A Comparative Evaluation of the Effectiveness of Three Different Irrigating Solution on Microorganisms in the Root Canal: An Invivo Study

Abstract

Introduction: An infected root canal system either due to caries exposure or trauma cannot be eliminated by the host defense mechanisms alone or in combination with systemic antibiotic therapy. It can be treated through professional endodontic intervention using both chemical and mechanical procedures.

Aim: To suggest triple antibiotic solution containing tetracycline, ornidazole and ciprofloxacin as a new endodontic irrigant that may possess superior antibacterial activity in comparison with chlorhexidine solution.

Materials and methods: This study was carried out on 60 teeth from 40 children with anterior tooth fracture, asymptomatic, non-vital and necrotic in nature. Patients were randomly divided into three groups of 20 teeth each depending upon the type of irrigant. After access opening microbial samples were obtained: a) Pre- irrigation i.e. sample after pulp extirpation and before irrigation, b) Post-irrigation i.e. sample after irrigation, stored in sterile containers and immediately transferred to microbiological laboratory. After incubation of samples aerobically at 37(0)C for 24 hours, the samples were streaked on blood agar culture media and incubated for 48 hours. After 48 hours, the colony forming units were counted using a colony counter. Statistical analysis was carried out using Kruskal-Wallis test, Wilcoxson signed rank test and Mann-Whitney test.

Results: On intra group comparison, highly significant differences in the colony forming units were found between pre-irrigation and post-irrigation sample for all the three groups. On inter group comparison, statistical difference was found between saline and chlorhexidine (p ≤ 0.001), saline and triple antibiotic paste (p< 0.001). The greatest percentage decrease was obtained in samples treated with Chlorhexidine solution (Group 2) i.e.73.91. The triple antibiotic irrigating solution group showed percentage decrease of 66.22 followed by Group 1 (Saline) 15.04. The difference found amongst the groups was statistically insignificant.

Conclusion: It was concluded that triple antibiotic irrigating solution can be used as an irrigating solution. The antibacterial action of triple antibiotic irrigating solution is comparable with chlorhexidine. Although saline may not be effective in the antimicrobial action but its flushing action may be able to decrease some microbial load.

Keywords: Ciprofloxacin; Non- vital anterior teeth; Normal saline; Ornidazole; Tetracycline; Triple antibiotic solution.

Figures

[Table/Fig-6]:

Mean comparison of LOG10 (CFU) of sample A (Pre-irrigation) and sample B (post-irrigation) for Group 1 (Saline), Group 2 (Chlorhexidine solution) and Group 3 (Triple antibiotic irrigating solution)