Skip to main content
Erschienen in: Clinical Oral Investigations 2/2018

01.07.2017 | Original Article

Effect of root canal preparation techniques on chlorhexidine substantivity on human dentin: a chemical analysis

verfasst von: Matheus Albino Souza, Carine Zen Menon, Louise Fochesatto Nery, Charise Dallazem Bertol, Luciana Grazziotin Rossato-Grando, Doglas Cecchin

Erschienen in: Clinical Oral Investigations | Ausgabe 2/2018

Einloggen, um Zugang zu erhalten

Abstract

Objectives

Chlorhexidine binds to dentine to provide sustained action. The aim of the present study was to evaluate and compare the substantivity of chlorhexidine using manual, rotary, and reciprocating systems for root canal preparation.

Methods

Forty-five extracted human single-rooted teeth were used for this study. The samples were divided into three groups (n = 15) according to the instrumentation technique used: manual instrumentation (K-File), rotary instrumentation (ProTaper), and reciprocating instrumentation (Reciproc R25). Chlorhexidine gel (2%) was used as auxiliary chemical substance during root canal preparation. Longitudinal grooves were carved on the free surfaces of the roots, providing two halves of each root and resulting in 30 samples per group. Each group was randomly divided into three subgroups (n = 10), and substantivity was evaluated after 48 h, 7 days, and 30 days of incubation. The amount of CHX (in mg/mL) was measured through reverse-phase high-performance liquid chromatography. Statistical analysis was performed by analysis of variance and the Tukey test for post hoc comparisons (α = 0.05).

Results

The manual did not show a statistical significant difference with rotary instrumentation (P > 0.05), but higher CHX substantivity was recorded in all periods of observation when compared to reciprocating instrumentation (P < 0.05).

Conclusions

The CHX substantivity on human dentine is lowest when using reciprocating compared to manual and rotary instrumentation.

