Effect of chemico-mechanical preparation on root canal microbiology in a resource-limited setting: A longitudinal study

ABSTRACT Background: Chemico-mechanical preparation is a crucial step in endodontic treatment, but its effectiveness in resource-limited settings is understudied. Aim: This study investigated the impact of chemico-mechanical preparation on root canal microbiology and assessed antimicrobial sensitivity of isolated microorganisms. Materials and Methods: This longitudinal study involved 40 patients undergoing root canal therapy. Microbial samples were collected during chemico-mechanical preparation and analyzed using microscopy, culture, and sensitivity tests. Results: The microbial load varied significantly at different treatment stages, while the types of organisms were not significantly different. The isolates showed resistance to co-trimoxazole and ampicillin, and sensitivity to gentamicin and nitrofurantoin. Conclusions: Chemico-mechanical preparation effectively reduces microbial load and diversity in root canals, even in resource-limited settings. The study highlights the potential benefit of using nitrofurantoin, tetracycline, and gentamicin as intracanal medications. Findings underscore the importance of chemico-mechanical preparation in endodontic treatment, suggesting a revisit of the antiseptics used as routine intracanal medications.