Evaluation of the effect of Irritrol as final irrigant against Staphylococcus epidermidis: an in Vitro Study.

Authors

  • Hezha Saadi Hassan Department of Conservative Dentistry, College of Dentistry, Tishik International University, Erbil, Iraq.
  • Diyar Khalid Bakr Department of Conservative Dentistry, College of Dentistry, Hawler Medical University, Erbil, Iraq.

DOI:

https://doi.org/10.15218/edj.2021.19

Keywords:

Irritrol, Antibacterial, Staphylococcus epidermidis, Disinfection

Abstract

Background and Objective: Endodontic infections are considered to be caused by the presence of various microorganisms within the root canal system. Staphylococcus epidermidis is one of the most isolated or detected species from oral infections, including marginal periodontitis, infected root canals, peri‐radicular, peri‐implantitis, and also detected in cases of failed endodontic therapy. In order to prevent endodontic treatment, failure irrigation is mandatory for the effective removal of smear, pulp tissue, smear layer,and microorganisms. The objective of the current study is to evaluate and compare the effect of Irritrol with other final irrigants regarding disinfecting root canal from S. epidermidis.
Methods: Fifty‐five single roots premolars with single canals were selected. All of the samples were infected with standard strains of Staphylococcus Epidermidis. Samples were randomly divided into five groups, and five teeth were put as a control group to be compared to the samples after disinfection. Each group consisted of 10 samples according to the type of final irrigants used during and after instrumentation: 5.25% NaOCl/ Irritrol as final irrigant G2 NaOCl 5.25% / NaOCl 5.25%, G3 Normal Saline, G4 Irritrol with activation, G5 NaOCl with activation. All samples were prepared and instrumented by using ProTaper NEXT rotary system till X3. 5.25% NaOCl was applied with a 27‐G double side‐vented syringe needle as an initial irrigant then followed by the final irrigants. Ultra X ultrasonic device was used for the activation of irrigation with a high degree of 45,000 kHz and using tip size 20# with taper of 2%. CFU of each sample was counted before irrigation regime and after the irrigation regime, and they were compared to the control group.
Results: In decreasing the amount of bacteria colonies G4 (Irritol with activation) 94% and G5 (NaOCl 5.25%), 92% of the CFU were decreased compared to the control group. Whereas, in Group 3 (Normal Saline) had the least effect on the CFU count decrease. In group 1 (Irritrol) and G2 without activation. Irritrol had less effect than NaOCl 5.25% in the amount of eliminating bacteria count.
Conclusion: Irritrol, NaOCl 5.25% with the aid of PUI, can eliminate a significant amount of bacteria in the root canal. In the future, irritrol might be able to be a promising antibacterial irrigant as well as a chelating agent.

References

Haapasalo M, Shen Y, Wang Z, Gao Y. Irrigation in endodontics. Br Dent J. 2014 Mar;216(6):299–303.

Vivacqua‐Gomes N, Ferraz CCR, Gomes BPFA, Zaia AA, Teixeira FB, Souza‐Filho FJ. Influence of irrigants on the coronal microleakage of laterally condensed gutta‐percha root fillings. Int Endod J. 2002 Sep;35(9):791–5.

Zhang K, Kim YK, Cadenaro M, Bryan TE, Sidow SJ, Loushine RJ, et al. Effects of different exposure times and concentrations of sodium hypochlorite/ethylenediaminetetraacetic acid on the structural integrity of mineralized dentin. J Endod. 2010 Jan;36(1):105–9.

Mohammadi Z, Abbott PV. The properties and applications of chlorhexidine in endodontics. Int Endod J. 2009 Apr;42(4):288–302.

Naenni N, Thoma K, Zehnder M. Soft tissue dissolution capacity of currently used and potential endodontic irrigants. J Endod. 2004 Nov;30(11):785–7.

Okino LA, Siqueira EL, Santos M, Bombana AC, Figueiredo J a. P. Dissolution of pulp tissue by aqueous solution of chlorhexidine digluconate and chlorhexidine digluconate gel. Int Endod J. 2004 Jan;37(1):38–41.

Arslan D, Guneser MB, Kustarci A, Er K, Siso SH. Pulp tissue dissolution capacity of QMix 2 in1 irrigation solution. Eur J Dent. 2015 Sep;9(3):423–7.

Küçük M, Kermeoğlu F. Efficacy of different irrigation methods on dentinal tubule penetration of Chlorhexidine, QMix and Irritrol: A confocal laser scanning microscopy study. Aust Endod J. 2019 Aug;45(2):202–8.

Niazi SA, Clarke D, Do T, Gilbert SC, Mannocci F, Beighton D. Propionibacterium acnes and Staphylococcus epidermidis Isolated from Refractory Endodontic Lesions Are Opportunistic Pathogens. Journal of Clinical Microbiology. 2010 Nov 1;48(11):3859–69.

Siqueira JF, Lima KC. Staphylococcus epidermidis and Staphylococcus xylosus in a secondary root canal infection with persistent symptoms: a case report. Aust Endod J. 2002 Aug;28(2):61–3.

Rogers KL, Fey PD, Rupp ME. Coagulase‐negative staphylococcal infections. Infect Dis Clin North Am. 2009 Mar;23(1):73–98.

George S, Kishen A, Song KP. The role of environmental changes on monospecies biofilm formation on root canal wall by Enterococcus faecalis. J Endod. 2005 Dec;31(12):867–72.

Tay FR, Gu L‐S, Schoeffel GJ, Wimmer C, Susin L, Zhang K, et al. Effect of vapor lock on root canal debridement by using a side‐vented needle for positive‐pressure irrigant delivery. J Endod. 2010 Apr;36(4):745–50.

