Chlorhexidine Use In Endodontics

Bacteria are the primary etiology in the development of periapical bone lesions, and endodontic treatment failures are often caused by bacteria remaining in the apical portions of root canals. A study by Zamany et al evaluated the use of a 2% chlorhexidine rinse as part of conventional endodontic treatment protocol in terms of disinfection of the root canal system. The study involved 24 teeth with infected necrotic pulps and resorbing apical periodontitis. The teeth were endodontically treated with conventional technique using 1% sodium hypochlorite as an irrigant. In half of the teeth, an additional rinse with 2% chlorhexidine was used, with the remaining half of the teeth serving as controls and receiving an additional rinse of sterile saline instead of chlorhexidine. Cultures of the root canals were obtained after the first treatment visit, incubated at 37°C, and visually inspected each day for the first 7 days, then the cultures were observed weekly for an additional 3 weeks. After 4 weeks of incubation, the control group showed 7 positive cultures compared to only 1 positive culture for the chlorhexidine group. The authors state that although the sample size in this study was small, the findings demonstrate that an additional rinse with 2% chlorhexidine resulted in enhanced disinfection of the root canal system.
(Source: Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics, Vol. 96, No. 5, 2003)