This study aims to correlate caries-causing microorganism load, lactic acid estimation, and blood groups to high caries risk in diabetic and non-diabetic individuals and low caries risk in healthy individuals.

This study includes 30 participants divided into 3 groups: Group A, High-risk caries diabetic individuals; Group B, High-risk caries non-diabetic individuals; and Group C, Low-risk caries individuals. The medical condition, oral hygiene, and caries risk assessment (American Dental Association classification and International Caries Detection and Assessment System scoring) were documented. Each individual’s 3 mL of saliva was analyzed for microbial load and lactic acid as follows: Part I: 2 mL for microbial quantity estimation using nutrient agar and blood agar medium, biochemical investigation, and carbohydrate fermentation tests; Part II: 0.5 mL for lactic acid estimation using spectrophotometric analysis. Among the selected individuals, blood group correlation was assessed. The χ² test, Kruskal-Wallis test, and post hoc analysis were done using Dunn’s test (p < 0.05).

Group A had the highest microbial load and lactic acid concentration, followed by Groups B and C. The predominant bacteria were Lactobacilli (63.00 ± 15.49) and Streptococcus mutans (76.00 ± 13.90) in saliva. Blood Group B is prevalent in diabetic and non-diabetic high-risk caries patients but statistically insignificant.

Diabetic individuals are more susceptible to dental caries due to high microbial loads and increased lactic acid production. These factors also lower the executing tendency of neutrophils, which accelerates microbial accumulation and increases the risk of caries in diabetic individuals.

This study aimed to investigate the efficacy of ionic and non-ionic-based contrast media (in vitro study) and the combinatorial effect of chitosan-based endo-radiopaque solution (CERS) (in vivo study) for visualization of the root canal anatomy.

In vitro study (120 teeth): The root canal of maxillary premolars and molars (in vitro group 1 and 2 respectively, n = 60 each) were analyzed using 4 different contrast media (subgroups: Omnipaque 350, Iopamidol, Xenetix 350, and Urografin 76; n = 15 each) in combination with 5.25% sodium hypochlorite (NaOCl). Based on the results of the in vitro study, in vivo study (80 teeth) was done to compare Xenetix 350 + 5.25% NaOCl with CERS (in vivo group 1 and 2 respectively, n = 40 each) on maxillary and mandibular premolars and molars. Two endodontists used radiovisiography to assess the depth of ingress and identify the aberrant root anatomy after access cavity preparation, and after initial cleaning and shaping of canals. Kruskal-Wallis test was used for in vitro comparison (p < 0.05), and Wilcoxon signed-rank test and Mann-Whitney U test for in vivo analysis (p < 0.01).

In vitro study, Xenetix 350 + 5.25% NaOCl facilitated a significant higher visualization (p < 0.05). For in vivo study, CERS had a statistically significant depth of ingress (p < 0.01), and was efficient in identifying the aberrant root canal anatomy of premolars and molars.

CERS facilitates better visualization of the root canal anatomy of human premolars and molars.