ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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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) 12801290Oncag/200360 freshly extracted intact, permanent teethLaboratory Study
Key resultsThe 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) 12801290Oncaq/200391 root canals (deciduous teeth) in 46 child patients 4-10yrs oldUncontrolled Clinical Study
Key resultsThe 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) 12801290Oncaq/2003Fifteen Swiss albinoLaboratory Study
Key resultsAfter 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: 05/05/2011spacer
E-mail goodwink@livemail.uthscsa.edu
Author Kathleen Goodwin
Co-author(s)
Co-author(s) e-mail
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 on the CAT
(FOR PRACTICING DENTISTS' and/or FACULTY COMMENTS ON PUBLISHED CATs)
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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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