Clinical significance

Using chemical analysis, this study showed that a manual and rotary multi-instrument system results in greater chlorhexidine substantivity on human dentin than a reciprocating single-instrument system.
Literatur
2.
Zurück zum Zitat Siqueira JF Jr, Roças IN (2008) Clinical implications and microbiology of bacterial persistence after treatment procedures. J Endod 34:1291–1301CrossRefPubMed Siqueira JF Jr, Roças IN (2008) Clinical implications and microbiology of bacterial persistence after treatment procedures. J Endod 34:1291–1301CrossRefPubMed
3.
Zurück zum Zitat Pashley EL, Birdsong NL, Bowman K, Pashley DH (1985) Cytotoxic effects of NaOCl on vital tissue. J Endod 11:525–528CrossRefPubMed Pashley EL, Birdsong NL, Bowman K, Pashley DH (1985) Cytotoxic effects of NaOCl on vital tissue. J Endod 11:525–528CrossRefPubMed
4.
Zurück zum Zitat Zhu WC, Gyamfi J, Niu LN, Schoeffel GJ, Liu SY, Santarcangelo F, Khan S, Tay KC, Pashley DH, Tay FR (2013) Anatomy of sodium hypochlorite accidents involving facial ecchymosis—a review. J Dent 41:935–948CrossRefPubMed Zhu WC, Gyamfi J, Niu LN, Schoeffel GJ, Liu SY, Santarcangelo F, Khan S, Tay KC, Pashley DH, Tay FR (2013) Anatomy of sodium hypochlorite accidents involving facial ecchymosis—a review. J Dent 41:935–948CrossRefPubMed
5.
Zurück zum Zitat Sim TP, Knowles JC, Ng YL, Shelton J, Gulabivala K (2001) Effect of sodium hypochlorite on mechanical properties of dentine and tooth surface strain. Int Endod J 34:120–132CrossRefPubMed Sim TP, Knowles JC, Ng YL, Shelton J, Gulabivala K (2001) Effect of sodium hypochlorite on mechanical properties of dentine and tooth surface strain. Int Endod J 34:120–132CrossRefPubMed
6.
Zurück zum Zitat Mai S, Kim YK, Arola DD, Gu LS, Kim JR, Pashley DH, Tay FR (2010) Differential aggressiveness of ethylenediamine tetraacetic acid in causing canal wall erosion in the presence of sodium hypochlorite. J Dent 38:201–206CrossRefPubMed Mai S, Kim YK, Arola DD, Gu LS, Kim JR, Pashley DH, Tay FR (2010) Differential aggressiveness of ethylenediamine tetraacetic acid in causing canal wall erosion in the presence of sodium hypochlorite. J Dent 38:201–206CrossRefPubMed
7.
Zurück zum Zitat Cecchin D, Farina AP, Souza MA, Albarello LL, Schneider AP, Vidal CM, Bedran-Russo AK (2015) Evaluation of antimicrobial effectiveness and dentine mechanical properties after use of chemical and natural auxiliary irrigants. J Dent 43:695–702CrossRefPubMed Cecchin D, Farina AP, Souza MA, Albarello LL, Schneider AP, Vidal CM, Bedran-Russo AK (2015) Evaluation of antimicrobial effectiveness and dentine mechanical properties after use of chemical and natural auxiliary irrigants. J Dent 43:695–702CrossRefPubMed
8.
Zurück zum Zitat Slutzky-Goldberg I, Maree M, Liberman R, Heling I (2004) Effect of sodium hypochlorite on dentin microhardness. J Endod 30:880–882CrossRefPubMed Slutzky-Goldberg I, Maree M, Liberman R, Heling I (2004) Effect of sodium hypochlorite on dentin microhardness. J Endod 30:880–882CrossRefPubMed
9.
Zurück zum Zitat Driscoll CO, Dowker SE, Anderson P, Wilson RM, Gulabivala K (2002) Effects of sodium hypochlorite solution on root dentine composition. J Mater Sci Mater Med 13:219–223CrossRefPubMed Driscoll CO, Dowker SE, Anderson P, Wilson RM, Gulabivala K (2002) Effects of sodium hypochlorite solution on root dentine composition. J Mater Sci Mater Med 13:219–223CrossRefPubMed
10.
