Efeito antimicrobiano e estrutural de diferentes soluções desinfetantes nos cones de guttapercha

: revisão sistemática

Abstract

Introduction: The main objectives of endodontic treatment are hermetic filling of the root canal system and its disinfection, given that the presence of microorganisms proves to be the main factor of post-treatment infection that determines its success. Gutta-percha cones (GPCs) are the most used root filling material in endodontics until today. They can be easily contaminated and due to their thermoplastic characteristics, chemical disinfection becomes an essential alternative to the conventional thermal sterilization methods. Therefore, a safe chemical disinfectant that doesn't change the GPCs structure and is effective in its disinfection must be used in daily clinical practice. Objective: The purpose of this work was to carry out a systematized review to evaluate the effect of different disinfectant solutions on GPCs structure. Methodology: The electronic search took place in PubMed® and Web of Science® databases until February 28th, 2023. The selection of studies was performed by two independent investigators in accordance with inclusion and exclusion criteria. Results: After the search, 112 articles were identified. With the elimination of duplicates, 88 remained. By reading the title and abstract, 73 articles were eliminated that were not in agreement with the theme and/or did not meet the requirements of the inclusion or exclusion criteria. The resulting number of articles for full reading and inclusion in this study was 15. Rapid disinfection of GPCs with NaOCl, 2% CHX and MTAD® is effective in eliminating resistant bacteria. The antimicrobial activity of the solutions depends on their duration of action, concentration and contaminating microorganisms. After disinfection, the solutions modify the GPCs topography, due to the formation of residues that are deposited on their surface, which can be removed with a final wash with distilled water. Regarding the physical properties of GPCs, its roughness and elasticity are also increased after disinfection. The use of NaOCl at 5.25% concentration can cause marked
changes in the GPCs, namely the precipitation of sodium chloride crystals, dilution of some of its components and an increase in its elasticity, which will impair the hermetic sealing of the obturation. Conclusion: The amount of chlorine available in NaOCl is responsible for its deteriorating effects, so the application of a low concentration solution or 2% CHX is a safer alternative for the rapid disinfection of GPCs. In any case, it's essential to wash the GPCs, namely with distilled water in order to avoid or mitigate the changes caused by
the disinfection procedures.

Date of Award	25 Jul 2023
Original language	Portuguese
Awarding Institution	Universidade Católica Portuguesa
Supervisor	Rita Noites (Supervisor) & Ana Sofia Duarte (Co-Supervisor)