201
|
Barros J, Silva MG, Rodrigues MA, Alves FRF, Lopes MA, Pina-Vaz I, Siqueira JF. Antibacterial, physicochemical and mechanical properties of endodontic sealers containing quaternary ammonium polyethylenimine nanoparticles. Int Endod J 2013; 47:725-34. [DOI: 10.1111/iej.12207] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Accepted: 10/15/2013] [Indexed: 12/01/2022]
Affiliation(s)
- J. Barros
- Department of Endodontics; Faculty of Dental Medicine; University of Porto; Porto Portugal
| | - M. G. Silva
- Institute of Microbiology Prof. Paulo de Góes; Federal University of Rio de Janeiro; RJ Brazil
| | - M. A. Rodrigues
- Department of Metallurgical and Materials Engineering; Faculty of Engineering; University of Porto; Porto Portugal
| | - F. R. F. Alves
- Department of Endodontics; Faculty of Dentistry; Estácio de Sá University; Rio de Janeiro RJ Brazil
| | - M. A. Lopes
- Department of Metallurgical and Materials Engineering; Faculty of Engineering; University of Porto; Porto Portugal
| | - I. Pina-Vaz
- Department of Endodontics; Faculty of Dental Medicine; University of Porto; Porto Portugal
| | - J. F. Siqueira
- Department of Endodontics; Faculty of Dentistry; Estácio de Sá University; Rio de Janeiro RJ Brazil
| |
Collapse
|
202
|
Sipert CR, Morandini AC, Dionísio TJ, Machado MAAM, Oliveira SHP, Campanelli AP, Kuo WP, Santos CF. In vitro regulation of CCL3 and CXCL12 by bacterial by-products is dependent on site of origin of human oral fibroblasts. J Endod 2013; 40:95-100. [PMID: 24331998 DOI: 10.1016/j.joen.2013.09.031] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2013] [Revised: 08/08/2013] [Accepted: 09/19/2013] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Production of chemokines by tissue resident cells is one of the main mechanisms involved in the inflammatory infiltrate formation during inflammation. The specific ability of fibroblasts from different oral tissues such as gingiva, periodontal ligament, and dental pulp from permanent and deciduous teeth in producing the chemokines CCL3 and CXCL12 under stimulation by bacterial products commonly found in endodontic infections was investigated. METHODS Cultures of fibroblasts from gingiva and periodontal ligament as well as from dental pulp from permanent and deciduous teeth were established by using an explant technique and stimulated with increasing concentrations of Escherichia coli lipopolysaccharide (EcLPS) and Enterococcus faecalis lipoteichoic acid (EfLTA) for 1, 6, and 24 hours. Supernatants were tested for CCL3 and CXCL12 by enzyme-linked immunosorbent assay. RESULTS In general, CCL3 production was induced by EcLPS in the 4 fibroblast subtypes and by EfLTA in fibroblasts from gingiva and periodontal ligament. Constitutive CXCL12 synthesis decreased in all fibroblast subtypes especially under stimulation with EcLPS. Fibroblast from permanent deciduous teeth was the cell type presenting the most expressive reduction in CXCL12 release by both stimuli. On the basis of computational matching of CXCL12 mRNA with the microRNAs miR-141 and miR-200a, their expression was also investigated. Although detected in the fibroblasts, these molecules remained unaltered by bacterial by-product stimulation. CONCLUSIONS EcLPS and EfLTA induced the production of CCL3 and unbalanced the synthesis of CXCL12 in a manner dependent on the specific tissue origin of fibroblasts.
Collapse
Affiliation(s)
- Carla Renata Sipert
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Ana Carolina Morandini
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Thiago José Dionísio
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | | | - Sandra Helena Penha Oliveira
- Department of Basic Sciences, Araçatuba School of Dentistry, Universidade Estadual Paulista, Araçatuba, São Paulo, Brazil
| | - Ana Paula Campanelli
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Winston Patrick Kuo
- Harvard Clinical and Translational Science Center, Laboratory for Innovative Translational Technologies, Harvard Medical School and Department of Developmental Biology, Harvard School of Dental Medicine, Boston, Massachusetts
| | - Carlos Ferreira Santos
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil.
| |
Collapse
|
203
|
Rezende TMB, Lima SMF, Petriz BA, Silva ON, Freire MS, Franco OL. Dentistry proteomics: From laboratory development to clinical practice. J Cell Physiol 2013; 228:2271-84. [DOI: 10.1002/jcp.24410] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2013] [Accepted: 05/21/2013] [Indexed: 12/12/2022]
Affiliation(s)
- Taia M. B. Rezende
- Centro de Análises Proteômicas e Bioquímicas, Programa de Pós-Graduação em Ciências Genômicas e Biotecnologia; Universidade Católica de Brasília; Brasília Distrito Federal Brazil
- Curso de Odontologia; Universidade Católica de Brasília; Brasília Distrito Federal Brazil
| | - Stella M. F. Lima
- Centro de Análises Proteômicas e Bioquímicas, Programa de Pós-Graduação em Ciências Genômicas e Biotecnologia; Universidade Católica de Brasília; Brasília Distrito Federal Brazil
- Curso de Odontologia; Universidade Católica de Brasília; Brasília Distrito Federal Brazil
| | - Bernardo A. Petriz
- Centro de Análises Proteômicas e Bioquímicas, Programa de Pós-Graduação em Ciências Genômicas e Biotecnologia; Universidade Católica de Brasília; Brasília Distrito Federal Brazil
| | - Osmar N. Silva
- Centro de Análises Proteômicas e Bioquímicas, Programa de Pós-Graduação em Ciências Genômicas e Biotecnologia; Universidade Católica de Brasília; Brasília Distrito Federal Brazil
| | - Mirna S. Freire
- Centro de Análises Proteômicas e Bioquímicas, Programa de Pós-Graduação em Ciências Genômicas e Biotecnologia; Universidade Católica de Brasília; Brasília Distrito Federal Brazil
| | - Octávio L. Franco
- Centro de Análises Proteômicas e Bioquímicas, Programa de Pós-Graduação em Ciências Genômicas e Biotecnologia; Universidade Católica de Brasília; Brasília Distrito Federal Brazil
| |
Collapse
|
204
|
Siqueira JF, Alves FR, Versiani MA, Rôças IN, Almeida BM, Neves MA, Sousa-Neto MD. Correlative Bacteriologic and Micro–Computed Tomographic Analysis of Mandibular Molar Mesial Canals Prepared by Self-Adjusting File, Reciproc, and Twisted File Systems. J Endod 2013; 39:1044-50. [DOI: 10.1016/j.joen.2013.04.034] [Citation(s) in RCA: 124] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2013] [Revised: 04/08/2013] [Accepted: 04/23/2013] [Indexed: 11/29/2022]
|
205
|
Poptani B, Sharaff M, Archana G, Parekh V. Detection of Enterococcus faecalis and Candida albicans in previously root-filled teeth in a population of Gujarat with polymerase chain reaction. Contemp Clin Dent 2013; 4:62-6. [PMID: 23853454 PMCID: PMC3703696 DOI: 10.4103/0976-237x.111622] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Micro-organisms are the primary causative agents of endodontic infections. Phenotype based procedures for bacterial identification has certain drawbacks especially, when investigating the microbiota of root-filled teeth. Thus, more sensitive methods like Polymerase chain reaction (PCR) can provide results that are more accurate and reliable for the microbial prevalence in the root filled teeth. AIM In this study, we have investigated twenty symptomatic root-filled teeth with chronic apical periodontitis for the prevalence of Enterococcus faecalis and Candida albicans in the root filled teeth associated with symptomatic cases with or without periradicular lesions. MATERIALS AND METHODS Microbiological samples were taken from the canals immediately after removal of previous gutta percha cones using aseptic techniques. After removal of root canal filling, samples were obtained with paper points placed in the canal. Paper points were transferred to a cryotube containing "Tris EDTA" buffer and immediately frozen at -20°C. RESULTS By PCR amplification of the samples using taxon specific primers, E. faecalis was found to be prevalent species, detected in 65% of the cases and C. albicans was detected in 35% of cases. CONCLUSION The results of the study shows that geographical influence and dietary factors might have some role to play in the prevalence of the species like C. albicans and presence of E. faecalis confirming the assertion of previous culture-dependent and independent approaches for the microbiological survey of root filled teeth.
