title: The Use of Different Irrigation Techniques to Decrease Bacterial Loads in Healthy and Diabetic Patients with Asymptomatic Apical Periodontitis.
abstract: BACKGROUND
  Diabetes mellitus is a multisystem disease which weakens the human's immunity. Subsequently, it worsens the sequelae of apical periodontitis by raising a fierce bacterial trait due to the impaired host response.
  
  
  OBJECTIVE
  This study aimed to estimate bacterial reduction after using different irrigation techniques in systemically healthy and diabetic patients with asymptomatic apical periodontitis.
  
  
  METHODS
  Enterococcus faecalis,Peptostreptococcus micros, andFusobacterium necleatumbacteria were chosen, as they are the most common and prevailing strains found in periodontitis. Bacterial samples were retrieved from necrotic root canals of systemically healthy and diabetic patients, before and after endodontic cleaning and shaping by using two different irrigation techniques; the conventional one and the EndoVac system. Quantitive polymerase chain reaction (qPCR) was utilised to detect the reduction in the bacterial count.
  
  
  RESULTS
  The EndoVac irrigation system was effective in reducing bacteria, especiallyPeptostreptococcus microsin the diabetic group when compared to conventional irrigation technique with a statistically significant difference.
  
  
  CONCLUSIONS
  The EndoVac can be considered as a promising tool in combination with irrigant solution to defeat the bacterial colonies living in the root canal system. Additional studies ought to be done to improve the means of bacterial clearance mainly in immune-compromised individuals.
authors.affiliation: Endodontics Department, National Research Centre, Cairo, Egypt.
authors.forename: Mai
authors.initials: M
authors.lastname: Ghoneim
authors.affiliation: Endodontics Department, Faculty of Dentistry, Ain Shams University, Cairo, Egypt.
authors.forename: Shehab ElDin
authors.initials: SE
authors.lastname: Saber
authors.affiliation: Orodental Genetics Department, National Research Centre, Cairo Egypt.
authors.forename: Tarek
authors.initials: T
authors.lastname: El-Badry
authors.affiliation: Endodontics Department, Faculty of Dentistry, Ain Shams University, Cairo, Egypt.
authors.forename: Maram
authors.initials: M
authors.lastname: Obeid
authors.affiliation: Orodental Genetics Department, National Research Centre, Cairo Egypt.
authors.forename: Nehal
authors.initials: N
authors.lastname: Hassib
keywords: Diabetes mellitus; Endovac; Irrigation; endodontic bacteria; qPCR