Intracanal Antibacterial Effects of a Bioceramic Medication Compared With Calcium Hydroxide Pastes in Different Vehicles

Abstract

Introduction: The intracanal antibacterial effectiveness of a bioceramic medication was compared with calcium hydroxide pastes in different vehicles.

Methods: Extracted mandibular incisors with a single long oval canal were selected and distributed into 5 groups based on anatomically paired microcomputed tomographic analyses. The root canals were prepared up to an instrument size 35/04 and contaminated for 30 days with a mixed bacterial culture from subgingival biofilm added with Enterococcus faecalis. The canals were medicated with Bio-C Temp (Angelus Indústria de Produtos Odontológicos, Londrina, PR, Brazil) or a calcium hydroxide paste in glycerin, camphorated paramonochlorophenol and glycerin (CHPG), or 2% chlorhexidine (CHCX). Control specimens were filled with sterile saline. After 7 days, the medication was removed by using rotary instruments and saline irrigation. A supplementary approach was conducted, which consisted of 2.5% sodium hypochlorite irrigation and agitation with XP-endo Finisher. Bacteriological samples were taken before application (S1) and after removal (S2) of the intracanal medication, and after the supplementary approach (S3). Bacterial DNA extracted from the samples was quantified using real-time polymerase chain reaction.

Results: Bacterial counts were significantly reduced from S1 to S2 in all groups, except for the control group. As for S1-to-S3 changes, all groups (control included) showed significant bacterial reduction. S2-to-S3 changes were only significant in the CHPG and CHCX groups (P < .05). Intergroup comparisons showed no significant differences in S2 (P > .05), with all medications significantly better than the control (P < .05). In S3, only the CHPG and CHCX groups showed further significant bacterial reductions. Categorical data analysis showed no intergroup differences (P > .05).

Conclusions: All tested medications significantly reduced the intracanal bacterial counts, with no significant differences between them. Final sodium hypochlorite irrigation and agitation using XP-endo Finisher further enhanced disinfection in the CHCX and CHPG groups.

Keywords: Bioceramic material; calcium hydroxide; calcium silicate; intracanal medication; root canal treatment.