EVALUATION OF ANTIBACTERIAL EFFICACY OF VARIOUS GEL FORMULATIONS WHEN USED AS AN INTRACANAL MEDICAMENT IN PRIMARY MOLARS - AN IN VIVO STUDY

Abstract

Introduction: The success of root canal treatment is mainly based on the complete eradication of microorganisms by instrumentation and disinfection protocols followed during the procedure. Due to anatomical complexities like lateral canals, achieving long term success would be difficult because these areas have limited access to instruments and irrigants. Hence, application of intracanal medicament has been considered as an important step to reduce the persistent bacterial load inside the root canal. Since the routine intracanal solutions have the limited time for action so gels were used in the study to increase the time of action and reduce the bacterial load. Aims and Objectives: To evaluate antibacterial efficacy of various gel formulations when used as an intracanal medicament in primary molars. Material and Method: Carious primary molars with adequate coronal tooth structure were selected and randomly allotted to 4 different groups-2% Metronidazole gel (Positive control), 2% Chlorhexidine gel, 2% Povidone-iodine gel and no medication group (Negative control). Selected tooth was anaesthetized and isolated using rubber dam. Access opening was done and canals were negotiated and biomechanical preparation was done using K-files upto #35 with frequent irrigation in between with normal saline. Pre-operative sample was taken using a paper point (#30) and was transported to lab in vial containing brain-heart infusion broth. Intracanal medicament was placed using a syringe in all the canals. Cotton pellet was placed on top of it and temporary restoration was placed. Bacterial culture of the sample was done on blood agar and colony forming units were counted. Patients were recalled after 3 days and second sample was taken immediately after removing the temporary restoration and cotton pellet using paper points and was sent for culture. Root canals were irrigated, obturated and teeth were restored with permanent restorative material. Results: Percentage reduction of colony forming units was calculated. Results were obtained and statistical analysis was performed using one-way ANOVA and Tukey's post-hoc test. Betadine group showed the best result among all four groups. Conclusion: On comparing the mean of pre-operative and post-operative CFUs, it was concluded that metronidazole, betadine and chlorhexidine showed a significant difference while no medication group showed non-significant difference.