112 © 2006 The Authors
Journal compilation © 2006 Australian Society of Endodontology
Aust Endod J 2006; 32: 112–115
Blackwell Publishing IncMalden, USAAEJAustralian Endodontic Journal1329-19472006 Australian Society of Endodontology2006323112115Original Research Antibacterial Action of Intra-canal AgentsA. ali Khademi
et al.
ORIGINAL RESEARCH
Evaluation of the antibacterial substantivity of several
intra-canal agents
Abbas ali Khademi, DMD, MS
1
; Zahed Mohammadi, DMD, MS
2
; and Asgar Havaee, PhD
3
1 Department of Endodontics, Isfahan University of Medical Sciences, Isfahan, Iran
2 Department of Endodontics, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
3 Department of Microbiology, Isfahan University of Medical Sciences, Isfahan, Iran
Abstract
The aim of this in vitro study was to compare the antimicrobial substantivity of
2% chlorhexidine gluconate (CHX), 100 mg ml
-1
doxycycline and 2.6% sodium
hypochlorite (NaOCl) in bovine root dentine. Eighty dentine tubes prepared
from bovine incisors were infected in vitro for 14 days with Enterococcus faecalis.
The specimens were divided into five groups as follows: doxycycline HCl; CHX;
NaOCl; infected dentine tubes (positive control); and sterile dentine tubes (neg-
ative control). Dentine chips were collected with round burs into tryptic soy
broth. After culturing, the number of colony-forming units (CFU) was counted.
In all experimental groups, the number of CFU was minimum in the first cul-
tures, and the results obtained were significantly different from each other at
any time period (P < 0.05). In the first culture, the NaOCl group and doxycy-
cline HCl group showed the lowest and highest number of CFU, respectively. In
each group, the number of CFU increased significantly by time-lapse ( P < 0.05).
In conclusion, the substantivity of CHX was significantly greater than NaOCl
and doxycycline.
Introduction
Viable microorganisms remaining after root canal prepa-
ration and disinfection contribute significantly to failure in
endodontic therapy (1). Numerous measures have been
described to reduce the numbers of root canal micro-
organisms, including the use of various instrumentation
techniques, irrigation regimens and intra-canal medica-
ments (1). In cases with necrotic pulps as well as in retreat-
ment cases, treatment should be performed in two visits,
which is more time-consuming than one-visit treatment
(2). Furthermore, some studies have suggested that cal-
cium hydroxide is ineffective against Enterococcus faecalis
(3). To overcome the aforementioned problems, an alter-
native protocol is to use antimicrobial agents that exhibit
substantivity, that is, agents that can have a therapeutic
effect for a prolonged period.
Sodium hypochlorite (NaOCl) is the most commonly
used root canal irrigant. It has both antimicrobial and
tissue-dissolving properties (4,5). Chlorhexidine glucon-
ate (CHX) seems to act by adsorbing onto the cell wall of
microorganisms and causing the leakage of intracellular
components (6). The antimicrobial substantivity of CHX in
the root canal system has been reported to last from 48 h
to 21 days (7–9). However, Rosenthal et al. indicated that
the substantivity of CHX could last up to 12 weeks (1).
Tetracyclines are effective against a wide range of micro-
organisms (10). Tetracyclines readily attach to dentine and
are subsequently released without losing their antibacte-
rial activity (11). In endodontics, tetracyclines have been
used to remove the smear layer from the instrumented
canals (12,13), irrigation of root–end cavities (14) and as
an intra-canal medicament (15). The aim of this study was
to compare the antimicrobial substantivity of CHX, doxy-
cycline HCl and NaOCl against E. faecalis in bovine root
dentine in vitro.
Materials and methods
The method used in this study was a modification of one
previously described by Haapasalo and Ørstavik (3). Thirty
intact bovine central incisors were selected for this study.
Keywords
chlorhexidine, doxycycline HCl, Enterococcus
faecalis, substantivity.
Correspondence
Dr Zahed Mohammadi, Department of
Endodontics, Shahid Sadoughi University of
Medical Sciences, Yazd, Iran. Email:
mohammadi_zahed@yahoo.com
doi: 10.1111/j.1747-4477.2006.00033.x