Evaluation of Gel and Solution of Chlorhexidine in Disinfection Root Canals of Primary Anterior Teeth.
Condition: Dental Caries; Infection, Bacterial; Tooth, Deciduous
MeSH terms: Bacterial Infections; Dental Caries
Study type: Interventional

Summary: 
      The process of removing bacteria and their products from the root canals is an essential step
      that is achieved through the combination of mechanical preparation and irrigation with
      chemicals. However, mechanical preparation alone can not reduce the microbial formations
      inside root canals, so at least about 35% of the root canal walls remain without the
      preparation tools reaching them.

      Many irrigants were used to irrigate the root canals, as sodium hypochlorite and
      chlorhexidine are the most famous. Although most studies have proven the effectiveness of
      sodium hypochlorite with its different concentrations in accomplishing this task, some of
      them showed the inability of the irrigant fluid to eliminate Enterococcus faecalis inside the
      canals. These bacteria are highly resistant, and therefore endodontic treatment fails in the
      long term.
    

Detailed description: 
      Bacteria and their products play an essential role in the initiation and persistence of
      endodontic diseases. Therefore, eliminating them and preventing the return of their
      effectiveness is the desired goal in any successful endodontic treatment in the short and
      long term.

      Due to the fact that mechanical preparation of the root canal alone is not capable of
      removing the entire bacterial content, chemical irrigants were considered necessary to reduce
      the number of bacteria and toxins resulting from them. Until now, there is no irrigant
      capable of removing the entire bacterial content from the root canal.

      Despite the many advantages of sodium hypochlorite, several studies have revealed the
      toxicity of the solution in high concentrations of it, and it tends to cause tissue
      irritation when it comes into contact with the apical tissues.

      Chlorhexidine has been used for a long time in dentistry due to its antibacterial properties,
      long period of effect, and relatively low toxicity. This has prompted its use as an irrigant
      and an intra-canal dressing in endodontic treatment.
    

Intervention name(s): Chlorhexidine solution; Activated chlorhexidine solution; Chlorhexidine gel; Activated chlorhexidine gel; Sodium hypochlorite solution
Intervention type(s): Other; Other; Other; Other; Other
Intervention description(s): Irrigate the root canal with 1 ml of 2% CHx solution between each file 1 mm from the apical foramen by using a 27-gauge irrigation needle.
Irrigate the root canal with 3 ml of the solution after using the last file.
Irrigation with 3 ml of 0.5% Tween 80 and 0.07 % lecithin to remove residual chlorhexidine solution.
Drying the canal with paper points (placing a 20 size paper point for 60 seconds in each canal) to take the bacterial smear.
Follow-up of endodontic treatment procedures for the treated tooth.; Irrigate the root canal with 1 ml of 2% CHx solution between each file 1 mm from the apical foramen by using a 27-gauge irrigation needle with activation using an ultrasonic irrigation head.
Irrigate the root canal with 3 ml of the solution after using the last file with activation using an ultrasonic irrigation head.
Irrigation with 3 ml of 0.5% Tween 80 and 0.07 % lecithin to remove residual chlorhexidine solution.
Drying the canal with paper points (placing a 20 size paper point for 60 seconds in each canal) to take the bacterial smear.
Follow-up of endodontic treatment procedures for the treated tooth.; Irrigate the root canal with 1 ml of 2% CHx gel between each file 1 mm from the apical foramen by using a 27-gauge irrigation needle.
Irrigate the root canal with 3 ml of the gel after using the last file.
Irrigation with 3 ml of 0.5% Tween 80 and 0.07 % lecithin to remove residual chlorhexidine gel.
Drying the canal with paper points (placing a 20 size paper point for 60 seconds in each canal) to take the bacterial smear.
Follow-up of endodontic treatment procedures for the treated tooth.; Irrigate the root canal with 1 ml of 2% CHx gel between each file 1 mm from the apical foramen by using a 27-gauge irrigation needle with activation using an ultrasonic irrigation head.
Irrigate the root canal with 3 ml of the gel after using the last file with activation using an ultrasonic irrigation head.
Irrigation with 3 ml of 0.5% Tween 80 and 0.07 % lecithin to remove residual chlorhexidine gel.
Drying the canal with paper points (placing a 20 size paper point for 60 seconds in each canal) to take the bacterial smear.
Follow-up of endodontic treatment procedures for the treated tooth.; Irrigate the root canal with 1 ml of 5.25% sodium hypochlorite solution between each file 1 mm from the apical foramen by using a 27-gauge irrigation needle.
Irrigate the root canal with 3 ml of the solution after using the last file.
Irrigating the canal with 3 ml of 5% sodium thiosulfate solution to remove residual of sodium hypochlorite.
Drying the canal with paper points (placing a 20 size paper point for 60 seconds in each canal) to take the bacterial smear.
Follow-up of endodontic treatment procedures for the treated tooth.
Intervention MeSH terms: Chlorhexidine; Chlorhexidine gluconate; Sodium Hypochlorite; Eusol; Pharmaceutical Solutions
Allocation: Randomized
Intervention model: Single Group Assignment
Masking: Triple (Participant, Investigator, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Anterior Primary Tetth; Infected canals; chlorhexidine; Sodium hypochlorite