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Souza MA, Zanella ML, Vanin GN, Dallepiane FG, Pizzi CYM, Ferreira ER, Fuhr MCS, Piccolo NM, Palhano HS, da Silva Koch J, Souza KR, da Costa UM, Dos Santos VV, Steier L, Bertol CD, Figueiredo JAPD. Antimicrobial action and cytotoxicity of hypochlorous acid obtained from an innovative electrolytic device - An in vitro study. Arch Oral Biol 2024; 163:105966. [PMID: 38657440 DOI: 10.1016/j.archoralbio.2024.105966] [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: 02/12/2024] [Revised: 04/01/2024] [Accepted: 04/06/2024] [Indexed: 04/26/2024]
Abstract
OBJECTIVE This study evaluated the antimicrobial effect and cytotoxicity of hypochlorous acid(HClO) obtained from an innovative electrolytic device. DESIGN The root canals of fifty extracted human teeth were inoculated with Enterococcus faecalis and divided into 5 groups (n = 10): DW (control); 2% chlorhexidine gel(CHX); 2.5% sodium hypochlorite(NaOCl); 250 ppm HClO and 500 ppm HClO. The counting of colony forming units evaluated the decontamination potential of each group. Cytotoxicity was evaluated after inoculation of tested protocols in fibroblastic cells for 3 min, calculating the cell viability. Specific statistical analysis was performed (α = 5%). RESULTS The highest bacterial reduction was observed in experimental groups, with no statistical differences from each other (p > 0.05). The highest number of viable cells was observed in control group, followed by 250 ppm HClO and 500 ppm HClO groups, with statistical differences from each other (p < 0.05). CONCLUSIONS It could be concluded that HClO presented high antimicrobial activity and low cytotoxicity at both tested concentrations.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Jordana da Silva Koch
- School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Kellyn Rocca Souza
- School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | | | | | - Liviu Steier
- School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA; Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai, India
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Souza MA, Steier L, Vanin GN, Zanella ML, Pizzi CM, Ferreira ER, Dallepiane FG, Piccolo NM, da Silva Koch J, Souza KR, Costa UMD, Dos Santos VV, Palatynska-Ulatowska A, de Figueiredo JAP. Antimicrobial action, cytotoxicity and erosive potential of hypochlorous acid obtained from an electrolytic device compared with sodium hypochlorite. Clin Oral Investig 2024; 28:282. [PMID: 38683234 DOI: 10.1007/s00784-024-05675-6] [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: 02/16/2024] [Accepted: 04/21/2024] [Indexed: 05/01/2024]
Abstract
OBJECTIVES This study aimed to compare the antimicrobial action, cytotoxicity, cleaning ability, and erosion of dentine of hypochlorous acid (HClO) obtained from an electrolytic device at two different concentrations (Dentaqua) and three concentrations of sodium hypochlorite (NaOCl). METHODS Microbiological test-The root canals of sixty single-rooted extracted human teeth were inoculated with Enterococcus faecalis and divided into 6 groups (n = 10), according to decontamination protocol: DW (control); 1% NaOCl; 2.5% NaOCl; 5.25% NaOCl; 250 ppm HClO and 500 ppm HClO. The colony-forming units were counted to evaluate the decontamination potential of each group, calculating the reduction in bacterial percentage. Cytotoxicity test-Cytotoxicity was evaluated after inoculation of the same tested protocols in fibroblastic cells for 3 min, calculating the cell viability percentages. Specifical statistical analysis was performed (α = 5%). Cleaning ability and erosion-Fifty-six single-rooted bovine lower incisors were divided into seven groups of 8 roots each, being the test groups 1% NaOCl; 2.5% NaOCl; 5,25% NaOCl; 250 ppm HClO and 500 ppm HClO, and a negative and positive control. Negative control was not contaminated, and the other groups were inoculated with Enterococcus faecalis. SEM images were ranked as from the cleanest to the least clean. Erosion was also assessed, being ranked from the least to the most eroded dentine. RESULTS The highest bacterial reduction was observed in experimental groups, with no statistical differences between them (p > 0.05). The highest number of viable cells was observed in control group, followed by 250 ppm HClO and 500 ppm HClO groups, with statistical differences between them (p < 0.05). 1% NaOCl; 2.5% NaOCl; 5.25% NaOCl and 500 ppm HClO displayed the cleanest areas. All sodium hypochlorite groups displayed erosion with higher ranks with greater concentration, while hypochlorous acid did not display any erosion regardless the concentration. CONCLUSIONS It is possible to conclude that HClO obtained from an electrolytic device presented high antimicrobial activity and low cytotoxicity in both tested concentrations. 500 ppm HClO did not display erosion and showed great cleaning ability. CLINICAL RELEVANCE The use of 500 ppm hypochlorous acid may reduce unfavorable behavior of sodium hypochlorite whilst maintaining its antimicrobial action.