Zurück zum Zitat Moreira DM, Almeida JF, Ferraz CC, Gomes BP, Line SR, Zaia AA (2009) Structural analysis of bovine root dentin after use of different endodontics auxiliary chemical substances. J Endod 35:1023–1027CrossRefPubMed Moreira DM, Almeida JF, Ferraz CC, Gomes BP, Line SR, Zaia AA (2009) Structural analysis of bovine root dentin after use of different endodontics auxiliary chemical substances. J Endod 35:1023–1027CrossRefPubMed
11.
Zurück zum Zitat Mohammadi Z, Abbott PV (2009) The properties and applications of chlorhexidine in endodontics. Int Endod J 42:288–302CrossRefPubMed Mohammadi Z, Abbott PV (2009) The properties and applications of chlorhexidine in endodontics. Int Endod J 42:288–302CrossRefPubMed
12.
Zurück zum Zitat Menezes MM, Valera MC, Jorge AO, Koga-Ito CY, Camargo CH, Mancini MN (2004) In vitro evaluation of the effectiveness of irrigants and intracanal medicaments on microorganisms within root canals. Int Endod J 37:311–319CrossRefPubMed Menezes MM, Valera MC, Jorge AO, Koga-Ito CY, Camargo CH, Mancini MN (2004) In vitro evaluation of the effectiveness of irrigants and intracanal medicaments on microorganisms within root canals. Int Endod J 37:311–319CrossRefPubMed
13.
Zurück zum Zitat Dametto FR, Ferraz CC, Gomes BP, Zaia AA, Teixeira FB, de Souza-Filho FJ (2005) In vitro assessment of the immediate and prolonged antimicrobial action of chlorhexidine gel as an endodontic irrigant against Enterococcus faecalis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 99:768–772CrossRefPubMed Dametto FR, Ferraz CC, Gomes BP, Zaia AA, Teixeira FB, de Souza-Filho FJ (2005) In vitro assessment of the immediate and prolonged antimicrobial action of chlorhexidine gel as an endodontic irrigant against Enterococcus faecalis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 99:768–772CrossRefPubMed
14.
Zurück zum Zitat Gomes BP, Ferraz CC, Vianna ME, Berber VB, Teixeira FB, Souza-Filho FJ (2001) In vitro antimicrobial activity of several concentrations of sodium hypochlorite and chlorhexidine gluconate in the elimination of Enterococcus faecalis. Int Endod J 34:424–428CrossRefPubMed Gomes BP, Ferraz CC, Vianna ME, Berber VB, Teixeira FB, Souza-Filho FJ (2001) In vitro antimicrobial activity of several concentrations of sodium hypochlorite and chlorhexidine gluconate in the elimination of Enterococcus faecalis. Int Endod J 34:424–428CrossRefPubMed
15.
Zurück zum Zitat Rôças IN, Siqueira JF Jr (2011) Comparison of the in vivo antimicrobial effectiveness of sodium hypochlorite and chlorhexidine used as root canal irrigants: a molecular microbiology study. J Endod 37:143–150CrossRefPubMed Rôças IN, Siqueira JF Jr (2011) Comparison of the in vivo antimicrobial effectiveness of sodium hypochlorite and chlorhexidine used as root canal irrigants: a molecular microbiology study. J Endod 37:143–150CrossRefPubMed
16.
Zurück zum Zitat Rôças IN, Provenzano JC, Neves MA, Siqueira JF Jr (2016) Disinfecting effects of rotary instrumentation with either 2.5% sodium hypochlorite or 2% chlorhexidine as the main irrigant: a randomized clinical study. J Endod 42:943–947CrossRefPubMed Rôças IN, Provenzano JC, Neves MA, Siqueira JF Jr (2016) Disinfecting effects of rotary instrumentation with either 2.5% sodium hypochlorite or 2% chlorhexidine as the main irrigant: a randomized clinical study. J Endod 42:943–947CrossRefPubMed
17.
Zurück zum Zitat Gendron R, Grenier D, Sorsa T, Mayrand D (1999) Inhibition of the activities of matrix metallo-proteinases 2, 8, and 9 by chlorhexidine. Clin Diagn Lab Immunol 6:437–439PubMedPubMedCentral Gendron R, Grenier D, Sorsa T, Mayrand D (1999) Inhibition of the activities of matrix metallo-proteinases 2, 8, and 9 by chlorhexidine. Clin Diagn Lab Immunol 6:437–439PubMedPubMedCentral
18.
