Er:YAG Laser Activated Chlorhexidine and Nano Chitosan Against Enterococcus faecalis-An In Vitro Study

Objective: This in vitro study aimed to compare the antibacterial properties of 2% chlorhexidine (CHX) and 0.2% nano chitosan, with and without Er:YAG laser activation using a side-firing tip, against Enterococcus faecalis. It evaluates their potential to improve disinfection in endodontic treatments and assesses the impact of laser activation on antimicrobial efficacy. Background: Successful endodontic treatment relies on effective root canal disinfection, often hindered by E. faecalis, which invades dentinal tubules. While sodium hypochlorite is effective, it can cause cytotoxicity and dentin damage. CHX is a biocompatible alternative, and nanochitosan offers promising antimicrobial properties with low toxicity. However, conventional irrigation methods are often insufficient. Er:YAG laser activation enhances irrigant penetration into dentinal tubules, improving antimicrobial effects. Method: Extracted human premolars were inoculated with E. faecalis and divided into four groups: Group A (2% CHX), Group B (0.2% nano chitosan), Group C (2% CHX + Er:YAG laser), and Group D (0.2% nano chitosan + Er:YAG laser). Bacterial counts were measured using colony-forming units on Mueller Hinton agar. Results: CHX showed superior antibacterial efficacy compared with nanochitosan. Laser activation significantly enhanced the antimicrobial effect of both irrigants, with Group C (CHX + laser) showing the greatest reduction in bacterial colonies. Conclusion: Er:YAG laser activation improves the antimicrobial effectiveness of both CHX and nano chitosan, particularly in combination, offering a promising approach for root canal disinfection. Furthermore, clinical studies are needed to confirm these findings in vivo.