1
|
Amhmed M, Liu H, Häkkinen L, Haapasalo M, Shen Y. Antimicrobial efficacy of DJK-5 peptide in combination with EDTA against biofilms in dentinal tubules: Primary irrigation, recovery and re-irrigation. Int Endod J 2024; 57:1343-1359. [PMID: 38837723 DOI: 10.1111/iej.14104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 05/10/2024] [Accepted: 05/20/2024] [Indexed: 06/07/2024]
Abstract
AIM To investigate the dynamic recovery of biofilms within dentinal tubules after primary irrigation with different protocols, and to evaluate the efficacy of various re-irrigation protocols on recovered biofilm, considering factors such as smear layer, nutrient conditions, and primary irrigants. METHODOLOGY A total of 416 mono or multi-species biofilms samples were prepared from human teeth and incubated for 3 weeks. After inducing a smear layer on half of the samples, all specimens were irrigated with one of the following irrigant sequences: (1) 6% NaOCl +17% EDTA, (2) 6% NaOCl +8.5% EDTA, (3) 6% NaOCl and (8.5% EDTA +10 μg/mL DJK-5 antimicrobial peptide), or (4) sterile water. Thirty-two samples were used to assess immediate effect, whilst the rest were re-incubated to assess biofilms recovery. Nutrient conditions were defined based on whether culture media were changed (nutrient-rich) or not (nutrient-poor) during re-incubation. After 16 weeks, recovered biofilms underwent re-irrigation using four additional protocols, with or without DJK-5 peptide, based on primary irrigants. Confocal laser scanning microscopy was employed to evaluate immediate irrigant effects, biofilms recovery intervals (1, 3, 5, 8, 12, and 16 weeks after primary irrigation), and re-irrigation effects at the 16-week. Statistical analysis included one-way anova and two-way mixed anova tests. RESULTS The DJK-5 peptide irrigation protocols demonstrated the highest killing rates during primary irrigation and resulted in a longer biofilms recovery time of 16 weeks compared to non-peptide protocols (p < .001). Both primary irrigation type and smear layer presence significantly influenced biofilms recovery (p < .001). In the absence of smear layer, re-irrigation efficacy didn't significantly differ from primary irrigation, regardless of primary irrigation type or nutrient conditions. However, with a smear layer present, re-irrigation led to significantly higher proportion of dead bacteria compared to primary irrigation (p < .05). Inclusion of the DJK-5 peptide into the re-irrigation protocol displayed superior killing rate compared to other protocols (p < .001). CONCLUSIONS Biofilms exhibited susceptibility to both peptide and non-peptide protocols during re-irrigation, irrespective of nutrient conditions or primary irrigation protocols. The DJK-5 peptide irrigation protocols consistently displayed superior effectiveness compared to non-peptide protocols.
Collapse
Affiliation(s)
- Mohamed Amhmed
- Department of Oral Biological and Medical Sciences, Faculty of Dentistry, The University of British Columbia, Vancouver, British Columbia, Canada
- Division of Prosthodontics, Department of Oral Health Sciences, Faculty of Dentistry, The University of British Columbia, Vancouver, British Columbia, Canada
- Department of Oral Biology, Faculty of Dentistry, The University of Sebha, Sebha, Libya
| | - He Liu
- Department of Oral Biological and Medical Sciences, Faculty of Dentistry, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Lari Häkkinen
- Department of Oral Biological and Medical Sciences, Faculty of Dentistry, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Markus Haapasalo
- Department of Oral Biological and Medical Sciences, Faculty of Dentistry, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Ya Shen
- Department of Oral Biological and Medical Sciences, Faculty of Dentistry, The University of British Columbia, Vancouver, British Columbia, Canada
| |
Collapse
|
2
|
Ruiz-Linares M, Fedoseev V, Solana C, Muñoz-Sandoval C, Ferrer-Luque CM. Antibiofilm Efficacy of Calcium Silicate-Based Endodontic Sealers. MATERIALS (BASEL, SWITZERLAND) 2024; 17:3937. [PMID: 39203118 PMCID: PMC11355656 DOI: 10.3390/ma17163937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2024] [Revised: 07/25/2024] [Accepted: 08/05/2024] [Indexed: 09/03/2024]
Abstract
BACKGROUND Using endodontic sealers with long-term antimicrobial properties can increase the success of endodontic treatment. This study aimed to assess the antimicrobial activity over time of two calcium silicate (CS)-based sealers, AH Plus Bioceramic and BioRoot RCS, and to compare them with an epoxy resin-based sealer, AH Plus Jet, against mature polymicrobial biofilms grown on human radicular dentin. METHODS The antimicrobial activity of the sealers was tested using a direct contact test after 1 and 6 weeks of contact with the biofilms. Cell viability was determined by the adenosine triphosphate (ATP) method and flow cytometry (FC). The results of the ATP test were analyzed using an ANOVA with Welch's correction, followed by the Games-Howell test. The number of cells with damaged membranes obtained by FC in each period was compared by means of an ANOVA and Duncan's test. For the comparison between times, a Student's t-test was used. RESULTS Globally, after a week of contact, the epoxy resin-based sealer obtained the best results. However, at 6 weeks, the two CSs showed the highest antimicrobial efficacy, with a significant increase in this activity over time. CONCLUSIONS Calcium silicate-based sealers exert long-term antimicrobial activity against endodontic biofilms.
Collapse
Affiliation(s)
- Matilde Ruiz-Linares
- Department of Stomatology, University of Granada, 18071 Granada, Spain; (V.F.)
- Instituto de Investigación Biosanitaria, 18012 Granada, Spain
| | - Vsevolod Fedoseev
- Department of Stomatology, University of Granada, 18071 Granada, Spain; (V.F.)
| | - Carmen Solana
- Department of Stomatology, University of Granada, 18071 Granada, Spain; (V.F.)
- Instituto de Investigación Biosanitaria, 18012 Granada, Spain
| | - Cecilia Muñoz-Sandoval
- Cariology Unit, Department of oral Rehabilitation, Faculty of Dentistry, University of Talca, Talca 3344158, Chile;
| | - Carmen María Ferrer-Luque
- Department of Stomatology, University of Granada, 18071 Granada, Spain; (V.F.)
- Instituto de Investigación Biosanitaria, 18012 Granada, Spain
| |
Collapse
|
3
|
Doğan MU, Arıcıoğlu B, Köse TE, Çıkman AŞ, Öksüzer MÇ. Association between the irrigation-agitation techniques and Periapical Healing of large periapical lesions: a Randomized Controlled Trial. Clin Oral Investig 2024; 28:376. [PMID: 38878107 PMCID: PMC11180158 DOI: 10.1007/s00784-024-05758-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 05/30/2024] [Indexed: 06/19/2024]
Abstract
OBJECTIVES The aim of this study was to evaluate the effects of manual dynamic activation (MDA), passive ultrasonic irrigation (PUI), and laser-activated irrigation (shock wave-enhanced emission photoacoustic streaming (SWEEPS)) on the periapical healing of large periapical lesions following nonsurgical root canal treatment. MATERIALS AND METHODS A total of fifty-six systemically healthy patients with a mandibular single-rooted tooth with periapical lesions of endodontic origin and a periapical index score of 3 or higher were included in the study. Before the treatment procedures, lesion volumes were determined volumetrically using cone-beam computed tomography (CBCT). Patients were randomized into treatment (MDA, PUI, SWEEPS) and control groups (n = 14). Root canal treatment and irrigation procedures were performed by a calibrated postgraduate operator and completed at one visit. For routine follow-up, clinical and radiographic evaluations were performed by a blinded evaluator using periapical (PA) radiographs according to Molven's criteria at 3, 6, and 9 months. At 12 months, lesion volumes were quantified volumetrically using CBCT (ITK-SNAP). The data were statistically analyzed with the Wilcoxon test. The significance level was set at p < 0.05. RESULTS In all groups, the mean lesion volume after treatment was significantly smaller than the mean volume before treatment (p = 0.001). Among the 56 teeth, 11 teeth were 'totally healed', and 39 teeth were 'reduced' on PA radiographs. No 'enlargement' was detected in any group. On CBCT, the lesion volume decreased in the following order: LAI-SWEEPS (86.9%) > PUI (85.4%) > MDA (80.4%) > control (74.5%), with no statistically significant difference (p > 0.05). CONCLUSIONS Despite the limitations of the present study, although a greater percentage of healing was observed in the LAI-SWEEPS and PUI groups, irrigation procedures had no statistically significant effect on the healing of periapical lesions with a single root canal at the 12-month follow-up. On the other hand, the outcome may change in multirooted teeth with curved and complex root canal systems. CLINICAL RELEVANCE In the short term and in single-canal teeth, advanced irrigation agitation methods such as laser and ultrasonic did not make a difference in healing other than manual irrigation agitation.
Collapse
Affiliation(s)
- Mehmet Umutcan Doğan
- Faculty of Dentistry, Department of Endodontics, Recep Tayyip Erdoğan University, Rize, Turkey
| | - Banu Arıcıoğlu
- Faculty of Dentistry, Department of Endodontics, Istanbul Medeniyet University, İstanbul, Turkey
| | - Taha Emre Köse
- Faculty of Dentistry, Department of Endodontics, Recep Tayyip Erdoğan University, Rize, Turkey
| | - Ahter Şanal Çıkman
- Faculty of Dentistry, Department of Endodontics, Recep Tayyip Erdoğan University, Rize, Turkey
| | - Merve Çoban Öksüzer
- Faculty of Dentistry, Department of Endodontics, Recep Tayyip Erdoğan University, Rize, Turkey.
| |
Collapse
|
4
|
Wang Y, Zhang X, Zheng H, Zhou Z, Li S, Jiang J, Li M, Fu B. Remineralization of Dentin with Cerium Oxide and Its Potential Use for Root Canal Disinfection. Int J Nanomedicine 2023; 19:1-17. [PMID: 38179219 PMCID: PMC10763684 DOI: 10.2147/ijn.s441060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 12/12/2023] [Indexed: 01/06/2024] Open
Abstract
Objective This study was to investigate a novel antibacterial biomimetic mineralization strategy for exploring its potential application for root canal disinfection when stabilized cerium oxide was used. Material and Methods A biomimetic mineralization solution (BMS) consisting of cerium nitrate and dextran was prepared. Single-layer collagen fibrils, collagen membranes, demineralized dentin, and root canal system were treated with the BMS for mineralization. The mineralized samples underwent comprehensive characterization using various techniques, including transmission electron microscopy (TEM), high-resolution TEM (HRTEM), Fourier transform infrared spectroscopy (FTIR), scanning transmission electron microscopy (STEM), selected-area electron diffraction (SAED), energy-dispersive X-ray spectroscopy (EDX), X-ray photoelectron spectroscopy (XPS), scanning electron microscopy (SEM), and micro-CT. Additionally, the antimicrobial properties of the BMS and the remineralized dentin were also analyzed with broth microdilution method, live/dead staining, and SEM. Results Cerium ions in the BMS underwent a transformation into cerium oxide nanoparticles, which were deposited in the inter- and intra-fibrillar collagen spaces through a meticulous bottom-up process. XPS analysis disclosed the presence of both Ce (III) and Ce (IV) of the generated cerium oxides. A comprehensive examination utilizing SEM and micro-CT identified the presence of cerium oxide nanoparticles deposited within the dentinal tubules and lateral canals of the root canal system. The BMS and remineralized dentin exhibited substantial antibacterial efficacy against E. faecalis, as substantiated by assessments involving the broth dilution method and live/dead staining technique. The SEM findings revealed the cell morphological changes of deceased E. faecalis. Conclusion This study successfully demonstrated antibacterial biomimetic mineralization as well as sealing dentinal tubules and lateral branches of root canals using cerium nitrate and dextran. This novel biomimetic mineralization could be used as an alternative strategy for root canal disinfection.
Collapse
Affiliation(s)
- Yinlin Wang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, People’s Republic of China
| | - Xinyue Zhang
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People’s Republic of China
| | - Haiyan Zheng
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, People’s Republic of China
| | - Zihuai Zhou
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, People’s Republic of China
| | - Si Li
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, People’s Republic of China
| | - Jimin Jiang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, People’s Republic of China
| | - Mingxing Li
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, People’s Republic of China
| | - Baiping Fu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, People’s Republic of China
| |
Collapse
|
5
|
Rossi-Fedele G, Rödig T. Effectiveness of root canal irrigation and dressing for the treatment of apical periodontitis: A systematic review and meta-analysis of clinical trials. Int Endod J 2023; 56 Suppl 3:422-435. [PMID: 35579074 DOI: 10.1111/iej.13777] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 05/12/2022] [Accepted: 05/13/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Sodium hypochlorite (NaOCl) and ethylenediaminetetraacetic acid (EDTA) and/or calcium hydroxide (Ca(OH)2 ) are commonly used during root canal treatment. Evaluation of their effectiveness regarding clinical and patient-related outcomes requires further understanding. OBJECTIVES To assess the effectiveness of root canal irrigation and dressing for the treatment of teeth with apical periodontitis (AP). METHODS A search was conducted in the PubMed-MEDLINE, Scopus, EMBASE, Google scholar databases and available repositories, followed by hand searches, until July 2021. Eligibility criteria followed the a priori formulated Population, Intervention, Comparator, Outcomes, Timing, and Study design (PICOTS) framework. Clinical studies restricted to English language were included. The revised Cochrane risk-of-bias tool for randomised trials (RoB 2) was used to assess the quality of included studies. Meta-analyses were performed using the fixed-effect model to obtain Risk Ratio (RR) and 95% Confidence Interval (CI), with sensitivity analysis. Overall quality of evidence of meta-analyses was assessed through the Grading of Recommendations Assessment, Development, and Evaluation tool. RESULTS The search identified 1357 records of which six fulfilled the inclusion criteria, providing data for 'irrigation' from 212 teeth and for 'dressings' from 438 teeth. Two studies reported no significant difference regarding the outcome 'pain at 7 days' using 2% chlorhexidine vs. 5.25% NaOCl and EDTA or after using different concentrations of NaOCl (1% vs. 5%). No significant difference was detected between different NaOCl concentrations regarding the reduction of AP. A meta-analysis was possible for the comparison of single-visit (SV) versus multiple-visits including the use of Ca(OH)2 demonstrating a significant effect in favour of SV (RR: 1.10; 95% CI: 1.03-1.19; p = .007; I2 = 0). RoB of included studies was moderate to low. DISCUSSION The use of Ca(OH)2 for the treatment of AP may not be beneficial. There is scarce or no evidence fulfilling the proposed PICOTS regarding irrigants and dressings. CONCLUSIONS There is moderate certainty that SV treatment is associated with better radiographic evidence of normal periodontal ligament space (strict criteria) compared with the use of Ca(OH)2. Reduction of AP is comparable after irrigation with 1% and 5% NaOCl, whereas postoperative pain at 7 days for the irrigants assessed is similar. REGISTRATION PROSPERO database CRD42021260271.
