Antibacterial Efficacy Of Calcium Hydroxide And Chlorhexidine Against Enterococcus Faecalis–A Systematic Review

Aim: To compare the antimicrobial efficacy of calcium hydroxide and chlorhexidine against E.faecalis. Material and Method: MEDLINE, the Cochrane library, Google Scholar and major journals were searched for studies from 1st Jan 2006 to 31st July 2017 to identify appropriate articles. A comprehensive search was designed, and the articles were independently screened for eligibility by two reviewers. In vitro studies comparing antimicrobial efficacy of calcium hydroxide and chlorhexidine against E.faecalis were considered for review. Results: Total of 905 articles were obtained using search strategies out of which 144 articles were selected after reading title and abstract. As a second step, full text publication were obtained. Studies in which calcium hydroxide and chlorhexidine were compared as an intracanal medicament against E.faecalis were selected for this review. Finally a total of 31 articles were included out of which 10 articles were excluded on basis of inclusion and exclusion criteria. Conclusion 1. CHX showed a better antimicrobial efficacy than calcium hydroxide against E.faecalis. Though 2% chlorhexidine has been found to be more effective against E.faecalis more sophisticated methods such as confocal laser microscopy have shown that bacteria may still be viable but in non-cultivable state so the results are not reliable. 2. The vehicle used for calcium hydroxide would alter its antimicrobial efficacy and substantivity. 3. 2% Chlorhexidine gel has increased bactericidal action when compared to lower concentrations of chlorhexidine gel. 4. Antimicrobial efficacy of calcium hydroxide and chlorhexidine decreases with the time.