Collapse
Affiliation(s)
- Bruhvi Poptani
- Department of Conservative Dentistry and Endodontics, Karnavati School of Dentistry, Ahmedabad, Gujarat, India
| | | | | | | |
Collapse
|
206
|
Ardizzoni A, Generali L, Righi E, Baschieri MC, Cavani F, Manca L, Lugli E, Migliarese L, Blasi E, Neglia RG. Differential efficacy of endodontic obturation procedures: an ex vivo study. Odontology 2013; 102:223-31. [DOI: 10.1007/s10266-013-0125-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Accepted: 06/04/2013] [Indexed: 12/01/2022]
|
207
|
Eswar K, Venkateshbabu N, Rajeswari K, Kandaswamy D. Dentinal tubule disinfection with 2% chlorhexidine, garlic extract, and calcium hydroxide against Enterococcus faecalis by using real-time polymerase chain reaction: In vitro study. J Conserv Dent 2013; 16:194-8. [PMID: 23833449 PMCID: PMC3698579 DOI: 10.4103/0972-0707.111312] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2012] [Revised: 01/02/2013] [Accepted: 03/04/2013] [Indexed: 11/04/2022] Open
Abstract
AIM To compare the efficacy of garlic extract with 2% chlorhexidine (CHX) and calcium hydroxide Ca(OH)2 in disinfection of dentinal tubules contaminated with Enterococcus faecalis by using real-time polymerase chain reaction (PCR). MATERIALS AND METHODS Agar diffusion test was done to evaluate the minimum inhibitory concentration of garlic extract against E. faecalis. Forty human extracted mandibular premolar teeth were selected for this study, access cavity was prepared and cleaning and shaping was done. Middle third of the root was cut using a rotary diamond disc. The teeth specimens were inoculated with E. faecalis for 21 days. Specimens were divided into four groups---Group 1: 2% CHX, Group 2: Garlic extract, Group 3: Ca(OH)2, and Group 4: Saline (negative control). The intracanal medicaments were packed inside the tooth specimens and incubated for 5 days. The dentinal chips were collected at 400 μm depth using a Gates-Glidden drill, following which DNA isolation was done. The specimens were analyzed using real-time PCR. The results were then statistically analyzed using one-way analysis of variance, followed by post hoc Tukey's honestly significant difference (HSD) multiple comparison of means. RESULTS Threshold cycle (Ct) values of 2% CHX was found to be 32.4, garlic extract to be 27.5, and Ca(OH)2 to be 25.6. CONCLUSION A total of 2% CHX showed the maximum efficacy against E. faecalis, followed by garlic extract and Ca(OH)2.
Collapse
Affiliation(s)
- Kandaswamy Eswar
- Department of Conservative Dentistry and Endodontics, Faculty of Dental Sciences, Sri Ramachandra University, Chennai, Tamil Nadu, India
| | | | | | | |
Collapse
|
208
|
Neves MAS, Rôças IN, Siqueira JF. Clinical antibacterial effectiveness of the self-adjusting file system. Int Endod J 2013; 47:356-65. [DOI: 10.1111/iej.12151] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Accepted: 06/13/2013] [Indexed: 02/03/2023]
Affiliation(s)
- M. A. S. Neves
- Department of Endodontics and Molecular Microbiology Laboratory; Faculty of Dentistry; Estácio de Sá University; Rio de Janeiro RJ Brazil
| | - I. N. Rôças
- Department of Endodontics and Molecular Microbiology Laboratory; Faculty of Dentistry; Estácio de Sá University; Rio de Janeiro RJ Brazil
| | - J. F. Siqueira
- Department of Endodontics and Molecular Microbiology Laboratory; Faculty of Dentistry; Estácio de Sá University; Rio de Janeiro RJ Brazil
| |
Collapse
|
209
|
Del Fabbro M, Samaranayake LP, Lolato A, Weinstein T, Taschieri S. Analysis of the secondary endodontic lesions focusing on the extraradicular microorganisms: an overview. ACTA ACUST UNITED AC 2013; 5:245-54. [PMID: 23766136 DOI: 10.1111/jicd.12045] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2012] [Accepted: 02/23/2013] [Indexed: 01/12/2023]
Abstract
The present study aimed at reviewing the literature on extraradicular infections of endodontically treated teeth, summarizing the main hypotheses on etiopathogenesis and describing the most suitable techniques to identify the composition of pathogenic extraradicular microorganisms. Medline database was searched using the keywords "Apical biofilm," "extraradicular infection," "secondary endodontic lesion," "endodontic retreatment," "biofilm" either alone or combined with AND. A further hand search was performed on the main endodontic journals. The most frequent bacterial species identified in different studies and with different techniques may vary considerably. Although the presence of some species of microorganisms seems to be determinant, the true origin of extraradicular infection is still undetermined. The literature analysis showed marked differences in methodology, materials, aims, and techniques adopted, which led to highly heterogeneous outcomes. The picture emerging from this review is that extraradicular infection is likely a multifactorial disease that requires further systematic investigation using standardized techniques.
Collapse
Affiliation(s)
- Massimo Del Fabbro
- Director of Center of Research for Oral Health, Department of Biomedical, Surgical and Dental Sciences, Dental Clinic, IRCCS Galeazzi Orthopedic Institute, Universitá degli Studi di Milano, Milano, Italy
| | | | | | | | | |
Collapse
|
210
|
Drago L, Vassena C, Saibene AM, Del Fabbro M, Felisati G. A case of coinfection in a chronic maxillary sinusitis of odontogenic origin: identification of Dialister pneumosintes. J Endod 2013; 39:1084-7. [PMID: 23880283 DOI: 10.1016/j.joen.2013.04.025] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2012] [Revised: 03/30/2013] [Accepted: 04/03/2013] [Indexed: 11/29/2022]
Abstract
INTRODUCTION In this report, we discuss the case of a 39-year-old woman presenting with a case of chronic maxillary sinusitis. METHODS Dialister pneumosintes, Staphylococcus epidermidis, and Peptostreptococcus spp. were isolated from endosinusal samples obtained during surgery. The patient showed extensive periodontopathy and had undergone prior endodontic treatment for endodontic infection of teeth #13, #14, and #15, which failed and presumably acted as a bridge for the sinusal infection. After nasosinusal surgery, consisting of opening and toilet of the maxillary sinus, combined with extraction of the 3 previously mentioned teeth and antibiotic treatment, the patient showed complete healing. RESULTS S. epidermidis and Peptostreptococcus spp. were identified with a traditional biochemical test and confirmed by pyrosequencing. Conversely, D. pneumosintes could not be identified with the conventional method, but it was identified using DNA pyrosequencing. In addition, to better understand the role and the virulence of this bacterium in odontogenic sinusitis, we have evaluated the ability of D. pneumosintes to produce biofilms onto inert surfaces. D. pneumosintes is a known endodontic and periodontal pathogen found in necrotic pulp, subgingival plaque, and deep periodontal pockets. CONCLUSIONS To our knowledge, the pathogenic role of D. pneumosintes in odontogenic sinusitis has never been evidenced. Thus, its detection in endosinusal specimens may provide a significant insight into the pathogenesis of this relevant medical condition.
