Polymicrobial biofilm disinfection in maxillary and mandibular molars with varying access designs: A microbiological study

Abstract

ABSTRACT Aim: The aim of the study is to evaluate and compare the effect of access cavity designs on the polymicrobial biofilm disinfection of root canal system. Methods: One hundred and twenty molar teeth were selected and randomly divided into four groups (n = 30) on the basis of access cavity design: traditional access cavity (TEC), contracted access cavity (CAC), truss access cavity (TAC), and caries-driven access cavity (CDAC). After access preparation, the samples were contaminated for 2 weeks to grow polymicrobial mature biofilm. Microbial sampling from the root canals was performed with sterile paper points before and after instrumentation to determine the bacterial load. The bacterial reduction was counted as CFU/ml and analyzed statistically. Results: Both maxillary and mandibular molars with different cavity designs showed significant decreased in the number of Enterococcus faecalis, Staphylococcus aureus, and Candida albicans postinstrumentation. TEC group showed significantly higher microbial reduction for all tested microorganisms than TAC and CDAC groups (P < 0.05). However, insignificant difference (P > 0.05) was observed between TEC and CAC and TAC and CDAC. Conclusion: In both maxillary and mandibular molars, complete elimination of microbes (E. faecalis, C. albicans, and S. aureus) could not be achieved with any access cavity design. Highest microbial reduction was achieved with TEC and lowest in CDAC. Both TEC and CAC resulted in equal microbial reduction and were superior to TAC and CDAC.