The effect of different root canal medicaments on the elimination of Enterococcus faecalis ex vivo

The Effect of Various Irrigants on Mixed Biofilms in Dentinal Tubules: A Confocal Laser Scanning Microscopy Study

This study evaluated the bacterial disinfection efficacy of three different irrigation solutions and their combined usage in dentin tubules contaminated with mixed biofilms. A total of 60 single-rooted mandibular premolars were prepared with ProTaper Next X4, sterilized, and then inoculated with mixed biofilm for 7 days. After biofilm formation, the teeth were randomly divided into six groups (n = 10) based on the irrigation solution used: Group 1: sodium hypochlorite (NaOCl), Group 2: chlorhexidine gluconate (CHX), Group 3: polyhexamethylene biguanide (PHMB), Group 4: NaOCl + CHX, Group 5: NaOCl + PHMB, Group 6: distilled water (control group). The teeth were sectioned at the coronal, middle, and apical thirds and stained with LIVE/DEAD BackLight and examined under a confocal laser scanning microscope (CLSM) to determine the depth of dead bacterial penetration into the dentinal tubules. Additionally, one tooth from each group was subjected to bacterial viable counting before and after irrigation. The CLSM analysis revealed that the greatest penetration of dead bacteria occurred in the coronal third, followed by the apical and middle third (p < 0.05). Combined solutions demonstrated significantly higher disinfection efficacy compared with PHMB alone (p < 0.001). Viable count analysis revealed that Group 4 and Group 5 exhibited the greatest reduction in bacterial proliferation, respectively. The combined use of solutions was found to be more effective than the sole use of solutions. Therefore, it is recommended to combine irrigation solutions during final irrigation in clinical settings.

Irrigation in Endodontics: Polyhexanide Is a Promising Antibacterial Polymer in Root Canal Treatment

Background:chronic apical periodontitis is a common pathology in dentistry, especially in endodontics. It is necessary to systematize data concerning commonly used irrigation solutions. The development of new protocols for endodontic treatment is a very promising direction. The use of a polyhexanide-based antiseptic can positively affect the results of endodontic treatment. Methods: the review was carried out involving the search for English language research and meta-analyses in the Google Scholar and PubMed databases. Results: the number of literary sources that were identified during the literature review is 180. After excluding publications that did not match the search criteria, the total number of articles included in the systematic review was determined to be 68. Conclusions: polyhexanide is a promising solution for infected root canal irrigation. The antibacterial activity of this substance is suitable for the elimination of pathogens responsible for the appearance of apical periodontitis.

Antibacterial Activity of Gallic Acid from the Leaves of Altingia excelsa Noronha to Enterococcus faecalis

AIM : The aim of this study was to determine the antibacterial compound of Altingia excelsa leaves to inhibit the growth of Entrococcus faecalis. METHODS : The study was true experimental laboratory design. Separating the ethyl acetate extract via their compounds using various chromatographic techniques. Four extracts from A. excelsa leaves was obtained by the maceration method. The highest inhibitory effect was then continued to be isolated until one compound was obtained. Therefore, additional assay to determine chemical structure of compounds was done using UV spectra, infrared (IR), core magnetic resonance (NMR), and comparison with spectra data from the literature. The data were analyzed by ANACOVA assay. RESULTS : The highest inhibitory effect was the ethyl acetate extract. The chemical structure of compound 1 was identified as an acidic compound 3,4,5 -trihydroxy benzoate, namely as the gallic acid which had inhibitory effect against Enterococcus faecalis. Antibacterial test against Enterococcus faecalis was done to determine inhibitory effect by its compound and MIC values showed of 12.25 µg/mL. CONCLUSION : Gallic acid as the compound of Altingia excelsa leaves had a strong inhibitory effect to Enterococcus faecalis.

Chemical Gastroenterocolitis after Dental Root Canal Therapy with Camphorated and Mentholated Chlorophenol

A 78-year-old man with a history of pancolitis, after the treatment of dental abscess with oral antibiotics and local application of camphorated and mentholated chlorophenol (CMCP), presented with abdominal pain of 4-day duration, as well as hair loss in the area of moustache and finger nail lifting. He was already treated with rectal application of budesonide because of pancolitis, diagnosed 6 weeks ago and interpreted as an allergic reaction to clindamycin. For further investigation, we performed gastroscopy and colonoscopy, which showed the edematous mucosa with polypus-like changes of the whole mucosa of the stomach, duodenum, first part of the jejunum, distal ileum, complete colon, and rectum. The diagnosis was complicated and was achieved in synopsis with anamnestic details, such as endodontic application of camphorated chlorophenol. The patient symptoms abated after he commenced on mesalazine therapy.

The influence of two forms of chlorhexidine on the accuracy of contemporary electronic apex locators

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.