Collapse
Affiliation(s)
- Lorenzo Drago
- Laboratory of Clinical-Chemistry and Microbiology, IRCCS Galeazzi Orthopaedic Institute, Department of Biomedical Sciences for Health, University of Milan, Italy.
| | | | | | | | | |
Collapse
|
211
|
Tong Z, Ling J, Lin Z, Li X, Mu Y. The Effect of MTADN on 10 Enterococcus faecalis Isolates and Biofilm: An In Vitro Study. J Endod 2013; 39:674-8. [DOI: 10.1016/j.joen.2012.12.010] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2012] [Revised: 12/04/2012] [Accepted: 12/10/2012] [Indexed: 11/30/2022]
|
212
|
Zhang H, Fouts DE, DePew J, Stevens RH. Genetic modifications to temperate Enterococcus faecalis phage Ef11 that abolish the establishment of lysogeny and sensitivity to repressor, and increase host range and productivity of lytic infection. MICROBIOLOGY-SGM 2013; 159:1023-1035. [PMID: 23579685 DOI: 10.1099/mic.0.067116-0] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Ef11 is a temperate bacteriophage originally isolated by induction from a lysogenic Enterococcus faecalis strain recovered from an infected root canal, and the Ef11 prophage is widely disseminated among strains of E. faecalis. Because E. faecalis has emerged as a significant opportunistic human pathogen, we were interested in examining the genes and regulatory sequences predicted to be critical in the establishment/maintenance of lysogeny by Ef11 as a first step in the construction of the genome of a virulent, highly lytic phage that could be used in treating serious E. faecalis infections. Passage of Ef11 in E. faecalis JH2-2 yielded a variant that produced large, extensively spreading plaques in lawns of indicator cells, and elevated phage titres in broth cultures. Genetic analysis of the cloned virus producing the large plaques revealed that the variant was a recombinant between Ef11 and a defective FL1C-like prophage located in the E. faecalis JH2-2 chromosome. The recombinant possessed five ORFs of the defective FL1C-like prophage in place of six ORFs of the Ef11 genome. Deletion of the putative lysogeny gene module (ORFs 31-36) and replacement of the putative cro promoter from the recombinant phage genome with a nisin-inducible promoter resulted in no loss of virus infectivity. The genetic construct incorporating all the aforementioned Ef11 genomic modifications resulted in the generation of a variant that was incapable of lysogeny and insensitive to repressor, rendering it virulent and highly lytic, with a notably extended host range.
Collapse
Affiliation(s)
- H Zhang
- Laboratory of Oral Infectious Diseases, Temple University Kornberg School of Dentistry, Philadelphia, PA 19140, USA
- Department of Endodontology, Temple University Kornberg School of Dentistry, Philadelphia, PA 19140, USA
| | - D E Fouts
- Genomic Medicine, J. Craig Venter Institute, Rockville, MD 20850, USA
| | - J DePew
- Genomic Medicine, J. Craig Venter Institute, Rockville, MD 20850, USA
| | - R H Stevens
- Laboratory of Oral Infectious Diseases, Temple University Kornberg School of Dentistry, Philadelphia, PA 19140, USA
- Department of Endodontology, Temple University Kornberg School of Dentistry, Philadelphia, PA 19140, USA
| |
Collapse
|
213
|
Carbajal Mejía JB. Antimicrobial effects of calcium hydroxide, chlorhexidine, and propolis on Enterococcus faecalis
and Candida albicans. ACTA ACUST UNITED AC 2013; 5:194-200. [DOI: 10.1111/jicd.12041] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2012] [Accepted: 01/19/2013] [Indexed: 01/12/2023]
Affiliation(s)
- Jeison B. Carbajal Mejía
- Department of Endodontics; Faculty of Dentistry; Daniel Alcides Carrión National University; Pasco Peru
| |
Collapse
|
214
|
Evaluation of the antibacterial activity of three gutta-percha solvents against Enterococcus faecalis. Int J Artif Organs 2013; 36:358-62. [PMID: 23504811 DOI: 10.5301/ijao.5000209] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2013] [Indexed: 11/20/2022]
Abstract
PURPOSE Enterococcus faecalis (E. faecalis) is implicated as the common etiological agent of root canal treatment failure. The study was aimed to compare the antibacterial efficacy and to assess the minimum inhibitory concentration (MIC) of 3 gutta-percha solvents-RC Solve, Endosolv-E, and xylene against E. faecalis. METHODS Agar well diffusion assay was performed to evaluate the antibacterial efficacy of the gutta-percha solvents against E. faecalis (ATCC 29212 and a clinical isolate). The standard drug vancomycin was used as the control. The MIC of the solvents was determined by broth microdilution assay. Two fold serial dilutions of the solvents were prepared and the lowest concentration of the solvent that inhibits visible bacterial growth was recorded as the MIC. Minimum bactericidal concentration (MBC) was determined by plating on Muller Hinton Agar plates and the lowest concentration of the solvent that resulted in 99% reduction of bacterial viability was scored as the MBC. RESULTS The antibacterial activity of RC Solve against E. faecalis was found to be comparable to that of the standard drug-vancomycin. Xylene did not exhibit antibacterial activity while the antibacterial activity of Endosolv-E was lesser than RC Solve. RC Solve recorded lower MIC values against both E. faecalis ATCC29212 and clinical isolate (1:2 and 1:4 dilution) than Endosolv-E (undiluted). RC Solve was found to possess antibacterial activity against E. faecalis even at half the concentration that is routinely being used. CONCLUSIONS Within the limitations of the study, we conclude that RC Solve can perform a dual role both as a gutta-percha solvent as well as a microbicide against E. faecalis.
Collapse
|
215
|
Brundin M, Figdor D, Sundqvist G, Sjögren U. DNA Binding to Hydroxyapatite: A Potential Mechanism for Preservation of Microbial DNA. J Endod 2013; 39:211-6. [DOI: 10.1016/j.joen.2012.09.013] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2012] [Revised: 09/23/2012] [Accepted: 09/24/2012] [Indexed: 10/27/2022]
|
216
|
Rôças IN, Lima KC, Siqueira JF. Reduction in bacterial counts in infected root canals after rotary or hand nickel-titanium instrumentation--a clinical study. Int Endod J 2013; 46:681-7. [PMID: 23331179 DOI: 10.1111/iej.12045] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2012] [Accepted: 12/10/2012] [Indexed: 01/30/2023]
Abstract
AIM To compare the antibacterial efficacy of two instrumentation techniques, one using hand nickel-titanium (NiTi) instruments and the other using rotary NiTi instruments, in root canals of teeth with apical periodontitis. METHODOLOGY Root canals from single-rooted teeth were instrumented using either hand NiTi instruments in the alternated rotation motion technique or rotary BioRaCe instruments. The irrigant used in both groups was 2.5% NaOCl. DNA extracts from samples taken before and after instrumentation were subjected to quantitative analysis by real-time polymerase chain reaction (qPCR). Qualitative analysis was also performed using presence/absence data from culture and qPCR assays. RESULTS Bacteria were detected in all S1 samples by both methods. In culture analysis, 45% and 35% of the canals were still positive for bacterial presence after hand and rotary NiTi instrumentation, respectively (P > 0.05). Rotary NiTi instrumentation resulted in significantly fewer qPCR-positive cases (60%) than hand NiTi instrumentation (95%) (P = 0.01). Intergroup comparison of quantitative data showed no significant difference between the two techniques. CONCLUSION There was no significant difference in bacterial reduction in infected canals after instrumentation using hand or rotary NiTi instruments. In terms of incidence of positive results for bacteria, culture also showed no significant differences between the groups, but the rotary NiTi instrumentation resulted in more negative results in the more sensitive qPCR analysis.