Collapse
Affiliation(s)
| | - Tina Rödig
- Department for Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Göttingen, Germany
| |
Collapse
|
6
|
Duncan HF, Kirkevang LL, Peters OA, El-Karim I, Krastl G, Del Fabbro M, Chong BS, Galler KM, Segura-Egea JJ, Kebschull M. Treatment of pulpal and apical disease: The European Society of Endodontology (ESE) S3-level clinical practice guideline. Int Endod J 2023; 56 Suppl 3:238-295. [PMID: 37772327 DOI: 10.1111/iej.13974] [Citation(s) in RCA: 36] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 08/25/2023] [Accepted: 08/26/2023] [Indexed: 09/30/2023]
Abstract
BACKGROUND The ESE previously published quality guidelines for endodontic treatment in 2006; however, there have been significant changes since not only in clinical endodontics but also in consensus and guideline development processes. In the development of the inaugural S3-level clinical practice guidelines (CPG), a comprehensive systematic and methodologically robust guideline consultation process was followed in order to produce evidence-based recommendations for the management of patients presenting with pulpal and apical disease. AIM To develop an S3-level CPG for the treatment of pulpal and apical disease, focusing on diagnosis and the implementation of the treatment approaches required to manage patients presenting with pulpitis and apical periodontitis (AP) with the ultimate goal of preventing tooth loss. METHODS This S3-level CPG was developed by the ESE, with the assistance of independent methodological guidance provided by the Association of Scientific Medical Societies in Germany and utilizing the GRADE process. A robust, rigorous and transparent process included the analysis of relevant comparative research in 14 specifically commissioned systematic reviews, prior to evaluation of the quality and strength of evidence, the formulation of specific evidence and expert-based recommendations in a structured consensus process with leading endodontic experts and a broad base of external stakeholders. RESULTS The S3-level CPG for the treatment of pulpal and apical disease describes in a series of clinical recommendations the effectiveness of diagnosing pulpitis and AP, prior to investigating the effectiveness of endodontic treatments in managing those diseases. Therapeutic strategies include the effectiveness of deep caries management in cases with, and without, spontaneous pain and pulp exposure, vital versus nonvital teeth, the effectiveness of root canal instrumentation, irrigation, dressing, root canal filling materials and adjunct intracanal procedures in the management of AP. Prior to treatment planning, the critical importance of history and case evaluation, aseptic techniques, appropriate training and re-evaluations during and after treatment is stressed. CONCLUSION The first S3-level CPG in endodontics informs clinical practice, health systems, policymakers, other stakeholders and patients on the available and most effective treatments to manage patients with pulpitis and AP in order to preserve teeth over a patient's lifetime, according to the best comparative evidence currently available.
Collapse
Affiliation(s)
- Henry F Duncan
- Division of Restorative Dentistry & Periodontology, Dublin Dental University Hospital, Trinity College Dublin, Dublin, Ireland
| | | | - Ove A Peters
- School of Dentistry, The University of Queensland, Herston, Queensland, Australia
| | - Ikhlas El-Karim
- School of Medicine Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Gabriel Krastl
- Department of Conservative Dentistry and Periodontology, University Hospital of Würzburg, Würzburg, Germany
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Bun San Chong
- Faculty of Medicine & Dentistry, Institute of Dentistry, Queen Mary University of London, London, UK
| | - Kerstin M Galler
- Department of Operative Dentistry and Periodontology, Friedrich-Alexander-University Erlangen-Nuernberg, Erlangen, Germany
| | - Juan J Segura-Egea
- Department of Stomatology, Endodontics Section, School of Dentistry, University of Sevilla, Sevilla, Spain
| | - Moritz Kebschull
- School of Dentistry, Institute of Clinical Sciences, College of Medical & Dental Sciences, University of Birmingham, Birmingham, UK
- Birmingham Community Healthcare NHS Trust, Birmingham, UK
- Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, College of Dental Medicine, Columbia University, New York, New York, USA
| |
Collapse
|
7
|
Hage W, Sarkis DK, Kallasy M, Sfeir G, Mallah M, Hachem RE, Khalil I, Zogheib C. Antimicrobial Activity of Five Calcium Silicate Based Root Canal Sealers against a Multispecies Engineered Biofilm: An In Vitro Study. J Contemp Dent Pract 2023; 24:707-714. [PMID: 38152946 DOI: 10.5005/jp-journals-10024-3556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2023]
Abstract
AIM The present study's objective was to compare the impact of CerasealR, total fill BC SealerR, Bio-C SealerR, AH Plus BioceramicR, and K-BiocerR on the elimination of a multispecies' endodontic biofilm at 3, 7 and 14 days. MATERIALS AND METHODS A total of 20 freshly extracted, caries-free premolars were prepared for the study to create dentinal disks. For the multispecies biofilm formation, Enterococcus faecalis, Proteus mirabilis, Pseudomonas aeruginosa, and Candida albicans were cultured and used to inoculate hydroxyapatite discs. After incubation, the biofilms were placed on blotting papers in petri dishes with an orthodontic bend. Different root canal sealers, including CeraSeal, total Fill BC Sealer, Bio-C Sealer, AH Plus Bioceramic, K-Biocer, and Sealite, were injected into the bend, facilitating contact with the biofilms. The samples were divided into seven groups, including a negative control. At specific intervals, 3, 7, and 14 days, 3 biofilm samples from each group were collected, diluted, and plated on Agar media for colony counting and analysis. RESULTS In all tested groups, the total bacterial count significantly decreased between day 3 and 14 (p < 0.05) with no statistically significant differences among the different sealers' groups at all-time points for the total bacterial count, E. faecalis count, and P. mirabilis count. However, Sealite demonstrated the most consistent effectiveness in reducing bacterial counts across multiple categories. The sealite group was capable of decreasing the C. albicans count significantly between day 3 and day 14 (p < 0.05) in comparison with the bioceramic groups. CONCLUSION All sealers had antibacterial activity against the multispecies biofilm between day 3 and day 14. The ascending order of sealers in terms of their effectiveness in killing bacteria, based on the provided results, is as follows: Sealite, Bio-C Sealer, AH Plus, CeraSeal, TotalFill, and K-Biocer. However, there were no statistically significant differences in the bacterial counts among the different sealer groups at any time point. CLINICAL SIGNIFICANCE The role of sealers in combating biofilm-associated infections highlights their potential clinical utility in preserving root canal health. Understanding the antimicrobial properties of these sealers is vital for informed decision-making in selecting the most effective materials for improved treatment outcomes and long-term success in endodontic procedures.
Collapse
Affiliation(s)
- Wajih Hage
- Department of Endodontics, Saint-Joseph University, Beirut, Lebanon. Phone: +961 70 188796, e-mail:
| | - Dolla Karam Sarkis
- Laboratory of Pathogens, Faculty of Pharmacy, Saint-Joseph University, Beirut, Lebanon
| | - Mireille Kallasy
- Department of Molecular and Cellular Biology, Saint-Joseph University, Beirut, Lebanon
| | - Germain Sfeir
- Department of Endodontic, Saint-Joseph University, Beirut, Lebanon
| | - May Mallah
- Department of Microbiological Quality Control of Food, Pharmaceutical and Cosmetic Products, Saint-Joseph University, Beirut, Lebanon
| | - Roula El Hachem
- Department of Endodontic, Saint-Joseph University, Beirut, Lebanon
| | - Issam Khalil
- Department of Endodontic, Saint-Joseph University, Beirut, Lebanon
| | - Carla Zogheib
- Department of Endodontic, Saint-Joseph University, Beirut, Lebanon
| |
Collapse
|
8
|
Bapat RA, Libat R, Yuin OS, Parolia A, Ilyas MS, Khan AS, Kay MK, Pichika MR, Saxena K, Seow LL, Sidhu P, Daood U. Antimicrobial FiteBac® K21 promotes antimicrobial Potency and wound healing. Heliyon 2023; 9:e19282. [PMID: 37664740 PMCID: PMC10469996 DOI: 10.1016/j.heliyon.2023.e19282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 07/27/2023] [Accepted: 08/17/2023] [Indexed: 09/05/2023] Open
Abstract
Objectives Successful root canal therapy is dependent on the efficacy of complete instrumentation and adequate use of chemical irrigant to eliminate the biofilm from dentin surface. The aim of the study was to examine antibiofilm and antimicrobial effectiveness of newly formulated Quaternary ammonium silane (QAS/also codenamed K21; against Fusobacterium nucleatum (F. nucleatum) and Enterococcus faecalis (E. faecalis) biofilm on radicular dentin with evaluation of the anti-inflammatory consequence in vivo. Methods Fourier Transform Infrared Spectroscopy (FTIR) was performed after complete hydrolysis of K21 solution. Human teeth were inoculated with biofilms for 7-days followed by treatment with various irrigants. The irrigant groups were Sodium hypochlorite [NaOCl (6%)], Chlorhexidine [CHX (2%)], K21 (0.5%), K21 (1%) and Saline. Scanning electron microscopy (SEM) was performed for biofilm and resin-dentin penetration. Transmission Electron Microscopy (TEM) of biofilms was done to evaluate application of K21. For in vivo evaluation, Albino wistar rats were injected subcutaneously and sections were stained with haematoxylin/eosin. Macrophage, M1/M2 expression were evaluated along with molecular simulation. Raman measurements were done on dried biofilms. Results FTIR K21 specimens demonstrated presence of ethanol/silanol groups. Raman band at 1359 cm-1 resemble to -CH2- wagging displaying 29Si atoms in Nuclear Magnetic Resonance (NMR). 0.5%K21 showed cells exhibiting folded membranes. SEM showed staggering amount of resin tags with 0.5% K21 group. TEM showed membrane disruption in K21-groups. K21 groups were initially irritant, which subsided completely afterwards showing increased CD68. K21 and MMP/collagen complex was thermodynamically favourable. Conclusion K21 root canal irrigant was able to penetrate bacterial wall and can serve as a potential irrigant for therapeutic benefits. Expression of M2 polarized subsets showed K21 can serve in resolving inflammation and potentiate tissue repair.
Collapse
Affiliation(s)
- Ranjeet Ajit Bapat
- Restorative Division, School of Dentistry, International Medical University Kuala Lumpur, 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | - Rikan Libat
- Restorative Division, School of Dentistry, International Medical University Kuala Lumpur, 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | - Ong Shu Yuin
- Restorative Division, School of Dentistry, International Medical University Kuala Lumpur, 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | - Abhishek Parolia
- Restorative Division, School of Dentistry, International Medical University Kuala Lumpur, 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | | | - Abdul Samad Khan
- Department of Restorative Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University; Dammam, Saudi Arabia
| | - Mak Kit Kay
- Pharmaceutical Chemistry, School of Pharmacy, International Medical University, Kuala Lumpur, Malaysia
| | - Mallikarjuna Rao Pichika
- Pharmaceutical Chemistry, School of Pharmacy, International Medical University, Kuala Lumpur, Malaysia
| | - Kirti Saxena
- Clinical Oral Health Sciences Division, School of Dentistry, International Medical University Kuala Lumpur, 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | - Liang Lin Seow
- Restorative Division, School of Dentistry, International Medical University Kuala Lumpur, 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | - Preena Sidhu
- Restorative Division, School of Dentistry, International Medical University Kuala Lumpur, 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | - Umer Daood
- Restorative Division, School of Dentistry, International Medical University Kuala Lumpur, 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000, Wilayah Persekutuan Kuala Lumpur, Malaysia
| |
Collapse
|
9
|
Baaij A, Visscher CM, Jansen M, Özok AR. Incidence of interappointment emergencies in multiple-visit root canal treatments performed with or without intracanal medicament by undergraduate students. Restor Dent Endod 2023; 48:e31. [PMID: 37675442 PMCID: PMC10477423 DOI: 10.5395/rde.2023.48.e31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 04/27/2023] [Accepted: 05/07/2023] [Indexed: 09/08/2023] Open
Abstract
Objectives This retrospective cohort study examined the incidence of interappointment emergencies during multiple-visit molar root canal treatments conducted by undergraduate students. Treatments performed without the use of intracanal medicament were compared to treatments that incorporated calcium hydroxide as an intracanal medicament. Materials and Methods Interappointment emergencies, defined as instances of pain or swelling that required the patient to make an unscheduled follow-up visit, were recorded for up to 2 months after the intervention. To avoid the influence of obturation on the observed incidence of emergency visits, only unscheduled visits occurring between the start and end of the root canal treatment were included. Results Of the 719 patients included in this study, 77 (10.7%) were recorded as experiencing interappointment emergencies. Of these emergencies, 62% occurred within 2 weeks following the most recent intervention. In the group of patients who did not receive intracanal medicament, the incidence of interappointment emergencies was 11.9% (46 of 385 patients). In comparison, this rate was 9.3% (31 of 334 patients) among those who received calcium hydroxide as an intracanal medicament (odds ratio, 1.33; 95% confidence interval, 0.82-2.15; p = 0.249). Conclusions Interappointment emergencies may arise at any point during root canal treatment, but they most commonly occur within the first 2 weeks following intervention. The omission of intracanal medicament in multiple-visit molar root canal treatments, performed by undergraduate students, did not significantly increase the incidence of these emergencies.
Collapse
Affiliation(s)
- Annemarie Baaij
- Department of Endodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Corine Mirjam Visscher
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Manon Jansen
- Department of Endodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Ahmet Rifat Özok
- Department of Endodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| |
Collapse
|
10
|
Wuersching SN, Moser L, Obermeier KT, Kollmuss M. Microleakage of Restorative Materials Used for Temporization of Endodontic Access Cavities. J Clin Med 2023; 12:4762. [PMID: 37510877 PMCID: PMC10381707 DOI: 10.3390/jcm12144762] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 07/06/2023] [Accepted: 07/17/2023] [Indexed: 07/30/2023] Open
Abstract
A tight temporary seal applied to an access cavity is thought to improve endodontic outcomes. This study aims to assess the bacterial and glucose microleakage of different types and combinations of temporary restorations. Human-extracted incisors were instrumented, dressed with a calcium hydroxide paste, and sealed with Cavit W (CW), CW/Ketac Molar (CW/KM), CW/Smart Dentin Replacement (CW/SDR), Intermediate restorative material/KM (IRM/KM), or Clip F (CF). Standardized 3D-printed hollow test specimens were manufactured and temporized in the same manner. The specimens were examined for bacterial and glucose leakage for 28 days. Data were analyzed using a Kaplan-Meier survival analysis. CW/SDR and CF showed the least bacterial and glucose leakage over time. CW, CW/KM, and IRM/KM had similarly high levels of glucose leakage, but CW/KM and IRM/KM provided a tighter seal against bacterial penetration than CW. CW/SDR and CF should be considered for the sealing of access cavities of teeth previously restored with methacrylate-based materials.
Collapse
Affiliation(s)
- Sabina Noreen Wuersching
- Department of Conservative Dentistry and Periodontology, LMU University Hospital, LMU Munich, 80336 Munich, Germany
| | - Luise Moser
- Department of Conservative Dentistry and Periodontology, LMU University Hospital, LMU Munich, 80336 Munich, Germany
| | - Katharina Theresa Obermeier
- Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery, LMU University Hospital, LMU Munich, 80337 Munich, Germany
| | - Maximilian Kollmuss
- Department of Conservative Dentistry and Periodontology, LMU University Hospital, LMU Munich, 80336 Munich, Germany
| |
Collapse
|
11
|
Hristov K, Doitchinova L, Gateva N. Regenerative endodontic treatment of immature permanent teeth after mechanical instrumentation with XP-Endo Finisher. Folia Med (Plovdiv) 2023; 65:460-467. [PMID: 38351823 DOI: 10.3897/folmed.65.e80063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 02/18/2022] [Indexed: 02/16/2024] Open
Abstract
INTRODUCTION The traditional treatment of immature permanent teeth with necrotic pulp involves creating an apical barrier by using calcium hydroxide or an MTA plug for an extended period of time. A novel therapeutic approach called regenerative endodontic procedures (REP) is used to allow root development to continue.
