title: Influence of dentin on pH of 2% chlorhexidine gel and calcium hydroxide alone or in combination.
abstract: The aims of endodontic treatment in cases of apical periodontitis are to reduce as much as possible the number of microorganisms inside the root canal system and to inactivate toxins produced by them. Most of the times, these objectives are not achieved solely by chemomechanical preparation, and intracanal dressing may be necessary. In these cases, calcium hydroxide is used as a root canal dressing due to its well-known and recognized antimicrobial activity. Chlorhexidine has a wide spectrum of antimicrobial activity and its association with calcium hydroxide has been recommended in an attempt to amplify antimicrobial effects of calcium hydroxide. It is also known that dentin exerts a buffering effect under wide pH variations, and may be responsible for decreasing the antimicrobial activity of drugs inside the root canal. The objectives of this study were to assess the pH of 2% chlorhexidine gel and calcium hydroxide alone or in combination, as well as the influence of dentin on the pH of these compounds. Dentin powder was obtained from bovine teeth and added as 1.8% to the volume of the medications. All substances were individually stored in plastic flasks, in triplicate. A pH meter was used at five different moments to assess pH in viscous medium: immediately after preparation and after 24 h, and 7, 14, and 21 days. Results were analyzed by paired Student's t-test. Statistically significant differences were observed in the 2% chlorhexidine gel group alone or associated with calcium hydroxide and added of dentin powder (P < 0.05). Mean pH values indicated the influence of dentin powder because of a significant increase in pH. Calcium hydroxide with propylene glycol as the vehicle always showed high pH, demonstrating that this compound was not affected by the presence of dentin.
authors.affiliation: Department of Endodontics, Dental School, University of São Paulo, São Paulo, Brazil.
authors.forename: Laila Gonzales
authors.initials: LG
authors.lastname: Freire
authors.forename: Ceci Nunes
authors.initials: CN
authors.lastname: Carvalho
authors.forename: Patricia Helena Pereira
authors.initials: PH
authors.lastname: Ferrari
authors.forename: Evandro Luiz
authors.initials: EL
authors.lastname: Siqueira
authors.forename: Giulio
authors.initials: G
authors.lastname: Gavini
mesh_terms: D000818:Animals; D000891:Anti-Infective Agents, Local / Q000737:chemistry*; D002021:Buffers; D002126:Calcium Hydroxide / Q000737:chemistry*; D002417:Cattle; D002710:Chlorhexidine / Q000737:chemistry*; D003786:Dental Pulp Cavity / Q000502:physiology; D003804:Dentin / Q000502:physiology*; D005782:Gels; D006863:Hydrogen-Ion Concentration; D014677:Pharmaceutical Vehicles; D019946:Propylene Glycol / Q000737:chemistry; D012388:Root Canal Irrigants / Q000737:chemistry*; D013997:Time Factors
chemical_list: D000891:Anti-Infective Agents, Local; D002021:Buffers; D005782:Gels; D014677:Pharmaceutical Vehicles; D012388:Root Canal Irrigants; D019946:Propylene Glycol; D002126:Calcium Hydroxide; D002710:Chlorhexidine