Antimicrobial Efficacy of Chlorhexidine and Sodium Hypochlorite in Root Canal Disinfection: A Systematic Review and Meta-analysis of Randomized Controlled Trials
Kasidid Ruksakiet, Lilla Hanák, Nelli Farkas, Péter Hegyi, Wuttapon Sadaeng, László Márk Czumbel, Thanyaporn Sang-Ngoen, András Garami, Alexandra Mikó, Gábor Varga, Zsolt Lohinai
Abstract
INTRODUCTION: We aimed to compare the antimicrobial efficacy of chlorhexidine (CHX) and sodium hypochlorite (NaOCl), 2 irrigants routinely used in root canal therapy of permanent teeth. METHODS: Electronic databases, including PubMed, EMBASE, Web of Science, and Cochrane Library, were searched for randomized controlled trials published until March 2020. The meta-analysis of relative risk (RR) and standardized mean difference (SMD) was performed using a random effects model with a 95% confidence interval (CI). Subgroup analysis was performed for culture and molecular methods of bacterial detection. RESULTS: = 76.336%, P = .005). CONCLUSIONS: Our findings suggest that both CHX and NaOCl can reduce bacterial infections after irrigation without any significant difference in antimicrobial efficacy between them. Although CHX and NaOCl showed similar efficacy, their molecular mechanisms were different. Therefore, they can be used as the main antibacterial root canal irrigants. However, our results were limited by inconsistencies among retrieved articles and a lack of clinically relevant outcomes. Further well-designed clinical studies are warranted to supplement our results.