Abstract
Background: Endodontic infection may persist despite root canal instrumentation. Thus, the use of intracanal medicaments plays an essential role in eliminating resistant bacteria like Enterococcus faecalis, known to be associated with persistent infections in endodontically treated teeth. Although calcium hydroxide is the gold standard intracanal medicament, it has been reported that Enterococcus faecalis is immune to its effects. Therefore, several studies assessed the efficacy of other intracanal medicaments, but none to date evaluated Casein Phosphopeptide-Amorphous Calcium Phosphate. Objectives: This in-vitro randomized controlled study aimed to assess the antibacterial efficacy of Casein phosphopeptide-amorphous calcium phosphate as an intracanal medicament against Enterococcus faecalis and compared it to calcium hydroxide. Methods: 60 extracted single root canal permanent teeth were prepared and later divided into three equal groups according to the intracanal medicament used. Group 1: No intracanal medicament (negative control), Group 2: Calcium hydroxide paste, and Group 3: Casein phosphopeptide-amorphous calcium phosphate paste. The intracanal medicaments were placed on the canals for 7 days. The outcome of this procedure was measured by counting colony-forming units. Statistical analysis was carried out using One-Way ANOVA and Tukey’s Post Hoc Test to determine significant differences between the groups. Results: The mean bacterial count for Group 2 was significantly lower than Group 1 and Group 3. Calcium hydroxide showed significantly more antibacterial efficacy against Enterococcus faecalis than Casein phosphopeptide-amorphous calcium phosphate and the negative control groups. Conclusion: Casein Phosphopeptide-amorphous calcium phosphate is ineffective in inhibiting Enterococcus faecalis growth compared to Calcium hydroxide.
Highlights
Pulpal and periapical diseases develop from bacterial colonization of the root canal system [1, 2]
Casein Phosphopeptide-amorphous calcium phosphate is ineffective in inhibiting Enterococcus faecalis growth compared to Calcium hydroxide
Intracanal medicament using Calcium Hydroxide (CH) was associated with significantly fewer colony-forming units of E. faecalis when compared to Casein Phosphopeptide (CPP)- Amorphous Calcium Phosphate (ACP) and negative control groups
Summary
Pulpal and periapical diseases develop from bacterial colonization of the root canal system [1, 2]. 258 The Open Dentistry Journal, 2021, Volume 15 This highlights the essential role of intracanal medicaments in eliminating the remaining bacteria and providing a favorable environment for periapical tissue repair [6]. In spite of CH's success, some studies found E. faecalis resistant to its effects [8] and its long-term use associated with root fracture [9]. This has prompted studies to examine other alternatives that can overcome the disadvantages of CH. The use of intracanal medicaments plays an essential role in eliminating resistant bacteria like Enterococcus faecalis, known to be associated with persistent infections in endodontically treated teeth. Several studies assessed the efficacy of other intracanal medicaments, but none to date evaluated Casein Phosphopeptide-Amorphous Calcium Phosphate
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