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Dentinal tubule disinfection using three calcium hydroxide formulations
Stephen J Cwikla1, Myriam Bélanger, Steeve Giguère
1Center for Molecular Microbiology, Department of Oral Biology, College of Dentistry, University of Florida, Gainesville, Florida 32610-0424, USA.
Journal of Endodontics
|December 23, 2004
Summary
This study compared three calcium hydroxide (CH) formulations against Enterococcus faecalis in dentinal tubules. Metapex demonstrated the highest antibacterial efficacy, outperforming CH mixed with iodine-potassium iodide and plain CH.
Area of Science:
- Endodontics
- Microbiology
- Dental Materials Science
Background:
- Enterococcus faecalis is a common pathogen in persistent root canal infections.
- Calcium hydroxide (CH) is a widely used intracanal medicament for its antimicrobial properties.
- Optimizing CH formulations may enhance disinfection of dentinal tubules.
Purpose of the Study:
- To evaluate and compare the in vitro antibacterial efficacy of three calcium hydroxide formulations against E. faecalis in infected dentinal tubules.
- To determine the effectiveness of CH, CH with iodine-potassium iodide (CH+IKI), and Metapex (CH with iodoform and silicone oil).
Main Methods:
- An in vitro model using human dentin specimens infected with E. faecalis was established.
- Specimens were treated with CH, CH+IKI, or Metapex and incubated for one week.
- Dentinal tubule disinfection was assessed by quantifying E. faecalis in collected dentin powder samples using different burs (ISO 018 and 021).
Main Results:
- All three CH formulations significantly reduced E. faecalis compared to controls.
- Metapex showed the highest efficacy, followed by CH+IKI, and then CH.
- At greater depths (ISO 021), CH alone showed increased E. faecalis compared to controls, unlike Metapex and CH+IKI.
Conclusions:
- Metapex is the most effective dentinal tubule disinfectant among the tested CH formulations.
- CH+IKI also offers improved efficacy over plain CH.
- Formulation choice is critical for effective E. faecalis disinfection in root canals.