Successful Endodontic Therapy Research Articles

Endodontic management of a mandibular second molar with C-shaped canals

The aim of this case report is to explain the etiology and management of C-shaped canals. An important anatomic variant in root canal morphology, the C configuration, presents as a thin fin connecting the canals with a predilection for mandibular second molars. Early recognition of the C-shape becomes imperative for its successful management. Newer diagnostic tools have facilitated a more precise diagnosis of this condition. Clinical and radiographic diagnoses can aid in the identification and negotiation of the fan-shaped areas. The inaccessible areas and unique canal patterns make provision of optimum treatment quality a highly challenging proposition. Successful endodontic therapy of this canal configuration can be achieved with rotary and hand instrumentation assisted with ultrasonics.

The monoblock concept in endodontics

The ultimate challenge for successful endodontic therapy is to establish a homogenous unit of the root canals which requires a hermetic seal. Adhesion of root canal sealers to dentin is important to seal the root canal system thoroughly and to prevent microleakage. Bonding of root filling materials to the radicular dentin is known as ‘monoblocks’ which has become more popular after introduction of bonding concept in the root canal system. The aim of this review highlights on newer materials and different concepts in rehabilitation of root canal space. Thus the potential of these monoblocks is discussed with the possibility of their application in endodontics in future. Keywords: Monoblocks, MTA, Fibre posts, Bonding to root canal.

Evaluation of dead space in post endodontically treated cast post cases - A retrospective study

The success of endodontic therapy is 53-96%. It depends on a multitude of factors like tooth type, preoperative apical status, method of obturation, irrigation, coronal seal permanent restoration. Grossly decayed endodontically treated teeth are often restored with post and core. Apical microleakage can lead to failure of the endodontic therapy. So, the aim of this study was to measure the distance between the post and residual gutta-percha in cast post cases. Dental records and radiographs of patients treated with cast post cases were obtained from DIAS (From June 2019- March 2020) examined by the same examiner. Patients were categorized into three groups based on the distance between the remaining obturation material and post. A total of 70 cases were examined. Out of which 21% of cases belonged to Group I and 68% of the cases were categorized into Group II. Within the limitation of the study, most of the cases had an average dead space of 0.1-2 mm (68%). Within the limitation of the study, most of the cases had an average dead space of 0.1-2 mm (68%). The dead space occurring after a post-restoration can be a good shelter for the microorganisms. So, radiographic confirmation of the post adaptation should be performed before cementation of all kinds of posts.

Sucesso no tratamento endodôntico em incisivo lateral superior com reabsorção radicular interna inflamatória não perfurante: relato de caso

As reabsorções dentárias internas são geralmente assintomáticas e quase sempre diagnosticadas em exames radiográficos de rotina. O objetivo deste estudo é apresentar um relato de caso clínico de um dente acometido por reabsorção radicular interna inflamatória não perfurante, com intuito de divulgar informações que sirvam de subsídios para orientar os profissionais frente a esses casos, auxiliando na conduta terapêutica. Paciente do sexo feminino, 53 anos de idade, foi encaminhada ao curso de especialização da Faculdade CIODONTO após realização de um exame radiográfico periapical de rotina, o qual mostrou reabsorção interna não perfurante à nível de terço médio radicular do dente 12. Radiograficamente foi verificado que o contorno dos limites pulpares sofre uma expansão relativamente simétrica de aspecto balonizante, contornos regulares e arredondados. Após a abertura coronária, foi observado sangramento compatível à polpa vital, irrigando-se, inicialmente, com água de Cal. O preparo biomecânico pela técnica coroa-ápice sem pressão foi realizado e como medicação intracanal foi selecionado o Callen por 30 dias e pasta L&C por 90 dias. Após esse período, foi realizada a obturação dos canais radiculares pela técnica termoplástica híbrida de Tagger e cimento endodôntico à base de hidróxido de cálcio. A proservação foi realizada após 1 ano e o sucesso da terapia endodôntica foi constatado. Dessa forma, de acordo com o protocolo indicado na literatura é permitida a resolução clínica efetiva de dentes acometidos por reabsorção interna não perfurante, mostrando-se uma ótima alternativa de tratamento conservador.

