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Sabu N, Thilakan A, Ramankutty R, Vidya KC, Thomas N, Jobe J. Antimicrobial activity of 0.05 N and 0.1 N silver nitrate mouthwash against Streptococcus mutans and Candida albicans: An in vitro study. J Int Oral Health 2022. [DOI: 10.4103/jioh.jioh_143_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Comparing the Antifungal Effect of Sodium Hypochlorite Gel versus Different Types of Root Canal Medicaments at Different Time Intervals Using the Agar Diffusion Test: An In Vitro Study. Int J Dent 2021; 2021:6550054. [PMID: 34938336 PMCID: PMC8687846 DOI: 10.1155/2021/6550054] [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: 09/29/2021] [Accepted: 11/24/2021] [Indexed: 11/23/2022] Open
Abstract
Aims The purpose of this study was to compare the antifungal activity of sodium hypochlorite gel to those of four intracanal medicaments at various time intervals. Materials and Methods The agar well diffusion technique was utilized to test the antifungal activity of the following medicaments against Candida albinans (C. albicans): sodium hypochlorite gel, chlorhexidine gel, calcium hydroxide paste, Ledermix, and Diapex Plus. The inhibition zone related to each medicine was measured in millimeter after 24, 48, and 72 hours of incubation at 37°C. The data were analyzed using one-way ANOVA and Games–Howell tests, at a significance level of P < 0.05. Results Except for Ledermix and Diapex Plus, which had no antifungal action, all of the medicaments showed varied inhibitory zones for C. albicans. At all periods, the NaOCl gel had the most significant inhibition zones, followed by the CHX gel and calcium hydroxide. At all time intervals, the NaOCl gel demonstrated comparable antifungal efficacy. When compared to a 24-hour time interval, the CHX gel showed an increased antifungal activity at the 48-hour and 72-hour intervals. Calcium hydroxide, on the other hand, showed a decrease in its antifungal activity at the 72-hour interval. Conclusion The antifungal activity of sodium hypochlorite gel was the highest among the investigated medicaments. Chlorhexidine gel's antifungal activity improved over time, whereas calcium hydroxide's antifungal activity declined. Diapex Plus and Ledermix did not have any antifungal properties.
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Chum JD, Lim DJZ, Sheriff SO, Pulikkotil SJ, Suresh A, Davamani F. In vitro evaluation of octenidine as an antimicrobial agent against Staphylococcus epidermidis in disinfecting the root canal system. Restor Dent Endod 2019; 44:e8. [PMID: 30834230 PMCID: PMC6387889 DOI: 10.5395/rde.2019.44.e8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 05/07/2018] [Accepted: 05/14/2018] [Indexed: 11/11/2022] Open
Abstract
Objectives Irrigants are imperative in endodontic therapy for the elimination of pathogens from the infected root canal. The present study compared the antimicrobial efficacy of octenidine dihydrochloride (OCT) with chlorhexidine (CHX) and sodium hypochlorite (NaOCl) against Staphylococcus epidermidis (S. epidermidis) for root canal disinfection. Materials and Methods The minimum inhibitory concentration (MIC) was obtained using serial dilution method. The agar diffusion method was then used to determine the zones of inhibition for each irrigant. Lastly, forty 6-mm dentin blocks were prepared from human mandibular premolars and inoculated with S. epidermidis. Samples were randomly divided into 4 groups of 10 blocks and irrigated for 3 minutes with saline (control), 2% CHX, 3% NaOCl, or 0.1% OCT. Dentin samples were then collected immediately for microbial analysis, including an analysis of colony-forming units (CFUs). Results The MICs of each tested irrigant were 0.05% for CHX, 0.25% for NaOCl, and 0.0125% for OCT. All tested irrigants showed concentration-dependent increase in zones of inhibition, and 3% NaOCl showed the largest zone of inhibition amongst all tested irrigants (p < 0.05). There were no significant differences among the CFU measurements of 2% CHX, 3% NaOCl, and 0.1% OCT showing complete elimination of S. epidermidis in all samples. Conclusions This study showed that OCT was comparable to or even more effective than CHX and NaOCl, demonstrating antimicrobial activity at low concentrations against S. epidermidis.
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Affiliation(s)
- Jia Da Chum
- Department of Dental Surgery, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
| | - Darryl Jun Zhi Lim
- Department of Dental Surgery, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
| | - Sultan Omer Sheriff
- Clinical Dentistry, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
| | - Shaju Jacob Pulikkotil
- Clinical Dentistry, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
| | - Anand Suresh
- Department of Conservative Dentistry and Endodontics, Penang International Dental College, Penang, Malaysia
| | - Fabian Davamani
- School of Health Sciences, International Medical University, Kuala Lumpur, Malaysia
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Zeng C, Meghil MM, Miller M, Gou Y, Cutler CW, Bergeron BE, Niu L, Ma J, Tay FR. Antimicrobial efficacy of an apical negative pressure root canal irrigation system against intracanal microorganisms. J Dent 2018; 72:71-75. [PMID: 29571954 DOI: 10.1016/j.jdent.2018.03.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 03/15/2018] [Accepted: 03/18/2018] [Indexed: 10/17/2022] Open
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Awawdeh L, Jamleh A, Al Beitawi M. The Antifungal Effect of Propolis Endodontic Irrigant with Three Other Irrigation Solutions in Presence and Absence of Smear Layer: An In Vitro Study. IRANIAN ENDODONTIC JOURNAL 2018; 13:234-239. [PMID: 29707021 PMCID: PMC5911300 DOI: 10.22037/iej.v13i2.19227] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 02/07/2018] [Accepted: 02/26/2018] [Indexed: 11/18/2022]
Abstract
INTRODUCTION The aim of this in vitro study was to compare the antifungal effect of propolis as an endodontic irrigant agent with a mixture of doxycycline, citric acid, and a detergent mixture (MTAD), 2% chlorhexidine (CHX) and 3% sodium hypochlorite (NaOCl) against Candida albicans in presence and absence of smear layer. METHODS AND MATERIALS Extracted teeth with single canals (n=104) were prepared and randomly distributed into four experimental groups; 30% propolis, MTAD, 2% CHX and 3% NaOCl. Each group had two subgroups; with and without smear layer. The antifungal effectiveness was evaluated. The Kruskal-Wallis and Mann-Whitney tests were used to compare the overall effectiveness of different treatments at significance level of 0.05. RESULTS Propolis, CHX and NaOCl had similar levels of effectiveness to each other against C. albicans, and these levels were not affected by the presence or absence of the smear layer. Each irrigant was significantly more effective than MTAD or saline solution. MTAD was less effective in the presence of the smear layer than in its absence. CONCLUSIONS Propolis irrigation can produce root canals that are free of C. albicans, even in the presence of the smear layer.
