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

Abstract

Please cite this article as follows: Walia V, Goswami M, Mishra S, Walia N, Sahay D. 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. Abstract 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.

Evaluation of bacterial kill in human roots infected with Enterococcus faecalis biofilm following 980 nm laser activation of chlorhexidine

“…For this study direct irradiation with the fiber tip was placed within the root canal at its working length, and light emission at tip and from the lateral sides, thus leading to even horizontal and vertical light distribution for disinfection. According to Walia et al [23] 980 nm near-infrared diode has antimicrobial action on its own due to laser scattered radiation and photodynamic effects, therefore not just purely relying on the irrigation solution to disinfect the canal space. For this study, clinically near infrared diode laser combines with CHX demonstrated the highest percentage of bacterial kill (>80%) compared to the other treatment groups with over 80% achieved on the external root surface over a 72-hour period.…”

“…Manual agitation of irrigant is recognized to only produce weak fluid movement that is not sufficient to remove bacterial biofilms [22] and hence this corresponds to the lowest percentage of bacterial kill compared to the other treatment groups; achieving less than 30% total kill up to 24 hours. A recent report by Walia et al [23], looked into irrigation solution for pulpectomy in deciduous teeth in which E. faecalis was isolated. The study showed no significant difference between using CHX or sodium hypochlorite, both achieved significant bacterial reduction, hence CHX was chosen for this study as it has fewer complications for clinical use compared to NaOCl or hydrogen peroxide.…”

Antibacterial Effects of a 940 nm Diode Laser With/ Without Silver Nanoparticles Against Enterococcus faecalis

“…Eventually, after being cooled, the extract was filtered and held in a refrigerator (4°C) to be used as PPE solution. 12…”

“…9 Among the types of lasers, diode lasers have been widely used due to their small size and low price. 10 Diode lasers can easily penetrate into curved canals due to their flexible and small size fibers, 11,12 better distribution of laser light in the root canal system and thus better disinfection of the canal. Diode lasers interfere slightly with water and hydroxyapatite, and enhances its bactericidal effect with thermal photo disruptive activity in inaccessible areas of dentin.…”

Assessment of Commonly used Irrigants During Pulpectomy in Primary Teeth in a Hospital Based Setting - A Retrospective Study

“…It is essential to eradicate the microorganisms and their by products from the root canal and pulp chamber. Some of the more commonly used irrigants during pulpectomy procedure include sodium hypochlorite, chlorhexidine gluconate, Ethylenediamine tetraacetic acid, mixture of tetracycline, acid and detergent, hydrogen peroxide, etc… (Walia et al, 2019) This research study shows promise as newer materials are being created everyday. The reasons for loss of pulp vitality could be attributed to dental caries that invades the pulp and results in pulpal in lammation and necrosis (Packiri, 2017;Panchal et al, 2019).…”