Research Article
Comparison of the Antifungal Efficacy of 1.3% NaOCl/MTAD
with Other Routine Irrigants: An Ex-Vivo Study
Neha Juneja
1
and Mithra N. Hegde
2
1
Conservative Dentistry & Endodontics, Manav Rachna Dental College, Manav Rachna Educational Institutions Aravalli Campus,
Sector 43, Delhi-Surajkund Road, Faridabad, Haryana 121004, India
2
Conservative Dentistry & Endodontics, Department of Conservative Dentistry & Endodontics,
A. B. Shetty Memorial Institute of Dental Sciences, Medical Sciences Complex, Deralakatte, Mangalore, Karnataka 575018, India
Correspondence should be addressed to Neha Juneja; nehabhalla 1999@yahoo.com
Received 23 June 2014; Revised 15 August 2014; Accepted 10 September 2014; Published 29 October 2014
Academic Editor: Hee-Jin Kim
Copyright © 2014 N. Juneja and M. N. Hegde. Tis is an open access article distributed under the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly
cited.
Objectives. To evaluate and compare the antifungal efcacy of 1.3% NaOCl/MTAD with 2.5% sodium hypochlorite (NaOCl), 2%
chlorhexidine gluconate (CHX), and iodine potassium iodide (IKI). Materials and Methods. Fify-two single rooted teeth were
used which were divided into four groups with 10 teeth in each group: 2.5% NaOCl, 2% CHX, IKI, 1.3% NaOCl/MTAD, and
physiologic saline. Two teeth served as negative controls and were placed in fresh brain-heart infusion broth (BHI) afer autoclaving.
Te teeth were inoculated and incubated with Candida albicans afer which the teeth were instrumented and irrigated with the
test irrigants. Te frst microbial sampling was then performed and colony forming unit/mL (cfu/mL) was counted. Te second
microbial sampling was performed 1 week afer instrumentation and irrigation. Results. Te test irrigants were efective against C.
albicans in both the frst and second microbial samplings. When the irrigants were compared, there was no statistical diference
in their activity in the 1st and 2nd microbial sampling. On comparison of the change in mean cfu/mL between the 1st and 2nd
microbial samplings, the antifungal activity of the test irrigants was in the order 2.5% NaOCl > 2% CHX > 1.3% NaOCl/MTAD >
IKI.
1. Introduction
Infection of the root canals with bacteria causes pulpitis
and leads to the initiation and progression of periapical
periodontitis. Te obvious objective of endodontic treatment
is thus to prevent or eliminate infection within the root canal
[1].
Mechanical instrumentation for root canal debridement
may leave certain areas of the root canal system untouched
due to its complex anatomy. It has been shown that mechani-
cal instrumentation without irrigation reduces but does not
predictably eliminate microorganisms in the canal. Tus, a
root canal irrigant is needed to achieve the goal of complete
debridement of the canals [2].
In addition to the identifcation of bacterial strains, fungi
have also been isolated from root canal infections, with the
most common isolate being C. albicans [3].
In current practice, the most common irrigants used
are sodium hypochlorite (NaOCl), chlorhexidine gluconate
(CHX), and Iodine potassium iodide (IKI). Biopure MTAD
cleanser (Dentsply/Tulsa) is a new root canal cleanser, intro-
duced by Mahmoud Torabinejad and associates in the year
2003. MTAD combines a surfactant (0.5% Tween 80), an
acid (4.25% citric acid), and a broad spectrum antibiotic (3%
doxycycline) [4].
Studies on the efectiveness of NaOCl, CHX, and IKI
against C. albicans show these irrigants to be useful in killing
C. albicans. Waltimo et al. found in their study that NaOCl
and IKI killed all the C. albicans within 30 seconds. Tey also
tested CHX which they found to take 5 minutes to kill all
the yeast cells [3]. Ruf et al. found 6% NaOCl and 2% CHX
to be equally efective and signifcantly superior to Biopure
MTAD in their antifungal activity [5]. However, there is still
Hindawi Publishing Corporation
International Scholarly Research Notices
Volume 2014, Article ID 575748, 5 pages
http://dx.doi.org/10.1155/2014/575748