EVALUACIÓN IN VITRO DE LA EFICACIA ANTIFÚNGICA DEL HIDRÓXIDO DE CALCIO EN AGUA DESTILADA Y DEL GEL DE DIGLUCONATO DE CLORHEXIDINA AL 0.2% COMO MEDICACIÓN INTRACONDUCTO FRENTE A CANDIDA ALBICANS
Palabras clave:
Medicación intraconducto, Candida albicans, Hidróxido de calcio, Clorhexidina
Resumen
Objetivo: Evaluar la eficacia in vitro de la pasta de Ca(OH)2 en agua destilada y gel de digluconato de clorhexidina (CHX) al 0.2%, separadamente, como medicaciones intraconducto frente a Candida albicans en raíces de dientes humanos extraídos.
Materiales y métodos: Mediante un estudio experimental in vitro, en el que se utilizaron 45 raíces uniradiculares, previamente inocula-das con Candida albicans, ATCC6455017 durante 72 horas y que luego fueron medicadas intraconducto con pasta de Ca(OH)2 (Eufar®) en agua destilada p/v 50% y con gel de digluconato de clorhexidina al 0.2% (Perioxidin®), durante 7 días; en el siguiente paso, cada espécimen radicular fue instrumentado con limas Hedstrom de la segunda serie para obtener barrillo dentinario del sistema del canales radiculares, el cual se diluye en 5 ml de tripticasa soya que se siembra en agar saboraud al 2%, durante 72 horas a 37°C, para determinar (UFC/ml) de esta levadura.
Resultado: La eficacia de la pasta de Ca(OH)2 fue del 62.5% y la del gel de CHX al 0.2% fue de 6.25%. El ANOVA reveló diferencias esta-dísticamente significativas (p=0.0013) entre los promedios de UFC/ml de Candida albicans, entre las medicaciones. También, el test de Bonferroni estableció diferencias significativas entre los promedios de UFC/ml de Candida albicans después de medicar con pasta de Ca(OH)2comparado con gel de CHX al 0.2% (p=0.002) y el grupo control (p=0.010). Sin embargo, no se encontraron diferencias significativas entre el tratamiento con gel de CHX al 0.2% y el grupo control.
Conclusiones: Se demostró, in vitro, que Candida albicans es capaz de establecerse al interior del sistema del canal radicular e interactuar con la dentina.
[Bedoya LF, Niño MP, Peña CM, Toloza E. Evaluación in vitro de la eficacia antifúngica del hidróxido de calcio en agua destilada y del gel de digluconato de clorhexidina al 0.2% como medicación intraconducto frente a Candida albicans. Ustasalud 2008; 7: 77 - 86]
Referencias
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2. Waltimo TM, Orstavik D, Sirén EK, Haapasalo MP. In vitro yeast infection of human dentin. J Endod 2000; 26: 207 - 209.
3. Waltimo TM, Haapasalo M, Zehnder M, Meyer J. Clinical aspects related to endodontic yeast infections. Endodontic Topics 2004; 9: 66 - 78.
4. Sen BH, Piskin B, Demirci T. Observation of bacteria and fungi in infected root canals and dentinal tubules by SEM. Endod Dent Traumatol 1995; 11: 6 - 9.
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6. Caviedes J, Muñoz H, y Meneses J. El paradigma del hidróxido de calcio en endodoncia: ¿Sustancia milagrosa? Pontificia Universidad Javeriana: Informe Grupo de Investigación. Especialización en Endodoncia inédito. Bogotá, 2006.
7. Estrela C, Bammann LL, Pimenta FC, Pécora JD. Control of microorganisms in vitro by calcium hydroxide pastes. Int Endodontic J 2001; 34: 341 - 345.
8. Teixeira K, Cortés M. Estado actual de la medicación antimicrobiana para la medicación intracanal. Acta Odontológica Venezolana. 2005; 43: 177 – 180.
9. Ercan E, Dalli M, Dulgergil CT. In vitro assessment of the effectiveness of clorhexidine gel and calcium hydroxide paste with chlorhexidine against Enterococcus faecalis and Candida albicans. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006;102:e27-e31.
