Antibacterial efficacy of calcium hydroxide intracanal dressing: a systematic review and meta-analysis.
OBJECTIVE
To determine to what extent does calcium hydroxide intracanal medication eliminate bacteria from human root canals, compared with the same canals before medication, as measured by the number of positive cultures, in patients undergoing root canal treatment for apical periodontitis (teeth with an infected root canal system).


METHODS
CENTRAL, MEDLINE and EMBASE databases were searched. Reference lists from identified articles were scanned. A forward search was undertaken on the authors of the identified articles. Papers that had cited these articles were also identified through the Science Citation Index to identify potentially relevant subsequent primary research.


METHODS
The included studies were pre-/post-test clinical trials comparing the number of positive bacterial cultures from treated canals. Data in those studies were independently extracted. Risk differences of included studies were combined using the generic inverse variance and random effect method.


RESULTS
Eight studies were identified and included in the review, covering 257 cases. Sample size varied from 18 to 60 cases; six studies demonstrated a statistically significant difference between pre- and post-medicated canals, whilst two did not. There was considerable heterogeneity among studies. Pooled risk difference was -21%; 95% CI: -47% to 6%. The difference between pre- and post-medication was not statistically significant (P = 0.12).


CONCLUSIONS
Calcium hydroxide has limited effectiveness in eliminating bacteria from human root canal when assessed by culture techniques.
Sathorn
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C
Endodontic Unit, School of Dental Science, The University of Melbourne, Melbourne,Vic. Australia. chankhrit@gmail.com
Parashos
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P
Messer
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H
D001419:Bacteria / Q000187:drug effects*; D002126:Calcium Hydroxide / Q000494:pharmacology* / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D003786:Dental Pulp Cavity / Q000382:microbiology*; D006801:Humans; D010485:Periapical Periodontitis / Q000188:drug therapy / Q000382:microbiology*; D012388:Root Canal Irrigants / Q000494:pharmacology* / Q000627:therapeutic use
D012388:Root Canal Irrigants; D002126:Calcium Hydroxide