The antimicrobial effect of calcium hydroxide in root canals pretreated with 5% iodine potassium iodide

Abstract

The antimicrobial effect of calcium hydroxide in root canals pretreated with 5% iodine potassium iodide Molander A, k i t C, Dahlen G. The antimicrobial effect of calcium hydroxide in root canals pretreated with 5% iodine potassium iodide. Endod Dent Traumatol 1999; 15: 205-209. 0 Munksgaard, 1999. Abstract -Calcium hydroxide (CH) is often used as a routine interappointment dressing during the endodontic treatment of teeth with apical periodontitis. However, it fails to consistently produce sterile root canals. The present study was set up to find out whether an antimicrobial strategy including the use of C H could be made more effective if: 1) canals were pretreated with 5% iodine potassium iodide (IPI), and 2) the dressing period was extended up to 2 months. Fifty human teeth, with radiographically verified apical periodontitis, were microbiologically sampled. After chemomechanical preparation the canals were pretreated with IPI for 3-7 days. Teeth where microorganisms persisted were then treated with C H for 2 months. Following instrumentation and dressing with IPI, 43 bacterial strains were recovered in 22 of the teeth. Samples obtained after the C H dressing period disclosed growth of 13 facultative and two strict anaerobic strains in 10 teeth. Enterococcus faecalis was identified in two specimens. In conclusion, the present study gave no evidence for an increased antimicrobial effect of C H if it was left for longer periods in the root canal. Although pretreatment with IPI from a quantitative point of view did not seem to add antimicrobial power, it might reduce the frequency of persisting strains of E. faecalis.The aim of modern endodontic treatment of teeth with apical periodontitis is total elimination of intracanal microbes. Data show that relatively few root canals will be bacteria free following only mechanical instrumentation (l), and that an interappointment dressing therefore is needed. Calcium hydroxide paste (CH) is considered the most effective dressing currently in use. However, it fails to consistently produce sterile root canals (2, 3). Few microorganisms will survive when directly exposed to CH, but several factors may impair its antimicrobial potency in the root canal. For example, complex anatomy will make it difficult to satisfactorily pack the whole canal system with C H paste (4, 5). Therefore, longer periods of time than those usually recommended (1-2 weeks) A. Molanderl, C. Reit', 6. Dahlen2

The use of calcium hydroxide, antibiotics and biocides as antimicrobial medicaments in endodontics

“…122,123 In 2% IPI-treated root canals in human teeth, a period of 1-2 hours was required to prevent growth of E. faecium in dentinal tubules, whilst the calcium hydroxide specimens still had positive cultures after 24 hours. 20 Molander et al 125 failed to demonstrate an enhanced antibacterial effect by combining 5% IPI for a period of 3-7 days with a subsequent two-month period of calcium hydroxide dressing in human teeth where the smear layer was not removed. When IPI was used, 44 per cent of the 50 cases examined showed positive growth, whilst the addition of calcium hydroxide to IPI resulted in only 20 per cent positive cultures.…”

The antimicrobial effects of root canal irrigation and medication

“…The combination of IKI and calcium hydroxide in vivo has been shown to be significantly better than pure calcium hydroxide in disinfecting the dentinal tubules. 104 In a clinical study, it was reported that treatment of root canals with IKI prior to calcium hydroxide dressing did not significantly reduce the amount of bacteria but that it might reduce the frequency of persisting strains of E faecalis. 105 The ability of calcium hydroxide to kill E faecalis has been shown to be improved by combining it with IKI or chlorhexidine.…”

An Investigation on the Antibacterial and Antibiofilm Efficacy of Cationic Nanoparticulates for Root Canal Disinfection

“…However, compromise in the physical properties of root canal sealers and the lack of adhesion between sealer and core filling material or between sealer and dentin may cause fluid leakage (6 -11). Studies have revealed Enterococcus faecalis as the most dominant and occasionally the only species to persist in endodontically treated teeth (12)(13)(14). This highlights the ability of E. faecalis to resist endodontic disinfectants and survive nutrient-stringent conditions within root-filled teeth (12,13).…”