Kasidid Ruksakiet1, Lilla Hanák2, Nelli Farkas3, Péter Hegyi2, Wuttapon Sadaeng4, László Márk Czumbel4, Thanyaporn Sang-Ngoen4, András Garami2, Alexandra Mikó2, Gábor Varga4, Zsolt Lohinai5. 1. Depatment of Oral Biology, Faculty of Dentistry, Semmelweis University, Budapest, Hungary; Department of Conservative Dentistry, Faculty of Dentistry, Semmelweis University, Budapest, Hungary. 2. Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary. 3. Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary; Institute of Bioanalysis, Medical School, University of Pécs, Pécs, Hungary. 4. Depatment of Oral Biology, Faculty of Dentistry, Semmelweis University, Budapest, Hungary. 5. Department of Conservative Dentistry, Faculty of Dentistry, Semmelweis University, Budapest, Hungary. Electronic address: lohinai.zsolt@dent.semmelweis-univ.hu.
Abstract
INTRODUCTION: We aimed to compare the antimicrobial efficacy of chlorhexidine (CHX) and sodium hypochlorite (NaOCl), two irrigants routinely used in root canal therapy of permanent teeth. METHODS: Electronic databases, including PubMed, EMBASE, Web of Science, and Cochrane Library, were searched for randomized controlled trials published until March 2020. The meta-analysis of relative risk (RR) and standardized mean difference (SMD) was performed using a random-effect model with a 95% confidence interval (CI). Subgroup analysis was performed for culture and molecular methods of bacterial detection. RESULTS: The literature search yielded 2,110 records without duplicates. Eight studies were eligible for a systematic review. No significant differences in the incidence of samples with positive bacterial growth after irrigation (RR=1.003, 95% CI: 0.729-1.380, p=0.987) and mean bacterial number changes (SMD=0.311, 95% CI: -0.368-0.991, p=0.369) were observed between CHX and NaOCl in the culture and molecular subgroups. Heterogeneity in RR (I2=0%, p=0.673) was low among studies, while considerable heterogeneity was observed in the analysis of SMD (I2=76.336%, p=0.005). CONCLUSION: Our findings suggest that both CHX and NaOCl can reduce bacterial infections after irrigation, without any significant difference in antimicrobial efficacy between them. Although CHX and NaOCl showed similar efficacy, their molecular mechanisms were different. Therefore, they can be used as the main antibacterial root canal irrigants. However, our results were limited by inconsistencies among retrieved articles and a lack of clinically relevant outcomes. Further well-designed clinical studies are warranted to supplement our results.
INTRODUCTION: We aimed to compare the antimicrobial efficacy of chlorhexidine (CHX) and sodium hypochlorite (NaOCl), two irrigants routinely used in root canal therapy of permanent teeth. METHODS: Electronic databases, including PubMed, EMBASE, Web of Science, and Cochrane Library, were searched for randomized controlled trials published until March 2020. The meta-analysis of relative risk (RR) and standardized mean difference (SMD) was performed using a random-effect model with a 95% confidence interval (CI). Subgroup analysis was performed for culture and molecular methods of bacterial detection. RESULTS: The literature search yielded 2,110 records without duplicates. Eight studies were eligible for a systematic review. No significant differences in the incidence of samples with positive bacterial growth after irrigation (RR=1.003, 95% CI: 0.729-1.380, p=0.987) and mean bacterial number changes (SMD=0.311, 95% CI: -0.368-0.991, p=0.369) were observed between CHX and NaOCl in the culture and molecular subgroups. Heterogeneity in RR (I2=0%, p=0.673) was low among studies, while considerable heterogeneity was observed in the analysis of SMD (I2=76.336%, p=0.005). CONCLUSION: Our findings suggest that both CHX and NaOCl can reduce bacterial infections after irrigation, without any significant difference in antimicrobial efficacy between them. Although CHX and NaOCl showed similar efficacy, their molecular mechanisms were different. Therefore, they can be used as the main antibacterial root canal irrigants. However, our results were limited by inconsistencies among retrieved articles and a lack of clinically relevant outcomes. Further well-designed clinical studies are warranted to supplement our results.
Authors: Amir Azarpazhooh; Anibal R Diogenes; Ashraf F Fouad; Gerald N Glickman; Anil Kishen; Linda Levin; Robert S Roda; Christine M Sedgley; Franklin R Tay; Kenneth M Hargreaves Journal: J Endod Date: 2020-08 Impact factor: 4.171
Authors: Bruna de Siqueira Nunes; Rosana Araújo Rosendo; Abrahão Alves de Oliveira Filho; Marcus Vinícius Lia Fook; Wladymyr Jefferson Bacalhau de Sousa; Rossemberg Cardoso Barbosa; Hermano de Vasconcelos Pina; João Emídio da Silva Neto; Solomon Kweku Sagoe Amoah; Carlos Eduardo Fontana; Carlos Eduardo da Silveira Bueno; Alexandre Sigrist De Martin Journal: Materials (Basel) Date: 2021-01-20 Impact factor: 3.623