10. Zerella J, Fouad A, Spangberg L, Conn F. Effectiveness of a calcium hydroxide and chlorhexidine digluconate mixture as disinfectant during retreatment of failed endodontic cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2005; 100: 756 - 761.
11. Haapasalo M, Orstavik D. In vitro infection and disinfection of dentinal tubules. J Dent Res1987; 6: 1375 - 1379.
12. Estrela C, Holland R. Calcium hydroxide: study based on scientific evidences. J Appl Oral 2003; 11: 269 - 282.
13. Ates M, Akdeniz B.G, Sen B.H. The effect of calcium chelating or binding agents on Candida albicans. Oral Surg Oral Pathol Oral Radiol Endod 2005; 100: 626 - 630.
14. Hosoya N, Takahashi G, Aral T, Nakamura J. Calcium concentration and pH of the periapical environment after applying calcium hydroxide into root canals in vitro. J Endod 2001; 27: 343 -346.
15. Heredia JM, Rodríguez S. Uso de la clorhexidina en endodoncia: revisión de la literatura. RAOA 2005; 93: 245 - 248.
16. Prado M. Monografía Clorhexidina [Trabajo de Grado]. Bogotá: Universidad Santo Tomás, Federación Odontológica Colombiana; 2001.
17. Siqueira JF, Rocas I, Lopes H, Magalhaes F, Uzeda M. Elimination of Candida albicans infection of the radicular dentin by intracanal medications. J Endod 2003; 29: 501 - 504.
18. Siqueira JF, de Uzeda M. Intracanal medicaments: evaluation of the antibacterial effects of chlorhexidine metronidazole and calcium hydroxide associated with three vehicles. J Endod 1997; 23: 167 - 169.
19. Barbosa C, Goncalves R, Siqueira J, De Uzeda M. Evaluation of the antibacterial activities of calcium hydroxide, chlorhexidine, and camphorated paramonochlorophenol as intracanal medicament. A clinical and laboratory study. J Endod 1997; 23: 297 - 300.
20. Sen BH, Safavi KE, Spanberg L. Antifugal effects of sodium hypochlorite and chlorhexidine in root canals. J Endod 1999; 25: 235 - 238.
21. Lynne RE, Liewehr FR, West LA, Patton WR, Buxton TV, Mcpherson JC. In vitro antimicrobial activity of various medication preparations on Enterococcus faecalis in root canal dentin. J Endod 2003; 29: 187- 190.
22. Paquette L, Legner M, Fillery E, Friedman S. Antibacterial efficacy of chlorhexidine gluconate intracanal medication in vivo. J Endod 2007; 33: 789 - 795.
23. Komorowski R, Grad H, Yu wu X, Friedman S. Antimicrobial substantivity of clorhexidine-treated bovine root dentin. J Endod 2000; 26: 315 - 317.
24. Lenet BJ, Komorowski R, Huang J, Grad H, Lawrence HP, Friedman S. Antimicrobial substantivity of bovine root dentin exposed to different chlorhexidine delivery vehicles. J Endod 2000; 26: 652 - 655.
25. Siqueira JF, Paiva S, Rocas I. Reduction in the cultivable bacterial populations in infected root canals by a chlorhexidine-based antimicrobial protocol. J Endod 2007; 33: 541 - 546.
26. Coelho I, Roedel M, Chevitarese O. Ca++ diffusion through dentin of Ca(OH)2 associated with seven different vehicles. J Endod 2003; 29: 822 - 824.
27. Salazar AR, Sarmiento LK, Mora LM, Pérez PA. Evaluación in vitro del hipoclorito de sodio al 5.25% vs. el gluconato de clorhexidina al 0,2% como agente irrigante en presencia de infecciones en el canal radicular [Trabajo de Grado]. Bucaramanga: Universidad Santo Tomás; 2007.
28. Valera MC, Rego de Moraes J, Jorge A. Effect of sodium hypochlorite and five intracanal medications on Candida albicans in root canals. J Endod 2001; 27: 401 - 403.
29. Schafer E, Bossmann K. Antimicrobial efficacy of chlorhexidine and two calcium hydroxide formulations against Enterococcus faecalis. J Endod 2005; 31: 53 - 55.
