The onset and persistence of endodontic infections due to residual biofilm after chemical\ndisinfection promotes secondary bacterial infection. Alternative methods to disinfect operated root\ncanals are a matter of great interest. The aim was to evaluate the antibacterial effectiveness of\nsodium hypochlorite (NaOCl) at low concentrations activated by the Er,Cr:YSGG laser-activated\nirrigation (LAI) against 10-day-old intracanal Enterococcus faecalis biofilm. Biofilms were formed\ninside the root canals and divided into 7 groups (n13): 0.5% NaOCl + Er,Cr:YSGG; Saline +\nEr,Cr:YSGG; 0.5% NaOCl + syringe irrigation(SI); 2.5% NaOCl + SI; 5% NaOCl + SI; positive and\nnegative controls. Bacterial survivors were counted and specimens visualized under scanning\nelectron and confocal laser scanning microscopy. Treatments with 0.5% NaOCl + Er,Cr:YSGG and\n2.5% NaOCl + SI gave a significant reduction in the number of CFU/mm2. Moreover, scanning\nelectron microscopy and confocal laser scanning microscopy imaging confirmed and reinforced\nbacteriological data. Thus, Er,Cr:YSGG LAI proved to be able to improve the intracanal distribution\nof 0.5% NaOCl after 60 s of activation, reaching the same level of effectiveness than 2.5% NaOCl.\nThis is regarded as of clinical interest, since working with lower concentrations may contribute to\nreduce undesired effects.
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