Collapse
|
12
|
Shaaban S, Genena S, Elraggal A, Hamad GM, Meheissen MA, Moussa S. Antibacterial effectiveness of multi-strain probiotics supernatants intracanal medication on Enterococcus faecalis biofilm in a tooth model. BMC Oral Health 2023; 23:228. [PMID: 37081415 PMCID: PMC10116691 DOI: 10.1186/s12903-023-02914-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 03/26/2023] [Indexed: 04/22/2023] Open
Abstract
BACKGROUND To assess the antibacterial activity of multi-strain probiotics supernatants (MSP); Lactobacillus plantarum, Lactobacillus rhamnosus, and Lactobacillus acidophilus as an intracanal medication on Enterococcus faecalis (E. faecalis) biofilm in a tooth model. METHODS Sixty extracted human single-rooted teeth with single canals were instrumented, sterilized, and inoculated with E. faecalis. After 21 days of incubation, four specimens were randomly selected to validate the biofilm formation by scanning electron microscope (SEM). The remaining specimens were randomly divided (n = 14), according to the intracanal medication (ICM) received into: Ca(OH)2: calcium hydroxide paste (35% Ultra Cal XS Ca(OH)2), Probiotics supernatants: MSP in poloxamer gel vehicle Poloxamer: poloxamer gel vehicle and, Control: E. faecalis biofilm only. The tested groups were further subdivided into two equal subgroups (n = 7) according to the incubation period (24 h and 7 days). Shaved dentin chips were obtained and collected by H-files and paper points, respectively for bacterial culture. The antibacterial activity was assessed after each incubation period quantitatively and qualitatively using bacterial colony-forming units per milliliter (CFUs/ml) and SEM, respectively. RESULTS The lowest CFUs/ml was found in Ca (OH)2 with a significant difference compared to other groups after 24 h. After 7 days, a similar outcome was found with a further significant reduction of CFUs/ml in all groups with no statistical difference between Ca(OH)2 and probiotics supernatants groups. Ca (OH)2 and Probiotics supernatants groups showed a significant (p < 0.05) percentage of overall bacterial reduction (100.00 ± 0.00% and 70.30 ± 12.95%, respectively) compared to poloxamer and control groups (27.80 ± 14.45 and 28.29 ± 19.79). SEM images showed a bacteria-free state in the Ca(OH)2 group after 7 days while few bacteria were found in the probiotics supernatants group. An extensive invasion of bacteria was found in poloxamer and controls groups. CONCLUSION MSP has a potential antibacterial effect on E. faecalis growth closely similar to the routinely used Ca (OH)2.
Collapse
Affiliation(s)
- Shymaa Shaaban
- Division of Endodontics, Conservative Dentistry Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Salma Genena
- Division of Endodontics, Conservative Dentistry Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Alaaeldin Elraggal
- Division of Operative Dentistry, Conservative Dentistry Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
| | - Gamal M Hamad
- Department of Food Technology, Arid Lands Cultivation Research Institute (ALCRI), City of Scientific Research and Technological Applications (SRTACity), New Borg El-Arab, Alexandria, Egypt
| | - Marwa A Meheissen
- Medical Microbiology & Immunology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Sybel Moussa
- Division of Endodontics, Conservative Dentistry Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| |
Collapse
|
13
|
Non-cytotoxic Root Canal Dressing with Improved Antimicrobial Efficacy. J Endod 2023; 49:205-211. [PMID: 36528174 DOI: 10.1016/j.joen.2022.11.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 10/31/2022] [Accepted: 11/02/2022] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Recurrent endodontic infections are primarily caused by Enterococcus faecalis and are more challenging to treat, compared with primary infection of the root canal system. Calcium hydroxide (CH) is used as an interappointment dressing in endodontics despite its inefficacy against E. faecalis and other pathogens. To improve antimicrobial properties and limit cytotoxicity of CH, we added salicylic acid to CH (CASA) to disinfect the canal. CASA overcomes the main pathogen responsible for recurrent endodontic infections. The aim of this study was to evaluate the antimicrobial activity of CASA and its cytotoxicity against dental pulp stem cells (DPSCs) and its effect on the differentiation potential of DPSCs. METHODS Mature E. faecalis biofilm cultured on dentin chips was exposed to CASA and studied using confocal laser scanning microscopy. The dose-dependency of CASA was also studied using the liquid suspension test. The cytotoxicity was tested against DPSCs, and its effect on the expression of osteocalcin and alkaline phosphatase was studied. RESULTS CASA produced larger zones of inhibition than CH for all species tested and demonstrated superior efficacy than CH against E. faecalis biofilm. Cytotoxicity studies indicated DPSC's high tolerance for CASA; addition of CASA to DPSCs was observed to increase the expression of biological markers related to mineralization. CONCLUSIONS CASA was proved to have superior antibacterial efficacy against E. faecalis when compared with CH. It also increased the expression of some DPSC differentiation markers involved in mineralization.
Collapse
|
14
|
Martinho FC, Corazza BJM, Khoury RD, Orozco EIF, Toia CC, Machado FP, Valera MC. Impact of N-acetylcysteine (NAC) and calcium hydroxide intracanal medications in primary endodontic infection: a randomized clinical trial. Clin Oral Investig 2023. [PMID: 35723751 DOI: 10.1007/s00784-022-04511-z.[e-pub]] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
OBJECTIVES This RCT investigated the impact of N-acetylcysteine (NAC) and calcium hydroxide [Ca(OH)2] intracanal medications (ICMs) in primary endodontic infection with apical periodontitis (PEIAP). MATERIALS AND METHODS Thirty-six teeth with PEIAP were randomly divided into groups according to the ICM: NAC, Ca(OH)2 + saline solution (SSL), and Ca(OH)2 + 2% chlorhexidine-gel (2% CHX-gel) (all, n = 12). Root canal samples (RCSs) were collected before (s1) and after instrumentation (s2) and after 14 days of ICM (s3). Chemomechanical preparation (CMP) was performed with a Reciproc file and 2.5% NaOCl. Checkerboard DNA-DNA hybridization was used to assess 40 target bacteria species. RESULTS At s1, bacterial DNA was detected in 100% of RCSs (36/36). All 40 bacterial species were found in PEIAP. The mean number of species per RCS was 17.92 ± 13.18. The most frequent bacteria were S. mitis (65%), E. nodatum (63%), E. faecalis (63%), F. nucl sp vicentii (58%), T. forsythia (58%), and F. periodonticum (56%). CMP reduced the mean number of species per RCS to 6.8 ± 2.36 (p < 0.05). At s3, the intragroup analysis revealed a broader antimicrobial activity for Ca (OH)2 + 2% CHX-gel and NAC than Ca(OH)2 + SSL (p < 0.05). NAC eliminated 8/12 bacteria species resistant to both Ca (OH)2 ICMs, including P. micra, P. nigrescens, T. denticola, A. israelii, P. endodontalis, P. acnes, C. ochracea, and E. corrodens. CONCLUSIONS Ca (OH)2 + 2% chlorhexidine gel (2% CHX gel) showed a greater bacterial elimination over the number of bacterial species; however, NAC eliminated 8/12 bacteria species resistant to both Ca (OH)2 ICMs (RBR-3xbnnn). CLINICAL RELEVANCE The use of intracanal medication with a broad antimicrobial activity can optimize root canal disinfection. Ca(OH)2 + 2% CHX gel and NAC showed a broader antimicrobial activity than Ca(OH)2 + SSL against endodontic pathogens in primary root canal infection. TRIAL REGISTRATION Brazilian Registry of Clinical Trials (REBEC), No. RBR-3xbnnn.
Collapse
Affiliation(s)
- Frederico C Martinho
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, 650 West Baltimore Street, 6th floor, Suite 6253, Baltimore, MD, 21201, USA.
| | - Bruna J M Corazza
- Department of Restorative Dentistry, Endodontic Division, Institute of Science and Technology, São Paulo State University - UNESP, São José dos Campos, São Paulo, Brazil
| | - Rayana D Khoury
- Department of Restorative Dentistry, Endodontic Division, Institute of Science and Technology, São Paulo State University - UNESP, São José dos Campos, São Paulo, Brazil
| | - Esteban I F Orozco
- Department of Restorative Dentistry, Endodontic Division, Institute of Science and Technology, São Paulo State University - UNESP, São José dos Campos, São Paulo, Brazil
| | - Cassia C Toia
- Department of Restorative Dentistry, Endodontic Division, Institute of Science and Technology, São Paulo State University - UNESP, São José dos Campos, São Paulo, Brazil
| | - Felipe P Machado
- Department of Restorative Dentistry, Endodontic Division, Institute of Science and Technology, São Paulo State University - UNESP, São José dos Campos, São Paulo, Brazil
| | - Marcia C Valera
- Department of Restorative Dentistry, Endodontic Division, Institute of Science and Technology, São Paulo State University - UNESP, São José dos Campos, São Paulo, Brazil
| |
Collapse
|
15
|
Martinho FC, Corazza BJM, Khoury RD, Orozco EIF, Toia CC, Machado FP, Valera MC. Impact of N-acetylcysteine (NAC) and calcium hydroxide intracanal medications in primary endodontic infection: a randomized clinical trial. Clin Oral Investig 2023; 27:817-826. [PMID: 35723751 DOI: 10.1007/s00784-022-04585-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 06/10/2022] [Indexed: 02/03/2023]
Abstract
OBJECTIVES This RCT investigated the impact of N-acetylcysteine (NAC) and calcium hydroxide [Ca(OH)2] intracanal medications (ICMs) in primary endodontic infection with apical periodontitis (PEIAP). MATERIALS AND METHODS Thirty-six teeth with PEIAP were randomly divided into groups according to the ICM: NAC, Ca(OH)2 + saline solution (SSL), and Ca(OH)2 + 2% chlorhexidine-gel (2% CHX-gel) (all, n = 12). Root canal samples (RCSs) were collected before (s1) and after instrumentation (s2) and after 14 days of ICM (s3). Chemomechanical preparation (CMP) was performed with a Reciproc file and 2.5% NaOCl. Checkerboard DNA-DNA hybridization was used to assess 40 target bacteria species. RESULTS At s1, bacterial DNA was detected in 100% of RCSs (36/36). All 40 bacterial species were found in PEIAP. The mean number of species per RCS was 17.92 ± 13.18. The most frequent bacteria were S. mitis (65%), E. nodatum (63%), E. faecalis (63%), F. nucl sp vicentii (58%), T. forsythia (58%), and F. periodonticum (56%). CMP reduced the mean number of species per RCS to 6.8 ± 2.36 (p < 0.05). At s3, the intragroup analysis revealed a broader antimicrobial activity for Ca (OH)2 + 2% CHX-gel and NAC than Ca(OH)2 + SSL (p < 0.05). NAC eliminated 8/12 bacteria species resistant to both Ca (OH)2 ICMs, including P. micra, P. nigrescens, T. denticola, A. israelii, P. endodontalis, P. acnes, C. ochracea, and E. corrodens. CONCLUSIONS Ca (OH)2 + 2% chlorhexidine gel (2% CHX gel) showed a greater bacterial elimination over the number of bacterial species; however, NAC eliminated 8/12 bacteria species resistant to both Ca (OH)2 ICMs (RBR-3xbnnn). CLINICAL RELEVANCE The use of intracanal medication with a broad antimicrobial activity can optimize root canal disinfection. Ca(OH)2 + 2% CHX gel and NAC showed a broader antimicrobial activity than Ca(OH)2 + SSL against endodontic pathogens in primary root canal infection. TRIAL REGISTRATION Brazilian Registry of Clinical Trials (REBEC), No. RBR-3xbnnn.
Collapse
Affiliation(s)
- Frederico C Martinho
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, 650 West Baltimore Street, 6th floor, Suite 6253, Baltimore, MD, 21201, USA.
| | - Bruna J M Corazza
- Department of Restorative Dentistry, Endodontic Division, Institute of Science and Technology, São Paulo State University - UNESP, São José dos Campos, São Paulo, Brazil
| | - Rayana D Khoury
- Department of Restorative Dentistry, Endodontic Division, Institute of Science and Technology, São Paulo State University - UNESP, São José dos Campos, São Paulo, Brazil
| | - Esteban I F Orozco
- Department of Restorative Dentistry, Endodontic Division, Institute of Science and Technology, São Paulo State University - UNESP, São José dos Campos, São Paulo, Brazil
| | - Cassia C Toia
- Department of Restorative Dentistry, Endodontic Division, Institute of Science and Technology, São Paulo State University - UNESP, São José dos Campos, São Paulo, Brazil
| | - Felipe P Machado
- Department of Restorative Dentistry, Endodontic Division, Institute of Science and Technology, São Paulo State University - UNESP, São José dos Campos, São Paulo, Brazil
| | - Marcia C Valera
- Department of Restorative Dentistry, Endodontic Division, Institute of Science and Technology, São Paulo State University - UNESP, São José dos Campos, São Paulo, Brazil
| |
Collapse
|
16
|
Rôças IN, Provenzano JC, Neves MS, Alves FR, Gonçalves LS, Siqueira JF. Effects of calcium hydroxide paste in different vehicles on bacterial reduction during treatment of teeth with apical periodontitis. J Endod 2022; 49:55-61. [DOI: 10.1016/j.joen.2022.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 09/29/2022] [Accepted: 10/14/2022] [Indexed: 11/07/2022]
|
17
|
KUTLU BASMACI G, HAZNEDAROĞLU F. Farklı irrigasyon tekniklerinin kalsiyum hidroksit uzaklaştırma etkinliğinin Bilgisayarlı Sıvı Filtrasyon methodu kullanılarak mikrosızıntılarının değerlendirilmesi. CUMHURIYET DENTAL JOURNAL 2022. [DOI: 10.7126/cumudj.1137675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Aim: To compare the efficiency of sonic irrigation, passive ultrasonic irrigation, and conventional syringe irrigation (CI) in removing pure and injectable calcium hydroxide (CH) from the root canals of mandibular second premolars by measuring the probable microleakage of residual CH particles in root canal obturation using computerized liquid filtration (CLF).
Materials and Methods: Eighty instrumented mandibular second premolars were categorized into three experimental groups (n = 20 each) based on the irrigation method used for removing CH and a control group (n = 20) in which CH was not used. Each experimental group was divided into two equal groups (pure and injectable CH). After 1 week, CH was removed from the root canals, and the teeth were obturated. CLF measurements were performed 1 week after obturation. Nonparametric variables between two groups were compared using the Mann-Whitney U test, and the Kruskal-Wallis test was used to compare more than two groups. The significance level was set at p < 0.05.
Results: All experimental groups showed higher leakage values than the control group. The highest leakage values were evident in the CI group, and the lowest leakage values were found in the sonic (EDDY) irrigation group. No significant differences were detected among the different forms of CH.
Conclusions: None of the analyzed techniques could completely remove CH from root canals, resulting in higher leakage values. Sonic irrigation with EDDY was the best in removing CH from root canals.
