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      Antimicrobial Effectiveness of Photodynamic Therapy, 5% Sodium Hypochlorite and 2% Chlorhexidine Gluconate in Root Canal Treated Teeth: A Clinical Study

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          Abstract

          Aim:

          To evaluate the effectiveness of photodynamic therapy (PDT), sodium hypochlorite (NaOCl) and chlorhexidine gluconate (CHO) in the endodontic re-treatment in the removing of microorganisms from previously filled infected root canals.

          Materials and Methods:

          The study samples consist of 54 root canal treated anterior teeth with apical periodontitis were randomly divided into three groups according to the disinfection protocol. Microbiological samples from the root canals were collected after removing the gutta-percha (S1) and following the endodontic re-treatment (S2) with either 5% NaOCl, 2% CHO or PDT procedure for 1 minute. Microbiological samples were cultivated on selective plates to assess the presence or absence of microbial growth and determine the average reduction of viable microorganisms.

          Results:

          Significant reduction in the total bacterial count in all the groups at post treatment ( P < .001). PDT provided statistically higher (99.74%) elimination of Enterococcus faecalis in comparison to NaOCl (95%) and CHO (88%).

          Conclusions:

          The use of PDT in endodontic re-treatment led to the significant reduction of the remaining bacterial species. So, PDT can be used for routine endodontic disinfection in failed root canal cases.

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          The Declaration of Helsinki and public health

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            Clinical implications and microbiology of bacterial persistence after treatment procedures.

            Apical periodontitis is an infectious disease caused by microorganisms colonizing the root canal system. For an optimal outcome of the endodontic treatment to be achieved, bacterial populations within the root canal should be ideally eliminated or at least significantly reduced to levels that are compatible with periradicular tissue healing. If bacteria persist after chemomechanical preparation supplemented or not with an intracanal medication, there is an increased risk of adverse outcome of the endodontic treatment. Therefore, bacterial presence in the root canal at the time of filling has been shown to be a risk factor for posttreatment apical periodontitis. About 100 species/phylotypes have already been detected in postinstrumentation and/or postmedication samples, and gram-positive bacteria are the most dominant. However, it remains to be determined by longitudinal studies if any species/phylotypes persisting after treatment procedures can influence outcome. This review article discusses diverse aspects of bacterial persistence after treatment, including the microbiology, bacterial strategies to persist, the requisites for persisting bacteria to affect the outcome, and future directions of research in this field.
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              Microbiologic analysis of teeth with failed endodontic treatment and the outcome of conservative re-treatment

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                Author and article information

                Contributors
                (View ORCID Profile)
                Journal
                Journal of Advanced Oral Research
                Journal of Advanced Oral Research
                SAGE Publications
                2320-2068
                2320-2076
                November 2021
                May 21 2021
                November 2021
                : 12
                : 2
                : 193-199
                Affiliations
                [1 ] Department of Conservative Dentistry and Endodontics, Faculty of Dental Sciences, King George’s Medical University Lucknow, Lucknow, Uttar Pradesh, India
                [2 ] Department of Conservative Dentistry and Endodontics, Faculty of Dental Sciences, King George’s Medical University, Lucknow, Uttar Pradesh, India
                [3 ] Department of Microbiology, Faculty of Medicine, King George’s Medical University Lucknow, Lucknow, Uttar Pradesh, India
                Article
                10.1177/23202068211018984
                6586048c-8cbc-4539-a6b1-4aefe80006b2
                © 2021

                http://journals.sagepub.com/page/policies/text-and-data-mining-license

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