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Affiliation(s)
- Lama Awawdeh
- Department of Conservative Dentistry, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | - Ahmed Jamleh
- Department of Conservative Dentistry, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | - Maha Al Beitawi
- Department of Conservative Dentistry, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
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Attur K, Joy MT, Karim R, Anil Kumar VJ, Deepika C, Ahmed H. Comparative analysis of endodontic smear layer removal efficacy of 17% ethylenediaminetetraacetic acid, 7% maleic acid, and 2% chlorhexidine using scanning electron microscope: An in vitro study. J Int Soc Prev Community Dent 2016; 6:S160-5. [PMID: 27652250 PMCID: PMC5022395 DOI: 10.4103/2231-0762.189755] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Aim: The aim of the present study was to evaluate the efficiency of different endodontic irrigants in the removal of smear layer through scanning electron microscopic image analysis. Materials and Methods: The present in vitro study was carried out on 45 single-rooted extracted human mandibular premolar teeth with single canal and complete root formation. Teeth were randomly assigned to three groups with 15 teeth in each group. Group I samples were irrigated with 17% ethylenediaminetetraacetic (EDTA) irrigation, Group II with 7% maleic acid irrigation, and Group III with 2% chlorhexidine irrigation. Scanning electron microscope evaluation was done for the assessment of smear layer removal in the coronal, middle, and apical thirds. Comparison of the smear layer removal between the three different groups was done by Kruskal–Wallis test, followed by Mann–Whitney U test for comparing individual groups. A P value less than 0.05 was considered to be statistically significant. Results: Statistically significant difference was seen between the two test groups (17% EDTA vs. 7% maleic acid and 17% EDTA vs. 2% chlorhexidine) in smear layer removal at coronal, middle, and apical thirds of the root canal. The most efficient smear layer removal was seen in Group I with 17% EDTA irrigation compared with other groups (P < 0.05) and the least by 2% chlorhexidine. Conclusion: The present study shows that 17% EDTA efficiently removes the smear layer from root canal walls.
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Affiliation(s)
- Kailash Attur
- Department of Conservative Dentistry and Endodontics, Narsinhbhai Patel Dental College and Hospital, Visnagar, Gujarat, India
| | - Mathew T Joy
- Department of Periodontology, Indira Gandhi Institute of Dental Sciences, Ernakulam, Kerala, India
| | - Riyas Karim
- Department of Periodontology, Indira Gandhi Institute of Dental Sciences, Ernakulam, Kerala, India
| | | | - C Deepika
- Department of Pediatric Dentistry, Sri Balaji Dental College, Moinabad, Telangana, India
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Kumar Y, Lohar J, Bhat S, Bhati M, Gandhi A, Mehta A. Comparative evaluation of demineralization of radicular dentin with 17% ethylenediaminetetraacetic acid, 10% citric acid, and MTAD at different time intervals: An in vitro study. J Int Soc Prev Community Dent 2016; 6:44-8. [PMID: 27011932 PMCID: PMC4784063 DOI: 10.4103/2231-0762.175412] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background: The smear layer has the capability to protect the bacteria within the dentinal tubules from intracanal medicament. After removal of the smear layer from infected root canals, it allows disinfection of the entire root canal. The smear layer compromising the seal between the root canal sealer and root canal wall also decreases the penetration of irrigants into dentinal tubules. Aims: This study compares the amount of phosphorous liberated and demineralization of the radicular dentin with 17% ethylenediaminetetraacetic acid, 10% citric acid and mixture of doxycycline, citric acid, and a detergent at different time intervals. Materials and Methods: Extracted maxillary single-rooted teeth were prepared by using a combination of passive step-back and rotary 0.04 taper nickel-titanium files. Sodium hypochlorite 5.25% and sterile distilled water were used as an intracanal irrigant. The canals were then treated with 5 mL of one of the following solutions such as final rinse sterile distilled water, 5.25% sodium hypochlorite, 17% ethylenediaminetetraacetic acid (EDTA) or mixture of doxycycline, citric acid, and a detergent. The presence or absence of smear layer and the amount of erosion on the surface of the root canal walls at the coronal, middle, and apical portions of each canal were examined under a scanning electron microscope. Statistical Analysis: Data were analyzed by one-way analysis of variance (ANOVA) to determine whether there were significant differences between the groups. Results: The results show that mixture of doxycycline, citric acid, and a detergent is an effective solution for the removal of the smear layer and does not significantly change the structure of the dentinal tubules. Conclusions: In this study, 10% citric acid shows the maximum amount of dimeneralization of radicular dentine followed by mixture of doxycycline, citric acid, and a detergent, and 17% ethylenediaminetetraacetic acid. When all the subgroups were compared, it was seen that the maximum amount of phosphorus liberation was performed by 10% citric acid >mixture of doxycycline, citric acid, and a detergent >17% EDTA at a different time interval.
