Assessment of the Survival and Sensibility of Mature Anterior Teeth with Periapical Lesion after One Step Regenerative Approach Using Different Disinfection Maneuvers : A Randomized Clinical Trial

Abstract

Aim: evaluate outcomes of single visit regenerative endodontic procedures using conventional irrigation protocol in comparison to LASER disinfection in comparison to 0.2% Nano Chitosan irrigating solution for treatment of necrotic mature anterior teeth with periapical lesions. Methodology: 45 patients were recruited in this trial. Preoperative standardized cone beam computed tomography (CBCT) was performed for the patients after fulfillment of inclusion criteria. After complete diagnostic steps and signing of consent forms and performance of access cavity preparation,patients were randomly distributed into three groups with three disinfection maneuvers:1. Group A (Intervention 1)final disinfection using Low Power Diode LASER disinfection.2. Group B (Intervention 2 ) final rinseusing 0.2% Nano Chitosan irrigation disinfection in a side perforated needle.3. Group C (Control) conventional irrigation protocol using 1.25% sodium hypochlorite irrigating solution and 17% EDTA only.Platelet rich fibrin was packed inside the root canals followed by collagen plug and Biodentin. Teeth were restored using resin modified glass ionomer. Patients were recalled for regular follow ups at 6 and 12 months. Patients were examined for survival of treated teeth and any inflammatory signs or symptoms. All samples were tested for sensibility. All data were statistically analyzed. Results: Single visit regenerative endodontics possessed an overall percentage of success 95.5% in all groups in terms of survival of treated teeth. Regarding sensibility nano chitosan also possessed the highest percentage of cases regaining sensitivity by 73.3% followed by laser group 67.7% followed by the control group with 46.7% also with no statistical significant difference between all groups. Conclusion: Within limitations of this study single visit regenerative endodontics can be applied to cases with necrotic pulps and periapical lesions where thorough disinfection is recommended in cases of single visit approach to ensure maximum elimination of bacterial cells from root canal hindering successful regenerative process