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Goncu B, Yucesan E, Basoglu H, Gul B, Aysan E, Ersoy YE. Xenotransplantation of Microencapsulated Parathyroid Cells as a Potential Treatment for Autoimmune-Related Hypoparathyroidism. EXP CLIN TRANSPLANT 2023; 21:901-912. [PMID: 34387152 DOI: 10.6002/ect.2020.0403] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES Hypoparathyroidism occurs as a part of a complex autoimmune syndrome or iatrogenically after neck surgery. The disease presents many challenges, such as hypocalcemia, hyperphosphatemia, and low/undetectable parathormone levels. Allotransplantation of parathyroid tissue or cells has been reported as a promising option to overcome these effects. Transplantation of microencapsulated parathyroid tissue or cells offers an immune escape, which particularly restores the parathyroid function for autoimmune-related hypoparathyroidism. So far, clinical and in vivo studies have demonstrated limited graft survival and instability for the available biocompatible materials. In addition, the transplant site, proper local isolation, and biocompatibility of materials are directly related to survival rate. MATERIALS AND METHODS A microencapsulated parathyroid xenotransplant model by using high guluronic acid-containing ultrapure alginate transplanted into rat omentum was tested in vivo for 1 year. RESULTS After stability of empty microcapsules was ensured, parathyroid cells were microencapsulated and transplanted in rats, with results compared versus rats with naked (nonencapsulated) parathyroid cells (both groups followed for 64 weeks). Rats remained normocalcemic, and preinflammatory cytokine levels showed dramatic changes. Despite a delay posttransplant, parathormone levels increased significantly. All retrieved microencapsules elicited pericapsular fibrotic overgrowth; however, the fibrosis area was shown to be well tolerated. CONCLUSIONS The possible role of accumulation/cell infiltration of immune response remains to be elucidated. In conjunction with this, the use of nonencapsulated parathyroid cells was also positively correlated with survival rates. A similar evaluation using ultrapure alginate materials and omental transplantation may enable the future determination for the long-term effects of correction of parathormone insufficiency in patients with severe hypocalcemic responses and other endocrine diseases.
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Affiliation(s)
- Beyza Goncu
- From the Experimental Research Center, the Vocational School of Health Services, Department of Medical Services and Techniques, Bezmialem Vakif University, Istanbul
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Solakoğlu E, Topçuoğlu HS, Düzgün S. Effect of different final irrigation agitation techniques on root canal dentin tubule penetration of nanoparticle calcium hydroxide dressing. AUST ENDOD J 2023; 49 Suppl 1:447-454. [PMID: 37144660 DOI: 10.1111/aej.12765] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 04/05/2023] [Accepted: 04/20/2023] [Indexed: 05/06/2023]
Abstract
This study is aimed to assess the efficacy of different final irrigation agitation techniques on dentin tubule penetration of nanoparticle calcium hydroxide (NCH) dressing. Ninety-six extracted upper incisors were shaped up to #40file. Then, Four experimental groups were formed according to the final irrigation procedure: conventional needle irrigation (CNI), manual dynamic agitation (MDA), sonic agitation (SA) and ultrasonic irrigant agitation (UIA). According to the intracanal drug used, these groups were divided into two subgroups: calcium hydroxide (CH) and NCH. Prepared CH preparations were labelled with Rhodamine B, and CH or NCH were placed in root canals. In the UIA group, both CH and NCH had the highest penetration depth and percentage compared to the other groups (p < 0.05). The penetration depth and percentage of NCH in the UIA and SA groups were significantly higher than in the CH groups (p < 0.05). UIA is more effective than other groups in increasing dentinal tubule penetration of CH and NCH.
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Affiliation(s)
| | | | - Salih Düzgün
- Department of Endodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
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Shamma BM, Kurdi SA, Rajab A, Arrag EA. Evaluation of antibacterial effects of different intracanal medicaments on Enterococcus faecalis in primary teeth: An in vitro study. Clin Exp Dent Res 2023; 9:341-348. [PMID: 36752174 PMCID: PMC10098284 DOI: 10.1002/cre2.718] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 01/22/2023] [Accepted: 01/26/2023] [Indexed: 02/09/2023] Open
Abstract
OBJECTIVES Successful endodontic therapy is based on the reduction of infecting bacteria by cleaning, shaping, and disinfecting of the root canal system, thus the use of intracanal dressing is necessary for optimal success of root canal treatment. This study was designed to evaluate the effect of chitosan and propolis as intracanal medicaments against Enterococcus faecalis compared to calcium hydroxide in primary root canals. MATERIAL AND METHODS Ninety-six extracted primary second molars were collected. Teeth preparation was completed to size 30 K-file. They were randomly divided into four groups; (A): chitosan, (B): propolis, (C): calcium hydroxide, and (D): control group (saline). The tooth specimens were inoculated with E. faecalis. Then, tested materials were applied for all groups in accordance to the groups each tooth belonged to. Following this, the bacterial colonies were counted after 24 h, 72 h, and 1 week of applying dressing materials and incubation. Finally, one-way analysis of variance and Fisher's least significant difference tests were used for statistical comparisons between the groups at a significance level of .05. RESULTS No statistically significant difference was found between groups A, B, and C for both 24 h and a week (p ≥ .05). Yet, a statistical difference between groups A, B, C, and D after 72 h and 1 week were seen (p ≤ .05). CONCLUSIONS Chitosan and propolis medicaments were as effective as calcium hydroxide against E. faecalis in primary root canal treatment and might be considered as an alternative dressing material between treatment sessions.
