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Nassar R, Nassar M, Senok A, Williams D. Phytic Acid Demonstrates Rapid Antibiofilm Activity and Inhibits Biofilm Formation When Used as a Surface Conditioning Agent. Microbiol Spectr 2023; 11:e0026723. [PMID: 37191582 PMCID: PMC10269681 DOI: 10.1128/spectrum.00267-23] [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: 01/17/2023] [Accepted: 04/24/2023] [Indexed: 05/17/2023] Open
Abstract
Root canal infections are associated with biofilms and are treated with chemical irrigants with a high success rate. However, treatment failure does arise, which is attributed primarily to resistance exhibited by biofilms. Currently used irrigants in root canal treatment have disadvantages, and there is therefore a need for more biocompatible alternatives with antibiofilm properties to reduce root canal treatment failure and complications. The aim of this study was to evaluate the in vitro antibiofilm properties of phytic acid (IP6), which is a potential alternative treatment agent. Single- and dual-species biofilms of Enterococcus faecalis and Candida albicans were developed on the well surfaces of 12-well plates and on hydroxyapatite (HA) coupons, and then exposed to IP6. In addition, selected HA coupons were preconditioned with IP6 before biofilm development. IP6 demonstrated bactericidal effects and altered the metabolic activity of biofilm cells. Confocal laser-scanning microscopy showed that IP6 caused significant and rapid reduction in live biofilm cells. At sublethal concentrations, IP6 did not alter the expression of tested virulence genes except for C. albicans hwp1, the expression of which was upregulated but not reflected by a change in hyphal transformation. IP6-preconditioned HA coupons led to extensive inhibition of dual-species biofilm formation. The results of this study highlight for the first time the antibiofilm inhibitory properties of IP6 and the potential for its exploitation in several clinical applications. IMPORTANCE Root canal infections are biofilm associated, and despite mechanical and chemical treatment procedures, infection recurrence occurs, and this is likely due to the high tolerance of associated biofilms to antimicrobials. The currently used treatment agents have several disadvantages, which necessitates the search for new improved agents. In this study, the natural chemical phytic acid was found to exhibit antibiofilm activity against established mono and dual mature biofilms over a short contact time. Most importantly, phytic acid was found to cause significant inhibition of dual-species biofilm formation when used as a surface preconditioning agent. The findings of this study identified a novel use of phytic acid as a potential antibiofilm agent that can be used in several clinical applications.
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Affiliation(s)
- Rania Nassar
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
- School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, United Kingdom
| | - Mohannad Nassar
- Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Abiola Senok
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - David Williams
- School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, United Kingdom
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Kumari M, Sarkar B, Mukherjee K. Nanoscale calcium oxide and its biomedical applications: A comprehensive review. BIOCATALYSIS AND AGRICULTURAL BIOTECHNOLOGY 2022. [DOI: 10.1016/j.bcab.2022.102506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Li F, Ren L, Chen R, Sun X, Xu J, Zhu P, Yang F. Assessing Efficacy of Clinical Disinfectants for Pathogenic Fungi by Single-Cell Raman Microspectroscopy. Front Cell Infect Microbiol 2022; 12:772378. [PMID: 35281452 PMCID: PMC8905662 DOI: 10.3389/fcimb.2022.772378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 01/24/2022] [Indexed: 11/29/2022] Open
Abstract
Disinfectants are crucial for root canal therapy (RCT), as metabolism of canal-inhabiting microbes can cause refractory infections. To develop effective yet patient- and environment-friendly disinfectant formulations, we quantitatively assessed the metabolism-inhibiting effects of intracanal disinfectants via D2O-probed Single-Cell Raman Spectra (SCRS), using Candida albicans (C. albicans) as a pathogen model. For chlorhexidine gluconate (CHX), sodium hypochlorite (NaClO), and hydrogen peroxide (H2O2), at their MIC of 4, 168, and 60 μg/ml, respectively, despite the complete growth halt, metabolic activity of individual fungal cells was reduced on average by 0.4%, 93.9%, and 94.1% at 8 h, revealing a “nongrowing but metabolically active” (NGMA) state that may underlie potential refractory infections, particularly for CHX. In contrast, at their Metabolic Activity-based Minimum Inhibitory Concentrations (MIC-MA) of 8, 336, and 120 μg/ml, respectively, metabolic activity of all cells was completely halted throughout 8 h exposure. Moreover, combined use of NaClO+H2O2 (combination at 0.5× MIC-MA each) outperforms solo uses of CHX, NaClO, H2O2, or other binary combinations. Furthermore, dynamics of SCRS revealed distinct fungicidal mechanisms of CHX, NaClO, H2O2, and their pairwise combinations. MIC-MA is advantageous in critically assessing antifungal efficacy, and NaClO+H2O2 can potentially serve as a more efficient disinfectant formula for fungal pathogens.
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Affiliation(s)
- Fan Li
- Stomatology Center, Qingdao Municipal Hospital, Qingdao, China
- School of Stomatology, Qingdao University, Qingdao, China
- Department of Pediatric Dentistry, School and Hospital of Stomatology, Tianjin Medical University, Tianjin, China
| | - Lihui Ren
- Single-Cell Center, Chinese Academy of Science Key Laboratory of Biofuels, Shandong Key Laboratory of Energy Genetics, Shandong Energy Institute, Qingdao New Energy Shandong Laboratory, Qingdao Institute of Bioenergy and Bioprocess Technology, Chinese Academy of Sciences, Qingdao, China
- University of Chinese Academy of Sciences, Beijing, China
- College of Information Science & Engineering, Ocean University of China, Qingdao, China
| | - Rongze Chen
- Single-Cell Center, Chinese Academy of Science Key Laboratory of Biofuels, Shandong Key Laboratory of Energy Genetics, Shandong Energy Institute, Qingdao New Energy Shandong Laboratory, Qingdao Institute of Bioenergy and Bioprocess Technology, Chinese Academy of Sciences, Qingdao, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Xi Sun
- College of Biological Engineering, Tianjin Agricultural University, Tianjin, China
- Tianjin Engineering Research Center of Agricultural Products Processing, Tianjin Agricultural University, Tianjin, China
| | - Jian Xu
- Single-Cell Center, Chinese Academy of Science Key Laboratory of Biofuels, Shandong Key Laboratory of Energy Genetics, Shandong Energy Institute, Qingdao New Energy Shandong Laboratory, Qingdao Institute of Bioenergy and Bioprocess Technology, Chinese Academy of Sciences, Qingdao, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Pengfei Zhu
- Single-Cell Center, Chinese Academy of Science Key Laboratory of Biofuels, Shandong Key Laboratory of Energy Genetics, Shandong Energy Institute, Qingdao New Energy Shandong Laboratory, Qingdao Institute of Bioenergy and Bioprocess Technology, Chinese Academy of Sciences, Qingdao, China
- University of Chinese Academy of Sciences, Beijing, China
- *Correspondence: Fang Yang, ; Pengfei Zhu,
| | - Fang Yang
- Stomatology Center, Qingdao Municipal Hospital, Qingdao, China
- School of Stomatology, Qingdao University, Qingdao, China
- *Correspondence: Fang Yang, ; Pengfei Zhu,
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Jadhav G, Mittal P, Kalra D. Effect of two different volumes of sodium hypochlorite on endodontic treatment outcome following single-visit root canal treatment: A split-mouth, double-blind, randomized controlled trial. ENDODONTOLOGY 2022. [DOI: 10.4103/endo.endo_10_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Nassar R, Nassar M, Vianna ME, Naidoo N, Alqutami F, Kaklamanos EG, Senok A, Williams D. Antimicrobial Activity of Phytic Acid: An Emerging Agent in Endodontics. Front Cell Infect Microbiol 2021; 11:753649. [PMID: 34765567 PMCID: PMC8576384 DOI: 10.3389/fcimb.2021.753649] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 09/30/2021] [Indexed: 01/15/2023] Open
Abstract
Background Phytic acid (IP6) is a promising and emerging agent, and because of its unique structure and distinctive properties, it lends itself to several applications in dentistry. Recently, IP6 was proposed as a potential chelating agent in endodontics. However, there is limited knowledge regarding its antimicrobial and antibiofilm effectiveness. The aims of this study, were therefore to evaluate the antimicrobial and antibiofilm activities of IP6 against a range of microbial species and compare these with ethylenediaminetetraacetic acid (EDTA) and sodium hypochlorite (NaOCl). The contact time required for IP6 to exert its bactericidal effect on Enterococcus faecalis was also determined. Methods The inhibitory and biocidal activities of IP6, EDTA and NaOCl were assessed using a broth microdilution assay against 11 clinical and reference strains of bacteria and a reference strain of Candida albicans. The contact time required for various IP6 concentrations to eliminate planktonic cultures of E. faecalis was determined using a membrane filtration method according to BS-EN-1040:2005. IP6 bactericidal activity was also evaluated using fluorescent microscopy, and the antibiofilm activity of the test agents was also determined. Results IP6 was biocidal against all tested microorganisms. At concentrations of 0.5%, 1% and 2%, IP6 required 5 min to exert a bactericidal effect on E. faecalis, while 5% IP6 was bactericidal after 30 s. IP6 also eradicated biofilms of the tested microorganisms. In conclusion, IP6 had notable antimicrobial effects on planktonic and biofilm cultures and exhibited rapid bactericidal effects on E. faecalis. This research highlighted, for the first time the antimicrobial and antibiofilm properties of IP6, which could be exploited, not only in dental applications, but also other fields where novel strategies to counter antimicrobial resistance are required.