30. Soares IJ, Goldberg F. Endodoncia Técnicas y Fundamentos. Buenos Aires, Argentina: Editorial Médica Panamericana; 2003. Capitulo 5 y 6, págs. 56 - 57 y 69 -70.
31. Tobón D. Manual Básico de Endodoncia. Medellín: Corporación para la Investigación Biológica CIB 2003. Capitulo 6, págs.49 - 50
32. Randi CC, Figueiredo BP, Zaia AA, Teixeira FB, Souza FJ. In vitro assessment of the antimicrobial action and the mechanical ability of chlorhexidine gel as an endodontic irrigant. J Endod 2001; 27: 452 - 455.
33. González-López S, Camejo-Aguilar D, Sánchez-Sánchez P, Bolaños-Carmona V. Effect of CHX on the decalcifying effect of 10% citric acid, 20% citric acid or 17% EDTA. J Endod 2006; 32: 781 - 784.
34. Figueiredo BP, Vianna ME, Teixeira N, Zaia AA, Randi CC, Souza FJ. In vitro evaluation of the antimicrobial activity of calcium hydroxide combined with chlorhexidine gel used as intracanal medicament. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. J Endod 2006; 102: 544 - 550.
35. Menezes M, Valera MC, Jorge AOC. Koga - Ito CY, Camargo CHR, Mancini MN. In vitro of the effectiveness of irrigants and intracanal medicaments on microorganisms within root canals. Int Endod J 2004; 37: 311 - 319.
36. Barthel CR, Zaritzki FF, Raab W. HM, Zimmer S. Bacterial leakage in roots filled with different medicaments and sealed with Cavit. J Endod 2006; 32: 127 - 129.
37. Almyroudi A, Mackenzie D, McHugh S, Saunders W.P. The effectiveness of various disinfectants used as endodontic intracanal medications: an in vitro study. J Endod 2002; 28: 163 - 167.
38. Basrani B, Ghanem A, Tjaderhane L. Physical and chemical properties of chlorhexidine and calcium hydroxide containing medications. J Endod 2004; 30: 413 - 417.
39. Wuerch R, Apicela M, Mines P, Yancich P, Pashley D. Effect of 2% chlorhexidine gel as an intracanal medication on the apical seal of the root-canal system. J Endod 2004; 30: 788 - 791.
40. Ferguson JW, Hatton FF, Gillespie MJ. Effectiveness of in- tracanal irrigants and medications against the yeast Candida albicans. J Endod 2002; 28: 68 - 71.
41. Haapasalo M, Quian W, Portenier I, Waltimo T. Effects of dentin on the antimicrobial properties of endodontic medicaments. J Endod 2007; 33: 187 - 924.
42. Madigan M, Martinko J, Parker J. Brock Biología de los microorganismos. 8ª Edición. España. Editorial Prentice Hall Inc, 2000, España. Capitulo 5, pág. 155-158.
43. Wayne D. Bioestadística base para el análisis de las ciencias de la salud. México: Editorial Noriega; 2000.
44. Baumgartner J, Watts C, Xian T. Occurrence of Candida albicans in infections of endodontic origin. J Endod 2000; 26: 695 - 697.
45. Law A, Messer H. An evidence – based analysis of the antibacterial effectiveness of intracanal medicaments. J Endod 2004; 30: 689 - 694.
46. Miñana M, Carnes DL, Walker W. pH changes at the sur- face of root dentin after intracanal dressing with calcium oxide and calcium hydroxide. J Endod 2001; 27: 43 - 45.
47. Solak H, Oztan MD. The pH changes of four different calcium hydroxide mixtures used for intracanal medication. J Oral Rehab 2003; 30: 436 - 439.
48. Pacios MG, De la Casa ML, Bulacio MA, López ME. Influence of different vehicles on the pH of calcium hydroxide pastes. J Oral Science 2004; 46: 107 - 111.
49. Rosenthal S, Spanberg L, Safavi K, Conn F. Clorhexidine substantivity in root canal dentin. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2004; 98: 488 - 492.