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Affiliation(s)
- Bushra Munzer Shamma
- Department of Pediatric Dentistry, Dental CollegeDamascus UniversityDamascusSyria
| | - Saleh Al Kurdi
- Department of Pediatric Dentistry, Dental CollegeDamascus UniversityDamascusSyria
| | - Anas Rajab
- Department of Organic Chemistry, Faculty of PharmacySyrian Private UniversityDaraaSyria
| | - Ettihad Abo Arrag
- Department of Pediatric Dentistry, Dental CollegeDamascus UniversityDamascusSyria
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Effect of Different Intracanal Medicaments on the Viability and Survival of Dental Pulp Stem Cells. J Pers Med 2022; 12:jpm12040575. [PMID: 35455691 PMCID: PMC9032254 DOI: 10.3390/jpm12040575] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 03/29/2022] [Accepted: 04/02/2022] [Indexed: 02/07/2023] Open
Abstract
Background: Stem cells play an important role in the success of regenerative endodontic procedures. They are affected by the presence of medicaments that are used before the induction of bleeding or the creation of a scaffold for endodontic regeneration. This study examines the effects of different intracanal medicaments on the viability and survival of dental pulp stem cells at different doses and over different exposure times. Methods: Dental pulp stem cells were cultured from healthy third molar teeth using the long-term explant culture method and characterized using flow cytometry and exposed to different concentrations of calcium hydroxide, doxycycline, potassium iodide, triamcinolone, and glutaraldehyde, each ranging from 0 (control) to 1000 µg/mL. Exposure times were 6, 24, and 48 h. Cell viability was measured using the MTT assay, and apoptosis was measured using the Annexin V-binding assay. Results: All medicaments significantly reduced cell viability at different concentrations over different exposure times. Calcium hydroxide and triamcinolone favored cell viability at higher concentrations during all exposure times compared to other medicaments. The apoptosis assay showed a significant increase in cell death on exposure to doxycycline, potassium iodide, and glutaraldehyde. Conclusion: The intracanal medicaments examined in our study affected the viability of dental pulp stem cells in a time and dose-dependent manner. They also adversely affected the survival of dental pulp stem cells. Further studies are needed to better understand the effect of prolonged exposure to medicaments according to clinical protocols and their effect on the stemness of dental pulp stem cells.
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Steroid as an Intracanal Medicament: An Advanced Review. JOURNAL OF RESEARCH IN DENTAL AND MAXILLOFACIAL SCIENCES 2021. [DOI: 10.52547/jrdms.6.3.47] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Parolia A, Kumar H, Ramamurthy S, Davamani F, Pau A. Effectiveness of chitosan-propolis nanoparticle against Enterococcus faecalis biofilms in the root canal. BMC Oral Health 2020; 20:339. [PMID: 33238961 PMCID: PMC7690148 DOI: 10.1186/s12903-020-01330-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 11/16/2020] [Indexed: 02/07/2023] Open
Abstract
Background The successful outcome of endodontic treatment depends on controlling the intra-radicular microbial biofilm by effective instrumentation and disinfection using various irrigants and intracanal medicaments. Instrumentation alone cannot effectively debride the root canals specially due to the complex morphology of the root canal system. A number of antibiotics and surfactants are being widely used in the treatment of biofilms however, the current trend is towards identification of natural products in disinfection. The aim of the study was to determine the antibacterial effect of chitosan-propolis nanoparticle (CPN) as an intracanal medicament against Enterococcus faecalis biofilm in root canal. Methods 240 extracted human teeth were sectioned to obtain 6 mm of the middle third of the root. The root canal was enlarged to an internal diameter of 0.9 mm. The specimens were inoculated with E. faecalis for 21 days. Following this, specimens were randomly divided into eight groups (n = 30) according to the intracanal medicament placed: group I: saline, group II: chitosan, group III: propolis100 µg/ml (P100), group IV: propolis 250 µg/ml (P250), group V: chitosan-propolis nanoparticle 100 µg/ml (CPN100), group VI: chitosan-propolis nanoparticle 250 µg/ml (CPN250), group VII: calcium hydroxide(CH) and group VIII: 2% chlorhexidine (CHX) gel. Dentine shavings were collected at 200 and 400 μm depths, and total numbers of CFUs were determined at the end of day one, three and seven. The non-parametric Kruskal Wallis and Mann–Whitney tests were used to compare the differences in reduction of CFUs between all groups and probability values of p < 0.05 were set as the reference for statistically significant results. The scanning electron microscope (SEM) and confocal laser scanning microscopy (CLSM) were also performed after exposure to CPNs. The effectiveness of CPNs were also evaluated against E. faecalis isolated obtained from patients having failed root canal treatment. Results The treatments of chitosan, P100, P250, CPN100, CPN250, CH and 2% CHX reduced the CFUs significantly compared to saline (p < .05). On day one and three, at 200 and 400-μm, CPN250 showed significant reduction of CFUs compared to all other groups (p < .05), while CPN100 was significantly better than other groups (p < .05) except CPN250 and 2% CHX. On day seven, at 200-μm CPN250 showed significant reduction of CFUs compared to all other groups (p < .05) except CPN100 and CHX, while at 400 μm CPN250 showed similar effectiveness as CPN100, CH and 2% CHX. SEM images showed root canal dentin treated with CPN250 had less coverage with E. faecalis bacteria similarly, CLSM images also showed higher percentage of dead E. faecalis bacteria with CPN250 than to CPN100. Conclusion CPN250 was the most effective in reducing E. faecalis colonies on day one, three at both depths and at day seven CPN250 was equally effective as CPN100 and 2% CHX.
