Antibacterial effectiveness in vitro of different formulations of calcium hydroxide paste

Abstract

Objective: To evaluate the antibacterial activity of four formulations of calcium hydroxide paste against microorganisms commonly found in infected root canals. Methods: To evaluate antibacterial activity through the agar diffusion method, pastes of calcium hydroxide were made from its pro-analysis form, diffused into four separate vehicles: distilled water, camphorated p-monochlorophenol, propylene glycol and Otosporin®, testing the antimicrobial activity of these on strains of Staphylococcus aureus, Bacillus subtilis and Enterococcus faecalis. After the incubation period, the presence or otherwise of inhibition zones were observed and their sizes in three stages: 24h, 48h and 72h. With this data, the median between the four dishes was obtained and the consequent value was submitted to Kruskal-Wallis nonparametric statistical analysis, with post-tests of Mann-Whitney and Bonferroni correction, at a significance level of 5%. Results: Only pastes with camphorated p-monochlorophenol and Otosporin vehicles caused the formation of significant inhibition zones, with medians of 8.0 mm. Against the strains of Enterococcus faecalis, only pastes with the camphorated p-monochlorophenol vehicle resulted in the formation of significant inhibition zones, with a median of 3.0 mm. Conclusion : Otosporin and CMCP vehicles provide greater antimicrobial potential to calcium hydroxide against the studied bacteria. However, only the Ca(OH)2 and CMCP combination was effective against all the strains, and can thus be regarded as the paste formulation with the greatest antimicrobial effectiveness in this study.

The Comparison of Different Irrigation Systems to Remove Calcium Hydroxide from the Root Canal: A Systematic Review and Meta-Analysis

“…For over 40 years, the calcium hydroxide has been employing as an antimicrobial agent. Some authors believe that it is probably the number one interappointment agent to eliminate the microbiota of the oral cavity [6].…”

Evaluación de la susceptibilidad de Enterococcus faecalis ATCC-29212 frente a medicamentos combinados con hidróxido de calcio

“…Enterococcus faecalis es un microorganismo anaerobio facultativo, Gram positivo, inmóvil, no esporulado que coloniza el tracto gastrointestinal y forma parte de la microbiota normal de la saliva. (1,2) Sin embargo, con la aparición de la terapia antibiótica, se ha convertido en un patógeno oportunista resistente que puede permanecer dentro de los conductos radiculares incluso después de la instrumentación endodóntica, (3,4) siendo una de las principales causas del fracaso en el tratamiento de conducto, debido a que componentes estructurales como el colágeno y la fibronectina ayudan a la adhesión de la bacteria en tejidos y dentina. También favorece la aparición de enfermedades periapicales por su capacidad de apoptosis y piroptosis a las células.…”

“…Se ha observado que la bacteria tiene la capacidad degradativa similar a la esterasa, pudiendo afectar los componentes de la resina ocasionando la contaminación de la pieza dental. (4,15,16) El Hidróxido de Calcio constituye la sustancia antibacteriana más utilizada en el tratamiento endodóntico, (4,7) debido a que su alto pH destruye la membrana celular bacteriana y las estructuras de proteínas; (17) sin embargo, varios estudios demuestran que Enterococcus faecalis puede ser resistente a varios antibacterianos incluyendo ese medicamento. (1,4,18) La eliminación de este microrganismo por medios convencionales puede llegar a ser poco eficaz, haciéndose necesaria la investigación de nuevos fármacos que potencien la acción de este o como alternativa terapéutica.…”