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Affiliation(s)
- Rania Nassar
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates.,Oral and Biomedical Sciences, School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, United Kingdom
| | - Mohannad Nassar
- Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Morgana E Vianna
- Oral and Biomedical Sciences, School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, United Kingdom
| | - Nerissa Naidoo
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Fatma Alqutami
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Eleftherios G Kaklamanos
- Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Abiola Senok
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - David Williams
- Oral and Biomedical Sciences, School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, United Kingdom
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Karataş E, Kirici DÖ, Arslan H. Postoperative Pain After the use of Sodium Hypochlorite gel and Solution Forms: A Randomized Clinical Study. Eur Endod J 2021; 6. [PMID: 33531449 PMCID: PMC8056817 DOI: 10.14744/eej.2020.08370] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 11/08/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The present study aimed to compare the effect of sodium hypochlorite (NaOCl) gel and solution forms on postoperative pain level. METHODS Fifty-two patients were divided into two groups according to the root canal irrigation solution. In the NaOCl solution group, the root canals were irrigated with 2 mL of 5.25% NaOCl between each pecking motion. In the NaOCl gel group, 5.25% NaOCl gel was used according to the manufacturer's instructions. The root canal treatments were completed and the participants were given instructions to record postoperative pain levels on 24, 48, and 72 hours and 1 week after treatment using VAS. RESULTS Intergroup analyses revealed that the NaOCl gel group resulted in significantly less postoperative pain than the NaOCl solution group on day 1. CONCLUSION It can be concluded that using NaOCl gel during root canal preparation results in less postoperative on day 1 when compared with the NaOCl solution.
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Affiliation(s)
- Ertuğrul Karataş
- From the Department of Endodontics, Faculty of Dentistry, Atatürk University, Erzurum, Turkey
| | - Damla Özsu Kirici
- Department of Endodontics, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
| | - Hakan Arslan
- From the Department of Endodontics, Faculty of Dentistry, Atatürk University, Erzurum, Turkey
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Yilmaz Ş, Yoldas O, Dumani A, Guler G, Ilgaz S, Akbal E, Oksuz H, Celik A, Yilmaz B. Calcium hypochlorite on mouse embryonic fibroblast cells (NIH3T3) in vitro cytotoxicity and genotoxicity: MTT and comet assay. Mol Biol Rep 2020; 47:5377-5383. [PMID: 32623618 DOI: 10.1007/s11033-020-05624-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 06/26/2020] [Indexed: 10/23/2022]
Abstract
Antimicrobial irrigation solutions are widely used under clinical settings. Their effect on dental tissue is a subject of recent research, which aims for a safer irrigant for clinical use. In this regard, here our goal was to evaluate the cytotoxicity and the genotoxicity of calcium hypochlorite (Ca(OCl)2) solution, along with NaOCl, on Mouse embryonic fibroblast cells (NIH3T3). First, Cells were treated either with NaOCl or Ca(OCl)2 in a time- and dose-dependent manner for cytotoxicity by 3-(4,5-dimethylthiazolyl-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay, then cell viability was calculated according to cell proliferation plots. Secondly, genotoxicity was assessed by Comet assay. Data were statistically analyzed by Tukey's test (P < .05). NaOCl and Ca(OCl)2 had similar effects on cellular viability at 3 and 6 h treatments. Cell viability of Ca(OCl)2 at concentrations of 0.0125%, 0.025%, 0.05%, or 0.125% was significantly lower than that of NaOCl at 24 h treatment (P < .05).Comparing Ca(OCl)2 and NaOCl treatments at all time points and concentrations, the damaged cell number of Ca(OCl)2 was almost fourfold higher than that of NaOCl. In conclusion, both, NaOCl and Ca(OCl)2 solutions were cytotoxic and genotoxic to NIH3T3, however, Ca(OCl)2 had a significantly higher damaged cell percentage than NaOCl at all time points and concentrations investigated.
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Affiliation(s)
- Şehnaz Yilmaz
- Department of Endodontics, Faculty of Dentistry, Cukurova University, Adana, Turkey
| | - Oguz Yoldas
- Department of Endodontics, Faculty of Dentistry, Cukurova University, Adana, Turkey
| | - Aysin Dumani
- Department of Endodontics, Faculty of Dentistry, Cukurova University, Adana, Turkey
| | - Gizem Guler
- Department of Biology, Faculty of Science and Letters, Mersin University, Mersin, Turkey
| | - Seda Ilgaz
- Department of Medical Biology, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - Eylül Akbal
- Department of Medical Biology, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - Hale Oksuz
- Department of Medical Biology, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - Ayla Celik
- Department of Biology, Faculty of Science and Letters, Mersin University, Mersin, Turkey.
| | - Bertan Yilmaz
- Department of Medical Biology, Faculty of Medicine, Cukurova University, Adana, Turkey
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Marek E, Łagocka R, Kot K, Woźniak K, Lipski M. The influence of two forms of chlorhexidine on the accuracy of contemporary electronic apex locators. BMC Oral Health 2019; 20:3. [PMID: 31892327 PMCID: PMC6938632 DOI: 10.1186/s12903-019-0994-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 12/19/2019] [Indexed: 11/23/2022] Open
Abstract
Background Accurate determination of working length (WL) is crucial for the success of endodontic therapy. The aim of this study was to determine the influence of 2% chlorhexidine digluconate solution, 2% chlorhexidine digluconate gel and 2% hypochlorite solution on the accuracy of two devices: the Raypex 5 and the ApexDal. Methods Twenty-nine single-rooted human teeth were used in this study. The crowns were cut horizontally and embedded in an alginate mass. In each tooth, six endodontic measurements were made using two electronic apex locators (EALs): a Raypex 5 and an ApexDal. For each EAL, measurements were taken with the following products: 2% chlorhexidine solution (CHX-S group), 2% chlorhexidine gel (CHX-G group) and 2% NaOCl (NaOCl group). After performing an endodontic measurement, the endodontic instruments were stabilized with flow resin composite. Afterwards, the roots were removed from the alginate mass, and the apical one-third of each root was cut lengthways to recover the canal system. Last, the distance between the file tip and the apical foramen was measured under a microscope at 60 x magnification. Results Statistically significant differences were found between CHX-S and NaOCl and CHX-G and NaOCl, but no significant differences were detected between CHX-S and CHX-G during the testing of both devices. No statistically significant differences were observed between the Raypex 5 and ApexDal for all intracanal media tested. Conclusion The EALs Raypex 5 and ApexDal had higher accuracy in the anatomical foramen of the root containing chlorhexidine in the gel or in the solution form than in the canal containing sodium hypochlorite.
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Affiliation(s)
- Ewa Marek
- Department of Preclinical Conservative Dentistry and Preclinical Endodontics, Pomeranian Medical University, Al. Powstańców Wielkopolskich 72, 70-111, Szczecin, Poland.
| | - Ryta Łagocka
- Department of Conservative Dentistry, Pomeranian Medical University, Al. Powstańców Wielkopolskich 72, 70-111, Szczecin, Poland
| | - Katarzyna Kot
- Department of Preclinical Conservative Dentistry and Preclinical Endodontics, Pomeranian Medical University, Al. Powstańców Wielkopolskich 72, 70-111, Szczecin, Poland
| | - Krzysztof Woźniak
- Department of Orthodontics, Pomeranian Medical University, Al. Powstańców Wielkopolskich 72, 70-111, Szczecin, Poland
| | - Mariusz Lipski
- Department of Preclinical Conservative Dentistry and Preclinical Endodontics, Pomeranian Medical University, Al. Powstańców Wielkopolskich 72, 70-111, Szczecin, Poland
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Verma N, Sangwan P, Tewari S, Duhan J. Effect of Different Concentrations of Sodium Hypochlorite on Outcome of Primary Root Canal Treatment: A Randomized Controlled Trial. J Endod 2019; 45:357-363. [PMID: 30827769 DOI: 10.1016/j.joen.2019.01.003] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 11/23/2018] [Accepted: 01/02/2019] [Indexed: 10/27/2022]
Abstract
INTRODUCTION The aim of this study was to evaluate the effect of 2 different concentrations of sodium hypochlorite on healing and postoperative pain after primary endodontic treatment. METHODS One hundred mandibular molars with pulp necrosis and chronic apical periodontitis were randomly assigned to 2 treatment groups: high-concentration (HC) 5% sodium hypochlorite and low-concentration (LC) 1% sodium hypochlorite. Root canal treatment was performed using a standardized protocol. Canals were prepared using equal volumes of respective irrigants after each instrument change. After chemomechanical preparation, the final flush was performed with 5 mL 17% EDTA solution followed by 5 mL 5% or 1% sodium hypochlorite depending on the group. All patients were asked to record the degree of pain on a visual analog scale every 24 hours for 1 week. At the second visit, canals were obturated, and the teeth were restored permanently. Clinical and radiographic evaluations were performed every 3 months for 12 months. The data collected were statistically analyzed. RESULTS Eighty-six teeth were available for evaluation at the 1-year follow-up. The overall healing rate observed was 76.7%. Greater healing was observed in the HC (81.4%) group compared with the LC group (72.1%), but the difference was not statistically significant (P > .05). No significant differences in pain incidence and pain scores were found between the 2 groups (P >.05), with lower values reported in the LC group. CONCLUSIONS The use of LC or HC sodium hypochlorite did not result in a significant difference in the clinical outcome.
