Fernando A.C. Magalhães

Mechanical reduction of the bacterial population in the root canal by three instrumentation techniques

The in vitro reduction of the bacterial population in the root canal by the mechanical action of instrumentation and irrigation was evaluated. Root canals inoculated with a Enterococcus faecalis suspension were instrumented using hand Nitiflex files, Greater Taper (GT) files, and Profile 0.06 taper Series 29 rotary instruments. Irrigation was performed using sterile saline solution. Root canals were sampled before and after instrumentation. In the group of the Nitiflex files, samples were also taken after each file size. After serial dilution, samples were plated onto Mitis-Salivarius agar, and the colony forming units grown were counted. All techniques and instruments tested were able to reduce significantly the number of bacterial cells in the root canal. Instrumentation to a Nitiflex #30 was significantly more effective than GT files. There were no significant differences when comparing the effects of the Profile instrument #5 with either the GT files or the Nitiflex #30. Enlargement to a Nitiflex #40 was significantly more effective in eliminating bacteria when compared with the other techniques and instruments tested (p < 0.05). The results of this study showed that the instrumentation and irrigation can mechanically remove more than 90% of bacterial cells from the root canal.

Efficacy of Instrumentation Techniques and Irrigation Regimens in Reducing the Bacterial Population within Root Canals

The purpose of this study was to compare the in vitro intracanal bacterial reduction produced by using two instrumentation techniques and different irrigation methods. Root canals inoculated with Enterococcus faecalis were prepared by using the following techniques and irrigants: alternated rotary motions (ARM) technique, hand nickel-titanium files and 2.5% sodium hypochlorite (NaOCl) as irrigant; ARM technique and combined irrigation with 2.5% NaOCl and citric acid; ARM technique and combined irrigation with 2.5% NaOCl and 2% chlorhexidine gluconate; and Greater Taper rotary files, using 2.5% NaOCl as irrigant. Controls were instrumented by using the ARM technique and irrigated with sterile saline. Canals were sampled before and after preparation. After serial dilution, samples were plated onto Mitis-Salivarius agar, and the colony forming units that were grown were counted. All test techniques and solutions significantly reduced the number of bacterial cells within the root canal (p < 0.05). There was no significant difference between the experimental groups (p > 0.05). Nonetheless, all of them were significantly more effective than the control group (p < 0.05). These findings support the importance of using antimicrobial irrigants during the chemomechanical preparation, regardless of the solutions or instrumentation techniques used.

Elimination of Candida albicans Infection of the Radicular Dentin by Intracanal Medications

Fungi have been associated with cases of secondary or persistent root canal infections. The purpose of this study was to evaluate the effectiveness of four intracanal medications in disinfecting the root dentin of bovine teeth experimentally infected with Candida albicans. Infected dentin cylinders were exposed to four different medications: calcium hydroxide/glycerin; calcium hydroxide/0.12% chlorhexidine digluconate; calcium hydroxide/camphorated paramonochlorophenol/glycerin; and 0.12% chlorhexidine digluconate/zinc oxide. Specimens were in contact with the medications for 1 h, 2 days, and 7 days. The viability of C. albicans after exposure was evaluated by specimen incubation in culture medium to compare the effectiveness of the medications in disinfecting dentin. Results showed that the specimens treated with calcium hydroxide/camphorated paramonochlorophenol/ glycerin paste or with chlorhexidine/zinc oxide paste were completely disinfected after 1 h of exposure. Calcium hydroxide/glycerin paste only consistently eliminated C. albicans infection after 7 days of exposure. Calcium hydroxide mixed with chlorhexidine was ineffective in disinfecting dentin even after 1 week of medication exposure. Among the medications tested, the calcium hydroxide/camphorated paramonochlorophenol/glycerin paste and chlorhexidine digluconate mixed with zinc oxide were the most effective in eliminating C. albicans cells from dentinal specimens.

Levels of infection and colonization of some oral bacteria after use of naf, chlorhexidine and a combined chlorhexidine with naf mouthrinses

This study was carried out to evaluate levels of infection of bacteria involved in caries and oral streptococci and their colonization after use of mouthrinses with NaF, chlorhexidine and chlorhexidine plus NaF. Combination of chlorhexidine and fluoride was the only agent that reduced levels of Streptococcus mutans (group) for 30 days.