Comparison of antibacterial effectiveness of three rotary file system with different geometry in infected root canals before and after instrumentation\u2013a double-blinded randomized controlled clinical trial

Riluwan Siddique,Pradeep Solete,Benoy Jacob,Manish Ranjan,Malli Sureshbabu Nivedhitha

doi:10.1038/s41405-020-0035-7

Abstract

IntroductionTo compare the antibacterial effectiveness of three rotary file systems i.e., ProTaper Next, ProTaper Gold and XP-endo Shaper in root canals of teeth with asymptomatic apical periodontitis by using the real-time polymerase chain reaction.Materials and methodsRoot canals from single or multi-rooted teeth (straight canals) with necrotic pulps and asymptomatic apical periodontitis were instrumented using either ProTaper Next (n = 20), ProTaper Gold (n = 20) and XP-endo Shaper (n = 20) under irrigation with 3% sodium hypochlorite. Samples obtained before and after instrumentation were subjected to DNA extraction, amplification and quantitation of total amount of bacteria by using the real-time polymerase chain reaction.ResultsSamples were taken before preparation (S1) were positive for presence of bacteria, with mean numbers of 9.94 × 107, 20.4 × 107 and 9.20 × 107 bacterial cells for the ProTaper Next, ProTaper Gold and XP-endo Shaper groups, respectively. After preparation (S2) with ProTaper Next, ProTaper Gold, and XP-endo Shaper, root canals still had bacteria with mean counts of 11.8 × 105, 87.2 × 105 and 4.52 × 105 bacterial cells, respectively. Both XP-endo Shaper (99.50%) and ProTaper Next (98.81%) were effective in reducing total bacterial count, and there was no statistically significant difference between them (P > 0.05). XP-endo Shaper succeeded in reducing total bacterial count than ProTaper Gold (95.72%) and there exists statistically significant difference between them (P < 0.05).ConclusionsXP-endo Shaper was highly effective in reducing total bacterial count from root canals of teeth with asymptomatic apical periodontitis than ProTaper Gold. ProTaper Next also showed improved microbial reduction percentage as compared with ProTaper Gold.

Highlights

To compare the antibacterial effectiveness of three rotary file systems i.e., ProTaper ProTaper Gold and XPendo Shaper in root canals of teeth with asymptomatic apical periodontitis by using the real-time polymerase chain reaction
XP-endo Shaper was highly effective in reducing total bacterial count from root canals of teeth with asymptomatic apical periodontitis than ProTaper Gold
The main goal of endodontic treatment is to reduce the number of bacteria and their byproducts which perpetuates apical periodontitis.1Effective chemo-mechanical debridement techniques on par with stringent disinfection protocols aid in possibly diminishing the bacterial load residing in the complexities of the root canal systems.[2]

Summary

Introduction

To compare the antibacterial effectiveness of three rotary file systems i.e., ProTaper ProTaper Gold and XPendo Shaper in root canals of teeth with asymptomatic apical periodontitis by using the real-time polymerase chain reaction. An off-centred rectangular cross-section design imparts improved file strength with unique asymmetric rotary motion that further enhances ProTaper canal shaping efficiency and cyclic fatigue resistance.[7,8,9] This property allows the file to maintain a two-point contact with each canal at a time. In accordance with a study by Tewari et al, ProTaper was found to be most effective in microbial reduction than K3XF, Hyflex CM and hand instruments.[10] ProTaper showed maximal microbial load reduction than self-adjusting files and manual instrumentation.[11] To sum it up, the PTN system reinforces file strength, capable of reducing lateral and apical compaction of debris with more efficient cleansing of the root canal system

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Results

Conclusion