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Affiliation(s)
- Matheus Albino Souza
- School of Dentistry, Graduate Program in Dentistry, University of Passo Fundo - UPF. BR 285/São José, Prédio A7, Apto 2, Passo Fundo, RS, CEP: 9052-900, Brazil
| | - Liviu Steier
- School of Dental Medicine, University of Pennsylvania - UPENN, 240 South 40Th Street (40Th & Locust St.), Philadelphia, PA, ZIP19104, USA
| | - Gabriele Nichetti Vanin
- School of Dentistry, Graduate Program in Dentistry, University of Passo Fundo - UPF. BR 285/São José, Prédio A7, Apto 2, Passo Fundo, RS, CEP: 9052-900, Brazil
| | - Mylena Lazareti Zanella
- School of Dentistry, Graduate Program in Dentistry, University of Passo Fundo - UPF. BR 285/São José, Prédio A7, Apto 2, Passo Fundo, RS, CEP: 9052-900, Brazil
| | - Camila Monteiro Pizzi
- School of Dentistry, Graduate Program in Dentistry, University of Passo Fundo - UPF. BR 285/São José, Prédio A7, Apto 2, Passo Fundo, RS, CEP: 9052-900, Brazil
| | - Eduarda Rizzon Ferreira
- School of Dentistry, Graduate Program in Dentistry, University of Passo Fundo - UPF. BR 285/São José, Prédio A7, Apto 2, Passo Fundo, RS, CEP: 9052-900, Brazil
| | - Felipe Gomes Dallepiane
- School of Dentistry, Graduate Program in Dentistry, University of Passo Fundo - UPF. BR 285/São José, Prédio A7, Apto 2, Passo Fundo, RS, CEP: 9052-900, Brazil
| | - Nathan Mateus Piccolo
- School of Dentistry, Graduate Program in Dentistry, University of Passo Fundo - UPF. BR 285/São José, Prédio A7, Apto 2, Passo Fundo, RS, CEP: 9052-900, Brazil
| | - Jordana da Silva Koch
- Graduate Program in Dentistry, Oral Biology Lab, Federal University of Rio Grande do Sul - UFRGS, Rua Sarmento Leite 500 Sala 134, Porto Alegre, RS, CEP90050-170, Brazil
| | - Kellyn Rocca Souza
- Graduate Program in Dentistry, Oral Biology Lab, Federal University of Rio Grande do Sul - UFRGS, Rua Sarmento Leite 500 Sala 134, Porto Alegre, RS, CEP90050-170, Brazil
| | - Ubirajara Maciel da Costa
- School of Veterinary Medicine, State University of Santa Catarina - UDESC, Av. Luiz de Camões, 2090, Conta Dinheiro, Lages, SC, CEP: 88.520-000, Brazil
| | - Vanessa Valgas Dos Santos
- School of Medicine, University of Planalto Catarinense - UNIPLAC, Av. Mal. Castelo Branco 170, Lages, SC, CEP 88526-075, Brazil
| | - Aleksandra Palatynska-Ulatowska
- Department of Endodontics, Medical Faculty, Division of Dentistry, Medical University of Lödz, 251 Pomorska Street, Lödz, 92-213, Poland
| | - José Antônio Poli de Figueiredo
- Graduate Program in Dentistry, Oral Biology Lab, Federal University of Rio Grande do Sul - UFRGS, Rua Sarmento Leite 500 Sala 134, Porto Alegre, RS, CEP90050-170, Brazil.
