Reduction of bacterial after irrigation with 6% naocl, and continued irrigation with 17%edta and 2%chx during endodontic treatment of chronic apical periodontitis

Introduction: Irrigants used during chemomechanical preparation of the root canal system play an essential role in the successful of endodontic treatment. Combination of irrigants have been recommended to optimize the elimination of bacteria. Purpose: This study was aimed to clinically evaluate the bacterial reduction following irrigation with 6% NaOCl, and continued irrigation with 17% EDTA and 2% CHX during endodontic treatment of chronic apical periodontitis. Methods: Samples from twenty four patients were recruited from Endodontic Department of Hasanuddin University Dental hospital. Exudates were collected from the root canals of upper anterior teeth before root canal preparration (S1 samples) and after manually-instrumented and irrigated using 6% NaOCl (S2 samples), continued irrigation with 17% EDTA and 2% CHX (S3 samples). All samples were incubated in blood agar and nutrient agar, evaluated for the bacterial load (CFU) using bacterial culture technique. Data were analyzed by Friedman test and Wilcoxon test. Results: All samples were positive for bacteria, and irrigations protocol either with 6% NaOCl, or 17% EDTA and 2% CHX, significantly reduced bacterial load respectively. Continued irrigation with 17% EDTA and 2% CHX showed significant bacterial reduction compared to irrigation with 6% NaOCl (p<0.05). Conclusion: Continued irrigation after mechanical preparation in chronic apical periodontitis reduced the amount of bacteria, however it should be followed with intracanal medication to succeed endodontic treatmemt.