Bacterial leakage in obturated root canals following the use of different intracanal medicaments.
The aim of this study was to examine whether intracanal medication prior to root canal obturation has an inhibitory effect on corono-apical penetration of bacteria. 93 single rooted teeth were instrumented and sterilized with ethylene oxide. They were assigned to three control groups and four test groups with n = 20 each. For one week, they were dressed with different medicaments: The first group with a 5% chlorhexidine gel, the second with Ledermix, the third with a fresh mix of calcium hydroxide and water and the fourth without any medication. After obturation (lateral condensation, AH26) the roots were fixed between a top and a bottom chamber. The top chamber contained 3 mL trypticase soy broth with 10(8) Staphylococcus epidermidis CFU's/mL, whereas the bottom chamber contained sterile trypticase soy broth. For one year, the mounts were incubated at 37 degrees C. They were checked on a regular basis for turbidity in their bottom chambers indicating bacterial growth. None of the test samples leaked for three months. After one year, the calcium hydroxide group had only 6 leaking samples whereas the chlorhexidine group had 14, the Ledermix group 15, and the unmedicated group had 13 leaking samples. It may be concluded that under the conditions of this study, calcium hydroxide was the medicament of choice to avoid bacterial penetration of the root canal. Ledermix did not perform better than no premedication. Chlorhexidine was superior to Ledermix in the second third of the observation period.
Barthel
C R
CR
Department of Operative and Preventive Dentistry and Endodontics, Charité, Humboldt University Berlin, Augustenburger Platz 1, D-13353 Berlin, Germany. claudia.barthel@charite.de
Zimmer
S
S
West
G
G
Roulet
J F
JF
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use; D001729:Bismuth / Q000627:therapeutic use; D002126:Calcium Hydroxide / Q000627:therapeutic use; D016009:Chi-Square Distribution; D002710:Chlorhexidine / Q000627:therapeutic use; D003707:Demeclocycline / Q000627:therapeutic use; D003763:Dental Leakage / Q000382:microbiology*; D003786:Dental Pulp Cavity / Q000382:microbiology*; D004338:Drug Combinations; D004853:Epoxy Resins; D006801:Humans; D008709:Methenamine / Q000627:therapeutic use; D012387:Root Canal Filling Materials / Q000627:therapeutic use; D012388:Root Canal Irrigants / Q000627:therapeutic use*; D012389:Root Canal Obturation; D012834:Silver / Q000627:therapeutic use; D013212:Staphylococcus epidermidis / Q000187:drug effects / Q000502:physiology*; D013997:Time Factors; D014025:Titanium / Q000627:therapeutic use; D014222:Triamcinolone Acetonide / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D000891:Anti-Infective Agents, Local; D004338:Drug Combinations; D004853:Epoxy Resins; D012387:Root Canal Filling Materials; D012388:Root Canal Irrigants; D012834:Silver; C028044:epoxy resin AH-26; D003707:Demeclocycline; C001527:Ledermix; D014025:Titanium; D014222:Triamcinolone Acetonide; D008709:Methenamine; D002126:Calcium Hydroxide; D002710:Chlorhexidine; D001729:Bismuth