Collapse
|
18
|
Shaaban S, Hamad GM, Genena S, Meheissen MA, Moussa S. Evaluation of the antibacterial activity of Lactobacilli probiotics supernatants against Enterococcus faecalis (in-vitro study). BMC Oral Health 2022; 22:407. [PMID: 36117178 PMCID: PMC9484162 DOI: 10.1186/s12903-022-02434-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 09/05/2022] [Indexed: 11/18/2022] Open
Abstract
Background There is an increasing demand to find a potent antibacterial agent against endodontic pathogens with the least toxic effect. The study aimed to evaluate the antibacterial activity of Lactobacilli probiotics on Enterococcus faecalis (E. faecalis) in comparison to calcium hydroxide paste. Methods The study involved two stages; (stage one): determination of the antibacterial properties of three strains of Lactobacilli probiotics supernatants (PS); Lactobacillus plantarum, Lactobacillus rhamnosus, Lactobacillus acidophilus, and a cocktail mix of the three supernatants against E. faecalis using agar well diffusion method in both solution and gel phase. The formed zones of inhibition (ZOI) were measured in millimeters (mm) and compared to each other. PS solution and gel of the largest ZOI were further compared with calcium hydroxide paste (35% Ultra Cal XS Ca(OH)2) This was followed by (stage two): assessment of the minimum inhibitory concentration (MIC) of the PS that showed the largest ZOI against E. faecalis by agar well diffusion assay for both PS solution and gel. Results All supernatants showed growth inhibition against E. faecalis, and the cocktail mix showed the largest ZOI. However, no significant difference was found between the supernatants in both the solution and gel phases (p > 0.05). Ca(OH)2 showed a significantly lower effect than both the cocktail mix solution and gel (p < 0.05). The MIC of the cocktail mix solution and gel against E. faecalis was 50 mg/ml. (p > 0.05). Conclusion PS has an antibacterial effect on E. faecalis and was more effective than Ca(OH)2.Lactobacilli probiotics could be a promising antibacterial agent used as an irrigant or an intracanal medication.
Collapse
|
19
|
Comparison of Er:YAG laser and ultrasonic in root canal disinfection under minimally invasive access cavity. Lasers Med Sci 2022; 37:3249-3258. [PMID: 35854018 DOI: 10.1007/s10103-022-03613-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 07/13/2022] [Indexed: 10/17/2022]
Abstract
The disinfection of root canal through minimally invasive access cavity remains questionable. This in vitro study compared the effectiveness of three disinfection measures including conventional irrigation, ultrasonic assisted irrigation, and erbium:yttrium-aluminum-garnet (Er:YAG) laser assisted irrigation through conventionally or minimally invasive access. Sixty-six extracted maxillary first molars were randomly divided into group 1 conventionally invasive access group (CIA) and group 2 computer-guided minimally invasive access group (MIA). Each group was further randomly divided into three subgroups, (A) conventional irrigation (CI), (B) passive ultrasonic agitation (PUI), and (C) Er:YAG laser activated irrigation (LAI). Enterococcus faecalis (E. faecalis) infection model was established inside all root canals after instrumentation was performed up to ProTaper Universal F2. After various disinfection methods, microbial samples were collected from root canals by paper tip method and cultured, and colony forming units (CFU) values of each sample were calculated. Then the root canals were enlarged to the size of F3, after which dentin debris was collected from the F3 file. After dilution and culturing, the CFU value was calculated for each group. Two-way analysis of variance (ANOVA) was performed to test the interaction. The results revealed a significant antagonism (F = 3.394, P = 0.043). The bacterial CFU counts of group B and group C were significantly less than that of group A (P < 0.05), and there was no significant difference between group B and C (P > 0.05). Additionally, group 2A was better than group 1A (P < 0.05); there was no significant difference between group 1B and group 2B, group 1C and group 2C (P > 0.05). Comparison of the bacterial CFU counts in dentin debris after disinfection, the results revealed a significant antagonism (F = 7.224, P = 0.002), and group C had the least. The disinfection effect of Er:YAG laser or ultrasonic assisted computer-guided minimally invasive access is similar to conventionally invasive access, and Er:YAG laser is better than ultrasonic in removing bacteria from dentinal tubules and is easy to operate, which is more suitable for minimally invasive root canal treatment.
Collapse
|
20
|
Impact of agitation/activation strategies on the antibiofilm potential of sodium hypochlorite/etidronate mixture in vitro. BMC Oral Health 2022; 22:201. [PMID: 35606751 PMCID: PMC9125931 DOI: 10.1186/s12903-022-02222-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 05/03/2022] [Indexed: 11/17/2022] Open
Abstract
Background To investigate the effect of a rotary agitation method or ultrasonically activated irrigation on the antibiofilm effect of a mixture of sodium hypochlorite (NaOCl) and etidronate (1-hydroxyethylidene-1,1-bisphosphonate, HEBP) using a dual-species biofilm model in root canal system. Methods Mature dual-species biofilms of Enterococcus faecalis and Streptococcus gordonii were formed in root canals of mandibular premolars. Teeth were randomly allotted (n = 12) to group 1, XP-endo Finisher (XPF); group 2, ultrasonically activated irrigation (UAI); group 3, syringe-and-needle irrigation (SNI). In all groups, canals were instrumented with a rotary instrument (XP-endo Shaper) prior to irrigant agitation/activation. A mixture containing 2.5% NaOCl and 9% HEBP was used throughout the experiment. Bacterial counts from the canal were determined using qPCR before preparation (S1), after preparation (S2), and after final irrigation agitation/activation (S3). Bacterial viability within the dentinal tubules in the coronal, middle and apical root-thirds was quantified using confocal microscopy after Live/Dead staining. The bacterial counts and viability were compared between groups using one-way ANOVA and post-hoc Tukey’s tests. Paired t-test was used to compare the bacterial counts within groups. Results Instrumentation alone could significantly reduce the microbial counts in all the groups (P < 0.0001). Subsequent agitation/activation resulted in significant microbial reduction only in XPF and UAI (P < 0.05), both of which reduced significantly more microbial counts than SNI (P < 0.05). Live/Dead staining revealed that XPF and UAI showed significantly greater percentage of dead bacteria within the dentinal tubules than SNI in the coronal third (P < 0.05); UAI resulted in the significantly highest percentage of dead bacteria in the middle third (P < 0.05); while there was no significant difference between the groups in the apical third (P > 0.05). Conclusions When using the sodium hypochlorite/etidronate mixture for irrigation, final irrigant agitation/activation with XP-endo Finisher or ultrasonic can improve disinfection of the main root canal space and the dentinal tubules in the coronal third, while ultrasonically activated irrigation appears to exhibit better disinfection within dentinal tubules in the middle third. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-022-02222-1.
Collapse
|
21
|
Phage therapy for refractory periapical periodontitis caused by Enterococcus faecalis in vitro and in vivo. Appl Microbiol Biotechnol 2022; 106:2121-2131. [PMID: 35190846 DOI: 10.1007/s00253-022-11810-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 01/19/2022] [Accepted: 01/22/2022] [Indexed: 11/02/2022]
Abstract
A phage PEf771 that specifically infects and lyses pathogenic Enterococcus faecalis YN771 in patients with refractory periapical periodontitis was used to investigate resistance against E. faecalis infection in vitro and in vivo. PEf771 completely lysed YN771 within 3 h, with a multiplicity of infection of 1. Compared with ten routinely used clinical antibiotics, PEf771 demonstrated the highest bacteriostatic effect within 72 h. The antibacterial effect of PEf771 on extracted teeth within 72 h was better than that of conventional root canal disinfectants such as camphorated phenol, formaldehyde cresol solution, and Ca(OH)2 (P < 0.05) within 72 h. Using E. faecalis, intraperitoneal and periapical infection models were established using Sprague Dawley (SD) rats. The results showed that all SD rats inoculated with 9.6 × 1011 CFU/mL E. faecalis YN771 or 2.9 × 1011 CFU/mL E. faecalis RYN771 died within 8 h. Additionally, all SD rats inoculated with YN771 and treated with antibiotics died within 72 h. Although SD rats inoculated with RYN771 and treated with antibiotics survived for 72 h, the pathological anatomy of these rats showed purulent discharge, numerous pus and blood-filled ascites, and extensive liver abscesses. Notably, YN771 rats treated with PEf771 and RYN771 rats treated with RPEf771 survived for 72 h, and their pathological anatomy showed that the liver, kidneys, intestine, and mesenteries were normal. Computed tomography analysis of SD rats infected with periapical periodontitis showed pathological changes in experimental teeth inoculated with YN771, despite undergoing a normal root canal treatment. Contrastingly, none of the experimental teeth exhibited root periapical inflammation following PEf771 treatment. Hematoxylin and eosin staining revealed a gap between the periodontal ligament and the cementum of experimental teeth, whereas PEf771-treated teeth exhibited normal results. These findings suggested that phage therapy using PEf771 might effectively prevent E. faecalis infection after root canal treatment.Key points• Compared with common clinical antibiotics, PEf771 showed the highest antibacterial.• The liver, kidney, intestine, and mesentery of SD rats treated with PEf771 were normal.• Phage therapy can effectively prevent E. faecalis YN771 and RYN771 infection.
Collapse
|
22
|
Rosa M, Morozova Y, Moštěk R, Holík P, Somolová L, Novotná B, Zábojníková S, Bogdanová K, Langová K, Voborná I, Pospíšilová L, Kovařík JP. The Short-Term Antibacterial Activity of Three Selected Endodontic Sealers against Enterococcus faecalis Bacterial Culture. Life (Basel) 2022; 12:life12020158. [PMID: 35207445 PMCID: PMC8879048 DOI: 10.3390/life12020158] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 01/13/2022] [Accepted: 01/19/2022] [Indexed: 11/16/2022] Open
Abstract
(1) Background: Microorganisms originating from the microflora of the oral cavity are the main cause of the inflammatory diseases of the dental pulp and periapical periodontium, as well as the failure of endodontic treatment. The subsequent root canal treatment is not able to remove all the pathogens, and a small number of viable bacteria remain in the dentine tubules, which must be sealed by endodontic sealers. These sealers should have at least a bacteriostatic effect to prevent the remaining bacteria from reproducing. The aim of this study is to compare the short-term antibacterial activity of three endodontic sealers based on poly-epoxy resin, zinc oxide-eugenol and calcium silicate with a calcium hydroxide-based sealer. Calcium hydroxide is used as temporary intracanal medicament and, thus, should show significant antibacterial activity. (2) Methods: A total of 25 bovine dentine samples infected with Enterococcus faecalis were used in this study. After the sealer placement and a 24 h incubation period, the root canal walls were scraped, and the suspension of dentine fillings was used for a semi-quantitative evaluation of microbial growth. (3) Results: The poly-epoxide resin-based sealer ADSeal™ showed significant antibacterial properties. (4) Conclusions: The highest antibacterial activity was shown in poly-epoxide resin-based sealer group, followed by the zinc oxide-eugenol-based sealer and calcium silicate-based sealer.
Collapse
Affiliation(s)
- Matej Rosa
- Institute of Dentistry and Oral Sciences, Faculty of Medicine and Dentistry, Palacký University, Hněvotínská 3, 775 15 Olomouc, Czech Republic; (Y.M.); (R.M.); (P.H.); (L.S.); (S.Z.); (I.V.); (L.P.); (J.P.K.)
- Correspondence: (M.R.); (B.N.)
| | - Yuliya Morozova
- Institute of Dentistry and Oral Sciences, Faculty of Medicine and Dentistry, Palacký University, Hněvotínská 3, 775 15 Olomouc, Czech Republic; (Y.M.); (R.M.); (P.H.); (L.S.); (S.Z.); (I.V.); (L.P.); (J.P.K.)
| | - Roman Moštěk
- Institute of Dentistry and Oral Sciences, Faculty of Medicine and Dentistry, Palacký University, Hněvotínská 3, 775 15 Olomouc, Czech Republic; (Y.M.); (R.M.); (P.H.); (L.S.); (S.Z.); (I.V.); (L.P.); (J.P.K.)
| | - Pavel Holík
- Institute of Dentistry and Oral Sciences, Faculty of Medicine and Dentistry, Palacký University, Hněvotínská 3, 775 15 Olomouc, Czech Republic; (Y.M.); (R.M.); (P.H.); (L.S.); (S.Z.); (I.V.); (L.P.); (J.P.K.)
| | - Lucia Somolová
- Institute of Dentistry and Oral Sciences, Faculty of Medicine and Dentistry, Palacký University, Hněvotínská 3, 775 15 Olomouc, Czech Republic; (Y.M.); (R.M.); (P.H.); (L.S.); (S.Z.); (I.V.); (L.P.); (J.P.K.)
| | - Barbora Novotná
- Institute of Dentistry and Oral Sciences, Faculty of Medicine and Dentistry, Palacký University, Hněvotínská 3, 775 15 Olomouc, Czech Republic; (Y.M.); (R.M.); (P.H.); (L.S.); (S.Z.); (I.V.); (L.P.); (J.P.K.)
- Correspondence: (M.R.); (B.N.)
| | - Soňa Zábojníková
- Institute of Dentistry and Oral Sciences, Faculty of Medicine and Dentistry, Palacký University, Hněvotínská 3, 775 15 Olomouc, Czech Republic; (Y.M.); (R.M.); (P.H.); (L.S.); (S.Z.); (I.V.); (L.P.); (J.P.K.)
| | - Kateřina Bogdanová
- Department of Microbiology, University Hospital Olomouc, I. P. Pavlova 6, 779 00 Olomouc, Czech Republic;
| | - Kateřina Langová
- Department of Medical Biophysics, Faculty of Medicine and Dentistry, Palacký University, Hněvotínská 3, 775 15 Olomouc, Czech Republic;
| | - Iva Voborná
- Institute of Dentistry and Oral Sciences, Faculty of Medicine and Dentistry, Palacký University, Hněvotínská 3, 775 15 Olomouc, Czech Republic; (Y.M.); (R.M.); (P.H.); (L.S.); (S.Z.); (I.V.); (L.P.); (J.P.K.)
| | - Lenka Pospíšilová
- Institute of Dentistry and Oral Sciences, Faculty of Medicine and Dentistry, Palacký University, Hněvotínská 3, 775 15 Olomouc, Czech Republic; (Y.M.); (R.M.); (P.H.); (L.S.); (S.Z.); (I.V.); (L.P.); (J.P.K.)
| | - Josef Paul Kovařík
- Institute of Dentistry and Oral Sciences, Faculty of Medicine and Dentistry, Palacký University, Hněvotínská 3, 775 15 Olomouc, Czech Republic; (Y.M.); (R.M.); (P.H.); (L.S.); (S.Z.); (I.V.); (L.P.); (J.P.K.)
| |
Collapse
|
23
|
Siqueira JF, Rôças IN. Present status and future directions - microbiology of endodontic infections. Int Endod J 2021; 55 Suppl 3:512-530. [PMID: 34958494 DOI: 10.1111/iej.13677] [Citation(s) in RCA: 95] [Impact Index Per Article: 31.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 12/22/2021] [Accepted: 12/26/2021] [Indexed: 11/29/2022]
Abstract
Apical periodontitis has a microbial aetiology and is one of the most common inflammatory diseases that affect humans. Fungi, archaea and viruses have been found in association with apical periodontitis, but bacteria are by far the most prevalent and dominant microorganisms in endodontic infections. Bacterial infection of the root canal system only occurs when the pulp is necrotic or was removed for previous treatment. In some specific cases, including acute and chronic abscesses, the bacterial infection may reach the periradicular tissues. Intracanal bacteria are usually observed as sessile multispecies communities (biofilms) attached to the dentinal root canal walls. Infection in the main root canal lumen can spread to other areas of the root canal system. Although more than 500 bacterial species have been detected in endodontic infections, a selected group of 20 to 30 species are most frequently detected and may be considered as the core microbiome. There is a high interindividual variability in the endodontic microbiome in terms of species composition and relative abundance. Obligate anaerobic species are more abundant in the intraradicular bacterial communities of teeth with primary apical periodontitis, while both anaerobes and facultatives dominate the communities in post-treatment apical periodontitis. Bacterial interactions play an essential role in determining the overall virulence of the community, which has been regarded as the unit of pathogenicity of apical periodontitis. This article reviews the microbiologic aspects of endodontic infections and provides perspectives for future research and directions in the field.
