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 Table of Contents  
ORIGINAL ARTICLE
Year : 2022  |  Volume : 7  |  Issue : 1  |  Page : 1-3

Comparative efficacy of laser disinfection versus chemical disinfection in primary root canal – An In vitro antimicrobial study


1 PG Student, Department of Pedodontics and Preventive Dentistry, A.C.P.M Dental College and Hospital, Dhule, Maharashtra, India
2 Professor and Head, Department of Pedodontics and Preventive Dentistry, A.C.P.M Dental College and Hospital, Dhule, Maharashtra, India
3 Professor, Department of Pedodontics and Preventive Dentistry, A.C.P.M Dental College and Hospital, Dhule, Maharashtra, India
4 Reader, Department of Pedodontics and Preventive Dentistry, A.C.P.M Dental College and Hospital, Dhule, Maharashtra, India
5 Senior Lecturer, Department of Pedodontics and Preventive Dentistry, A.C.P.M Dental College and Hospital, Dhule, Maharashtra, India

Date of Submission23-May-2022
Date of Acceptance03-Jun-2022
Date of Web Publication30-Jun-2022

Correspondence Address:
Dr. Nikhil Khandare
Department of Pedodontics and Preventive Dentistry, A.C.P.M Dental College and Hospital, Dhule, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijmo.ijmo_11_22

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  Abstract 


Background: Conventional chemical root canal disinfection has been around for generations but it has its own drawbacks. Because of this there is a need for a better alternative for intracanal disinfection method. This alternative can be in the form of lasers, especially due to recent advances in laser technology. Methodology: The aim of the study is to compare chemical vs laser disinfection in primary root canal. This method has been tested in permanent teeth but not in primary teeth, this study was performed to evaluate the efficacy of laser disinfection compared to chemical disinfection. Results: The use of chemical disinfection by 5 ml of 5.25% NaOCl led to 96.7% microbial reduction against diode laser which achieved 97.7% reduction as compared to baseline microbial count and 34.4% reduction after irrigation using normal saline solution. Conclusion: Diode laser has similar root canal disinfection efficacy as compared to 5.25% NaOCl in primary canals. Diode lasers can be used as an alternative to chemical disinfection.

Keywords: Chemical disinfection, dentistry, in vitro antimicrobial study, laser disinfection, primary root canal


How to cite this article:
Khandare N, Bondarde P, Patil S, Mujawar S, Vishwakarma A. Comparative efficacy of laser disinfection versus chemical disinfection in primary root canal – An In vitro antimicrobial study. Int J Med Oral Res 2022;7:1-3

How to cite this URL:
Khandare N, Bondarde P, Patil S, Mujawar S, Vishwakarma A. Comparative efficacy of laser disinfection versus chemical disinfection in primary root canal – An In vitro antimicrobial study. Int J Med Oral Res [serial online] 2022 [cited 2022 Aug 20];7:1-3. Available from: http://www.ijmorweb.com/text.asp?2022/7/1/1/349240




  Introduction Top


The major cause of endodontic failure is the survival of microorganisms in the apical portion of root filled teeth. Enterococcus faecalis is considered one of the primary organisms in patients with posttreatment endodontic infection. E. faecalis is also known to resist intra canal medicaments like calcium hydroxide by maintaining pH homeostasis. Various in vitro studies conducted by different authors using NaOCl and other disinfecting solutions concluded that none of the tested substances could completely eliminate the E. fecalis from the root canal space.[1],[2],[3],[4],[5] In addition, few in vitro studies have evaluated the disinfection potential of diode laser following chemo-mechanical procedures against E. fecalis, and concluded that 980 nm diode laser can even eliminate bacteria that has immigrated into dentin, thus being able to increase the success rate in endodontic therapy.[6],[7],[8] The aim of the study is to compare efficacy of laser disinfection vs chemical disinfection in primary root canal. The objectives were to compare disinfection potential of NaOCl and 980 nm diode laser and to compare the percentage reduction in E. faecalis colony count by disinfecting the primary root canal with NaOCl and 980 nm diode laser.


  Methodology Top


Thirty-six primary root canals were selected for the study purpose. Access opening of all the 12 primary teeth were done using airotor and round bur. This was followed by biomechanical preparation of all the 12 primary teeth using k files up to the size 30. After the root canal preparation, the teeth were sterilized using autoclave. After sterilization of all the sample teeth, all the 36 canals were inoculated with E. faecalis broth culture. The teeth were then kept for incubation for the growth of E. faecalis. A swab was collected from the incubated teeth and was cultured on nutrient agar media

GROUP 1 (Preoperative group)

  • 12 canals with four root canals form each test groups are randomly selected
  • Preoperative culture is obtained without any disinfection procedure
  • The image indicates successful growth of E. fecalis from the incubated teeth.


GROUP 2 (normal saline group):

  • 12 canals were irrigated using 5 ml normal saline for 15 s for each canal GROUP 3 (NaOCl group)
  • 12 canals were disinfected using 5 ml of 5.25% NaOCl for 15 s for each canal GROUP 4 (diode laser group)
  • 12 canals were disinfected using 980 nm diode laser at 3 w power for 5 s with 15 s of cooling time
  • After following the disinfection protocol swabs were collected with paper points and sent for culture of remaining viable count of E. faecalis
  • The paper points were inoculated into the glucose broth and incubated for 24 h
  • Thus the growth on the broth was inoculated on nutrient agar plate and was incubated for 48 h.



