Antibacterial efficacy of chlorhexidine gluconate intracanal medication In Vivo

By Paquette L, Legner M, Fillery E, and Friedman S

Date: 12/2008
Journal: JOE

Purpose: 

(1) to assess the efficacy of intracanal medication with 2% chlorhexidine gluconate liquid (CHX) in eliminating bacteria  and

(2) to quantify the concentrations of viable bacteria per root canal unit volume, before and after chemomechanical preparation and intracanal medication

N= patients with 22 teeth (17 premolars and 5 anteriors.)

Materials/Methods:

•Samples from root canals were obtained before chemomechanical preparation(A1) by Reduced transport fluid (RTF).

•canals were instrumented using ProFile .04 and .06 taper rotary instruments in a crown down technique and niti hand files to at least #35 .2.5 % NaOCL was used to irrigate the canals throughout the procedure. Post chemomechanical preparation samples were obtained (B1).

•After chemomechanical preparation was completed, the canals were dried and filled with 2% CHX liquid and teeth were temporarily sealed.

•the 2nd tx performed after 7 to 15 days, the temporary filling removed, CHX was inactivated and the canals rinsed with saline, A postmedication root canal sample (2A) was obtained, the canals rinsed with 2.5% NaOCL and saline then a final sample was obtained (B2).

•Viable bacterial counts were obtained by culture (CFU) and microscopy using vital dyes.

Most highlighted Results:  

•Microscopic counts were higher than CFU counts.

•Consistently high CFU counts in 1A samples decreased significantly in 1B samples.

•Numbers increased significantly in 2A samples, and decreased in 2B samples to the level of 1B samples.

Clinical significance:

Since Intracanal medication with 2% chlorhexidine gluconate liquid did not reduce the bacterial concentration, it is not recommended to be used as an intracanal medicament.