Collapse
Affiliation(s)
- José F Siqueira
- Department of Dental Research, Faculty of Dentistry, Iguaçu University (UNIG), Nova Iguaçu, RJ, and Department of Endodontics and Molecular Microbiology Laboratory, Faculty of Dentistry, Grande Rio University, Rio de Janeiro, RJ, Brazil
| | - Isabela N Rôças
- Department of Dental Research, Faculty of Dentistry, Iguaçu University (UNIG), Nova Iguaçu, RJ, and Department of Endodontics and Molecular Microbiology Laboratory, Faculty of Dentistry, Grande Rio University, Rio de Janeiro, RJ, Brazil
| |
Collapse
|
24
|
Wang Z, Shen Y, Haapasalo M. Antimicrobial and Antibiofilm Properties of Bioceramic Materials in Endodontics. MATERIALS (BASEL, SWITZERLAND) 2021; 14:7594. [PMID: 34947188 PMCID: PMC8706218 DOI: 10.3390/ma14247594] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 11/30/2021] [Accepted: 12/07/2021] [Indexed: 12/19/2022]
Abstract
Microbes are prevalent in the root canals of necrotic teeth, and they are the cause of primary and post-treatment apical periodontitis. Bacteria can dwell within the infected root canal system as surface-adherent biofilm structures, which exhibit high resistance to antimicrobial agents. Bioceramic materials, with their biocompatible nature and excellent physico-chemical properties, have been widely used in dental applications, including endodontics. This review focuses on the application of bioceramic technology in endodontic disinfection and the antibiofilm effects of endodontic bioceramic materials. Different bioceramic materials have shown different levels of antibiofilm effects. New supplements have emerged to potentially enhance the antibiofilm properties of bioceramics aiming to achieve the goal of microbial elimination in the root canal system.
Collapse
Affiliation(s)
| | | | - Markus Haapasalo
- Division of Endodontics, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, The University of British Columbia, Vancouver, BC V6T 1Z3, Canada; (Z.W.); (Y.S.)
| |
Collapse
|
25
|
Rajda M, Miletić I, Baršić G, Krmek SJ, Šnjarić D, Baraba A. Efficacy of Reciprocating Instruments in the Removal of Bioceramic and Epoxy Resin-Based Sealers: Micro-CT Analysis. MATERIALS 2021; 14:ma14216670. [PMID: 34772195 PMCID: PMC8587586 DOI: 10.3390/ma14216670] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 10/30/2021] [Accepted: 11/02/2021] [Indexed: 12/27/2022]
Abstract
The objective of this study was to evaluate the efficacy of reciprocating instruments in the removal of bioceramic and epoxy resin-based sealers using micro-CT analysis. Root canals of 40 extracted human teeth were instrumented with a size R25 Reciproc instrument. Specimens were randomly divided into two groups (n = 20) according to the root canal filling material. In the first group, root canals were obturated with AH Plus sealer and Reciproc R25 gutta-percha. In the second group, a combination of bioceramic gutta-percha (TotalFill BC) and bioceramic sealer (TotalFill BC) was used. After one week, the retreatment of all specimens was performed using Reciproc instruments. To analyze the differences in the filling remnants, specimens were scanned in a micro-CT device after obturation and after the retreatment procedure. Statistical analysis was performed using the Mann-Whitney U test (p < 0.05). A combination of bioceramic sealer and bioceramic gutta-percha was more effectively removed from canals using a reciprocating instrument, with a filling remnants volume of 4.01 ± 3.13 mm3, in comparison to the combination of epoxy resin-based sealer and gutta-percha (6.96 ± 2.70 mm3) (p < 0.05). A reciprocating instrument was more effective in removing bioceramic sealers than epoxy resin-based sealers, although none of the root canal filling materials were completely removed from the root canals.
Collapse
Affiliation(s)
- Marko Rajda
- Dental Health Center—Center, Runjaninova 4, 10000 Zagreb, Croatia;
| | - Ivana Miletić
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, Gundulićeva 5, 10000 Zagreb, Croatia; (I.M.); (S.J.K.)
| | - Gorana Baršić
- Department for Quality, Department for Measurement and Control, Faculty of Mechanical Engineering and Naval Architecture, IvanaLučića 5, 10002 Zagreb, Croatia;
| | - Silvana Jukić Krmek
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, Gundulićeva 5, 10000 Zagreb, Croatia; (I.M.); (S.J.K.)
| | - Damir Šnjarić
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Rijeka, 51000 Rijeka, Croatia;
| | - Anja Baraba
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, Gundulićeva 5, 10000 Zagreb, Croatia; (I.M.); (S.J.K.)
- Correspondence:
| |
Collapse
|
26
|
Fahim MM, Saber SEM, Elkhatib WF, Nagy MM, Schafer E. The antibacterial effect and the incidence of post-operative pain after the application of nano-based intracanal medications during endodontic retreatment: a randomized controlled clinical trial. Clin Oral Investig 2021; 26:2155-2163. [PMID: 34697657 DOI: 10.1007/s00784-021-04196-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 09/21/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This clinical trial aimed to evaluate the effect of nano-silver and nano-calcium hydroxide intracanal medicaments (ICM) during retreatment regarding their antibacterial effect and their effect on post-operative pain and flare-ups. MATERIALS AND METHODS Sixty-nine patients scheduled for endodontic retreatment were included in this randomized clinical trial and randomly allocated to 3 equal groups (n = 23) according to the type of ICM used. The first microbial sampling (S1) representing the original microbiota was obtained after the removal of the old canal filling. After chemo-mechanical debridement, another sample (S2) was obtained representing the microbial state before ICM application. Patients were randomly allocated to receive either nano-silver (nano-Ag), nano-calcium hydroxide (nano-CH), or calcium hydroxide (CH) as ICM. Patients rated their pain pre-operatively and then after 6, 12, 24, 48, and 72 h. During the second visit (7 days later), the last microbial sample (S3) was obtained after removal of the ICM. Reduction of total bacterial and total E. faecalis counts and the biofilm-forming capability of the existing microbiota were determined. RESULTS Results showed reduction in total bacterial count, total E. faecalis count and the biofilm-forming,capability of the existing microbiota after chemo-mechanical debridement (S1-S2) and after the application of ICM (S3-S2). However, the reduction after cleaning and shaping was significantly more pronounced (p < 0.001) compared to the effect of ICM application, with no difference between the 3 ICM (p > 0.05). Post-operative pain was significantly reduced at the 48- and 72-h intervals after the application of nano-Ag and nano-CH only (p < 0.001), with no significant difference between these two ICM (p > 0.05). The incidence of flare-ups in all groups was similar (p > 0.05). CONCLUSIONS The antibacterial effect of the nano-Ag and nano-CH was equivalent to that of CH, but they contributed to better pain control. CLINICAL RELEVANCE Nanoparticles may have a positive impact on post-endodontic pain.
Collapse
Affiliation(s)
- Mahmoud M Fahim
- Department of Endodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - Shehab Eldin Mohamed Saber
- Department of Endodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt.
- Department of Endodontics, Faculty of Dentistry, The British University, Cairo, Egypt.
| | - Walid F Elkhatib
- Department of Microbiology and Immunology, Faculty of Pharmacy, Ain Shams University, Cairo, Egypt
- Department of Microbiology and Immunology, Faculty of Pharmacy, Galala University, Galala City, Egypt
| | - Mohamed Mokhtar Nagy
- Department of Endodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - Edgar Schafer
- Central Interdisciplinary Ambulance in the School of Dentistry, University of Münster, Münster, Germany
| |
Collapse
|
27
|
Tosun S, Karataslioglu E, Tulgar MM, Derindag G. Fractal analysis and periapical index evaluation of multivisit nonsurgical endodontic retreatment: A retrospective study. Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 133:245-251. [PMID: 34556458 DOI: 10.1016/j.oooo.2021.08.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 08/20/2021] [Accepted: 08/21/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE This retrospective study compared changes in periapical trabecular patterns using fractal analysis and the periapical index (PAI) on the periapical radiographs of patients who underwent multivisit nonsurgical endodontic retreatment of persistent periapical disease. STUDY DESIGN In total, 50 participants were included in the study. For each patient, baseline periapical radiographs were acquired just before retreatment and postoperative radiographs were acquired 1 year later. The region of interest, located in the abnormal tissue around the root apex, was selected from each of the paired radiographs and the fractal dimension (FD) was calculated. Periapical status was classified using the PAI as "healed" (PAI <3) or "unhealed" (PAI ≥3). RESULTS According to the PAI scores, retreatment after 1 year had a healing rate of 70%. In healed cases, the FD values increased significantly (P < .001), whereas FD decreased significantly in unhealed cases (P = .021). Change in FD was significantly different between healed and unhealed cases (P < .001). However, change in FD did not have a significant correlation with PAI in either healed or unhealed cases (P > .05). There was no significant effect of sex on the change in FD values in either healed or unhealed cases (P ≥ .690). CONCLUSIONS The significant differences in FD suggest that this parameter may be useful in detecting increased trabeculation and estimating retreatment prognosis.
Collapse
Affiliation(s)
- Samet Tosun
- Assistant Professor, Department of Endodontics, Faculty of Dentistry, Pamukkale University, Denizli, Turkey.
| | - Emrah Karataslioglu
- Associate Professor, Department of Endodontics, Faculty of Dentistry, Katip Çelebi University, İzmir, Turkey
| | - Mustafa Mert Tulgar
- Research Assistant, Department of Endodontics, Faculty of Dentistry, Katip Çelebi University, İzmir, Turkey
| | - Gözde Derindag
- Assistant Professor, Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Pamukkale University, Denizli, Turkey
| |
Collapse
|
28
|
Govindaraju L, Jenarthanan S, Subramanyam D, Ajitha P. Antibacterial Activity of Various Intracanal Medicament against Enterococcus faecalis, Streptococcus mutans and Staphylococcus aureus: An In vitro Study. J Pharm Bioallied Sci 2021; 13:S157-S161. [PMID: 34447065 PMCID: PMC8375934 DOI: 10.4103/jpbs.jpbs_623_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 09/30/2020] [Accepted: 10/01/2020] [Indexed: 11/04/2022] Open
Abstract
Aim The aim of this study was to evaluate and compare the antimicrobial efficacy of triple antibiotic paste (TAP), calcium hydroxide, and Odontopaste which are used as intracanal medicaments against Enterococcus faecalis, Streptococcus mutants, and Staphylococcus aureus. Materials and Methods Antibiotic sensitivity testing was done using agar well diffusion method of the following intracanal medicaments: Group 1: TAP (Ciprofloxacin, metronidazole, and doxycycline mixed in a ratio of 1:1:1; Group 2: Calcium hydroxide paste; Group 3: Odontopaste; Group 4: Sterile saline (0.9%) as a negative control. Each medicament was tested against E. faecalis, S. mutants, and S. aureus. The maximum zone of inhibition was noted by diameter size (mm) and analyzed with one-way ANOVA. Results TAP showed the highest zone of inhibition. There is no significant difference between Odontopaste and calcium hydroxide against E. faecalis and S. aureus. There is a significant difference between TAP, Odontopaste, and calcium hydroxide against S. mutants. The order of the highest zone of inhibition is TAP > Odontopaste>Calciumhydroxide. Conclusion With in the limitations of the study, TAP had better antibacterial activity against E. faecalis, S. mutants, and S. aureus followed by odontopaste and calcium hydroxide, Hence, Odontopaste can be used as an alternative for calcium hydroxide in the infected root canal.
Collapse
Affiliation(s)
- Lokhasudhan Govindaraju
- Department of Conservative Dentistry and Endodontics, Faculty of Dental Sciences, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
| | - Sowjanyaa Jenarthanan
- Department of Conservative Dentistry and Endodontics, Faculty of Dental Sciences, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
| | - Divya Subramanyam
- Department of Pediatric and Pediatric Dentistry, Asan Memorial Dental College and Hospital, Chengalpattu, Tamil Nadu, India
| | - P Ajitha
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College and Hospital, Saveetha Institute of Medical and Technical Sciences, Chennai, India
| |
Collapse
|
29
|
Daood U, Bapat RA, Sidhu P, Ilyas MS, Khan AS, Mak KK, Pichika MR, Nagendrababu V, Peters OA. Antibacterial and antibiofilm efficacy of k21-E in root canal disinfection. Dent Mater 2021; 37:1511-1528. [PMID: 34420798 DOI: 10.1016/j.dental.2021.08.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 07/21/2021] [Accepted: 08/04/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVES The aim of the current project was to study the antimicrobial efficacy of a newly developed irrigant, k21/E against E. faecalis biofilm. METHODS Root canals were instrumented and randomly divided into the following groups: irrigation with saline, 6% NaOCl (sodium hypochlorite), 6% NaOCl+2% CHX (Chlorhexidine), 2% CHX, 0.5% k21/E (k21 - quaternary ammonium silane) and 1% k21/E. E. faecalis were grown (3-days) (1×107CFU mL-1), treated, and further cultured for 11-days. Specimens were subjected to SEM, confocal and Raman analysis and macrophage vesicles characterized along with effect of lipopolysaccharide treatment. 3T3 mouse-fibroblasts were cultured for alizarin-red with Sortase-A active sites and Schrödinger docking was performed. TEM analysis of root dentin substrate with matrix metalloproteinases profilometry was also included. A cytotoxic test analysis for cell viability was measured by absorbance of human dental pulp cells after exposure to different irrigant solutions for 24h. The test percentages have been highlighted in Table 1. RESULTS Among experimental groups, irrigation with 0.5% k21/E showed phase separation revealing significant bacterial reduction and lower phenylalanine 1003cm-1 and Amide III 1245cm-1 intensities. Damage was observed on bacterial cell membrane after use of k21/E. No difference in exosomes distribution between control and 0.5%k21/E was observed with less TNFα (*p<0.05) and preferential binding of SrtA. TEM images demonstrated integrated collagen fibers in control and 0.5%k21/E specimens and inner bacterial membrane damage after k21/E treatment. The k21 groups appeared to be biocompatible to the dental pulpal cells grown for 24h. SIGNIFICANCE Current investigations highlight potential advantages of 0.5% k21/E as irrigation solution for root canal disinfection.
