International Journal of Clinical Pediatric Dentistry

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VOLUME 15 , ISSUE S1 ( Special issue-1 (Pediatr Endodont), 2022 ) > List of Articles


Assessment of Bacterial Load Using 3.8% SDF as an Irrigant in Pulpectomized Primary Molars: A Randomized Controlled Trial

Viral Maru, Dimple Padawe, Shilpa Naik, Vilas Takate, Kishor Sarjeraodighe, Sayali Mali

Keywords : 3.8% SDF, Endodontic irrigation, NaOCl, Primary molars

Citation Information :

DOI: 10.5005/jp-journals-10005-2130

License: CC BY-NC 4.0

Published Online: 28-02-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Aim and objective: The aim of the present study was to evaluate the reduction in bacterial loading using 3.8% as an irrigating solution in pulpectomized primary molars. Study design: A randomized, controlled clinical trial was performed that included primary molars with pulp necrosis. Sixty necrotic canals were included, 30 irrigated with 3.8% SDF (experimental group) and 30 with 1% NaOCl solution (control group); in all cases, two microbiological samples from within the canals were taken with sterile paper points, the first after the canal opening and before the first irrigation, and the second after instrumentation and final irrigation, before obturation. All samples were evaluated by Agar plate method. Results: The results were statistically analyzed by student “t“ test. After analyzing samples before and after irrigation in the control group (NaOCl), we found a strong significant decrease of bacterial load (p = < 0.001). The same occurred in the 3.8% SDF group samples (p = < 0.001). When both groups were compared post irrigation, a statistically significant difference was observed in favor of 3.8 % SDF. Conclusion: 3.8% SDF can be suggested as an alternative irrigant for pulpectomy of necrotic teeth.

