Efficacy of chlorhexidine as a final irrigant in one‐visit root canal treatment: a prospective comparative study

摘要

Abstract Aim To evaluate postoperative pain and radiographic evidence of periapical healing in teeth with apical periodontitis treated in one visit with an additional final?irrigation using 2% chlorhexidine ( CHX ) and to compare the results with conventional two‐visit root canal treatment ( RCT ) with an intracanal calcium hydroxide ( CH ) dressing as a control group. Methodology Ninety asymptomatic maxillary anterior teeth with periapical lesions were treated by a single operator. Root canals were prepared using the step‐back technique with manual instrumentation with 2.5% Na OC l and 5% EDTA as irrigants. Half of the teeth were randomly assigned to the one‐visit ( OV ) group and received an additional final rinse with 2% CHX before canal filling. The other teeth were treated in two visits ( TV ) with a CH paste made by mixing CH powder and distilled water as an interappointment dressing. All patients were recalled and investigated clinically and radiographically for 24?months. Postoperative pain at 24–48?h and changes in apical bone?density indicating radiographic healing were evaluated statistically using the Mann–Whitney U ‐test followed by the Friedman and the Wilcoxon tests (α? =? 0.05). Results There were no significant differences between two groups regarding the incidence of postoperative pain at 24?h ( OV group 50% no pain, 47.6% mild, 2.4% moderate pain/ TV group 55% no pain, 42.5% mild, 2.5% moderate pain) and at 48?h ( OV group 95% no pain, 5% mild pain/ TV group 98% no pain, 2% mild pain). None of the patients reported severe postoperative pain, swelling and/or flare‐ups during the follow‐up period. There was no significant difference in the radiographic healing rates ( OV group 97.6% PAI 1 and/or PAI 2 and 2.4% PAI 3/ TV group 95% PAI 1 and/or PAI 2 and 5% PAI 3; P ??0.05). Conclusion Both groups provided favourable and similar postoperative pain and periapical healing rates at 24?months. Thus, one‐visit RCT with a final rinse with 2% CHX is an acceptable alternative to two‐visit RCT with CH as temporary dressing in maxillary anterior teeth.