Comparative Evaluation of Different Modes of Laser Assisted Endodontics in Primary Teeth: An In vitro Study

The Effectiveness of Aqueous Propolis Extract in Reducing the Enterococcus faecalis Count in Primary Teeth: An In Vitro Study

Objective: To evaluate the efficacy of 11% aqueous propolis extract in eliminating Enterococcus faecalis in necrotic pulp canals of primary anterior teeth compared to 2.5% sodium hypochlorite. Materials and Methods: E. faecalis were isolated from necrotic primary anterior teeth with periapical lesions, cultured, and incubated using paper points. The research sample comprised 30 extracted single-rooted necrotic primary anterior teeth, divided equally into two groups according to the irrigants used. Access cavities were prepared, and working lengths were determined. Afterward, canals were shaped using K-files, contaminated with E. faecalis, and placed in an incubator for a week. Initial microbial swabs were taken, and then each canal was irrigated with either 3 mL of a hand-made 11% aqueous propolis extract or 3 mL of 2.5% sodium hypochlorite for 5 min. Postirrigation microbial swabs were taken, cultured on blood agar plates, and incubated at 37°C for 48 h, followed by colony counts. Statistical tests included the paired sample T-test, Wilcoxon signed ranks, and Mann-Whitney U tests. The significance level was set at α = 0.05. Results: In total, 11% aqueous propolis extract contributed to a 61.8% reduction in E. faecalis (p < 0.001), while 2.5% sodium hypochlorite contributed to an 84.1% reduction (p < 0.001). The average change in logarithmic values in the sodium hypochlorite group was more significant than in the propolis group (p=0.002). Conclusion: In total, 11% aqueous propolis extract is antimicrobial against E. faecalis. However, its efficacy was less than 2.5% sodium hypochlorite.

Efficacy of antimicrobial photodynamic therapy in endodontics of primary teeth: a scoping review

The objective of this study was to identify, describe and synthesize the data published about the effectiveness of antimicrobial photodynamic therapy (aPDT) in the pulpectomy of primary teeth. A search was conducted in six electronic databases and the gray literature in June and July 2023, without restrictions on language or date of publication. The search strategy included indexed terms (MeSH terms) and your synonyms. Clinical trials, in vitro studies, case reports and retrospective studies that used photodynamic therapy in primary teeth pulpectomies were considered eligible. Among the 1,674 articles retrieved, 15 were included, published between 2014 and 2022, comprising six in vitro studies, five clinical trials, and four case reports. The sample consisted of children aged 2 to 8 years of both sexes, and included 1 to 62 teeth, mostly anterior. In two in vitro studies, the sample was taken from root canals. Most studies used a diode laser, methylene blue, and optical fiber. The pre-irradiation time ranged from 1 to 5 min. All protocols demonstrated microbial reduction before and after using aPDT, with no statistical difference among the groups. Furthermore, six studies demonstrated treatment success. Despite the divergence in methodology and protocols, aPDT is an effective method for reducing microorganisms, and is a promising adjunct treatment in primary teeth pulpectomies.

Photodynamic therapy in the root canal treatment of primary teeth: A systematic review of clinical trials

BACKGROUND

Dental caries is the most common oral disease worldwide, and it is estimated to affect 2.3 billion people, with at least 530 million of them being schoolchildren with decayed primary teeth. This condition can rapidly evolve into irreversible pulp inflammation and pulp necrosis and thus requiring endodontic intervention. Photodynamic therapy (PDT) is a supplementary method to conventional pulpectomy and is used to improve the protocol used for disinfection.

AIM

The main objective of this study was to evaluate through a systematic review the efficacy of supplementary PDT on the pulpectomy of primary teeth. This review was registered a priori on the PROSPERO database (CRD42022310581).

DESIGN

Two independent and blinded reviewers carried out a comprehensive search in five databases: PubMed, Cochrane, Scopus, Embase, and Web of Science. Eligible studies were randomized and nonrandomized clinical trials that evaluated in vivo microbiological load or clinical outcomes after using supplementary PDT in infected primary teeth.

RESULTS

After the selection process, four studies met the inclusion criteria and were included in this study. Data regarding the sample characteristics and PDT protocols were retrieved. All included trials used phenothiazinium salts as photosensitizer agents. Only one study observed a significant difference in the in vivo microbiological load reduction outcome when performing PDT on primary teeth. The remaining studies all discussed the possible benefits of this intervention; however, none observed a significant difference in this outcome.

CONCLUSION

In this systematic review, moderate-to-low certainty of the available evidence was observed, and thus, no significant conclusions can be drawn from the findings.

