Publication

Abstract : Aim: This systematic review aims to evaluate the antimicrobial efficacy of octenidine dihydrochloride (OCT) and chlorhexidine (CHX) as endodontic irrigants when used against Enterococcus faecalis (E. faecalis) and to compare the efficacy of both when used as a chemomechanical agent. Background: This systematic review literature search was undertaken in the databases Medical Literature Analysis and Retrieval System Online (MEDLINE) Ovid (from 1946), Scopus, and Google Scholar, as well as a hand search of the references of included publications. Ex vivo and in vitro, studies were included. The risk of bias was assessed using a customized tool. In vitro and ex vivo studies were done on a natural tooth and agar cultures to measure the colony forming unit (CFU), zone of inhibition (ZOI), minimum inhibitory concentration (MIC), and proportion of dead cells to evaluate the antimicrobial efficacy of octenidine and CHX were considered outcomes in this review. Review results: From 152 articles, 25 were reviewed for full text. A total of 12 in vitro studies were included for qualitative analysis. Out of 12 studies, eight studies reported better antimicrobial efficacy for OCT than CHX; two studies showed comparable results, and two studies favored CHX. Conclusion: Octenidine was a more potent disinfectant in the root canal for better antimicrobial efficacy than CHX as an irrigant against E. faecalis. Clinical significance: Octenidine dihydrochloride (OCT) has been described as a potential substitute for CHX during chemomechanical debridement in endodontic treatment. OCT is less cytotoxic to the periapical tissues than CHX; however, as an antimicrobial, it is highly effective against a range of gram-positive and gram-negative oral bacterial species. The substance of CHX in dentin seems to be an advantage over OCT. Thus, different studies have been conducted to compare the effectiveness of OCT and CHX for disinfection of the root canal, and the evidence seems to support the clinical use of OCT more.