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Affiliation(s)
- Abhishek Parolia
- Division of Clinical Dentistry, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia.
| | - Haresh Kumar
- Department of Pathology, School of Medicine, International Medical University, Kuala Lumpur, Malaysia
| | - Srinivasan Ramamurthy
- College of Pharmacy and Health Sciences, University of Science and Technology of Fujairah, Fujairah, UAE
| | - Fabian Davamani
- School of Health Sciences, International Medical University, Kuala Lumpur, Malaysia
| | - Allan Pau
- Division of Clinical Dentistry, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
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Gupta D, Kamat S, Hugar S, Nanjannawar G, Kulkarni R. A comparative evaluation of the antibacterial efficacy of Thymus vulgaris, Salvadora persica, Acacia nilotica, Calendula arvensis, and 5% sodium hypochlorite against Enterococcus faecalis: An in-vitro study. J Conserv Dent 2020; 23:97-101. [PMID: 33223650 PMCID: PMC7657435 DOI: 10.4103/jcd.jcd_48_20] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Revised: 07/14/2020] [Accepted: 07/27/2020] [Indexed: 11/19/2022] Open
Abstract
Objectives: The aim of this study is to evaluate and compare the antibacterial efficacy of Thymus vulgaris, Salvadora persica, Acacia nilotica, Calendula arvensis, and 5% sodium hypochlorite against Enterococcus faecalis. Methodology: Herbal extracts of T. vulgaris, S. persica, A. nilotica and C. arvensis were prepared. Tryptone soya broth was used to grow E. faecalis and agar plates were prepared. The tested solutions (Group A: 5% NaOCl, Group B: 20% T. vulgaris, Group C: 12.5% S. persica, Group D: 10% A. nilotica, Group E: 10% C. arvensis) were added to the wells made on agar media. Agar diffusion test was performed. Plates were incubated at 37°C for 24 h. Bacterial zones of inhibition were recorded. Results: The data were analyzed statistically by Analysis of Variance (ANOVA) and post hoc comparison by Tukey's t-test. The highest zone of inhibition against E. faecalis was shown by 5% NaOCl, followed by 10% C. arvensis, 20% T. vulgaris and 10% A. nilotica showed similar comparable antibacterial activity. The least zone of inhibition was showed by S. persica. Conclusion: 5% NaOCl showed the maximum antibacterial activity, and herbal products demonstrated significant antibacterial activity against E. faecalis and can be employed as an alternative to NaOCl.
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Affiliation(s)
- Divya Gupta
- Department of Conservative Dentistry and Endodontics, Bharati Vidyapeeth (Deemed to be) University Dental College and Hospital, Sangli, Maharashtra, India
| | - Sharad Kamat
- Department of Conservative Dentistry and Endodontics, Bharati Vidyapeeth (Deemed to be) University Dental College and Hospital, Sangli, Maharashtra, India
| | - Santosh Hugar
- Department of Conservative Dentistry and Endodontics, Bharati Vidyapeeth (Deemed to be) University Dental College and Hospital, Sangli, Maharashtra, India
| | - Girish Nanjannawar
- Department of Conservative Dentistry and Endodontics, Bharati Vidyapeeth (Deemed to be) University Dental College and Hospital, Sangli, Maharashtra, India
| | - Ravindra Kulkarni
- Department of Pharmacology, Bharati Vidyapeeth (Deemed to be) University Medical College and Hospital, Sangli, Maharashtra, India
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Antibacterial, drug delivery, and osteoinduction abilities of bioglass/chitosan scaffolds for dental applications. J Drug Deliv Sci Technol 2020. [DOI: 10.1016/j.jddst.2020.101757] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Vasudeva A, Sinha DJ, Tyagi SP, Singh NN, Garg P, Upadhyay D. Disinfection of dentinal tubules with 2% Chlorhexidine gel, Calcium hydroxide and herbal intracanal medicaments against Enterococcus faecalis: An in-vitro study. ACTA ACUST UNITED AC 2019; 38:39-44. [PMID: 29229073 DOI: 10.1016/j.sdj.2017.06.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Revised: 10/17/2016] [Accepted: 06/21/2017] [Indexed: 11/17/2022]
Abstract
AIM This in vitro study was conducted to evaluate the disinfection of dentinal tubules using 2% Chlorhexidine gel, Honey, Aloe vera gel, Curcuma longa, Propolis gel and Calcium hydroxide against Enterococcus faecalis. MATERIALS AND METHOD Two hundred and ten human mandibular first premolars were infected with Enterococcus faecalis for 21 days. Samples were divided into 7 groups. Group I- Saline (negative control), Group II- 2% Chlorhexidine gel(CHX), Group III- honey, Group IV- Aloe vera gel, Group V- 20% Curcuma longa gel, Group VI- Propolis gel and Group VII -Calcium hydroxide (CH). At the end of 1, 3 and 5 days, the antimicrobial efficacy of medicaments against E.faecalis was assessed at the depths of 200µm and 400µm. RESULTS 2% Chlorhexidine gel was most effective followed by Propolis and Curcuma longa. CONCLUSION 2% Chlorhexidine gel gave the best results. Among the herbal extracts Propolis and Curcuma longa hold a promising future but to implement their use as sole intracanal medicaments clinically, further in vivo and long term studies are warranted.