Liu Y, Guo L, Li Y, Guo X, Wang B, Wu L. In vitro comparison of antimicrobial effectiveness of QMix and other final irrigants in human root canals. Scientific Reports [Internet]. 2015 [cited 2019 Mar 24];5. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4668572/

Niu L, Luo X, Li G, Bortoluzzi EA, Mao J, Chen J, etal. Effects of different sonic activation protocols on debridement efficacy in teeth with single‐rooted canals. J Dent. 2014 Aug;42(8):1001–9.

Di Fiore PM, Genov KA, Komaroff E, Li Y, Lin L. Nickel‐titanium rotary instrument fracture: a clinical practice assessment. Int Endod J. 2006 Sep;39(9):700–8.

Das SC, Kapoor KN. Effect of growth medium on hydrophobicity of Staphylococcus epidermidis. Indian J Med Res. 2004 Mar;119(3):107–9.

Mahdi SF, Bakr DK. Evaluation of the effect of SmearOFF on Smear Layer Removal and Erosion of Root Canal Dentin. Erbil Dental Journal (EDJ). 2019 Dec 6;2(2):269–77.

Agrawal R, Purayil TP, Ballal NV, Belle VS. Comparative evaluation of postobturation apical seal following intracanal irrigation with maleic acid or a combination of chlorhexidine and ethylenediaminetetraacetic acid: An in vitro study. Saudi Endodontic Journal. 2018 Jan 1;8(1):34. 20. Zehnder M. Root canal irrigants. J Endod. 2006 May;32(5):389–98.

Ayhan H, Sultan N, Cirak M, Ruhi MZ, Bodur H. Antimicrobial effects of various endodontic irrigants on selected microorganisms. Int Endod J. 1999 Mar;32(2):99–102.

Ringel AM, Patterson SS, Newton CW, Miller CH, Mulhern JM. In vivo evaluation of chlorhexidine gluconate solution and sodium hypochlorite solution as root canal irrigants. J Endod. 1982 May;8(5):200–4.

Siqueira JF, Rôças IN, Santos SRLD, Lima KC, Magalhães FAC, de Uzeda M. Efficacy of instrumentation techniques and irrigation regimens in reducing the bacterial population within root canals. J Endod. 2002 Mar;28(3):181–4.

Rôças IN, Siqueira JF. Comparison of the in vivo antimicrobial effectiveness of sodium hypochlorite and chlorhexidine used as root canal irrigants: a molecular microbiology study. J Endod. 2011 Feb;37(2):143–50.

van der Sluis LWM, Gambarini G, Wu MK, Wesselink PR. The influence of volume, type of irrigant and flushing method on removing artificially placed dentine debris from the apical root canal during passive ultrasonic irrigation. Int Endod J. 2006 Jun;39(6):472–6.

Nagendrababu V, Jayaraman J, Suresh A, Kalyanasundaram S, Neelakantan P. Effectiveness of ultrasonically activated irrigation on root canal disinfection: a systematic review of in vitro studies. Clin Oral Invest. 2018 Mar 1;22(2):655–70.

Cohenca N, Silva LAB, Silva RAB, Nelson‐Filho P, Heilborn C, Watanabe E, et al. Microbiological Evaluation of Different Irrigation Protocols on Root Canal Disinfection in Teeth with Apical Periodontitis: An In Vivo Study. Brazilian Dental Journal. 2013 Oct;24(5):467–73.

Forghani M, Afshari E, Parisay I, Garajian R. Effect of a passive sonic irrigation system on elimination of Enterococcus faecalis from root canal systems of primary teeth, using different concentrations of sodium hypochlorite: An in vitro evaluation. J Dent Res Dent Clin Dent Prospects. 2017;11(3):177–82.

Wilson C, Lukowicz R, Merchant S, Valquier‐Flynn H, Caballero J, Sandoval J, et al. Quantitative and Qualitative Assessment Methods for Biofilm Growth: A Mini‐review. Res Rev J Eng Technol [Internet]. 2017 Dec [cited 2020 Feb

;6( 4). Available from: https://www.ncbi.nlm.nih.g ov/pmc/articles/PMC6133255/

Sabharwal S, Sabharwal S, Bhagat SK, Bhagat SK, Gami KS, Gami KS, et al. An in vivo study to compare anti microbial activity of triantibiotic paste, 2% chlorhexidine gel, and calcium hydroxide on microorganisms in the root canal of immature teeth. Journal of International Society of Preventive and Community Dentistry. 2019 May 1;9(3):263.

Dumani A, Guvenmez HK, Yilmaz S, Yoldas O, Kurklu ZGB. Antibacterial Efficacy of Calcium Hypochlorite with Vibringe Sonic Irrigation System on Enterococcus faecalis: An In Vitro Study [Internet]. BioMed Research International. 2016 [cited 2020 Feb 15]. Available from: https://www.hindawi.com/journals/bmri/2016/8076131/

Hage W, De Moor RJG, Hajj D, Sfeir G, Sarkis DK, Zogheib C. Impact of Different Irrigant Agitation

Methods on Bacterial Elimination from Infected Root Canals. Dentistry Journal. 2019 Sep;7(3):64.

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Published

2022-02-11

How to Cite

1.
Hassan HS, Bakr DK. Evaluation of the effect of Irritrol as final irrigant against Staphylococcus epidermidis: an in Vitro Study. EDJ [Internet]. 2022 Feb. 11 [cited 2022 May 29];4(2):144-52. Available from: https://edj.hmu.edu.krd/index.php/journal/article/view/133

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