  Results Top


Our study showed the below results GROUP 1– Group without any disinfection protocol showed normal growth of E. fecalis. GROUP 2-Normal saline group showed minimum reduction in the E. faecalis count as large number of colonies were seen on the inoculated agar plate. GROUP 3-5.25% NaOCl group showed reduction in the E. faecalis count and few colonies were seen on the inoculated agar plate. GROUP 4–980 nm diode laser group showed significant reduction in the E. faecalis count as compared to the other disinfection protocols with very few colonies visible on the agar plate as shown in [Figure 1].
Figure 1: Reduction in the E. faecalis

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  Discussion Top


The primary aim of disinfection of the root canals intentionally inoculated with E. faecalis bacteria was successfully achieved in the present study. BMP was performed in all samples before evaluating the effect of adjunctive disinfection agent. Following this disinfection protocols were performed.[9],[10],[11],[12],[13],[14],[15] The results of the study showed that though sodium hypochlorite is a routinely used disinfecting solution in the clinical practice it could not completely disinfect the root canals. Furthermore, the study suggest that 980 nm diode laser has greater efficacy in disinfecting the root canals. This is in accordance with the study by Gunwal et al. which showed that 810 nm diode laser reduces microbial count more significantly as compared to 5.25% NaOCl.[10],[11],[12],[13],[14],[15]


  Conclusion Top


To conclude, BMP is the basic and most important step in our progress toward achieving 100% disinfection of root canals, in terms of mechanically removing the micro-organisms and allowing effective use of adjunctive disinfection mediums. Within the scope of this research we found that chemical disinfection with 5.25%NaOCl or 980 nm diode laser is helpful in achieving significant eradication of E. faecalis from the root canals. The diode laser induces adverse thermal changes in radicular dentin, resulting in slight charring spots in the canals. The amount of heat generated in the tooth or surrounding tissues was not evaluated in the present study. Further studies are needed to evaluate in vivo application of lasers for disinfection of root canals.

Acknowledgment

All equipments, culture media and other laboratory instruments for microbial analysis were provided by Dept of Microbiology at JMF's ACPM Medical College, Dhule.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Agrawal AA, Kolhe S, Sope A, Erlewad D. Root canal disinfection potential of 5.25% sodium hypochlorite, 2% chlorhexidine and 810nm diode laser – A comparative in vitro antimicrobial study. Int J Oral Craniofac Sci 2016;2:35-8.  Back to cited text no. 1
    
2.
Stuart CH, Schwartz SA, Beeson TJ, Owatz CB. Enterococcus faecalis: Its role in root canal treatment failure and current concepts in retreatment. J Endod 2006;32:93-8.  Back to cited text no. 2
    
3.
Kaiwar A, Usha HL, Meena N, Ashwini P, Murthy CS. The efficiency of root canal disinfection using a diode laser: In vitro study. Indian J Dent Res 2013;24:14-8.  Back to cited text no. 3
[PUBMED]  [Full text]  
4.
Shrestha A, Shi Z, Neoh KG, Kishen A. Nanoparticulates for antibiofilm treatment and effect of aging on its antibacterial activity. J Endod 2010;36:1030-5.  Back to cited text no. 4
    
5.
Portenier I, Waltimo TM, Haapasalo M. Enterococcus faecalis-the root canal survivor and 'star' in post treatment disease. Endod Top 2003;6:135-59.  Back to cited text no. 5
    
6.
Evans M, Davies JK, Sundqvist G, Figdor D. Mechanisms involved in the resistance of Enterococcus faecalis to calcium hydroxide. Int Endod J 2002;35:221-8.  Back to cited text no. 6
    
7.
Hohscheidt GL, Böttcher DE, Fatturi Parolo CC, Montagner F, Grecca FS. Response of E. faecalis biofilms to different associations of auxiliary substances during root canal preparation: A confocal laser microscopy analysis. Microsc Res Tech 2013;76:658-62.  Back to cited text no. 7
    
8.
Hmud R, Kahler WA, Walsh LJ. Temperature changes accompanying near infrared diode laser endodontic treatment of wet canals. J Endod 2010;36:908-11.  Back to cited text no. 8
    
9.
Machado ME, Sapia LA, Cai S, Martins GH, Nabeshima CK. Comparison of two rotary systems in root canal preparation regarding disinfection. J Endod 2010;36:1238-40.  Back to cited text no. 9
    
10.
Arias-Moliz MT, Ferrer-Luque CM, González-Rodríguez MP, Valderrama MJ, Baca P. Eradication of Enterococcus faecalis biofilms by cetrimide and chlorhexidine. J Endod 2010;36:87-90.  Back to cited text no. 10
    
11.
Gunwal M, Shenoi P. Evaluation of the efficacy of 5.25% of sodium hypochlorite, 2% of chlorhexidine, mtad and 810 diode laser in reduction of microbial count in root canal – An in vivo study. J Endodontol 2013;25:56-62.  Back to cited text no. 11
    
12.
Mashalkar S, Pawar MG, Kolhe S, Jain DT. Comparative evaluation of root canal disinfection by conventional method and laser: An in vivo study. Niger J Clin Pract 2014;17:67-74.  Back to cited text no. 12
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13.
Luddin N, Ahmed HM. The antibacterial activity of sodium hypochlorite and chlorhexidine against Enterococcus faecalis: A review on agar diffusion and direct contact methods. J Conserv Dent 2013;16:9-16.  Back to cited text no. 13
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14.
Gerek M, Asci S, Yaylali DI. Ex-vivo evaluation of antibacterial effects of Nd:YAG and diode lasers in root canals. Biotechnol Biotechnol Equip 2010;24:2031-4.  Back to cited text no. 14
    
15.
Ashofteh K, Sohrabi K, Iranparvar K, Chiniforush N. In vitro comparison of the antibacterial effect of three intracanal irrigants and diode laser on root canals infected with Enterococcus faecalis. Iran J Microbiol 2014;6:26-30.  Back to cited text no. 15
    


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