Collapse
Affiliation(s)
- I N Rôças
- Department of Endodontics and Molecular Microbiology Laboratory, Faculty of Dentistry, Estácio de Sá University, Rio de Janeiro, RJ, Brazil
| | | | | |
Collapse
|
217
|
Good ML, McCammon A. Removal of gutta-percha and root canal sealer: a literature review and an audit comparing current practice in dental schools. ACTA ACUST UNITED AC 2012; 39:703-8. [PMID: 23367635 DOI: 10.12968/denu.2012.39.10.703] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- M-L Good
- Consultant, Department of Restorative Dentistry, The Royal Hospitals, Belfast Health and Social Care Trust, Grosvenor Road, Belfast, BT12 6BP, Northern Ireland
| | - A McCammon
- Vocational Trainee, Whitehead, Carrickfergus, Northern Ireland
| |
Collapse
|
218
|
Anderson AC, Hellwig E, Vespermann R, Wittmer A, Schmid M, Karygianni L, Al-Ahmad A. Comprehensive analysis of secondary dental root canal infections: a combination of culture and culture-independent approaches reveals new insights. PLoS One 2012; 7:e49576. [PMID: 23152922 PMCID: PMC3495864 DOI: 10.1371/journal.pone.0049576] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2012] [Accepted: 10/10/2012] [Indexed: 01/11/2023] Open
Abstract
Persistence of microorganisms or reinfections are the main reasons for failure of root canal therapy. Very few studies to date have included culture-independent methods to assess the microbiota, including non-cultivable microorganisms. The aim of this study was to combine culture methods with culture-independent cloning methods to analyze the microbial flora of root-filled teeth with periradicular lesions. Twenty-one samples from previously root-filled teeth were collected from patients with periradicular lesions. Microorganisms were cultivated, isolated and biochemically identified. In addition, ribosomal DNA of bacteria, fungi and archaea derived from the same samples was amplified and the PCR products were used to construct clone libraries. DNA of selected clones was sequenced and microbial species were identified, comparing the sequences with public databases. Microorganisms were found in 12 samples with culture-dependent and -independent methods combined. The number of bacterial species ranged from 1 to 12 in one sample. The majority of the 26 taxa belonged to the phylum Firmicutes (14 taxa), followed by Actinobacteria, Proteobacteria and Bacteroidetes. One sample was positive for fungi, and archaea could not be detected. The results obtained with both methods differed. The cloning technique detected several as-yet-uncultivated taxa. Using a combination of both methods 13 taxa were detected that had not been found in root-filled teeth so far. Enterococcus faecalis was only detected in two samples using culture methods. Combining the culture-dependent and –independent approaches revealed new candidate endodontic pathogens and a high diversity of the microbial flora in root-filled teeth with periradicular lesions. Both methods yielded differing results, emphasizing the benefit of combined methods for the detection of the actual microbial diversity in apical periodontitis.
Collapse
Affiliation(s)
- Annette Carola Anderson
- Department of Operative Dentistry and Periodontology, Albert-Ludwigs-University, Freiburg, Germany
| | - Elmar Hellwig
- Department of Operative Dentistry and Periodontology, Albert-Ludwigs-University, Freiburg, Germany
| | - Robin Vespermann
- Department of Operative Dentistry and Periodontology, Albert-Ludwigs-University, Freiburg, Germany
| | - Annette Wittmer
- Department of Hygiene and Microbiology, Albert-Ludwigs-University, Freiburg, Germany
| | - Michael Schmid
- Michael Schmid, Research Unit Microbe-Plant Interactions, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Lamprini Karygianni
- Department of Operative Dentistry and Periodontology, Albert-Ludwigs-University, Freiburg, Germany
| | - Ali Al-Ahmad
- Department of Operative Dentistry and Periodontology, Albert-Ludwigs-University, Freiburg, Germany
- * E-mail:
| |
Collapse
|
219
|
Gulsahi K, Tirali RE, Cehreli SB, Karahan ZC, Uzunoglu E, Sabuncuoglu B. The effect of temperature and contact time of sodium hypochlorite on human roots infected with Enterococcus faecalis and Candida albicans. Odontology 2012; 102:36-41. [PMID: 23011474 DOI: 10.1007/s10266-012-0086-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2012] [Accepted: 09/10/2012] [Indexed: 10/27/2022]
Abstract
The aim of this study was to evaluate the effectiveness of 2.5 % NaOCl at different temperature and time intervals on Enterococcus faecalis and Candida albicans-infected human roots. A total of 112 root cylinders prepared from extracted single-rooted humans were infected by E. faecalis (Group A, n = 56) or C. albicans (Group B, n = 56); 3 root cylinders served as negative controls. Both groups were further divided into 6 subgroups according to three contact times (30 s, 1 min, 5 min) with NaOCl at two different temperatures (25 or 37 °C). Microorganism growth was controlled at the 24th and 48th hours. Statistical analysis was performed using the Chi-square test. While NaOCl at 25 °C for 5 min was the most effective irrigation regimen to eliminate E. faecalis (p < 0.001), NaOCl at 37 °C for 5 min exhibited significantly superior antifungal properties (p < 0.05). At the same contact times, difference in the temperature of NaOCl did not affect the growth of either E. faecalis or C. albicans. As a result, the irrigation time of NaOCl was more effective than the temperature to eliminate E. faecalis, while pre-heating of NaOCl to 37 °C increased its effectiveness on C. albicans at 5 min contact time.
Collapse
Affiliation(s)
- Kamran Gulsahi
- Department of Endodontics, Faculty of Dentistry, Baskent University, Ankara, Turkey
| | | | | | | | | | | |
Collapse
|
220
|
|
221
|
Good M, El Karim IA, Hussey DL. Endodontic 'Solutions'. Part 2: An audit comparing current practice in Belfast with UK and Republic of Ireland Dental Schools. ACTA ACUST UNITED AC 2012; 39:327-8, 330-2. [PMID: 22852510 DOI: 10.12968/denu.2012.39.5.327] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
UNLABELLED Endodontic lubricants, irrigating solutions and medicaments help reduce the microbial load within root canals. Primary and secondary cases involve different microbes. Each'solution'or combinations thereof could play a significant role but no detailed guidelines exist on their use. An audit was undertaken to compare current practice in Belfast Dental School to the others across the UK and Republic of Ireland (ROI). This audit highlighted three main differences between Belfast and other dental schools. Many other institutions utilized other irrigants besides sodium hypochlorite (NaOCl), different intracanal medicaments, including calcium hydroxide, and higher concentrations of NaOCl. Having gathered this information, we ask, 'Is there sufficient evidence to change the endodontic regime currently used at Belfast Dental School?'. Using the findings from the literature review (Part 1), we introduce new evidence-based protocols for primary and secondary cases for use in Belfast Dental School. CLINICAL RELEVANCE In the absence of detailed clinical guidelines on the use of endodontic lubricants, irrigants and medicaments in primary and secondary cases, it is important to be aware of current practice in UK and ROI dental schools where dentists and specialists are trained.
Collapse
Affiliation(s)
- Melissa Good
- Department of Restorative Dentistry, The Royal Hospitals, Belfast Health and Social Care Trust, UK
| | | | | |
Collapse
|
222
|
Vera J, Siqueira JF, Ricucci D, Loghin S, Fernández N, Flores B, Cruz AG. One- versus Two-visit Endodontic Treatment of Teeth with Apical Periodontitis: A Histobacteriologic Study. J Endod 2012; 38:1040-52. [DOI: 10.1016/j.joen.2012.04.010] [Citation(s) in RCA: 151] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2012] [Revised: 04/06/2012] [Accepted: 04/10/2012] [Indexed: 10/28/2022]
|
223
|
Good M, El KIA, Hussey DL. Endodontic 'solutions' part 1: a literature review on the use of endodontic lubricants, irrigants and medicaments. ACTA ACUST UNITED AC 2012; 39:239-40, 242-4, 246. [PMID: 22774686 DOI: 10.12968/denu.2012.39.4.239] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Endodontic lubricants, irrigants and medicaments help prepare and disinfect root canal systems (RCS) but primary and secondary cases involve different microbes and therefore it is unlikely that one protocol will be effective for both case types. Each individual 'solution' or sequence of'solutions' could play a significant role in each case type, but there are no detailed published guidelines in existence. To help inform clinical practice it was decided to undertake a literature review followed by a UK and Republic of Ireland wide audit on current endodontic'solution' usage within dental schools. The literature review was undertaken under the following headings: pre-op oral rinse; file lubricants; root canal irrigants and intracanal medicaments and provides an evidence base for protocol development for both primary and retreatment cases.The audit project and the protocols developed from the findings of both the literature review and audit will be presented in Part 2.
