Abstract
Aims: To evaluate the antibacterial effect of a novel root canal irrigant, QMix, by evaluating its effect against E. faecalis and comparing it to 17% EDTA and 2% Chlorhexidine digluconate. Materials and Methods: Minimum Inhibitory Concentration (MIC), Minimum bactericidal concentration (MBC) and direct exposure test were the techniques used. In the MIC and MBC technique, the irrigants (QMix, 17% EDTA, 2% CHX) were serially diluted in BHI broth and 0.2 mL of the tested bacterial suspensions was added. Results were obtained on the basis of turbidity and growth on agar plates. In the direct exposure test, Enterococcus faecalis were exposed to QMix, 2% Chlorhexidinedigluconate and 17% EDTA for 5 seconds, 30 seconds and 3 minutes. Following exposure, samples were taken and serially diluted and incubated anaerobically on E. faecalis selective media for 24 hours to count the resistance of the bacteria. Results: In the MIC and MBC technique, CHX showed to be more effective against E. faecalis than both QMix and EDTA, as lower dilutions were required to inhibit growth of both bacteria. Ethylene diamine tetra acid (EDTA) was the least effective. In the direct exposure test, QMix was more effective than CHX and EDTA as it was the only solution to be able to kill all bacteria. Few E. faecalis cells remained even after exposure of bacteria to 3 minutes of EDTA and CHX. There was significant difference between QMix and both EDTA and CHX in killing of E. feacalis at 5 seconds exposure (p<0.05). QMix killed more than 95% of bacteria, whereas CHX and EDTA killed fewer than 20% (p<0.05). There was no statistical significance between the irrigant solutions at 3 minutes of exposure. Conclusions: In the MIC and MBC techniques, Chlorhexidinedigluconate was found superior to both QMix and EDTA. In the Direct Exposure Test, QMix showed the best performance as it was the only irrigant solution to kill all E. faecalis cells, as well as killing more than 95% of all bacteria at 5 seconds exposure.
Highlights
Bacteria are the main cause of periapical disease.[1]
The aim of this study is to evaluate the antimicrobial efficacy of QMix against E.faecalis and compare it to Ethylene diamine tetra acid (EDTA) and CHX
Minimum Inhibitory Concentration (MIC) An overnight culture of E. faecalis was harvested in brain-heart infusion (BHI) broth and the concentration was adjusted to optical density of 0.11 at 570 nm using spectrophotometer.[7]. To determine the MIC of the irrigant solutions (QMix, 2% CHX, 17% EDTA), the serial microdilution assay was used
Summary
Mechanical preparation is the main mechanism to reduce the bacterial load in canals, which is enhanced by intracanal irrigants. In spite of these procedures, some bacteria might persist within the canals. Sodium hypochlorite (NaOCl) in concentrations from 0.5% to 6% is the most commonly recommended irrigating solution. It has strong antibacterial and tissue dissolving effects.[9]. It is toxic to periapical tissue[10] and has been suggested to degrade micromechanical characteristics of dentine.[11]. It has no effect on the inorganic part of the smear layer.[12]. Qian et al,(13) showed that if NaOCl is used again after EDTA or citric acid as the final antibacterial rinse, it causes marked erosion of the root canal wall dentine
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