Comparative evaluation of antimicrobial efficacy of bioactive glass, 1% chlorhexidine gluconate with calcium hydroxide and 1% chlorhexidine gluconate, as intracanal medicament in primary molars: An in vivo study

Abstract

Aims: To compare the antimicrobial efficacy of Bioactive glass, combination of 1% Chlorhexidine gluconate gel and Calcium hydroxide powder and 1% Chlorhexidine gluconate gel as intracanal medicament in primary molars.Settings and Design: In vivo study design Methods and Material: The present study was conducted in the Department of Pediatric and Preventive Dentistry, Krishnadevaraya College of Dental Sciences and Hospital, Bengaluru. This study included 48 subjects within the age group ranging from 4-11 years who were indicated for multi visit Pulpectomy. These subjects were randomly divided into three experimental groups, containing sixteen samples per group. Group 1: Bioactive glass; Group 2:1% Chlorhexidine gel and Calcium hydroxide powder; Group 3:1% Chlorhexidine gel. Under rubber dam isolation, following lesion sterilization S0 sample was obtained. Following access opening and working length, sample S1 was obtained and the respective medicament was placed inside the canals after cleaning and shaping and a double seal was done with ZOE and GIC. Patient was recalled after a period of 5 to 7 days and the medicaments were flushed under isolation and sample S2 was obtained. Pulpectomy procedure was then completed. S0, S1, S2 samples were subjected to microbiological analysis and the total bacterial count in CFU/ml was calculated.Statistical analysis used: Kruskal Wallis Test and One-way ANOVA.Results: The mean percentage of reduction of bacterial count from S1- S2 (Before and after placement of medicament) with Group 1: Bioactive glass was 75.7%, with Group 2:1% Chlorhexidine gluconate and calcium hydroxide was 52% and Group 3:1% Chlorhexidine gluconate was 28.6%, revealing that bioactive glass has the superior antibacterial efficacy when compared with other groups. Antibacterial efficacy of bioactive glass was significant in both primary maxillary and mandibular first molar and second molar proving it to work best for all types of root anatomy in mixed dentition population. Superior clinical and microbiological results were found when bioactive glass was used as intracanal medicament in both intraoral and extra oral abscess cases in primary molars.Conclusions: Bioactive glass; intracanal medicament; primary dentition; primary molar; mixed dentition.