Collapse
Affiliation(s)
- Umer Daood
- Division of Clinical Dentistry, School of Dentistry, International Medical University Kuala Lumpur, 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000 Bukit Jalil, Wilayah Persekutuan Kuala Lumpur, Malaysia.
| | - Ranjeet Ajit Bapat
- Division of Clinical Dentistry, School of Dentistry, International Medical University Kuala Lumpur, 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000 Bukit Jalil, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | - Preena Sidhu
- Division of Clinical Dentistry, School of Dentistry, International Medical University Kuala Lumpur, 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000 Bukit Jalil, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | - Muhammad Sharjeel Ilyas
- Department of Oral Biology, Post Graduate Medical Institute, 6 Birdwood Road, Lahore, Pakistan
| | - Abdul Samad Khan
- Department of Restorative Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
| | - Kit-Kay Mak
- School of Pharmacy, International Medical University Kuala Lumpur, 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000 Bukit Jalil, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | - Mallikarjuna Rao Pichika
- School of Pharmacy, International Medical University Kuala Lumpur, 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000 Bukit Jalil, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | | | - Ove A Peters
- School of Dentistry, University of Queensland, Herston, Qld 4006, Australia; Department of Endodontics, Arthur A Dugoni School of Dentistry, University of the Pacific, San Francisco, CA, USA
| |
Collapse
|
30
|
Alberti A, Corbella S, Taschieri S, Francetti L, Fakhruddin KS, Samaranayake LP. Fungal species in endodontic infections: A systematic review and meta-analysis. PLoS One 2021; 16:e0255003. [PMID: 34293029 PMCID: PMC8297845 DOI: 10.1371/journal.pone.0255003] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 07/07/2021] [Indexed: 12/30/2022] Open
Abstract
Fungal infections are common on oral mucosae, but their role in other oral sites is ill defined. Over the last few decades, numerous studies have reported the presence of fungi, particularly Candida species in endodontic infections, albeit in relatively small numbers in comparison to its predominant anaerobic bacteriome. Here, we review the fungal biome of primary and secondary endodontic infections, with particular reference to the prevalence and behavior of Candida species. Meta-analysis of the available data from a total of 39 studies fitting the inclusion criteria, indicate the overall weighted mean prevalence (WMP) of fungal species in endodontic infections to be 9.11% (from a cumulative total of 2003 samples), with 9.0% in primary (n = 1341), and 9.3% in secondary infections (n = 662). Nevertheless, WMP for fungi in primary and secondary infections which were 6.3% and 7.5% for culture-based studies, increased to 12.5% and 16.0% in molecular studies, respectively. The most prevalent fungal species was Candida spp. The high heterogeneity in the reported fungal prevalence suggests the need for standardized sampling, and speciation methods. The advent of the new molecular biological analytical platforms, such as the next generation sequencing (NGS), and matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF), that enables identification and quantitation of a broad spectrum of hitherto unknown organisms in endodontic infections should radically alter our understanding of the endodontic mycobiome in the future. Candida spp. appear to be co-pathogens with bacteria in approximately one in ten patients with endodontic infections. Hence, clinicians should comprehend the importance and the role of fungi in endodontic infections and be cognizant of the need to eradicate both bacteria and fungi for successful therapy.
Collapse
Affiliation(s)
- Alice Alberti
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
- * E-mail:
| | - Stefano Corbella
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
- Institute of Dentistry, I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Silvio Taschieri
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
- Institute of Dentistry, I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Luca Francetti
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | | | - Lakshman Perera Samaranayake
- College of Dental Medicine, University of Sharjah, Sharjah, UAE
- The University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China
| |
Collapse
|
31
|
Herce-Ros N, Álvarez-Sagües A, Álvarez-Losa L, Nistal-Villan E, Amador U, Presa J, Azabal M. Antibacterial Ability of Sodium Hypochlorite Activated with PUI vs. XPF File against Bacteria Growth on Enterococcus faecalis Mature Biofilm. Dent J (Basel) 2021; 9:dj9060067. [PMID: 34200637 PMCID: PMC8228713 DOI: 10.3390/dj9060067] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 06/03/2021] [Accepted: 06/08/2021] [Indexed: 12/12/2022] Open
Abstract
The objectives of the present study were to assess the antibacterial effectiveness of two sodium hypochlorite (NaOCl) concentrations (2.5% and 5.25%) activated by means of two techniques, passive ultrasonic irrigation (PUI) and XP-endo® Finisher (FKG Dentaire SA, La Chaux-de-Fonds, Switzerland) (XPF) against bacteria growth in intracanal mature biofilm. Our aim was to determine if the effect of heating up NaOCl at body temperature (BT) contributed to an improvement of the efficacy of XPF. Sixty-two single-canal human roots previously instrumented were infected with E. faecalis inoculum at 0.5 McFarland and incubated at 37 °C for two weeks. Twelve specimens were randomly selected as positive control, and the remaining fifty were divided into five experimental groups (n = 10). The first two were irrigated with 2.5 vs. 5.25% NaOCl at room temperature (RT), activated with PUI, and the other three were irrigated with XPF. Of these three, two were irrigated using 2.5 vs. 5.25% NaOCl at RT and one was irrigated with 5.25% NaOCl at BT. Our results showed that NaOCl was effective in biofilm removal for all experimental groups (p > 0.05), especially in the groups irrigated with 5.25% NaOCl at room temperature (RT) activated with PUI and the group treated with 5.25% NaOCl at BT with XPF. These groups were the most successful ones (p < 0.001). NaOCl, activated with XPF, was as effective as PUI in biofilm removal from the apical third of the canal when it was used at higher concentration and heated up. This study indicates that XPF only reached the efficacy of PUI when NaOCl was heated up.
Collapse
Affiliation(s)
- Nerea Herce-Ros
- Dentistry Department, Faculty of Medicine, San Pablo CEU University, 28668 Madrid, Spain; (A.Á.-S.); (M.A.)
- Correspondence: (N.H.-R.); (L.Á.-L.); Tel.: +34-67-938-2974 (N.H.-R.)
| | - Alejandro Álvarez-Sagües
- Dentistry Department, Faculty of Medicine, San Pablo CEU University, 28668 Madrid, Spain; (A.Á.-S.); (M.A.)
| | - Laura Álvarez-Losa
- Dentistry Department, Faculty of Medicine, San Pablo CEU University, 28668 Madrid, Spain; (A.Á.-S.); (M.A.)
- Correspondence: (N.H.-R.); (L.Á.-L.); Tel.: +34-67-938-2974 (N.H.-R.)
| | - Estanislao Nistal-Villan
- Microbiology Section, Department of Pharmaceutical and Health Sciences, Faculty of Pharmacy, San Pablo CEU University, 28668 Madrid, Spain;
| | - Ulises Amador
- Department of Chemistry and Biochemistry, Faculty of Pharmacy, San Pablo CEU University, 28668 Madrid, Spain;
| | - Jesús Presa
- Independent Researcher, 28003 Madrid, Spain;
| | - Magdalena Azabal
- Dentistry Department, Faculty of Medicine, San Pablo CEU University, 28668 Madrid, Spain; (A.Á.-S.); (M.A.)
| |
Collapse
|
32
|
da Costa Ferreira I, da Costa Ferreira G, Tavares WLF, de Souza Côrtes MI, Braga T, Amaral RR. Use of technology in endodontics by undergraduate dental students in a south-eastern state of Brazil. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2021; 25:225-231. [PMID: 32815645 DOI: 10.1111/eje.12594] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 03/16/2020] [Accepted: 08/07/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION This study aimed to determine the level of incorporation of current technologies for endodontic treatment in undergraduate dentistry courses in a south-eastern state of Brazil. METHODS For data collection, a self-assessment-based online questionnaire was created using the "Google Forms" platform, consisting of 12 multiple-choice and a few open-ended questions. The questions were related to the use of current technologies for diagnosis, imaging, use of ultrasonics in endodontics, instrumentation, use of apex locator, microscopy, photodynamic therapy and thermoplastic techniques during endodontic treatment. The questionnaire was sent to 54 dental schools in Minas Gerais. RESULTS The results show low technological incorporation during the various stages of endodontic treatment by undergraduate students in dentistry courses in Minas Gerais. CONCLUSION Despite the availability of several technologies to help perform different stages of endodontic treatment, it was observed that most universities do not teach the use of these technologies. Additional studies are needed to correlate how the lack of incorporation of these technologies could impact on the quality of the endodontic learning for undergraduate students.
Collapse
Affiliation(s)
| | | | - Warley Luciano Fonseca Tavares
- Department of Restorative Dentistry, Faculty of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Maria Ilma de Souza Côrtes
- Department of Dentistry, Pontifícia Universidade Católica de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Tiago Braga
- School of Dentistry and Oral Health Griffith University, Gold Coast, Qld, Australia
| | - Rodrigo Rodrigues Amaral
- Department of Dentistry, Pontifícia Universidade Católica de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- School of Dentistry and Oral Health Griffith University, Gold Coast, Qld, Australia
| |
Collapse
|
33
|
Ismail IH, Al-Bayaty FH, Yusof EM, Gulam Khan HBS, Hamka FA, Azmi NA. Evaluation of antimicrobial effect of Malaysian geopropolis with Aloe vera against Enterococcus faecalis to be used as an intracanal medicament in endodontics. J Conserv Dent 2021; 23:489-496. [PMID: 33911359 PMCID: PMC8066667 DOI: 10.4103/jcd.jcd_528_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 11/25/2020] [Accepted: 11/27/2020] [Indexed: 12/05/2022] Open
Abstract
Introduction: Enterococcus faecalis can be found in failed endodontic treatment (FET) even after performing primary endodontic treatment (PET). Calcium hydroxide (Ca(OH)2) cannot fully eliminate this microorganism during PET. Brazilian green propolis (bee glue) was found to be more effective against E. faecalis when compared to Ca(OH)2. A much less studied Malaysian geopropolis (MP) as well as Aloe vera (AV) is antibacterial but is unknown against E. faecalis. Objective: The objective of this study is to determine the antimicrobial effects of MP, AV, and MP + AV in comparison with Ca(OH)2 against E. faecalis, as an intracanal medicament. Materials and Methods: Antimicrobial activity of MP, AV, MP + AV, Ca(OH)2, and dimethyl sulfoxide was tested against E. faecalis using antimicrobial sensitivity testing, minimum inhibitory concentration (MIC), and minimum bactericidal concentration (MBC). The results were analyzed by Kruskal–Wallis test with Mann–Whitney post hoc test and repeated measures analysis of variance with Bonferroni post hoc test (P < 0.05). Results: For agar well-diffusion method, MP + AV gave maximum inhibition zone diameter (mean: 8.11 ± 0.015 mm), MP (mean: 6.21 ± 0.046 mm, Ca(OH)2 (mean: 5.5 ± 0.006), and AV (mean: 5.05 ± 0.012) with P < 0.05. MIC for MP + AV was 2 mg/ml, MP at 8 mg/ml, Ca(OH)2 at 8 mg/ml, and AV at 16 mg/ml. The MBC for MP + AV is at 4 mg/ml, MP at 16 mg/ml, Ca(OH)2 at 16 mg/ml, and AV at 32 mg/ml. Conclusion: The combination of MP and AV consistently showed better antimicrobial activity compared to MP and AV alone against E. faecalis. The findings suggest that MP and AV used in combination may be an ideal intracanal medicament in FET and PET.
Collapse
Affiliation(s)
- Ikmal Hisham Ismail
- Centre for Comprehensive Care Studies UiTM, Faculty of Dentistry, Universiti Teknologi MARA (UiTM), Selangor, Malaysia
| | - Fouad Hussain Al-Bayaty
- Centre for Periodontology Studies UiTM, Faculty of Dentistry, Universiti Teknologi MARA (UiTM), Selangor, Malaysia
| | - Eleena Mohd Yusof
- Centre for Restorative Dentistry Studies UiTM, Faculty of Dentistry, Universiti Teknologi MARA (UiTM), Selangor, Malaysia
| | | | - Farah Aminah Hamka
- Undergraduate Students, Faculty of Dentistry, Universiti Teknologi MARA (UiTM), Selangor, Malaysia
| | - Nur Amirah Azmi
- Undergraduate Students, Faculty of Dentistry, Universiti Teknologi MARA (UiTM), Selangor, Malaysia
| |
Collapse
|
34
|
An HJ, Yoon H, Jung HI, Shin DH, Song M. Comparison of Obturation Quality after MTA Orthograde Filling with Various Obturation Techniques. J Clin Med 2021; 10:jcm10081719. [PMID: 33923426 PMCID: PMC8074131 DOI: 10.3390/jcm10081719] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 04/08/2021] [Accepted: 04/13/2021] [Indexed: 11/30/2022] Open
Abstract
This study aimed to quantify and compare the obturation quality after mineral trioxide aggregate (MTA) orthograde fillings with three different obturation techniques. Thirty-three extracted human maxillary molars were collected. Distobuccal and palatal canals were prepared to an apical size of #40/06 with a Profile Ni-Ti system. All 66 canals were divided into two groups according to the material (EZ-seal or OrthoMTA) and then obturated using three different techniques: manual compaction using S-kondenser (group H), compactor activation (group C), or reverse rotary motion of Ni-Ti file (group R). The obturated roots were scanned using micro-computed tomography (micro-CT). The percentage of voids located in the apical 5 mm was measured separately, that is, closed, open, and total porosity. There was no relation between the filling material and obturation technique (p > 0.05). The percentage volume of open and total porosity was higher in EZ-seal than in OrthoMTA (open: p = 0.002, total: p = 0.001). Group H showed higher open and total porosity than groups C and R. Micro-CT analysis showed that the void volume after orthograde MTA fillings significantly decreased when the additional activation was accompanied by hand condensation. Obturation with a Ni-Ti file using reverse motion could be recommended as an MTA orthograde filling technique.
Collapse
Affiliation(s)
- Hae Jin An
- Department of Conservative Dentistry, College of Dentistry, Dankook University, Cheonan 31116, Korea; (H.J.A.); (H.Y.); (D.-H.S.)
| | - Hyunjung Yoon
- Department of Conservative Dentistry, College of Dentistry, Dankook University, Cheonan 31116, Korea; (H.J.A.); (H.Y.); (D.-H.S.)
| | - Hoi In Jung
- Department of Preventive Dentistry & Public Oral Health, College of Dentistry, Yonsei University, Seoul 03722, Korea;
| | - Dong-Hoon Shin
- Department of Conservative Dentistry, College of Dentistry, Dankook University, Cheonan 31116, Korea; (H.J.A.); (H.Y.); (D.-H.S.)
| | - Minju Song
- Department of Conservative Dentistry, College of Dentistry, Dankook University, Cheonan 31116, Korea; (H.J.A.); (H.Y.); (D.-H.S.)
- Institute of Tissue Regeneration Engineering (ITREN), Dankook University, Cheonan 31116, Korea
- Correspondence:
| |
Collapse
|
35
|
Kumar G, Tewari S, Tagg J, Chikindas ML, Popov IV, Tiwari SK. Can Probiotics Emerge as Effective Therapeutic Agents in Apical Periodontitis? A Review. Probiotics Antimicrob Proteins 2021; 13:299-314. [PMID: 33580864 DOI: 10.1007/s12602-021-09750-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2021] [Indexed: 01/09/2023]
Abstract
Apical periodontitis (AP) is a biofilm-associated disease initiated by the invasion of dental pulp by microorganisms from the oral cavity. Eradication of intracanal microbial infection is an important goal of endodontic treatment, and this is typically accomplished by mechanical instrumentation and application of sodium hypochlorite and chlorhexidine. However, these agents are tissue-irritating at higher concentrations and cytotoxic. Certain probiotics have been found effective in controlling marginal periodontitis, as evidenced by reduction of pathogenic bacterial loads, gains in clinical attachment levels, and reduced bleeding on probing. In vitro studies have shown inhibitory activity of some probiotics against endodontic pathogens. Similarly, in vivo studies in rats have demonstrated a positive immuno-modulatory role of probiotics in AP, as manifested by decreased levels of proinflammatory markers and increased levels of anti-inflammatory markers. A role for probiotics in effecting a reduction of bone resorption has also been reported. This review provides an outline of current research into the probiotic management of AP, with a focus on understanding the mechanisms of their direct antagonistic activity against target pathogens and of their beneficial modulation of the immune system.
