A comparative study on the disinfection potentials of bioactive glass S53P4 and calcium hydroxide in contra‐lateral human premolars ex vivo

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Abstract
Aim  To evaluate the effects of bioactive glass S53P4 versus calcium hydroxide when used as dressings in contra‐lateral human premolars infected with Enterococcus faecalis ATCC 29212.Methodology  Pairs of contra‐lateral premolar teeth plus single control premolars were obtained from 23 individuals aged 10–26 years undergoing orthodontic treatment. Root canals of teeth with fully formed apices (nine contra‐lateral pairs, seven controls) were instrumented using a size 60 FlexoFiles 2 mm short of canal length. Canals with open apices (six contra‐lateral pairs, four controls) were circumferentially instrumented using a FlexoFile. Root canals were rinsed with 1% sodium hypochlorite and 10% citric acid. Teeth were then suspended in tryptic soy broth (TSB) and autoclaved. Positive controls and study teeth were infected with E. faecalis ATCC 29212 for 2 weeks in TSB, while negative controls were kept in sterile TSB. Subsequently, contra‐lateral premolars were dressed with bioactive glass S53P4 (BAG) or calcium hydroxide suspensions for 10 days. Dentine samples were obtained from teeth with fully formed apices using ISO‐size 70, 80 and 90 FlexoFiles to working length and cultured. Teeth with open apices were fixed, fractured and examined using scanning electron microscopy (SEM).Results  Calcium hydroxide had a strong antibacterial effect and was significantly more effective than BAG in preventing residual bacterial growth (P < 0.01). SEM analysis revealed apparent substance‐specific modes of action.Conclusions  Calcium hydroxide was an effective disinfectant in human teeth.

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