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Affiliation(s)
- Agrima Vasudeva
- Department of Conservative Dentistry and Endodontics, Kothiwal Dental College and Research Centre, Moradabad, Uttar Pradesh 244001, India.
| | - Dakshita Joy Sinha
- Department of Conservative Dentistry and Endodontics, Kothiwal Dental College and Research Centre, Moradabad, Uttar Pradesh 244001, India
| | - Shashi Prabha Tyagi
- Department of Conservative Dentistry and Endodontics, Kothiwal Dental College and Research Centre, Moradabad, Uttar Pradesh 244001, India
| | - Narendra Nath Singh
- Department of Oral Pathology and Microbiology, Kothiwal Dental College and Research Centre, Moradabad, Uttar Pradesh 244001, India
| | | | - Deepti Upadhyay
- Department of Oral Pathology and Microbiology, Buddha Institute of Dental Sciences, Patna, Bihar, India
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Erdem Hepsenoglu Y, Eyuboglu TF, Özcan M. Postoperative Pain Intensity after Single- versus Two-visit Nonsurgical Endodontic Retreatment: A Randomized Clinical Trial. J Endod 2018; 44:1339-1346. [DOI: 10.1016/j.joen.2018.05.017] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 05/24/2018] [Accepted: 05/27/2018] [Indexed: 11/15/2022]
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Navit S, Jaiswal N, Khan SA, Malhotra S, Sharma A, Mukesh, Jabeen S, Agarwal G. Antimicrobial Efficacy of Contemporary Obturating Materials used in Primary Teeth- An In-vitro Study. J Clin Diagn Res 2016; 10:ZC09-ZC12. [PMID: 27790570 DOI: 10.7860/jcdr/2016/21883.8426] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Accepted: 08/10/2016] [Indexed: 01/12/2023]
Abstract
INTRODUCTION Preservation of primary tooth with non-vital pulp has been a major problem for pediatric dentist. In such cases, the preferred treatment modality is pulpectomy. The objective of pulpectomy is complete removal of necrotic and irreversibly infected pulp of an affected tooth but, in spite of chemomechanical preparation and copious irrigation of canal, there are chances of failure of pulp therapy due to the entrapped micro organisms in the canal space owing to the tortuous and complex nature of the root canal system and change in their morphology with root resorption. Thus, for optimal success of endodontic treatment, obturating material with antimicrobial properties is advocated in deciduous teeth. AIM The aim of the study was to assess the antimicrobial efficacy of different obturating materials used in pediatric dentistry. MATERIALS AND METHODS In the present study, antimicrobial efficacy of endoflas, Zinc Oxide Eugenol (ZOE), calcium hydroxide with chlorhexidine, calcium hydroxide with iodoform and distilled water, metapex and saline as control were assessed and compared with each other. The antimicrobial efficacy of obturating materials was evaluated against E. faecalis (ATCC 29212) by agar diffusion method. The statistical analysis was done using SPSS Version 15.0. The Analysis of Variance (ANOVA) and Post-Hoc Tests (Tukey-HSD) were performed to reveal the statistical significance. RESULTS Intergroup comparison at 24 hours (Tukey's test) revealed significant difference amongst all the groups. Endoflas had significantly higher zone of inhibition as compared to all the other groups except group treated with ZOE (p-value <0.001). CONCLUSION The antimicrobial activity of obturating materials according to results obtained from the present study can be summarized as follows: Endoflas > ZOE >Calcium hydroxide + Chlorhexidine > Calcium hydroxide + Iodoform +Distilled water ~ Metapex > Saline.
