Comparison of Antimicrobial Efficacy of Diode Laser, Ultrasonic Activated and Conventional Irrigation with 2.5% NaOCl during RCT: An Interventional Study.

AIM AND OBJECTIVE: The aim and objective of the study was to evaluate and compare the antimicrobial efficacy of a diode laser irradiation, ultrasonic activated and conventional irrigation with 2.5% NaOCl on obligatory and facultative anaerobic bacteria in single-rooted canals. MATERIALS AND METHODS: Total of 60 permanent maxillary and mandibular single-rooted (single canal) anterior teeth were selected. First microbial sample (S1) was collected after access opening and working length determination, using a sterile paper point. Cleaning and shaping were performed, with each instrument change accompanied by irrigation using 2 mL 2.5% NaOCl. After cleaning and shaping, disinfection protocol using diode laser (group1), ultrasonic activated irrigation with 2.5% NaOCl (group 2) and conventional irrigation with 2.5% NaOCl (group 3) was performed and second microbial sample (S2) was obtained. The colony characters of each type of growth on each media were noted and the organisms were identified using standard biochemical reactions. RESULT: Gram-positive and gram-negative facultative anaerobe were predominantly isolated from the culture, and the highest reduction of the microbial count was seen in diode laser group with 60.92% followed by the ultrasonic group with 47.22% reduction and least reduction was observed in conventional irrigation with the ultrasonic group with 37.97%. The results were statistically significant with p-value <0.05. CONCLUSION: Diode laser disinfection showed the highest reduction of microbial count compared to ultrasonic activated and conventional needle irrigation with 2.5% NaOCl group. CLINICAL SIGNIFICANCE: This study will help us to choose wisely between various irrigating methods and protocols. Diode laser in our study has shown superior disinfection of the root canals compared to others.

Evaluation of Push-out Bond Strength of a Resin Sealer to Dentin after a Final Flush of Three Irrigants.

AIM: To evaluate the push-out bond strength of resin-based sealer to root dentin after a final flush of three different irrigants. MATERIALS AND METHODS: Thirty extracted human mandibular premolars were sectioned 4 mm below the cement-enamel junction and 60 horizontal disks of 2 mm from middle one-third of the root were prepared. The disks were immersed in 3% sodium hypochlorite for 1 minute, and after drying the disks, they were finally flushed with the following irrigants: group I-Chitosan solution, group II-Morinda citrifolia juice (MCJ), and group III-ethylenediaminetetraacetic acid (EDTA). The disks were filled with AH Plus sealer, and after 7 days, the disks were subjected to push-out bond strength using a universal testing machine. RESULTS: EDTA had the highest push-out bond strength followed by MCJ and then chitosan. CONCLUSION: Chitosan and MCJ can be used as alternative irrigants as a final flush during the cleaning and shaping of the root canals. CLINICAL SIGNIFICANCE: EDTA, chitosan solution, and MCJ are efficient in smear layer removal which thereby increases better sealer penetration and prevents the dislocation of obturating materials.

Anesthetic efficacy of anterior middle superior alveolar injection in single-visit endodontic therapy: an in vivo study.

OBJECTIVES: To evaluate and compare the anesthetic efficacy of anterior middle superior alveolar (AMSA) injection in single-visit endodontic therapy, an in vivo study. MATERIALS AND METHODS: Teeth in the maxillary anterior segment (N = 60) requiring single-visit endodontic (SVE) therapy were selected. A conventional syringe with 26-guage needle containing 1.5 ml lignocaine with 1:80,000 epinephrine was used for the AMSA injection. The SVE therapy was performed using standard protocol. Profoundness of anesthesia during therapy was evaluated at 15-, 30-, 60-, and 90-min intervals using pain rating score and marked on visual analogue scale. In patients who reported pain/ineffectiveness of anesthesia during the course of endodontic therapy, additional supplemental anesthesia (buccal/labial infiltration) was administered. Depending on effectiveness of anesthesia with the AMSA injection alone or the need for additional supplementary injections, patients were divided as: group I-only AMSA and group II-AMSA with one or two supplemental anesthesia. RESULTS: The AMSA injection was effective in 91.67% of the patients undergoing the SVE therapy and the duration of anesthesia for the AMSA injection alone was adequate until the completion of the SVE therapy. Supplementary injections were required in 8.33% of cases at 15-min interval to achieve profound anesthesia. CONCLUSION: The AMSA injection technique could be used as an alternative to the conventional infiltration technique for anesthetizing teeth in maxillary anterior segment during the SVE therapy. CLINICAL RELEVANCE: The AMSA injection provides profound pulpal anesthesia of teeth in maxillary anterior segment during endodontic therapy.