Microbiological evaluation of the disinfection of the root canal system using different irrigation protocol – An interventional study

Abstract

Aim: The focus of the present research is to analyze the potential role of irrigants along with the activation system in the disinfection of the root canal space. Methods: Ninety root canals were randomly divided into two experimental groups based on the irrigants: Group I (n = 45) – Sodium hypochlorite irrigant and Group II (n = 45) –Chlorhexidine irrigant. The two groups are further subdivided into three subgroups base on the activation devices, i.e., passive ultrasonic irrigation, endoactivator, and laser. The first sample as a baseline, and the second sample was collected after the disinfection procedure. All the samples were streaked in brain − heart infusion agar plate to analyze the bacterial colony growth. The confirmatory analysis for the presence of Enterococcus faecalis was done using gram staining, biochemical analysis, and polymerase chain reaction. The nonparametric analysis was done using Kruskal–Wallis, Mann–Whitney U, and Wilcoxon signed-rank test and P < 0.05 was considered to be statistically significant. Results: The mean colony-forming unit was significantly reduced and there exhibited a statistically significant difference in pretreatment and posttreatment irrigated with sodium hypochlorite and chlorhexidine activated with passive ultrasonic activation with (P = 0.001), endoactivator with (P = 0.001), and laser with (P = 0.001). Conclusion: In consideration with advantage of the properties of both irrigants, the present study concludes a combined use with sodium hypochlorite during instrumentation followed by laser activation and a final rinse with chlorhexidine for a better eradication of the microbes from the root canal system thus preventing re-infection.

Keywords

• endoactivator
• enterococcus faecalis
• laser
• passive ultrasonic irrigation
• polymerase chain reaction