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Affiliation(s)
- Saumya Navit
- Professor and Head of Department, Department of Pedodontics, Saraswati Dental College , Lucknow, Uttar Pradesh, India
| | - Neha Jaiswal
- Postgraduate Student, Department of Pedodontics, Saraswati Dental College , Lucknow, Uttar Pradesh, India
| | - Suleman Abbas Khan
- Professor, Department of Pedodontics, Saraswati Dental College , Lucknow, Uttar Pradesh, India
| | - Seema Malhotra
- Reader, Department of Pedodontics, Saraswati Dental College , Lucknow, Uttar Pradesh, India
| | - Anshul Sharma
- Senior Lecturer, Department of Pedodontics, Saraswati Dental College , Lucknow, Uttar Pradesh, India
| | - Mukesh
- Professor, Department of Orthodontics, Teerthanker Mahaveer Dental College , Moradabaad, Uttar Pradesh, India
| | - Seema Jabeen
- Postgraduate Student, Department of Pedodontics, Saraswati Dental College , Lucknow, Uttar Pradesh, India
| | - Gaurav Agarwal
- Postgraduate Student, Department of Pedodontics, Saraswati Dental College , Lucknow, Uttar Pradesh, India
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Palaniswamy U, Lakkam SR, Arya S, Aravelli S. Effectiveness of N-acetyl cysteine, 2% chlorhexidine, and their combination as intracanal medicaments on Enterococcus faecalis biofilm. J Conserv Dent 2016; 19:17-20. [PMID: 26957787 PMCID: PMC4760006 DOI: 10.4103/0972-0707.173186] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Aim: The purpose of this study was to evaluate the antibacterial efficacies of 2% chlorhexidine (CHX), N-acetyl cysteine (NAC) and assess their synergistic or antagonist action as intracanal medicament. Materials and Methods: Agar diffusion test was performed with 2% CHX, NAC, and their combination against E. faecalis planktonic cells. The diameters of the zones of bacterial inhibition were measured and recorded for each solution. The assay was further extended to 2 weeks old E. faecalis dentinal biofilm. Sixteen freshly extracted teeth were vertically sectioned into two halves resulting in a total of 32 samples. The samples were inoculated with bacterial suspension and incubated at 37°C for 2 weeks for biofilm formation. The samples were then divided into four experimental groups with 8 samples in each group. The samples were gently washed in saline and placed in culture wells containing the test solutions, i.e., 2% CHX, NAC, a combination of 2% CHX and NAC in 1:1 ratio, and a control group containing saline. The biofilm formed on the root canal surface were removed with a sterile scalpel and inoculated on blood agar plates to check for the formation of E. faecalis colonies. Statistical Analysis: For agar diffusion test, data were analyzed statistically using one-way analysis of variance and then by post-hoc Scheffe's test to compare the antimicrobial efficacy between the groups. Statistical analysis was not done for the cultures obtained from the biofilm as there was no growth in all the three test groups except the control group, i.e., saline. Results: In agar diffusion test, among the three groups tested, 2% CHX and NAC showed almost equal zones of inhibition whereas maximum inhibition was shown by a combination of NAC and 2% CHX suggesting a synergistic action. The results obtained were highly significant (P < 0.001) for the combination of medicament when compared to individual test group. In culture analysis, which was done for the biofilm, no growth was observed in all the three test groups. The results obtained were biologically significant but statistically insignificant. Conclusion: NAC has almost equal antimicrobial property as 2% CHX whereas their combination showed a synergistic action.
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Affiliation(s)
- Udayakumar Palaniswamy
- Department of Conservative and Endodontics, SVS Institute of Dental Sciences, Mahabubnagar, Telangana, India
| | - Surender Ram Lakkam
- Department of Conservative and Endodontics, SVS Institute of Dental Sciences, Mahabubnagar, Telangana, India
| | - Shikha Arya
- Department of Conservative and Endodontics, SVS Institute of Dental Sciences, Mahabubnagar, Telangana, India
| | - Swathi Aravelli
- Department of Conservative and Endodontics, SVS Institute of Dental Sciences, Mahabubnagar, Telangana, India
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Joy Sinha D, Garg P, Verma A, Malik V, Maccune ER, Vasudeva A. Dentinal Tubule Disinfection with Propolis & Two Extracts of Azadirachta indica Against Candida albicans Biofilm Formed on Tooth Substrate. Open Dent J 2015; 9:369-74. [PMID: 26962368 PMCID: PMC4763964 DOI: 10.2174/1874210601509010369] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Revised: 08/26/2015] [Accepted: 09/13/2015] [Indexed: 11/22/2022] Open
Abstract
Aim: This study evaluates the disinfection of dentinal tubules using Propolis, Azadirachta indica (alcoholic and aqueous extracts), 2% chlorhexidine gel and calcium hydroxide against Candida albicans biofilm formed on tooth substrate. Materials & Method: One hundred and five human teeth were infected with Candida albicans for 2 days. Samples were divided into 7 groups. Group I- Propolis, Group II- Alcoholic extract of Azadirachta indica, Group III- Aqueous extract of Azadirachta indica, Group IV- 2% Chlorhexidine, Group V- Calcium hydroxide, Group VI- Ethanol and Group VII- Saline (negative control). At the end of 1,3 and 5 days, the antimicrobial efficacy of medicaments against Candida albicans was assessed at the depths of 200 µm and 400 µm. Results: The overall percentage inhibition of fungal growth (at 200 µm and 400 µm depth) was 99.2% with 2% chlorhexidine gel. There was no statistical difference between propolis, alcoholic extract of Azadirachta indica (neem) and 2% chlorhexidine. Conclusion: Propolis and alcoholic extract of Azadirachta indica performed equally well as that of 2% Chlorhexidine.
