Clotrimazole as adjunct to endodontic irrigation protocol improves pulpectomy results

Several factors are involved in the development of pulp and periapical disease in primary and permanent teeth, with dental caries being the main factor. Although these factors are similar, the clinical management of a primary or permanent tooth with pulp or periapical disease may be quite different. Despite endodontic infections being a common problem in the primary dentition, some of the infected primary teeth can remain functional until the exfoliation through endodontic treatment. The primary endodontic treatment goal must be to optimize root canal disinfection and to prevent reinfection.

Therefore, Pallavi Anand and colleagues from the Department of Pediatric and Preventive Dentistry, ITS-CDSR, Ghaziabad, Uttar Pradesh, India conducted the present study to compare the antifungal efficacy of antimicrobial photodynamic therapy, LASER, and 1% clotrimazole as irrigants by reducing the colony-forming units (CFU) of Candida albicans in the infected root canals of primary teeth.

The authors performed pulp therapy on deciduous mandibular second molars of 20 healthy children aged 5–8 years. The children were divided into four groups of intracanal disinfection protocols: Group 1 (n = 5) – Sodium Hypochlorite, Group 2 (n = 5) – Photodynamic, Group 3 (n = 5) – Normal saline with LASER, and Group 4 – (n = 5) Antifungal. Disinfection potential was compared by collecting samples one just after access opening and the other after the experimental groups using paper points. The samples were cultured and incubated for 48 h to check the change in CFU of the fungi.

The key finding noted in the study was that there was no significant difference found between the different groups. However, complete inhibition of C. Albicans CFU was seen with Group 4.

Hence, Anand concluded that "One percent Clotrimazole (antifungal) can be utilized as an adjunct in the endodontic irrigation protocol for better success of pulpectomy in children."