Zurück zum Zitat Scaffa PM, Vidal CM, Barros N, Gesteira TF, Carmona AK, Breschi L, Pashley DH, Tjäderhane L, Tersariol IL, Nascimento FD, Carrilho MR (2012) Chlorhexidine inhibits the activity of dental cysteine cathepsins. J Dent Res 91:420–425CrossRefPubMed Scaffa PM, Vidal CM, Barros N, Gesteira TF, Carmona AK, Breschi L, Pashley DH, Tjäderhane L, Tersariol IL, Nascimento FD, Carrilho MR (2012) Chlorhexidine inhibits the activity of dental cysteine cathepsins. J Dent Res 91:420–425CrossRefPubMed
19.
Zurück zum Zitat Cecchin D, Farina AP, Giacomin M, Vidal CM, Carlini-Júnior B, Ferraz CC (2014) Influence of chlorhexidine application time on the bond strength between fiber posts and dentin. J Endod 40:2045–2048CrossRefPubMed Cecchin D, Farina AP, Giacomin M, Vidal CM, Carlini-Júnior B, Ferraz CC (2014) Influence of chlorhexidine application time on the bond strength between fiber posts and dentin. J Endod 40:2045–2048CrossRefPubMed
20.
Zurück zum Zitat Rosenthal S, Spångberg L (2004) Safavi K (2004) Chlorhexidine substantivity in root canal dentin. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 98:488–492CrossRefPubMed Rosenthal S, Spångberg L (2004) Safavi K (2004) Chlorhexidine substantivity in root canal dentin. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 98:488–492CrossRefPubMed
21.
Zurück zum Zitat Leonardo MR, Tanomaru Filho M, Silva LA, Nelson Filho P, Bonifácio KC, Ito IY (1999) In vivo antimicrobial activity of 2% chlorhexidine used as a root canal irrigating solution. J Endod 25:167–171CrossRefPubMed Leonardo MR, Tanomaru Filho M, Silva LA, Nelson Filho P, Bonifácio KC, Ito IY (1999) In vivo antimicrobial activity of 2% chlorhexidine used as a root canal irrigating solution. J Endod 25:167–171CrossRefPubMed
22.
Zurück zum Zitat Souza M, Cecchin D, Farina AP, Leite CE, Cruz FF, Pereira Cda C, Ferraz CC, Figueiredo JA (2012) Evaluation of chlorhexidine substantivity on human dentin: a chemical analysis. J Endod 38:1249–1252CrossRefPubMed Souza M, Cecchin D, Farina AP, Leite CE, Cruz FF, Pereira Cda C, Ferraz CC, Figueiredo JA (2012) Evaluation of chlorhexidine substantivity on human dentin: a chemical analysis. J Endod 38:1249–1252CrossRefPubMed
23.
Zurück zum Zitat Böttcher DE, Sehnem NT, Montagner F, Fatturi Parolo CC, Grecca FS (2015) Evaluation of the effect of enterococcus faecalis biofilm on the 2% chlorhexidine substantivity: an in vitro study. J Endod 41:1364–1370CrossRefPubMed Böttcher DE, Sehnem NT, Montagner F, Fatturi Parolo CC, Grecca FS (2015) Evaluation of the effect of enterococcus faecalis biofilm on the 2% chlorhexidine substantivity: an in vitro study. J Endod 41:1364–1370CrossRefPubMed
24.
Zurück zum Zitat Souza MA, Montagner A, Lana DL, Vidal CM, Farina AP, Cecchin D (2017) Comparative evaluation of the retaining of QMix and chlorhexidine formulations on human dentin: a chemical analysis. Clin Oral Investig 21:873–878CrossRefPubMed Souza MA, Montagner A, Lana DL, Vidal CM, Farina AP, Cecchin D (2017) Comparative evaluation of the retaining of QMix and chlorhexidine formulations on human dentin: a chemical analysis. Clin Oral Investig 21:873–878CrossRefPubMed
25.
Zurück zum Zitat Guelzow A, Stamm O, Martus P, Kielbassa AM (2005) Comparative study of six rotary nickel-titanium systems and hand instrumentation for root canal preparation. Int Endod J 38:743–752CrossRefPubMed Guelzow A, Stamm O, Martus P, Kielbassa AM (2005) Comparative study of six rotary nickel-titanium systems and hand instrumentation for root canal preparation. Int Endod J 38:743–752CrossRefPubMed
26.