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Affiliation(s)
- Neha Verma
- Post Graduate Institute of Dental Sciences, Rohtak, Haryana, India
| | - Pankaj Sangwan
- Post Graduate Institute of Dental Sciences, Rohtak, Haryana, India.
| | - Sanjay Tewari
- Post Graduate Institute of Dental Sciences, Rohtak, Haryana, India
| | - Jigyasa Duhan
- Post Graduate Institute of Dental Sciences, Rohtak, Haryana, India
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El-Sayed H, Aly Y, Elgamily H, Nagy MM. A Promising Probiotic Irrigant: An In Vitro Study. Open Access Maced J Med Sci 2019; 7:407-411. [PMID: 30834012 PMCID: PMC6390147 DOI: 10.3889/oamjms.2019.074] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 12/01/2019] [Accepted: 12/02/2019] [Indexed: 01/12/2023] Open
Abstract
AIM: The present study aimed to investigate the inhibitory effect of Lactobacillus rhamnosus (B-445) as a probiotics irrigant on the growth of Enterococcus faecalis. METHODS: Forty-two extracted single human canal anterior teeth were prepared with rotary instrumentation and sterilised. Teeth were divided into 3 groups according to the type of irrigant, N = 14. Three experimental groups were inoculated with E. faecalis and cultured for 21 days before use; Group 1 was 2.5% NaOCl (positive control), Group 2 was saline (negative control), Group 3 was the experimental probiotic irrigant. Paper point sampling of the canals of each group was obtained before irrigation (S1), immediately after irrigation (S2) and after 24 hours (post irrigation samples) (S3) to determine remaining colony forming units for E. faecalis. Also, Colony counts for L. rhamnosus in Group 3 after immediate irrigation, as well as 24 hours post irrigation, was performed to determine the survival profile of these bacteria in infected root canal with E. faecalis. RESULTS: The NaOCl irrigant group had the lowest mean value of (log 10 CFU/mL) of E. faecalis after immediate irrigation and after 24 hrs post irrigation followed by the probiotic group, while the highest mean value was the saline group (P ≤ 0.001). The survival profile for L. rhamnosus in Group 3 after immediate irrigation and post-irrigation were slightly higher than for E. faecalis (P ≤ 0.001). CONCLUSION: Lactobacillus rhamnosus which revealed a potential inhibitory effect on the growth of Enterococcus faecalis, could be used as a new natural, safe probiotic irrigant agent.
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Affiliation(s)
- Hoda El-Sayed
- National Research Centre, Dairy Science Department (Microbiology Lab.), Food Industries and Nutrition Division, Giza, Egypt
| | - Yousra Aly
- National Research Centre, Restorative Dentistry and Dental Material Department, Giza, Egypt
| | - Hanaa Elgamily
- National Research Centre, Restorative Dentistry and Dental Material Department, Giza, Egypt
| | - Mohamed M Nagy
- Endodontic Department, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
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Mallya L, Shenoy R, Mala K, Shenoy S. Evaluation of the antimicrobial efficacy of 20% Punica granatum, 0.2% chlorhexidine gluconate, and 2.5% sodium hypochlorite used alone or in combinations against Enterococcus faecalis: An in-vitro study. J Conserv Dent 2019; 22:367-370. [PMID: 31802821 PMCID: PMC6873594 DOI: 10.4103/jcd.jcd_43_19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Objectives The study was aimed at evaluating the antimicrobial efficacy of 20% Punica granatum, 0.2% chlorhexidine (CHX) gluconate, and 2.5% sodium hypochlorite used alone or in combinations against Enterococcus faecalis. Materials and Methods Aqueous extract of pomegranate peel was prepared in the Pharmacology Departmental Laboratory. A total of 240 wells were prepared (40 for each group) with 5 wells per with a diameter of 6 mm and depth of 4 mm at equidistant from each other. Using a pipette, each well was filled with 50 μl of the test irrigant solution. CHX (0.2%), 2.5% sodium hypochlorite, and aqueous extract of pomegranate peel and their combinations were tested as root canal irrigants against a standard strain of E. faecalis (ATCC 29212) on sheep blood agar plate by calculating the zones of inhibition. The mean diameter of zones was calculated and tabulated. Data were analyzed using one-way analysis of variance and Tukey's post hoc test. Descriptive statistics was obtained using SPSS software (version 11.5) with P established at < 0.05. Results Combination of Punica granatum with sodium hypochlorite and CHX showed maximum mean zones of inhibition with mean of 23.9 and 25.7 mm, respectively, and showed significantly better results than all other groups either irrigants used alone or in combinations. Conclusions Punica granatum and CHX was proved to be a very good combination among experimental groups against E. faecalis, and sodium hypochlorite was least effective against E. Faecalis.
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Affiliation(s)
- Laxmish Mallya
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Affiliated to Manipal Academy of Higher Education, Mangalore, Karnataka, India
| | - Ramya Shenoy
- Department of Public Health Dentistry, Manipal College of Dental Sciences, Affiliated to Manipal Academy of Higher Education, Mangalore, Karnataka, India
| | - Kundabala Mala
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Affiliated to Manipal Academy of Higher Education, Mangalore, Karnataka, India
| | - Suchitra Shenoy
- Department of Microbiology, Kasturba Medical College, Affiliated to Manipal Academy of Higher Education, Mangalore, Karnataka, India
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Dal Bello Y, Mezzalira GI, Jaguszewski LA, Hoffmann IP, Menchik VHS, Cecchin D, Souza MA. Effectiveness of calcium and sodium hypochlorite in association with reciprocating instrumentation on decontamination of root canals infected with Enterococcus faecalis. AUST ENDOD J 2018; 45:92-97. [PMID: 30113742 DOI: 10.1111/aej.12289] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2018] [Indexed: 12/01/2022]
Abstract
The aim of this study was to evaluate the antimicrobial activity of sodium and calcium hypochlorite utilising reciprocating instrumentation. Sixty root canals were inoculated with E. faecalis for 14 days. Samples were divided into six groups according to decontamination protocol: G1: no treatment, G2: distilled water, G3: 2.5% sodium hypochlorite, G4: 2.5% calcium hypochlorite, G5: 5.25% sodium hypochlorite and G6: 5.25% calcium hypochlorite. Instrumentation was performed with Wave One reciprocating system (Dentsply Sirona Endodontics, York, PA, USA) in groups G2 to G6. Colony-forming units (CFUs) counting was performed and the data were subjected to Anova and Tukey (α = 0.05). Group 1 and 2 showed the highest mean contamination, with a significant difference between them (P < 0.05). Groups 3, 4, 5 and 6 showed the lowest contamination means with no significant difference between them (P < 0.05). Sodium and calcium hypochlorite, in association with reciprocating instrumentation, can be an effective decontamination protocol in root canals infected with E. faecalis.
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Affiliation(s)
- Yuri Dal Bello
- School of Dentistry, University of Passo Fundo, Passo Fundo, RS, Brazil
| | - Gean I Mezzalira
- School of Dentistry, University of Passo Fundo, Passo Fundo, RS, Brazil
| | | | - Igor P Hoffmann
- School of Dentistry, University of Passo Fundo, Passo Fundo, RS, Brazil
| | | | - Doglas Cecchin
- School of Dentistry, University of Passo Fundo, Passo Fundo, RS, Brazil
| | - Matheus A Souza
- School of Dentistry, University of Passo Fundo, Passo Fundo, RS, Brazil
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13
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Bactericidal efficacy of three parameters of Nd:YAP laser irradiation against Enterococcus faecalis compared with NaOCl irrigation. Lasers Med Sci 2018; 34:359-366. [DOI: 10.1007/s10103-018-2603-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 07/26/2018] [Indexed: 01/12/2023]
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14
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Ramezanali F, Samimi S, Kharazifard M, Afkhami F. The in Vitro Antibacterial Efficacy of Persian Green Tea Extract as an Intracanal Irrigant on Enterococcus faecalis Biofilm. IRANIAN ENDODONTIC JOURNAL 2016; 11:304-308. [PMID: 27790260 PMCID: PMC5069907 DOI: 10.22037/iej.2016.9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Introduction: The aim of this study was to compare the antibacterial effect of Persian green tea extract (GTE) and 2.5% sodium hypochlorite (NaOCl) against Enterococcus faecalis (E. faecalis) as an intracanal irrigant. Methods and Materials: Thirty freshly extracted teeth were instrumented and sectioned into mesial and distal segments. The specimens were put into wells containing 2 mL of E. faecalis-containing medium. After 3 weeks, the specimens were removed and divided randomly into three groups (n=20). Each group was exposed to 3 mL of different irrigants for 3 min. Groups 1, 2 and 3 were irrigated with GTE, 2.5% NaOCl and normal saline, respectively. Biofilm formed in the middle third of the root canal was carved by sterile scalpel and cultured in Mueller-Hinton medium. Number of colony forming units (CFU) was counted on each plate. In addition, antimicrobial activity of the irrigants was evaluated by the agar disc diffusion test. The diameter of inhibition zone (IZ) around each irrigant was evaluated. The Kruskal-Wallis and Dunn tests were used to analysis the data. Results: While in NaOCl group no bacterial colonies were observed, the mean number of E. faecalis in GTE and control groups were 275±74 CFU/mL (P<0.001) and 119×108±11×108 (P<0.001), respectively. The mean of IZ in NaOCl and GTE groups were 24.35±0.78 and 6.9±0.87 mm, in order of appearance (P<0.001). Zone of inhibition was not observed around the control group (P<0.001). Conclusion: This research highlighted the potential role of plant extracts in antimicrobial root canal irrigation protocol.
