title: Action of Chlorhexidine, Zingiber officinale, and Calcium Hydroxide on Candida albicans, Enterococcus faecalis, Escherichia coli, and Endotoxin in the Root Canals.
abstract: OBJECTIVE
  The purpose of this in vitro study was to evaluate the antimicrobial activity of 2% chlorhexidine gel (CHX) as auxiliary chemical substance and intracanal medications on Candida albicans, Enterococcus faecalis, Escherichia coli, and their endotoxins in the root canals.
  
  
  METHODS
  The study was conducted on 48 single-rooted human teeth divided into four groups (n = 12), according to intracanal medications used: (1) Calcium hydroxide + apyrogenic saline solution (Ca(OH)2 + SS), (2) 20% ginger glycolic extract (GEN), (3) calcium hydroxide + 20% ginger glycolic extract (Ca(OH)2 + GEN), (4) apyrogenic SS (control). Collections were made from the root canal content before preparation (baseline-S1), immediately after instrumentation (S2), 7 days after instrumentation (S3), after 14 days the action of intracanal medication (S4), and 7 days after removal of the intracanal medication (S5). The antimicrobial activity and endotoxin content were analyzed for all collections. The results were statistically analyzed by the Kruskal-Wallis and Dunn tests at a significance level of 5%.
  
  
  RESULTS
  After instrumentation with CHX, there was complete elimination of E. coli and C. albicans, except for E. faecalis, which was significantly reduced and then completely eliminated after intracanal medication. There was significant reduction of endotoxin after instrumentation. Comparison of collection after instrumentation and intracanal medication revealed reduction of endotoxins in all groups; this reduction was greater in group Ca(OH)2 followed by the group GEN.
  
  
  CONCLUSIONS
  It was concluded that the instrumentation using CHX and intracanal medication used were able to eliminate the microorganisms from the root canal; the endotoxins were reduced, yet not completely eliminated.
  
  
  CONCLUSIONS
  This study is important and relevant for searching alternatives during endodontic therapy, since it aims to study the effect of Zingiber officinale on microorganisms and endotoxins present in root canals.
authors.affiliation: Department of Restorative Dentistry, Institute of Science and Technology, UNESP-Univ Estadual Paulista, Sao Jose dos Campos, Sao Paulo, Brazil, CEP 12245-000, Phone: (55) 12 3947 9400 e-mail: marcia@fosjc.unesp.br.
authors.forename: Marcia C
authors.initials: MC
authors.lastname: Valera
authors.affiliation: Department of Restorative Dentistry, Institute of Science and Technology, UNESP-Univ Estadual Paulista, Sao Jose dos Campos, Sao Paulo, Brazil.
authors.forename: Sarah Ac
authors.initials: SA
authors.lastname: Oliveira
authors.affiliation: Department of Restorative Dentistry, Institute of Science and Technology, UNESP-Univ Estadual Paulista, Sao Jose dos Campos, Sao Paulo, Brazil.
authors.forename: Lilian E
authors.initials: LE
authors.lastname: Maekawa
authors.affiliation: Division of Endodontics, Department of Odontology, University of Taubate, Taubate, Sao Paulo, Brazil.
authors.forename: Flávia Gr
authors.initials: FG
authors.lastname: Cardoso
authors.affiliation: Department of Restorative Dentistry, Institute of Science and Technology, UNESP-Univ Estadual Paulista, Sao Jose dos Campos, Sao Paulo, Brazil.
authors.forename: Adriana
authors.initials: A
authors.lastname: Chung
authors.affiliation: Department of Restorative Dentistry, Institute of Science and Technology, UNESP-Univ Estadual Paulista, Sao Jose dos Campos, Sao Paulo, Brazil.
authors.forename: Stephanie Fp
authors.initials: SF
authors.lastname: Silva
authors.affiliation: Department of Restorative Dentistry, Institute of Science and Technology, UNESP-Univ Estadual Paulista, Sao Jose dos Campos, Sao Paulo, Brazil.
authors.forename: Cláudio At
authors.initials: CA
authors.lastname: Carvalho
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001419:Bacteria / Q000187:drug effects*; D002126:Calcium Hydroxide / Q000494:pharmacology*; D002176:Candida albicans / Q000187:drug effects; D002710:Chlorhexidine / Q000494:pharmacology*; D003786:Dental Pulp Cavity / Q000737:chemistry / Q000187:drug effects / Q000382:microbiology*; D004731:Endotoxins; D013293:Enterococcus faecalis / Q000187:drug effects; D004926:Escherichia coli / Q000187:drug effects; D020939:Zingiber officinale; D006801:Humans; D066298:In Vitro Techniques; D008826:Microbial Sensitivity Tests; D012388:Root Canal Irrigants / Q000494:pharmacology*; D018915:Root Canal Preparation / Q000379:methods
chemical_list: D000900:Anti-Bacterial Agents; D004731:Endotoxins; D012388:Root Canal Irrigants; D002126:Calcium Hydroxide; D002710:Chlorhexidine
keywords: Chlorhexidine; Endotoxins; Intracanal medications; Microorganisms; Zingiber officinale.