An alternative regimen for root canal disinfection.

Area of Science:

• Endodontics
• Microbiology
• Biomedical Engineering

Background:

• Root canal treatment aims to eliminate intraradicular bacteria.
• Biofilm disruption and bacterial reduction are critical for successful endodontic outcomes.
• Conventional irrigation protocols often involve sodium hypochlorite, but alternatives are being explored.

Purpose of the Study:

• To compare the efficacy of 20% citric acid with photo-activated disinfection (PAD) against 20% citric acid and 2.25% sodium hypochlorite in reducing dentinal wall bacterial load in vivo.
• To evaluate PAD as an adjunct or primary disinfection method in root canal preparation.

Main Methods:

• Sixty-four cases were divided into two groups.
• Group 1: Citric acid + PAD, followed by conventional irrigation.
• Group 2: Conventional irrigation with citric acid and sodium hypochlorite, followed by PAD. Bacterial samples were collected at multiple stages and cultured.

Main Results:

• In Group 1, only two of 23 infected canals remained culturable after citric acid and PAD. One of these was cleared by subsequent conventional treatment.
• In Group 2, four of 23 infected canals remained contaminated after conventional treatment. PAD cleared three of these four canals.

Conclusions:

• The combination of a chelating agent (citric acid) and photo-activated disinfection is an effective alternative for root canal cleaning.
• This approach demonstrates potential to replace or supplement sodium hypochlorite in endodontic disinfection protocols.