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Affiliation(s)
- Dakshita Joy Sinha
- Conservative Dentistry & Endodontics, Kothiwal Dental College & Research Centre, Moradabad (U.P.)- 244001, India
| | - Paridhi Garg
- Conservative Dentistry & Endodontics, Kothiwal Dental College & Research Centre, Moradabad (U.P.)- 244001, India
| | - Anurag Verma
- School of Pharmaceutical Sciences, IFTM University, Moradabad, India
| | | | | | - Agrima Vasudeva
- Conservative Dentistry & Endodontics, Kothiwal Dental College & Research Centre, Moradabad (U.P.)- 244001, India
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14
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Saatchi M, Shokraneh A, Navaei H, Maracy MR, Shojaei H. Antibacterial effect of calcium hydroxide combined with chlorhexidine on Enterococcus faecalis: a systematic review and meta-analysis. J Appl Oral Sci 2015; 22:356-65. [PMID: 25466470 PMCID: PMC4245746 DOI: 10.1590/1678-775720140032] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Accepted: 05/15/2014] [Indexed: 11/22/2022] Open
Abstract
Objective Enterococcus faecalis (E. faecalis) is the most
frequently isolated strain in failed endodontic therapy cases since it is
resistant to calcium hydroxide (CH). Whether a combination of CH and chlorhexidine
(CHX) is more effective than CH alone against E. faecalis is a matter of
controversy. Thus, the aim of this study was to conduct a systematic review and
meta-analysis of the literature. Material and Methods A comprehensive search in PubMed, EMbase, EBSCOhost, The Cochrane Library, SciELO,
and BBO databases, Clinical trials registers, Open Grey, and conference
proceedings from the earliest available date to February 1, 2013 was carried out
and the relevant articles were identified by two independent reviewers. Backward
and forward search was performed and then inclusion and exclusion criteria were
applied. The included studies were divided into "comparisons" according to the
depth of sampling and dressing period of each medicament. Meta-analysis was
performed using Stata software 10.0. The level of significance was set at
0.05. Results Eighty-five studies were retrieved from databases and backward/forward searches.
Fortyfive studies were considered as relevant (5 in vivo, 18
in vitro, 18 ex vivo, and 4 review articles).
Nine studies were included for meta-analysis. Inter-observer agreement (Cohen
kappa) was 0.93. The included studies were divided into 21 comparisons for
meta-analysis. Chi-square test showed the comparisons were heterogeneous
(p<0.001). Random effect model demonstrated no significant difference between
CH/CHX mixture and CH alone in their effect on E. faecalis
(p=0.115). Conclusions According to the evidence available now, mixing CH with CHX does not significantly
increase the antimicrobial activity of CH against E. faecalis. It
appears that mixing CH with CHX does not improve its ex vivo
antibacterial property as an intracanal medicament against E.
faecalis. Further in vivo studies are necessary to
confirm and correlate the findings of this study with the clinical outcomes.
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Affiliation(s)
- Masoud Saatchi
- Department of Endodontics, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ali Shokraneh
- Department of Endodontics, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hooman Navaei
- Torabinejad Dental Research Center, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Reza Maracy
- Department of Biostatistics and Epidemiology, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hasan Shojaei
- Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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15
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Kim D, Kim E. Antimicrobial effect of calcium hydroxide as an intracanal medicament in root canal treatment: a literature review - Part I. In vitro studies. Restor Dent Endod 2014; 39:241-52. [PMID: 25383341 PMCID: PMC4223092 DOI: 10.5395/rde.2014.39.4.241] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Accepted: 06/14/2014] [Indexed: 11/11/2022] Open
Abstract
The goal of endodontic treatment is the prevention and control of pulpal and periradicular infections. Calcium hydroxide (Ca(OH)2) has been widely used in endodontics as an intracanal medicament to eliminate the remaining microorganisms after chemomechanical preparation. The purpose of this article is to review the antimicrobial properties of Ca(OH)2 as an intracanal medicament in root canal treatment. The first part of this review details the characteristics of Ca(OH)2 and summarizes the results of in vitro studies related to its antimicrobial effect. The antimicrobial effect of Ca(OH)2 results from the release of hydroxyl ions when it comes into contact with aqueous fluids. Ca(OH)2 has a wide range of antimicrobial effects against common endodontic pathogens, but is less effective against Enterococcus faecalis and Candida albicans. The addition of vehicles or other agents might contribute to the antimicrobial effect of Ca(OH)2.
