CLINICAL INVESTIGATION OF ANTIMICROBIAL EFFICACY AND RESOLVIN E1 IMMUNOEXPRESSION USING CHITOSAN, N- ACETYL CYSTEINE AND CALCIUM HYDROXIDE INTRACANAL MEDICAMENTS IN APICAL PERIODONTITIS

INTRODUCTION: 

One of the primary goals of root canal treatment is to eliminate or reduce the levels of microorganisms present in root canals below a threshold compatible with the healing of periapical tissues.‘Programmed resolution’ at the tissue level involves the participation of resolvins, a type of immuno resolvents, which actively drive the resolution of inflammation.

Embracing the concept of ‘natural resolution of inflammation’ and the aim of healing through tissue regeneration, an ideal intracanal medication should possess numerous desirable properties, such as antimicrobial activity, biocompatibility, and also must be capable of promoting endogenous production of lipid mediators that actively drive the resolution of inflammation.

AIM:

The aim of the present study is to clinically investigate the antimicrobial efficacy of chitosan, N- acetyl cysteine and calcium hydroxide as intracanal medicaments and their influence on level of inflammatory mediator Resolvin E1 in apical periodontitis.

JUSTIFICATION: Only one RCT evaluating the influence of intracanal medicaments on the levels of resolvins in apical periodontitis and one RCT evaluating antimicrobial efficacy of chitosan.

METHODOLOGY:

Root canal procedure will be performed by single Post-Graduate student under strict aseptic condition with local anesthesia (2% lidocaine & epinephrine at 1:200000) and rubber dam isolation. After complete instrumentation and irrigation, the teeth will be randomly divided into three groups according to the intracanal medicaments to be used.

GROUPS:

Group I : Chitosan (n=20)

Group II: N - Acetyl cysteine (n=20)

Group III: Calcium hydroxide (n=20)

Samples for microbiological analysis and resolvin level evaluation will be done before and after intracanal medicament placement.