Collapse
Affiliation(s)
- Gaurav Kumar
- Department of Conservative Dentistry and Endodontics, Post Graduate Institute of Dental Sciences, Rohtak, India
| | - Sanjay Tewari
- Department of Conservative Dentistry and Endodontics, Post Graduate Institute of Dental Sciences, Rohtak, India
| | - John Tagg
- BLIS Technologies Ltd, Dunedin, New Zealand
| | - Michael Leonidas Chikindas
- Health Promoting Naturals Laboratory, School of Environmental and Biological Sciences, Rutgers State University, 65 Dudley Road, New Brunswick, NJ, 08901, USA.,Center for Agrobiotechnology, Don State Technical University, Gagarin Square 1, Rostov-on-Don, 344002, Russia.,I.M. Sechenov First Moscow State Medical University, Bol'shaya Pirogovskaya Str., 19c1, Moscow, 119146, Russia
| | - Igor V Popov
- Center for Agrobiotechnology, Don State Technical University, Gagarin Square 1, Rostov-on-Don, 344002, Russia
| | | |
Collapse
|
36
|
KarataŞ E, Ayaz N, UlukÖylÜ E, Baltaci MÖ, AdigÜzel A. Effect of final irrigation with sodium hypochlorite at different temperatures on postoperative pain level and antibacterial activity: a randomized controlled clinical study. J Appl Oral Sci 2021; 29:e20200502. [PMID: 33624688 PMCID: PMC7875544 DOI: 10.1590/1678-7757-2020-0502] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 09/01/2020] [Accepted: 10/08/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To evaluate the effect of final irrigation of root canals with NaOCl solution at different temperatures on postoperative pain level and antimicrobial activity. METHODOLOGY 45 patients were randomly divided into three groups using a web program according to the irrigation selected: NaOCl 2ºC, NaOCl 25ºC and NaOCl 45ºC. First root canal samples were collected before treatment (S1). After chemo-mechanical preparation, final irrigation was performed with the selected irrigant (NaOCl 2ºC, NaOCl 25ºC and NaOCl 45ºC) and second samples were collected (S2). Samples were subjected to quantitative real-time polymerase chain reaction to evaluate the levels of total bacteria. The root canal treatments were completed and the participants were given instructions to record postoperative pain levels at 24, 48 and 72 hours, 5 days and 1 week after treatment using a visual analog scale (VAS). RESULTS The reduction in the number of total bacterial cell equivalents from S1 to S2 was statistically significant in all groups (p<0.001). The NaOCl 2˚C group reported significantly less postoperative pain than the NaOCl 45˚C group (p<0.05). Postoperative analgesic intake was significantly higher in the NaOCl 45˚C group than in the NaOCl 2˚C group (p<0.05). CONCLUSION We conclude that final irrigation with NaOCl at different temperatures results in similar antibacterial effectiveness. Final irrigation with cold NaOCl (2˚C) is better than NaOCl 45˚C when comparing postoperative pain levels.
Collapse
Affiliation(s)
- Ertuğrul KarataŞ
- Ataturk University, Faculty of Dentistry, Department of Endodontics, Erzurum, Turkey
| | - Nilay Ayaz
- Ataturk University, Faculty of Dentistry, Department of Endodontics, Erzurum, Turkey
| | - Esra UlukÖylÜ
- Ataturk University, Faculty of Dentistry, Department of Endodontics, Erzurum, Turkey
| | - Mustafa Özkan Baltaci
- Ataturk University, Faculty of Science, Molecular Biology and Genetics Microbiology, Erzurum, Turkey
| | - Ahmet AdigÜzel
- Ataturk University, Faculty of Science, Molecular Biology and Genetics Microbiology, Erzurum, Turkey
| |
Collapse
|
37
|
Gazzaneo I, Amoroso-Silva P, Pacheco-Yanes J, Alves FRF, Marceliano-Alves M, Olivares P, Meto A, Mdala I, Siqueira JF, Rôças IN. Disinfecting and Shaping Type I C-shaped Root Canals: A Correlative Micro-computed Tomographic and Molecular Microbiology Study. J Endod 2020; 47:621-630. [PMID: 33220400 DOI: 10.1016/j.joen.2020.11.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 11/09/2020] [Accepted: 11/09/2020] [Indexed: 02/06/2023]
Abstract
INTRODUCTION This ex vivo study compared the disinfection and shaping abilities of 2 preparation protocols in C-shaped canals. METHODS Mandibular second molars with type I C-shaped canals were pair matched based on micro-computed tomographic (micro-CT) analysis and distributed into 2 groups. The canals were contaminated with a mixed bacterial culture and prepared using 2 protocols, both with 2.5% sodium hypochlorite irrigation: XP-endo Shaper (FKG Dentaire, La Chaux-de-Fonds, Switzerland) supplemented with XP-endo Finisher (FKG Dentaire) (XP-E) and BioRaCe (FKG Dentaire) supplemented with a Hedström file (Dentsply/Sirona, Tulsa, OK) (BR-Hed). Micro-CT scans and intracanal bacteriologic samples were taken before (scan #1 and sample 1) and after preparation (scan #2 and sample 2) and after the supplementary step (scan #3 and sample 3). Canal shaping was evaluated by micro-CT imaging, and disinfection was assessed by quantitative polymerase chain reaction. RESULTS Micro-CT data from the XP-E (n = 21) and BR-Hed (n = 23) protocols revealed no significant differences between groups regarding shaping parameters (canal volume, surface area, structure model index, and prepared walls) after preparation and after the supplementary step (P > .05). All these parameters significantly increased after each preparation step (P < .05), except for structure model index changes after the XP-endo Finisher (P > .05). Bacteriologic data from the XP-E (n = 21) and BR-Hed (n = 22) groups showed that 14 (66.7%) and 10 (45.5%) S2 samples still had detectable bacteria, respectively. The corresponding figures for supplementary steps with the XP-endo Finisher and Hedström file were 11 (52.4%) and 10 (45.5%), respectively. Bacterial counts in sample 1 significantly decreased in samples 2 and 3 in both groups (P < .01). Intragroup comparison between sample 2 and sample 3 showed a 66% reduction in counts after using the Hedström file and 18% after using the XP-endo Finisher (P > .05 for both groups). The quantitative bacterial reduction was not different between groups (P > .05). CONCLUSIONS The XP-endo Shaper and BioRaCe systems have similar disinfecting and shaping abilities in C-shaped canals. Supplementary steps with the Hedström file and the XP-endo Finisher were similarly effective in improving shaping, but this was not sufficient to enhance disinfection. About half of the cases, in both groups, still harbored detectable amounts of bacteria.
Collapse
Affiliation(s)
- Isbelia Gazzaneo
- Postgraduate Program in Dentistry, University of Grande Rio, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Pablo Amoroso-Silva
- Postgraduate Program in Dentistry, University of Grande Rio, Rio de Janeiro, Rio de Janeiro, Brazil; Department of Restorative Dentistry, Londrina State University, Paraná, Brazil
| | - Juan Pacheco-Yanes
- Department of Endodontics, Faculty of Dentistry, Iguaçu University, Nova Iguaçu, Rio de Janeiro, Brazil
| | - Flávio R F Alves
- Postgraduate Program in Dentistry, University of Grande Rio, Rio de Janeiro, Rio de Janeiro, Brazil; Department of Endodontics, Faculty of Dentistry, Iguaçu University, Nova Iguaçu, Rio de Janeiro, Brazil.
| | - Marilia Marceliano-Alves
- Department of Endodontics, Faculty of Dentistry, Iguaçu University, Nova Iguaçu, Rio de Janeiro, Brazil
| | - Patricia Olivares
- Department of Endodontics, Faculty of Dentistry, Iguaçu University, Nova Iguaçu, Rio de Janeiro, Brazil
| | - Aida Meto
- Laboratory of Microbiology and Virology, University of Modena and Reggio Emilia, Modena, Italy
| | - Ibrahimu Mdala
- Department of General Practice, University of Oslo, Oslo, Norway
| | - José F Siqueira
- Postgraduate Program in Dentistry, University of Grande Rio, Rio de Janeiro, Rio de Janeiro, Brazil; Department of Endodontics, Faculty of Dentistry, Iguaçu University, Nova Iguaçu, Rio de Janeiro, Brazil
| | - Isabela N Rôças
- Postgraduate Program in Dentistry, University of Grande Rio, Rio de Janeiro, Rio de Janeiro, Brazil; Department of Endodontics, Faculty of Dentistry, Iguaçu University, Nova Iguaçu, Rio de Janeiro, Brazil
| |
Collapse
|
38
|
Rechenberg DK, Munir A, Zehnder M. Correlation between the clinically diagnosed inflammatory process and periapical index scores in severely painful endodontically involved teeth. Int Endod J 2020; 54:172-180. [PMID: 32918280 PMCID: PMC7894281 DOI: 10.1111/iej.13407] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 09/03/2020] [Accepted: 09/03/2020] [Indexed: 11/28/2022]
Abstract
Aim To assess and correlate three distinct states of severely painful endodontically derived inflammation with their depiction on periapical radiographs using periapical index (PAI) scores. Methodology During a period of 15 months, 368 consecutively enrolled patients with suspected endodontic emergency conditions were examined at the University of Zurich, Center of Dental Medicine. Cases with a severely painful (numeric rating scale, NRS‐11 > 6) endodontically involved tooth and a clear pulpal and apical diagnosis (n = 162) were selected (one tooth per patient). Teeth were divided into three groups according to the clinically diagnosed main location of the inflammatory process: level 1: pulp (positive response to cold test), level 2: periodontium (no response to cold without swelling) and level 3: periapical tissues (no response to cold with swelling). Periapical radiographs were obtained using a digital unit and analysed by two calibrated observers. For level 2, which had the highest PAI variance (n = 76), the PAI scores were further scrutinized regarding their dependence on tooth location and the duration of pain. Data were analysed using chi‐squared and non‐parametric tests, alpha = 0.05. Results Overall, the PAI scores correlated well with the clinically diagnosed main location of periapical inflammation (Spearman’s rho = 0.5131, P < 0.001), with level 1 having the lowest scores by far (P < 0.001) and level 2 having significantly lower scores compared to level 3 (P < 0.05). However, a PAI score of 5 was found in merely 3 teeth within the entire cohort, and 49% of the teeth in the level 2 group had no radiolucency (PAI < 3). Within level 2, the PAI scores were not dependent on tooth location but were substantially (P < 0.001) higher for teeth which had hurt for more than one week, and for root filled teeth. Conclusions For the analysed, severely painful endodontically involved teeth, the clinically diagnosed main location of inflammation was reflected by the periapical index. PAI scores were not significantly influenced by anatomical noise, yet in some cases under‐estimated the clinical situation.
Collapse
Affiliation(s)
- D K Rechenberg
- Division of Endodontology, Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - A Munir
- Division of Endodontology, Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - M Zehnder
- Division of Endodontology, Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| |
Collapse
|
39
|
Effect of Various Irrigating Devices on the Removal of Two Different Forms of Calcium Hydroxide from Internal Resorption Cavities. Int J Dent 2020; 2020:8881177. [PMID: 33005191 PMCID: PMC7503104 DOI: 10.1155/2020/8881177] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 08/21/2020] [Accepted: 08/26/2020] [Indexed: 11/18/2022] Open
Abstract
The present study aimed to investigate the efficiency of passive ultrasonic irrigation (PUI), EndoActivator (EA), standard needle irrigation (SNI), and XP-endo Finisher files in removing pure calcium hydroxide (pCH) and injectable CH from in vitro root resorption cavities. Using a rotary system, the root canals of 116 extracted single rooted teeth were prepared. Imitated internal resorption cavities were then created in root halves. The specimens were divided into two groups according to the form of CH (n = 58): (I) pCH; (II) injectable CH. The teeth of each group were randomly divided into six subgroups: negative control (n = 5), positive control (n = 5), PUI (n = 12), XP-endo Finisher (n = 12), EA (n = 12), and SNI (n = 12). The root canals were irrigated using NaOCl and EDTA and split longitudinally, and both halves were evaluated with a stereomicroscope. Kruskal–Wallis and Mann–Whitney U tests were used to analyze data. The present results revealed that PUI completely removed pCH in 79% and injectable CH in 70.8% of the internal resorption cavities which was significantly higher than other methods (p < 0.05). There was no statically significant difference between different forms of CH in terms of CH removal (p=0.918). The PUI technique was observed as the most efficient method of P-CH and injectable CH removal from a replicated internal resorption cavity. Finally, according to the findings, different forms of CH were comparable in terms of CH removal.
Collapse
|
40
|
Orhan EO, Bahadır D, Akgün C, Aktaş S. Scanning electron microscopic evaluation of the efficacy of 5% ethylenediaminetetraacetic acid for smear layer removal. Microsc Res Tech 2020; 84:253-260. [PMID: 32905662 DOI: 10.1002/jemt.23582] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 08/14/2020] [Accepted: 08/16/2020] [Indexed: 11/07/2022]
Abstract
The purpose of the study was to evaluate the smear layer removal efficacy of novel Saver® irrigating solution including 5% EDTA and to compare the 17% EDTA as the most used counterpart. Forty-four single-rooted teeth were divided into four groups, were instrumented, and irrigated. The smear treatment groups were as follows: sterile distilled water; 5.25% sodium hypochlorite; Saver®; 17% EDTA. The root samples were blinded. The micrographic images of root samples were collected by scanning electron microscope. The percentages of open dentin tubules were quantified using an image analysis software on micrographs. Two-way ANOVA followed by Tukey's multiple comparisons was used (p < .05). The 17% EDTA showed the highest percentages of open dentin tubules than the other treatments (p < .01). The mean percentages of open dentin tubules of 17% EDTA revealed statistically highly significant differences than Saver® treatment in all root regions (p < .01). Dentin tubules were covered by dense smear layer in distilled water irrigation whereas, the tubular pattern of dentin structure was not observed in hypochlorite irrigation. The commercial Saver® product presented to be less cleaning property on the smear layer than 17% EDTA and failed to show any improvement in the removal of smear layer compared with its tested counterpart.