Zurück zum Zitat Marinho AC, Martinho FC, Gonçalves LM, Rabang HR, Gomes BP (2015) Does the Reciproc file remove root canal bacteria and endotoxins as effectively as multifile rotary systems? Int Endod J 48:542–548CrossRefPubMed Marinho AC, Martinho FC, Gonçalves LM, Rabang HR, Gomes BP (2015) Does the Reciproc file remove root canal bacteria and endotoxins as effectively as multifile rotary systems? Int Endod J 48:542–548CrossRefPubMed
27.
Zurück zum Zitat Neves MA, Provenzano JC, Rôças IN, Siqueira JF Jr (2016) Clinical antibacterial effectiveness of root canal preparation with reciprocating single-instrument or continuously rotating multi-instrument systems. J Endod 42:25–29CrossRefPubMed Neves MA, Provenzano JC, Rôças IN, Siqueira JF Jr (2016) Clinical antibacterial effectiveness of root canal preparation with reciprocating single-instrument or continuously rotating multi-instrument systems. J Endod 42:25–29CrossRefPubMed
28.
Zurück zum Zitat Yared G (2008) Canal preparation using only one Ni-Ti rotary instrument: preliminar observations. Int Endod J 41:339–344CrossRefPubMed Yared G (2008) Canal preparation using only one Ni-Ti rotary instrument: preliminar observations. Int Endod J 41:339–344CrossRefPubMed
29.
Zurück zum Zitat Mittal R, Singla MG, Garg A, Dhawan A (2015) A comparison of apical bacterial extrusion in manual, ProTaper rotary, and one shape rotary instrumentation techniques. J Endod 41:2040–2044CrossRefPubMed Mittal R, Singla MG, Garg A, Dhawan A (2015) A comparison of apical bacterial extrusion in manual, ProTaper rotary, and one shape rotary instrumentation techniques. J Endod 41:2040–2044CrossRefPubMed
30.
Zurück zum Zitat Ricucci D, Loghin S, Siqueira JF Jr (2013) Exuberant biofilm infection in a lateral canal as the cause of short-term endodontic treatment failure: report of a case. J Endod 39:712–718CrossRefPubMed Ricucci D, Loghin S, Siqueira JF Jr (2013) Exuberant biofilm infection in a lateral canal as the cause of short-term endodontic treatment failure: report of a case. J Endod 39:712–718CrossRefPubMed
31.
Zurück zum Zitat Gomes BPFA, Lilley JD, Drucker DB (1996) Variation in the susceptibilities of components of the endodontic microflora to biomechanical procedures. Int Endod J 29:235–241CrossRefPubMed Gomes BPFA, Lilley JD, Drucker DB (1996) Variation in the susceptibilities of components of the endodontic microflora to biomechanical procedures. Int Endod J 29:235–241CrossRefPubMed
32.
Zurück zum Zitat Gomes BP, Montagner F, Berber VB, Zaia AA, Ferraz CC, de Almeida JF, Souza-Filho FJ (2009) Antimicrobial action of intracanal medicaments on the external root surface. J Dent 37:76–81CrossRefPubMed Gomes BP, Montagner F, Berber VB, Zaia AA, Ferraz CC, de Almeida JF, Souza-Filho FJ (2009) Antimicrobial action of intracanal medicaments on the external root surface. J Dent 37:76–81CrossRefPubMed
33.
Zurück zum Zitat Basrani B, Tjäderhane L, Santos JM, Pascon E, Grad H, Lawrence HP, Friedman S (2003) Efficacy of chlorhexidine- and calcium hydroxide-containing medicaments against Enterococcus faecalis in vitro. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 96:618–624CrossRefPubMed Basrani B, Tjäderhane L, Santos JM, Pascon E, Grad H, Lawrence HP, Friedman S (2003) Efficacy of chlorhexidine- and calcium hydroxide-containing medicaments against Enterococcus faecalis in vitro. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 96:618–624CrossRefPubMed
34.
Zurück zum Zitat Ferguson DB, Marley JT, Hartwell GR (2003) The effect of chlorhexidine gluconate as an endodontic irrigant on the apical seal: long-term results. J Endod 29:91–94CrossRefPubMed Ferguson DB, Marley JT, Hartwell GR (2003) The effect of chlorhexidine gluconate as an endodontic irrigant on the apical seal: long-term results. J Endod 29:91–94CrossRefPubMed
