Association of calcium hypochlorite, reciprocating instrumentation and photodynamic therapy: Antimicrobial analysis and effects on root dentin structure

Introduction: This study aimed to evaluate the antimicrobial action of calcium hypochlorite(Ca[OCl]₂) and sodium hypochlorite (NaOCl) with reciprocating instrumentation and photodynamic therapy(PDT), and its influence on root dentin structure.

Methods: One hundred and ten human teeth were used to antimicrobial evaluation, inoculated with Enterococcus faecalis and divided into 11 groups (n = 10): G1 - distilled water(control); G2-1 % NaOCl; G3-5.25 % NaOCl; G4-1 % Ca(OCl)₂; G5-5.25 % Ca(OCl)₂; G6-PDT; G7-distilled water + PDT; G8-1 % NaOCl + PDT; G9-5.25 % NaOCl + PDT; G10-1 % Ca(OCl)₂+PDT; G11-5.25 % Ca(OCl)₂+PDT. In all groups, except G6, the root canals were instrumented with #R50 Reciproc file in the working length in association with tested chemical auxiliary substance. The counting of colony forming units (CFUs) was performed to calculate the bacterial percentage reduction of each group. Following, 55 bovine teeth were used to microhardness evaluation and divided into the same 11 groups (n = 5), with no instrumentation and immersion in the tested protocols. The modification of root dentin microhardness was evaluated by using the Vicker tester. Finally, 33 bovine teeth were used to organic components evaluation and divided into the same 11 groups (n = 3), with no instrumentation and immersion in the tested protocols. The modification of organic components of root dentin was evaluated by light microscopy. Specific statistical analysis was performed for each evaluation.

Results: The higher bacterial reduction was observed in groups 3,4,5,8,9,10 and 11, with no statistical difference between them (p > 0.05). The higher microhardness reduction was observed in groups 8,9,10 e 11, with no statistical difference between them (p > 0.05). The highest modification on organic components was observed in groups 3,5,9 and 11, with no statistical difference between them (p > 0.05).

Conclusions: The association of Ca(OCl)₂, reciprocating instrumentation and PDT promotes effective antimicrobial action. Moreover, lower modification was induced in microhardness and organic components of root dentin, by using Ca(OCl)₂ in low concentration associated to PDT.