Prevalence of Root Canal Morphology of Mandibular Molar in Western Nepalese Population: A Cross-sectional Study

INTRODUCTION: A main variant in the mandibular molars is the presence of radix entomolaris (RE) and radix paramolaris (RP) in the mandibular first molars and fused roots in 2nd mandibular molar. Hence, the present prospective study intends to evaluate the prevalence of radix entomolaris, radix paramolaris and molars with fused roots in a local population of Western Nepal.
 MATERIAL AND METHODS: This is prospective cross-sectional study. The total of 336 patient's mandibular first and second permanent molars having radiological and clinical evidence of pulpal pathology were included in this study. The criteria for the identification of an extra root were justified by crossing of the translucent lines defining the pulp space and periodontal ligaments in the mandibular first molars, and for the mandibular second molars, the outline of the periodontal ligament was followed to see the presence of the fused roots.
 RESULTS: Thirty nine patients (24 females and 15 males) showed a supernumerary distolingual root (RE) in mandibular first molars and 42 patients (18 females and 24 males) showed mesiolingual root (RP). The prevalence of patients with radix entomolaris was 11.6% (39 of 336), 13.6% for females (24 of 176) and 9.3 % for males (15 of 160). The prevalence of radix paramolaris was 12.5%(42 of 336), 10.5%(18 of 176) for females and 15% (24 of 160) for males. 54 patients (27 females and 27 males) showed C-shaped canals in mandibular molars. The prevalence of C-shaped mandibular molars was 30% for females (27 of 90) and 34.6% (27 of 78) for males. There was statistically no significant difference in the prevalence of entomolaris, paramolaris and C-shaped canals among male and female population.
 CONCLUSION: Failure to diagnose radix entomolaris, paramolaris and fused root may lead to missed canal and incomplete debridement of canal resulting in compromised treatment outcome. The successful endodontic therapy employed all the roots and canals to be located, cleaned, shaped and obturated.

Evaluation of root dentin microhardness prepared with hand and two rotary file systems with 2.5% sodium hypochlorite irrigation solution - an in vitro study

Background: Success in endodontic therapy depends on effective chemomechanical preparation of the root canal, but their compromising effects on root dentin microhardness should be taken into consideration. AIM: To evaluate the effect on microhardness of root dentin prepared with hand stainless steel K-Files, ProTaper and K3 NiTi Rotary file systems with 2.5% Sodium Hypochlorite as common irrigating solution. Materials and Methods : Fifty human mandibular single-rooted premolar teeth selected. Access opening was done and working length was determined. All the specimens were then randomly divided into five groups with 10 specimens in each group. Group I- Neither instrumented nor irrigated. Group II- 2.5% NaOCl irrigation Group III- Stainless steel K-files using 2.5% NaOCl Group IV- ProTaper rotary files using 2.5% NaOCl solution. Group V - K3 rotary files using 2.5% NaOCl solution. The specimens were prepared for microhardness testing at a distance of 500 mm and 1000 mm from the lumen of each sample using vickers microhardness test. Results: 1) Significant difference in microhardness values were seen at 500 mm and 1000 mm (P from the lumen in all groups. 2) Statistically significant differences were seen among all the groups except between Group IV & V. Conclusion: Instrumentation with NiTi Rotary files affected dentin microhardness significantly to a lesser extent when compared to Stainless Steel K files using 2.5% NaOCl irrigating solution. Keywords: Microhardness, Sodium hypochlorite, Nickel Titanium Rotary files.,

Biodentine management and setting time with Vicat and Vickers evaluation; a survey-based study on clinicians' experience

Purpose: of this paper was to analyse clinicians’ views on the management and handling procedures of the Biodentine tricalcium silicate cement with the following evaluation of the real setting time of the material with two independent physical tests. Design/methodology/approach: A survey study included 174 clinicians who answered the questionnaire designed to collect opinions on the Biodentine management during endodontic procedures. To verify the setting time of the cement, two independent hardness tests were performed. Macroscopic evaluation was carried out using the Vicat device. Microscopic assessment with subsequent SEM observation was conducted with the aid of the Clemex appliance. Findings: 43% of respondents using Biodentine in their practice described the setting time as long or definitively too long. One fifth of the dentists surveyed continue dental procedures without waiting. The setting time tests confirmed the existence of two phases of the Biodentine setting process, which corresponds to the general definition of cement setting. After mixing of the material, the initial setting stage lasts for 15 minutes. The next one, described by the authors as “maturation” of Biodentine lasts for 120 minutes. Research limitations/implications: The material initially sets within 15 minutes, however it is not the end of the process. In certain endodontic procedures the awareness of a longer setting time of Biodentine is essential for decision-making in root canal therapy. Practical implications: It is advisable to divide the endodontic treatment with Biodentine into two separate appointments. Originality/value: From the clinicians’ perspective the setting time and correct handling of Biodentine are crucial factors in the successful endodontic therapy. The information regarding proper material management is included in this paper.

