title: The Effect of Sodium Hypochlorite and Chlorhexidine as Irrigant Solutions for Root Canal Disinfection: A Systematic Review of Clinical Trials.
abstract: BACKGROUND
  This systematic review aimed to compare the effectiveness of sodium hypochlorite and chlorhexidine for root canal disinfection during root canal therapy.
  
  
  METHODS
  A literature search for clinical trials was made on the PubMed (MEDLINE), Web of Knowledge, SCOPUS, and Science Direct databases and in the reference lists of the identified articles up to January 2015. Quality assessment of the selected studies was performed according to the Consolidated Standards of Reporting Trials statement.
  
  
  RESULTS
  One clinical trial and 4 randomized clinical trials were selected from the 172 articles initially identified. There was heterogeneity in the laboratory methods used to assess the root canal disinfection as well as in the concentrations of the irrigants used. Therefore, meta-analysis was not performed. Two studies reported effective and similar reductions in bacterial levels for both irrigants. Sodium hypochlorite was more effective than chlorhexidine in reducing microorganisms in 1 study, and another reported opposite findings. Both root irrigants were ineffective in eliminating endotoxins from necrotic pulp root canals in 1 study. Trial design and information regarding randomization procedures were not clearly described in the clinical trials. No study compared laboratory results with clinical outcomes.
  
  
  CONCLUSIONS
  The available evidence on this topic is scarce, and the findings of studies were not consistent. Additional randomized clinical trials using clinical outcomes to compare the use of sodium hypochlorite and chlorhexidine during root canal therapy are needed.
authors: Faculty of Dentistry, Estácio de Sá University, Rio de Janeiro, Rio de Janeiro, Brazil. Electronic address: luciogoncalves@yahoo.com.br.
authors: Lucio Souza
authors: LS
authors: Gonçalves
authors: Faculty of Dentistry, Estácio de Sá University, Rio de Janeiro, Rio de Janeiro, Brazil; Department of Endodontics, Faculty of Dentistry, Veiga de Almeida University, Rio de Janeiro, Rio de Janeiro, Brazil.
authors: Renata Costa Val
authors: RC
authors: Rodrigues
authors: Faculty of Dentistry, Estácio de Sá University, Rio de Janeiro, Rio de Janeiro, Brazil; Department of Health, Dentistry Division, Southwest State University of Bahia, Jequié, Bahia, Brazil.
authors: Carlos Vieira
authors: CV
authors: Andrade Junior
authors: Faculty of Dentistry, Estácio de Sá University, Rio de Janeiro, Rio de Janeiro, Brazil.
authors: Renata G
authors: RG
authors: Soares
authors: Unit of Dental Public Health, School of Clinical Dentistry, University of Sheffield, Sheffield, England.
authors: Mario Vianna
authors: MV
authors: Vettore
mesh_terms: D000890:Anti-Infective Agents / Q000627:therapeutic use; D001419:Bacteria / Q000187:drug effects; D002710:Chlorhexidine / Q000627:therapeutic use*; D006801:Humans; D008826:Microbial Sensitivity Tests; D012388:Root Canal Irrigants / Q000627:therapeutic use*; D018915:Root Canal Preparation / Q000379:methods; D012390:Root Canal Therapy / Q000379:methods*; D012973:Sodium Hypochlorite / Q000627:therapeutic use*
chemical_list: D000890:Anti-Infective Agents; D012388:Root Canal Irrigants; D012973:Sodium Hypochlorite; D002710:Chlorhexidine
keywords: Chlorhexidine; clinical trial; endodontic; sodium hypochlorite