Quantitative Assessment of the Efficacy of Two Irrigation Activation Systems

Aim of the present study was to determine the intraradicular microbiota of previously root canal-treated teeth with apical periodontitis using droplet digital polymerase chain reaction (ddPCR) and to investigate the antibacterial effectiveness of different irrigation activation methods [ XP-endo Finisher and EndoActivator ] that will make classical chemomechanical preparation more effective. This superiority, parallel, randomized clinical trial was conducted in the clinic of the Endodontic Department, Faculty of Dentistry, Istanbul Medipol University, Istanbul. 20 patients with posttreatment apical periodontitis (one tooth each) were randomly allocated into two groups according to the used (n=10, for each): the EA group (A) or the XPF group (B). Total bacterial loads, as well as the amount of Enterococcus faecalis (E.faecalis) were determined before (S1) and after (S2) chemomechanical preparation and finally, after intracanal medication (S3) by means of ddPCR.

Inclusion Criteria:root canal-treated teeth exhibiting clinical and radiographic evidence of chronic apical periodontitis lesions.Teeth with post-treatment apical periodontitis had endodontic therapy completed more than 2 years earlier and required retreatment.Radiographically, the diameter of the periapical radiolucency ranged from 2 to 7 mm.Termini of the root canal fillings ranged from 0-4 mm short of the radiographic apex, with no overfilling.The teeth had intact coronal restorations, with no obvious exposure of the root-filling material to the oral cavity.Selected teeth had enough crown structure for adequate isolation with a rubber dam and showed an absence of periodontal pockets or attachment level deeper than 4 mm.Exclusion Criteria:teeth from patients who had received antibiotics within the previous 3 months or who had any general disease, teeth that could not be properly isolated with rubber dam, teeth with absence of coronary sealing, teeth with periodontal pocket depth >4 mm; and teeth with crown/root fracture. Only one tooth was included from each patient.