Two Canals in Palatal Root of Maxillary Molar: Case Series

Evaluating morphology of a root canal is important in determination of a successful endodontic therapy. This article highlights the need to be aware of different morphologies, which can exist in the root canal system of upper molars. This is usually associated with buccal root and has been documented in several studies in literature. On the other hand, it is not often that we come across variations in the palatal roots. These cases discuss such a case where two canals were discovered in palatal root during root canal treatment of maxillary first molar. It is essential to evaluate pre-operative radiographs and have proper knowledge of anatomy of the root canal system before initiating the treatment. All roots must be explored carefully to ensure that all canals are negotiated, debrided and obturated to ensure successful endodontic outcome. This case report shows a case series in endodontic management of a maxillary first molar with two palatal canals.

MTA apexification of an endodontically failed tooth with wide open apex in multiple visits

Success of endodontic therapy is dependent on multiple factors such as thorough preoperative evaluation, magnification and isolation techniques, complete debridement of diseased pulp tissue with disinfection of the canal and three-dimensional obturation. The process of root formation can be hampered in young permanent teeth due to trauma. Endodontic treatment of such cases with open apex is a challenge and retreatment in such cases is an even bigger challenge. Use of contemporary materials such as mineral trioxide aggregate, thermoplasticized gutta percha, and magnification in the form of a dental operating microscope can help in achieving predictable and long-term success in such cases.

In vivo evaluation of zinc oxide-propolis mixture as root canal filling material in the primary molars: A 24-month follow-up randomized controlled trial.

Pulpectomy is a routine practice in children with pulpal and periapical infections, the success of which depends on the elimination of bacteria from the root canals. Propolis, a natural product with proven antibacterial and anti-inflammatory properties when mixed with zinc oxide powder as root canal filling material, it could provide good success in endodontic therapy of primary teeth. The aim was to evaluate and compare the clinical effectiveness of zinc oxide-propolis mixture with zinc oxide eugenol (ZOE) as root canal filling material in nonvital primary molars. This was a 2-arm, parallel group randomized controlled trial with blinded outcome assessment. Forty primary molars from children aged 4-8 years requiring pulpectomy treatment were randomly allocated into two groups according to the obturating material used: zinc oxide-propolis mixture (test group) and ZOE (control group). All the pulpectomy treated teeth were finally restored with stainless steel crowns, and the children were recalled at 6, 12, and 24 months for postoperative clinical and radiographic evaluation. Chi-square test was used to analyze the data. The overall success rate of pulpectomy with zinc oxide-propolis mixture and ZOE was found to be 95% and 70%, respectively, and the difference was statistically significant (P = 0.037). Zinc oxide-propolis mixture has shown a success rate of 100% at 6 months and 95% at 12 and 24 months follow-up, whereas ZOE has shown 80% success rate at 6 and 12 months, and it declined to 70% at 24-month follow-up. Zinc oxide-propolis mixture demonstrated good clinical and radiographic success at the end of 24 months, and hence, it can be considered as an alternate root canal filling material in the primary teeth.

Comparative evaluation of pulp tissue dissolution ability of sodium hypochlorite by various activation techniques: An in vitro study

Background:The success in endodontic therapy is dependent largely on the absolute elimination of pulp tissue remnants and the maximum reduction of pathologic microbial load present within the root canal system.Aim:The aim of this in vitro study was to compare and evaluate the ability of pulp tissue dissolution with and without activation of 5.25% sodium hypochlorite (NaOCl).Materials and Methods:Pulp tissue samples collected from intact, noncarious extracted third molars were standardized to 8 mg in each group. These samples were placed in conical Eppendorf tubes of 15 ml with 10 ml 5.25% NaOCl for 4 min and were activated suitably according to the group specifications. All the procedures in this study were carried out at room temperature. The preweighed pulp tissue samples were further weighed again after the dissolution phase, and residual weight loss in each group along with its percentage was obtained. The results were then statistically analyzed using one-way analysis of variance and Tukey post hoc test.Results:The maximum amount of pulp tissue dissolution was found in the laser-assisted irrigation group, i.e., NaOCl with Er, Cr: YSGG (P < 0.05) and showed a statistically significant result in comparison with other groups.Conclusion:Within the limitations of the study, laser-assisted irrigation with a radial firing tip (NaOCl activated by Er, Cr: YSGG) was the most effective in dissolving the pulp tissue in comparison with other groups. The ultrasonic activation also showed a considerable amount of pulp tissue dissolution comparable to laser-activated irrigation in this study.

