International Journal of Clinical Pediatric Dentistry

Register      Login

SEARCH WITHIN CONTENT

FIND ARTICLE

Volume / Issue

Online First

Archive
Volume  17 (2024)
Volume  16 (2023)
Volume  15 (2022)
Volume  14 (2021)
Volume  13 (2020)
Volume  12 (2019)
Volume  11 (2018)
Volume  10 (2017)
Volume  9 (2016)
Volume  8 (2015)
Volume  7 (2014)
Volume  6 (2013)
Volume  5 (2012)
Volume  4 (2011)
Volume  3 (2010)
Volume  2 (2009)
Volume  1 (2008)
Related articles

VOLUME 16 , ISSUE 3 ( May-June, 2023 ) > List of Articles

ORIGINAL RESEARCH

Comparative Evaluation of Antimicrobial Efficacy of Calcium Hydroxide, Chlorhexidine, and Triple Antibiotic Paste in Different Combination Forms as Intracanal Medicaments against Enterococcus faecalis in Primary Teeth: An In Vivo Randomized Clinical Trial

Seema Qamar, Rashmi Jayanna, Vipin R Ahuja

Keywords : Antimicrobial efficacy, Calcium hydroxide, Enterococcus faecalis, Intracanal medicament, Triple antibiotic powder

Citation Information : Qamar S, Jayanna R, Ahuja VR. Comparative Evaluation of Antimicrobial Efficacy of Calcium Hydroxide, Chlorhexidine, and Triple Antibiotic Paste in Different Combination Forms as Intracanal Medicaments against Enterococcus faecalis in Primary Teeth: An In Vivo Randomized Clinical Trial. Int J Clin Pediatr Dent 2023; 16 (3):448-452.

DOI: 10.5005/jp-journals-10005-2599

License: CC BY-NC 4.0

Published Online: 03-07-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Abstract

Aim: To compare and evaluate the antimicrobial efficacy against Enterococcus faecalis (E. faecalis) between a mix of calcium hydroxide [Ca(OH)2] powder and normal saline, a mix of Ca(OH)2 powder and 2% chlorhexidine (CHX) gluconate solution, a mix of triple antibiotic powder (TAP) and normal saline, and mix of TAP and 2% CHX gluconate solution. Materials and methods: A total of 60 teeth were included in the study. The first sample (S1) was collected after access opening from the widest canal of the tooth by inserting sterile absorbable paper point no 20 up to the full length of the canal for 1 minute. The second sample (S2) was collected after the chemomechanical preparation and irrigation. After that, subjects were randomly divided into four groups—group I—a mix of Ca(OH)2 and normal saline; group II—a mix of Ca(OH)2 and 2% CHX; group III—a mix of TAP and normal saline; and group IV—a mix of TAP and 2% CHX. Assigned intracanal medicaments were placed in the canals, and the teeth were temporarily sealed with a temporary restorative material. On the 7th day, canals were reopened and irrigated, and a third bacteriological sample (S3) was taken out. Later, canals were filled with suitable obturating material, followed by the placement of the permanent restoration. Results: There was a very highly significant (p < 0.005) difference in E. faecalis count in all the groups on day 7 after placement of intracanal medicament, being highest in group IV followed by group II, group III, and group I. Conclusion: Triple antibiotic powder (TAP) mixed with 2% CHX gluconate solution has superior antimicrobial efficacy against E. faecalis in primary teeth.