Collapse
Affiliation(s)
- Ekim Onur Orhan
- Department of Endodontics, Faculty of Dentistry, Eskişehir Osmangazi University Eskişehir, Eskişehir, Turkey
| | - Duygu Bahadır
- Department of Endodontics, Faculty of Dentistry, Eskişehir Osmangazi University Eskişehir, Eskişehir, Turkey
| | - Ceyda Akgün
- Department of Endodontics, Faculty of Dentistry, Eskişehir Osmangazi University Eskişehir, Eskişehir, Turkey
| | - Seher Aktaş
- Department of Endodontics, Faculty of Dentistry, Eskişehir Osmangazi University Eskişehir, Eskişehir, Turkey
| |
Collapse
|
41
|
Improving the Efficiency of Photodynamic Chemotherapy in Root Canals against Enterococcus faecalis In Vitro. Antibiotics (Basel) 2020; 9:antibiotics9090543. [PMID: 32859004 PMCID: PMC7560177 DOI: 10.3390/antibiotics9090543] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 08/23/2020] [Accepted: 08/25/2020] [Indexed: 11/17/2022] Open
Abstract
The aim of this study was to evaluate the effect of photoactivated chemotherapy (PACT) on Enterococcus faecalis (E. faecalis) biofilms in root canals using an 90% isopropanol (IPA)-based photosensitizer and removing excess photosensitizer before light incubation. Three hundred and seven extracted human teeth with one root canal were infected with E. faecalis for 72 h and treated in groups: IPA irrigation; PACT; PACT and final rinse with IPA; PACT with photosensitizer removal using either 0.9% NaCl solution or sterile paper points or both; PACT using IPA-based photosensitizer with and without a final rinse of IPA. Root canals were sampled using sterile paper points and dentin chips collected from the root canal walls. Additionally, SEM (Scanning Electron Microscopy) images of the specimens were taken to evaluate the root canal walls for residue bacterial contamination. In all antimicrobial treatment groups treatments E. faecalis counts were significantly reduced in the root canals. Using IPA-based photosensitizer the antimicrobial effect of PACT was significantly enhanced. Irrigation with IPA alone or after PACT significantly increased the antimicrobial effect compared to PACT alone. The collected dentin chips revealed the highest amount of culture negative root canals (10%) after PACT using IPA-based photosensitizer. In the other groups, the culture negative samples ranged from only 0–2 specimens of 30 specimens. REM images show remaining E. faecalis cells on the root canal wall and inside dentin tubules. Using IPA-based photosensitizer significantly enhanced the antimicrobial effect of PACT against E. faecalis in the root canals.
Collapse
|
42
|
Cleaning, Shaping, and Disinfecting Abilities of 2 Instrument Systems as Evaluated by a Correlative Micro–computed Tomographic and Histobacteriologic Approach. J Endod 2020; 46:846-857. [DOI: 10.1016/j.joen.2020.03.017] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 02/28/2020] [Accepted: 03/13/2020] [Indexed: 12/14/2022]
|
43
|
Marcoux E, Lagha AB, Gauthier P, Grenier D. Antimicrobial activities of natural plant compounds against endodontic pathogens and biocompatibility with human gingival fibroblasts. Arch Oral Biol 2020; 116:104734. [PMID: 32454322 DOI: 10.1016/j.archoralbio.2020.104734] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 04/16/2020] [Accepted: 04/16/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVES The aim of the present study was to investigate three licorice-derived polyphenols (glabridin, licochalcone A, licoricidin) as well as cinnamon oil for their antimicrobial activities against major endodontic pathogens: Enterococcus faecalis, Streptococcus mutans, Actinomyces israelii, Fusobacterium nucleatum, Prevotella intermedia, Porphyromonas endodontalis, and Candida albicans. The synergistic interactions between the four compounds and chlorhexidine were assessed on E. faecalis. Lastly, the biocompatibility of the tested compounds was assessed using human gingival fibroblasts. DESIGN Minimal inhibitory concentrations (MIC) and minimal microbicidal concentrations (MMC) were determined using a microplate dilution assay. A luminescence assay monitoring adenosine triphosphate was used to assess the antimicrobial activity of the tested compounds against E. faecalis biofilm. The synergistic effects of the tested compounds in association with chlorhexidine were evaluated using the checkerboard technique. Cytotoxicity toward human gingival fibroblasts was assessed by determination of cell metabolic activity using a colorimetric assay. RESULTS Cinnamon oil showed the strongest microbicidal activity. Licochalcone A, licoricidin, and glabridin had MIC values ranging from 1.56 to 25 μg/mL against the six endodontic bacterial pathogens. The natural plant compounds were active to various extents against E. faecalis embedded in a biofilm. Synergistic antibacterial effects between chlorhexidine and the compounds, mainly glabridin, were observed against E. faecalis. Following a 2-h exposure, licochalcone A, licoricidin, and glabridin demonstrated no cytotoxicity toward gingival fibroblasts at concentrations up to 50 μg/mL, while cinnamon oil and, to a lesser extent, chlorhexidine displayed some cytotoxicity. CONCLUSIONS The present study provides evidence that the natural plant compounds tested show promise as root canal disinfection agents.
Collapse
Affiliation(s)
- Eve Marcoux
- Oral Ecology Research Group, Faculty of Dentistry, Université Laval, Quebec City, QC, Canada
| | - Amel Ben Lagha
- Oral Ecology Research Group, Faculty of Dentistry, Université Laval, Quebec City, QC, Canada
| | - Philippe Gauthier
- Oral Ecology Research Group, Faculty of Dentistry, Université Laval, Quebec City, QC, Canada
| | - Daniel Grenier
- Oral Ecology Research Group, Faculty of Dentistry, Université Laval, Quebec City, QC, Canada.
| |
Collapse
|
44
|
Velozo C, Silva S, Almeida A, Romeiro K, Vieira B, Dantas H, Sousa F, De Albuquerque DS. Shaping ability of XP‐endo Shaper and ProTaper Next in long oval‐shaped canals: a micro‐computed tomography study. Int Endod J 2020; 53:998-1006. [DOI: 10.1111/iej.13301] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Accepted: 03/23/2020] [Indexed: 11/28/2022]
Affiliation(s)
- C. Velozo
- Department of Restorative Dentistry and Endodontics Dental College of Pernambuco University of Pernambuco Camaragibe Brazil
| | - S. Silva
- Department of Restorative Dentistry and Endodontics Dental College of Pernambuco University of Pernambuco Camaragibe Brazil
| | - A. Almeida
- Department of Restorative Dentistry and Endodontics Dental College of Pernambuco University of Pernambuco Camaragibe Brazil
| | - K. Romeiro
- Department of Restorative Dentistry and Endodontics Dental College of Pernambuco University of Pernambuco Camaragibe Brazil
| | - B. Vieira
- Department of Morphology Health Science Center Federal University of Paraíba Paraíba Brazil
| | - H. Dantas
- Department of Morphology Health Science Center Federal University of Paraíba Paraíba Brazil
| | - F. Sousa
- Department of Morphology Health Science Center Federal University of Paraíba Paraíba Brazil
| | - D. S. De Albuquerque
- Department of Restorative Dentistry and Endodontics Dental College of Pernambuco University of Pernambuco Camaragibe Brazil
| |
Collapse
|
45
|
Effects of Contemporary Irrigant Activation Schemes and Subsequent Placement of an Interim Dressing on Bacterial Presence and Activity in Root Canals Associated with Asymptomatic Apical Periodontitis. J Clin Med 2020; 9:jcm9030854. [PMID: 32245051 PMCID: PMC7141523 DOI: 10.3390/jcm9030854] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 03/18/2020] [Accepted: 03/18/2020] [Indexed: 01/09/2023] Open
Abstract
New tools for activating endodontic irrigants have evolved, yet their impact on root canal disinfection, in comparison to the passive placing of an inter-visit medication, have not yet been fully elucidated. The use of DNA- and rRNA-based methods may cast some new light on this issue, as they allow a comparison to be made between microbial presence and activity. Therefore, the aim of this single-arm intervention trial is to evaluate the antibacterial effect of endodontic procedures using both molecular methods. Root canal samples were obtained from 20 patients with asymptomatic apical periodontitis after each treatment step: access cavity, chemo-mechanical preparation, adjunctive procedures (XP-endo Finisher file and passive ultrasonic irrigation), calcium hydroxide medication, and 2nd-visit root canal preparation. DNA and cDNA from the samples were subjected to quantitative polymerase chain reaction with universal primers for the bacterial 16S rRNA gene. Chemo-mechanical preparation promoted a drastic reduction in bacterial levels and activity, whereas the adjunctive procedures did not make a significant contribution to further disinfection. At the 2nd visit, bacteria were active after the use of calcium hydroxide medication; however, they were significantly reduced after a 2nd-visit preparation. Consequently, the lowest bacterial levels were found at the end of the treatment. This clinical trial, which used an rRNA and rDNA combined approach, confirmed previous studies showing that root canal preparation represents the main strategy for root canal disinfection.
Collapse
|
46
|
Karataş E, Baltacı MÖ, Uluköylü E, Adıgüzel A. Antibacterial effectiveness of calcium hydroxide alone or in combination with Ibuprofen and Ciprofloxacin in teeth with asymptomatic apical periodontitis: a randomized controlled clinical study. Int Endod J 2020; 53:742-753. [DOI: 10.1111/iej.13277] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 02/06/2020] [Indexed: 12/13/2022]
Affiliation(s)
- E. Karataş
- Department of Endodontics Faculty of Dentistry Ataturk University ErzurumTurkey
| | - M. Ö. Baltacı
- Molecular Biology and Genetics, Microbiology Faculty of Science Ataturk University Erzurum Turkey
| | - E. Uluköylü
- Department of Endodontics Faculty of Dentistry Ataturk University ErzurumTurkey
| | - A. Adıgüzel
- Molecular Biology and Genetics, Microbiology Faculty of Science Ataturk University Erzurum Turkey
| |
Collapse
|
47
|
Milanovic I, Milovanovic P, Antonijevic D, Dzeletovic B, Djuric M, Miletic V. Immediate and Long-Term Porosity of Calcium Silicate-Based Sealers. J Endod 2020; 46:515-523. [PMID: 32094001 DOI: 10.1016/j.joen.2020.01.007] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 01/05/2020] [Accepted: 01/08/2020] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Open pores between endodontic sealer and root canal walls present potential niches for bacterial growth and migration pathways. The aim was to assess the internal and external porosity of calcium silicate-based sealers and to ascertain the long-term effect of storage in simulated body fluid on sealer porosity. METHODS Sixteen single-rooted teeth were filled with gutta-percha and 1 of 4 root canal sealers: BioRoot RCS, EndoSequence BC, MTA Fillapex, or AH Plus. Obturated roots, stored in Hank's balanced salt solution, were scanned after 7 days and after 6 months by using micro-computed tomography at an isotropic resolution of 9.9 μm. Total, open, and closed porosity were calculated in the coronal, middle, and apical thirds. Data were statistically analyzed by using general linear model and paired t test (α = 0.05). RESULTS Significantly higher percentage of open than closed porosity was found in all groups. Initially, significantly greater open and total porosity were found for MTA Fillapex than for AH Plus. After 6 months, the percentage of open and total porosity increased in BioRoot RCS and MTA Fillapex and decreased in AH Plus and EndoSequence BC. Both initially and after storage, coronal region of all sealers had significantly greater total porosity than middle and apical regions, which were comparable. CONCLUSIONS None of the root fillings were void-free, with predominant open porosity persisting after long-term storage.
Collapse
Affiliation(s)
- Ivana Milanovic
- DentalNet Research Group, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Petar Milovanovic
- Laboratory for Anthropology, Institute of Anatomy, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Djordje Antonijevic
- Laboratory for Anthropology, Institute of Anatomy, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Bojan Dzeletovic
- DentalNet Research Group, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Marija Djuric
- Laboratory for Anthropology, Institute of Anatomy, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Vesna Miletic
- DentalNet Research Group, School of Dental Medicine, University of Belgrade, Belgrade, Serbia.
| |
Collapse
|
48
|
Mostafa MEHAA, El‐Shrief YAI, Anous WIO, Hassan MW, Salamah FTA, El Boghdadi RM, El‐Bayoumi MAA, Seyam RM, Abd‐El‐Kader KG, Amin SAW. Postoperative pain following endodontic irrigation using 1.3% versus 5.25% sodium hypochlorite in mandibular molars with necrotic pulps: a randomized double‐blind clinical trial. Int Endod J 2020; 53:154-166. [DOI: 10.1111/iej.13222] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Affiliation(s)
| | - Y. A. I. El‐Shrief
- Department of Endodontics Faculty of Dentistry Cairo University Cairo Egypt
| | - W. I. O. Anous
- Department of Endodontics Faculty of Dentistry Cairo University Cairo Egypt
| | - M. W. Hassan
- Department of Endodontics Faculty of Dentistry Cairo University Cairo Egypt
| | - F. T. A. Salamah
- Department of Endodontics Faculty of Dentistry Cairo University Cairo Egypt
| | - R. M. El Boghdadi
- Department of Endodontics Faculty of Dentistry Cairo University Cairo Egypt
| | | | - R. M. Seyam
- Department of Endodontics Faculty of Dentistry Cairo University Cairo Egypt
| | - K. G. Abd‐El‐Kader
- Department of Endodontics Faculty of Dentistry Cairo University Cairo Egypt
| | - S. A. W. Amin
- Department of Endodontics Faculty of Dentistry Cairo University Cairo Egypt
| |
Collapse
|
49
|
Ruiz-Linares M, Baca P, Arias-Moliz MT, Ternero FJ, Rodríguez J, Ferrer-Luque CM. Antibacterial and antibiofilm activity over time of GuttaFlow Bioseal and AH Plus. Dent Mater J 2019; 38:701-706. [PMID: 31257302 DOI: 10.4012/dmj.2018-090] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The sealers' antibacterial and antibiofilm activities against Enterococcus faecalis were evaluated by direct contact test (DCT) and confocal laser scanning microscopy (CLSM), respectively, after 1 day, and 1 and 4 weeks of aging. Cell viability was determined by adenosin triphosphate (ATP) assay after DCT. The parameters evaluated for the antibiofilm property were total biovolume and percentage of green cells in E.faecalis biofilms. The data from the bioluminescence ATP assay as well as the total biovolume and green percentage were analyzed by non-parametric tests, Kruskal-Wallis for global comparison and Kolmogorov-Smirnov for each two variables. Results of the DCT and CLSM for all parameters evaluated show that the antimicrobial activity of AH Plus decreased over time, whereas GuttaFlow Bioseal had an opposite property, increasing its antibacterial activity as the material aged.
Collapse
Affiliation(s)
- Matilde Ruiz-Linares
- Department of Stomatology, School of Dentistry, University of Granada, Campus de Cartuja
| | - Pilar Baca
- Department of Stomatology, School of Dentistry, University of Granada, Campus de Cartuja
| | | | | | - Jesús Rodríguez
- Department of Stomatology, School of Dentistry, University of Granada, Campus de Cartuja
| | | |
Collapse
|
50
|
Microcomputed Tomography Studies of the Effectiveness of XP-endo Shaper in Root Canal Preparation: A Review of the Literature. ScientificWorldJournal 2019; 2019:3570870. [PMID: 31531000 PMCID: PMC6721469 DOI: 10.1155/2019/3570870] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 07/31/2019] [Indexed: 12/13/2022] Open
Abstract
The aim of this study was to undertake a literature review on the use of XP-endo Shaper (FKG Dentaire SA, La Chaux-de-Fonds, Switzerland) for root canal preparation evaluated using microcomputed tomography (micro-CT) technology, with emphasis on the analysis of untouched canal walls. We searched the PubMed, Science Direct, SciELO, and MEDLINE databases for articles published from 2017 to 2019 using the following keywords: micro-CT, untouched walls, XP shaper, and XP endo. Articles without an abstract were excluded. Five papers were selected. Few studies on this topic are available. The studies published so far show that the XP-endo® Shaper system performs well in terms of canal preparation but leaves untouched walls.
Collapse
|