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Affiliation(s)
- Fatemeh Ramezanali
- Department of Endodontics, Dental School, Tehran University of Medical Sciences, International Campus, Tehran, Iran
| | | | | | - Farzaneh Afkhami
- Department of Endodontics, Dental School, Tehran University of Medical Sciences, International Campus, Tehran, Iran; ; Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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Souza MA, Montagner A, Lana DLD, Vidal CMP, Farina AP, Cecchin D. Comparative evaluation of the retaining of QMix and chlorhexidine formulations on human dentin: a chemical analysis. Clin Oral Investig 2016; 21:873-878. [DOI: 10.1007/s00784-016-1837-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 04/24/2016] [Indexed: 12/16/2022]
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16
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Microbiological Profile Resistant to Different Intracanal Medications in Primary Endodontic Infections. J Endod 2015; 41:824-30. [DOI: 10.1016/j.joen.2015.01.031] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Revised: 01/26/2015] [Accepted: 01/29/2015] [Indexed: 11/17/2022]
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17
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Comparative Evaluation of Calcium Hypochlorite and Sodium Hypochlorite Associated with Passive Ultrasonic Irrigation on Antimicrobial Activity of a Root Canal System Infected with Enterococcus faecalis: An In Vitro Study. J Endod 2014; 40:1953-7. [DOI: 10.1016/j.joen.2014.08.025] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Revised: 08/04/2014] [Accepted: 08/29/2014] [Indexed: 11/22/2022]
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18
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Soares ADJ, Lins FF, Nagata JY, Gomes BPFDA, Zaia AA, Ferraz CCR, Almeida JFAD, Souza-Filho FJD. Pulp Revascularization after Root Canal Decontamination with Calcium Hydroxide and 2% Chlorhexidine Gel. J Endod 2013; 39:417-20. [DOI: 10.1016/j.joen.2012.10.005] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2012] [Revised: 09/25/2012] [Accepted: 10/02/2012] [Indexed: 11/17/2022]
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19
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Cole MR, Li M, Jadeja R, El-Zahab B, Hayes D, Hobden JA, Janes ME, Warner IM. Minimizing human infection from Escherichia coli O157:H7 using GUMBOS. J Antimicrob Chemother 2013; 68:1312-8. [PMID: 23447139 DOI: 10.1093/jac/dkt010] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Reduction in faecal shedding of Shiga toxin-producing enterohaemorrhagic Escherichia coli (EHEC) in food-producing animals is a viable strategy to minimize human disease initiated by exposure to these microorganisms. To this end, an intervention strategy involving the electrostatic hybridization of two commonly used anti-infective agents for veterinary practice (i.e. chlorhexidine and ampicillin) was evaluated to curtail EHEC-transmitted disease from ruminant sources. Chlorhexidine di-ampicillin is a novel group of uniform material based on organic salts (GUMBOS) with inherent in vitro antibacterial activity that comes from its parent antimicrobial ions, chlorhexidine and ampicillin. METHODS Antibacterial activities for chlorhexidine diacetate, sodium ampicillin, chlorhexidine di-ampicillin and stoichiometrically equivalent 1 : 2 chlorhexidine diacetate : sodium ampicillin were assessed using the serial 2-fold dilution method and time-kill studies against seven isolates of E. coli O157:H7 and one non-pathogenic E. coli 25922. Further studies to investigate synergistic interactions of reacted and stoichiometrically equivalent unreacted antimicrobial agents at MICs and possible mechanisms were also investigated. RESULTS Synergism and in vitro antibacterial activities against EHEC were observed in this study, which suggests chlorhexidine di-ampicillin could be a useful reagent in reducing EHEC transmission and minimizing EHEC-associated infections. Likewise, chlorhexidine di-ampicillin reduced HeLa cell toxicity as compared with chlorhexidine diacetate or the stoichiometric combination of antimicrobial agents. Further results suggest that the mechanisms of action of chlorhexidine di-ampicillin and chlorhexidine diacetate against E. coli O157:H7 are similar. CONCLUSIONS Reacting antimicrobial GUMBOS as indicated in this study may enhance the approach to current combination drug therapeutic strategies for EHEC disease control and prevention.
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Affiliation(s)
- Marsha R Cole
- Department of Chemistry, Louisiana State University, Baton Rouge, LA 70803, USA
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20
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Singh RD, Khatter R, Bal RK, Bal C. Intracanal medications versus placebo in reducing postoperative endodontic pain – a double – blind randomized clinical trial. Braz Dent J 2013; 24:25-9. [DOI: 10.1590/0103-6440201302039] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2012] [Accepted: 02/05/2013] [Indexed: 05/27/2023] Open
Abstract
This prospective randomized, double-blind factorial study aimed to compare the efficacy of three different intracanal medicaments with the placebo in controlling the postoperative pain after complete root canal preparation. The study was performed on 64 mandibular molars of 64 patients with diagnosis of pulp necrosis and acute apical periodontitis. After chemomechanical procedures using the stepback technique and 1% sodium hypochlorite, the teeth were randomized into four treatment groups (n=16). In group I, canals were filled with calcium hydroxide paste mixed with 2% chlorhexidine gel, group II received 2% chlorhexidine gel, group III was treated with calcium hydroxide paste, and group IV received no dressing (control). Before dismissal, preoperative pain experience was recorded using a visual analog pain scale. Patients were then instructed to quantify the degree of pain experienced 4 h after treatment and daily for a further 24, 48, 72 and 96 h. Two-way repeated measures ANOVA test and post hoc Tukey's HSD test revealed that at each time interval groups I and II were significantly more effective in reducing the postoperative pain values than groups III and IV (p<0.05). Dunnett's test showed that groups I and II differed significantly from control whereas difference between group III and control was not significant (p>0.05). Patients with pulp necrosis and acute apical periodontitis that had been dressed with chlorhexidine alone and calcium hydroxide plus chlorhexidine gave rise to less pain than that experienced by patients who had a calcium hydroxide dressing alone or no dressing at all.
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Affiliation(s)
- Ripu Daman Singh
- Sri Guru Ram Das Institute of Dental Sciences and Research, India
| | - Ramneek Khatter
- Sri Guru Ram Das Institute of Dental Sciences and Research, India
| | - Rupam Kaur Bal
- Sri Guru Ram Das Institute of Dental Sciences and Research, India
| | - C.S. Bal
- Sri Guru Ram Das Institute of Dental Sciences and Research, India
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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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22
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Saghiri MA, Delvarani A, Mehrvarzfar P, Nikoo M, Lotfi M, Karamifar K, Asgar K, Dadvand S. The impact of pH on cytotoxic effects of three root canal irrigants. Saudi Dent J 2011; 23:149-52. [PMID: 23960509 DOI: 10.1016/j.sdentj.2011.03.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2010] [Revised: 11/08/2010] [Accepted: 03/02/2011] [Indexed: 11/25/2022] Open
Abstract
AIM Cytotoxicity of root canal irrigants is important due to their close contact with host tissues. This study was to assess the possible impact of pH on cytotoxic effects of MTAD, 17% EDTA, and 2.6% NaOCl on the human gingival fibroblasts using MTT assay. MATERIALS AND METHODS Human gingival fibroblasts were exposed to the irrigants and their viability was assessed after 1, 6, and 12 h. The pH of the medium was measured in each interval. Light absorption values were measured for each culture medium using Elisa Reader device. RESULTS NaOCl had significantly less cytotoxicity than EDTA and MTAD. Also irrigants cytotoxicity decreased in 12, 1, and 6 h, respectively. CONCLUSION It seems that variation of the pH resulted in variation in the cytotoxicity of solutions; i.e., it follows the pattern of the pH variation.
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Affiliation(s)
- Mohammad Ali Saghiri
- Department of Dental Material, Islamic Azad University (Dental Branch), Tehran, Iran
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23
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[Chlorhexidine as a root canal irrigant--antimicrobial and scanning electron microscopic evaluation]. SRP ARK CELOK LEK 2010; 138:557-63. [PMID: 21180084 DOI: 10.2298/sarh1010557p] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION Selection of irrigant is very important for long-term success of root canal therapy. OBJECTIVE This study was undertaken to evaluate the antimicrobial effects of 2% chlorhexidine digluconate solution (CHX) against five selected microorganisms and to evaluate its efficacy in root canal cleaning. METHODS In this study, by agar diffusion test, were evaluated antimicrobial effects of three root canal irrigants: 5.25% NaOCl, 2.5% NaOCl and 2% CHX. The microorganisms tested in this study were Staphylococcus aureus, Streptococcus mutans, Enterococcus faecalis, Escherichia coli and Candida albicans. A scanning electron microscope was used to evaluate root canal cleaning ability of 5.25% NaOCl, 2.5% NaOCl, 2% CHX and 15% EDTA. Twelve extracted single-root human teeth were divided into four groups depending on the irrigant used during instrumentation. Mechanical preparation was performed with Step back technique and K files. Data were analysed statistically by Student's t-test. RESULTS 5.25% NaOCl was the most effective against all tested microorganisms. 2.5% NaOCl and 2% CHX showed antimicrobial effects against all tested microorganisms but zones of inhibition were smaller.The best results in root canal walls cleaning were obtained in the group where the irrigant was 15% EDTA (score 2.33). In 5.25% NaOCl, 2.5% NaOCl and 2% CHX groups, there was more smear layer (score 4 and 5). CONCLUSION 2% chlorhexidine digluconate showed strong antimicrobial effect on the tested microorganisms, but was not effective in cleaning root canal walls.
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Verdugo F, Sáez-Rosón A, Uribarri A, Martínez-Conde R, Cabezas-Olcoz J, Moragues MD, Pontón J. Bone microbial decontamination agents in osseous grafting: an in vitro study with fresh human explants. J Periodontol 2010; 82:863-71. [PMID: 21138353 DOI: 10.1902/jop.2010.100514] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Establishing a safe prophylactic antimicrobial protocol in bone grafting may enhance osseous volume outcomes. The purpose of this in vitro study is to assess human osteoblast response and safety after explant antimicrobial exposure. METHODS Fresh human bone explants were exposed to three antimicrobials: povidone-iodine (PovI; 0.05%, 1%, and 5%), chlorhexidine (CHX; 0.2% and 1%), and sodium hypochlorite (NaOCl; 2.5%, 4.5%, and 5.25%) at different times (15, 30, 45, and 60 seconds) and concentrations to assess cellular toxicity. Explants were washed three times with saline after exposure. Controls, explants cultured in the absence of antimicrobials, were performed for all experimental situations tested. Trials were conducted in triplicate. Particle size influence on osteoblast growth was determined between bone fragments with a diameter <2 and ≥2 to 5 mm. Test and control groups were monitored by light microscopy to evaluate cellular growth. Osteoblast differentiation and morphology was assessed by alkaline phosphatase activity and scanning electron microscopy (SEM). RESULTS Osteoblast growth was similar for particles <2 and ≥2 to 5 mm. Alkaline phosphatase control reference values were not significantly different from test groups (0.35 mU/mL ± 0.004 versus 0.34 mU/mL ± 0.009; P >0.05). Light microscopy showed on average 97% osteoblastic growth for bone particles exposed to PovI 5% and CHX 0.2% for all times and CHX 1% up to 30 seconds. The odds ratio of positive osteoblastic growth after a 30-second 2.5% NaOCl exposure was 2.4 times higher than after 5.25%. On average, one of two replicas yielded positive growth with 2.5% NaOCl and one of three with 5.25%. After 60-second explant exposure, positive osteoblastic growth was 7.7 times more likely to occur with 5% PovI or 0.2% CHX than with 5.25% NaOCl (P <0.05). SEM analysis confirmed light microscopy similar cellular adhesion and osteoblast phenotypic features between test and control groups. CONCLUSIONS Best osteoblastic growth occurred after bone PovI exposure and CHX 0.2%. Cellular toxicity seems to be influenced by the type of antimicrobial, concentration, and exposure time. SEM analysis confirmed absence of osteoblast phenotypic alterations after exposure. Decontamination agents can safely be used in bone transplantation using up to 5% PovI and 0.2% CHX for 1 minute and CHX 1% for 30 seconds.