50. Kuruvilla JR, Kamath MP. Antimicrobial activity of 2.5% sodium hypochlorite and 0.2% chlorhexidine gluconate separately and combined, as endodontic irrigants. J Endod 1998; 24: 472 – 476.
51. Caviedes J, Aguilar M, Álvarez J, Canales P y Reyes E. Irrigantes efectos sobre el tejido dental y periapical. Pon- tificia Universidad Javeriana: Informe Grupo de Investigación. Especialización en Endodoncia inédito. Bogotá; 2006.
52. Estrela C, Bammann LL, Pécora JD. Control of microorganisms in vitro by endodontic irrigants. Braz Dent J 2003; 14: 187 - 192.
53. Lekshmy D, Kamath PM. Antimicrobial efficacy of 0.2% and 2% chlorhexidine and sodium hypochlorite as root canal irrigants: an in vivo study. Endodontology 2001; 13: 57 - 62.
2. Waltimo TM, Orstavik D, Sirén EK, Haapasalo MP. In vitro yeast infection of human dentin. J Endod 2000; 26: 207 - 209.
3. Waltimo TM, Haapasalo M, Zehnder M, Meyer J. Clinical aspects related to endodontic yeast infections. Endodontic Topics 2004; 9: 66 - 78.
4. Sen BH, Piskin B, Demirci T. Observation of bacteria and fungi in infected root canals and dentinal tubules by SEM. Endod Dent Traumatol 1995; 11: 6 - 9.
5. Sen BH, Chugal NM, Liu H, Fleischmann J. A new method for studying the adhesion of Candida albicans to dentin in the presence or absence of smear layer. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2003; 96: 201- 206.
6. Caviedes J, Muñoz H, y Meneses J. El paradigma del hidróxido de calcio en endodoncia: ¿Sustancia milagrosa? Pontificia Universidad Javeriana: Informe Grupo de Investigación. Especialización en Endodoncia inédito. Bogotá, 2006.
7. Estrela C, Bammann LL, Pimenta FC, Pécora JD. Control of microorganisms in vitro by calcium hydroxide pastes. Int Endodontic J 2001; 34: 341 - 345.
8. Teixeira K, Cortés M. Estado actual de la medicación antimicrobiana para la medicación intracanal. Acta Odontológica Venezolana. 2005; 43: 177 – 180.
9. Ercan E, Dalli M, Dulgergil CT. In vitro assessment of the effectiveness of clorhexidine gel and calcium hydroxide paste with chlorhexidine against Enterococcus faecalis and Candida albicans. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006;102:e27-e31.
10. Zerella J, Fouad A, Spangberg L, Conn F. Effectiveness of a calcium hydroxide and chlorhexidine digluconate mixture as disinfectant during retreatment of failed endodontic cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2005; 100: 756 - 761.
11. Haapasalo M, Orstavik D. In vitro infection and disinfection of dentinal tubules. J Dent Res1987; 6: 1375 - 1379.
12. Estrela C, Holland R. Calcium hydroxide: study based on scientific evidences. J Appl Oral 2003; 11: 269 - 282.
13. Ates M, Akdeniz B.G, Sen B.H. The effect of calcium chelating or binding agents on Candida albicans. Oral Surg Oral Pathol Oral Radiol Endod 2005; 100: 626 - 630.
14. Hosoya N, Takahashi G, Aral T, Nakamura J. Calcium concentration and pH of the periapical environment after applying calcium hydroxide into root canals in vitro. J Endod 2001; 27: 343 -346.
15. Heredia JM, Rodríguez S. Uso de la clorhexidina en endodoncia: revisión de la literatura. RAOA 2005; 93: 245 - 248.
16. Prado M. Monografía Clorhexidina [Trabajo de Grado]. Bogotá: Universidad Santo Tomás, Federación Odontológica Colombiana; 2001.
17. Siqueira JF, Rocas I, Lopes H, Magalhaes F, Uzeda M. Elimination of Candida albicans infection of the radicular dentin by intracanal medications. J Endod 2003; 29: 501 - 504.
