Evidence map›Paper›PMID 40150951›Full record

Trial reportDental traumatology : official publication of International Association for Dental Traumatology2025

Microbial Loads in Traumatized Immature Teeth and Their Impact on the Treatment Outcomes of Regenerative Endodontic Treatment: A Randomized Clinical Trial Comparing Chlorhexidine and Calcium Hydroxide.

Alina Wikström, Olena Rakhimova, Pavel Călin, Georgios Tsilingaridis, Malin Brundin, Nelly Romani Vestman

Abstract readRandomized Controlled TrialComparative Study
In one paragraph

Trial report in Dental traumatology : official publication of International Association for Dental Traumatology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Observational
  2. Evidence Mapping and Quality Assessment of Randomized Controlled Trials in Dental Traumatology.Dental traumatology : official publication of International Association for Dental Traumatology · 2026
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Alina WikströmDepartment of Endodontics, Public Dental Health Services, Eastman Institute, Stockholm, Sweden.ORCID 0000-0002-8281-9241
Olena RakhimovaDivision of Paediatric Dentistry, Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden.
Pavel CălinDepartment of Odontology, "Nicolae Testemitanu" State University of Medicine and Pharmacy, Chisinau, Moldova.
Georgios TsilingaridisDivision of Paediatric Dentistry, Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden.
Malin BrundinDepartment of Odontology, Umeå University, Umeå, Sweden.
Nelly Romani VestmanDepartment of Odontology, Umeå University, Umeå, Sweden.

Funding

Kempe Foundation JCSMK23-0158Region of Västerbotten (Sweden) via ALF RV-966705Region of Västerbotten (Sweden) via TUA RV 7004028Region of Västerbotten (Sweden) via TUA RV-977100
6 · The paper itself

Abstract

introductionRegenerative endodontic treatment (RET) aims to promote root maturation in necrotic immature teeth, where effective microbial disinfection is crucial for treatment success. This study evaluated the effect of calcium hydroxide (CH) and 2% chlorhexidine gluconate (CHD) as intracanal medicaments and their impact on bacterial loads and RET outcomes.

methodsThe material consisted of bacterial samples from 41 patients who participated in a previously conducted randomized controlled clinical trial comparing CH and CHD during RET. A total of 123 microbial samples were analyzed using real-time quantitative polymerase chain reaction (qPCR). Bacterial loads were assessed at three time points: before root canal disinfection (S1), after root canal disinfection (S2), and after intracanal dressing (S3). The microbial composition was evaluated at the kingdom (Eubacteria), phylum (Actinomycetota), and species (Enterococcus faecalis) levels.

resultsSignificant reductions in bacterial loads were observed after root canal disinfection (S2) in both CH and CHD subgroups, regardless of treatment outcome. Further reductions after intracanal dressing (S3) occurred exclusively in the successful cases. Actinomycetota loads significantly decreased after root canal disinfection in the successful cases but remained unchanged after intracanal medication. The presence of E. faecalis after intracanal dressing was associated with failed RET (OR = 9.778; p = 0.0432), although no significant differences in the effectiveness of the intracanal medicaments were found.

conclusionBoth CH and CHD effectively reduced bacterial loads, with greater reductions linked to successful outcomes. The association between E. faecalis and failed RET suggests that this species may play a role in treatment outcomes. Further research, including microbiome profiling, is desirable to identify potential prognostic markers for failed RET.

Indexed as

Bacterial LoadCalcium HydroxideChlorhexidineDental Pulp NecrosisRegenerative EndodonticsRoot Canal IrrigantsTooth InjuriesAdolescentChildFemaleHumansMaleReal-Time Polymerase Chain ReactionRoot Canal TherapyTreatment OutcomeCalcium HydroxideChlorhexidinechlorhexidine gluconateRoot Canal Irrigantsantibacterial effectiveness of calcium hydroxide and 2% chlorhexidinebacterial loadsimmature traumatized teethquantitative polymerase chain reactionregenerative endodontic treatment

Identifiers

PMID40150951
PMCPMC12424100

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.