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One-Visit Versus Two-Visit Root Canal Treatment: Effectiveness in the Removal of Endotoxins and Cultivable Bacteria

2013; Elsevier BV; Volume: 39; Issue: 8 Linguagem: Inglês

10.1016/j.joen.2013.04.027

1878-3554

Ana Cláudia Carvalho Xavier, Frederico C. Martinho, Adriana Chung, Luciane Dias de Oliveira, Antônio Olavo Cardoso Jorge, Márcia Carneiro Valera, Cláudio Antônio Talge Carvalho,

Dental Radiography and Imaging

Introduction This clinical study was conducted to compare the effectiveness of 1-visit versus 2-visit root canal treatment in removing endotoxins and cultivable bacteria from primarily infected root canals. Methods Forty-eight primarily infected root canals were selected and randomly divided into 4 groups: G1, 1% NaOCl; G2, 2% chlorhexidine (CHX) gel; G3, 1% NaOCl + Ca(OH)2; and G4, 2% CHX gel + Ca(OH)2 (all, n = 12). G1 and G2 involved 1-visit treatment, whereas G3 and G4 involved 2-visit treatment with the placement of Ca(OH)2 medication for 14 days. Samples were collected before and after root canal procedures. A chromogenic LAL assay test was used to quantify endotoxins. Culture techniques were used to determine bacterial counts. Results Endotoxins and cultivable bacteria were detected in 100% of the initial samples. All treatment protocols were effective in reducing bacterial load from infected root canals: G1 (1% NaOCl, 99.97%), G2 (2% CHX gel, 99.75%), G3 (1% NaOCl + Ca(OH)2, 99.90%), and G4 (2% CHX gel + Ca(OH)2, 96.81%), respectively (P < .05). No differences were found in bacterial load reduction when comparing 1-visit and 2-visit treatment groups, irrespective of the irrigant tested (P > .05). Higher median percentage values of endotoxin reduction were achieved in the 2-visit treatment groups (G3, 98.01% and G4, 96.81%) compared with 1-visit treatment groups (G1, 86.33% and G2, 84.77%) (all P < .05). Conclusions Both 1-visit and 2-visit root canal treatment protocols were effective in reducing bacteria and endotoxins, but they were not able to eliminate them in all root canals analyzed. Furthermore, 2-visit root canal treatment protocols were more effective in reducing endotoxins than 1-visit root canal treatment protocols.