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Affiliation(s)
- Fernando Verdugo
- VA Hospital, Greater Los Angeles, Healthcare System, Los Angeles, CA, USA.
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25
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Yamazaki AK, Moura-Netto C, Salgado RJC, Kleine BM, Prokopowitsch I. Ex vivo analysis of root canal cleaning using Endo-PTC associated to NaOCl and different irrigant solutions. Braz Oral Res 2010; 24:15-20. [DOI: 10.1590/s1806-83242010000100003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2009] [Accepted: 11/09/2009] [Indexed: 11/22/2022] Open
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Aubut V, Pommel L, Verhille B, Orsière T, Garcia S, About I, Camps J. Biological properties of a neutralized 2.5% sodium hypochlorite solution. ACTA ACUST UNITED AC 2010; 109:e120-5. [DOI: 10.1016/j.tripleo.2009.09.022] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2009] [Revised: 09/01/2009] [Accepted: 09/10/2009] [Indexed: 11/25/2022]
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de Vasconcelos BC, Luna-Cruz SM, De-Deus G, de Moraes IG, Maniglia-Ferreira C, Gurgel-Filho ED. Cleaning ability of chlorhexidine gel and sodium hypochlorite associated or not with EDTA as root canal irrigants: a scanning electron microscopy study. J Appl Oral Sci 2009; 15:387-91. [PMID: 19089166 PMCID: PMC4327257 DOI: 10.1590/s1678-77572007000500003] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2007] [Accepted: 07/11/2007] [Indexed: 11/21/2022] Open
Abstract
The aim of this study was to evaluate the cleaning efficacy of 2% chlorhexidine gluconate gel (CHX) compared to 2.5% sodium hypochlorite solution (NaOCl) associated or not with 17% EDTA used as irrigants during the biomechanical preparation. Fifty freshly extracted single-rooted human teeth with complete apex formation were randomly divided into five groups: G1 - sterile saline, G2 - 2.5% NaOCl, G3 - 2% CHX, G4 - 2.5% NaOCl + EDTA and G5 - 2% CHX + EDTA. The specimens of G1 were subdivided into two control groups. The teeth were decoronated and the coronal and middle root thirds were prepared with Gates-Glidden burs, and the apical third was reserved to manual instrumentation. All procedures were performed by a single operator. In all groups, 2 mL of irrigant was delivered between each file change. The teeth were sectioned and prepared for analyses under scanning electron microscopy (SEM). SEM micrographs were graded according to a score scale by two examiners. Data were analyzed statistically by Kruskal-Wallis and Dunn tests at 1% significance level. The best results were obtained in the groups in which the irrigant was used followed by the chelating agent. No statistically significant difference was observed among G4, G5 and the positive control group (p<0.01). The groups G2 and G3 were significantly different from the others, presenting the worst cleaning capacity. In conclusion, the use of the chelating agent is necessary to obtain clean canal walls, with open tubules and no heavy debris. The use of 2% chlorhexidine gluconate gel alone is not able to remove the smear layer.
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Verdugo F, Castillo A, Moragues MD, Pontón J. Bone microbial contamination influences autogenous grafting in sinus augmentation. J Periodontol 2009; 80:1355-64. [PMID: 19656037 DOI: 10.1902/jop.2009.090113] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The oral occurrence of putative microbial pathogens in humans has been documented in health and disease. The presence of periodontopathogens in patients with a history of periodontal disease may have a negative impact on bone regeneration. This investigation was conducted to confirm the presence of periodontal pathogens in bone particles harvested intraorally for maxillary sinus augmentation and to assess the clinical and radiographic outcomes 6 to 12 months after bone augmentation. METHODS Culture and polymerase chain reaction (PCR)-based identification were performed by paper-point sampling of intraorally harvested bone particles in a group of 12 maintenance patients undergoing maxillary sinus augmentation. Radiographs were taken to assess and compare bone healing and volume gain at baseline and at 6 to 12 months after augmentation. RESULTS The presence of periodontal pathogens (Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans [previously Actinobacillus actinomycetemcomitans], Prevotella intermedia, Tannerella forsythia [previously T. forsythensis], Fusobacterium nucleatum, Parvimonas micra [previously Peptostreptococcus micros or Micromonas micros], Campylobacter rectus, enteric Gram-negative rods, and Dialister pneumosintes) was identified in 10 of 12 patients (83%) by culture, PCR, or both and was associated with greater bone volume loss at 6 months postaugmentation. The PCR-positive triad, P. gingivalis, A. actinomycetemcomitans, and P. intermedia, was associated with pronounced volume loss of the grafted sinus at 6 months. CONCLUSIONS To the best of our knowledge, this is the first study to confirm osseous microbial contamination with major periodontopathogens in individuals undergoing maxillary sinus augmentation with a history of periodontitis. The effect on the grafting outcome translated into bone volume loss in the grafted sinus 6 months postaugmentation. Specific microbial contamination may have an impact on osteogenesis in osseous regeneration.
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Tirali RE, Turan Y, Akal N, Karahan ZC. In vitro antimicrobial activity of several concentrations of NaOCl and Octenisept in elimination of endodontic pathogens. ACTA ACUST UNITED AC 2009; 108:e117-20. [DOI: 10.1016/j.tripleo.2009.07.012] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2009] [Revised: 07/03/2009] [Accepted: 07/06/2009] [Indexed: 11/30/2022]
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Montecucco F, Bertolotto M, Ottonello L, Pende A, Dapino P, Quercioli A, Mach F, Dallegri F. Chlorhexidine prevents hypochlorous acid-induced inactivation of α1-antitrypsin. Clin Exp Pharmacol Physiol 2009; 36:e72-7. [DOI: 10.1111/j.1440-1681.2009.05270.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Comparison of 2.5% Sodium Hypochlorite and 2% Chlorhexidine Gel on Oral Bacterial Lipopolysaccharide Reduction from Primarily Infected Root Canals. J Endod 2009; 35:1350-3. [DOI: 10.1016/j.joen.2009.06.011] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2009] [Revised: 06/18/2009] [Accepted: 06/22/2009] [Indexed: 11/20/2022]
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Salgado RJC, Moura-Netto C, Yamazaki AK, Cardoso LN, de Moura AAM, Prokopowitsch I. Comparison of different irrigants on calcium hydroxide medication removal: microscopic cleanliness evaluation. ACTA ACUST UNITED AC 2009; 107:580-4. [PMID: 19201223 DOI: 10.1016/j.tripleo.2008.12.008] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2008] [Revised: 12/01/2008] [Accepted: 12/05/2008] [Indexed: 11/16/2022]
Abstract
Calcium hydroxide dressing residuals can compromise endodontic sealing. This study evaluated the cleaning efficacy of different endodontic irrigants in removing calcium hydroxide by SEM image analysis. Fifty-four single-rooted mandibular premolars were instrumented to a master apical file #60 and dressed with calcium hydroxide. After 36 hours, the teeth were reopened and Ca(OH)(2) medication was removed by 5 different experimental groups: 0.5% NaOCl (G1), EDTA-C (G2), citric acid (G3), EDTA-T (G4), and re-instrumentation with MAF using NaOCl and lubrificant, followed by EDTA-T (G5). The roots were split in the buccal-lingual direction and prepared for SEM analysis in cervical, middle, and apical thirds (9, 6, and 3mm from the apex). Five blinded examiners evaluated the wall cleanliness using a scale from 1 to 5. Statistical analysis was performed using Kruskal-Wallis at 5% level of significance. Group G5 had the best results in all thirds, with significant statistical differences compared to all other groups in the middle and coronal third, and to G1 in the apical third. On the other hand, G1, only flushed with NaOCl, had the worst results, with statistical differences in all thirds compared to the other groups. The best cleanliness was achieved by G4 and G5 groups. The recapitulation of MAF in combination with irrigants improved the removal of calcium hydroxide medication better than an irrigant flush alone.
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Gurgel-Filho ED, Vivacqua-Gomes N, Gomes BPFDA, Ferraz CCR, Zaia AA, Souza-Filho FJD. In vitro evaluation of the effectiveness of the chemomechanical preparation against Enterococcus faecalis after single- or multiple-visit root canal treatment. Braz Oral Res 2008; 21:308-13. [PMID: 18060256 DOI: 10.1590/s1806-83242007000400005] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2006] [Accepted: 04/27/2007] [Indexed: 05/25/2023] Open
Abstract
The purpose was to assess the elimination of Enterococcus faecalis in vitro in human mandibular premolars after chemomechanical preparation with or without the use of a calcium hydroxide dressing. After 60 days of contamination with E. faecalis, the root canals were prepared using the Crown-Down technique combined with 2% chlorhexidine gel irrigation. Then, the specimens were divided into two experimental groups, treated in a single visit or in multiple visits, and two control groups. The multiple-visit group received a dressing with calcium hydroxide for 14 days (Calen) and the single-visit group did not receive any medication. In the two control groups, the canals were filled with BHI after chemomechanical preparation with 2% chlorhexidine gel or distilled water. Microbial samples were taken from the root canals for colony forming unit count for each phase of the treatment using sterile paper points inside the root canal lumen. Data were ranked and analyzed by the Kruskal-Wallis statistical test. The residual microbial colonies were then assessed. The results showed that chemomechanical preparation using 2% chlorhexidine gel with no intra-canal dressing reduced by 100% the E. faecalis contamination of the root canal lumen. The calcium-hydroxide group that received the 14-day intra-canal dressing allowed a small number of bacteria to grow between visits, but without statistical differences between groups.