18. Siqueira JF, de Uzeda M. Intracanal medicaments: evaluation of the antibacterial effects of chlorhexidine metronidazole and calcium hydroxide associated with three vehicles. J Endod 1997; 23: 167 - 169.
19. Barbosa C, Goncalves R, Siqueira J, De Uzeda M. Evaluation of the antibacterial activities of calcium hydroxide, chlorhexidine, and camphorated paramonochlorophenol as intracanal medicament. A clinical and laboratory study. J Endod 1997; 23: 297 - 300.
20. Sen BH, Safavi KE, Spanberg L. Antifugal effects of sodium hypochlorite and chlorhexidine in root canals. J Endod 1999; 25: 235 - 238.
21. Lynne RE, Liewehr FR, West LA, Patton WR, Buxton TV, Mcpherson JC. In vitro antimicrobial activity of various medication preparations on Enterococcus faecalis in root canal dentin. J Endod 2003; 29: 187- 190.
22. Paquette L, Legner M, Fillery E, Friedman S. Antibacterial efficacy of chlorhexidine gluconate intracanal medication in vivo. J Endod 2007; 33: 789 - 795.
23. Komorowski R, Grad H, Yu wu X, Friedman S. Antimicrobial substantivity of clorhexidine-treated bovine root dentin. J Endod 2000; 26: 315 - 317.
24. Lenet BJ, Komorowski R, Huang J, Grad H, Lawrence HP, Friedman S. Antimicrobial substantivity of bovine root dentin exposed to different chlorhexidine delivery vehicles. J Endod 2000; 26: 652 - 655.
25. Siqueira JF, Paiva S, Rocas I. Reduction in the cultivable bacterial populations in infected root canals by a chlorhexidine-based antimicrobial protocol. J Endod 2007; 33: 541 - 546.
26. Coelho I, Roedel M, Chevitarese O. Ca++ diffusion through dentin of Ca(OH)2 associated with seven different vehicles. J Endod 2003; 29: 822 - 824.
27. Salazar AR, Sarmiento LK, Mora LM, Pérez PA. Evaluación in vitro del hipoclorito de sodio al 5.25% vs. el gluconato de clorhexidina al 0,2% como agente irrigante en presencia de infecciones en el canal radicular [Trabajo de Grado]. Bucaramanga: Universidad Santo Tomás; 2007.
28. Valera MC, Rego de Moraes J, Jorge A. Effect of sodium hypochlorite and five intracanal medications on Candida albicans in root canals. J Endod 2001; 27: 401 - 403.
29. Schafer E, Bossmann K. Antimicrobial efficacy of chlorhexidine and two calcium hydroxide formulations against Enterococcus faecalis. J Endod 2005; 31: 53 - 55.
30. Soares IJ, Goldberg F. Endodoncia Técnicas y Fundamentos. Buenos Aires, Argentina: Editorial Médica Panamericana; 2003. Capitulo 5 y 6, págs. 56 - 57 y 69 -70.
31. Tobón D. Manual Básico de Endodoncia. Medellín: Corporación para la Investigación Biológica CIB 2003. Capitulo 6, págs.49 - 50
32. Randi CC, Figueiredo BP, Zaia AA, Teixeira FB, Souza FJ. In vitro assessment of the antimicrobial action and the mechanical ability of chlorhexidine gel as an endodontic irrigant. J Endod 2001; 27: 452 - 455.
33. González-López S, Camejo-Aguilar D, Sánchez-Sánchez P, Bolaños-Carmona V. Effect of CHX on the decalcifying effect of 10% citric acid, 20% citric acid or 17% EDTA. J Endod 2006; 32: 781 - 784.
34. Figueiredo BP, Vianna ME, Teixeira N, Zaia AA, Randi CC, Souza FJ. In vitro evaluation of the antimicrobial activity of calcium hydroxide combined with chlorhexidine gel used as intracanal medicament. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. J Endod 2006; 102: 544 - 550.
35. Menezes M, Valera MC, Jorge AOC. Koga - Ito CY, Camargo CHR, Mancini MN. In vitro of the effectiveness of irrigants and intracanal medicaments on microorganisms within root canals. Int Endod J 2004; 37: 311 - 319.
