Microbiome Changes After Laser and Chlorhexidine Disinfection in Caries Removal

Condition(s) studied

Investigational drug(s) / intervention(s)

CHX disinfection: Each CHX cavity will be treated with disinfectant with a disposable micro brush tip and left undisturbed for 20 seconds. They will then be air-dried for 10 seconds and restore the tooth.

Laser Disinfection: After the caries removal procedure, the cavity will be disinfected using an Er,Cr: YSGG laser (EPIC X™, BIOLASE, USA) with 940 nm and 0.1 W output power. The laser tip will be a 400 µm tip with an energy density of 138.12 J/cm in non-contact mode (2 mm distance), 5 s/mm2 sweeping motion.

Tungsten carbide bur: Carious tissue will be completely removed from the surrounding cavity walls with a tungsten carbide bur, leaving at least 2 mm of peripheral intact tooth structure for good adaptation and sealing of the restoration.

Polymer bur: Access to the lesion will be achieved using a high-speed handpiece with a sterile high-speed bur. The polymer bur will be used with a low-speed handpiece at 5,000-10,000 RPM to remove carious dentin in sizes RA4, RA6, and RA8 according to the size of the caries lesion. The instrument will be used with a circular, light force starting from the center of the carious lesion towards the periphery as recommended by the manufacturer. Caries removal will be stopped when the instrument is macroscopically worn and blunt and can no longer remove tissue. An excavator will be used to verify if any caries remain at the base of the cavity. If necessary, a new polymer bur will be used to remove the remaining decay.

Study summary

The aim of this study was to investigate the effects of cavity disinfection with laser and chlorhexidine on the microbiome in cavities prepared using different caries removal methods.

Eligibility

Primary outcome measure(s)

• Microbiome Changes — 3 months
  In all groups, dentin samples will be taken from the affected dentin at the base of the cavity as a result of three different subgroup disinfection procedures applied after the caries removal method using 2 sterile number 6 round sterile steel roun burs moistened with saline for microbial analysis. The burs will be placed in 5 ml sterile vials and stored at -80 0C until the analyses are performed. The prepared cavities will be completed with routine and standard treatment protocols. Following the finishing and polishing procedures, occlusion will be checked. The samples collected during the research process will be delivered to the A\&D Genetic Diseases Evaluation Centre (Ankara, Turkey) where DNA isolation and sequence analysis will be performed together with molecular biologists. In the method, following the extraction of total genomic DNA from clinical samples, broad-range 16S rRNA PCR will be performed and MicroSeq 500 16S rRNA Sequencing kit will be used for sequence analysis.

Trial sites (1)

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