Effectiveness of polyhexamethylene biguanide, chlorhexidine, and calcium hydroxide intracanal medicament against intraradicular mature polymicrobial biofilm: A microbiological study
Vineeta Nikhil, Aleena Khan, Anita Pandey, Priyanka Chaturvedi
Abstract
<b>Aim:</b> To compare the effectiveness of different intracanal medicaments against polymicrobial biofilm formed by <i>Enterococcus faecalis, Staphylococcus aureus,</i> and <i>Candida albicans</i>.<br><b>Materials and Methods:</b> Eighty mature human roots with intraradicular polymicrobial biofilm were randomly assigned into four groups (<i>n</i> = 20). Intracanal medicaments 0.2% polyhexamethylene biguanide (PHMB), 2% chlorhexidine (CHX), and calcium hydroxide (CH) were applied into the root canals. Collected dentine samples were tested at 7<sup>th</sup>, 15<sup>th</sup>, and 30<sup>th</sup> day for microbial growth, and the colony-forming units per ml (CFU/ml) were determined.<br><b>Results:</b> The CFU/ml data were analyzed using unpaired <i>t</i>-test and one-way ANOVA-F comparison test. All medicaments resulted in a significant reduction (<i>P</i> < 0.05) in microbial growth at all time intervals compared to the control group. CHX and PHMB showed a similar reduction in CFU/ml at 7<sup>th</sup> and 15<sup>th</sup> day but significantly more than CH at all time intervals. At 30<sup>th</sup> day, PHMB caused a significantly more reduction in CFU/ml than CHX.<br><b>Conclusions:</b> All the three tested intracanal medicaments such as CH, CHX, and PHMB Gel were effective in reducing the microbial count. CH has a limited antimicrobial effect against the polymicrobial biofilm found inside the root canal. 2% CHX gel has a time-dependent antimicrobial effect. PHMB has a superior antimicrobial effect in comparison with CHX and CH.<br>