Abstract
This clinical study investigated the bacterial reduction after instrumentation using
2.5% sodium hypochlorite (NaOCl) as an irrigant and further interappointment dressing
with a calcium hydroxide (Ca(OH)2)/camphorated paramonochlorophenol (CPMC) paste. Eleven teeth with primary intraradicular
infections and chronic apical periodontitis selected according to stringent inclusion/exclusion
criteria followed in the study. Bacterial samples were taken before treatment (S1),
after chemomechanical preparation using hand NiTi files and 2.5% NaOCl (S2), and following
a 7-day medication with a Ca(OH)2 paste in CPMC (S3). Cultivable bacteria recovered from infected root canals at the
three stages were counted and identified by means of 16S rRNA gene sequencing analysis.
At S1, all cases harbored bacteria, with a mean number of 2.8 taxa per canal (range,
1–6). At S2, 6 of 11 (54.5%) of the cases yielded positive cultures, with one to three
species per canal. At S3, only one case (9.1%) was positive for the presence of bacteria,
with Propionibacterium acnes as the only taxon isolated. A significantly high reduction in bacterial counts was
observed between S1 and S2, and S1 and S3. Significant differences were also observed
for comparisons involving S2 and S3 samples with regard to both quantitative bacterial
reduction (p = 0.029) and number of culture-negative cases (p = 0.03). It was concluded
that chemomechanical preparation with 2.5% NaOCl as an irrigant significantly reduced
the number of bacteria in the canal but failed to render the canal free of cultivable
bacteria in more than one-half of the cases. A 7-day intracanal dressing with Ca(OH)2/CPMC paste further significantly increased the number of culture-negative cases.
Key Words
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Article info
Publication history
Published online: March 24, 2007
Footnotes
Supported by grants from Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), a Brazilian governmental institution.
Identification
Copyright
© 2007 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.