Comparative Evaluation of Root Dentin Microhardness after using Different Standard Irrigating Solutions and Stevia Leaf Extract- An In vitro Study

Introduction: Success in endodontic therapy largely depends on mechanical and chemical debridement of the root canals by using instruments and effective irrigating solutions which are not only important for cleaning and disinfecting the root canals, but also, are capable of altering the chemical and structural properties of dentin. As the microhardness test is sensitive to surface changes of tooth structure, it is useful in making a correlation between irrigating solutions and root dentin microhardness. Aim: To evaluate the effect of different standard irrigating solutions at standard concentrations and Stevia leaf extract (2.5%) on the microhardness of root canal dentin. Materials and Methods: This is an in-vitro comparative study where forty intact single rooted teeth were selected and decoronated to get an apico-coronal length of 10 mm and were randomly divided into four groups as per the irrigant used; Group 1 (control): Irrigation with Normal saline, Group 2: Irrigation with 2.5% Sodium Hypochloride (NaOCl) followed by 17% EDTA, Group 3: Irrigation with 2.5% Stevia extract solution, Group 4: Irrigation with SmearClear solution. They were prepared using ProTaper Universal Rotary Files with intermittent irrigation with the respective irrigating solution. The teeth were then embedded in acrylic resin and subjected to Vicker’s Hardness test and the data obtained were analysed using one way ANOVA test. p&lt;0.05 was taken to be statistically significant. Results: At 500 microns, Vickers Hardness Number (VHN) value was less than at 1000 micron, but was not statistically significant, (p&gt;0.05). Between the groups, the control group showed the highest microhardness at 500 and 1000 microns, namely, 51.27±4.36 VHN and 53.60±5.12 VHN, respectively. Group 3 and 4 showed a comparable reduction in microhardness with Group 3 showing slightly better results (47.98±4.34 VHN and 48.89±5.26 VHN, respectively) as compared to Group 4 (47.36±5.50 VHN and 48.62±5.84 VHN, respectively). Group 2 showed the least value (36.60±5.71 VHN and 37.11±5.82 VHN, respectively). Conclusion: Within the limitations of this study, teeth irrigated with normal saline showed least reduction in microhardness followed by irrigation with Stevia leaf extract solution, SmearClear and Hypochlorite followed by EDTA.

Maxillary Central Incisor with Two Roots – A case report

Knowledge of the external and internal dental anatomy and its variations is a prime factor of success of endodontic therapy. The maxillary central incisor usually presents with one root canal system within one root. This report portrays an endodontic re-treatment of a maxillary central incisor of a healthy 38-year-old Saudi female patient with two canal systems and two roots presented to the clinic complaining of swelling and pus drainage. The case was initially misdiagnosed and not treated fully, however, correct diagnosis through detailed examination and evaluation, using tracing and imaging. Retreatment was done and the tooth was asymptomatic clinically and radiographically at 6 months follow-up.

Cone-beam computed tomography study of tooth root and canal morphology of permanent molars in a Serbian population