Collapse
Affiliation(s)
- Melissa Good
- Department of Restorative Dentistry, The Royal Hospitals, Belfast Health and Social Care Trust, Belfast, BT12 6BP, Northern Ireland, UK
| | | | | |
Collapse
|
224
|
Baca P, Junco P, Arias-Moliz MT, Castillo F, Rodríguez-Archilla A, Ferrer-Luque CM. Antimicrobial substantivity over time of chlorhexidine and cetrimide. J Endod 2012; 38:927-30. [PMID: 22703655 DOI: 10.1016/j.joen.2012.04.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2012] [Revised: 03/28/2012] [Accepted: 04/10/2012] [Indexed: 11/17/2022]
Abstract
INTRODUCTION To reach an adequate control of dentin infection and to promote success in endodontic therapy, antimicrobial irrigating solutions with confirmed substantivity are recommended. The aim of the present study was to evaluate the antimicrobial substantivity against Enterococcus faecalis of a dentin-volumetric unit exposed for 1 minute to chlorhexidine (CHX) and cetrimide (CTR). METHODS Standardized coronal dentin blocks of human molars, with and without collagen, were treated for 1 minute with 0.2% and 2% CHX and 0.2% CTR. Afterwards, they were exposed to E. faecalis suspension to determine the antimicrobial substantivity over a period of 60 days. Results were analyzed by means of Kaplan-Meier survival analysis (P < .05). RESULTS A direct relationship was seen between CHX concentration and survival time, and the most statistically significant results were obtained in specimens with collagen. CTR showed intermediate survival values close to those of 2% CHX. CONCLUSIONS The present study shows that 2% CHX used for 1 minute provides the longest substantivity followed by 0.2% CTR when applied to a dentin-volumetric model.
Collapse
Affiliation(s)
- Pilar Baca
- Department of Preventive Dentistry, School of Dentistry, University of Granada, Granada, Spain.
| | | | | | | | | | | |
Collapse
|
225
|
Alves FRF, Rôças IN, Almeida BM, Neves MAS, Zoffoli J, Siqueira JF. Quantitative molecular and culture analyses of bacterial elimination in oval-shaped root canals by a single-file instrumentation technique. Int Endod J 2012; 45:871-7. [DOI: 10.1111/j.1365-2591.2012.02045.x] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
226
|
Characterization of microbiota of root canal-treated teeth with posttreatment disease. J Clin Microbiol 2012; 50:1721-4. [PMID: 22403423 DOI: 10.1128/jcm.00531-12] [Citation(s) in RCA: 92] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
This study evaluated the microbiota of root canals undergoing retreatment. The most prevalent taxa detected by checkerboard included Propionibacterium species, Fusobacterium nucleatum, streptococci, and Pseudoramibacter alactolyticus. Quantitative real-time PCR detected Enterococcus faecalis and streptococci in 38% and 41% of the cases, comprising 9.76% and 65.78% of the total bacterial counts, respectively. The findings call into question the status of E. faecalis as the main pathogen and suggest that other species can be candidate pathogens associated with persistent/secondary endodontic infections.
Collapse
|
227
|
Dumani A, Yoldas O, Yilmaz S, Koksal F, Kayar B, Akcimen B, Seydaoglu G. Polymerase chain reaction of enterococcus faecalis and candida albicans in apical periodontitis from Turkish patients. J Clin Exp Dent 2012; 4:e34-9. [PMID: 24558522 PMCID: PMC3908807 DOI: 10.4317/jced.50669] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2011] [Accepted: 10/02/2011] [Indexed: 11/23/2022] Open
Abstract
Aim: The aim of this study was to determine the frequency of two important pathogenic microorganisms associated with endodontic infections, Enterococcus faecalis and Candida albicans, in root canal samples from patients with necrotic pulps or failed canal therapy by polymerase chain reaction method.
Method: Microbial samples were obtained from 117 teeth with necrotic pulp tissues and 114 teeth with failed endodontic treatment.
Results: E.faecalis were identified in 16% of the necrotic and 10% of the retreated root canal infections by PCR. C.albicans genome were identified in 20% and 11% of the necrotic and retreated root canal infections, respectively, by PCR. The frequencies of microbiota were not statistically different between necrotic and retreatment groups (p > 0.05, chi squared test).
Conclusions: PCR analysis of teeth with periapical lesions revealed that E.faecalis was found in fewer patients than in previous studies. The C.albicans prevelance was consistent with previous reports. No statistical difference was found between primary and secondary root canal infections for C.albicans or E.faecalis.
Key words:Primary root canal infection, secondary root canal infection, E.faecalis, C.albicans.
Collapse
Affiliation(s)
- Aysin Dumani
- DDS, PhD. Assistant Professor, Cukurova University, Faculty of Dentistry, Department of Endodontics
| | - Oguz Yoldas
- DDS, PhD. Professor, Cukurova University, Faculty of Dentistry, Department of Endodontics
| | - Sehnaz Yilmaz
- DDS, PhD. Assistant Professor, Cukurova University, Faculty of Dentistry, Department of Endodontics
| | - Fatih Koksal
- MD, PhD. Professor, Cukurova University, Department of Microbiology
| | - Begum Kayar
- DDS, PhD. Research Asistant, Cukurova University, Department of Microbiology
| | - Beril Akcimen
- DDS, PhD. Research Asistant, Cukurova University, Department of Microbiology
| | - Gulsah Seydaoglu
- MD, PhD. Associated Professor, Cukurova University, Department of Biostatistic
| |
Collapse
|
228
|
An In Vitro Study Comparing the Intracanal Effectiveness of Calcium Hydroxide– and Linezolid-based Medicaments against Enterococcus faecalis. J Endod 2012; 38:95-100. [DOI: 10.1016/j.joen.2011.09.031] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2011] [Revised: 09/30/2011] [Accepted: 09/30/2011] [Indexed: 11/22/2022]
|
229
|
Wang L, Yin W, Dong M, Zheng J, Song Q, Li J, Niu W. Endodontic Retreatment Patients with Clinical Symptoms Have Strong Biofilm Formation Ability and High Expression of Virulence Factors of E. faecalis. J HARD TISSUE BIOL 2012. [DOI: 10.2485/jhtb.21.285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
230
|
Baca P, Mendoza-Llamas ML, Arias-Moliz MT, González-Rodríguez MP, Ferrer-Luque CM. Residual effectiveness of final irrigation regimens on Enteroccus faecalis-infected root canals. J Endod 2011; 37:1121-3. [PMID: 21763905 DOI: 10.1016/j.joen.2011.05.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2011] [Revised: 04/27/2011] [Accepted: 05/03/2011] [Indexed: 10/17/2022]
Abstract
INTRODUCTION The application of a final irrigating solution that remains active over a fairly long period of time stands as one strategy for preventing bacterial recolonization or eliminating the bacteria that persist after root canal treatment. The aim of this study was to evaluate the residual antimicrobial activity of four final irrigation regimens in root canals contaminated with Enterococcus faecalis. METHODS Biofilms of E. faecalis were grown in uniradicular roots for 4 weeks. After preparing the roots chemomechanically, four final irrigation regimens were applied: (1) group EDTA-NaOCl, 17% EDTA followed by 5.25% sodium hypochlorite (NaOCl); (2) group MA-NaOCl, 7% maleic acid (MA) followed by 5.25% NaOCl; (3) group EDTA-CHX + CTR, 17% EDTA followed by 2% chlorhexidine (CHX) + 0.2% cetrimide (CTR); and (4) group MA-CHX + CTR, 7% MA followed by 2% CHX + 0.2% CTR. Samples were collected for 60 days to denote the presence of bacterial growth. The Fisher exact test was used to compare the percentages of specimens without E. faecalis regrowth. RESULTS All root canals in which the final irrigant was 5.25% NaOCl yielded positive cultures on the fifth day. Groups EDTA-CHX + CTR and MA-CHX + CTR with a final irrigation of 2% CHX + 0.2% CTR showed respective percentages of samples without regrowth of 72.1% and 66.8% at 60 days. There were no statistically significant differences between these groups. CONCLUSIONS The combination of 2% CHX + 0.2% CTR would be an effective alternative final irrigation regimen given its antimicrobial action over time.
