Antimicrobial activity of calcium hydroxide and chlorhexidine on intratubular Candida albicans

Abstract

This study investigated the efficacy of calcium hydroxide and chlorhexidine gel for the elimination of intratubular Candida albicans (C. albicans). Human single-rooted teeth contaminated with C. albicans were treated with calcium hydroxide, 2% chlorhexidine gel, calcium hydroxide plus 2% chlorhexidine gel, or saline (0.9% sodium chloride) as a positive control. The samples obtained at depths of 0–100 and 100–200 µm from the root canal system were analyzed for C. albicans load by counting the number of colony forming units and for the percentage of viable C. albicans using fluorescence microscopy. First, the antimicrobial activity of calcium hydroxide and the 2% chlorhexidine gel was evaluated by counting the number of colony forming units. After 14 days of intracanal medication, there was a significant decrease in the number of C. albicans colony forming units at a depth of 0–100 µm with chlorhexidine treatment either with or without calcium hydroxide compared with the calcium hydroxide only treatment. However, there were no differences in the number of colony forming units at the 100–200 µm depth for any of the medications investigated. C. albicans viability was also evaluated by vital staining techniques and fluorescence microscopy analysis. Antifungal activity against C. albicans significantly increased at both depths in the chlorhexidine groups with and without calcium hydroxide compared with the groups treated with calcium hydroxide only. Treatments with only chlorhexidine or chlorhexidine in combination with calcium hydroxide were effective for elimination of C. albicans.

Antimicrobial effect of calcium hydroxide as an intracanal medicament in root canal treatment: a literature review - Part I.In vitrostudies

“…However, a significant reduction in the bacterial number was observed. Similar results were exhibited in other studies 102,103,104,105. Lana et al said that a Ca(OH) 2 paste induced a 70% elimination of E. faecalis for 14 days 106.…”

Antimicrobial activity of Psidium cattleianum associated with calcium hydroxide against Enterococcus faecalis and Candida albicans: an in vitro study

“…When Enterococcus faecalis was inoculated prior, the growth of yeasts was not affected. However, when Candida albicans was inoculated first, the growth of E. faecalis into de dentinal tubules was significantly affected, probably due to formation of aggregates of yeasts, pseudohyphae, and hyphae on dentinal tubules, as previously reported [3,13,15,47]. At the 8th day after initial inoculation, the contamination by enterococci was high and reached the highest values.…”

“…Candida albicans is the most common yeast isolated from the oral cavity or root canals and has the ability to form bilayer biofilm, rich in an extracellular matrix composed by carbohydrates, proteins, phosphorus, and hexosamines, allowing good tolerance and growth in nutrient-restricted environments, as occurs in retreatment of the canal system [13,14]. Also, has been considered tolerant to chemical compounds commonly used in the biomechanical instrumentation of infected root canals or dressings, such as calcium hydroxide [15][16][17], and this resistance may be comparable to that evidenced for E. faecalis [18]; E.faecalis is a cocci Gram-positive anaerobe facultative which occur in primary root canal infections and is the most common organism cultured from failed root canal therapy, with 12-90% prevalence [19]. Both species exhibit similar starvation survival behaviors and are capable of starvation survival for 6 months, using low levels of serum for growth.…”

Peptoid Efficacy against Polymicrobial Biofilms Determined by Using Propidium Monoazide‐Modified Quantitative PCR

“…Although widely used in biofilm assays, the crystal violet assay detects both live and dead organisms, in addition to matrix components. Conventional CFU assays have been reported to underestimate live cell numbers because they cannot quantify VBNC cells . Furthermore, microorganisms have been shown to enter the VBNC sate when exposed to antibiotic treatment .…”