(PR06) Effectiveness of GentleWave System and Passive Ultrasonic Irrigation with Minimally Invasive and Conventional Instrumentation Technique Against Enterococcus Faecalis Lipoteichoic Acid (LTA) in Infected Root Canals

Abstract: Enterococcus faecalis is gram-positive bacteria known to be resistant to root canal treatment. Lipoteichoic acid (LTA) is a major virulence factor of E. faecalis that plays a major role in the inflammatory response involved in apical periodontitis. The GentleWave® System (GWS) is a novel approach to endodontic treatment using fluid dynamics and acoustic energy to debride root canals. There is limited evidence of the effectiveness of GWS in root canal disinfection. In this study, we evaluated the ability of the GWS to remove E. faecalis LTA from infected root canals after minimally invasive (MIT) and conventional instrumentation (CIT) techniques. Secondly, we investigated the ability of passive ultrasonic irrigation (PUI) to disinfect E. faecalis LTA after MIT and CIT. Finally, we compared GWS versus PUI in E. faecalis LTA disinfection. Sixty extracted human maxillary premolars were inoculated with E. faecalis LTA. Teeth were randomly divided into the following experimental groups: GWS + MIT, GWS + CIT, PUI + MIT, and GWS + CIT. Samples were collected before (s1) and after a root canal procedure (s2) and after cryogenically ground for intraradicular analysis (s3). LTA was quantified using LTA ELISA kit. Results showed that PUI + CIT was more effective than PUI + MIT (p < .05) but less effective than GWS + MIT and GWS + CIT (p < .05). The GWS + MIT and GWS + CIT protocols were the most effective in disinfecting E. faecalis LTA from infected root canals.