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Sy K, Chevalier C, Maton M, Mokbel I, Mahieux S, Houcke I, Neut C, Grosgogeat B, Deveaux E, Gritsch K, Agossa K. Therapeutic Potential of Chlorhexidine-Loaded Calcium Hydroxide-Based Intracanal Medications in Endo-Periodontal Lesions: An Ex Vivo and In Vitro Study. Antibiotics (Basel) 2023; 12:1416. [PMID: 37760713 PMCID: PMC10525524 DOI: 10.3390/antibiotics12091416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 08/21/2023] [Accepted: 08/31/2023] [Indexed: 09/29/2023] Open
Abstract
Endo-periodontal lesions are challenging clinical situations where both the supporting tissues and the root canal of the same tooth are infected. In the present study, chlorhexidine (CHX)-loaded calcium hydroxide (CH) pastes were used as intracanal medications (ICMs). They were prepared and tested on pathogens found in both the root canal and the periodontal pocket. Exposure to 0.5% and 1% CHX-loaded ICMs decreased the growth of Porphyromonas gingivalis and was effective in eradicating or inhibiting an Enterococcus faecalis biofilm. CH was injected into the root canal of extracted human teeth immersed in deionized water. CHX-loaded ICMs resulted in the transradicular diffusion of active components outside the tooth through the apex and the lateral dentinal tubules, as shown by the release of CHX (from 3.99 µg/mL to 51.28 µg/mL) and changes in pH (from 6.63 to 8.18) and calcium concentrations (from 2.42 ppm to 14.67 ppm) after 7 days. The 0.5% CHX-loaded ICM was non-toxic and reduced the release of IL-6 by periodontal cells stimulated by P. gingivalis lipopolysaccharides. Results indicate that the root canal may serve as a reservoir for periodontal drug delivery and that CHX-based ICMs can be an adjuvant for the control of infections and inflammation in endo-periodontal lesions.
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Affiliation(s)
- Kadiatou Sy
- U1008, Controlled Drug Delivery Systems and Biomaterials, Inserm, CHU Lille, Université de Lille, 59000 Lille, France; (M.M.); (E.D.); (K.A.)
- Faculté d’Odontologie, Hospices Civils de Lyon, Pôle d′Odontologie, Université Lyon 1, Université de Lyon, 69372 Lyon Cedex 08, France; (B.G.); (K.G.)
| | - Charlène Chevalier
- UMR CNRS 5615 Laboratoire des Multimatériaux et Interfaces, Université Lyon 1, 69100 Villeurbanne, France; (C.C.); (I.M.)
| | - Mickaël Maton
- U1008, Controlled Drug Delivery Systems and Biomaterials, Inserm, CHU Lille, Université de Lille, 59000 Lille, France; (M.M.); (E.D.); (K.A.)
| | - Ilham Mokbel
- UMR CNRS 5615 Laboratoire des Multimatériaux et Interfaces, Université Lyon 1, 69100 Villeurbanne, France; (C.C.); (I.M.)
| | - Séverine Mahieux
- U1286 Infinite, Institute for Translational Research in Inflammation, Inserm, CHU Lille, Université de Lille, 59000 Lille, France; (S.M.); (I.H.); (C.N.)
| | - Isabelle Houcke
- U1286 Infinite, Institute for Translational Research in Inflammation, Inserm, CHU Lille, Université de Lille, 59000 Lille, France; (S.M.); (I.H.); (C.N.)
| | - Christel Neut
- U1286 Infinite, Institute for Translational Research in Inflammation, Inserm, CHU Lille, Université de Lille, 59000 Lille, France; (S.M.); (I.H.); (C.N.)
| | - Brigitte Grosgogeat
- Faculté d’Odontologie, Hospices Civils de Lyon, Pôle d′Odontologie, Université Lyon 1, Université de Lyon, 69372 Lyon Cedex 08, France; (B.G.); (K.G.)
| | - Etienne Deveaux
- U1008, Controlled Drug Delivery Systems and Biomaterials, Inserm, CHU Lille, Université de Lille, 59000 Lille, France; (M.M.); (E.D.); (K.A.)
| | - Kerstin Gritsch
- Faculté d’Odontologie, Hospices Civils de Lyon, Pôle d′Odontologie, Université Lyon 1, Université de Lyon, 69372 Lyon Cedex 08, France; (B.G.); (K.G.)
| | - Kevimy Agossa
- U1008, Controlled Drug Delivery Systems and Biomaterials, Inserm, CHU Lille, Université de Lille, 59000 Lille, France; (M.M.); (E.D.); (K.A.)
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Drews DJ, Nguyen AD, Diederich A, Gernhardt CR. The Interaction of Two Widely Used Endodontic Irrigants, Chlorhexidine and Sodium Hypochlorite, and Its Impact on the Disinfection Protocol during Root Canal Treatment. Antibiotics (Basel) 2023; 12:antibiotics12030589. [PMID: 36978457 PMCID: PMC10044599 DOI: 10.3390/antibiotics12030589] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 03/09/2023] [Accepted: 03/09/2023] [Indexed: 03/18/2023] Open
Abstract
In recent years, sodium hypochlorite and chlorhexidine digluconate have been the gold standard of irrigation solutions utilized within the disinfection protocol during root canal treatments. Nowadays, it is known that, during chemical disinfection of the root canal, consecutive application of sodium hypochlorite and chlorhexidine digluconate leads to the formation of an orange-brown precipitate. This precipitate is described as being chemically similar to para-chloroaniline, which is suspected to have cytotoxic and carcinogenic effects. Concerns also exist regarding its influence on the leakage of root canal fillings, coronal restorations, and tooth discoloration. The purpose of this article is to review the literature on the interaction of sodium hypochlorite and chlorhexidine digluconate on the tooth and its surrounding tissues, and to discuss the effect of the precipitate formed during root canal treatment. We further address options to avoid the formation of the precipitate and describe alternative irrigation solutions that should not interact with sodium hypochlorite or chlorhexidine digluconate.
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Affiliation(s)
- Dirk-Joachim Drews
- Private Dental Practice, 69469 Weinheim, Germany
- University Outpatient Clinic for Conservative Dentistry and Periodontology, Martin-Luther-University Halle-Wittenberg, 06112 Halle, Germany
| | - Anh Duc Nguyen
- University Outpatient Clinic for Conservative Dentistry and Periodontology, Martin-Luther-University Halle-Wittenberg, 06112 Halle, Germany
| | - Antje Diederich
- University Outpatient Clinic for Conservative Dentistry and Periodontology, Martin-Luther-University Halle-Wittenberg, 06112 Halle, Germany
| | - Christian Ralf Gernhardt
- University Outpatient Clinic for Conservative Dentistry and Periodontology, Martin-Luther-University Halle-Wittenberg, 06112 Halle, Germany
- Correspondence: ; Tel.: +49-345-557-3741
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Orhan EO, Irmak Ö, Hür D. What does not form after accidental sodium hypochlorite contact with chlorhexidine? Int Endod J 2022; 55:685-688. [PMID: 35511028 DOI: 10.1111/iej.13729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 02/23/2022] [Accepted: 03/18/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Ekim Onur Orhan
- Translational Medicine Research and Clinical Center, Eskisehir Osmangazi University, Eskisehir, Turkey.,Department of Endodontics, Faculty of Dentistry, Eskişehir Osmangazi University, Eskişehir, Turkey
| | - Özgür Irmak
- Department of Restorative Dentistry, Faculty of Dentistry, Near East University, Nicosia, Cyprus
| | - Deniz Hür
- Department of Chemistry, Faculty of Science, Eskişehir Technical University, Eskisehir, Turkey
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