Therapeutic Potential of Chlorhexidine-Loaded Calcium Hydroxide-Based Intracanal Medications in Endo-Periodontal Lesions: An Ex Vivo and In Vitro Study

Therapeutic Potential of Chlorhexidine-Loaded Calcium Hydroxide-Based Intracanal Medications in Endo-Periodontal Lesions: An Ex Vivo and In Vitro Study

Endo-periodontal lesions are challenging clinical situations where both the supporting tissues and the root canal of the same tooth are infected. In the present study, chlorhexidine (CHX)-loaded calcium hydroxide (CH) pastes were used as intracanal medications (ICMs). They were prepared and tested o...

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Bibliographic Details
Main Authors: Kadiatou Sy, Charlène Chevalier, Mickaël Maton, Ilham Mokbel, Séverine Mahieux, Isabelle Houcke, Christel Neut, Brigitte Grosgogeat, Etienne Deveaux, Kerstin Gritsch, Kevimy Agossa
Format: Article
Language:English
Published: MDPI AG 2023-09-01
Series:Antibiotics
Subjects:
endo-periodontal lesions
intracanal medication
ion release
local drug delivery
periodontal cells
Online Access:https://www.mdpi.com/2079-6382/12/9/1416
Description
Summary:Endo-periodontal lesions are challenging clinical situations where both the supporting tissues and the root canal of the same tooth are infected. In the present study, chlorhexidine (CHX)-loaded calcium hydroxide (CH) pastes were used as intracanal medications (ICMs). They were prepared and tested on pathogens found in both the root canal and the periodontal pocket. Exposure to 0.5% and 1% CHX-loaded ICMs decreased the growth of <i>Porphyromonas gingivalis</i> and was effective in eradicating or inhibiting an <i>Enterococcus faecalis</i> biofilm. CH was injected into the root canal of extracted human teeth immersed in deionized water. CHX-loaded ICMs resulted in the transradicular diffusion of active components outside the tooth through the apex and the lateral dentinal tubules, as shown by the release of CHX (from 3.99 µg/mL to 51.28 µg/mL) and changes in pH (from 6.63 to 8.18) and calcium concentrations (from 2.42 ppm to 14.67 ppm) after 7 days. The 0.5% CHX-loaded ICM was non-toxic and reduced the release of IL-6 by periodontal cells stimulated by <i>P. gingivalis</i> lipopolysaccharides. Results indicate that the root canal may serve as a reservoir for periodontal drug delivery and that CHX-based ICMs can be an adjuvant for the control of infections and inflammation in endo-periodontal lesions.
ISSN:2079-6382

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