Comparative Evaluation of 6% Citric acid and Chitosan as irrigants on root canals of pulpectomized primary teeth. (A clinical, Radio graphical and Microbiological study)

Objectives: In primary teeth, the clinical success of pulpectomy depends on the eradication of pathogenic microorganisms from the infected canals . Thus, this study was directed to evaluate the antimicrobial effect of citric acid and chitosan in comparison with sodium hypochlorite (NaOCl) on E. faecalis. S ubjects and Methods: A total of 30 children aged between 4-7 years were included in the present study. The enrolled children had primary carious teeth that were indicated for pulpectomy treatment. The involved teeth were categorized into three main groups according to the type of irrigant solution; 6% citric acid (A), 6% chitosan (B), and 1% NaOCl (C). Then each main group was further subdivided into non-activated (A1, B1, and C1) or ultrasonic activated (A2, B2, and C2). E. faecalis count was carried out using a colony-forming unit (CFU). Results: All tested irrigants with and without activation showed a significant reduction in E. faecalis count. The ultrasonic activation significantly improves the antibacterial effect of the tested irrigant. In comparison between the tested irrigants, there was a significant difference. The higher reduction in E. faecalis count was recorded with 1% NaOCl followed by 6% chitosan. The use of 6% citric acid has a lower effect among the tested irrigants. Conclusion: Activation of irrigant solution significantly improves their antibacterial effect. chitosan has a significant effect on the reduction of E. faecalis count. Citric acid cannot be used alone as an irrigant solution.