An evidence-based analysis of the antibacterial effectiveness of intracanal medicaments.

Abstract:

:The authors reviewed the literature evaluating the antibacterial effectiveness of intracanal medicaments used in the management of apical periodontitis. A PICO (problem, intervention, comparison, outcome) strategy was developed to identify studies dealing with calcium hydroxide, phenolic derivatives, iodine-potassium iodide, chlorhexidine, and formocresol. The final inclusion/exclusion criteria eliminated all papers except five that evaluated calcium hydroxide. The total sample size in the included studies was 164 teeth. Microbiologic sampling was performed before endodontic treatment (S1), after instrumentation and irrigation (S2), and after intracanal medication (S3). At S2, 62% of canals were positive. After medication, 27% still showed detectable growth. Of cultures that were positive at S2, 45% were still positive at S3. Most studies did not address issues of culture reversals or false positive and false negative cultures. The main component of antibacterial action appears to be associated with instrumentation and irrigation, although canals cannot be reliably rendered bacteria free. Calcium hydroxide remains the best medicament available to reduce residual microbial flora further.

journal_name

J Endod

journal_title

Journal of endodontics

authors

Law A,Messer H

doi

10.1097/01.don.0000129959.20011.ee

keywords:

subject

Has Abstract

pub_date

2004-10-01 00:00:00

pages

689-94

issue

10

eissn

0099-2399

issn

1878-3554

pii

00004770-200410000-00003

journal_volume

30

pub_type

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