title: Limewater and Polymyxin B Associated with NaOCl for Endotoxin Detoxification in Root Canal with Necrotic Pulp.
abstract: This clinical study investigated the effects of endodontic treatment by using different irrigants (limewater + NaOCl and polymyxin B + NaOCl) and intracanal medication on endotoxins in teeth with primary endodontic infection and radiographically visible apical periodontitis. Thirty-three teeth with necrotic pulp and periapical lesions from different patients were selected for this study. Samples were collected after the coronal opening (S1) and after instrumentation (S2). Root canals were divided in 3 groups (n = 11) according to the irrigant combination used: NaOCl + LW: 2.5% NaOCl + calcium hydroxide solution (0.14%, limewater); NaOCl + PmB: 2.5% NaOCl + 10.000 UI/mL polymyxin B; 2.5% NaOCl (control). The third sampling (S3) was performed after ethylenediaminetetraacetic acid and the fourth (S4) after samples got 14 days with intracanal medication with 2% chlorhexidine gel + calcium hydroxide. Endotoxins (lipopolysaccharide) were quantified by chromogenic Limulus amebocyte lysate (LAL). Endotoxins were detected in all root canals after the coronal opening (S1). NaOCl + PmB group presented the greatest endotoxin reduction after instrumentation (76.17%), similar to NaOCl + LW group (67.64%, p<0.05) and different from NaOCl group (42.17%, p<0.05). After intracanal medication period (S4), there was significant increase of endotoxins neutralization. It was concluded that NaOCl + PmB promoted the greatest reduction of endotoxin levels, followed by NaOCl + LW. Intracanal medications had no significant complementary role in the reduction of endotoxins at the end of the treatment.
authors.affiliation: Department of Restorative Dentistry, Endodontics Division, Institute of Science and Technology, UNESP - Univ Estadual Paulista, São José dos Campos, SP, Brazil.
authors.forename: Alessandra Sverberi
authors.initials: AS
authors.lastname: Carvalho
authors.affiliation: Department of Biosciences, Institute of Science and Technology, UNESP - Univ Estadual Paulista, São José dos Campos, SP, Brazil.
authors.forename: Luciane Dias de
authors.initials: LD
authors.lastname: Oliveira
authors.affiliation: Department of Restorative Dentistry, Endodontics Division, Institute of Science and Technology, UNESP - Univ Estadual Paulista, São José dos Campos, SP, Brazil.|Department of Odontology, Endodontics Division, UNITAU - Universidade de Taubaté, Taubaté, SP, Brazil.
authors.forename: Flávia Goulart da Rosa
authors.initials: FG
authors.lastname: Cardoso
authors.affiliation: Department of Biosciences, Institute of Science and Technology, UNESP - Univ Estadual Paulista, São José dos Campos, SP, Brazil.
authors.forename: Felipe Eduardo de
authors.initials: FE
authors.lastname: Oliveira
authors.affiliation: Department of Restorative Dentistry, Endodontics Division, Institute of Science and Technology, UNESP - Univ Estadual Paulista, São José dos Campos, SP, Brazil.
authors.forename: Marcia Carneiro
authors.initials: MC
authors.lastname: Valera
authors.affiliation: Department of Restorative Dentistry, Endodontics Division, Institute of Science and Technology, UNESP - Univ Estadual Paulista, São José dos Campos, SP, Brazil.
authors.forename: Cláudio Antônio Talge
authors.initials: CA
authors.lastname: Carvalho
mesh_terms: D000328:Adult; D004731:Endotoxins / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008297:Male; D011112:Polymyxin B / Q000008:administration & dosage*; D012390:Root Canal Therapy / Q000379:methods*
chemical_list: D004731:Endotoxins; D011112:Polymyxin B