Abstract

Root canal disinfection is one of the most important factors governing success of root canal treatment, especially when regenerative strategies are used. This study evaluated the efficacy of 5 intracanal medicaments against mature biofilms of Enterococcus fecalis in vitro: Light activated curcumin, triple antibiotic paste (TAP), double antibiotic paste (DAP), chlorhexidine, calcium hydroxide. Untreated teeth with biofilms served as controls. Confocal microscopy was used to analyse the biofilm mass and percentage of live/dead bacteria within the root canal as well as dentinal tubules. Dentinal shavings obtained from the root canal walls (at 200 and 400 microns depth) were used to quantify the colony forming units/mL. The results showed that light activated curcumin and triple antibiotic paste brought about complete disruption of the biofilm structure (P < 0.05) while chlorhexidine and calcium hydroxide were not significantly different from the control (P > 0.05). Light activated curcumin brought about the highest percentage of dead cells at both depths, but this was not significantly different from triple antibiotic paste (P > 0.05). Curcumin, TAP and DAP brought about a significant reduction of CFU/mL at both depths compared to the control and other groups (P < 0.05). Light activated curcumin brought about a 7 log reduction of bacteria at both depths.

Highlights

  • Bacteria within root canal systems form highly organized communities called biofilms, which are highly resistant to chemomechanical debridement procedures[1]

  • A recent report showed that light activated curcumin showed superior antibacterial activity than sodium hypochlorite, when used against Enterococcus fecalis biofilms, when used as a root canal irrigant[11]

  • This study was undertaken to compare the antibiofilm activity of photoactivated curcumin with triple antibiotic paste, double antibiotic paste, chlorhexidine and calcium hydroxide when used as an intracanal medicament

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Summary

Introduction

Bacteria within root canal systems form highly organized communities called biofilms, which are highly resistant to chemomechanical debridement procedures[1]. Recent reports suggest that these intracanal medicaments, including calcium hydroxide, triple antibiotic paste (TAP) and double antibiotic paste (DAP) could be potentially toxic to the cells of the apical papilla[8] in addition to having deleterious effects on root dentin[9]. A recent report showed that light activated curcumin showed superior antibacterial activity than sodium hypochlorite, when used against Enterococcus fecalis biofilms, when used as a root canal irrigant[11]. It is not known if the antibacterial activity of photo activated curcumin is superior to that of other medicaments used in pulp revascularisation. This study was undertaken to compare the antibiofilm activity of photoactivated curcumin with triple antibiotic paste, double antibiotic paste, chlorhexidine and calcium hydroxide when used as an intracanal medicament

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