Clinical ResearchAn Evidence-Based Analysis of the Antibacterial Effectiveness of Intracanal Medicaments
Section snippets
MATERIALS AND METHODS
To answer the clinically relevant question, a four-step method of evidence-based analysis was applied: Step 1, a search for the best evidence, conducting a comprehensive search of the endodontic literature in electronic databases; Step 2, appraisal and selection of papers according to study validity and clinical importance; Step 3, collection and analysis of the published evidence; and Step 4, determining the clinical applicability of the results.
A MEDLINE search strategy was developed to
Included and Excluded Studies
The primary search from all sources identified 152 related references. After scanning of the titles and abstracts, the full text of 17 studies was obtained and underwent the data extraction process. These articles covered calcium hydroxide (13 papers), camphorated para-monochlorophenol (3 papers), camphorated phenol (1 paper), iodine–potassium iodide (3 papers), chlorhexidine (1 paper), and formocresol (2 papers). Based on the inclusion and exclusion criteria developed at the start of the
DISCUSSION
The studies evaluated in this analysis reinforce the strong correlation between apical periodontitis and the presence of bacteria in canals (162 of 164 teeth, or 99%). Cleaning, shaping, and irrigation greatly reduce the cultivable numbers of bacteria, typically by 99% to 99.9%. However, these studies have shown that it is impossible to achieve a sterile root canal system in all cases by cleaning and shaping alone (62% remaining positive), in agreement with the findings of Byström and Sundqvist
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