Efficacy of Sodium Hypochlorite and Chlorhexidine Against Enterococcus Faecalis--a Systematic Review

Overview

Journal J Appl Oral Sci

Specialty Dentistry

Date 2008 Dec 17

PMID 19082392

Citations 40

Authors

Carlos Estrela

Julio Almeida Silva

Ana Helena Goncalves de Alencar

Claudio Rodrigues Leles

Daniel Almeida Decurcio

Affiliations

Soon will be listed here.

Abstract

The efficacy of the sodium hypochlorite (NaOCl) and chlorhexidine (CHX) on Enterococcus faecalis was evaluated by systematic review and meta-analysis. The search strategies included search in electronic biomedical journal databases (MEDLINE, EMBASE, CENTRAL) and handsearching records, using different matches of keywords for NaOCl, CHX and Enterococcus faecalis. From 41 in vivo studies, 5 studies met the inclusion criteria. In a sample containing 159 teeth, E. faecalis was detected initially in 16 (10%) teeth by polymerase chain reaction (PCR) and 42 (26.4%) teeth by microbial culture techniques. After root canal disinfection, this species was observed in 11 (6.9%) teeth by PCR and 12 (7.5%) teeth by culture. Risk differences of included studies were combined as generic inverse variance data type (Review Manager Version 5.0 _ Cochrane Collaboration, http://www.cc-ims.net, accessed 15 May 2008), taking into account the separate tracking of positive and negative cultures/PCR. The level of statistical significance was set at p<0.05. In conclusion, NaOCl or CHX showed low ability to eliminate E. faecalis when evaluated by either PCR or culture techniques.

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References

Estrela C, Estrela C, Barbin E, Spano J, Marchesan M, Pecora J . Mechanism of action of sodium hypochlorite. Braz Dent J. 2002; 13(2):113-7. DOI: 10.1590/s0103-64402002000200007. View

Torabinejad M, Bahjri K . Essential elements of evidenced-based endodontics: steps involved in conducting clinical research. J Endod. 2005; 31(8):563-9. DOI: 10.1097/01.don.0000164137.28104.2f. View

Zerella J, Fouad A, Spangberg L . Effectiveness of a calcium hydroxide and chlorhexidine digluconate mixture as disinfectant during retreatment of failed endodontic cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005; 100(6):756-61. DOI: 10.1016/j.tripleo.2005.05.072. View

Ayhan H, Sultan N, Cirak M, Ruhi M, Bodur H . Antimicrobial effects of various endodontic irrigants on selected microorganisms. Int Endod J. 1999; 32(2):99-102. DOI: 10.1046/j.1365-2591.1999.00196.x. View

Estrela C, Ribeiro R, Estrela C, Pecora J, Sousa-Neto M . Antimicrobial effect of 2% sodium hypochlorite and 2% chlorhexidine tested by different methods. Braz Dent J. 2003; 14(1):58-62. DOI: 10.1590/s0103-64402003000100011. View

Haapasalo M, Orstavik D . In vitro infection and disinfection of dentinal tubules. J Dent Res. 1987; 66(8):1375-9. DOI: 10.1177/00220345870660081801. View

Sundqvist G, Figdor D, Persson S, Sjogren U . Microbiologic analysis of teeth with failed endodontic treatment and the outcome of conservative re-treatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998; 85(1):86-93. DOI: 10.1016/s1079-2104(98)90404-8. View

Ringel A, Patterson S, Newton C, Miller C, Mulhern J . In vivo evaluation of chlorhexidine gluconate solution and sodium hypochlorite solution as root canal irrigants. J Endod. 1982; 8(5):200-4. DOI: 10.1016/S0099-2399(82)80354-3. View

Holland R, Otoboni Filho J, Souza V, Nery M, Bernabe P, Dezan Jr E . A comparison of one versus two appointment endodontic therapy in dogs' teeth with apical periodontitis. J Endod. 2003; 29(2):121-4. DOI: 10.1097/00004770-200302000-00009. View

10.

Law A, Messer H . An evidence-based analysis of the antibacterial effectiveness of intracanal medicaments. J Endod. 2004; 30(10):689-94. DOI: 10.1097/01.don.0000129959.20011.ee. View

11.

Williams J, Trope M, Caplan D, Shugars D . Detection and quantitation of E. faecalis by real-time PCR (qPCR), reverse transcription-PCR (RT-PCR), and cultivation during endodontic treatment. J Endod. 2006; 32(8):715-21. DOI: 10.1016/j.joen.2006.02.031. View

12.

Estrela C, Holland R, Bernabe P, Souza V, Estrela C . Antimicrobial potential of medicaments used in healing process in dogs' teeth with apical periodontitis. Braz Dent J. 2005; 15(3):181-5. DOI: 10.1590/s0103-64402004000300003. View

13.

Gomes B, Ferraz C, Vianna M, Berber V, Teixeira F, Souza-Filho F . In vitro antimicrobial activity of several concentrations of sodium hypochlorite and chlorhexidine gluconate in the elimination of Enterococcus faecalis. Int Endod J. 2001; 34(6):424-8. DOI: 10.1046/j.1365-2591.2001.00410.x. View

14.

Siqueira Jr J, Rocas I, Santos S, Lima K, Magalhaes F, de Uzeda M . Efficacy of instrumentation techniques and irrigation regimens in reducing the bacterial population within root canals. J Endod. 2002; 28(3):181-4. DOI: 10.1097/00004770-200203000-00009. View

15.

Ferrari P, Cai S, Bombana A . Effect of endodontic procedures on enterococci, enteric bacteria and yeasts in primary endodontic infections. Int Endod J. 2005; 38(6):372-80. DOI: 10.1111/j.1365-2591.2005.00947.x. View

16.

Sathorn C, Parashos P, Messer H . Antibacterial efficacy of calcium hydroxide intracanal dressing: a systematic review and meta-analysis. Int Endod J. 2007; 40(1):2-10. DOI: 10.1111/j.1365-2591.2006.01197.x. View

17.

Estrela C, Estrela C, Decurcio D, Hollanda A, Silva J . Antimicrobial efficacy of ozonated water, gaseous ozone, sodium hypochlorite and chlorhexidine in infected human root canals. Int Endod J. 2007; 40(2):85-93. DOI: 10.1111/j.1365-2591.2006.01185.x. View

18.

Spratt D, Pratten J, Wilson M, Gulabivala K . An in vitro evaluation of the antimicrobial efficacy of irrigants on biofilms of root canal isolates. Int Endod J. 2001; 34(4):300-7. DOI: 10.1046/j.1365-2591.2001.00392.x. View

19.

Peciuliene V, Balciuniene I, Eriksen H, Haapasalo M . Isolation of Enterococcus faecalis in previously root-filled canals in a Lithuanian population. J Endod. 2001; 26(10):593-5. DOI: 10.1097/00004770-200010000-00004. View

20.

Peciuliene V, Reynaud A, Balciuniene I, Haapasalo M . Isolation of yeasts and enteric bacteria in root-filled teeth with chronic apical periodontitis. Int Endod J. 2001; 34(6):429-34. DOI: 10.1046/j.1365-2591.2001.00411.x. View