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Title |
Comparison of Antibacterial and Toxic Effects of Clorhexidine and Sodium Hypochlorite Root Canal Irrigants in Primary Teeth |
Clinical Question |
In a patient with primary dentition, does irrigating the root canal system with concentrated chlorhexidine provide better anti-microbial activity than irrigating with sodium hypochlorite? |
Clinical Bottom Line |
Irrigating canals of primary teeth with chlorhexidine shows substantially better microbial inhibition and is more biocompatable than NaOCl; low level of evidence. (See Comments on the CAT below) |
Best Evidence |
(you may view more info by clicking on the PubMed ID link) |
PubMed ID |
Author / Year |
Patient Group |
Study type
(level of evidence) |
#1) 12801290 | Oncag/2003 | 60 freshly extracted intact, permanent teeth | Laboratory Study | Key results | The study demonstrated that Chlorhexidine (in the form of 2% chlorhexidine gluconate and Cetrexidin) was significantly more effective on E. faecalis than the 5.25% NaOCl (P < 0.05). | #2) 12801290 | Oncaq/2003 | 91 root canals (deciduous teeth) in 46 child patients 4-10yrs old | Uncontrolled Clinical Study | Key results | The results if this in vivo study gave evidence that chlorhexidine significantly impeded the growth of anaerobic bacteria than NaOCl at 48 h (P < 0.05). | #3) 12801290 | Oncaq/2003 | Fifteen Swiss albino | Laboratory Study | Key results | After 2 weeks NaOCl was demonstrated to be more toxic to the body than the other irrigants tested (P < 0.05). | |
Evidence Search |
pulpectomy and deciduous teeth ...view in PubMed |
Comments on
The Evidence |
The laboratory studies and the cohort study started with similar groups and treated them the same. These are low level evidence. The completion rates were all greater than 80%. The follow-up and compliance were adequate for all studies. There were no competing interests. |
Applicability |
The subjects in the in vivo study were most representative of the target population, and the treatment would be feasible in a pediatric setting. Chlorhexidine is a more biocompatible substance than sodium hypochlorite which is a benefit to the patient, especially in cases in which the root apices are open. |
Specialty/Discipline |
(Endodontics) (General Dentistry) (Pediatric Dentistry) |
Keywords |
Pulpectomy, deciduous teeth, chlorhexidine, sodium hypochlorite
|
ID# |
811 |
Date of submission: |
05/05/2011 |
E-mail |
goodwink@livemail.uthscsa.edu |
Author |
Kathleen Goodwin |
Co-author(s) |
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Co-author(s) e-mail |
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Faculty mentor/Co-author |
Maria Mendez Cervantes, DDS |
Faculty mentor/Co-author e-mail |
CervantesMen@uthscsa.edu |
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?) |
post a rationale |
None available | |
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Comments and Evidence-Based Updates on the CAT
(FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs) |
post a comment |
by Salim Aqil (San Antonio, TX) on 10/08/2014 A PubMed search on irrigants used during a Non-surgical root canal treatment of mature permanent teeth was performed October 2014. A recent publication was found: Fedorowicz Z 2012, PubMed: 22972129. This RCT compared effectiveness of Sodium hypochlorite and chlorhexidine in de-naturing bacteria in a root canal system and found insufficient evidence that one irrigant is superior to another in de-activating bacteria. | |
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