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Affiliation(s)
- Yogender Kumar
- Department of Conservative and Endodontics, Darshan Dental College and Hospital, Udaipur, Rajasthan, India
| | - Jitendra Lohar
- Department of Conservative and Endodontics, Darshan Dental College and Hospital, Udaipur, Rajasthan, India
| | - Sureka Bhat
- Department of Conservative and Endodontics, Darshan Dental College and Hospital, Udaipur, Rajasthan, India
| | - Manisha Bhati
- Department of Dentistry, Mathura Das Mathur Hospital, Jodhpur, Rajasthan, India
| | - Aanesh Gandhi
- Department of Conservative and Endodontics, Darshan Dental College and Hospital, Udaipur, Rajasthan, India
| | - Abhishek Mehta
- Department of Conservative and Endodontics, Dashvani Dental College and Hospital, Kota, Rajasthan, India
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Elakanti S, Cherukuri G, Rao VG, Chandrasekhar V, Rao AS, Tummala M. Comparative evaluation of antimicrobial efficacy of QMix™ 2 in 1, sodium hypochlorite, and chlorhexidine against Enterococcus faecalis and Candida albicans. J Conserv Dent 2015; 18:128-31. [PMID: 25829691 PMCID: PMC4379652 DOI: 10.4103/0972-0707.153067] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Revised: 12/19/2014] [Accepted: 01/02/2015] [Indexed: 11/05/2022] Open
Abstract
Aim/Objective: The aim of this study is to compare the antimicrobial efficacy of QMix™ 2 in 1, sodium hypochlorite (NaOCl), and chlorhexidine (CHX) against Enterococcus faecalis and Candida albicans. Materials and Methods: Eighty freshly extracted, single-rooted human mandibular premolar teeth were instrumented and autoclaved. Samples were divided into two groups of 40 teeth each based on the type of microorganism used. Group I was inoculated with E. faecalis and Group II with C. albicans and incubated for 3 days. Each group was subdivided into four subgroups based on the type of irrigant used. Group IA, IIA, 5.25% NaOCl; Group IB, IIB, 2% CHX; Group IC, IIC, QMix™ 2 in 1; and Group ID, IID, 0.9% saline (the control group). Ten microliters of the sample from each canal was taken and was placed on Brain Heart Infusion agar and Sabouraud dextrose agar. The plates were incubated at 37°C for 24 h and colony forming units (CFUs) that were grown were counted. Data was analyzed with analysis of variance (ANOVA) followed by post-hoc Games-Howell test. Results: The greatest antimicrobial effects were observed in samples treated with QMix™ 2 in 1 (P < 0.001). No statistical significant difference was found between 5.25% NaOCl and 2% CHX (P > 0.001) against E. faecalis and C. albicans. Conclusion: QMix™ 2 in 1 demonstrated significant antimicrobial efficacy against E. faecalis and C. albicans.
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Affiliation(s)
- Soujanya Elakanti
- Department of Conservative Dentistry and Endodontics, Mamata Dental College, Khammam, Andhra Pradesh, India
| | - Gayathri Cherukuri
- Oral Pathology and Microbiology, Mamata Dental College, Khammam, Andhra Pradesh, India
| | - Venkateswara G Rao
- Oral Pathology and Microbiology, Mamata Dental College, Khammam, Andhra Pradesh, India
| | | | - Anitha S Rao
- Department of Conservative Dentistry and Endodontics, Mamata Dental College, Khammam, Andhra Pradesh, India
| | - Muralidhar Tummala
- Department of Conservative Dentistry and Endodontics, Mamata Dental College, Khammam, Andhra Pradesh, India
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Willershausen I, Wolf TG, Schmidtmann I, Berger C, Ehlers V, Willershausen B, Briseño B. Survey of root canal irrigating solutions used in dental practices within Germany. Int Endod J 2014; 48:654-60. [PMID: 25088019 DOI: 10.1111/iej.12360] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Accepted: 07/31/2014] [Indexed: 11/28/2022]
Abstract
AIM Irrigant usage information in relation to years of professional experience was collected from general dentists in different German federal states by means of a questionnaire. METHODOLOGY A short survey concerning endodontic treatment and use of irrigants was mailed to 4240 dentists or delivered to 3720 dental offices as an extra page in a journal in eight German states. Detailed information concerning the most frequently used irrigants, their concentrations, the spectrum of disinfectants used in root canal treatment concepts for vital and nonvital pulps, main topics of continuing education as well as years of professional experience was collected. The statistical analysis of differences found amongst the dentists in relation to professional experience or federal state was performed using the chi-square test. RESULTS Of a total of 7960 invitations, 1630 replies were evaluated (response rate 20.5%). The majority of the dentists (57.3%) had >20 years of professional experience, 23% had >30 years. Dentists with long-standing professional experience (20-30 years) used H2 O2 significantly more often than dentists with less experience (P < 0.001), and of the older colleagues (>30 years of professional experience), 14.6% never used NaOCl, whilst the younger colleagues almost always used it (P < 0.001). Differences were also found for the usage of irrigants amongst dentists from the various German states. CONCLUSIONS Whilst NaOCl was used in almost all states, regional differences were found regarding the choice of additional irrigants, which were mainly determined by the irrigation protocols taught at different universities.
