Aim: The aim of the ex vivo study was to assess the efficacy of 17% ethylenediaminetetraacetic acid (EDTA) with 2.5% sodium hypochlorite (NaOCl), 1% peracetic acid (PAA), and ozonated water in mesiobuccal (MB) canals with curved mandibular molars infected with Candida albicans, Streptococcus mutans, and Enterococcus faecalis and to compare with normal saline irrigation.
Materials and methods: A total of 240 mandibular molars were selected. The WaveOne Gold (WOG) primary reciprocating system was used to prepare the MB canals. The selected teeth were allocated randomly into 12 groups, 20 in each group. Based on the microbiological strains, irrigants were employed following the instrumentation of the tooth. Microbiological samples were collected prior to instrumentation and also following the irrigation after instrumentation. The load of the microbes was measured using the colony-forming units (CFU/mL). The paired t-test and one-way analysis of variance (ANOVA) were used to evaluate the data, followed by Tukey's post hoc test.
Results: The tested irrigants demonstrated a significant decrease (p < 0.001) in CFU/mL following the irrigation after instrumentation compared to the saline group. However, PAA, ozonated water, and EDTA with NaOCl showed statistically insignificant differences from each other in the mean reduction of microbial loads. The positive control (17% EDTA with 2.5% NaOCl) had a mean reduction of 90.75%; test groups PAA and ozonated water produced a reduction of 90.31 and 91.11%, respectively, against E. faecalis; while the saline group showed the least reduction in microbial counts (3.84%).
Conclusion: According to the findings of this study, chemomechanical preparations incorporating irrigants such as PAA and ozonated water could be as beneficial as EDTA and NaOCl in reducing microbial content in root canal therapy.
Clinical significance: Microbial lysis results from the oxidative action of PAA and ozonated water on cell membranes. These irrigants have better applicability and rather encouraging results, and they could be an important therapeutic tool for endodontists.
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