Disinfecting oval-shaped root canals: effectiveness of different supplementary approaches
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Abstract
Introduction: This study compared the ability of
different approaches to supplement the antibacterial
effects of chemomechanical preparation in ovalshaped root canals. Methods: Long oval canals from
extracted teeth infected with Enterococcus faecalis
(ATCC 29212) were chemomechanically prepared up to
a 40/04 rotary BioRaCe instrument using 2.5% NaOCl
irrigation and then subjected to two supplementary
protocols. In the passive ultrasonic irrigation (PUI)/
chlorhexidine (CHX) group, canals were subjected to
PUI for the activation of NaOCl followed by a final
rinse with 0.2% CHX digluconate solution. In the
Hedstr€om group, canals received additional Hedstr€om
filing directed towards the buccal and lingual canal
recesses. Bacteriological samples were taken before
and after preparation, after PUI or Hedstr€om instrumentation, and after CHX final rinsing. Results: Chemomechanical preparation and the supplementary
steps promoted a highly significant bacterial reduction
(P < .001). Quantitative (reduction in levels) and qualitative (frequency of negative cultures) analyses showed
that PUI alone or Hedstr€om filing did not significantly
increase bacterial reduction (P > .05). Further rinsing
with CHX also failed to significantly increase bacterial
elimination when compared with post-PUI samples.
However, the cumulative antibacterial effects of PUI
and CHX final rinse were effective in significantly
reducing bacterial counts to levels below those achieved
after preparation (P = .03). This combined PUI/CHX
approach also resulted in a significant increase in the
incidence of negative cultures (P = .04). Conclusions:
Findings suggest that there may be a benefit of using
the PUI for the activation of NaOCl followed by a final rinse with CHX as supplementary steps in the treatment of infected oval-shaped root
canals.
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