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Affiliation(s)
- I Willershausen
- Department of Operative Dentistry, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - T G Wolf
- Department of Operative Dentistry, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - I Schmidtmann
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), Johannes Gutenberg University, Mainz, Germany
| | - C Berger
- Department of Operative Dentistry, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - V Ehlers
- Department of Operative Dentistry, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - B Willershausen
- Department of Operative Dentistry, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - B Briseño
- Department of Operative Dentistry, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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Comparison of the Antifungal Efficacy of 1.3% NaOCl/MTAD with Other Routine Irrigants: An Ex-Vivo Study. INTERNATIONAL SCHOLARLY RESEARCH NOTICES 2014; 2014:575748. [PMID: 27379317 PMCID: PMC4897288 DOI: 10.1155/2014/575748] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Revised: 08/15/2014] [Accepted: 09/10/2014] [Indexed: 11/17/2022]
Abstract
Objectives. To evaluate and compare the antifungal efficacy of 1.3% NaOCl/MTAD with 2.5% sodium hypochlorite (NaOCl), 2% chlorhexidine gluconate (CHX), and iodine potassium iodide (IKI). Materials and Methods. Fifty-two single rooted teeth were used which were divided into four groups with 10 teeth in each group: 2.5% NaOCl, 2% CHX, IKI, 1.3% NaOCl/MTAD, and physiologic saline. Two teeth served as negative controls and were placed in fresh brain-heart infusion broth (BHI) after autoclaving. The teeth were inoculated and incubated with Candida albicans after which the teeth were instrumented and irrigated with the test irrigants. The first microbial sampling was then performed and colony forming unit/mL (cfu/mL) was counted. The second microbial sampling was performed 1 week after instrumentation and irrigation. Results. The test irrigants were effective against C. albicans in both the first and second microbial samplings. When the irrigants were compared, there was no statistical difference in their activity in the 1st and 2nd microbial sampling. On comparison of the change in mean cfu/mL between the 1st and 2nd microbial samplings, the antifungal activity of the test irrigants was in the order 2.5% NaOCl > 2% CHX > 1.3% NaOCl/MTAD > IKI.
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Bohn S, Ilie N. Wetting behaviour of silicone- and resin-based root canal sealers. Int Endod J 2013; 47:542-9. [DOI: 10.1111/iej.12184] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2013] [Accepted: 08/14/2013] [Indexed: 11/30/2022]
Affiliation(s)
- S. Bohn
- Department of Restorative Dentistry; Dental School Ludwig-Maximilians-University; Munich Germany
| | - N. Ilie
- Department of Restorative Dentistry; Dental School Ludwig-Maximilians-University; Munich Germany
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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]
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Tirali RE, Gulsahi K, Cehreli SB, Karahan ZC, Uzunoğlu E, Elhan A. Antimicrobial efficacy of octenidine hydrochloride, MTAD and chlorhexidine gluconate mixed with calcium hydroxide. J Contemp Dent Pract 2013; 14:456-60. [PMID: 24171989 DOI: 10.5005/jp-journals-10024-1344] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE The aim of this in vitro study was to investigate whether mixing with calcium hydroxide [Ca(OH)2] affects the antimicrobial action of Octenidine hydrochloride (Octenisept), MTAD and chlorhexidine against Enterococcus faecalis and Candida albicans. MATERIALS AND METHODS Freshly grown cultures of Enterococcus faecalis, Candida albicans and a mixture of both strains were incubated in agar plates containing brain-heart infusion broth (BHIB). Zones of inhibition were measured at 24 and 48 hours. Statistical analysis was performed using Mann-Whitney U test and Kruskal-Wallis one-way analysis of variance (ANOVA, both p=0.05). RESULTS Mixing with Ca(OH)2 significantly increased the antibacterial effect of Octenisept (p<0.05), but did not alter its antifungal activity. Only chlorhexidine showed more antibacterial and antifungal efficiency compared to its Ca(OH)2-mixed version (both p<0.05). Mixing with Ca(OH)2 decreased the antibacterial efficacy of MTAD, but increased its antifungal effect (both p<0.05). CONCLUSION These results demonstrate the differential effects of Ca(OH)2 addition on the antimicrobial action of the tested endodontic medicaments in vitro. Ca(OH)2 was as effective as its combination with all of the tested medicaments.
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Affiliation(s)
- Resmiye Ebru Tirali
- Assistant Professor, Department of Pediatric Dentistry, Baskent University, Ankara, Turkey, e-mail:
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Srikumar GPV, Sekhar KS, Nischith KG. Mixture tetracycline citric acid and detergent - A root canal irrigant. A review. J Oral Biol Craniofac Res 2013; 3:31-5. [PMID: 25737877 DOI: 10.1016/j.jobcr.2012.09.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2012] [Accepted: 09/09/2012] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND Root canal irrigants play an indispensable role for the complete disinfection of the root canal system, in particular those areas of the root canal that are not accessible for instrumentation. Sodium hypochlorite, ethylene diamine tetra acetic acid, hydrogen peroxide and chlorhexidine are the most commonly used root canal irrigants in endodontic practice, but they do not satisfy all the properties of an ideal root canal irrigant. Mixture tetracycline, citric acid and detergent, a root canal irrigant, is commercially available as BioPure MTAD (Dentsply, Tulsa Dental, Tulsa, OK). METHODOLOGY The literature was searched for root canal irrigants used in the last 3 decades in PubMed. Data showed 83 relevant articles, of which 24 were found most suitable on the basis of description of properties, advantages and disadvantages of MTAD, hence were included. The aim of this study was to evaluate the properties of MTAD for its antibacterial efficiency, biocompatibility, chelating action with removal of endodontic smear layer and compare it with other commonly used root canal irrigants like sodium hypochlorite, ethylene diamine tetra acetic acid, hydrogen peroxide, chlorhexidine. RESULTS MTAD was found to be highly effective intracanal irrigant compared to other commonly used root canal irrigants with excellent disinfection of the entire root canal system. CONCLUSION MTAD is biocompatible with superior antimicrobial efficiency compared to other commonly used root canal irrigants.
