IADR Abstract Archives
Endodontic Operative Field Asepsis in General Dental Care
Objectives: Studies on endodontic operative field asepsis have generally been carried out by endodontists at specialist clinics. The aim of this study was to evaluate the establishment of an aseptic endodontic operative field in general dental care by assessing general dental practitioners’ ability to reduce the amount of contamination to a non-cultivable level.
Methods: 120 adult patients, scheduled for root canal treatment at a general dental care clinic, contributed with 151 teeth. After rubber dam isolation, the operative fields were disinfected with the dentists’ preferred choice of 30% hydrogen peroxide followed by either 5% iodine tincture or 0,5% chlorhexidine-solution. After inactivation (5% sodium thioglycolate/polysorbate 80), samples were taken from the contact area between rubber dam/tooth and occlusal/incisal area. Samples were placed in fluid thioglycolate medium, incubated (37°, 2-5d), evaluated for growth/non-growth, and statistically analyzed (Pearson’s chi-squared test, p<.05).
Results: 41.7% (63/151) of the operative fields showed growth. 20.5% (31/151) showed growth from both sample sites. Significantly more positive samples were taken from the contact area than from the occlusal area (p<.001). There were significantly more positive samples when the chlorhexidine-protocol had been used, as compared to the iodine-protocol (p<.001).
Conclusions: A sizable proportion of the operative fields showed signs of contamination, indicating incomplete asepsis. It is likely that inadequate isolation of the teeth contributed to the contamination of the operative fields since more positive samples were collected at the contact area than occlusally. The difference between the chlorhexidine- and iodine-protocols may not reflect a true difference in the effectiveness of the antimicrobial solutions, as it could be a consequence of different operators’ skills and thoroughness when isolating and disinfecting the operative field.
Methods: 120 adult patients, scheduled for root canal treatment at a general dental care clinic, contributed with 151 teeth. After rubber dam isolation, the operative fields were disinfected with the dentists’ preferred choice of 30% hydrogen peroxide followed by either 5% iodine tincture or 0,5% chlorhexidine-solution. After inactivation (5% sodium thioglycolate/polysorbate 80), samples were taken from the contact area between rubber dam/tooth and occlusal/incisal area. Samples were placed in fluid thioglycolate medium, incubated (37°, 2-5d), evaluated for growth/non-growth, and statistically analyzed (Pearson’s chi-squared test, p<.05).
Results: 41.7% (63/151) of the operative fields showed growth. 20.5% (31/151) showed growth from both sample sites. Significantly more positive samples were taken from the contact area than from the occlusal area (p<.001). There were significantly more positive samples when the chlorhexidine-protocol had been used, as compared to the iodine-protocol (p<.001).
Conclusions: A sizable proportion of the operative fields showed signs of contamination, indicating incomplete asepsis. It is likely that inadequate isolation of the teeth contributed to the contamination of the operative fields since more positive samples were collected at the contact area than occlusally. The difference between the chlorhexidine- and iodine-protocols may not reflect a true difference in the effectiveness of the antimicrobial solutions, as it could be a consequence of different operators’ skills and thoroughness when isolating and disinfecting the operative field.