Evaluation of antibacterial effects of different intracanal medicaments on Enterococcus faecalis in primary teeth: An in vitro study

OBJECTIVES

Successful endodontic therapy is based on the reduction of infecting bacteria by cleaning, shaping, and disinfecting of the root canal system, thus the use of intracanal dressing is necessary for optimal success of root canal treatment. This study was designed to evaluate the effect of chitosan and propolis as intracanal medicaments against Enterococcus faecalis compared to calcium hydroxide in primary root canals.

MATERIAL AND METHODS

Ninety-six extracted primary second molars were collected. Teeth preparation was completed to size 30 K-file. They were randomly divided into four groups; (A): chitosan, (B): propolis, (C): calcium hydroxide, and (D): control group (saline). The tooth specimens were inoculated with E. faecalis. Then, tested materials were applied for all groups in accordance to the groups each tooth belonged to. Following this, the bacterial colonies were counted after 24 h, 72 h, and 1 week of applying dressing materials and incubation. Finally, one-way analysis of variance and Fisher's least significant difference tests were used for statistical comparisons between the groups at a significance level of .05.

RESULTS

No statistically significant difference was found between groups A, B, and C for both 24 h and a week (p ≥ .05). Yet, a statistical difference between groups A, B, C, and D after 72 h and 1 week were seen (p ≤ .05).

CONCLUSIONS

Chitosan and propolis medicaments were as effective as calcium hydroxide against E. faecalis in primary root canal treatment and might be considered as an alternative dressing material between treatment sessions.

Antibacterial Efficacy of Cold Atmospheric Plasma, Photodynamic Therapy with Two Photosensitizers, and Diode Laser on Primary Mandibular Second Molar Root Canals Infected with Enterococcus faecalis: An In Vitro Study

Objectives

This study aimed to compare the antibacterial efficacy of cold atmospheric plasma (CAP), photodynamic therapy (PDT) with two photosensitizers (PSs), and diode laser for disinfection of primary mandibular second molar root canals infected with Enterococcus faecalis (E. faecalis).

Materials and Methods

In this in vitro experimental study, 50 primary second primary molars underwent chemomechanical preparation of root canals. The root canals were then inoculated with E. faecalis. After 3 weeks of incubation, the teeth were randomly assigned to five groups of CAP, 940 nm diode laser, PDT with 445 nm laser and curcumin PS, PDT with 660 nm laser and methylene blue (MB) PS, and 2.5% sodium hypochlorite (NaOCl). Samples were collected from the vortexed root canals and cultured on agar, and the number of colonies was counted. Data were analyzed by one-way analysis of variance.

Results

The percentage of reduction in bacterial count was significantly different among the study groups (P < 0.001). The highest reduction in bacterial count was noted in 2.5% NaOCl and the lowest in 940 nm diode laser group. The difference in bacterial count reduction between 445 nm laser + curcumin and 660 nm laser + MB (P = 0.989), and CAP and NaOCl (P = 1.000) groups was not significant.

Conclusion

CAP was found to be more effective than PDT and diode laser as an adjunct to mechanical root canal disinfection of primary molars for elimination of E. faecalis and can serve as an alternative to 2.5% NaOCl irrigation.

Laser Activation of Aquatine Endodontic Cleanser: A Novel Approach to Root Canal Disinfection

Aim

To evaluate and compare the antimicrobial efficacy of 2.5% sodium hypochlorite (NaOCl) and Aquatine Endodontic Cleanser (EC) with and without laser-activated disinfection against Enterococcus faecalis in the root canals of primary teeth.

Materials and methods

A total of 45 human primary teeth were selected and inoculated with E. faecalis and divided into three groups as per intervention. In group I, irrigation was done using 2.5% NaOCl, in group II using Aquatine EC solution, and in group III with Aquatine EC activated by 810 nm diode laser.

Results

Intragroup comparisons showed a decrease in colony-forming units in all three groups. Intergroup comparisons showed a statistically significant difference between group I and group II (p = 0.024) and between group I and group III (p = 0.03).

Conclusion

Aquatine EC showed maximum antimicrobial efficacy under laser activation.

Clinical significance

Aquatine EC can be considered a suitable alternative to NaOCl in light of its known toxic effects.

How to cite this article

Kodical S, Attiguppe P, Siddalingappa RO, et al. Laser Activation of Aquatine Endodontic Cleanser: A Novel Approach to Root Canal Disinfection. Int J Clin Pediatr Dent 2022;15(6):761-763.