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Affiliation(s)
- G P V Srikumar
- Senior Lecturer, Department of Conservative Dentistry & Endodontics, Purvanchal Institute of Dental Sciences, GIDA, Gorakhpur, Uttar Pradesh, India
| | - K S Sekhar
- Principal and HOD, Department of Conservative Dentistry & Endodontics, Purvanchal Institute of Dental Sciences, GIDA, Gorakhpur, Uttar Pradesh, India
| | - K G Nischith
- Professor & HOD, Department of Conservative Dentistry & Endodontics, Malabar Dental College, Kuttippuram, Kerala, India
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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: 6] [Impact Index Per Article: 0.5] [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.
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Affiliation(s)
- Kamran Gulsahi
- Department of Endodontics, Faculty of Dentistry, Baskent University, Ankara, Turkey
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Kurian J, Bolla N, Damaraju B. Comparative evaluation of effectiveness of sodium dichloroisocyanurate and calcium hydroxide against Candida albicans. J Contemp Dent Pract 2012; 13:665-670. [PMID: 23250172 DOI: 10.5005/jp-journals-10024-1206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
INTRODUCTION Candida albicans is the most commonly isolated fungi from the oral cavity. It is the most infective to various intracanal medicaments and is considered as invasive yeast. Sodium dichloroisocyanurate (NaDCC) which is used as a disinfectant and as a biocide in treating potable water has similar action to that of sodium hypochlorite against microbes. The aim of the present study is to compare the effectiveness of calcium hydroxide and NaDCC against Candida albicans. MATERIALS AND METHODS After obtaining the stock cultures of Candida, the isolates were divided into six groups which were exposed to different concentrations of NaDCC and calcium hydroxide Ca(OH)₂. Group 1 consisted of the isolates which were subdivided into three groups, subjected to three different concentrations of NaDCC. Group 2 also consisted of three subgroups exposed to three different concentrations of Ca(OH)₂. Group three consisted of three subgroups which were exposed to three different concentrations of combinations of both NaDCC and Ca(OH)₂. RESULTS The results of the present study show that calcium hydroxide was totally ineffective at all concentrations and NaDCC was effective and also the combination of both was shown to be effective. CONCLUSION NaDCC alone was effective at all concentrations and the combination with Ca(OH)₂ was found to be less effective. Ca(OH)₂ was totally ineffective.
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Affiliation(s)
- Jacob Kurian
- Department of Conservative Dentistry and Endodontics, Kannur Dental College, Kannur, Kerala India.
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Kamberi B, Bajrami D, Stavileci M, Omeragiq S, Dragidella F, Koçani F. The Antibacterial Efficacy of Biopure MTAD in Root Canal Contaminated with Enterococcus faecalis. ISRN DENTISTRY 2012; 2012:390526. [PMID: 22991671 PMCID: PMC3443582 DOI: 10.5402/2012/390526] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/18/2012] [Accepted: 07/30/2012] [Indexed: 11/23/2022]
Abstract
Aim. The purpose of this in vitro study was to assess the antimicrobial efficacy of Biopure MTAD against E. faecalis in contaminated root canals. Materials and Methods. Forty-two single rooted extracted human teeth were inoculated with E. faecalis and incubated for four weeks. The samples were divided in two control and five experimental groups irrigated with 1.5% sodium hypochlorite solution (NaOCl); 3% NaOCl; BioPure MTAD; 1.5% NaOCl/17% EDTA; or 3% NaOCl/17% EDTA. After a one-week incubation, complete disinfection was confirmed by the absence of turbidity in the incubation media. Dentin shavings were taken from samples with no turbidity to verify whether E. faecalis was present in dentin tubules. Results were analyzed statistically using Fisher's exact test, with the level of significance set at P < 0.05. Results. Statistical analysis of the data obtained at Day 7 and after dentin shaving analysis showed that BioPure MTAD had significantly greater antibacterial activity than 1.5% NaOCl, 1.5% NaOCl/17% EDTA and 3% NaOCl/17% EDTA. No significant difference was detected between MTAD and 3% NaOCl. Conclusions. These findings suggest that BioPure MTAD possesses superior bactericidal activity compared with NaOCl and EDTA against E. faecalis.
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Affiliation(s)
- Blerim Kamberi
- Department of Dental Pathology and Endodontics, University Dentistry Clinical Center of Kosovo, 10000 Prishtina, Kosovo
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Influence of an apical negative pressure irrigation system on bacterial elimination during endodontic therapy: a prospective randomized clinical study. J Endod 2012; 38:1177-81. [PMID: 22892731 DOI: 10.1016/j.joen.2012.06.013] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2011] [Revised: 06/07/2012] [Accepted: 06/08/2012] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Recent in vitro studies that use an apical negative pressure irrigation system, EndoVac, have demonstrated promising results in the production of debris-free root canals, while also preventing potential extrusion of irrigants into the periapical region. We conducted a randomized, controlled, prospective clinical study to determine whether the use of EndoVac irrigation (EndoVac group) was more efficient compared with standard needle irrigation (control group) in obtaining canals from which microbes could not be cultivated. METHODS Routine endodontic therapy was performed in 48 patients with necrotic, single-rooted, single-canal teeth. The patients were randomly assigned to either the EndoVac group (n = 25) or control group (n = 23). Irrigation with either method was carried out with 0.5% sodium hypochlorite. After surface disinfection, before instrumentation and on completion of chemomechanical preparation, intracanal microbial samples were obtained and cultured under anaerobic conditions. The frequency of microbial cultivability by using either irrigation system was analyzed. RESULTS The frequency of obtaining culture-negative root canals was 90.9% and 82.6% for the control group and EndoVac group, respectively. There was no significant difference in the antimicrobial efficacy of either control group or EndoVac group (Fisher exact test, P = .665). Furthermore, no significant association between study variables and the irrigation systems' antimicrobial efficacy was found (P > .05). CONCLUSIONS The results of this prospective in vivo study demonstrate that the antimicrobial efficacy of EndoVac irrigation is comparable to that of standard irrigation.