Background/Aim. For successful endodontic therapy, it is necessary to know root morphology. Therefore, the aim of our study was to analyze root canal morphology and root canal length of permanent molars in a Serbian population, using cone-beam computed tomography (CBCT). Methods. The study included a total of 305 maxillary molars, and 280 mandibular molars receiving cone-beam computed tomography examination and determined root numbers, canal morphology according to Vertucci classification, and canal lengths. Results were correlated with sex and tooth location in the jaw. Results. The mesiobuccal roots of first maxillary molars showed Vertucci type I in 45.7%, followed by type II in 29% of cases. For the second molar, Vertucci type I was found in 60.5% of cases in mesiobuccal canals. Palatal and distobuccal canals mostly presented Vertucci type I configuration. The mesial roots of mandibular molars had the highest frequency of two canals with Vertucci type IV as the most frequent for the first molar, and Vertucci type II for the second molar. Distal roots most commonly had one canal in both molars. Palatal canal length was the highest in maxillary first molars, with the mean value of 20.62 mm, while in second molars, the highest length value was for the mesiobuccal canal (20.09 mm). In both mandibular molars the mesial root canal was the longest one. Differences were found according to sex and tooth location in the jaw. Conclusion. Mesiobuccal roots of maxillary first molars had two canals; it was more frequently compared to second molars. Mesial roots of mandibular molars showed same frequency of two canals, and diversity in Vertucci types. Male patients tended to have higher complexity of root canal morphology compared to that of females. CBCT can improve understanding of the root canal morphology.

Evaluation of the outcome of various laser therapy applications in root canal disinfection: A systematic review.

Any successful endodontic therapy requires elimination of the endodontic biofilms through meticulous root canal disinfection methods. Sodium hypochlorite (NaOCl) and ethylenediaminetetraacetic acid (EDTA) are the most common effective irrigants, in removing smear-layer from the coronal and middle thirds of the dental canals but reduced considerably towards the apical one third. In recent years, newly alternative treatment modalities have been proposed, including high-power lasers and antimicrobial photodynamic therapy (aPDT). Our work was conducted to evalaute the outcome of root canal disinfection in relation to the efficacy of various treatment modalities. Furthermore, every effort was made to present an overview of the aPDT outcomes, as a model for this application, and to propose laser parameters protocol with positive results. The electronic databases PubMed was searched from January 2013- January 2019. Our inclusive criteria based on laser therapy applications, as a model for root canal disinfection. The search terms utilised various combinations as follows: photodynamic therapy or antimicrobial photodynamic therapy or photoactivated disinfection or light activated disinfection or laser activated disinfection or laser therapy, and endodontic. The results of this systematic review concluded that the effectiveness of aPDT and various laser wavelengths protocols, in removing endodontic biofilms from infected root canals, remains unattainable. Study concluded that the combination of aPDT with antimicrobial irrigants could provide a synergetic effect. However, due to the heterogeneity of the selected studies and their limitations, in terms of lack of standardised protocol or discrepancy in the methodology, authors suggest further validated approaches to achieve optimal outcomes.

PERMANENT MAXILLARY PREMOLARS WITH THREE CANALS- A CASE REPORT

Maxillary first premolar is a bi-rooted tooth with several variations in the root canal morphology. Usually it has 2 canals, however at times there could be an additional third canal present which could easily be missed by the clinician owing to lack of awareness and knowledge about the canal variations. Awareness of internal and external anatomy of tooth and also about its variations are essential for successful endodontic therapy. Prevalence of three canals in maxillary premolar is very low. This case report describes the endodontic management of permanent maxillary premolars with three root canals

Rare Occurrence of Single Rooted Mandibular Left First and Third Permanent Mandibular Molar: A Case Report

For any practicing clinician, successful endodontic therapy is highly dependent upon complete knowledge of the anatomy and the variations present in the human dentition. There are variances in anatomical configurations in teeth seen across the globe and might needs specialized treatment techniques. The tendency of Asians to show a C- shaped canal morphology has been documented in the literature, however, in contrast to those findings, we report a unique and a rare case of left mandibular first and third molars

Evaluation of the bactericidal potential of 2780-nm ER,CR:YSGG and 940-nm diode lasers in the root canal system

Successful endodontic therapy relies on chemomechanical debridement. Laser-assisted irrigation techniques are available for debridement. However, there are limited studies demonstrating the effectiveness of dual lasers for root canal disinfection. Hence, the aim of the present study is to determine if laser activation irrigation using the Er,Cr:YSGG and 940-nm diode laser is as effective as positive pressure needle irrigation using sodium hypochlorite (NaOCl) and ethylenediamine tetraacetic acid (EDTA). Fifty-two caries-free premolars were divided into six groups: G1, sterile water via positive pressure irrigation; G2, EDTA and NaOCl via positive pressure irrigation; G3, sterile water and the Er,Cr:YSGG cleaning and disinfection step; G4, sterile water and the Er,Cr:YSGG cleaning and disinfection step followed by disinfection with the 940-nm diode; G5, sterile water and the Er,Cr:YSGG cleaning step followed by a disinfection step with the Er,Cr:YSGG and diode laser together; and G6, negative controls. S1 samples were validated in both negative and positive control groups via culturing. All teeth, except the negative controls, were inoculated with Enterococcus faecalis. S2 sampling after treatments was completed and tested for bacterial presence via culturing and SEM and CLSM analysis. The data demonstrated that the traditional irrigation group (G2) and the dual laser group (G5) showed the greatest percentage decrease in bacterial counts from the S1 to the S2 group. The data demonstrates that the combination of the Er,Cr:YSGG and 940-nm diode laser wavelengths is safe and more effective than either laser alone and is comparable to needle irrigation with sodium hypochlorite and EDTA.