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Lu J, Kahler B, Jiang X, Lu Z, Lu Y. Treatment outcomes of regenerative endodontic procedures in nonvital mature permanent teeth: a retrospective study. Clin Oral Investig 2023; 27:7531-7543. [PMID: 37875745 DOI: 10.1007/s00784-023-05343-1] [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: 08/24/2023] [Accepted: 10/14/2023] [Indexed: 10/26/2023]
Abstract
OBJECTIVES This retrospective study was undertaken to clinically and radiographically evaluate the long-term outcomes of regenerative endodontic procedures (REPs) for nonvital mature permanent teeth, to analyze predictors influencing treatment outcomes. METHODS Nonvital mature permanent teeth treated by REPs with a minimum follow-up period of 6 months were included from 2015 to 2017. Treatment outcomes were categorized as success and failure. The periapical status and lesion healing were assessed in terms of the periapical index (PAI) and the percentage changes in periapical radiolucency (PARL) area. The clinical and radiographic outcomes of REPs were assessed by Mann-Whitney test at different follow-up period. Kaplan-Meier curves and Univariate Cox regression analysis were conducted to assess the success and identify potential predictors affecting outcomes, respectively. RESULTS A total of 37 mature teeth with an average follow-up of 4.3 years satisfied the criteria, and 89.2% of the teeth had a successful outcome. Significant differences in PAI scores were found between each period with respect to the baseline (p < .05). Among different periods, there was a significant difference between intervals of 3-6 months and 7-12 months (p = .039) and no significant difference between each interval of more than 12 months (p > .05). Eighty-seven percent of teeth with preoperative PARL presented completely healed. REPs significantly decreased the PARL area at the interval of 7-12 months compared to 3-6 months (p = .025), with no significant difference between each interval of more than 12 months (p > .05). No significant predictor was found for the success of outcome (p > .05). Thirteen teeth (35.1%) regained pulp sensibility, and 40.5% of the teeth exhibited intracanal calcification. CONCLUSIONS Within the limitations of this study, REPs provided a high long-term success rate and promoted the resolution of PARL as a biologically-based alternative treatment option for nonvital mature teeth. CLINICAL RELEVANCE REPs provide a high long-term success rate and promoted healing of apical periodontitis comparable with reported outcomes for root canal therapy of mature teeth.
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Affiliation(s)
- Jing Lu
- Fujian Key Laboratory of Oral Diseases, School and Hospital of Stomatology, Fujian Medical University, 246 Yangqiao Zhong Road, Fuzhou, 350002, Fujian, China
| | - Bill Kahler
- School of Dentistry, University of Sydney, Camperdown, Australia
| | - Xing Jiang
- Fujian Key Laboratory of Oral Diseases, School and Hospital of Stomatology, Fujian Medical University, 246 Yangqiao Zhong Road, Fuzhou, 350002, Fujian, China
| | - Zhaojie Lu
- Fujian Key Laboratory of Oral Diseases, School and Hospital of Stomatology, Fujian Medical University, 246 Yangqiao Zhong Road, Fuzhou, 350002, Fujian, China
| | - Youguang Lu
- Fujian Key Laboratory of Oral Diseases, School and Hospital of Stomatology, Fujian Medical University, 246 Yangqiao Zhong Road, Fuzhou, 350002, Fujian, China.
