Evaluation of intracanal medications associated with N-acetyl cysteine on microorganisms, LPS and LTA present in primary endodontic infections

Abstract

This randomized clinical trial will evaluate in teeth with pulp necrosis and apicalperiodontitis (PA) the antimicrobial activity and the effect on endotoxins andlipotheicoic acid (LTA) of treatment protocols using different intracanalmedications. For this, 45 teeth of patients with primary endodontic infection andPA will be selected and prepared using a single reciprocating file and irrigationwith 2.5% sodium hypochlorite. After instrumentation, the channels will be filledfor 14 days with intracanal medications to be evaluated: calcium hydroxide(Ca(OH)2) + saline (n = 15); Ca(OH)2 + N-acetylcysteine (NAC) (n = 15); andchlorhexidine (CHX) + NAC (n = 15). Microbiological and endotoxin sampleswill be collected from the channels after coronary opening (S1), afterbiomechanical preparation (S2) and after intracanal medication for furtheranalysis of antimicrobial activity by microbiological culture and quantification ofendotoxins (EU / mL) by the Amebocyte Lysate test of Limulus - (LAL) andquantification of LTA by the enzyme-linked immunosorbent assay (ELISA). Thedata obtained will be subjected to statistical analysis Kolmogorov-Smirnov andLilliefors, Kruskal-Wallis and Dunn, and Friedman and Dunn Statiscal tests ofnormality.