Comparison of Antimicrobial Efficacy of Povidone Iodine, Sodium Hypochlorite and Chlorhexidine Gluconate on Disinfecting Rubber Dam Surfaces in the Root Canal Treatment
Keywords:
Disinfectant, Endodontic Treatment, Povidone Iodine, Sodium Hypochlorite, Chlorhexidine GluconateAbstract
This study aimed to investigate the effectiveness (at 0 minute) and the duration of disinfection effectiveness (at 30 and 90 minutes) of three antiseptics including 10% povidone iodine, 2.5% sodium hypochlorite, and 2% chlorhexidine gluconate in eliminating Enterococcus faecalis and Candida albicans on the rubber dam in the root canal treatment. The experiment was conducted at 3 time points (0, 30, and 90 minutes), with a sample size of 120 plates per microorganism per time point, resulting in a total of 720 plates for 2 microorganisms. The number of surviving microorganisms on the dental rubber dam sheets was counted and analyzed using descriptive statistics only, as the data contained an unusually high number of zero values (zero-inflated).
Results: At the time 0 minutes, all three antiseptics agents are effectively eliminated both Enterococcus faecalis and Candida albicans. However, at the time 30 and 90 minutes, 2.5% sodium hypochlorite demonstrated comparatively lower antimicrobial efficacy than 10% povidone iodine and 2% chlorhexidine gluconate, as no microbial growth was observed with the latter two agents at these time points. This study concluded that 10% povidone iodine and 2% chlorhexidine gluconate were more effective and sustained in eliminating Candida albicans and Enterococcus faecalis than 2.5% sodium hypochlorite. However, as this was an in vitro study, further clinical research is warranted to confirm these results in real conditions.
References
Arias-Moliz MT, Ferrer-Luque CM, Espigares-García M, Baca P. Enterococcus faecalis biofilms eradication by root canal irrigants. J Endod 2009;35(5):711-4.
Kaptan RF, Haznedaroglu F, Kayahan MB, Basturk FB. An investigation of current endodontic practice in Turkey. Sci World J 2012;2012(1):565413.
Li B, Nentwich MM, Hoffmann LE, Haritoglou C, Kook D, Kampik A, Sheng M, de Kaspar HM. Comparison of the efficacy of povidone–iodine 1.0%, 5.0%, and 10.0% irrigation combined with topical levofloxacin 0.3% as preoperative prophylaxis in cataract surgery. J Cataract Refrac Surg 2013; 39(7):994-1001.
Thakur V, Kaur M, Jamwal P, Thakur B. 2% Chlorhexidine in root canal treatment: A review. Curr Med Res and Opin 2020;3(12):770-4.
Whitworth JM, Seccombe GV, Shoker K, Steele JG. Use of rubber dam and irrigant selection in UK general dental practice. Int Endod J 2000;33(5):435-41.
Jenkins SM, Hayes SJ, Dummer PM. A study of endodontic treatment carried out in dental practice within the UK. Int Endod J 2001;34(1):16-22.
Zahran S, Mannocci F, Koller G. Assessing the Iatrogenic Contribution to Contamination During Root Canal Treatment. J Endod 2022;48(4):479-86.
Jakkrawanpithak P, Powattanasuk W, Sooppapipatt N, Pudla M, Srimaneekarn N, Buranachad N, Yuma S, Supa-Amornkul S. Efficacy of antiseptics for rubber dam sterilization prior to endodontic treatment. J Oral Sci 2024;66(1):5-8.
Susini G, Pommel LU, Camps J. Accidental ingestion and aspiration of root canal instruments and other dental foreign bodies in a French population. Int Endod J 2007;40(8):585-9.
Milanović M, Dimitrijević M, Juloski J, Juloski J. Isolation with rubber dam: knowledge, training, and attitudes of final year dental students. Vojnosanit Pregl 2022;79(10) : 996-1001.
Eggers M. Infectious disease management and control with povidone iodine. Infect Dis Ther 2019;8(4):581-93.
Estrela C, Estrela CR, Barbin EL, Spanó JC, Marchesan MA, Pécora JD. Mechanism of action of sodium hypochlorite. Braz Dent J 2002;13:113-7.
Mohammadi Z. Sodium hypochlorite in endodontics: an update review. Int Dent J 2008;58(6):329-41.
Basrani B, Haapasalo M. Update on endodontic irrigating solutions. Endod Topics 2012;27(1):74-102.
Sajjan P, Laxminarayan N, Kar PP, Sajjanar M. Chlorhexidine as an antimicrobial agent in dentistry–a review. Oral Health Dent Manag 2016;15(2):93-100.
Gomes BP, Pinheiro ET, Jacinto RC, Zaia AA, Ferraz CC, Souza-Filho FJ. Microbial analysis of canals of root-filled teeth with periapical lesions using polymerase chain reaction. J Endod 2008;34(5):537-40.
Sitheeque MA, Samaranayake LP. Chronic hyperplastic candidosis/candidiasis (candidal leukoplakia). Crit Rev Oral Biol Med 2003;14(4):253-67.
Patel P, Tonog P, Lakhkar AD. Normal Saline. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025.
McDonnell G, Russell AD. Antiseptics and disinfectants: activity, action, and resistance. Clin Microbiol Rev 1999;12(1):147–79.
Hugo WB, Longworth AR. Some aspects of the mode of action of chlorhexidine. J Pharm Pharmacol 1964;16(10):655-62.
Denton GW. Chlorhexidine. In: Block SS (ed.) Disinfection, Sterilization, and Preservation (5th ed.). Philadelphia: Lippincott Williams & Wilkins; 2001.
Vianna ME, Gomes BP, Berber VB, Zaia AA, Ferraz CC, de Souza-Filho FJ. In vitro evaluation of the antimicrobial activity of chlorhexidine and sodium hypochlorite. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2004;97(1):79-84.
White RR, Hays GL, Janer LR. Residual antimicrobial activity after canal irrigation with chlorhexidine. J Endod 1997;23(4):229-31.
Kuyyakanond T, Quesnel LB. The mechanism of action of chlorhexidine. FEMS Microbiology Letters 1992;100(1-3):211-5.
Haapasalo M, Shen Y, Qian W, Gao Y. Irrigation in endodontics. Dental Clinics 2010;54(2):291-312.
Clarkson RM, Moule AJ, Podlich HM. The shelf-life of sodium hypochlorite irrigating solutions. Aust Dent J 2001;46(4):269–76.
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