Clinical and microbiological assessment of root canal decontamination in chronic apical periodontitis using the ultrasound

Abstract

The aim: To study the effectiveness of chronic apical periodontitis treatment by the combined use of ultrasonic treatment of root canals and multicomponent antimicrobial gel according to the results of clinical and microbiological researches. Materials and methods: 64 patients with chronic apical periodontitis at the age of 18-56 years were treated. Patients were divided into two groups: the main and control. In the main group the root canals of 36 teeth were sonicated in combination with multicomponent antimicrobial gel, in the control – 35 teeth were treated by a standard method. The content of the root canals for microbiological studies was obtained before endodontic treatment and before permanent obturation. Frequency of content and number of bacteria in the samples were evaluated. Results: All samples before treatment were positive for the presence of variable bacterial flora, among which Staphylococcus epidermidis (43.9%), Enterococcus faecalis (37.9%), Streptococcus spp. (24.8%), Candida albicans (24.4%), Fusibacterium (9.4%) were the most dominant, their number was 7.4-4.8 lg CFU/ml. Repeated research after the proposed and standard method of root canal decontamination has shown a significant decrease in microflora. According to the data of clinical and microbiological examination, the method which was developed by us revealed a positive result in 86% of cases compared with 63% when treated by the standard method. Conclusions: The effectiveness of a complex treatment method with combined use of the ultrasonic irrigation and multicomponent antimicrobial gel for root canals decontamination in chronic apical periodontitis is demonstrated. Significant reduction of microflora growth and destruction of microbial associations, good penetration of multicomponent antimicrobial gel into endodontic structures due to ultrasound compared with a standard method were achieved.