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Postoperative pain following the use of two different intracanal medications. Clin Oral Investig 2008; 12:325-30. [PMID: 18401602 DOI: 10.1007/s00784-008-0199-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2008] [Accepted: 03/17/2008] [Indexed: 11/27/2022]
Abstract
This study evaluated the incidence of postoperative pain after intracanal dressings with either 0.12% chlorhexidine digluconate gel (CHX) or a calcium hydroxide/camphorated paramonochlorophenol/glycerin paste (CH/CPMC). Overall, 138 asymptomatic teeth had their canals instrumented under irrigation with 2.5% NaOCl and then dressed with either CH/CPMC or CHX. The incidence of different intensity levels of postoperative pain was registered for the period between appointments. Data revealed that 84% of the total number of cases treated with either medicament showed absence of any level of pain. No case medicated with CH/CPMC and four cases (5.8%) medicated with CHX were categorized as flare-ups. There were no statistically significant differences between all possible comparisons involving the two medicaments in treatment/retreatment cases and teeth with/without apical periodontitis lesions. The low incidence of postoperative pain after the use of both medications, coupled to their antimicrobial effectiveness, gives support to using one or the other in routine treatment/retreatment.
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Wang CS, Arnold RR, Trope M, Teixeira FB. Clinical efficiency of 2% chlorhexidine gel in reducing intracanal bacteria. J Endod 2008; 33:1283-9. [PMID: 17963947 DOI: 10.1016/j.joen.2007.07.010] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2007] [Revised: 06/18/2007] [Accepted: 07/01/2007] [Indexed: 10/22/2022]
Abstract
This study evaluated the clinical efficacy of 2% chlorhexidine (CHX) gel on intracanal bacteria reduction during root canal instrumentation. The additional antibacterial effect of an intracanal dressing (Ca[OH](2) mixed with 2% CHX gel) was also assessed. Forty-three patients with apical periodontitis were recruited. Four patients with irreversible pulpitis were included as negative controls. Teeth were instrumented using rotary instruments and 2% CHX gel as the disinfectant. Bacterial samples were taken upon access (S1), after instrumentation (S2), and after 2 weeks of intracanal dressing (S3). Anaerobic culture was performed. Four samples showed no bacteria growth at S1, which were excluded from further analysis. Of the samples cultured positively at S1, 10.3% (4/39) and 8.3% (4/36) sampled bacteria at S2 and S3, respectively. A significant difference in the percentage of positive culture between S1 and S2 (p < 0.001) but not between S2 and S3 (p = 0.692) was found. These results suggest that 2% CHX gel is an effective root canal disinfectant and additional intracanal dressing did not significantly improve the bacteria reduction on the sampled root canals.
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Affiliation(s)
- Ching S Wang
- Department of Endodontics, University of North Carolina School of Dentistry, Chapel Hill, North Carolina 27599, USA
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36
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Bacteriologic investigation of the effects of sodium hypochlorite and chlorhexidine during the endodontic treatment of teeth with apical periodontitis. ACTA ACUST UNITED AC 2007; 104:122-30. [PMID: 17499528 DOI: 10.1016/j.tripleo.2007.01.027] [Citation(s) in RCA: 95] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2006] [Revised: 01/08/2007] [Accepted: 01/21/2007] [Indexed: 11/24/2022]
Abstract
OBJECTIVE This clinical study was undertaken to compare the effectiveness of 2.5% sodium hypochlorite (NaOCl) and 0.12% chlorhexidine digluconate as irrigants in reducing the cultivable bacterial populations in infected root canals of teeth with apical periodontitis. STUDY DESIGN According to stringent inclusion/exclusion criteria, 32 teeth with primary intraradicular infections and chronic apical periodontitis were selected and followed in the study. Bacterial samples were taken at the baseline (S1) and after chemomechanical preparation using either NaOCl (n = 16) or chlorhexidine (n = 16) as irrigants (S2). Cultivable bacteria recovered from infected root canals at the 2 stages were counted. Isolates from S2 samples were identified by means of 16S rRNA gene sequencing analysis. RESULTS At S1, all canals were positive for bacteria, and the median number of bacteria per canal was 7.32 x 10(5) for the NaOCl group and 8.5 x 10(5) for the chlorhexidine group. At S2, the median number of bacteria in canals irrigated with NaOCl and chlorhexidine was 2.35 x 10(3) and 2 x 10(2), respectively. Six of 16 (37.5%) canals from the NaOCl group and 8 of 16 (50%) canals from the chlorhexidine group yielded negative cultures. Chemomechanical preparation using either solution substantially reduced the number of cultivable bacteria in the canals. No significant difference was observed between the NaOCl and chlorhexidine groups with regard to the number of cases yielding negative cultures (P = .72) or quantitative bacterial reduction (P = .609). The groups irrigated with NaOCl or chlorhexidine showed a mean number of 1.3 and 1.9 cultivable species per canal, respectively. The great majority of isolates in S2 were from gram-positive bacteria, with streptococci as the most prevalent taxa. CONCLUSIONS The present findings revealed no significant difference when comparing the antibacterial effects of 2.5% NaOCl and 0.12% chlorhexidine used as irrigants during the treatment of infected canals.
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Oliveira DP, Barbizam JVB, Trope M, Teixeira FB. In vitro antibacterial efficacy of endodontic irrigants against Enterococcus faecalis. ACTA ACUST UNITED AC 2007; 103:702-6. [PMID: 17368057 DOI: 10.1016/j.tripleo.2006.11.007] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2006] [Revised: 10/31/2006] [Accepted: 11/04/2006] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The objective of this study was to compare the in vitro antimicrobial activity of 2% chlorhexidine gel against Enterococcus faecalis with sodium hypochlorite in 2 different concentrations (1.5% and 5.25%). STUDY DESIGN Eighty human lower premolars with single root canals were prepared, autoclaved, and infected for 7 days with E. faecalis monocultures. The roots were then separated into 5 experimental groups according to the irrigant solution used during the standardized preparation. To assess the antimicrobial action of the irrigant solutions, 3 microbial samples were taken: S1--initial (before the biomechanical preparation), S2--posttreatment (immediately after the biomechanical preparation), and S3--final (7 days after the biomechanical preparation). The microbiological samples were plated to count the colony-forming units (CFU). RESULTS The 2% chlorhexidine gel and 5.25% sodium hypochlorite significantly reduced the E. faecalis CFU in the posttreatment and final microbiological samples. The 1.5% sodium hypochlorite also reduced the E. faecalis CFU immediately after the root canal instrumentation, but the E. faecalis CFU increased in the final sample showing no statistical difference from the control group. CONCLUSION The 2% chlorhexidine gluconate gel and 5.25% sodium hypochlorite were effective in eliminating E. faecalis even 7 days after the instrumentation; moreover, the higher the concentration of sodium hypochlorite the better its antimicrobial action.
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Affiliation(s)
- Daniel P Oliveira
- University of North Carolina School of Dentistry, Chapel Hill, NC, USA
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Siqueira JF, Paiva SSM, Rôças IN. Reduction in the cultivable bacterial populations in infected root canals by a chlorhexidine-based antimicrobial protocol. J Endod 2007; 33:541-7. [PMID: 17437868 DOI: 10.1016/j.joen.2007.01.008] [Citation(s) in RCA: 96] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2006] [Revised: 01/05/2007] [Accepted: 01/09/2007] [Indexed: 11/24/2022]
Abstract
The present clinical study was conducted to assess the bacterial reduction after chemomechanical preparation using 0.12% chlorhexidine digluconate solution as an irrigant and the additive antibacterial effect of intracanal dressing with calcium hydroxide (Ca(OH)(2)) associated with 0.12% chlorhexidine digluconate gel. According to stringent inclusion/exclusion criteria, 13 teeth with primary intraradicular infections and chronic apical periodontitis were selected and followed in the study. Bacterial samples were taken at the baseline (before treatment) (S1), after chemomechanical preparation using chlorhexidine (CHX) as an irrigant (S2), and after a 7-day dressing with Ca(OH)(2)/CHX paste (S3). Cultivable bacteria recovered from infected root canals at the three stages were counted and identified by means of 16S ribosomal RNA gene sequencing analysis. At S1, all canals were positive for bacteria, with the mean number of 3.5 taxa per canal (range, 2-9). At S2, 7 cases (53.8%) still harbored cultivable bacteria, with a mean number of 1.7 taxon per canal (range, 1-4). At S3, only one case (7.7%) was positive for the presence of bacteria. The great majority of taxa found in posttreatment samples were gram-positive bacteria. A significantly high reduction in bacterial counts was observed between S1 and S2 and S1 and S3 (p<0.001). Also, significant differences were observed for comparisons involving S2 and S3 samples with regard to both quantitative bacterial reduction (p=0.014) and number of cases yielding negative cultures (p=0.01). It was concluded that chemomechanical preparation with 0.12% CHX solution as an irrigant significantly reduced the number of intracanal bacteria but failed to render the canal free of cultivable bacteria in about one half of the cases. Application of a 7-day intracanal dressing with Ca(OH)(2)/CHX paste further increased significantly the number of cases yielding negative cultures.
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Affiliation(s)
- José F Siqueira
- Department of Endodontics, Faculty of Dentistry, Estácio de Sá University, Rio de Janeiro, RJ, Brazil.
