scholarly journals Comparative Evaluation of the Efficacy of Chlorhexidine, Sodium Hypochlorite, the Diode Laser and Saline in Reducing the Microbial Count in Primary Teeth Root Canals – An In Vivo Study

2019 ◽  
Vol 10 (4) ◽  
pp. 268-274 ◽  
Author(s):  
Vidhi Walia ◽  
Mousumi Goswami ◽  
Shivesh Mishra ◽  
Nidhi Walia ◽  
Divya Sahay

Introduction: One of the primary goals of pulpectomy is to decrease the sum total of microorganisms and disinfect the tooth root canal system. To achieve this, mechanical preparation, irrigation, disinfection and obturation of the root canal is necessary. The present study was set out to evaluate the difference in the antibacterial efficacy of primary teeth root canals either irrigated with chlorhexidine, saline, and sodium hypochlorite or irradiated with a soft tissue diode laser (980 nm, Photon Plus, Zolar Tech & Mfg Co. Inc, Ontario, Canada). Methods: Sixty primary teeth of children requiring pulpectomy were divided into 4 groups of 15 each, group 1 (2% chlorhexidine), group 2 (1% sodium hypochlorite), group 3 (laser irradiation) and group 4 (saline). Pulp tissue was extirpated from the canals and the samples were collected using sterile absorbent paper points. After cleaning and shaping, the root canals of the teeth in each group were irrigated using sodium hypochlorite, chlorhexidine, and saline or were irradiated with the laser. The samples were obtained again and sent for microbiological examination. Results: The colony-forming unit (CFU) counts from pre-disinfection sample served as a baseline for comparisons throughout the study. The mean bacterial colony counts of all the isolated bacteria reduced after irrigation or irradiation. Intergroup comparisons showed no significant difference when groups 1, 2, and 3 were compared to each other (P>0.05). However, a significant difference was seen when groups 1, 2, 3 were compared to group 4 (P<0.05). Conclusion: Two percent chlorhexidine, 1% sodium hypochlorite and laser irradiation succeeded in reducing the root canal infection. Hence, diode laser irradiation may be a possible supplement to existing protocols for disinfecting the root canal system.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Francisco Gomez ◽  
Gisbeli Brea ◽  
Jose Francisco Gomez-Sosa

Abstract Background The purpose of this study was to determine the anatomical variations of the root canal system of mandibular second molars using cone-beam computed tomography (CBCT). Methods 190 mandibular second molars cone-beam computed tomography images were reviewed. The evaluation was performed by a radiologist with endodontic experience and two endodontists trained with CBCT technology. Tooth position, number of root and root canals, C-shaped root canal system configuration, presence of extra root (radix), and radicular grooves were assessed. Data was statistically analyzed using The Chi-square test (α = 0,05) to determine any significant difference between gender and the total number of root and root canals, and any significant difference between gender and root canal anatomical variation. Results Overall, 85.5% showed two separated roots, 12.1% a single root, 2.6% three roots or radix. 87.7% showed three root canals, 12.1% two root canals, 2.6% four root canals, and 1.6% a single root canal. 10% showed a single foramen, 75.3% two foramina, 13.6% three foramina and 1% showed four foramina.19.5% showed C-shaped anatomical variation, 51.4% in male patients, 48.6% in female patients. According to Fan classification: C1 13.6% in cervical third, C2 10% in the middle third, C3 17.3% in middle third, 15.5% in apical third, and C4 12.7% in the apical third. Root canals number in these samples were 5.4% a single canal, 21.6% two canals, 70.3% three canals, and 2.7% four canals. The root showed 46% with one foramen, 46% two foramina, and 8% three foramina. Radicular grooves 83.3% were found in the lingual area and 16.2% towards the buccal area. Conclusions The most prevalent anatomic presentation of the evaluated sample was a mandibular second molars with two roots, three root canals, and two apical foramina. Their variation was C-shaped root canals and Radix Paramolaris.


2018 ◽  
Vol 25 (3) ◽  
Author(s):  
Raksha Bhat ◽  
◽  
Preethesh Shetty ◽  
Mithra N. Hegde ◽  
◽  
...  

