Συγκριτική in vivo μελέτη της δράσης των διαλυμάτων χλωρεξιδίνης και χλωρεξιδίνης-κετριμίδης στη βακτηριακή χλωρίδα απολφών δοντιών

Abstract

This study was undertaken in order to investigate the antimicrobial effects of two Chlorhexidine solutions (0.2% Chlorhexidine gluconate and 1% Chlorhexidine-Cetrimide) on root canal microbialflora. As a control a 3% Sodium hypochlorite solution was used. A total of sixty single rooted teeth with necrotic pulp and periapical lesion were randomly divided in three equal groups A Β C of20 each. In the group A the hypochlorite solution was used as irrigant; In the group Β the Chlorhexidine gluconate 0,2% solution was used as irrigant and the group C the Chrorhexidine-Cetrimide 1% solution was used. Using standard antiseptic endodontic technique, access to the root canal was achieved and an initial culture from the canal was obtained by means of sterile paper points. In the first appointment the canal was then biomechanically cleaned by using as irrigation solution one of the above antibacterial solutions. When the biomechanical cleaning was completed the root canals were irrigated with sterile distilled water, dried with paper points and asecond culture was taken. A sterile cotton pellet was placed in the pulp champer and a temporary filling was placed. In the second appointment, 24 h later, using again antiseptic technique, a third culture was taken. No irrigation was performed at this stage. Optimal tecniques were employed for transportation and quantitative evaluation of both aerobic and anaerobic bacteria. From the results of the present study the following conclusions were drawn: 1. The three irrigation solutions studied, possess essentially the same antiseptic action against aerobic, anaerobic and compinedmicrobial flora of the root canal system. 2. The combination of mechanical preparation of the root canal and irrigation with any of the studied solutions significantly decreased the number of bacteria without fully eliminating them. 3. Because there may be a reversal in bactériologie status of theroot canal system between appointments, culturing provides only a temporary indication of the bactériologie status of the root canal system. 4. The culture change from positive to negative was more often than the opposite. Further research is needed on the antimicrobial and toxic effects ofstronger Chlorhexidine and Chlorhexidine-Cetrimide solutions in order to be used clinically not only as irrigants but also as medicaments of the root canal between appointments during the endodontic therapy.

Η ΕΞΑΛΕΙΨΗ ΤΩΝ ΜΙΚΡΟΒΙΩΝ ΑΠΟ ΤΟ ΣΥΣΤΗΜΑ ΤΩΝ ΡΙΖΙΚΩΝ ΣΩΛΗΝΩΝ ΑΠΟΤΕΛΕΙ ΤΗΝ ΑΠΑΡΑΙΤΗΤΗ ΠΡΟΥΠΟΘΕΣΗ ΜΙΑΣ ΕΠΙΤΥΧΗΜΕΝΗΣ ΕΝΔΟΔΟΝΤΙΚΗΣ ΘΕΡΑΠΕΙΑΣ. ΓΙΑ ΤΟ ΣΚΟΠΟ ΑΥΤΟ ΧΡΗΣΙΜΟΠΟΙΗΘΗΚΑΝ ΔΙΑΦΟΡΑ ΑΝΤΙΣΚΟΠΙΚΑ ΔΙΑΛΥΜΑΤΑ ΤΟΣΟ ΚΑΤΑ ΤΟ ΣΤΑΔΙΟ ΤΟΥ ΧΗΜΙΚΟΜΗΧΑΝΙΚΟΥ ΚΑΘΑΡΙΣΜΟΥ ΤΩΝ ΡΙΖΙΚΩΝ ΣΩΛΗΝΩΝ ΟΣΟ ΚΑΙ ΜΕΤΑΞΥ ΤΩΝ ΣΥΝΕΔΡΙΩΝ. Σ'ΑΥΤΗ ΤΗΝ ΕΡΓΑΣΙΑ ΔΟΚΙΜΑΖΟΝΤΑΙ ΔΥΟ ΝΕΑ ΔΙΑΛΥΜΑΤΑ Η ΧΛΩΡΕΞΙΔΙΝΗ 0.2% ΚΑΙ ΤΟ ΔΙΑΛΥΜΑ ΧΛΩΡΕΞΙΔΙΝΗΣ-ΚΕΤΡΙΕΙΔΗΣ 1% ΓΙΑ ΔΙΑΚΛΥΣΜΟΥΣ ΤΩΝ ΡΙΖΙΚΩΝ ΣΩΛΗΝΩΝ ΚΑΤΑ ΤΟ ΣΤΑΔΙΟ ΤΟΥ ΧΗΜΕΙΟΜΗΧΑΝΙΚΟΥ ΚΑΘΑΡΙΣΜΟΥ. ΚΥΡΙΑ ΜΕΛΕΤΑΤΑΙ ΑΝ, Η ΙΔΙΟΤΗΤΑ ΤΗΣ ΧΛΩΡΕΞΙΔΙΝΗΣ ΝΑ ΑΠΟΡΡΟΦΑΤΑΙ ΑΠΟ ΤΗΝ ΟΔΟΝΤΙΝΗ ΚΑΙ ΝΑ ΕΛΕΥΘΕΡΩΝΕΤΑΙ ΣΤΑΔΙΑΚΑ ΑΣΚΕΙ ΜΙΑ ΔΙΑΡΚΗ ΑΝΤΙΣΚΟΠΙΚΗ ΔΡΑΣΗ ΚΑΤΑ ΤΩΝ ΒΑΚΤΗΡΙΩΝ ΤΩΝ ΡΙΖΙΚΩΝ ΣΩΛΗΝΩΝ. ΚΑΙ ΤΑ ΔΥΟ ΔΙΑΛΥΜΑΤΑ ΠΡΟΚΑΛΟΥΝ ΣΗΜΑΝΤΙΚΗ ΜΕΙΩΣΗ ΤΗΣ ΧΛΩΡΙΔΑΣ ΤΟΥ ΣΩΜΑΤΟΣ ΑΛΛΑ ΔΕΝ ΤΗΝ ΕΞΑΛΕΙΦΟΥΝ ΤΕΛΕΙΩΣ. ΙΣΩΣ ΜΕΓΑΛΥΤΕΡΕΣ ΣΥΓΚΕΝΤΡΩΣΕΙΣ ΑΥΤΩΝ ΤΩΝ ΔΙΑΛΥΜΑΤΩΝ ΣΕ ΣΥΝΔΥΑΣΜΟ ΜΕ ΤΗΝ ΜΗ ΤΟΞΙΚΗΤΟΥΣ ΔΡΑΣΗ ΣΤΟΥΣ ΠΕΡΙΑΚΡΟΡΡΙΖΙΚΟΥΣ ΙΣΤΟΥΣ ΝΑ ΕΧΟΥΝ ΣΗΜΑΝΤΙΚΟΤΕΡΑ ΑΠΟΤΕΛΕΣΜΑΤΑ ΚΑΙ ΝΑ ΣΥΜΒΑΛΛΟΥΝ ΠΕΡΙΣΣΟΤΕΡΟ ΣΤΗΝ ΕΞΑΛΕΙΨΗ ΤΩΝ ΜΙΚΡΟΒΙΩΝ ΑΠΟ ΤΟ ΣΥΣΤΗΜΑ ΤΩΝ ΡΙΖΙΚΩΝ ΣΩΛΗΝΩΝ.