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39
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Athanassiadis B, Abbott PV, Walsh LJ. The use of calcium hydroxide, antibiotics and biocides as antimicrobial medicaments in endodontics. Aust Dent J 2007; 52:S64-82. [PMID: 17546863 DOI: 10.1111/j.1834-7819.2007.tb00527.x] [Citation(s) in RCA: 182] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Bacteria have been implicated in the pathogenesis and progression of pulp and periapical diseases. The primary aim of endodontic treatment is to remove as many bacteria as possible from the root canal system and then to create an environment in which any remaining organisms cannot survive. This can only be achieved through the use of a combination of aseptic treatment techniques, chemomechanical preparation of the root canal, antimicrobial irrigating solutions and intracanal medicaments. The choice of which intracanal medicament to use is dependent on having an accurate diagnosis of the condition being treated, as well as a thorough knowledge of the type of organisms likely to be involved and their mechanisms of growth and survival. Since the disease is likely to have been caused by the presence of bacteria within the root canal, the use of an antimicrobial agent is essential. Many medicaments have been used in an attempt to achieve the above aims but no single preparation has been found to be completely predictable or effective. Commonly used medicaments include calcium hydroxide, antibiotics, non-phenolic biocides, phenolic biocides and iodine compounds. Each has advantages and disadvantages, and further research is required to determine which is best suited for root canal infections.
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Affiliation(s)
- B Athanassiadis
- School of Dentistry, The University of Western Australia, Nedlands
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40
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Sena NT, Gomes BPFA, Vianna ME, Berber VB, Zaia AA, Ferraz CCR, Souza-Filho FJ. In vitro antimicrobial activity of sodium hypochlorite and chlorhexidine against selected single-species biofilms. Int Endod J 2006; 39:878-85. [PMID: 17014526 DOI: 10.1111/j.1365-2591.2006.01161.x] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM To investigate the antimicrobial activity of 2.5% and 5.25% sodium hypochlorite and 2.0% chlorhexidine gel and liquid as endodontic-irrigating substances against selected single-species biofilms. METHODS Single-species biofilms of Enterococcus faecalis, Staphylococcus aureus, Candida albicans, Prevotella intermedia, Porphyromonas gingivalis, Porphyromonas endodontalis and Fusobacterium nucleatum were generated on a cellulose nitrate membrane placed on agar medium. The biofilms were then immersed in the endodontic-irrigating substances for 30 s and also for 5, 10, 15, 30 and 60 min, with and without mechanical agitation. Sterile saline was used as control. After each time period, the membrane filters were then transferred to tubes containing 2 mL of fresh broth medium plus neutralizers (in order to prevent the residual action of the tested substances). The micro-organisms were suspended using a vortex, and the inoculum was serially diluted 10-fold. Aliquots of the dilutions were plated on 5% sheep blood agar medium, and incubated under adequate gaseous conditions. Colony-forming units were calculated. The samples were compared using the Friedman and Tukey test, when necessary, at a significance level of P < 0.05. RESULTS Mechanical agitation promoted the effectiveness of the antimicrobial agents, resulting in less time to eliminate the same micro-organisms, except for S. aureus with 2.5% NaOCl. Antimicrobial agents in liquid presentation, especially 5.25% NaOCl and 2% chlorhexidine, killed the tested micro-organisms more rapidly. Saline did not inhibit the growth of any of the tested micro-organisms, with or without agitation, being statistically different (P < 0.05) from NaOCl and chlorhexidine. P. intermedia, P. gingivalis, P. endodontalis and F. nucleatum were eliminated in 30 s by all antimicrobial agents, with our without agitation, in contrast with the facultative and aerobe strains. CONCLUSIONS Mechanical agitation improved the antimicrobial properties of the chemical substances tested using a biofilm model, favouring the agents in liquid presentation, especially 5.25% NaOCl and 2% chlorhexidine.
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Affiliation(s)
- N T Sena
- Piracicaba Dental School, State University of Campinas, UNICAMP, Piracicaba, São Paulo, Brazil
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41
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Silva Garcez A, Núñez SC, Lage-Marques JL, Jorge AOC, Ribeiro MS. Efficiency of NaOCl and laser-assisted photosensitization on the reduction of Enterococcus faecalis in vitro. ACTA ACUST UNITED AC 2006; 102:e93-8. [PMID: 16997103 DOI: 10.1016/j.tripleo.2006.02.015] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2005] [Revised: 02/02/2006] [Accepted: 02/08/2006] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To investigate the action of a red laser associated with a photosensitizer on the reduction of Enterococcus faecalis in dental root canal in vitro. STUDY DESIGN Thirty prepared teeth with single canals were contaminated. The chemical group was irrigated with 0.5% NaOCl and left flooded for 30 minutes. In the laser group, a paste-based photosensitizer was maintained in the root canals for 5 minutes, and then irradiated with a laser at 685 nm using an optical fiber for an E of 1.8 J during 3 minutes. After treatment, the canal content was collected, serially diluted, and cultured to determine the number of colony-forming units. RESULTS Photosensitizer alone or laser alone did not have any bactericidal effect. Chemical solution reduced viable bacteria in 93.25%. Laser photosensitization resulted in a reduction of 99.2%, a significantly higher bacterial reduction than NaOCl. CONCLUSION Laser photosensitization was effective for reducing E. faecalis in root canals and could be an adjunct to endodontic treatment.
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42
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Gomes BPFDA, Vianna ME, Sena NT, Zaia AA, Ferraz CCR, de Souza Filho FJ. In vitro evaluation of the antimicrobial activity of calcium hydroxide combined with chlorhexidine gel used as intracanal medicament. ACTA ACUST UNITED AC 2006; 102:544-50. [PMID: 16997123 DOI: 10.1016/j.tripleo.2006.04.010] [Citation(s) in RCA: 83] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2006] [Revised: 04/06/2005] [Accepted: 04/21/2006] [Indexed: 11/28/2022]
Abstract
The aim of this study was to investigate the antimicrobial activity of calcium hydroxide (Ca(OH)2) combined with 2% chlorhexidine gluconate (CHX) gel against endodontic pathogens and to compare the results with the ones achieved by Ca(OH)2 mixed with sterile water and by CHX gel alone. Two methods were used: the agar diffusion test and the direct contact test. Ca(OH)2 + 2% CHX gel produced inhibitory zones ranging from 2.84 to 6.5 mm, and required from 30 seconds to 6 hours to eliminate all tested microorganisms. However, 2% CHX gel showed the largest microbial growth zones from 4.33 to 21.67 mm, and required 1 minute or less to inhibit all tested microorganisms. A paste of Ca(OH)2 plus sterile water inhibited only the microorganisms with which it was in direct contact and required from 30 seconds to 24 hours to kill all tested microorganisms. In conclusion, 2% CHX gel + Ca(OH)2 showed better antimicrobial activity than Ca(OH)2 manipulated with sterile water.
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43
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Stratton RK, Apicella MJ, Mines P. A Fluid Filtration Comparison of Gutta-Percha versus Resilon, a New Soft Resin Endodontic Obturation System. J Endod 2006; 32:642-5. [PMID: 16793471 DOI: 10.1016/j.joen.2005.09.002] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2005] [Revised: 09/02/2005] [Accepted: 09/03/2005] [Indexed: 11/22/2022]
Abstract
The purpose of this study was to compare the sealing ability of gutta-percha and AH Plus sealer versus Resilon and Epiphany Resin Root Canal sealer using three different final irrigants with the fluid filtration model. There were 140 teeth prepared using a crown-down method to a size 50 file. The teeth were randomly divided into two groups: (A) GP and AH Plus and (B) Resilon and Epiphany. After removal of the smear layer each group was irrigated with either 5.25% NaOCl, 0.012% chlorhexidine (CHX), or 2% CHX for 10 minutes. Obturation was performed using the continuous wave of condensation. The teeth were stored for 20 days in 100% humidity before testing. Two-way ANOVA analysis indicated significantly less leakage (p < 0.05) using Resilon with Epiphany sealer compared to gutta-percha and AH Plus sealer. There was no statistical significance between any of the irrigants used for either obturation group.
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Affiliation(s)
- Ryan K Stratton
- US Army, Ft. Bragg Endodontic Residency, North Carolina, USA.
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44
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Vianna ME, Horz HP, Gomes BPFA, Conrads G. In vivo evaluation of microbial reduction after chemo-mechanical preparation of human root canals containing necrotic pulp tissue. Int Endod J 2006; 39:484-92. [PMID: 16674744 DOI: 10.1111/j.1365-2591.2006.01121.x] [Citation(s) in RCA: 95] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
AIM To determine in vivo, the degree of microbial reduction after chemo-mechanical preparation of human root canals containing necrotic pulp tissue when using two endodontic irrigating reagents, sodium hypochlorite (NaOCl) or chlorhexidine gel (CHX). METHODOLOGY Thirty-two single rooted teeth with necrotic pulp were divided into two groups. One group (n=16) was irrigated with 2.5% NaOCl, whilst the other group (n=16) was irrigated with 2% CHX gel. Assessment of the bacterial load was accomplished by use of real-time quantitative-polymerase chain reaction (RTQ-PCR) directed against the small subunit ribosomal DNA using the SYBRGreen and TaqMan formats. Statistical analysis was performed using the Mann-Whitney test. For contrast, bacterial load was also determined by traditional culture techniques. RESULTS The bacterial load was reduced substantially in both groups (over 96%). However, using RTQ-PCR the bacterial load before and after chemo-mechanical preparation was greater when compared with evaluation using colony forming units (CFU). Furthermore, as measured by RTQ-PCR, the bacterial reduction in the NaOCl-group (SYBRGreen 99.99%; TaqMan: 99.63%) was significantly greater (P<0.01) than in the CHX-group (SYBRGreen 96.62%; TaqMan: 96.60%). According to culture technique 75% of cases were free of bacteria after chemo-mechanical preparation in the NaOCl-group, whilst 50% of cases were bacteria free in the CHX-group. CONCLUSION NaOCl has not only a higher capacity to kill microorganisms but is also more able to remove cells from the root canal.