Collapse
Affiliation(s)
- Pilar Baca
- Department of Preventive and Operative Dentistry, School of Dentistry, University of Granada, Granada, Spain
| | | | | | | | | |
Collapse
|
231
|
Quah SY, Wu S, Lui JN, Sum CP, Tan KS. N-acetylcysteine inhibits growth and eradicates biofilm of Enterococcus faecalis. J Endod 2011; 38:81-5. [PMID: 22152626 DOI: 10.1016/j.joen.2011.10.004] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2011] [Revised: 10/04/2011] [Accepted: 10/16/2011] [Indexed: 11/29/2022]
Abstract
INTRODUCTION The aims of this study were to evaluate the antibacterial and biofilm eradication efficacies of N-acetylcysteine (NAC) on Enterococcus faecalis. METHODS The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of NAC on E. faecalis were determined. In addition, the ability of dentin powder to neutralize the antibacterial activity of NAC was examined. Calcium hydroxide, a commonly used intracanal medicament, was included as a comparison. The efficacy of NAC on E. faecalis biofilms was tested by exposure of 21-day old E. faecalis biofilms to NAC. RESULTS NAC was most bactericidal at pH 11 with MIC and MBC of 1.56 mg/mL and 12.5 mg/mL, respectively. Although preincubation of calcium hydroxide with dentin powder abolished its antibacterial effects, NAC completely killed E. faecalis regardless of dentin powder preincubation. In addition, prolonged incubation of NAC with dentin powder (up to 3 weeks) did not significantly reduce its antibacterial activity on E. faecalis. Furthermore, NAC also effectively eradicated E. faecalis biofilms. CONCLUSIONS NAC was bactericidal against both the planktonic and biofilm forms of E. faecalis. This antibacterial property of NAC was unaffected by the presence of dentin.
Collapse
Affiliation(s)
- Samantha Yiling Quah
- Discipline of Oral Biology, Faculty of Dentistry, National University of Singapore, Singapore
| | | | | | | | | |
Collapse
|
232
|
Vaghela DJ, Kandaswamy D, Venkateshbabu N, Jamini N, Ganesh A. Disinfection of dentinal tubules with two different formulations of calcium hydroxide as compared to 2% chlorhexidine: As intracanal medicaments against Enterococcus faecalis and Candida albicans: An in vitro study. J Conserv Dent 2011; 14:182-6. [PMID: 21814363 PMCID: PMC3146114 DOI: 10.4103/0972-0707.82625] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2010] [Revised: 09/21/2010] [Accepted: 10/05/2010] [Indexed: 11/29/2022] Open
Abstract
Aim: To evaluate the disinfection of dentinal tubules using calcium hydroxide with propylene glycol and calcium hydroxide with iodoform in silicone oil, as compared to 2% chlorhexidine gel. Materials and Methods: The antimicrobial efficacy of the medicaments against E.faecalis and C.albicans were assessed in vitro, using a dentinal tubule model at depths of 200 μm and 400 μm in extracted single rooted teeth. Saline was taken as the negative control (Group I) Results: All three medicaments used in this study exerted antibacterial and antifungal activity. Group II (calcium hydroxide with propylene glycol) and Group IV (2% chlorhexidine gel) had the highest antimicrobial activity and the differences between their antibacterial activities were not statistically significant. Group III (calcium hydroxide with iodoform in silicone oil) and Group IV had the highest antifungal activity and the differences between their antifungal activities were not statistically significant. The inhibition of growth at 200 μm and 400 μm was uniform, with no statistical difference. Conclusions: Two percent chlorhexidine gel was effective against both E.faecalis and C.albicans. Calcium hydroxide with propylene glycol was the most effective intracanal medicament along with 2% chlorhexidine against E.faecalis, whereas, calcium hydroxide with iodoform in silicone oil was the most effective intracanal medicament along with 2% chlorhexidine against C.albicans.
Collapse
Affiliation(s)
- Dakshita Joy Vaghela
- Department of Conservative Dentistry and Endodontics, Kothiwal Dental College Research Center and Hospital, Moradabad, India
| | | | | | | | | |
Collapse
|
233
|
Time-dependent Antibacterial Effects of the Self-Adjusting File Used with Two Sodium Hypochlorite Concentrations. J Endod 2011; 37:1451-5. [DOI: 10.1016/j.joen.2011.06.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2011] [Revised: 06/02/2011] [Accepted: 06/03/2011] [Indexed: 11/21/2022]
|
234
|
van der Waal SV, van der Sluis LWM, Özok AR, Exterkate RAM, van Marle J, Wesselink PR, de Soet JJ. The effects of hyperosmosis or high pH on a dual-species biofilm of Enterococcus faecalis and Pseudomonas aeruginosa: an in vitro study. Int Endod J 2011; 44:1110-7. [DOI: 10.1111/j.1365-2591.2011.01929.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
235
|
Senges C, Wrbas KT, Altenburger M, Follo M, Spitzmüller B, Wittmer A, Hellwig E, Al-Ahmad A. Bacterial and Candida albicans adhesion on different root canal filling materials and sealers. J Endod 2011; 37:1247-52. [PMID: 21846541 DOI: 10.1016/j.joen.2011.05.034] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2011] [Revised: 05/27/2011] [Accepted: 05/31/2011] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Microbial adhesion and subsequent biofilm formation on endodontic root canal filling materials and sealers lead to survival of microorganisms in treated root canals and subsequently to endodontic treatment failures. The present study focused on initial microbial adhesion to different endodontic filling materials. METHODS The following endodontic biomaterials were tested: AH-Plus, Tubli Seal, gutta-percha, Real Seal SE, EndoREZ, Apexit Plus, GuttaFlow, and dentin. Samples of each material were prepared. Bovine dentin samples were used as a control. The initial adhesions of salivary bacteria as well as the subsequent single species were quantified by determination of colony-forming units (CFUs) and visualized by scanning electron microscopy and confocal microscopy (CLSM): Enterococcus faecalis, Streptococcus mutans, Streptococcus sanguis, Candida albicans, and Prevotella nigrescens. RESULTS Initially adherent microorganisms could be detected and microscopically visualized on each of the materials tested. Considering the values of the CFUs and the covering grade as detected by CLSM, there were significant differences among the materials. Fewer bacteria tended to adhere to Apexit Plus, whereas Real Seal SE and the widely used gutta-percha showed the highest number of adherent bacteria. This tendency was not detected for C. albicans. CONCLUSIONS Endodontic microorganisms have a high affinity to root canal filling materials and sealers, especially to gutta-percha. Because of this high level of bacterial adhesion, subsequent biofilm formation on these materials could be suggested as leading to the persistence of microorganisms in root canals.
Collapse
Affiliation(s)
- Christian Senges
- Department of Operative Dentistry and Periodontology, Albert-Ludwigs-University, Freiburg, Germany
| | | | | | | | | | | | | | | |
Collapse
|
236
|
Sardi JCO, Almeida AMF, Mendes Giannini MJS. New antimicrobial therapies used against fungi present in subgingival sites--a brief review. Arch Oral Biol 2011; 56:951-9. [PMID: 21676377 DOI: 10.1016/j.archoralbio.2011.03.007] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2010] [Revised: 03/16/2011] [Accepted: 03/17/2011] [Indexed: 01/14/2023]
Abstract
Although the main reservoir of Candida spp. is believed to be the buccal mucosa, these microorganisms can coaggregate with bacteria in subgingival biofilm and adhere to epithelial cells. The treatment of periodontal disease includes scaling and root planning (SRP) associated with proper oral hygiene. However, some patients may have negative responses to different therapeutic procedures, with a continuous loss of insertion, so the use of antimicrobials is needed as an adjuvant to SRP treatment. The use of a broad-spectrum antibiotic, such as tetracycline and metronidazole, as an aid in periodontal treatment has also been a factor for the development of superinfections by resistant bacteria and Candida species, even in patients with HIV. In the dental practice, the most commonly used antifungals are nystatin and fluconazole. However, the introduction of new drugs like the next generation of azoles is essential before the onset of emergent species in periodontal disease. Plants are good options for obtaining a wide variety of drugs. This alternative could benefit a large population that uses plants as a first treatment option. Plants have been used in medicine for a long time and are extensively used in folk medicine, because they represent an economic alternative, are easily accessible and are applicable to various diseases. Herein, we briefly review the literature pertaining the presence of Candida sp. in periodontal pockets, the conventional antifungal resistance and new therapies that include natural antifungal agents are reviewed.
