ANTIMICROBIAL EFFICIENCY OF INTRACANAL MEDICAMENT AGAINST E. FAECALIS BACTERIA IN INFECTED PRIMARY MOLARS BY USING REAL-TIME PCR: A RANDOMOMIZED CLINICAL TRIAL

1. ANTIMICROBIAL EFFICIENCY OF
INTRACANAL MEDICAMENT
AGAINST E. FAECALIS BACTERIA IN
INFECTED PRIMARY MOLARS BY
USING REAL-TIME PCR: A
RANDOMOMIZED CLINICAL TRIAL.
Yasamin Ghahramani , Najmeh
Mohammadi , Ahmed Gholami And
Ahmed Ghaffaripour.

2. INTRODUCTION
 Along with mechanical
instrumentation and
irrigation, icm is used for
complete sterilization of
canal.
 Caoh and triple antibiotic
paste are commonly used.
 Faecalis is the most
resistant bacteria specie.

3. AIM OF STUDY
 Purpose of study was to
compare the antimicrobial
efficacy of TAP and CH
against faecalis bacteria.

4. MATERIAL
AND
METHODS
Study design: randomized clinical
trial.
Sample size: 39 patients.
Distribution of sample : randomly
divided into 3 groups
1. group1(n= 13): CaOH paste
2.group 2(n=13): TAP
3. group3(n=13):control group.
Statistical analysis: SPSS software,
ANOVA followed by Tukeys test
and t- test.

5. MATERIAL AND METHODS
Inclusion Criteria
•39 children.
•Age: 4-6 years.
•Infected primary
maxillary and
mandibular molars.
•Clinically: exposure
of pulp with caries
and fistula.
Exclusion Criteria
•Radiographical sign of
resorption.
•Mobile teeth.
•Involvement of
permanent tooth bud
•History f taking
antibiotics.

7. COLLECTION
OF SAMPLE
After 7 days , canals were irrigated and (S2)
was collected.
Either CH or TAP was applied and cavity
was sealed(ZnO2E).
Canals were prepared with K-fie.
Transferred to test tube containing 2ml (BHI
broth).
Following access cavity preparation, first
microbial sample (S1) were collected by
inserting absorbent paper point.

8. MICROBIOLOGICAL PROCEDURES
Test tubes preincubated
at 37 C for 24 hrs.
Transferred to tryptic soy
broth.
Microbial count was
achieved via real time
PCR.
DNA EXTRACTION:
genomic DNA was isolated
by using bacterial genomic
DNA isolation kit.
PCR CONDITIONS: 95 C for
5min and then 50 cycles of 95
C for15s, 60 C for 30 s and 72 C
for 20 s.

9. RESULTS
ANOVA showed that mean count of E. Faecalis were homogenous
before ICM paced, however 3 groups were significantly different at
S2.

10. RESULTS
• Tukey s test showed E. faecalis bacteria count decreased significantly
in treatment group compared with control group(P<0.001).
• Yet 2 treatment groups(TAP AND CH) were not significantly
different.

11. DISCUSSION
Study shows necessity of topical application of
ICM in primary teeth.
More recent study showed that none of the ICM
completely eliminate aerobic and facultative
anaerobic microorganism, this opened new door
of research.
Present study was limited pioneer studies because
of its clinical nature on deciduous teeth.
E. Faecalis were found to be resistant to caoh,
while it was reported that primary teeth treated
with TAP were more successful.
Study detected significant reduction of bacterial
count between S1 and S2 in all study groups.

12. DISCUSSION
Similar study using PCR shows CH and
TAP significantly reduce bacteria,
however they observed no significant
difference two medicaments.
Investigations found higher efficacy of
TAP.
PCR used in present study is one of the
most sensitive technique for
quantification of microbial specie that are
difficult to culture.

13. DISCUSSION
STRENGTH
•In vivo study: can be
applied to clinical
practice.
•True randomization
eliminates biasness from
study.
•It gives option of further
study in comparison of
different ICM.
LIMITATIONS
•Small sample size
•Short term follow up.

14. CONCLUSION
It was concluded that both TAP and
CH have significant antimicrobial
effect between treatment session in
infected primary teeth.

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17. THANK YOU