(PR080) Comparative Evaluation of Lipoteichoic Acid (LTA) Removal From Infected Root Canals by GentleWave or Laser-Activated Irrigation

Advances in technology have introduced adjuncts in the chemomechanical debridement of canals. Among these, laser-activated irrigation (LAI) and multi-sonic irrigation such as the GentleWave system (GSW) have been shown to promote the disinfection of root canal systems and the removal of Lipoteichoic Acid (LTA) in vitro studies. However, it is unknown if these adjuncts are effective in removing LTA from infected canals in the clinical setting. Thus, we hypothesized that the GWS promotes a greater reduction of LTA compared to needle irrigation and LAI. To test this hypothesis, we performed a single-blinded randomized clinical trial including patients with teeth diagnosed with pulp necrosis and symptomatic apical periodontitis undergoing non-surgical root canal treatment. Patients were randomized to either needle, Gentle Wave, or Laser-Assisted irrigation. The root canal systems were sampled with paper points for LTA levels pre-operatively and after irrigation with one of the standardized protocols. The concentration of LTA was determined using an ELISA test for human LTA following well-established protocols, and statistical significance was determined by one-way ANOVA with Bonferroni’s post hoc test set at p< 0.05. LTA was detected in all canals, and the chemomechanical preparation greatly reduced its levels in all groups, with the greatest removal observed in the Gentle Wave system group. Collectively, these results support the use of adjunct irrigation methods not only in the disinfection of canals but also in detoxification, resulting in the removal of antigenic molecules that could be responsible for flare-ups and persistent inflammation.