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Dumani A, Yoldas O, Yilmaz S, Akcimen B, Seydaoglu G, Kipalev A, Koksal F. In vitro susceptibility of e.faecalis and c.albicans isolates from apical periodontitis to common antimicrobial agents, antibiotics and antifungal medicaments. J Clin Exp Dent 2012; 4:e1-7. [PMID: 24558517 PMCID: PMC3908802 DOI: 10.4317/jced.50593] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2011] [Accepted: 10/27/2011] [Indexed: 11/11/2022] Open
Abstract
The aim of this study was to evaluate in vitro antimicrobial activity of 4 antibiotic agents (for E.faecalis) and 4 antifungal agents (for C.albicans) by agar dilution method. Additionally, modified strip diffusion method was used for detection of in vitro antimicrobial activities of 5% NaOCl, 2.5% NaOCl, 17% EDTA and 2% CHX and agar diffusion method for detection of in vitro susceptibilities of three intracanal medicaments for 18 E.faecalis and 18 C.albicans isolates from primary and secondary root canal infection. Isolates were recovered from 231 endodontic samples of patients, with the need of root canal treatment and retreatment. All tested E.faecalis isolates showed resistance to antibiotics. For irrigation solutions, 2% CHX was more effective in eliminating E.faecalis but 5% NaOCl showed larger inhibition zone than 2.5% NaOCl, 17% EDTA and 2% CHX. For intracanal medication, Ca(OH)2-CHX worked efficiently in killing E.faecalis isolates compared to Ca(OH)2-Steril saline solution, Ca(OH)2-Glycerin. For C.albicans, 18 isolates were susceptible to amphotericin B, nistatin, fluconazole but showed resistance to ketoconazole. 5% NaOCl was more effective in eliminating and produced larger inhibition zone compared to 2.5% NaOCl, 17% EDTA and 2% CHX. Ca(OH)2-Glycerin intracanal medication was better in eliminating C.albicans isolates and produced larger inhibition zone compared to other Ca(OH)2 medicaments.
Key words:E.faecalis, C.albicans, antimicrobial, antibiotic, antifungal.
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Affiliation(s)
- Aysin Dumani
- DDS PhD. Assistant Professor, Department of Conservative Dentistry and Endodontics, University of Cukurova, Faculty of Dentistry, Adana, Turkey
| | - Oguz Yoldas
- DDS PhD. Professor, Department of Conservative Dentistry and Endodontics, University of Cukurova, Faculty of Dentistry, Adana, Turkey
| | - Sehnaz Yilmaz
- DDS PhD. Assistant Professor, Department of Conservative Dentistry and Endodontics, University of Cukurova, Faculty of Dentistry, Adana, Turkey
| | - Beril Akcimen
- PhD. Research Assistant, Department of Microbiology, University of Cukurova, Adana, Turkey
| | - Gulsah Seydaoglu
- PhD. Associate Professor, Department of Biostatistic, University of Cukurova, Adana, Turkey
| | - Arzu Kipalev
- PhD. Research Assistant, Department of Microbiology, University of Cukurova, Adana, Turkey
| | - Fatih Koksal
- PhD. Professor, Department of Microbiology, University of Cukurova, Adana, Turkey
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Newer root canal irrigants in horizon: a review. Int J Dent 2011; 2011:851359. [PMID: 22190936 PMCID: PMC3235459 DOI: 10.1155/2011/851359] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2011] [Revised: 09/25/2011] [Accepted: 10/11/2011] [Indexed: 11/20/2022] Open
Abstract
Sodium hypochloride is the most commonly used endodontic irrigant, despite limitations. None of the presently available root canal irrigants satisfy the requirements of ideal root canal irrigant. Newer root canal irrigants are studied for potential replacement of sodium hypochloride. This article reviews the potential irrigants with their advantages and limitations with their future in endodontic irrigation.
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Stojicic S, Shen Y, Qian W, Johnson B, Haapasalo M. Antibacterial and smear layer removal ability of a novel irrigant, QMiX. Int Endod J 2011; 45:363-71. [DOI: 10.1111/j.1365-2591.2011.01985.x] [Citation(s) in RCA: 146] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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De-Deus G, Reis C, Paciornik S. Critical appraisal of published smear layer-removal studies: methodological issues. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 2011; 112:531-543. [PMID: 21696983 DOI: 10.1016/j.tripleo.2011.01.046] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2011] [Accepted: 01/31/2011] [Indexed: 05/31/2023]
Abstract
The smear layer phenomenon has been extensively addressed over the past 3 decades. However, there still are unanswered questions on this issue and the main responsible factor is the qualitative and nonreproducible character of most in vitro smear layer removal studies. The methodological reasons that led to the current lack of reliable conclusions on procedures aiming to remove the smear layer are comprehensively addressed. The limitations and outcomes related to different assessment methods are discussed as well. General speaking, the results by score-based conventional SEM studies are not trustworthy and reproducible. Computational routines able to automatically extract quantitative data of dentin morphology are necessary to minimize the human bias. An ideal experimental model should have a longitudinal observational character, in which a given dentin area can be observed at different times. The use of flat dentin samples should be avoided because of the influence of gravity as well as root canal anatomy on the final result of the chelating process. The experimental model also needs to take into consideration the amount and distribution of sclerotic dentin and irregular secondary dentin, otherwise the final results can be compromised. Inasmuch as there is a clear lack of scientific standard, simple comparative SEM evaluations are pointless at the present moment. The ideal experimental model to assess smear layer removal is not currently available. Therefore, further research efforts should be directed to the development of and testing of new methodological approaches to be used in the smear layer removal studies. The improvement of the experimental models is a requirement to draw up optimized clinical guidelines for the chemical treatment of the root dentin.