Collapse
Affiliation(s)
- Janaina Cássia Orlandi Sardi
- Faculty of Pharmaceutical Sciences of Araraquara, Department of Clinical Analysis, Laboratory of Clinical Mycology, Univ Estadual Paulista, UNESP, Araraquara, SP, Brazil
| | | | | |
Collapse
|
237
|
Martins CHG, Carvalho TC, Souza MGM, Ravagnani C, Peitl O, Zanotto ED, Panzeri H, Casemiro LA. Assessment of antimicrobial effect of Biosilicate® against anaerobic, microaerophilic and facultative anaerobic microorganisms. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2011; 22:1439-1446. [PMID: 21556979 DOI: 10.1007/s10856-011-4330-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2010] [Accepted: 04/27/2011] [Indexed: 05/30/2023]
Abstract
This study assessed the antimicrobial activity of a new bioactive glass-ceramic (Biosilicate®) against anaerobic, microaerophilic, and facultative anaerobic microorganisms. Evaluation of the antimicrobial activity was carried out by three methods, namely agar diffusion, direct contact, and minimal inhibitory concentration (MIC). For the agar diffusion technique, bio glass-ceramic activity was observed against various microorganisms, with inhibition haloes ranging from 9.0 ± 1.0 to 22.3 ± 2.1 mm. For the direct contact technique, Biosilicate® displayed activity against all the microorganisms, except for S. aureus. In the first 10 min of contact between the microorganisms and Biosilicate®, there was a drastic reduction in the number of viable cells. Confirming the latter results, MIC showed that the Biosilicate® inhibited the growth of microorganisms, with variations between ≤ 2.5 and 20 mg/ml. The lowest MIC values (7.5 to ≤ 2.5 mg/ml) were obtained for oral microorganisms. In conclusion, Biosilicate® exhibits a wide spectrum of antimicrobial properties, including anaerobic bacteria.
Collapse
|
238
|
Desai SV, Love RM, Rich AM, Seymour GJ. Toll-like receptor 2 expression in refractory periapical lesions. Int Endod J 2011; 44:907-16. [DOI: 10.1111/j.1365-2591.2011.01893.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
|
239
|
Relationship of Biofilm Formation and gelE Gene Expression in Enterococcus faecalis Recovered from Root Canals in Patients Requiring Endodontic Retreatment. J Endod 2011; 37:631-6. [DOI: 10.1016/j.joen.2011.02.006] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2010] [Revised: 01/22/2011] [Accepted: 02/03/2011] [Indexed: 01/18/2023]
|
240
|
HAAPASALO MARKUS, SHEN YA, RICUCCI DOMENICO. Reasons for persistent and emerging post-treatment endodontic disease. ACTA ACUST UNITED AC 2011. [DOI: 10.1111/j.1601-1546.2011.00256.x] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
|
241
|
FIGDOR DAVID, GULABIVALA KISHOR. Survival against the odds: microbiology of root canals associated with post-treatment disease. ACTA ACUST UNITED AC 2011. [DOI: 10.1111/j.1601-1546.2011.00259.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
242
|
Alves FR, Almeida BM, Neves MA, Moreno JO, Rôças IN, Siqueira JF. Disinfecting Oval-shaped Root Canals: Effectiveness of Different Supplementary Approaches. J Endod 2011; 37:496-501. [DOI: 10.1016/j.joen.2010.12.008] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2010] [Revised: 12/11/2010] [Accepted: 12/20/2010] [Indexed: 10/18/2022]
|
243
|
Kayaoglu G, Ömürlü H, Akca G, Gürel M, Gençay Ö, Sorkun K, Salih B. Antibacterial activity of Propolis versus conventional endodontic disinfectants against Enterococcus faecalis in infected dentinal tubules. J Endod 2011; 37:376-81. [PMID: 21329825 DOI: 10.1016/j.joen.2010.11.024] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2010] [Revised: 11/10/2010] [Accepted: 11/12/2010] [Indexed: 11/24/2022]
Abstract
INTRODUCTION The antibacterial activity against Enterococcus faecalis of 2 propolis samples was investigated in a dentin block model, and their effectiveness was compared with that of established endodontic disinfectants, chlorhexidine (CHX) and calcium hydroxide [Ca(OH)(2)]. METHODS Standardized dentin blocks were infected with E. faecalis ATCC 29212. The root canal space was filled with one of the ethanolic extracts of propolis (Artvin or Tekirdağ mix [TM]), CHX 2%, Ca(OH)(2), or ethanol or phosphate-buffered saline for control. Canal dentin was sampled after 1 or 7 days by using a standard-size bur. The dentinal shavings were vortexed vigorously in phosphate-buffered saline, and aliquots were cultured on tryptone soy agar plates. Colonies were counted after 2 days of incubation. Statistical significance was set to 5%. RESULTS All experimental agents significantly reduced the number of the cultivable bacteria. CHX was the most potent disinfectant at both times. Compared with the ethanol control, no significant reduction in the number of colonies was found for the propolis extracts at day 1; however, significant reduction was found at day 7. The 2 propolis samples were statistically similar to each other and to Ca(OH)(2), but the TM sample was also similar to CHX at day 7. This has been linked to the greater concentration of flavonoids, a group of antibacterially active compounds, in the TM sample as determined by gas chromatography-mass spectrometry analysis. CONCLUSIONS The antimicrobial activity of the propolis samples tested in this study was between Ca(OH)(2) and CHX. Both propolis samples were antimicrobially effective; however, their activity did not exceed CHX.
Collapse
Affiliation(s)
- Guven Kayaoglu
- Department of Restorative Dentistry and Endodontics, Faculty of Dentistry, Gazi University, Ankara, Turkey.
| | | | | | | | | | | | | |
Collapse
|
244
|
Karale R, Thakore A, Shetty VK. An evaluation of antibacterial efficacy of 3% sodium hypochlorite, high-frequency alternating current and 2% chlorhexidine on Enterococcus faecalis: An in vitro study. J Conserv Dent 2011; 14:2-5. [PMID: 21691496 PMCID: PMC3099107 DOI: 10.4103/0972-0707.80721] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2009] [Revised: 06/16/2010] [Accepted: 07/03/2010] [Indexed: 11/29/2022] Open
Abstract
AIM The purpose of this study was to evaluate the antibacterial efficacy of 3% sodium hypochlorite (NaOCl), high-frequency alternating current (HFAC) (Endox Endodontic System), 2% chlorhexidine (CHX) in elimination of Enterococcus faecalis from experimentally infected root canals, in vitro. MATERIALS AND METHODS Eighty extracted, single rooted permanent upper anterior teeth were instrumented up to size 50, teeth were sterilized and inoculated with E. faecalis, subcultured in BHI broth which had its optical density adjusted to approximately 1.5Χ10(8) colony forming units (CFUs) ml(-1) by comparing its turbidity to a McFarland 0.5 BaSO(4) standard solution. After incubation for 24 h, the contaminated root canals were divided into four groups and subjected to action of NaOCl 3%, CHX 2%, and HFAC with physiological saline as a positive control. Sterile paper points were selected to take the sample of the bacteria and transferred to tubes containing 5ml of BHI broth and then incubated for 24 and 48 h, followed by agar plating of the resultant broth turbidity on Enterococcus confirmatory agar. RESULTS Data obtained were analyzed statistically for differences using chi-squared test, comparing different groups, with a significance level established at P<0.05 and 3% NaOCl showed no growth postoperatively, CHX and HFAC showed reduction of postoperative growth compared to physiological saline and, were statistically significant (P<0.05). CONCLUSION In the present study, sodium hypochlorite, CHX, HFAC all were significantly effective in eliminating E. faecalis and sodium hypochlorite showed the maximum anti-bacterial activity against E. faecalis.
