Abstract
Final root canal irrigation stands as an effective strategy for eliminating the dentin infection. This study aimed to investigate and compare the antibacterial efficacy of QMix and other four final irrigation regimens in reducing Enterococcus faecalis within human root canals. Single-canal human teeth contaminated with E. faecalis for 4 weeks were prepared chemomechanically with sodium hypochlorite (NaOCl). Then, the teeth were randomly assigned into six groups according to the final irrigation protocols: (1) EDTA/NaOCl, 17% EDTA followed by 5.25% NaOCl; (2) EDTA/chlorhexidine (CHX), 17% EDTA followed by 2% CHX; (3) EDTA/cetrimide (CTR), 17% EDTA followed by 2% CTR; (4) MTAD; (5) QMix; and (6) control, 0.9% saline. Bacterial samples collected before instrumentation and after final irrigation were cultured and the colony-forming units (CFUs) were counted. The CFUs in the QMix, EDTA/CHX, and EDTA/CTR groups were significantly lower than those in the EDTA/NaOCl group. No significant differences were observed between the QMix, EDTA/CHX, and EDTA/CTR groups. MTAD showed weaker ability than QMix and EDTA/CHX to eliminate E. faecalis, but it caused a greater reduction in CFU than EDTA/NaOCl. Hence, the antimicrobial activity of QMix was comparable to that of EDTA/CHX and EDTA/CTR and more effective than that of EDTA/NaOCl against intracanal E. faecalis.
Highlights
QMix is a novel one–step irrigating solution that contains a mixture of bisbiguanide antimicrobial agent, calcium–chelating agent, saline, and surfactant
Ferrer–Luque et al.[22] reported the antimicrobial activity of EDTA combined with CTR as a final irrigating solution for root canals infected with E. faecalis; the results were restricted to residual antimicrobial activity
We evaluated the antimicrobial activity of QMix, MTAD, 17% EDTA/5.25% NaOCl, 17% EDTA/2% CHX, and 17% EDTA/0.2% CTR as the final irrigation regimens against E. faecalis biofilms within human root canals
Summary
QMix is a novel one–step irrigating solution that contains a mixture of bisbiguanide antimicrobial agent, calcium–chelating agent, saline, and surfactant. Sequential use of EDTA with CHX in the final irrigation of human teeth infected with E. faecalis has not been previously investigated. Ferrer–Luque et al.[22] reported the antimicrobial activity of EDTA combined with CTR as a final irrigating solution for root canals infected with E. faecalis; the results were restricted to residual antimicrobial activity. The most commonly used final irrigation regimens include the use of EDTA, followed by sodium hypochlorite (NaOCl), which exhibits the capacity to remove the smear layer and eliminate the biofilm[23,24]. MTAD is known to remove the smear layer, disinfect contaminated root canals, and eliminate E. faecalis[25,26,27]. We hypothesized that the novel final irrigation regimens, QMix, 17% EDTA/2% CHX and 17% EDTA/0.2% CTR, would have effective antimicrobial activity in human teeth infected with E. faecalis
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