The Use of Different Irrigation Techniques to Decrease Bacterial Loads in Healthy and Diabetic Patients with Asymptomatic Apical Periodontitis

Abstract

BACKGROUND:Diabetes mellitus is a multisystem disease which weakens the human’s immunity. Subsequently, it worsens the sequelae of apical periodontitis by raising a fierce bacterial trait due to the impaired host response.AIM:This study aimed to estimate bacterial reduction after using different irrigation techniques in systemically healthy and diabetic patients with asymptomatic apical periodontitis.MATERIAL AND METHODS:Enterococcus faecalis, Peptostreptococcus micros, and Fusobacterium necleatum bacteria were chosen, as they are the most common and prevailing strains found in periodontitis. Bacterial samples were retrieved from necrotic root canals of systemically healthy and diabetic patients, before and after endodontic cleaning and shaping by using two different irrigation techniques; the conventional one and the EndoVac system. Quantitive polymerase chain reaction (qPCR) was utilised to detect the reduction in the bacterial count.RESULTS:The EndoVac irrigation system was effective in reducing bacteria, especially Peptostreptococcus micros in the diabetic group when compared to conventional irrigation technique with a statistically significant difference.CONCLUSION:The EndoVac can be considered as a promising tool in combination with irrigant solution to defeat the bacterial colonies living in the root canal system. Additional studies ought to be done to improve the means of bacterial clearance mainly in immune-compromised individuals.

Antibacterial Effect of Longan Extract and Diode Laser Combination on Peptostreptococcus Species in Type 2 Diabetic Patients with Apical Periodontitis - A Pilot Study

“…6 Various irrigants like MTAD, chlorhexidine, doxycycline, NaOCl and irrigation techniques have been evaluated against Peptostreptococcus spp. 16,17 Study conducted by Ghoneim et al obtained 82% reduction of Peptostreptococcus spp following disinfection using Endovac system in diabetic patients. 17 This is a preliminary study evaluating longan extract as a root canal irrigant against peptostreptococcus.…”

“…16,17 Study conducted by Ghoneim et al obtained 82% reduction of Peptostreptococcus spp following disinfection using Endovac system in diabetic patients. 17 This is a preliminary study evaluating longan extract as a root canal irrigant against peptostreptococcus. Results of the ijlpr 2020; doi 10.22376/ijpbs/lpr.2021.11.1.L49-53…”

Impairment of the angiogenic process may contribute to lower success rate of root canal treatments in diabetes mellitus

“…T2DM has a direct influence on immune system function, which leads to a decreased healing rate and a delay in the function of immune cells (Arya et al, 2017; Ghoneim et al, 2016). There is a positive regulation of pro‐inflammatory cytokines produced by monocytes or leukocytes and a reduction of several growth factors that predispose to chronic inflammation, leading to reduced capacity of tissue repair and angiogenesis (Arya et al, 2017; Segura‐Egea et al, 2016).…”

“…Apical periodontitis, namely an acute or chronic inflammatory disease in the bone around the apex of a tooth, is one of the world's most prevalent diseases, affecting 27 and 70% in European populations (Georgopoulou et al, 2005; Kirkevang et al, 2001; Marques et al, 1998). AP appears following bacterial infection of the root canal system, can increase with age, and the presence of T2DM (Arya et al, 2017; Cabanillas‐Balsera et al, 2019; Farcas‐Berechet et al, 2019; Ghoneim et al, 2016; Marotta et al, 2012; Segura‐Egea et al, 2012; Smadi, 2017). The periapical inflammation responsible for the development of periradicular lesions results from the presence of polymicrobial factors, immunological agents, products of pulp degeneration and products from necrotic pulp tissue (Lopez‐Lopez et al, 2011; Segura‐Egea et al, 2019).…”

“…angiogenesis, apical periodontitis, diabetes mellitus, endodontic success, endodontic treatment Farcas-Berechet et al, 2019;Ghoneim et al, 2016;Marotta et al, 2012;Segura-Egea et al, 2012;Smadi, 2017). The periapical inflammation responsible for the development of periradicular lesions results from the presence of polymicrobial factors, immunological agents, products of pulp degeneration and products from necrotic pulp tissue (Lopez-Lopez et al, 2011;Segura-Egea et al, 2019).…”