Bacteriologic investigation of the effects of sodium hypochlorite and chlorhexidine during the endodontic treatment of teeth with apical periodontitis

SIQUEIRA JR. et al. Bacteriologic investigation of the effects of sodium hypochlorite and chlorhexidine during the endodontic treatment of teeth with apical periodontitis. Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod., v. 104, n. 1, p. 122-130, 2007.Objective. This clinical study was undertaken to compare the effectiveness of 2.5% sodium hypochlorite (NaOCl) and 0.12% chlorhexidine digluconate as irrigants in reducing the cultivable bacterial populations in infected root canals of teeth with apical periodontitis. Study design. According to stringent inclusion/exclusion criteria, 32 teeth with primary intraradicular infections and chronic apical periodontitis were selected and followed in the study. Bacterial samples were taken at the baseline (S1) and after chemomechanical preparation using either NaOCl (n 16) or chlorhexidine (n 16) as irrigants (S2). Cultivable bacteria recovered from infected root canals at the 2 stages were counted. Isolates from S2 samples were identified by means of 16S rRNA gene sequencing analysis. Results. At S1, all canals were positive for bacteria, and the median number of bacteria per canal was 7.32 105 for the NaOCl group and 8.5 105 for the chlorhexidine group. At S2, the median number of bacteria in canals irrigated with NaOCl and chlorhexidine was 2.35 103 and 2 102, respectively. Six of 16 (37.5%) canals from the NaOCl group and 8 of 16 (50%) canals from the chlorhexidine group yielded negative cultures. Chemomechanical preparation using either solution substantially reduced the number of cultivable bacteria in the canals. No significant difference was observed between the NaOCl and chlorhexidine groups with regard to the number of cases yielding negative cultures (P .72) or quantitative bacterial reduction (P .609). The groups irrigated with NaOCl or chlorhexidine showed a mean number of 1.3 and 1.9 cultivable species per canal, respectively. The great majority of isolates in S2 were from gram-positive bacteria, with streptococci as the most prevalent taxa. Conclusions. The present findings revealed no significant difference when comparing the antibacterial effects of 2.5% NaOCl and 0.12% chlorhexidine used as irrigants during the treatment of infected canal

Root Canal Microbiome Associated with Asymptomatic Apical Periodontitis

Root canal samples from 25 patients (ethics committee approval CAAE 9713 1918 7 0000 5137 )were prepared for DNA sequencing analysis Inclusion criteria were patients presenting no systemic disease, teeth with a single root and a single canal presenting with a carious lesion with intact pulp chamber walls, pulp necrosis confirmed by pulp sensibility tests, and clinical and radiographic evidence of asymptomatic primary apical periodontitis with no sinus tract. Bacterial diversity of the microbiome was identified and compared between cases and to the size of related periapical lesions Statistical analysis of the operational taxonomic unit distribution ( was performed using PCoA with Bray Curtis distance and PCoA Two Way Permanova Fisher Exact test was used to evaluate the prevalence of different OTUs related to small and large periapical lesions