Antimicrobial Efficacy of Tubulicid Red as a Cavity Disinfectant in Comparison with Chlor-X Gel against S. mutans in Primary Teeth: Randomised Split-mouth Clinical Study

Abstract

Introduction: Microorganisms act as precursors to dental caries. Following cavity preparation, traces of resident bacteria in the smear layer may contribute to the recurrence of caries. Thus, eliminating the underlying causes improves the likelihood of treatment success. Disinfectants are adjuvant tools that should focus on removing microorganisms when combined with procedures that yield positive outcomes. Aim: To compare and evaluate the antimicrobial efficacy of Tubulicid Red (TR) Label as a cavity disinfectant with Chlor X gel (2% chlorhexidine) in primary teeth. Materials and Methods: The present randomised double-blind clinical trial was conducted at the Department of Paediatric and Preventive Dentistry, GSL Dental College and Hospital, YSRUHS, Rajahmundry, Andhra Pradesh, India from September 2021 to April 2022. The study assessed the antimicrobial efficacy of TR label against S. mutans in 60 primary carious teeth involving 1/3rd of the dentin. The teeth were divided into two groups, each consisting of 30 teeth. Group-I received TR Label, while Group-II received Chlor X. After excavating the infected dentine, the affected dentine was left in the cavity, and a dentinal sample was collected from the base of the cavity. The cavity was then disinfected with either TR or Chlor X gel, followed by rinsing with saline. A second sample was collected from the base of the same cavity. The collected samples were transferred to Eppendorf tubes and subjected to microbiological analysis to calculate the number of Colony-forming Units (CFU) of S. mutans on Mutans Sanguis (MS) agar medium. The obtained data were subjected to statistical analysis using the Wilcoxon’s’s signedrank test and Mann-Whitney test. Results: In the intragroup comparison (Wilcoxon’s signedrank test), both groups showed significant reductions in S. mutans count (p<0.001). The intergroup comparison showed no statistically significant difference (p>0.05) between the Tubulicid and Chlor X groups at baseline and post-treatment. Conclusion: The TR could be used as an alternative to Chlor X gel as a cavity disinfectant in primary teeth before restoration, potentially reducing the occurrence of secondary caries.