Quantitative Analysis Of Antibacterial Efficacy Of Octenidine Dihydrochloride, Sodium Hypochlorite and Chlorhexidine Digluconate against Endodontic Microflora: An In-Vivo Study

Endodontic treatment, commonly known as root canal therapy,

aims to eliminate infection and prevent reinfection of the dental

pulp and surrounding tissues. The process involves cleaning and

disinfecting the tooth’s interior, followed by filling and sealing it

with a restorative material in a three-dimensional manner. The

disinfection process entails mechanical instrumentation along

with the application of irrigating solutions and intracanal

medicaments. A variety of root canal irrigants have been

employed to achieve optimal outcomes, including normal saline,

oxidizing agents like hydrogen peroxide, chelating agents such

as EDTA, sodium hypochlorite, chlorhexidine, and several

natural substances like Triphala and green tea. Of these, the

most frequently used irrigating solutions are sodium

hypochlorite and chlorhexidine.

Although both chemicals have demonstrated potential as root

canal irrigants, they come with certain drawbacks. This

highlights the need for further research to identify new

chemicals that could serve as effective alternatives for root canal

irrigation.

A range of antimicrobial disinfectants used in medicine has been

assessed for their potential as endodontic irrigants, among these

is Octenidine Dihydrochloride . Multiple in-vitro studies

have examined the antimicrobial effectiveness of Octenidine

Dihydrochloride in comparison to other widely used root canal

irrigants, with promising results. These studies suggest that this

chemical could be a viable irrigant for use in patients’ mouth

during endodontic treatment. Moreover, microorganisms that resists root canal treatment exist

in low numbers in the root canal or can be located in areas of

difficult access to paper points used for sampling. Thus, a low

number of microbial cells may be collected and if less sensitive

methods are used for identification these organisms pass

unnoticed and their prevalence in failed cases can be over

shadowed. Polymerase chain reaction has advantages of

being tremendously sensitive and possibly less affected by

chemical factors such as remnants of medications that can enter

a sample and inhibit the microbial growth in the laboratory. This

method can also detect the occurrence of fastidious or even

uncultivable bacterial species in endodontic infections including

the cases of secondary persistent infections associated with

failed endodontic therapy. Epidemiological studies investigating

the microbiota of root canal treated teeth have revealed that

Enterococcus faecalis is the most commonly detected species

associated with treatment failures irrespective of the method

used for identification.

Despite the existing literature on these agents, there remains a

need for comparative studies assessing their antibacterial

efficacy against endodontic microflora in vivo. Such research is

crucial for understanding the effectiveness of these agents in

clinical scenarios and guiding endodontic treatment protocols.