Alpha-hemolytic streptococci and root canal irrigants. An evaluation of the bactericidal efficacy of sodium hypochlorite and chlorhexidine gluconate plus cetrimide

BACKGROUND AND AIMS: The main bacterial species present in pulpal and periapical microbic flora is alpha-hemolytic streptococci. They are regarded as facultative anaerobes which prefer to grow in anaerobiosis. Canal irrigation plays an important role in the success of endodontic treatment given that, on the one hand, it encourages the gradual elimination of the smear layer, and on the other it neutralises microbic flora in the root canal. The aim of this study was to test the microbiological efficacy of sodium hypochlorite 1% and s new generation irrigant based on chlorhexidine 0.2% and cetrimide 0.2%. METHODS: The test was performed on the following alpha-hemolytic streptococci bacteria (Dasit, Cornaredo, Italy): Streptococcus mitis ATCC 9811; Streptococcus mutans ATCC 35668; Streptococcus salivarius ATCC 13419; Streptococcus sanguis ATCC 10556. The working concentration (CFU/ml) was defined as 0.5 Mc Farland which corresponds to a concentration of microorganisms of approximately 1.5 x 10(8) bacteria. The following canal irrigants were used: 1) cetrimide 0.2% + chlorhexidine 0.2% (Cetrexidin Vebas, S. Giuliano Milanese, Italy); 2) NaOCl 1% (Ogna, Milan, Italy). Each individual substance remained in contact with the bacterial species used in the test for 10'-20'-30'. RESULTS: The results obtained show the bactericidal efficacy of both the irrigants used, even after a short period of contact. CONCLUSIONS: This does not mean that all irrigants are equal and/or promise the same results. This was a microbiological study, but it is nonetheless important to take other variables into account, such as contact time. Moreover, in order to increase the probabilities for the success of endodontic treatment, canal irrigants must also present other characteristics, namely: biocompatibility, scarce toxicity, high proteolytic power.-