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Singla MG, Garg A, Gupta S. MTAD in endodontics: an update review. ACTA ACUST UNITED AC 2011; 112:e70-6. [DOI: 10.1016/j.tripleo.2011.02.015] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2010] [Revised: 11/06/2010] [Accepted: 02/12/2011] [Indexed: 11/24/2022]
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Tong Z, Zhou L, Li J, Jiang W, Ma L, Ni L. In Vitro Evaluation of the Antibacterial Activities of MTAD in Combination with Nisin against Enterococcus faecalis. J Endod 2011; 37:1116-20. [DOI: 10.1016/j.joen.2011.03.020] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2011] [Revised: 03/23/2011] [Accepted: 03/25/2011] [Indexed: 11/24/2022]
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Mohammadi Z, Giardino L, Palazzi F. Evaluation of the antifungal activity of four solutions used as a final rinsein vitro. AUST ENDOD J 2010; 39:31-4. [DOI: 10.1111/j.1747-4477.2010.00278.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Pappen FG, Shen Y, Qian W, Leonardo MR, Giardino L, Haapasalo M. In vitro antibacterial action of Tetraclean, MTAD and five experimental irrigation solutions. Int Endod J 2010; 43:528-35. [DOI: 10.1111/j.1365-2591.2010.01712.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Chandra SS, Miglani R, Srinivasan M, Indira R. Antifungal Efficacy of 5.25% Sodium Hypochlorite, 2% Chlorhexidine Gluconate, and 17% EDTA With and Without an Antifungal Agent. J Endod 2010; 36:675-8. [DOI: 10.1016/j.joen.2010.01.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2009] [Revised: 01/06/2010] [Accepted: 01/15/2010] [Indexed: 10/19/2022]
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Comparison of 2.5% Sodium Hypochlorite and 2% Chlorhexidine Gel on Oral Bacterial Lipopolysaccharide Reduction from Primarily Infected Root Canals. J Endod 2009; 35:1350-3. [DOI: 10.1016/j.joen.2009.06.011] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2009] [Revised: 06/18/2009] [Accepted: 06/22/2009] [Indexed: 11/20/2022]
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Câmara AC, de Albuquerque MM, Aguiar CM, de Barros Correia ACR. In vitro antimicrobial activity of 0.5%, 1%, and 2.5% sodium hypochlorite in root canals instrumented with the ProTaper Universal system. ACTA ACUST UNITED AC 2009; 108:e55-61. [DOI: 10.1016/j.tripleo.2009.03.037] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2009] [Revised: 03/20/2009] [Accepted: 03/22/2009] [Indexed: 10/20/2022]
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De-Deus G, Reis C, Fidel S, Fidel RAS, Paciornik S. Longitudinal and quantitative evaluation of dentin demineralization when subjected to EDTA, EDTAC, and citric acid: a co-site digital optical microscopy study. ACTA ACUST UNITED AC 2008; 105:391-7. [DOI: 10.1016/j.tripleo.2007.08.038] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2006] [Revised: 08/07/2007] [Accepted: 08/21/2007] [Indexed: 10/22/2022]
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Newberry BM, Shabahang S, Johnson N, Aprecio RM, Torabinejad M. The Antimicrobial Effect of Biopure MTAD on Eight Strains of Enterococcus faecalis: An In Vitro Investigation. J Endod 2007; 33:1352-4. [DOI: 10.1016/j.joen.2007.07.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2007] [Revised: 06/27/2007] [Accepted: 07/01/2007] [Indexed: 10/22/2022]
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Nudera WJ, Fayad MI, Johnson BR, Zhu M, Wenckus CS, Begole EA, Wu CD. Antimicrobial Effect of Triclosan and Triclosan with Gantrez on Five Common Endodontic Pathogens. J Endod 2007; 33:1239-42. [PMID: 17889698 DOI: 10.1016/j.joen.2007.06.009] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2007] [Revised: 06/04/2007] [Accepted: 06/11/2007] [Indexed: 11/28/2022]
Abstract
Microbial control of the root canal system is one of the key objectives of root canal therapy. Triclosan is a widely accepted broad spectrum antimicrobial agent proven to be effective against many gram-positive and gram-negative bacteria. Triclosan acts by blocking bacterial fatty acid biosynthesis. The addition of Gantrez copolymer has been shown to enhance the antimicrobial activity of triclosan. The purpose of this study was to determine the minimum inhibitory and bactericidal concentrations of triclosan and triclosan with Gantrez against Prevotella intermedia, Fusobacterium nucleatum, Actinomyces naeslundii, Porphyromonas gingivalis, and Enterococcus faecalis. The minimum inhibitory concentration (MIC) of both test solutions was determined for each of the 5 microorganisms by using microtiter serial dilutions. Samples were streaked on 5% sheep blood agar plates and placed in an anaerobic incubator to determine the minimum bactericidal concentration (MBC). The MBC of triclosan ranged from 12-94 microg/mL. The MBC of triclosan with Gantrez ranged from <0.3-10.4 microg/mL. The addition of Gantrez enhanced the bactericidal activity of triclosan. Both triclosan and triclosan with Gantrez demonstrated bactericidal activity against the 5 specific endodontic pathogens.
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Abstract
This article presents a review of materials currently used in the practice of endodontics. Current endodontic materials include those that have been thoroughly tested by scientific investigation, clinical usage, and time, as well as others that are the result of new knowledge in the field of dental materials. Article sections are devoted to obturation materials, sealers, irrigation materials, smear layer removal, root-end filling materials, and intracanal medicaments. Knowing the particular qualities of materials can aid the clinician in choosing those that are appropriate for a given situation. Properties, components, and rationale for the materials' use are presented to aid the clinician in choosing materials for a particular need.
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Affiliation(s)
- R Scott Gatewood
- Department of Endodontics, University of Mississippi School of Dentistry, 2500 North State Street, Jackson, MS 39216, USA.
