instrumentation. Braz Dent J. 1990 1(1):37-44.
Effects of rotary instruments and ultrasonic irrigation on debris and smear layer scores: a scanning electron microscopic study. Int Endod J. 2002 35(7):582-89.
Histological analysis of the cleaning capacity of niquel-titanium rotatory instrumentation with ultrasonic irrigation in root canals. Aust Endod J. 2004 30(2):56-58.
In vivo debridament efficacy of ultrasonic irrigation following hand-rotary instrumentation in human mandibular molars. J Endod. 2005 31(3):166-70.
In vitro evaluation of endodontic debris removal as obtained by rotary instrumentation coupled with ultrasonic irrigation. Aust Endod J. 2006 32(3):123-28.
The effect of passive ultrasonic activation of 2% chlorhexidine or 5.25% sodium hypochlorite irrigant on residual on residual antimicrobial activity in root canals. J. Endod. 2003 29(9):562-64.
The use of ultrasonics in the removal of smear layer: a scanning electron microscope study. J Endod. 1983 9(7):289-92.
Influence of Passive Ultrasonic Activation on the Penetration Depth of Different Sealers. J Contemp Dent Pract. 2004 (5)1:115-25.
Dissolution of pulp tissue by aqueous solution of chlorhexidine digluconate and chlorhexidine digluconate gel. Int Endod J. 2004 37(1):38-41.
Soft Tissue Dissolution Capacity of Currently Used and Potencial Endodontic Irrigants. J Endod. 2004 30(11):785-87.
Chemical analysis of the flocculate formed by the association of sodium hypochlorite and chlorhexidine. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007 103(5):e103-5.