  1. Aminabadi NA, Farahani RM, Gajan EB. Study of root canal accessibility in human primary molars. J Oral Sci 2008; 50(1):69–74. DOI: 10.2334/josnusd.50.69
  2. Medici MC, Froner IC. A scanning electron microscopic evaluation of different root canal irrigation regimes. Braz Oral Res 2006;20:235-240. DOI: 10.1590/s1806-83242006000300010
  3. Zehnder M, Kosicki D, Luder H, et al. Tissue dissolving capacity and antimicrobial effect of buffered and unbuffered hypochlorite solutions. Oral Surg Oral Med Oral Radiol Endod 2002;94:756–762. DOI: 10.1067/moe.2002.128961
  4. Hulsmann M, Hahn W. Complications during root canal irrigation: literature review and case reports. Int Endod J 2003;33:186–193. DOI: 10.3390/ma14102580
  5. Gernhardt CR, Eppendorf K, Kozlowski A, et al. Toxicity of concentrated sodium hypochlorite used as an endodontic irrigant. Int Endod J 2004;37:272-280. DOI: 10.1111/j.0143-2885.2004.00804.x
  6. Bohora A, Hegde V, Kokate S. Comparison of antibacterial efficacy of neem leaf extract and 2% sodium hypochlorite against E. faecalis, C. albicans and mixed culture — An in vitro study. Endodontology 2010;22:8–12.
  7. Kandaswamy D, Venkateshbabu N. Root canal irrigants. J Conserv Dent 2010;13:256–264. DOI: 10.4103/0972-0707.73378
  8. Vinod BM, Koppolu M, Nuvulla S, et al. Anti-microbial efficiency of silver diamine fluoride as an endodontic medicament – An ex vivo study. Contemp Clin Dent 2012;3(3):262–264. DOI: 10.4103/0976-237X.103615
  9. Noriko H, Cynthia KYY, Nigel MK, et al. Antimicrobial Efficacy of 3.8% Silver Diamine Fluoride and Its Effect on Root Dentin. J Endod 2010;36(6):1026–1029. DOI: 10.1016/j.joen.2010.02.029
  10. Vahid Z, Hadi M, Mehrdad L, et al. A scanning electron microscope study on the effect of an experimental irrigation solution on smear layer removal. Iran Endod J 2014;9(2):131–136.
  11. Frais S, Ng YL, Gulabivala K. Some factors affecting the concentration of available chlorine in commercial sources of sodium hypochlorite. Int Endod J 2001;34(3):206–215. DOI: 10.1046/j.1365-2591.2001.00371.x
  12. Hiraishi N, Yiu CK, King NM, et al. Antimicrobial efficacy of 3.8% silver diamine fluoride and its effect on root dentin. J Endod 2010 36:1026–1029. DOI: 10.1016/j.joen.2010.02.029
  13. Landis JR, Koch G. The measurement of observer agreement for categorical data Biometrics 1977;33:159–174. DOI: 10.2307/2529310
  14. Carlsson J, Sundqvist G. Evaluation of methods of transport and cultivation of bacterial specimens from infected dental root canals. Oral Surg Oral Med Oral Pathol 1980;49(5):451–454. DOI: 10.1016/0030-4220(80)90290-x
  15. Manzur A, Gonzalez AM, Pozos A, et al. Bacteria quantification in teeth with apical periodontitis related to instrumentation and different intracanal medications: a randomized clinical trial. J Endod 2007;33:114–118. DOI: 10.1016/j.joen.2006.11.003
  16. Siqueira JF Jr, Rocas IN. Catonella morbid and Granulicatella adiancodens: new species in endodontic infections. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006;102:259–264.
  17. Elizabeth M, Mangala AN, Nicholas A. Jacques Neil Hunter. Quantitative microbiological study of human carious dentin by culture and real-time PCR: Association of anaerobes with histopathological changes in chronic pulpitis. Clin Microbiol 2002;40 (5):1698-1704.
  18. Ounsi HF, Debaybo D, Salameh Z, et al. Endodontic considerations in pediatric dentistry: A clinical perspective. Int Dent South Afr 2009;11:40–50.
  19. Berk H, Krakow AA. A comparison of the management of pulpal pathosis in deciduous and permanent teeth. Oral Surg Oral Med Oral Pathol 1972;34(6):944–955. DOI: 10.1016/0030-4220(72)90232-0
  20. Mehdipour O, Kleier DJ, Averbach R. Anatomy of sodium hypochlorite accidents. Compendium of continuing education in dentistry (1995)2007;28(10): 544–546.
  21. Gatot A, Arbelle J, Leiberman A, et al. Effects of sodium hypochlorite on soft tissues after its inadvertent injection beyond the root apex. J Endod 1991;17(11):573–574.
  22. Siqueria JF, Machado AG, Silveria RM, et al. Evaluation of the effectiveness of sodium hypochlorite used with three irrigation methods in the elimination of Enterococcus Faecalis from root canals in vitro. Int Endod J 1997;30:279–282. DOI: 10.1046/j.1365-2591.1997.00096.x
  23. Craig GG, Powell KR, Cooper MH. Caries progression in primary molars: 24-month results from a minimal treatment programme. Community Dent Oral Epidemiol 1981;9(6):260–265. DOI: 10.1111/j.1600-0528.1981.tb00342.x
  24. Mei ML, Ito L, Cao Y, et al. The inhibitory effects of silver diamine fluorides on cysteine cathepsins. J Dent 2014;42(3):18–27. DOI: 10.1016/j.jdent.2013.11.018
  25. Suzuki T, Nishida M, Sobue S, et al. Effects of diamine silver fluoride on tooth enamel S. J Osaka Univ Dent Sch 1974 14: 61–72.
  26. Tanaka M. The effect of Silver Fluoride Applied in Pulp-removed Root Canal. J Osaka Univ Dent Soc. 1970;15: 34–47.
  27. Okamoto E, Kutsuna H, Nakamura Y. Effect of Diammine Silver Fluoride on Treatment of Infected Root Canal Part 1. On the Number of Treatments Required far Root Canal Filling. Nippon Dent Rev. 1971; 343:625–626.
  28. Mathew VB, Madhusudhana K, Sivakumar N, et al. Anti-microbial efficiency of silver diamine fluoride as an endodontic medicament - An ex vivo study. Contemp Clin Dent 2012;3(3):262–264. DOI: 10.4103/0976-237X.103615
  29. Sauvik G, Shubharata P, Sagar P, et al. Stretching new boundaries of caries prevention with Silver Diamine Fluoride: A review of literature. Int J Pedod Rehabil 2018;3:1–4. DOI: 10.4103/ijpr.ijpr_32_17
  30. Ng YL, Spratt D, Sriskantharajah S, et al. Evaluation of protocols for field contamination before bacterial sampling of root canals for contemporary microbiology techniques. J Endod 2003;29:317–320. DOI: 10.1097/00004770-200305000-00001
  31. Siqueira JF Jr, Rocas IN, Favieri A, et al. Chemomechanical reduction of the bacterial population in the root canal after instrumentation and irrigation with 1%, 2.5% and 5.25% sodium hypochlorite. J Endod 2000;26:331–334. DOI: 10.1097/00004770-200006000-00006
  32. Siqueira JF Jr, Rocas IN, Santos SR, et al. Efficacy of instrumentation techniques and irrigation regimes I reducing the bacterial population within root canals. J Endod 2002;28:181–184. DOI: 10.1097/00004770-200203000-00009
  33. Estrela CR, Estrela C, Reis C, et al. Control of microorganisms in vitro by endodontic irrigants. Braz Dent J 2003;14:187–192. DOI: 10.1590/s0103-64402003000300009
  34. Camara AC, de Albuquerque MM, Aguiar CM, et al. In vitro antimicrobial activity of 0.5%, 1% and 2.5% sodium hypochlorite in root canals instrumented with the Protaper Universal system. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009;108:e55–e61. DOI: 10.1016/j.tripleo.2009.03.037
  35. D Arcangelo C, Varvara G, de Fazio P. An evaluation of the action of different root canal irrigants on facultative aerobicanareobic, obligate anaerobic and microaerophilic bacteria. J Endod 1999;25:351–353. DOI: 10.1016/S0099-2399(06)81170-2
  36. Naenni N, Thoma K, Zehnder M. Soft tissue dissolution capacity of currently used and potential endodontic irrigants. J Endod 2004;30(11):785–787. DOI: 10.1097/00004770-200411000-00009
  37. Baumgartner JC, Cuenin PR. Efficacy of several concentrations of sodium hypochlorite for root canal irrigation. J Endod 1992;18: 605–612.
  38. Beltz RE, Torabinejad M, Pouresmail M. Quantitative analysis of the solubilizing action of MTAD, sodium hypochlorite and EDTA on bovine pulp and dentin. J Endod 2003;29:334–337. DOI: 10.1097/00004770–200305000-00004
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