HTML PDF Share
  1. Lele GS, Subba Reddy VV. Comparison of antibacterial efficacy of intracanal medicaments in multiple visit pulpectomies in primary molars-an in vivo study. J Indian Soc Pedod Prev Dent 2010;28(1):18–24. DOI: 10.4103/0970-4388.60482
  2. Delgado RJR, Gasparoto TH, Sipert CR, et al. Antimicrobial effects of calcium hydroxide and chlorhexidine on Enterococcus faecalis. J Endod 2010;36(8):1389–1393. DOI: 10.1016/j.joen.2010.04.013
  3. Stuart CH, Schwrtz SA, Beeson TJ, et al. Enterococcus faecalis: its role in root treatment failure and current concepts in retreatment. J Endod 2006;32(2): 93–98. DOI: 10.1016/j.joen.2005.10.049
  4. Sundqvist G, Figder D, Persson S, et al. Microbiologic analysis of teeth with failed endodontic treatment and the outcome of conservative re-treatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1998;85(1):86–93. DOI: 10.1016/s1079-2104(98)90404-8
  5. Soares JA, Leonardo MR, da Silva LA, et al. Elimination of intracanal infection in dog's teeth with induced periapical lesions after rotary instrumentation: influence of different calcium hydroxide pastes. J Appl Oral Sci 2006;14(3):172–177. DOI: 10.1590/s1678-77572006000300005
  6. Molander A, Reit C, Dahlen G, et al. Microbiological status of root-filled teeth with apical periodontitis. Int Endod J 1998;31(1):1–7. DOI: 10.1046/j.1365-2591.1998.00111.x
  7. Arslan H, Topcuoglu HS, Saygili G, et al. Effect of various intracanal medicaments on the bond strength of self-adhesive resin cement to root canal dentin. Acta Biomater Odontol Scand 2015;1(1):18–21. DOI: 10.3109/23337931.2015.1031764
  8. Sjogren U, Figdor D, Spangberg L, et al. The antimicrobial effect of Ca(OH)2 as a short-term intracanal dressing. Int Endod J 1991;24(3):119–125. DOI: 10.1111/j.1365-2591.1991.tb00117.x
  9. Tronstad L. Root resorption-etiology, terminology and clinical manifestations. Endod Dent Traumatol 1988;4(6):241–252. DOI: 10.1111/j.1600-9657.1988.tb00642.x
  10. Freeman B, Crapo J. Biology of diseases free radicals and tissue injury. Lab Invest 1982; 47(5):412–424.
  11. Evans MD, Baumgartner JC, Khemaleelakul SU, et al. Efficacy of calcium hydroxide: chlorhexidine paste as an intracanal medication in bovine dentin. J Endod 2003;29(5):338–339. DOI: 10.1097/00004770-200305000-00005
  12. Basrani B, Derhane LT, Santos JM, et al. Efficacy of chlorhexidine and calcium hydroxide containing medicaments against Enterococcus faecalis in vitro. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2003;96:618–624. DOI: 10.1016/s1079-2104(03)00166-5
  13. Gomes BP, Vianna ME, Sena NT, et al. In vitro evaluation of the antimicrobial activity of calcium hydroxide combined with chlorhexidine gel used as intracanal medicament. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006;102(4):544–550. DOI: 10.1016/j.tripleo.2006.04.010
  14. Oncag O, Cogulu D, Uzel A. Efficacy of various intracanal medicaments against Enterococcus faecalis in primary teeth: an in vivo study. J Clin Pediatr Dent 2006; 30(3): 233–237. DOI: 10.17796/jcpd.30.3.r773j6l674lw0268
  15. Hoshino E, Kurihara–Ando N, Sato I, et al. In–vitro antibacterial susceptibility of bacteria taken from infected root dentine to a mixture of ciprofloxacin, metronidazole and minocycline. Int Endod J 1996;29(2):125–130. DOI: 10.1111/j.1365-2591.1996.tb01173.x
  16. Sato I, Ando-Kurihara N, Kota K, et al. Sterilization of infected root-canal dentine by topical application of a mixture of ciprofloxacin, metronidazole and minocycline in situ. Int Endod J 1996;29(2):118–124. DOI: 10.1111/j.1365-2591.1996.tb01172.x
  17. Mozayeni MA, Haeri A, Dianat O, et al. Antimicrobial effects of four intracanal medicaments on Enterococcus faecalis: an in vitro study. Iran Endod J 2014;9(3):195–198.
  18. Ghabraei S, Bolhari B, Sabbagh MM, et al. Comparison of antimicrobial effects of triple antibiotic paste and calcium hydroxide mixed with 2% chlorhexidine as intracanal medicaments against Enterococcus faecalis biofilm. J Dent (Tehran) 2018;15(3):151–160.
  19. Adl A, Shojaee NS, Motamedifar M. A Comparison between the antimicrobial effects of triple antibiotic paste and calcium hydroxide against Entrococcus faecalis. Iran Endod J 2012;7(3):149–155.
  20. Shokraneh A, Farhad AR, Farhadi N, et al. Antibacterial effect of triantibiotic mixture versus calcium hydroxide in combination with active agents against Enterococcus faecalis biofilm. Dent Mater J 2014;33(6):733–738. DOi: 10.4012/dmj.2014-090
  21. Oliveira DP, Barbizam JV, Trope M, et al. In-vitro antibacterial efficacy of endodontic irrigants against E. faecalis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007;103(5):702–706. DOI: 10.1016/j.tripleo.2006.11.007
  22. Sjögren U, Figdor D, Persson S, et al. Influence of infection at the time of root filling on the outcome of endodontic treatment of teeth with apical periodontitis. Int Endod J 1997; 30(5):297–306. DOI: 10.1046/j.1365-2591.1997.00092.x
  23. Rôças IN, Siqueira JF jr, Santos KR. Association of Enterococcus faecalis with different forms of periradicular diseases. J Endod 2004; 30(5):315–320. DOI: 10.1097/00004770-200405000-00004
  24. Saleh IM, Ruyter IE, Haapasalo M, et al. Survival of Enterococcus faecalis in infected dentinal tubules after canal filling with different root canal sealers in vitro. Int Endod J 2004;37(3):193–198. DOI: 10.1111/j.0143-2885.2004.00785.x
  25. Oncag O, Gogulu D, Uzel A. Efficacy of various intracanal medicaments against Enterococcus faecalis in primary teeth: an in vivo study. J Clin Pediatr Dent 2006; 30(3): 233–238.
  26. Grossman LI. Poly antibiotic treatment of pulpless teeth. J Am Dent Assoc 1951;43(3):265–278. DOI: 10.14219/jada.archive.1951.0213
  27. Gomes BPFA, Souza SFC, Ferraz CCR, et al. Effectiveness of 2% chlorhexidine gel and calcium hydroxide against Enterococcus faecalis in bovine root dentine in vitro. Int Endod J 2003;36(4):267–275. DOI: 10.1046/j.1365-2591.2003.00634.x
  28. Sinha N, Patil S, Dodwad PK, et al. Evaluation of antimicrobial efficacy of calcium hydroxide paste, chlorhexidine gel, and a combination of both as intracanal medicament: an in vivo comparative study. J Conserv Dent 2013;16(1):65–70. DOI: 10.4103/0972-0707.105302
  29. Bystrom A, Sundqvist G. Bacteriologic evaluation of the efficacy of mechanical root canal instrumentation in endodontic therapy. Scand J Dent Res 1981;89(4):321–328. DOI: 10.1111/j.1600-0722.1981.tb01689.x
  30. Schafer E, Bossmann K. Antimicrobial efficacy of chlorhexidine and two calcium hydroxide formulations against Enterococcus faecalis. J Endod 2005;31(1):53–56. DOI: 10.1097/01.don.0000134209.28874.1c
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.