Ex Vivo Detection of Apical Delta in Premolars: A Comparative Study Using Periapical Radiography, Cone-beam Computed Tomography, and Micro–computed Tomography

IntroductionImaging methods are essential for the correct identification of root canal anatomy, which is a key factor for successful endodontic therapy. This study aimed to evaluate the performance of periapical radiography (PR) and cone-beam computed tomographic (CBCT) imaging in identifying the apical delta (AD) using micro-computed tomographic imaging as the gold standard. MethodsPR and CBCT images of 110 human premolars (120 root canals) were obtained using the VistaScan digital intraoral system (Durr Dental, Beitigheim-Bissinger, Germany) and the 3D Accuitomo CBCT unit (J Morita, Kyoto, Japan), respectively. Two oral radiologists assessed the PR and CBCT images for the presence of ADs using a 5-point scale. Additionally, in the CBCT images, the number of apical foramina was also evaluated. The gold standard was established by means of micro–computed tomographic imaging. The diagnostic values related to PR and CBCT imaging were compared using the McNemar test. The detection of the number of foramina was compared using the paired t test (α ≤ 0.05). ResultsADs were present in 40 root canals (33.3%). Both PR and CBCT images differed significantly from the gold standard (P < .05) in the detection of ADs. CBCT imaging showed higher values than PR for all diagnostic tests (P < .05). Despite the moderate accuracy of PR (0.62) and CBCT imaging (0.73), these methods presented very low sensitivity values (0.07 and 0.35 for PR and CBCT, respectively). CBCT imaging had a tendency of underestimating the number of foramina (P < .05). ConclusionsCBCT imaging showed better performance than PR in the detection of ADs; both imaging modalities underestimate its presence when compared with the gold standard. In general, the number of apical foramina cannot be reliably assessed using CBCT imaging.

Antibacterial effect of fluorinated graphene and zinc oxide nanoparticles incorporated in zinc oxide-based sealers on Enterococcus faecalis (in vitro study)

Background: Incorporation of nanoparticles with antibacterial properties plays an essential role in the success of endodontic therapy. Aim: The aim of this study is to evaluate the antimicrobial efficacy of zinc oxide (ZnO)-based sealer incorporated with fluorinated graphene and ZnO nanoparticles against Enterococcus faecalis. Subjects and Methods: Sixty human extracted mandibular premolars with single canal were selected. After biomechanical preparation of all teeth and inoculation with E. faecalis, teeth were divided into three groups according to the type of the tested sealer, Group 1: Teeth were obturated with ZnO-based sealer only, Group 2: Teeth were obturated using sealer incorporated with fluorinated graphene, and Group 3: Teeth were obturated using sealer incorporated with ZnO nanoparticles. Each group was subdivided into two subgroups according to the timing of filling removal and culture sample. Subgroup A: Obturation removal and culture sample were taken after 1 week. Subgroup B: Obturation removal and culture sample were taken after 3 weeks. The number of colonies forming units was counted to assess the effect against E. faecalis. Data were recorded, tabulated, and statistically analyzed using the Kruskal–Wallis test was applied to find significance among the groups (1, 2, and 3). The Mann–Whitney U-test was applied to find significance between the groups. The Wilcoxon signed-rank test was applied to find significance between two-time intervals (24 h to 1 week, 24 h to 2 weeks) in each group. P Results: After 3 weeks from obturation, fluorinated graphene had a better antibacterial effect and there was a significant difference between the three tested groups. Conclusion: After 1- and 3-weeks samples after obturation fluorinated graphene had a better antibacterial effect and there was a significant difference between the three tested groups.