Attaining a sterile root canal system is important since microorganisms can cause persistent inflammation in the periradicular tissues. Objectives: This study sought to evaluate the efficacy of two irrigation delivery systems; the EndoVac and semiconductor diode laser irradiation with 5.25% sodium hypochlorite and 2% chlorhexidine. Methods: Fifty teeth were disinfected according to the Occupational Safety and Health Administration regulations. The teeth were then instrumented, followed by inoculation with bacterial strains of Enterococcus faecalis (ATCC 29212). The teeth were randomly assigned to five groups, Group I: Control group; Group II: Teeth irrigated with 5.25% NaOCl + Endovac; Group III: Teeth irrigated with 2% Chlorhexidine + Endovac; Group IV: Teeth irrigated with 5.25% NaOCl + laser irradiation; and Group V: Teeth irrigated with 2% Chlorhexidine laser irradiation. All samples were incubated on Muller–Hilton media plates for a period of 24 h. We determined the colony-forming units and analyzed them statistically using Fisher’s exact test. Results: Laser irradiation completely disinfected the root canal system. The EndoVac system produced significant disinfection but was comparatively less effective than laser irradiation. Conclusion: Laser irradiation had a significantly greater bactericidal effect than the EndoVac system, used in conjunction with sodium hypochlorite and chlorhexidine.


2006 ◽  
Vol 14 (4) ◽  
pp. 260-263 ◽  
Author(s):  
Fernanda Vieira Medina ◽  
Manoel Damião Souza-Neto ◽  
Jacy Ribeiro Carvalho-Junior ◽  
Heid Sueli Leme dos Santos ◽  
Melissa Albanese Mezzena ◽  
...  

OBJECTIVES: The aim of this study was to determine the effect of Er:YAG laser irradiation used to clean dentinal walls on the apical sealing of root canals filled with different types of sealers. Background Data: Laser application to the dentinal walls removed debris, rendering the root canals free of smear layers and leaving the dentinal canaliculi open. METHODS: Sixty-four maxillary canines obtained from laboratory files were instrumented with K-files (Dentsply, Maillefer, Ballaigues, Switzerland) using the crown-down technique, and irrigated with a 0.5% sodium hypochlorite solution. The specimens were divided into two groups of 32 teeth each. In group I, the teeth were instrumented and irrigated with sodium hypochlorite solution, and divided into four subgroups to be sealed with the different materials (Endofill, N-Rickert, Sealapex and Sealer 26). In group II, the root canals were subjected to Er:YAG laser irradiation (200 mJ, 7 Hz and 60 J total energy), followed by root canal sealing as in group I. RESULTS: The data showed lower levels of apical microleakage in the teeth filled with N-Rickert, Sealapex and Sealer 26 cements than in those sealed with Endofill (p < 0.01). No significant difference in microleakage was observed between teeth irrigated only with 0.5% sodium hypochlorite and those submitted to Er:YAG laser application (p > 0.05). CONCLUSIONS: The Er:YAG laser irradiation applied to the root canal walls was not able to prevent apical microleakage.


2005 ◽  
Vol 13 (1) ◽  
pp. 93-100 ◽  
Author(s):  
Janir Alves Soares ◽  
Mario Roberto Leonardo ◽  
Léa Assed Bezerra da Silva ◽  
Mário Tanomaru Filho ◽  
Izabel Yoko Ito

In the endodontic treatment of root canals with necrotic pulps associated with periapical radiolucent areas, one of the main objectives of treatment consists in eliminating the microorganisms spread throughout the ramifications of the root canal system. The scope of this study was to evaluate the antiseptic efficacy of biomechanical preparation and two calcium hydroxide-based pastes, in dogs' teeth with experimentally induced chronic periapical lesions. After initial microbiological sampling, instrumentation of the root canals was undertaken using the conventional technique, using K type files used in conjunction with a solution of 5.25% sodium hypochlorite. After ninety-six hours, further microbiological sampling was undertaken and Calen/CPMC or Calasept pastes were applied for 15 and 30 days. Ninety six hours after the removal of the medication, the third microbiological sampling was undertaken and finally histomicrobiological analysis followed using Brown & Brenn staining. The results were analyzed using the Kruskall-Wallis test, with a level of significance established at 5% (p<0.05). It was shown that the biomechanical preparation significantly reduced the number of colony forming units of microorganisms in root canals. In contrast, there was no significant difference between the antiseptic action of long-term dressings over two periods of action, although 30 days produced a greater reduction in the quantity of microorganisms and of positive microbiological cultures. In histological sections of the four experimental groups, similar microbiological patterns were shown (p>0.05), characterized by an elevated incidence of cocci, bacilli and filaments, predominantly gram-positive, in root canals, secondary canals and accessories, apical cementoplasts and dentinal tubules, but with a low incidence of microorganisms in areas of cementum resorption and the periapical lesion. The biomechanical preparation and intracanal dressing based on calcium hydroxide were important in the antisepsis of the root canal; however, both procedures did not produce significant changes in the microbiological aspects of the root canal system.