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Bacteriologic investigation of the effects of sodium hypochlorite and chlorhexidine during the endodontic treatment of teeth with apical periodontitis. ACTA ACUST UNITED AC 2007; 104:122-30. [PMID: 17499528 DOI: 10.1016/j.tripleo.2007.01.027] [Citation(s) in RCA: 95] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2006] [Revised: 01/08/2007] [Accepted: 01/21/2007] [Indexed: 11/24/2022]
Abstract
OBJECTIVE This clinical study was undertaken to compare the effectiveness of 2.5% sodium hypochlorite (NaOCl) and 0.12% chlorhexidine digluconate as irrigants in reducing the cultivable bacterial populations in infected root canals of teeth with apical periodontitis. STUDY DESIGN According to stringent inclusion/exclusion criteria, 32 teeth with primary intraradicular infections and chronic apical periodontitis were selected and followed in the study. Bacterial samples were taken at the baseline (S1) and after chemomechanical preparation using either NaOCl (n = 16) or chlorhexidine (n = 16) as irrigants (S2). Cultivable bacteria recovered from infected root canals at the 2 stages were counted. Isolates from S2 samples were identified by means of 16S rRNA gene sequencing analysis. RESULTS At S1, all canals were positive for bacteria, and the median number of bacteria per canal was 7.32 x 10(5) for the NaOCl group and 8.5 x 10(5) for the chlorhexidine group. At S2, the median number of bacteria in canals irrigated with NaOCl and chlorhexidine was 2.35 x 10(3) and 2 x 10(2), respectively. Six of 16 (37.5%) canals from the NaOCl group and 8 of 16 (50%) canals from the chlorhexidine group yielded negative cultures. Chemomechanical preparation using either solution substantially reduced the number of cultivable bacteria in the canals. No significant difference was observed between the NaOCl and chlorhexidine groups with regard to the number of cases yielding negative cultures (P = .72) or quantitative bacterial reduction (P = .609). The groups irrigated with NaOCl or chlorhexidine showed a mean number of 1.3 and 1.9 cultivable species per canal, respectively. The great majority of isolates in S2 were from gram-positive bacteria, with streptococci as the most prevalent taxa. CONCLUSIONS The present findings revealed no significant difference when comparing the antibacterial effects of 2.5% NaOCl and 0.12% chlorhexidine used as irrigants during the treatment of infected canals.
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El Karim I, Kennedy J, Hussey D. The antimicrobial effects of root canal irrigation and medication. ACTA ACUST UNITED AC 2007; 103:560-9. [PMID: 17223590 DOI: 10.1016/j.tripleo.2006.10.004] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2006] [Revised: 06/17/2006] [Accepted: 10/04/2006] [Indexed: 10/23/2022]
Abstract
The role of microorganisms in the development and maintenance of pulpal and periapical inflammation have been well documented. The success of root canal treatment largely depends on the elimination of microbial contamination from the root canal system. Although mechanical instrumentation of root canals can reduce bacterial population, effective elimination of bacteria cannot be achieved without the use of antimicrobial root canal irrigation and medication. This review will discuss the antimicrobial effects of the known root canal irrigants and medicaments and explore future developments in the field.
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Affiliation(s)
- Ikhlas El Karim
- Department of Restorative Dentistry, School of Clinical Dentistry, Queen's University Belfast, Belfast, Northern Ireland.
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Siqueira JF, Paiva SSM, Rôças IN. Reduction in the cultivable bacterial populations in infected root canals by a chlorhexidine-based antimicrobial protocol. J Endod 2007; 33:541-7. [PMID: 17437868 DOI: 10.1016/j.joen.2007.01.008] [Citation(s) in RCA: 96] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2006] [Revised: 01/05/2007] [Accepted: 01/09/2007] [Indexed: 11/24/2022]
Abstract
The present clinical study was conducted to assess the bacterial reduction after chemomechanical preparation using 0.12% chlorhexidine digluconate solution as an irrigant and the additive antibacterial effect of intracanal dressing with calcium hydroxide (Ca(OH)(2)) associated with 0.12% chlorhexidine digluconate gel. According to stringent inclusion/exclusion criteria, 13 teeth with primary intraradicular infections and chronic apical periodontitis were selected and followed in the study. Bacterial samples were taken at the baseline (before treatment) (S1), after chemomechanical preparation using chlorhexidine (CHX) as an irrigant (S2), and after a 7-day dressing with Ca(OH)(2)/CHX paste (S3). Cultivable bacteria recovered from infected root canals at the three stages were counted and identified by means of 16S ribosomal RNA gene sequencing analysis. At S1, all canals were positive for bacteria, with the mean number of 3.5 taxa per canal (range, 2-9). At S2, 7 cases (53.8%) still harbored cultivable bacteria, with a mean number of 1.7 taxon per canal (range, 1-4). At S3, only one case (7.7%) was positive for the presence of bacteria. The great majority of taxa found in posttreatment samples were gram-positive bacteria. A significantly high reduction in bacterial counts was observed between S1 and S2 and S1 and S3 (p<0.001). Also, significant differences were observed for comparisons involving S2 and S3 samples with regard to both quantitative bacterial reduction (p=0.014) and number of cases yielding negative cultures (p=0.01). It was concluded that chemomechanical preparation with 0.12% CHX solution as an irrigant significantly reduced the number of intracanal bacteria but failed to render the canal free of cultivable bacteria in about one half of the cases. Application of a 7-day intracanal dressing with Ca(OH)(2)/CHX paste further increased significantly the number of cases yielding negative cultures.
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Affiliation(s)
- José F Siqueira
- Department of Endodontics, Faculty of Dentistry, Estácio de Sá University, Rio de Janeiro, RJ, Brazil.
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