36. Barthel CR, Zaritzki FF, Raab W. HM, Zimmer S. Bacterial leakage in roots filled with different medicaments and sealed with Cavit. J Endod 2006; 32: 127 - 129.
37. Almyroudi A, Mackenzie D, McHugh S, Saunders W.P. The effectiveness of various disinfectants used as endodontic intracanal medications: an in vitro study. J Endod 2002; 28: 163 - 167.
38. Basrani B, Ghanem A, Tjaderhane L. Physical and chemical properties of chlorhexidine and calcium hydroxide containing medications. J Endod 2004; 30: 413 - 417.
39. Wuerch R, Apicela M, Mines P, Yancich P, Pashley D. Effect of 2% chlorhexidine gel as an intracanal medication on the apical seal of the root-canal system. J Endod 2004; 30: 788 - 791.
40. Ferguson JW, Hatton FF, Gillespie MJ. Effectiveness of in- tracanal irrigants and medications against the yeast Candida albicans. J Endod 2002; 28: 68 - 71.
41. Haapasalo M, Quian W, Portenier I, Waltimo T. Effects of dentin on the antimicrobial properties of endodontic medicaments. J Endod 2007; 33: 187 - 924.
42. Madigan M, Martinko J, Parker J. Brock Biología de los microorganismos. 8ª Edición. España. Editorial Prentice Hall Inc, 2000, España. Capitulo 5, pág. 155-158.
43. Wayne D. Bioestadística base para el análisis de las ciencias de la salud. México: Editorial Noriega; 2000.
44. Baumgartner J, Watts C, Xian T. Occurrence of Candida albicans in infections of endodontic origin. J Endod 2000; 26: 695 - 697.
45. Law A, Messer H. An evidence – based analysis of the antibacterial effectiveness of intracanal medicaments. J Endod 2004; 30: 689 - 694.
46. Miñana M, Carnes DL, Walker W. pH changes at the sur- face of root dentin after intracanal dressing with calcium oxide and calcium hydroxide. J Endod 2001; 27: 43 - 45.
47. Solak H, Oztan MD. The pH changes of four different calcium hydroxide mixtures used for intracanal medication. J Oral Rehab 2003; 30: 436 - 439.
48. Pacios MG, De la Casa ML, Bulacio MA, López ME. Influence of different vehicles on the pH of calcium hydroxide pastes. J Oral Science 2004; 46: 107 - 111.
49. Rosenthal S, Spanberg L, Safavi K, Conn F. Clorhexidine substantivity in root canal dentin. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2004; 98: 488 - 492.
50. Kuruvilla JR, Kamath MP. Antimicrobial activity of 2.5% sodium hypochlorite and 0.2% chlorhexidine gluconate separately and combined, as endodontic irrigants. J Endod 1998; 24: 472 – 476.
51. Caviedes J, Aguilar M, Álvarez J, Canales P y Reyes E. Irrigantes efectos sobre el tejido dental y periapical. Pon- tificia Universidad Javeriana: Informe Grupo de Investigación. Especialización en Endodoncia inédito. Bogotá; 2006.
52. Estrela C, Bammann LL, Pécora JD. Control of microorganisms in vitro by endodontic irrigants. Braz Dent J 2003; 14: 187 - 192.
53. Lekshmy D, Kamath PM. Antimicrobial efficacy of 0.2% and 2% chlorhexidine and sodium hypochlorite as root canal irrigants: an in vivo study. Endodontology 2001; 13: 57 - 62.
Publicado
2008-07-01
Cómo citar
Bedoya R., L., Niño C., M., Peña M., C., & Toloza R., E. (2008). EVALUACIÓN IN VITRO DE LA EFICACIA ANTIFÚNGICA DEL HIDRÓXIDO DE CALCIO EN AGUA DESTILADA Y DEL GEL DE DIGLUCONATO DE CLORHEXIDINA AL 0.2% COMO MEDICACIÓN INTRACONDUCTO FRENTE A CANDIDA ALBICANS. Ustasalud, 7(2), 77-86. https://doi.org/https://doi.org/10.15332/us.v7i2.1183
Número
Sección
Artículos de Investigación Científica y Tecnológica
