BackgroundThrough chemomechanical debridement of the root canal is a primary requisite for successful endodontic therapy. Thus the aim of this study was to evaluate the effects of using QmiX alone, QmiX with EndoActivator and QmiX with Er,Cr:YSGG laser for final irrigation on sealer penetration into the dentinal tubules.Material and Methods75 extracted human mandibular premolar teeth were treated with sodium hypochlorite (NaOCl) irrigation. The samples were divided into 5 groups according to the final irrigation solution used: (1) 17% EDTA and 2.5% NaOCl, (2) QmiX (3) QmiX with Er,Cr:YSGG laser and (4) QmiX with EndoActivator (5) 2.5%NaOCl. All teeth were obturated using cold lateral condensation technique with gutta percha and AH 26 sealer (Dentsply; DeTrey,Konstanz, Germany) labeled with Rhodamine B dye. The teeth were sectioned at distances of 2 and 5 from root apex. Total percentage and maximum depth of sealer penetration were measured using confocal laser scanning microscopy.ResultsResults of one way Anova analysis showed that there was a significant difference in the percentage and depth of sealer penetration among all groups at 3 and 5 mm level sections (P < .05). Within the groups maximum sealer penetration was recorded for Er,Cr:YSGG laser activated group. Greater depth of sealer penetration was recorded at 5mm as compared to 3mm in all the groups.ConclusionsActivation of QMix using EndoActivator and Er,Cr:YSGG laser enhanced the sealer penetration at apical and middle third. Thus Er,Cr:YSGG laser and EndoActivator may act as an appropriate adjunct during chemomechanical preparation of the root canal. Key words:EndoActivator, Er,Cr:YSGG laser, Qmix, confocal microscopy, sealer penetration.

BackgroundBacterial biofilms formed on the root canal wall are often difficult to remove. This study aimed to evaluate the cytotoxic effect and antibacterial efficacy of chitosan when used as root canal irrigant against E. Faecalis and Candida albicans biofilm formed on tooth substrate.Material and MethodsThe present study evaluated antibacterial effect of 0.25% Chitosan, 0.5% Chitosan, 2% chlorhexidine and 3% sodium hypochlorite against Enterococcus faecalis and Candida Albicans. Agar-well diffusion methods, minimal inhibitory concentration tests and biofilm susceptibility assays were used to determine antibacterial activity. Teeth specimens were sectioned to obtain a standardized tooth length of 12mm. Specimens were inoculated with 10 mL of the freshly prepared E. Faecalis suspension and Candida albicans for 4 weeks. The specimens were then instrumented with ProTaper rotary files F3 size. After irrigation with test solution, three sterile paper points were placed into one canal, left for 60 s and transferred to a test tube containing 1 mL of reduced transport fluid. The number of CFU in 1 mL was determined.Results3-week biofilm qualitative assay showed complete inhibition of bacterial growth with 3% Sodium hypochlorite, 2% Chlorhexidine and Chitosan except saline, which showed presence of bacterial growth. Significant reduction of colony forming units (CFU)/mL was observed for the chitosan groups and the antibacterial activity of the chitosan groups was at par with 3% NaOCl and 2% Chlorhexidine. It was observed that the chitosan showed no cytotoxicity at 3mg/ml and 10% cytotoxicity at 6mg/ml.ConclusionsThe use of chitosan as a root canal irrigant might be an alternative considering the various undesirable properties of NaOCl and chlorhexidine. Key words:Biofilm, Candida albicans, Chitosan, Cytotoxicity, Enterococcus faecalis.

Aim The aim of this study was to assess and compare the clinical and radiographic outcome of partial pulpotomy and full pulpotomy using Biodentine in cariously exposed mature molar teeth with symptoms indicative of irreversible pulpitis. Methodology This study is an unicentric, double‐arm, randomized superiority clinical trial with parallel experimental groups, registered under CTRI (CTRI/2019/12/022559). Fifty mature permanent molar teeth with carious exposures with symptoms indicative of irreversible pulpitis were randomly allocated equally into two groups. Partial pulpotomy (PP) and full pulpotomy (FP) were performed in the first and second group, respectively, following standardized protocols. Exposed pulp tissue was removed up to a depth of 2–3 mm for partial pulpotomy, whereas complete coronal pulp tissue was removed up to the level of root orifices for full pulpotomy. Haemostasis was achieved with placement of 2.5% sodium hypochlorite‐moistened cotton pellets placed on amputated pulp tissue for a maximum of 10 min. Biodentine was used as the pulp capping material. Pain scores were evaluated using 11‐point Visual Analogue Scale (VAS) preoperatively, at 24 h, 48 h and 7th day after the intervention(s). Clinical and radiographic evaluation was done at 3 months, 6 months and 1 year. The data were statistically analysed using chi‐squared test, Mann–Whitney U‐test, Friedman's test and Wilcoxon signed‐rank test. The significance level was pre‐determined at p < .05. Cumulative survival probabilities were assessed at 12 months using Kaplan–Meier analysis. Results Intra‐group analysis of pain scores revealed significant reduction in pain scores preoperatively and at 24 h, 48 h and 7th day in both the groups. However, the difference in the pain score(s) reduction between both the groups was not statistically significant at any time interval (p > .05). At 1‐year follow‐up, the success rate was 88% (22/25) and 91.6% (22/24) for PP and FP respectively (p > .05). Conclusions Partial pulpotomy showed comparable results to full pulpotomy in terms of clinical/radiographic treatment outcome. If the long‐term results remain the same, partial pulpotomy can be proposed as an alternative treatment modality for mature teeth with cariously exposed pulp tissue presenting with signs of symptomatic irreversible pulpitis.

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