Antimicrobial effect and pH of chlorhexidine gel and calcium hydroxide alone and associated with other materials

The purposes of this study were to evaluate the effectiveness of 2% chlorhexidine (CHX) gluconate gel, calcium hydroxide [Ca(OH)2] and their combination with iodoform and zinc oxide powder as intracanal medications against select microorganisms, and to measure the pH changes caused by these medications. Antimicrobial activity was determined by the agar diffusion method. The zones of growth inhibition were measured and the results were analyzed statistically by Kruskal-Wallis test (p<0.05). The pH of the pastes was measured right after preparation, after 24 h and 1 week later. The largest mean zones of microbial inhibition were produced by 2% CHX gel, followed by Ca(OH)2 + 2% CHX gel + iodoform, Ca(OH)2 + 2% CHX gel, Ca(OH)2 + 2% CHX gel + zinc oxide, and Ca(OH)2 + water. The mean pH of all medications stayed above 12.0 during the whole experiment, except for CHX gel (pH=7.0). The results of this study showed that all medications had antimicrobial activity, but the most effective against the tested microorganisms were 2% CHX gel, followed by its combination with Ca(OH)2 and iodoform.