Comparative evaluation of antimicrobial efficacy of triple antibiotic paste, calcium hydroxide, and a proton pump inhibitor against resistant root canal pathogens

Objective:

The objective of this study is to compare the antimicrobial efficacy of triple antibiotic paste (TAP) and a proton pump inhibitor (PPI) (omeprazole) in combination with calcium hydroxide (CH) against Enterococcus faecalis and Candida albicans.

Materials and Methods:

E. faecalis and C. albicans were subcultured and inoculated at 37° overnight and were treated with different dilutions of TAP, 25 μg/ml (Group 1), CH (Group 2, control), CH 16 mg/ml + omeprazole 2 mg/ml (Group 3a) (CH 16 mg/ml + omeprazole 4 mg)/ml (Group 3b) for 24, 48, and 72 h in sterile uncoated 96-well microtiter plates. Minimum concentration at which the medicaments produced least optical density was determined using ELISA reader (ELx 808 BioTek Inc., USA) device set at optical density of 630 nm. Results were analyzed statistically by one-way analysis of variance followed by Tukey's multiple comparison tests. The significance level was set at 0.05.

Results:

Mean concentration (irrespective of time) for TAP at which mean minimum optical density was recorded at 1.25 μg/ml (1:20 dilution) and 25 μg/ml (0 dilution) against E. faecalis and C. albicans, respectively. Least optical density for CH plus PPI group was obtained 1.6 μg/ml (1:10 dilution) and 16 μg/ml (0 dilution) for E. faecalis and C. albicans, respectively. However, CH alone showed a weaker antimicrobial action against either of the strains even at full concentration.

Conclusions:

PPI enhanced the antibacterial efficacy of CH against E. faecalis and C. albicans. However, TAP showed the best antibacterial property followed by CH plus PPIs against both the selected strains.

16S rRNA gene-based metagenomic analysis identifies a novel bacterial co-prevalence pattern in dental caries

Objective:

To identify the prevalence of acidogenic and nonacidogenic bacteria in patients with polycaries lesions, and to ascertain caries specific bacterial prevalence in relation to noncaries controls.

Materials and Methods:

Total genomic DNA extracted from saliva of three adults and four children from the same family were subjected to 16S rRNA gene sequencing analysis on a next generation sequencer, the PGS-Ion Torrent. Those bacterial genera with read counts > 1000 were considered as significant in each of the subject and used to associate the occurrence with caries.

Results and Conclusion:

Sequencing analysis indicated a higher prevalence of Streptococcus, Rothia, Granulicatella, Gemella, Actinomyces, Selenomonas, Haemophilus and Veillonella in the caries group relative to controls. While higher prevalence of Streptococcus, Rothia and Granulicatella were observed in all caries samples, the prevalence of others was observable in 29–57% of samples. Interestingly, Rothia and Selenomonas, which are known to occur within anaerobic environments of dentinal caries and subgingival plaque biofilms, were seen in the saliva of these caries patients. Taken together, the study has identified for the first time a unique co-prevalence pattern of bacteria in caries patients that may be explored as distinct caries specific bacterial signature to predict cariogenesis in high-risk primary and mixed dentition age groups.

The antimicrobial activity of Azadirachta indica, Mimusops elengi, Tinospora cardifolia, Ocimum sanctum and 2% chlorhexidine gluconate on common endodontic pathogens: An in vitro study

Objective:

To check the antimicrobial activity of Azadirachta indica (Neem), Ocimum sanctum (Tulsi), Mimusops elelngi (Bakul), Tinospora cardifolia (Giloy) and Chlorhexidine Gluconate (CHX) on common endodontic pathogens like Streptococcus mutans, Enterococcus faecalis and staphylococcus aureus.

Materials and Methods:

The agar diffusion test was used to check the antimicrobial activity of the Methanolic extracts of the medicinal plants along with CHX. Six different concentrations of the tested agents were used for the study. The values of Zone of Inhibition were tabulated according to the concentration of the tested agent and data was statistically analyzed using ANOVA and Bonferroni post- hoc tests. The Minimum Inhibitory Concentration (MIC) and Minimum Bactericidal Concentrations (MBC) values were also recorded.

Results:

All the plants extracts showed considerable antimicrobial activity against selected endodontic pathogens. At 3mg. concentration, O.sanctum was the most effective against S. mutans, M. elengi showed highest zone of inhibition against E.faecalis, whereas CHX was the most effective agent against S.aureus. CHX was also the most consistent of all the medicaments testes, showing inhibitory effect against all the tree pathogens at all the selected concentrations.

Conclusions:

The Methanolic extract of A.Indica, O.sanctum, M. Elengi, T.cardifolia and Chlorhexidine Gluconate has considerable antimicrobial activity against S. mutans, E. faecalis and S. aureus.