The influence of two forms of chlorhexidine on the accuracy of contemporary electronic apex locators

BMC Oral Health. 2019 Dec 31;20(1):3. doi: 10.1186/s12903-019-0994-z.

Abstract

Background: Accurate determination of working length (WL) is crucial for the success of endodontic therapy. The aim of this study was to determine the influence of 2% chlorhexidine digluconate solution, 2% chlorhexidine digluconate gel and 2% hypochlorite solution on the accuracy of two devices: the Raypex 5 and the ApexDal.

Methods: Twenty-nine single-rooted human teeth were used in this study. The crowns were cut horizontally and embedded in an alginate mass. In each tooth, six endodontic measurements were made using two electronic apex locators (EALs): a Raypex 5 and an ApexDal. For each EAL, measurements were taken with the following products: 2% chlorhexidine solution (CHX-S group), 2% chlorhexidine gel (CHX-G group) and 2% NaOCl (NaOCl group). After performing an endodontic measurement, the endodontic instruments were stabilized with flow resin composite. Afterwards, the roots were removed from the alginate mass, and the apical one-third of each root was cut lengthways to recover the canal system. Last, the distance between the file tip and the apical foramen was measured under a microscope at 60 x magnification.

Results: Statistically significant differences were found between CHX-S and NaOCl and CHX-G and NaOCl, but no significant differences were detected between CHX-S and CHX-G during the testing of both devices. No statistically significant differences were observed between the Raypex 5 and ApexDal for all intracanal media tested.

Conclusion: The EALs Raypex 5 and ApexDal had higher accuracy in the anatomical foramen of the root containing chlorhexidine in the gel or in the solution form than in the canal containing sodium hypochlorite.

Keywords: Chlorhexidine digluconate; Electronic apex locator; Length determination; Sodium hypochlorite.

MeSH terms

  • Anti-Infective Agents, Local / therapeutic use
  • Chlorhexidine / pharmacology*
  • Dental Pulp Cavity / anatomy & histology*
  • Disinfectants / therapeutic use
  • Electrical Equipment and Supplies
  • Electronics, Medical / instrumentation
  • Humans
  • Mouthwashes / therapeutic use
  • Odontometry / instrumentation*
  • Root Canal Preparation / instrumentation*
  • Sodium Hypochlorite / therapeutic use
  • Tooth Apex / anatomy & histology*

Substances

  • Anti-Infective Agents, Local
  • Disinfectants
  • Mouthwashes
  • Sodium Hypochlorite
  • Chlorhexidine