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Affiliation(s)
- Dohyun Kim
- Microscope Center, Department of Conservative Dentistry and Oral Science Research Center, Yonsei University College of Dentistry, Seoul, Korea
| | - Euiseong Kim
- Microscope Center, Department of Conservative Dentistry and Oral Science Research Center, Yonsei University College of Dentistry, Seoul, Korea
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16
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Delgado RJR, Gasparoto TH, Sipert CR, Pinheiro CR, de Moraes IG, Garcia RB, Duarte MAH, Bramante CM, Torres SA, Garlet GP, Campanelli AP, Bernardineli N. Antimicrobial activity of calcium hydroxide and chlorhexidine on intratubular Candida albicans. Int J Oral Sci 2013; 5:32-6. [PMID: 23538639 PMCID: PMC3632761 DOI: 10.1038/ijos.2013.12] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
This study investigated the efficacy of calcium hydroxide and chlorhexidine gel for the elimination of intratubular Candida albicans (C. albicans). Human single-rooted teeth contaminated with C. albicans were treated with calcium hydroxide, 2% chlorhexidine gel, calcium hydroxide plus 2% chlorhexidine gel, or saline (0.9% sodium chloride) as a positive control. The samples obtained at depths of 0–100 and 100–200 µm from the root canal system were analyzed for C. albicans load by counting the number of colony forming units and for the percentage of viable C. albicans using fluorescence microscopy. First, the antimicrobial activity of calcium hydroxide and the 2% chlorhexidine gel was evaluated by counting the number of colony forming units. After 14 days of intracanal medication, there was a significant decrease in the number of C. albicans colony forming units at a depth of 0–100 µm with chlorhexidine treatment either with or without calcium hydroxide compared with the calcium hydroxide only treatment. However, there were no differences in the number of colony forming units at the 100–200 µm depth for any of the medications investigated. C. albicans viability was also evaluated by vital staining techniques and fluorescence microscopy analysis. Antifungal activity against C. albicans significantly increased at both depths in the chlorhexidine groups with and without calcium hydroxide compared with the groups treated with calcium hydroxide only. Treatments with only chlorhexidine or chlorhexidine in combination with calcium hydroxide were effective for elimination of C. albicans.
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17
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Pan J, Sun K, Liang Y, Sun P, Yang X, Wang J, Zhang J, Zhu W, Fang J, Becker KH. Cold plasma therapy of a tooth root canal infected with enterococcus faecalis biofilms in vitro. J Endod 2012; 39:105-10. [PMID: 23228267 DOI: 10.1016/j.joen.2012.08.017] [Citation(s) in RCA: 77] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2012] [Revised: 08/19/2012] [Accepted: 08/21/2012] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Complete sterilization of an infected root canal is an important challenge in endodontic treatment. Traditional methods often cannot achieve high-efficiency sterilization because of the complexity of the root canal system. The objective of the study was to investigate in vitro the feasibility of using a cold plasma treatment of a root canal infected with Enterococcus faecalis biofilms. METHODS Seventy single-root teeth infected with E. faecalis biofilms were divided into 7 groups. Group 1 served as the negative control group (no treatment), and group 7 was the positive control group with teeth treated with calcium hydroxide intracanal medication for 7 days. Groups 2 to 6 included teeth treated by cold plasma for 2, 4, 6, 8, and 10 minutes, respectively. The disinfection of the E. faecalis biofilm was evaluated by colony-forming unit (CFU) counting. Scanning electron microscopy was used to evaluate the structural changes of the E. faecalis biofilm before and after plasma treatment. Confocal scanning laser microscopy was used to investigate the vitality of the microorganisms in the biofilm before and after plasma treatment. RESULTS A significant decrease in the number of CFUs was observed after prolonged cold plasma treatment (based on the statistical analysis of the teeth in groups 2-6). Compared with the positive control group, cold plasma treatment of 8 or 10 minutes (groups 5 and 6) had a significantly higher antimicrobial efficacy (P < .05). The scanning electron microscopic analysis showed that the bacteria membrane was ruptured, and the structure of the biofilm was fully destroyed by the plasma. Confocal scanning laser microscopic studies indicated that the plasma treatment induced E. faecalis death and destruction of the biofilm. CONCLUSIONS The cold plasma had a high efficiency in disinfecting the E. faecalis biofilms in in vitro dental root canal treatment.
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Affiliation(s)
- Jie Pan
- Department of General Dentistry, Peking University School and Hospital of Stomatology, Beijing, China
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18
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Neelakantan P, Rao CVS, Indramohan J. Bacteriology of deep carious lesions underneath amalgam restorations with different pulp-capping materials--an in vivo analysis. J Appl Oral Sci 2012; 20:139-45. [PMID: 22666827 PMCID: PMC3894753 DOI: 10.1590/s1678-77572012000200003] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2009] [Accepted: 05/30/2010] [Indexed: 11/21/2022] Open
Abstract
Microorganisms remaining in dentin following cavity preparation may induce pulp
damage, requiring the use of pulp-capping agents with antimicrobial activity
underneath permanent restorations.
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Affiliation(s)
- Prasanna Neelakantan
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College and Hospitals, Saveetha University, Chennai, India.