35.
Zurück zum Zitat Gomes BP, Souza SF, Ferraz CC, Teixeira FB, Zaia AA, Valdrighi L, Souza-Filho FJ (2003) Effectiveness of 2% chlorhexidine gel and calcium hydroxide against Enterococcus faecalis in bovine root dentine in vitro. Int Endod J 36:267–275CrossRefPubMed Gomes BP, Souza SF, Ferraz CC, Teixeira FB, Zaia AA, Valdrighi L, Souza-Filho FJ (2003) Effectiveness of 2% chlorhexidine gel and calcium hydroxide against Enterococcus faecalis in bovine root dentine in vitro. Int Endod J 36:267–275CrossRefPubMed
36.
Zurück zum Zitat Komorowski R, Grad H, Wu XY, Friedman S (2000) Antimicrobial substantivity of chlorhexidine-treated bovine root dentin. J Endod 26:315–317CrossRefPubMed Komorowski R, Grad H, Wu XY, Friedman S (2000) Antimicrobial substantivity of chlorhexidine-treated bovine root dentin. J Endod 26:315–317CrossRefPubMed
37.
Zurück zum Zitat Rasimick BJ, Wan J, Musikant BL, Deutsch AS (2010) Stability of doxycycline and chlorhexidine absorbed on root canal dentin. J Endod 36:489–492CrossRefPubMed Rasimick BJ, Wan J, Musikant BL, Deutsch AS (2010) Stability of doxycycline and chlorhexidine absorbed on root canal dentin. J Endod 36:489–492CrossRefPubMed
38.
Zurück zum Zitat Hwang YH, Bae KS, Baek SH, Kum KY, Lee W, Shon WJ, Chang SW (2014) Shaping ability of the conventional nickel-titanium and reciprocating nickel-titanium file systems: a comparative study using micro-computed tomography. J Endod 40:1186–1189CrossRefPubMed Hwang YH, Bae KS, Baek SH, Kum KY, Lee W, Shon WJ, Chang SW (2014) Shaping ability of the conventional nickel-titanium and reciprocating nickel-titanium file systems: a comparative study using micro-computed tomography. J Endod 40:1186–1189CrossRefPubMed
39.
Zurück zum Zitat Torabinejad M (1994) Passive step-back technique. Oral Surg Oral Med Oral Pathol 77:398–401CrossRefPubMed Torabinejad M (1994) Passive step-back technique. Oral Surg Oral Med Oral Pathol 77:398–401CrossRefPubMed
40.
Zurück zum Zitat Sattapan B, Nervo GJ, Palamara JE, Messer HH (2000) Defects in rotary nickel-titanium files after clinical use. J Endod 26:161–165CrossRefPubMed Sattapan B, Nervo GJ, Palamara JE, Messer HH (2000) Defects in rotary nickel-titanium files after clinical use. J Endod 26:161–165CrossRefPubMed
41.
Zurück zum Zitat Bürklein S, Hinschitza K, Dammaschke T, Schäfer E (2012) Shaping ability and cleaning effectiveness of two single-file systems in severely curved root canals of extracted teeth: Reciproc and WaveOne versus Mtwo and ProTaper. Int Endod J 45:449–461CrossRefPubMed Bürklein S, Hinschitza K, Dammaschke T, Schäfer E (2012) Shaping ability and cleaning effectiveness of two single-file systems in severely curved root canals of extracted teeth: Reciproc and WaveOne versus Mtwo and ProTaper. Int Endod J 45:449–461CrossRefPubMed
Metadaten
Titel
Effect of root canal preparation techniques on chlorhexidine substantivity on human dentin: a chemical analysis
verfasst von
Matheus Albino Souza
Carine Zen Menon
Louise Fochesatto Nery
Charise Dallazem Bertol
Luciana Grazziotin Rossato-Grando
Doglas Cecchin
Publikationsdatum
01.07.2017
Verlag
Springer Berlin Heidelberg
Erschienen in
Clinical Oral Investigations / Ausgabe 2/2018
Print ISSN: 1432-6981
Elektronische ISSN: 1436-3771
DOI
https://doi.org/10.1007/s00784-017-2162-7

Weitere Artikel der Ausgabe 2/2018

Clinical Oral Investigations 2/2018 Zur Ausgabe

Newsletter

Bestellen Sie unseren kostenlosen Newsletter Update Zahnmedizin und bleiben Sie gut informiert – ganz bequem per eMail.