2015 ◽  
Vol 26 (4) ◽  
pp. 342-346 ◽  
Author(s):  
Juliane Maria Guerreiro-Tanomaru ◽  
Gisselle Moraima Chávez-Andrade ◽  
Norberto Batista de Faria-Júnior ◽  
Evandro Watanabe ◽  
Mário Tanomaru-Filho

<p>Endodontic irrigation aims to clean and disinfect the root canal system. Passive ultrasonic irrigation (PUI) is based on the use of an ultrasound-activated instrument into the root canal filled with irrigant. The aim of this study was to evaluate, ex vivo, the effectiveness of PUI in eliminating <italic>Enterococcus faecalis</italic> from root canals. Seventy-five extracted human single-root teeth were used. After root canal preparation, specimens were inoculated with <italic>E. faecalis</italic> and incubated at 37 °C for 21 days. Specimens were distributed into five groups (n=15), according to the irrigation method: PUI + saline solution (PUI/SS); PUI + 1% NaOCl (PUI/NaOCl); conventional needle irrigation (CNI) + saline solution (CNI/SS); CNI + 1% NaOCl (CNI/NaOCl); No irrigation (control). Microbiological samples were collected at three time points: initial (21 days after inoculation), post-irrigation (immediately after irrigation), and final (7 days after irrigation). Data were obtained in CFU mL<sup>-1</sup> and subjected to analysis by ANOVA and Tukey's tests at 5% significance level. The post-irrigation samples did not demonstrate statistical difference between PUI/SS and CNI/SS nor between PUI/NaOCl and CNI/NaOCl (p>0.05), but PUI/NaOCl and CNI/NaOCl had lower CFU mL<sup>-1</sup> number than the other groups (p>0.05). Statistically significant difference was observed between the initial and post-irrigation samples and between the post-irrigation and final samples (p<0.05) in all groups, except in the control. The final samples of all groups presented bacterial counts similar to the initial samples. PUI or CNI with 1% NaOCl contribute to disinfection, but are unable to eradicate <italic>E. faecalis</italic> from the root canal system.</p>


2016 ◽  
Vol 31 (3) ◽  
pp. 114
Author(s):  
Matheus Albino Souza ◽  
Liviu Steier ◽  
Giampiero Rossi-Fedele ◽  
Valdir Barth Júnior ◽  
Silvia Dias De Oliveira ◽  
...  

Objective: The purpose of this study was to evaluate, in vitro, the effectiveness of photodynamic therapy and sodium hypochlorite over root canal system infected with Enterococcus faecalis.Methods: The root canals of 45 single-rooted human extracted teeth were enlarged up to a file 60, autoclaved, inoculated with Enterococcus faecalis and incubated for 30 days. The samples were divided into five groups (G1 – n=5; G2-G5 – n=10) according to the protocol of decontamination: G1 (negative control) – no procedure was performed; G2 – distilled water; G3 –  hotodynamictherapy (PDT); G4 – 2.5% sodium hypochlorite (NaOCl); and G5 – 2.5% NaOCl+PDT. Scanning electron microscopy (SEM) were performed to evaluate the effectiveness of proposed treatments. The assessment was made by images of each third at 5000x magnification for the canal wall and 10000x for the exposed tubule area. The presence of bacteria was scored by position ranks from 1 to 45, where the higher the value, the cleanliness of the sample. Data were subjected to one-way ANOVA followed by post-hoc Tukey test (α=0.05).Results: Group 4 (2.5% NaOCl) and 5 (2.5% NaOCl + PDT) had the highest mean of position ranks for all thirds of the root canal in the canal wall, which was statistically different from groups 1, 2 and 3 (p<0.05). Group 3 (PDT), group 4 (2.5% NaOCl) and 5 (2.5% NaOCl+PDT) had the highest mean of position ranks in the exposed tubule area, which was statistically different from groups 1 and 2 (p<0.05).Conclusion: the association of 2.5% sodium hypochlorite + photodynamic therapy can be considered an effective protocol for the elimination of Enterococcus faecalis.