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19
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Pereira MSS, Faria G, Bezerra da Silva LA, Tanomaru-Filho M, Kuga MC, Rossi MA. Response of mice connective tissue to intracanal dressings containing chlorhexidine. Microsc Res Tech 2012; 75:1653-8. [PMID: 22887775 DOI: 10.1002/jemt.22112] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2012] [Accepted: 07/13/2012] [Indexed: 11/08/2022]
Abstract
Substances containing chlorhexidine (CHX) have been studied as intracanal medicaments. The aim of the present study was to characterize the response of mouse subcutaneous connective tissue to CHX-containing medications by conventional optical microscopy. The tissue response was evaluated by implanting polyethylene tubes containing one of the substances evaluated: Calen paste + 0.5% CHX, Calen + 2% CHX, 2% CHX gel, and Calen paste (control). After experimental periods of 7, 21, and 63 days, the implants (n = 10) were removed along with the subcutaneous connective tissue. Tissue samples were subjected to histological processing, and sections were stained with hematoxylin and eosin. Qualitative and quantitative analyses of the number of inflammatory cells, blood vessels, and vascularized areas were performed. Results were analyzed by ANOVA and Tukey tests with the significance level set at 5%. We concluded that Calen + 0.5% CHX led to reparative tissue response in contrast with Calen + 2% CHX and 2% CHX gel, which induced persistent inflammatory response, pointing to the aggressive nature of this mixture. When Calen + 2% CHX and 2% CHX gel were compared, the latter induced more intense inflammatory response.
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Affiliation(s)
- Maristela Soares Swerts Pereira
- Department of Paediatric Dentistry, Preventive and Community Dentistry, Dental School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
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20
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Guerreiro-Tanomaru JM, Chula DG, de Pontes Lima RK, Berbert FLVC, Tanomaru-Filho M. Release and diffusion of hydroxyl ion from calcium hydroxide-based medicaments. Dent Traumatol 2012; 28:320-3. [DOI: 10.1111/j.1600-9657.2011.01112.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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21
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Abstract
Purpose The objective of this study was to perform an in vitro evaluation of the antibacterial properties of 6 endodontic sealers (Endomethasone C, Argoseal, Bioseal Normal, Acroseal, AH Plus, Sicura Seal). Methods The agar diffusion test (well and paper disc methods) with Enterococcus faecalis, Staphylococcus aureus and Streptococcus mutans was used. For the well method, Petri dishes were inoculated with bacterial suspensions. Each well was completely filled with freshly mixed endodontic sealer. For the paper disc method, sterile paper discs were immersed in freshly mixed sealers and put on agar plates. Diameters of halos formed around the sealers were measured after 24 h and 48 h. Statistical analysis: The effects of well method and of paper disc method were analyzed by 1-way ANOVA. Results Endomethasone C, Argoseal and Bioseal showed the largest inhibition halos for all the tested microorganisms, while Sicura Seal and AH Plus showed low antibacterial effects. Moreover, the comparison of well method and paper disc methods showed significant statistical differences (P<0,01) for all sealers and indicated a dose-dependent antimicrobial effect.
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22
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Lima RKP, Guerreiro-Tanomaru JM, Faria-Júnior NB, Tanomaru-Filho M. Effectiveness of calcium hydroxide-based intracanal medicaments against Enterococcus faecalis. Int Endod J 2011; 45:311-6. [DOI: 10.1111/j.1365-2591.2011.01976.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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23
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Vaghela DJ, Kandaswamy D, Venkateshbabu N, Jamini N, Ganesh A. Disinfection of dentinal tubules with two different formulations of calcium hydroxide as compared to 2% chlorhexidine: As intracanal medicaments against Enterococcus faecalis and Candida albicans: An in vitro study. J Conserv Dent 2011; 14:182-6. [PMID: 21814363 PMCID: PMC3146114 DOI: 10.4103/0972-0707.82625] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2010] [Revised: 09/21/2010] [Accepted: 10/05/2010] [Indexed: 11/29/2022] Open
Abstract
Aim: To evaluate the disinfection of dentinal tubules using calcium hydroxide with propylene glycol and calcium hydroxide with iodoform in silicone oil, as compared to 2% chlorhexidine gel. Materials and Methods: The antimicrobial efficacy of the medicaments against E.faecalis and C.albicans were assessed in vitro, using a dentinal tubule model at depths of 200 μm and 400 μm in extracted single rooted teeth. Saline was taken as the negative control (Group I) Results: All three medicaments used in this study exerted antibacterial and antifungal activity. Group II (calcium hydroxide with propylene glycol) and Group IV (2% chlorhexidine gel) had the highest antimicrobial activity and the differences between their antibacterial activities were not statistically significant. Group III (calcium hydroxide with iodoform in silicone oil) and Group IV had the highest antifungal activity and the differences between their antifungal activities were not statistically significant. The inhibition of growth at 200 μm and 400 μm was uniform, with no statistical difference. Conclusions: Two percent chlorhexidine gel was effective against both E.faecalis and C.albicans. Calcium hydroxide with propylene glycol was the most effective intracanal medicament along with 2% chlorhexidine against E.faecalis, whereas, calcium hydroxide with iodoform in silicone oil was the most effective intracanal medicament along with 2% chlorhexidine against C.albicans.
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Affiliation(s)
- Dakshita Joy Vaghela
- Department of Conservative Dentistry and Endodontics, Kothiwal Dental College Research Center and Hospital, Moradabad, India
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24
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Hiraishi N, Yiu CK, King NM, Tay FR. Antibacterial Effect of Experimental Chlorhexidine-releasing Polymethyl Methacrylate–based Root Canal Sealers. J Endod 2009; 35:1255-8. [DOI: 10.1016/j.joen.2009.06.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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