•Of
the 172 potential articles, only 4 randomized clinical trials and 1
nonrandomized clinical trial were included in this systematic review.
•The
laboratory methods used to evaluate root canal disinfection were
heterogeneous among studies (culture techniques and molecular methods).
•The
5 studies compared sodium hypochlorite and chlorhexidine by collecting
samples from the root canal before and after the protocol treatments.
•Randomization was conducted in 4 of the 5 studies.
•There was a lack of agreement between the findings of the selected studies.
Abstract
Introduction
This
systematic review aimed to compare the effectiveness of sodium
hypochlorite and chlorhexidine for root canal disinfection during root
canal therapy.
Methods
A literature
search for clinical trials was made on the PubMed (MEDLINE), Web of
Knowledge, SCOPUS, and Science Direct databases and in the reference
lists of the identified articles up to January 2015. Quality assessment
of the selected studies was performed according to the Consolidated
Standards of Reporting Trials statement.
Results
One
clinical trial and 4 randomized clinical trials were selected from the
172 articles initially identified. There was heterogeneity in the
laboratory methods used to assess the root canal disinfection as well as
in the concentrations of the irrigants used. Therefore, meta-analysis
was not performed. Two studies reported effective and similar reductions
in bacterial levels for both irrigants. Sodium hypochlorite was more
effective than chlorhexidine in reducing microorganisms in 1 study, and
another reported opposite findings. Both root irrigants were ineffective
in eliminating endotoxins from necrotic pulp root canals in 1 study.
Trial design and information regarding randomization procedures were not
clearly described in the clinical trials. No study compared laboratory
results with clinical outcomes.
Conclusions
The
available evidence on this topic is scarce, and the findings of studies
were not consistent. Additional randomized clinical trials using
clinical outcomes to compare the use of sodium hypochlorite and
chlorhexidine during root canal therapy are needed.
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