Antimicrobial efficacy of silver diamine fluoride in comparison to photodynamic therapy and chlorhexidine on canal disinfection and bond strength to radicular dentin

Eisha Abrar; Mustafa Naseem; Qaiser Ali Baig; Fahim Vohra; Ahmed M Maawadh; Thamer Almohareb; Mohammed Q AlRifaiy; Tariq Abduljabbar

doi:10.1016/j.pdpdt.2020.102066

Antimicrobial efficacy of silver diamine fluoride in comparison to photodynamic therapy and chlorhexidine on canal disinfection and bond strength to radicular dentin

Photodiagnosis Photodyn Ther. 2020 Dec:32:102066. doi: 10.1016/j.pdpdt.2020.102066. Epub 2020 Oct 19.

Authors

Eisha Abrar¹, Mustafa Naseem², Qaiser Ali Baig³, Fahim Vohra⁴, Ahmed M Maawadh⁵, Thamer Almohareb⁶, Mohammed Q AlRifaiy⁷, Tariq Abduljabbar⁸

Affiliations

¹ MDS Trainee Department of Operative Dentistry, Dow International Dental College, Pakistan. Electronic address: eisha.abrar@duhs.edu.pk.
² Department of Community and Preventive Dentistry, Dow International Dental College, Pakistan. Electronic address: Mustafa.naseem@duhs.edu.pk.
³ Department of Community and Preventive Dentistry, Dow International Dental College, Pakistan. Electronic address: qaiser.ali@duhs.edu.pk.
⁴ Prosthetic Dental Science Department, College of Dentistry, King Saud University, Saudi Arabia. Electronic address: fvohra@ksu.edu.sa.
⁵ Restorative Dental Science Department, College of Dentistry, King Saud University, Riyadh, Saudi Arabia. Electronic address: amaawadh@ksu.edu.sa.
⁶ Restorative Dental Science Department, College of Dentistry, King Saud University, Riyadh, Saudi Arabia. Electronic address: talmohareb@ksu.edu.sa.
⁷ Prosthetic Dental Science Department, College of Dentistry, King Saud University, Saudi Arabia. Electronic address: dental_dean@ksu.edu.sa.
⁸ Prosthetic Dental Science Department, College of Dentistry, King Saud University, Saudi Arabia. Electronic address: tajabbar@ksu.edu.sa.

PMID: 33091618
DOI: 10.1016/j.pdpdt.2020.102066

Abstract

Aim: To assess the antimicrobial efficacy of Silver diamine fluoride (SDF), Sodium hypochlorite (NaOCl), Chlorhexidine (CHX) and Photodynamic therapy (PDT) in radicular dentin and subsequent bond strength of Fiber reinforced composite post (FRCP) to radicular dentin.

Material and methods: Forty extracted premolars were disinfected and decoronated up-to cement-o-enamel junction (CEJ). Canals were instrumented using crown-down technique, dried and filled with gutta percha. Post space was prepared with the help of peso reamers and inoculated with E. faecalis. Samples were randomly allocated into four groups based on chemical irrigation (n = 10). Group 1, canal disinfected with (PDT, MB), group 2 (5.25 % NaOCl +17 % EDTA), group 3 (3.8 % SDF) and group 4 (CHX). Specimens were tested with confocal laser scanning microscopy analysis (CLSM) to confirm the presence of E. faecalis. Fibre post were luted in root canal and sectioned at three levels (apical, middle and coronal). Push-out test was performed and failure analysis of debonded surfaces was evaluated using stereomicroscope. Live and dead cells after exposure were calculated in percentage. One-way analysis of variance (ANOVA) assessed the means and standard deviations of extrusion bond strength (EBS). Tukey multiple comparison tests was used to compare means of bond strength (p = 0.05).

Results: The maximum antimicrobial efficacy against E. faecalis was observed in group 2 which included canal disinfected with 5.25 % NaOCl and 17 % EDTA (64.41 ± 1.22). Similarly, CHX showed lowest effectiveness as canal irrigant against E.faecalis (58.29 ± 2.41). Intragroup comparison revealed highest bond strength for group 2 at all three level. Similarly, the lowest EBS was found in CHX group. Inter-group comparison confirmed comparable EBS at all root levels (apical, middle and coronal) for group 2 and group 3 (p > 0.05).

Conclusion: Radicular dentin treated with 5.25 % NaOCl and 17 % EDTA displayed highest antimicrobial and bond strength scores. SDF and PDT can potentially be used in canal irrigation.

Keywords: Confocal laser scanning microscopy; Extrusion bond strength; Photodynamic therapy; Silver diamine fluoride.

MeSH terms

Chlorhexidine* / pharmacology
Dental Pulp Cavity
Dentin
Disinfection
Fluorides, Topical
Photochemotherapy* / methods
Photosensitizing Agents / pharmacology
Quaternary Ammonium Compounds
Root Canal Irrigants
Root Canal Preparation
Silver Compounds
Sodium Hypochlorite / pharmacology

Substances

Fluorides, Topical
Photosensitizing Agents
Quaternary Ammonium Compounds
Root Canal Irrigants
Silver Compounds
silver diamine fluoride
Sodium Hypochlorite
Chlorhexidine