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Ahmed YE, Ahmed GM, Ghoneim AG. Evaluation of postoperative pain and healing following regenerative endodontics using platelet-rich plasma versus conventional endodontic treatment in necrotic mature mandibular molars with chronic periapical periodontitis. A randomized clinical trial. Int Endod J 2023; 56:404-418. [PMID: 36565044 DOI: 10.1111/iej.13886] [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: 06/24/2022] [Revised: 12/20/2022] [Accepted: 12/21/2022] [Indexed: 12/25/2022]
Abstract
AIM To evaluate the post-operative pain and the healing of necrotic mature permanent mandibular molar teeth with peri-apical periodontitis after conventional endodontic treatment versus after platelet-rich plasma (PRP) revascularization. METHODOLOGY The protocol of this randomized clinical trial was registered at www. CLINICALTRIALS gov with identification number NCT03350841. Twenty-eight patients were included in the study after confirming the diagnosis clinically and radiographically. In the first visit, mandibular molar teeth of both groups were mechanically prepared. Double antibiotic paste was prepared and injected then the cavity that was sealed with glass ionomer. At the second visit, the patients were randomized either to control group where standard endodontic treatment was completed by lateral condensation technique or assigned to intervention group where PRP revascularization technique. The degree of spontaneous pain was assessed using numerical rating scale (NRS) pre-operatively, then post-operatively after 6, 12 h and daily for 5 days. Patients were given a placebo to be administrated in case of pain. An analgesic (ibuprofen 400mg) was prescribed in case of persistent pain. Clinical and radiographic healing was assessed after 6 and 12 months. All demographic, baseline and outcome data were collected and statistically analysed. RESULTS Regarding the post revascularization/obturation pain, there was no statistically significant difference between severity of pain in the two groups at all time intervals except after 12 h, revascularization group showed statistically significantly higher prevalence of no pain than endodontic treatment group. Regarding the healing; the periapical lesions decrease in size significantly from the pre-operative lesion size in both groups without significant difference between the both groups. CONCLUSION Within the limitation of this study, PRP revascularization could be an alternative treatment to root canal treatment but further randomized clinical trials with standardized techniques and long follow up periods are recommended for more reliable results.
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El-Kateb NM, El-Backly RN, Amin WM, Abdalla AM. Quantitative Assessment of Intracanal Regenerated Tissues after Regenerative Endodontic Procedures in Mature Teeth Using Magnetic Resonance Imaging: A Randomized Controlled Clinical Trial. J Endod 2020; 46:563-574. [DOI: 10.1016/j.joen.2020.01.026] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 01/23/2020] [Accepted: 01/31/2020] [Indexed: 12/15/2022]
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The Effect of Long-term Dressing with Calcium Hydroxide on the Fracture Susceptibility of Teeth. J Endod 2018; 44:464-469. [DOI: 10.1016/j.joen.2017.09.018] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2017] [Revised: 07/02/2017] [Accepted: 09/30/2017] [Indexed: 12/12/2022]
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Kahler B, Chugal N, Lin LM. Alkaline Materials and Regenerative Endodontics: A Review. MATERIALS 2017; 10:ma10121389. [PMID: 29206139 PMCID: PMC5744324 DOI: 10.3390/ma10121389] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 11/23/2017] [Accepted: 11/29/2017] [Indexed: 12/16/2022]
Abstract
Periapical health is the primary goal of endodontic treatment in mature and immature teeth. In addition, the goals of treatment of immature teeth with arrested root development include root growth to length and maturation of the apex, as well as thickening of the canal wall. These goals are valid for immature teeth that have been subjected to trauma and dental caries or that are the result of developmental anomalies that expose the tooth to the risk of pulp necrosis and consequently result in the cessation of root maturation. Regenerative endodontic procedures (REPs) have been described as a “paradigm shift” in the treatment of immature teeth with pulp necrosis and underdeveloped roots, as there is the potential for further root maturation and return of vitality. Treatment with REPs is advocated as the treatment of choice for immature teeth with pulp necrosis. REP protocols involve the use of alkaline biomaterials, primarily sodium hypochlorite, calcium hydroxide, mineral trioxide aggregates and Biodentine, and are the essential components of a successful treatment regimen.
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Affiliation(s)
- Bill Kahler
- The School of Dentistry, The University of Queensland, Brisbane 4072, Australia.
| | - Nadia Chugal
- School of Dentistry, UCLA, CHS A3-075, Los Angeles, CA 90095-1668, USA.
| | - Louis M Lin
- College of Dentistry, New York University, 345 East 24th Street, New York, NY 10010, USA.
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