Abstract
BackgroundWe established an in vivo intraradicular biofilm model of apical periodontitis in pigs in which we compared the efficacy of different irrigant activation techniques for biofilm removal.MethodsTwenty roots from the deciduous mandibular second premolar of 5 male pigs were used. After pulpectomy, canals were left open for 2 weeks and then sealed for 4 weeks to enable the development of an intracanal biofilm. The intraradicular biofilms was evaluated using SEM and bacterial 16S rRNA gene-sequencing. To investigate the efficacy of biofilm removal, root canal irrigations were performed using conventional needle, passive ultrasonic, subsonic, or laser-activated irrigation. Real-time PCR was conducted to quantitate the remaining biofilm components. Statistical analysis was performed using ANOVA followed by a Tukey kramer post-hoc test with α = 0.05.ResultsThe pulp exposure model was effective in inducing apical periodontitis and SEM analysis revealed a multi-layer biofilm formation inside the root canal. 16S rRNA sequence analysis identified Firmicutes, Bacteroidetes, and Fusobacteria as the predominant bacterial phyla components, which is similar to the microbiome profile seen in humans. None of the tested irrigation techniques completely eradicated the biofilm components from the root canal, but the subsonic and laser-activated irrigation methods produced the lowest bacterial counts (p < 0.05).ConclusionsAn experimental intraradicular biofilm model has been successfully established in pigs. Within the limitations of the study, subsonic or laser-activated irrigation demonstrated the best biofilm removal results in the pig system.
Highlights
We established an in vivo intraradicular biofilm model of apical periodontitis in pigs in which we compared the efficacy of different irrigant activation techniques for biofilm removal
Effects of root canal irrigation techniques in the pig model We investigated the biofilm-cleaning ability of Conventional needle irrigation (CNI), Ultrasonically activated irrigation (UAI), EA and Laser-activated irrigation (LAI) in the infected root canals in the pig model
We focused in our present study on the chemical reduction of biofilm using Sodium hypochlorite (NaOCl) [61, 62] and agitating irrigation techniques
Summary
We established an in vivo intraradicular biofilm model of apical periodontitis in pigs in which we compared the efficacy of different irrigant activation techniques for biofilm removal. Infection and biofilm formation in the root canal system are important causative factors for apical periodontitis. Sodium hypochlorite (NaOCl) is the most commonly used root canal irrigant that has disinfecting capacity and the ability to disrupt biofilms and dissolve organic. Delivering irrigants close to the root canal apex can cause severe pain and acute inflammation. Extruding irrigants such as NaOCl through the extraradicular area can sometimes lead to hospitalization due to the high toxicity of this compound towards vital tissues [11]. The establishment of an alternative irrigation technique that can efficiently remove the infection source in the root canal system is essential for improving the efficacy and outcomes of endodontic treatments
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