ArticleBMC oral health2026
Comparative antimicrobial efficacy of three intracanal medicaments in an in vitro Enterococcus faecalis root canal infection model.
Article in BMC oral health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundEnterococcus faecalis (E. faecalis) commonly persists in endodontic infections and shows high resistance to traditional intracanal medicaments like calcium hydroxide [Ca(OH)2]. Alternatives such as chlorhexidine (CHX) and RG-Dent (metronidazole, iodoform, dexamethasone) are promising, but comparative evidence, especially regarding optimal application duration, remains limited.
methodsSixty human single-rooted teeth were prepared, sterilized, and inoculated with E. faecalis for 21 days to establish an in vitro root canal infection model. Specimens were randomly assigned to three medicament groups (RG-Dent, 2% CHX gel, Ca(OH)2; n = 20 each) with two subgroups by application duration (2 or 7 days; n = 10 each). Bacterial loads (log10 CFU/mL) were measured pre- and post-treatment. Data were analyzed using two-way ANOVA, t-tests, Tukey’s HSD (α = 0.05), and effect size calculations.
resultsAll medicaments significantly reduced bacterial loads (p < 0.001). Both CHX (mean reduction 4.94 ± 0.23) and RG-Dent (4.77 ± 0.26) were significantly more effective than Ca(OH)2 (3.69 ± 0.27) (p < 0.001, d > 4). CHX showed marginal superiority over RG-Dent (p = 0.036, d = 0.69). Application duration (2 vs. 7 days) had no significant effect (p = 0.78) and there was no interaction between duration and medicament.
conclusionsBoth 2% CHX gel and RG-Dent were significantly more effective than Ca(OH)2 against mature E. faecalis in vitro root canal infection model. Prolonged application beyond 2 days did not enhance efficacy, supporting the use of shorter medicament protocols for efficient clinical disinfection.
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