2017 ◽  
Vol 29 (3) ◽  
Author(s):  
Haikal Halil ◽  
Mazlifa Mahidin ◽  
Nik Nur Farahiyah ◽  
Khairul Bariah Chi Adam

Introduction: Successful endodontic treatment requires the clinician to be able to locate, disinfect, and obturate all canals presence in the root canal system to remove the infection and prevent re-infection. However, some canals, such as secondary mesiobuccal (MB) root canal often missed upon examination and the treatment. The success of locating these canals is determined by the methods used, a periapical radiograph and Cone Beam Computed Tomography (CBCT). The purpose of this study was to examine the sensitivity and accuracy of the periapical radiograph (PA) and CBCT on determining the presence of the secondary MB root canal. Methods: As much as 40 intact crown and intact radicular of the maxillary first molars, without root caries, root restoration, and endodontic treated, were taken as the samples. The presence of a secondary MB root canal was evaluated by a PA radiograph, CBCT, and clinical sectioning. Samples were undergone each test and sectioned after being completed the radiographic evaluation steps. Results: CBCT radiograph was successfully identifying 62.5% secondary MB root canal presence, whilst the PA radiograph has detected only 20% of the samples. The sensitivity of CBCT and PA radiograph was compared with the gold standard method, resulting 86.2 and 27.6% respectively. The statistical analysis showed that there was no significant difference between CBCT test and the gold standard (p=0.00). Conclusion: CBCT was proven to be a reliable method to detect the presence of secondary MB root canals due to its accuracy as high as the clinical sectioning compared to the PA radiograph.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Alfredo Sierra-Cristancho ◽  
Luis González-Osuna ◽  
Daniela Poblete ◽  
Emilio A. Cafferata ◽  
Paola Carvajal ◽  
...  

AbstractThis study aimed to analyze the root anatomy and root canal system morphology of mandibular first premolars in a Chilean population. 186 teeth were scanned using micro-computed tomography and reconstructed three-dimensionally. The root canal system morphology was classified using both Vertucci’s and Ahmed’s criteria. The radicular grooves were categorized using the ASUDAS system, and the presence of Tomes’ anomalous root was associated with Ahmed’s score. A single root canal was identified in 65.05% of teeth, being configuration type I according to Vertucci’s criteria and code 1MP1 according to Ahmed’s criteria. Radicular grooves were observed in 39.25% of teeth. The ASUDAS scores for radicular grooves were 60.75%, 13.98%, 12.36%, 10.22%, 2.15%, and 0.54%, from grade 0 to grade 5, respectively. The presence of Tomes’ anomalous root was identified only in teeth with multiple root canals, and it was more frequently associated with code 1MP1–2 of Ahmed’s criteria. The root canal system morphology of mandibular first premolars showed a wide range of anatomical variations in the Chilean population. Teeth with multiple root canals had a higher incidence of radicular grooves, which were closely related to more complex internal anatomy. Only teeth with multiple root canals presented Tomes’ anomalous root.


2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Seyedeh Sareh Hendi ◽  
Negin Amiri ◽  
Banafsheh Poormoradi ◽  
Mohammad Yousef Alikhani ◽  
Saeid Afshar ◽  
...  

This study investigates the antibacterial effects of erbium chromium laser at 2780 nm, silver nanoparticles, and erbium chromium along with silver nanoparticles on Enterococcus faecalis in comparison with sodium hypochlorite. In the present study, 90 extracted human single-rooted teeth were selected and standardized to a length of 15 mm. The canals were prepared by V-taper Gold rotary files and then incubated with E. faecalis for 21 days. The samples were divided into four experimental groups including hypochlorite sodium, silver nanoparticle, erbium chromium laser, and erbium chromium laser along with silver nanoparticle groups. Results showed that there was a significant reduction in colony count for all groups after interventions. Moreover, there was a significant reduction in the colony count for sodium hypochlorite group in comparison with another groups, and this group showed the highest reduction of colony count. There was a significant difference between silver nanoparticles and erbium chromium laser groups in colony count. According to the results, the silver nanoparticles offered strong antibacterial effects on E. faecalis and therefore can decrease bacterial colonies, while the use of the laser, despite the reduction of the bacterial colony, could not be sufficiently used for disinfection of root canal system.


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