Collapse
Affiliation(s)
- Rupali Karale
- Department of Conservative Dentistry and Endodontics, The Oxford Dental College, Bangalore, India
| | | | - VK Shetty
- Nair Hospital Dental College, Mumbai, India
| |
Collapse
|
245
|
Onay EO, Alikaya C, Seker E. Evaluation of antifungal efficacy of erbium, chromium: yttrium-scandium-gallium-garnet laser against Candida albicans. Photomed Laser Surg 2010; 28 Suppl 1:S73-8. [PMID: 20666577 DOI: 10.1089/pho.2010.2780] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The purpose of this in vitro study was to investigate the ability of Er,Cr:YSGG laser irradiation at different energy settings to eliminate Candida albicans, either with or without 5.25% sodium hypochlorite (NaOCl) treatment. METHODS In total, 90 extracted human single-rooted teeth were shaped by using a crown-down technique with HERO Shaper rotary instruments and irrigated with 1 mL of 2.5% NaOCl between each instrument. The specimens were autoclaved and incubated with a suspension of C. albicans (ATCC 90028). Then the specimens were divided into six treatment groups (n = 15 per group): group 1, NaOCl + 1-W laser; group 2, 1-W laser; group 3, NaOCl + 0.75-W laser; group 4, 0.75-W laser, group 5, NaOCl; and group 6, no treatment. Aliquots of the experimental teeth were transferred onto Sabouraud's dextrose agar plates with paper points, and colony-forming units (CFUs) were counted as a measure of antifungal activity. One root from each group, which was not submitted to the sampling procedure, was fixed in glutaraldehyde, split into two halves, and evaluated with scanning electron microscopy (SEM). Statistical analysis was performed by using analysis of variance (ANOVA) and the Dunnett t test. Significance was set at alpha = 0.05. RESULTS All the treatment groups resulted in a significant reduction of C. albicans, but no sterilization, and all the groups were significantly different from each other (p < 0.0001). Group 1 (NaOCl and 1-W laser combination) exhibited the greatest reduction, whereas group 5 (NaOCl) resulted in a minimal reduction in CFUs of C. albicans. The SEM observations were in accordance with the microbiologic analysis. CONCLUSIONS The 5.25% NaOCl and 1-W laser treatment combination may be a valuable cleaning tool for root canals infected with C. albicans.
Collapse
Affiliation(s)
- Emel Olga Onay
- Department of Endodontics, Baskent University, School of Dentistry, Ankara, Turkey.
| | | | | |
Collapse
|
246
|
Vidana R, Sullivan A, Billström H, Ahlquist M, Lund B. Enterococcus faecalis infection in root canals - host-derived or exogenous source? Lett Appl Microbiol 2010; 52:109-15. [PMID: 21155997 DOI: 10.1111/j.1472-765x.2010.02972.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIMS Enterococcus faecalis is associated with a significant number of refractory endodontic infections. Previous studies report a prevalence of Ent. faecalis ranging from 24% up to 77% in teeth with failed endodontic treatment. The origin of the micro-organism remains unclear, as enterococci do not belong to the normal oral microflora. The aim of this study was to determine whether these enterococci were of endogenous or exogenous origin. METHODS AND RESULTS Fifty consecutive patients with apical periodontitis in need of endodontic orthograde re-treatment were included. Samples were collected from root canals, saliva and faeces and subjected to microbiological culturing. The genetic relationship between Ent. faecalis from root canals and isolates from the different host sources was determined using pulsed-field gel electrophoresis. In 16% (8/50) of the patients, enterococci were collected from the root canal samples. The genetic analysis showed that the isolates from the root canals were not related to those from the normal gastrointestinal microflora. None of these patients had enterococci in their saliva samples. CONCLUSIONS Endodontic infections with Ent. faecalis are probably not derived from the patient's own normal microflora, which indicates that these infections ent. faecalis are of exogenous origin. SIGNIFICANCE AND IMPACT OF THE STUDY This is the first study to genetically compare endodontic infectious Ent. faecalis isolates with isolates from the hosts' own normal microflora.
Collapse
Affiliation(s)
- R Vidana
- Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | | | | | | | | |
Collapse
|
247
|
Fidalgo TKDS, Barcelos R, Portela MB, Soares RMDA, Gleiser R, Silva-Filho FCE. Inhibitory activity of root canal irrigants against Candida albicans, Enterococcus faecalis and Staphylococcus aureus. Braz Oral Res 2010; 24:406-12. [DOI: 10.1590/s1806-83242010000400006] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2010] [Accepted: 08/09/2010] [Indexed: 11/22/2022] Open
|
248
|
Zoletti GO, Pereira EM, Schuenck RP, Teixeira LM, Siqueira JF, dos Santos KRN. Characterization of virulence factors and clonal diversity of Enterococcus faecalis isolates from treated dental root canals. Res Microbiol 2010; 162:151-8. [PMID: 21111042 DOI: 10.1016/j.resmic.2010.09.018] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2010] [Accepted: 09/06/2010] [Indexed: 11/16/2022]
Abstract
The high prevalence of Enterococcus faecalis in root canal treated teeth with post-treatment disease, as evidenced by both molecular and traditional culturing methods, suggests that this species may be a key player in endodontic treatment failure. This study aimed to detect virulence factors by phenotypic and western blotting tests, and virulence genes by PCR from 20 clinical strains of E. faecalis isolated from treated root canals of teeth with (10) or without (10) apical periodontitis. Moreover, genomic diversity of these strains was assessed by pulsed-field gel electrophoresis (PFGE) and rep-PCR. All 20 strains presented the gelE gene (gelatinase), but 10 of them did not hydrolyze gelatin. Seven of the 10 gelatinase-producing isolates were recovered from root canals with lesions, which suggests a role for this virulence factor in the pathogenesis of post-treatment disease. The esp gene was expressed only in cases where gelatinase production was negative. The other virulence genes were found in 90% (efaA and ace genes), 45% (agg gene) and 95% (cpd gene) of the E. faecalis isolates. As for PFGE and rep-PCR, no specific clonal type of E. faecalis was found in association with teeth with or without disease, revealing the interindividual clonal diversity of endodontic infections.
Collapse
Affiliation(s)
- Gustavo O Zoletti
- Institute of Microbiology Prof Paulo de Góes, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | | | | | | | | |
Collapse
|
249
|
Pelvic actinomycosis-like disease due to Propionibacterium propionicum after hysteroscopic removal of an intrauterine device. J Clin Microbiol 2010; 49:466-8. [PMID: 21068286 DOI: 10.1128/jcm.01772-10] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
A female patient presented with episodes of fever and pain in the lower right abdomen after hysteroscopic removal of an intrauterine device 2 months earlier. Pelvic actinomycosis originating from a tubo-ovarian abscess was diagnosed with Propionibacterium propionicum, formerly known as Arachnia propionica, as causative agent.
Collapse
|
250
|
Comparison of endodontic bacterial community structures in root-canal-treated teeth with or without apical periodontitis. J Med Microbiol 2010; 59:1360-1364. [DOI: 10.1099/jmm.0.018887-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Bacterial occurrence in treated root canals, even in patients without post-treatment apical periodontitis, raises the possibility that factors other than mere bacterial presence can be determinants for a favourable outcome of endodontic treatment. Because these factors may be related to the bacterial communities colonizing the root canal, including virulence, density and interactions, the objective of this study was to compare the community structures found in root-canal-treated teeth with (12 samples) and without (11 samples) apical periodontitis lesions by means of a PCR-denaturing gradient gel electrophoresis fingerprinting approach. Results confirmed a polymicrobial composition even in treated patients without post-treatment disease. A large microbial community diversity was observed for treated teeth both with or without disease, but no specific pattern was detected for diseased teeth. Nevertheless, the number of bands from samples with apical periodontitis lesions was statistically significantly higher (P=0.04) than that from samples collected from root-canal-treated teeth without post-treatment apical periodontitis. Furthermore, predominant bands in samples from patients with apical disease were also observed.
Collapse
|