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Affiliation(s)
- M E Vianna
- Endodontic Area, Department of Restorative Dentistry, Piracicaba Dental School, State University of Campinas, Piracicaba, SP, Brazil, and Department of Medical Microbiology, RWTH Aachen University Hospital, Germany
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45
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Vivacqua-Gomes N, Gurgel-Filho ED, Gomes BPFA, Ferraz CCR, Zaia AA, Souza-Filho FJ. Recovery of Enterococcus faecalis after single- or multiple-visit root canal treatments carried out in infected teeth ex vivo. Int Endod J 2005; 38:697-704. [PMID: 16164683 DOI: 10.1111/j.1365-2591.2005.00992.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIM To assess the presence of Enterococcus faecalis after root canal treatment in single or multiple visits in an ex vivo model. METHODOLOGY Forty-five premolar teeth were infected ex vivo with E. faecalis for 60 days. The canals were then prepared using a crowndown technique with System GT and Gates-Glidden burs and irrigated with 2% chlorhexidine gel. The specimens were divided into five groups (G1, G2, G3, G4 and G5) according to the time elapsed between chemical-mechanical preparation and root canal filling, the irrigant solution used and the use or nonuse of a calcium hydroxide intra-canal medicament. The teeth were then root-filled and incubated for 60 days at 37 degrees C. Dentine chips were removed from the canal walls with sequential sterile round burs at low speed. The samples obtained with each bur were immediately collected in separate test tubes containing Brain-Heart Infusion broth. These samples were placed onto agar plates and colony forming units were counted after 24 h at 37 degrees C. Data were ranked and analysed using the Kruskal-Wallis statistical test. RESULTS Enterococcus faecalis was recovered from 20% (three of 15 specimens) of G1 (chlorhexidine irrigation and immediate root filling in a single visit), 25% (four of 15 specimens) of G2 (chlorhexidine irrigation and filling after 14 days use of a calcium hydroxide dressing in multiple visits), 40% (two of five specimens) of G3 (chlorhexidine irrigation and filling after 7 days), 60% (three of five specimens) of G4 (saline irrigation and filling after 7 days) and from 100% (five of five specimens) of G5 (saline irrigation and immediate filling without sealer). CONCLUSIONS Neither single- nor multiple-visit root canal treatment ex vivo, eliminated E. faecalis completely from dentinal tubules. Up to 60 days after root filling, E. faecalis remained viable inside dentinal tubules. When no sealer was used, E. faecalis presented a higher growth rate.
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Affiliation(s)
- N Vivacqua-Gomes
- Dental School of Piracicaba--State University of Campinas, UNICAMP, Piracicaba-SP, Brazil
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Dammaschke T, Schneider U, Stratmann U, Yoo JM, Schäfer E. Effect of root canal dressings on the regeneration of inflamed periapical tissue. Acta Odontol Scand 2005; 63:143-52. [PMID: 16191907 DOI: 10.1080/00016350510019801] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The aim of this study was to evaluate the effects of chlorhexidine and calcium hydroxide on apical periodontitis in rats. Experimentally induced apical periodontitis was established on the mesial roots of maxillary molars of Wistar rats by leaving the root canals exposed to the oral cavity for 14 d. In the positive control group (n=10 teeth), the root canals were not further treated, but the coronal access openings were filled with composite. In the negative control group (n=10 teeth), partial pulpotomies were performed aseptically and the coronal access openings were sealed immediately. In a third control group (n=10 teeth) the canals were instrumented, left empty, and the coronal access openings were sealed. In the experimental groups, the root canals were instrumented and filled with either 2% chlorhexidine gel or calcium hydroxide paste (n=10 teeth per group). After 7 d all rats were killed and the histological sections were stained for microscopic analysis of periapical regeneration. The data of the subjective evaluation were analyzed with the Kruskal-Wallis test. Lesion sizes were measured and statistically analyzed using the ANOVA and post-hoc Scheffé test. The two treatment groups showed significantly lower average inflammatory scores and smaller lesion sizes than the positive and third control group (p<0.05). No statistically significant differences were obtained between the two treatment groups (p>0.05). Chlorhexidine used as an intra-canal medicament showed good periapical regeneration, suggesting that this may be an alternative to calcium hydroxide root canal dressing.
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Affiliation(s)
- Till Dammaschke
- Poliklinik für Zahnerhaltung, Westfälische Wilhelms-Universität, Münster, Germany.
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47
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de Oliveira LD, Carvalho CAT, Valera MC, Koga-Ito CY, Jorge AOC. Diffusion ability of endotoxin through dentinal tubules. Braz Oral Res 2005; 19:5-10. [PMID: 16229349 DOI: 10.1590/s1806-83242005000100002] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to evaluate the ability of endotoxin to diffuse through dentinal tubules towards the cement and to observe the period of time needed for it to reach the external root surface. Thirty single-rooted human teeth had their crowns and apices removed in order to standardize the root length to 15 mm. Teeth were instrumented until #30 K-file and made externally impermeable with epoxy adhesive, leaving 10 mm of the exposed root (middle third). The specimens were placed in plastic vials and irradiated (60Co gamma-rays). Then, they were divided into 2 groups (n = 15): G1) Escherichia coli endotoxin was inoculated into the root canal of the specimens and 1 ml of pyrogen-free water was put in the tubes; G2) (control): pyrogen-free water was inoculated into the root canals and 1 ml of pyrogen-free water was put in each tube. After 30 min, 2 h, 6 h, 12 h, 24 h, 48 h, 72 h and 7 days, the water of the tubes was removed and replaced. The removed aliquot was tested for the presence of endotoxin. Considering that the endotoxin is a B-lymphocyte polyclonal activator, at each experimental period, B-lymphocyte culture was stimulated with a sample of water removed from each tube and antibody (IgM) production was detected by ELISA technique. The results of IgM production were higher in groups of 24 h, 48 h, 72 h and 7 days in relation to the other studied groups, with statistically significant differences (ANOVA and Tukey's test p < 0.05). Endotoxin was able to diffuse through the dentinal tubules towards the cement, reaching the external root surface after the period of 24 h.
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48
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Wuerch RMW, Apicella MJ, Mines P, Yancich PJ, Pashley DH. Effect of 2% Chlorhexidine Gel as an Intracanal Medication on the Apical Seal of the Root-Canal System. J Endod 2004; 30:788-91. [PMID: 15505512 DOI: 10.1097/00004770-200411000-00010] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The purpose of this study was to determine what effect intracanal medications might have on the apical seal of the root-canal system. Forty-two teeth were cleaned and shaped in a crown-down manner to a size #50 K-file. The teeth were divided into three groups: (A) immediate obturation; (B) intracanal placement of calcium hydroxide placed for 14 days; and (C) 2% chlorhexidine gel placed for 14 days. After 14 days, these materials were removed using copious irrigation and obturation was completed on groups B and C. Obturation was performed using the continuous wave of condensation technique using AH Plus sealer in all groups. Leakage was evaluated 60 days after obturation by using a fluid-filtration device. Using the one-way ANOVA test, there was no statistically significant difference in leakage between the three groups. Under the conditions of this study, 2% chlorhexidine gel and calcium hydroxide paste did not adversely affect the apical seal of the root-canal system.
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49
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Gernhardt CR, Eppendorf K, Kozlowski A, Brandt M. Toxicity of concentrated sodium hypochlorite used as an endodontic irrigant. Int Endod J 2004; 37:272-80. [PMID: 15056354 DOI: 10.1111/j.0143-2885.2004.00804.x] [Citation(s) in RCA: 133] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
AIM To present a clinical case that illustrates the toxicity of concentrated sodium hypochlorite (NaOCl) on vital tissues. SUMMARY The severe clinical consequences of extruding concentrated NaOCl into the periradicular tissues during root canal irrigation are described. After diagnosis of external resorption in tooth 34, endodontic treatment was initiated. Following irrigation with a concentrated NaOCl solution, a rapidly developing swelling and haematoma were visible. During the next few days, an extensive bruise and local necrosis of the oral mucosa developed. After healing of the involved tissues, the canal was prepared and obturated. At this time, no clinical symptoms remained. KEY LEARNING POINTS * The use of concentrated NaOCl as a root canal irrigant might cause severe clinical problems when extruded into vital tissues. * The present report confirms the known toxicity of NaOCl to soft tissues following inadvertent extrusion. * To avoid extrusion, it is always prudent to confirm the length and integrity of the root canal system before irrigating with concentrated solutions.
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Affiliation(s)
- C R Gernhardt
- Department of Operative Dentistry and Periodontology, University School of Dental Medicine, Martin-Luther-University, Halle, Germany.
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Vianna ME, Gomes BPFA, Berber VB, Zaia AA, Ferraz CCR, de Souza-Filho FJ. In vitro evaluation of the antimicrobial activity of chlorhexidine and sodium hypochlorite. ACTA ACUST UNITED AC 2004; 97:79-84. [PMID: 14716261 DOI: 10.1016/s1079-2104(03)00360-3] [Citation(s) in RCA: 212] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The aim of this study was to investigate in vitro the antimicrobial activity of 0.2%, 1%, and 2% chlorhexidine gluconate (CHX gel and CHX liquid), against endodontic pathogens and compare the results with the ones achieved by 0.5%, 1%, 2.5%, 4%, and 5.25% sodium hypochlorite (NaOCl). A broth dilution test was performed, and the timing for irrigants to kill microbial cells was recorded and statistically analyzed. Both 2.0% gel and liquid formulations eliminated Staphylococcus aureus and Candida albicans in 15 seconds, whereas the gel formulation killed Enterococcus faecalis in 1 minute. All tested irrigants eliminated Porphyromonas endodontalis, Porphyromonas gingivalis, and Prevotella intermedia in 15 seconds. The timing required for 1.0% and 2.0% CHX liquid to eliminate all microorganisms was the same required for 5.25% NaOCl. The antimicrobial action is related to type, concentration, and presentation form of the irrigants as well as the microbial susceptibility.
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Affiliation(s)
- Morgana Eli Vianna
- Department of Restorative Dentistry, Piracicaba Dental School, State University of Campinas, SP, Brazil
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