Comparative evaluation of antimicrobial efficacy of various intracanal medicament in young permanent teeth: An in vivo study.

INTRODUCTION: Bacteria and their byproducts are key contributors to the onset and perpetuation of pulpoperiapical pathosis. Intracanal medication is vital in achieving successful endodontic outcomes as it targets and eradicates remaining microorganisms following biomechanical preparation. AIM AND OBJECTIVE: The aim of the study was to compare and evaluate the antimicrobial efficacy of calcium hydroxide (CH) paste, triple antibiotic paste (TAP), and probiotics (PBs) as intracanal medicament in 12-17-year-old children undergoing root canal treatment for the management of infected pulpal tissues in young permanent teeth. MATERIALS AND METHODS: A total of 30 patients aged 12-17 years indicated for endodontic therapy in maxillary incisors and with no systemic complications were selected. They were randomly divided into three groups, i.e., Group I - CH group, Group II - TAP, and Group III - PB allocating 10 teeth in each group. After access opening, the first sample (S1) was collected by inserting a paper point into the root canal, the second sample (S2) was collected immediately after biomechanical preparation, and the third sample (S3) was collected after 7 days, i.e., postintracanal medication. Samples were sent for microbiological analysis to assess the microbial count, and statistical analysis was done for the obtained data. RESULTS: The three intracanal medicaments were successful in reducing the microbial counts of Enterococcus faecalis in the infected root canals. However, according to the results of the study, the PB group demonstrated greater effectiveness against E. faecalis compared to the CH group and displayed similar antimicrobial efficacy as the TAP group. CONCLUSION: PB exhibited antimicrobial efficacy comparable to TAP but greater than Ca (OH) 2 paste. Hence, PB can be utilized as an intracanal medicament in young permanent teeth.

Comparison of the efficacy of chlorhexidine varnish and chip in the treatment of chronic periodontitis.

BACKGROUND: The purpose of this study was to clinically evaluate the benefits of sub gingival chlorhexidine (CHX) varnish and biodegradable CHX chip application used as an adjunct to scaling and root planning (SRP) as combined therapy and also to compare the effect of combined therapy with SRP alone. MATERIALS AND METHODS: Fifteen patients with at least three sites with a probing pocket depth (PPD) of 5-8 mm were considered. Following baseline evaluation, all three sites were subjected for SRP. After completing SRP, each site was randomly subjected for CHX varnish, CHX chip application and the 3(rd) site was left without any medication as a control. Clinical parameters such as sulcus bleeding index, plaque index, bleeding on probing (BOP), PPD, and clinical attachment level (CAL) were recorded at baseline, 1 month and 3 months post-operatively. RESULTS: All three groups presented with an improvement in clinical parameters compared to baseline. The mean reduction in PPD was 2.4 mm in SRP sites, 2.5 mm in SRP + CHX varnish sites and 2.8 mm in SRP + CHX chip sites. The mean gain in CAL was 2.4 mm in SRP sites, 2.3 mm in SRP + CHX varnish sites and 2.8 mm SRP + CHX chip sites. INTERPRETATION AND CONCLUSION: The present study indicated that application of CHX varnish and placement of CHX chip as an adjunct to SRP produced a clinically significant reduction in the PPD, BOP and a gain in CAL at 30(th) day and 90(th) day from baseline when compared to SRP alone. The results though were not statistically significant.

Comparative evaluation of oxygen saturation levels using pulse oxymeter during nonsurgical and surgical periodontal therapy in chronic periodontitis patients.

BACKGROUND AND AIM: Monitoring is the global method of observation and data recording in relation to body organ and system function that afford constant information to ensure continuous evalutation of the patient's physical condition. Basic monitoring provides essential information for assessing the vital signs, both circulatory and respiratory, and fundamentally comprises the control of blood pressure (BP) and heart rate (HR) and rhythm. Pulse oxymetry is used to record HR and oxygen saturation. The objective of the study was to assess and compare hemodynamic changes by monitoring oxygen saturation level changes during periodontal surgical and nonsurgical therapy. MATERIALS AND METHODS: A cross-sectional observational study was conducted in 30 chronic periodontitis patients. Patients were divided into two groups; Group A consisted of 15 patients undergoing surgical periodontal therapy, Group B consisted of 15 patients undergoing nonsurgical periodontal therapy. The hemodynamic changes were evaluated by monitoring HR and oxygen saturation level using pulse oxymeter (SaO2). HR and SaO2 were monitored continuously and registered pre-operatively, i.e. 10 minutes before the procedure, intra-operatively and postoperatively, i.e. 10 minutes after the procedure. One-way analysis of variance test (ANOVA) was performed for data analysis. RESULTS: Both the groups showed a slight fall in oxygen saturation levels intraoperatively, but within the normal range. More decrease in oxygen saturation levels was observed in nonsurgical periodontal therapy as compared to surgical periodontal therapy at intraoperative levels. The differences in the values were statistically significant. There was no statistical difference seen in the postoperative and preoperative values. CONCLUSION: Most of the hemodynamic changes induced during the periodontal therapy were within normal limits, taking into consideration the anxiety and stress produced by the surgical intervention. The hemodynamic change was more in nonsurgical as compared to surgical periodontal therapy.