Abstract
Background and Objectives: The purpose of the present study was to investigate the anti-bacterial efficacy of passive ultrasonic irrigation (PUI) and a 980-nm-gallium-aluminum-arsenide (GaAlAs) laser using a real-time DNA-based quantitative polymerase chain reaction (qPCR) assay and scanning electron microscopy (SEM). Materials and Methods: Eighty-six extracted single- and double-rooted human teeth were used in the experiment. The following four experimental groups were evaluated, as well as a control group: group 1: single root + PUI (n = 20); group 2: single root + laser application (n = 20); group 3: double roots + PUI (n = 20); group 4: double roots + laser application (n =20); control group (n = 6): 3 single roots, 3 double roots. The qPCR assay was performed in three stages to evaluate the efficacy of the adjunctive method against Enterococcus faecalis. SEM analysis was also used to examine the microstructure of root canal surfaces. The data were statistically analyzed using the Friedman test and the Kruskal–Wallis test with Bonferroni adjustment. Results: The decrease in the DNA levels from S1 (before preparation) to S2 (just after preparation) was highly significant in all groups, and decreases in DNA levels from S2 to S3 (after incubation for 1 week) were found in all experimental groups except group 1. An inter-group analysis showed that PUI was significantly more effective in terms of antibacterial efficacy than GaAlAs laser irradiation in single root (p < 0.05). However, in double roots, experimental groups did not show significantly lower DNA levels than the control group (p > 0.05). SEM images showed that cleaning of the root canal surface and reduction of dentin debris were achieved only in single-rooted teeth when using PUI application. Conclusions: Two adjunctive methods were effective in reducing E. faecalis in single rooted tooth.
Highlights
The root canal system has various complex structures, such as isthmuses, ramifications, deltas, and accessory canals, which can result in incomplete debridement of bacteria and their by-products when infected root canals are cleaned using traditional irrigation delivery systems [1]
The present study conducted a comparative evaluation of the antibacterial efficacy of two adjunctive methods (PUI vs. GaAlAs laser) on single- and double-rooted teeth using a quantitative polymerase chain reaction (qPCR) assay and scanning electron microscopy (SEM) analysis, whereas the majority of previous studies analyzed only in single-rooted teeth [16]
The current study used qPCR assay with the C(t) value parameter, which refers to the cycle at which fluorescence achieves a defined threshold; this is a sensitive parameter for E. faecalis detection and quantitation of bacterial levels
Summary
The root canal system has various complex structures, such as isthmuses, ramifications, deltas, and accessory canals, which can result in incomplete debridement of bacteria and their by-products when infected root canals are cleaned using traditional irrigation delivery systems [1]. A number of irrigation methods and protocols have been introduced to accomplish the major goal of root canal therapy, which is the complete elimination of the irritant and debris generated during biomechanical instrumentation. Passive ultrasonic irrigation (PUI) has been widely used since its introduction by Weller as a way to remove irritants more effectively [6]. The purpose of the present study was to investigate the antibacterial efficacy of passive ultrasonic irrigation (PUI) and a 980-nm-gallium-aluminum-arsenide (GaAlAs) laser using a real-time DNA-based quantitative polymerase chain reaction (qPCR) assay and scanning electron microscopy (SEM). An inter-group analysis showed that PUI was significantly more effective in terms of antibacterial efficacy than GaAlAs laser irradiation in single root (p < 0.05)
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