Different Disinfection Protocols for Pulp Revitalization: An In Vitro Study

Pulp revitalization is a procedure indicated for immature teeth with pulp necrosis. This study aimed to investigate the microbial load reduction of four cleaning protocols for pulp revitalization: Prophylactic Brush for canal (MK Life), microbrush Aplik Extrafine (Angelus), n. 50 K file (Dentsply) and XP Endo Finisher (FKG).

Fifty single-rooted mandibular premolars were standardized in canal size and diameter. Contamination by E. faecalis was induced for 21 days in 50 specimens, where 48 were used for the experimental groups (n=12) and 2 were used as a negative control to validate the sterilization process before contamination. Irrigation with saline solution at 36.5°C was performed, where the mechanical resource for cleaning was varied (n=12). Colony counting (CFU) was performed before (S1) and after (S2) the cleaning procedure. Kruskal Wallis accounted for and analyzed the differences between S2 and S1.

Prophylactic Brush for the canal reduced 99.27% of the microbial load, followed by XP Endo Finisher (99.13%), Aplik microbrush (98.71%) and K file (98.66%). (p=0.3616). There was no statistical difference in the reduction of microbial load between the groups tested.

The mechanical cleaning methods tested alone were effective in substantially reducing the microbial load of E. faecalis on lower premolars by simulating open apex teeth and showed that bristle instruments such as Prophylactic Brush for Canal and microbrush Aplik Extrafine could be used to accomplish mechanical debridement of large canals.