RESUMO
The antibacterial efficacy of intracanal medication with 2% chlorhexidine liquid (CHX) was assessed in teeth with apical periodontitis. Canals in 22 teeth were instrumented at the first session, medicated with CHX, and reaccessed after 7 to 15 days. Bacteriological samples were aspirated at the first and second sessions, before (1A, 2A) and after (1B, 2B) canal instrumentation. Viable bacterial counts were obtained by culture (CFU) and microscopy using vital dyes. Microscopic counts were higher than CFU counts. Consistently high CFU counts in 1A samples (mean, 2 x 10(5) microL(-1) canal volume) decreased significantly (p < 0.0001) in 1B samples, increased significantly (p < 0.04) in 2A samples, and decreased in 2B samples to the level of 1B samples. Proportions of negative cultures followed the pattern of CFU counts. Intracanal medication with CHX did not reduce the bacterial concentration. Bacterial counts expressed per microliter canal volume added information beyond the counts per tooth as expressed in previous studies.
Assuntos
Anti-Infecciosos Locais/uso terapêutico , Clorexidina/análogos & derivados , Cavidade Pulpar/microbiologia , Periodontite Periapical/tratamento farmacológico , Irrigantes do Canal Radicular/uso terapêutico , Adulto , Idoso , Idoso de 80 Anos ou mais , Análise de Variância , Anti-Infecciosos Locais/administração & dosagem , Distribuição de Qui-Quadrado , Clorexidina/administração & dosagem , Clorexidina/uso terapêutico , Contagem de Colônia Microbiana , Humanos , Modelos Lineares , Pessoa de Meia-Idade , Periodontite Periapical/microbiologia , Preparo de Canal Radicular/métodosRESUMO
INTRODUCTION: Chlorhexidine gluconate (CHX) is a potential intracanal medicament, but data on healing after its use are lacking. Previously we reported on bacterial sampling in 22 teeth with apical periodontitis medicated with CHX. This study assessed healing in those teeth. METHODS: Canals were instrumented and medicated with 2% CHX liquid for 7-15 days and subsequently irrigated and filled. Bacterial samples were taken before and after instrumentation, after medication and before root filling, and enumerated by culture and vital microscopy. After 2-4 years, subjects were examined clinically and radiographically by assigning Periapical Index scores by independent calibrated examiners. Outcome was dichotomized as healed or disease. RESULTS: With 2 teeth extracted, 1 deceased subject, and 2 nonrespondents, 16 of 17 examined teeth (94%) were healed without association with bacterial sampling results. The proportion of healed teeth in this study did not differ significantly (Fisher exact test; P = .20) from that in a historical control (90%). CONCLUSIONS: The results suggested a comparable outcome after medication with 2% CHX liquid and calcium hydroxide.