Antibacterial Effects of Chitosan, Formocresol and CMCP as Pulpectomy Medicament on Enterococcus ‎ faecalis , Staphylococcus aureus and Streptococcus ‎ mutans .

Introduction: During pulpectomy of primary teeth, cytotoxic medicaments such as formocresol or camphor mono-chlorophenol (CMCP) are used as medicaments. For the first time it is theorized that chitosan can substitute these traditional materials used in pulpectomy of infectious primary teeth.

Methods and Materials: This preliminary in vitro study consisted of two separate phases ( n =75), each of which assessed the antibacterial effects of chitosan versus formocresol and CMCP and positive/negative controls ( n =15) on three bacteria types [ Enterococcus ‎ faecalis, Staphylococcus aureus, Streptococcus ‎ mutans , ( n =5 per subgroup)]. Phases 1 and 2 concerned respectively with 1- and 7-day effects of these materials. Bacteria were cultured and injected into sterilized canals and colonies were counted. Medicaments were applied and colonies were re-counted after 1 day of treatment (phase 1). Specimens were re-sterilized and re-randomized, and used for phase 2, in which the same procedures were performed for a 7-day period. Effects of agents on bacteria were analyzed statistically (Kruskal-Wallis α =0.05 and Mann-Whitney α =0.017).

Results: Treatments reduced bacterial count either after 1 or 7 days ( P =0.000). Their effects on different bacteria types were not significant either after 1 or 7 days ( P >0.48). Antibacterial efficacies of treatments (indicated by colony reduction) were significantly different, after 7 days ( P =0.045). Antibacterial efficacy of chitosan was similar to that of formocresol or CMCP, in both phases [either after 1 or 7 days of treatment ( P >0.017). Formocresol and CMCP had similar efficacies in either phase ( P >0.017).

Conclusions: This preliminary study confirmed the appropriate antibacterial efficacy of chitosan as a medicament in pulpectomy of infectious primary teeth.