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Alquria TA, Acharya A, Tordik P, Griffin I, Martinho FC. Impact of root canal disinfection on the bacteriome present in primary endodontic infection: A next generation sequencing study. Int Endod J 2024; 57:1124-1135. [PMID: 38700876 DOI: 10.1111/iej.14074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 04/05/2024] [Accepted: 04/08/2024] [Indexed: 07/03/2024]
Abstract
AIM To investigate the bacteriome present in teeth with primary endodontic infection (PEI) and apical periodontitis (AP) and to determine quantitatively and qualitatively the impact of chemomechanical preparation (CMP) using 2.5% sodium hypochlorite NAOCl on the bacteriome found in PEI with AP using the Illumina MiSeq platform. METHODOLOGY Thirty-six paired samples from 18 patients were successfully sequenced and analysed. Samples were collected at two sampling times: before (s1) and after (s2) CMP using 2.5% NaOCl. The DNA was extracted from s1 and s2 samples and quantified using quantitative PCR (qPCR). All 36 samples were sequenced using the Illumina MiSeq platform. Raw V3-V4 amplicon sequencing data were processed with the DADA2 pipeline to generate amplicon sequence variants (ASVs). Alpha diversity metrics representing abundance (Chao1) and diversity and evenness (Shannon, Simpson) were computed. The paired-sample Wilcoxon's test was used to compare alpha diversity metrics and qPCR counts between s1 and s2. The PERMANOVA method (with 999 permutations) was applied to compare community composition between sample types (s1 versus s2) and between patient IDs. ALDEx2 (ANOVA-like differential expression tool for high-throughput sequencing data) to investigate differentially abundant taxa between s1 and s2. A paired-sample Wilcoxon's test was used to compare alpha diversity metrics and qPCR counts between s1 and s2. RESULTS The qPCR counts were significantly higher in s1 compared to s2 (p = .0007). The Chao1 index indicated no difference in alpha diversity (p < .7019); whereas Shannon (p = .0056) and Simpson (p = .02685) indexes showed higher values in s2. The PERMANOVA test using Adonis2 showed a significant effect of sample time on community composition (R2 = .0630, p = .012). Patient ID also showed a significant effect on community composition (R2 = .6961, p = .001). At the genus level, Dialister, Mogibacterium, Prevotella, and Olsenella were differentially enriched at s1, while Actinomyces, Stenotrophomonas_unclassified, Enterococcus_unclassified, and Actinomyces_unclassified were differentially enriched in s2. CONCLUSION The bacteriome present in teeth with PEI with AP is complex and diverse. CMP using 2.5% NaOCl showed a high quantitatively and qualitatively disinfectant impact on the bacteriome present in PEI with AP.
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Affiliation(s)
- Theeb Abdullah Alquria
- Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, Maryland, USA
| | - Aneesha Acharya
- Department of Periodontics and Oral Implantology, Dr D.Y. Patil Dental College and Hospital, Dr D Y Patil Vidyapeeth, Pune, India
- Periodontology and Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong SAR
| | - Patricia Tordik
- Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, Maryland, USA
| | - Ina Griffin
- Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, Maryland, USA
| | - Frederico C Martinho
- Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, Maryland, USA
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Xiao S, Sun G, Huang S, Lin C, Li Y. Nanoarchitectonics-Based Materials as a Promising Strategy in the Treatment of Endodontic Infections. Pharmaceutics 2024; 16:759. [PMID: 38931881 PMCID: PMC11207628 DOI: 10.3390/pharmaceutics16060759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2024] [Revised: 05/19/2024] [Accepted: 05/29/2024] [Indexed: 06/28/2024] Open
Abstract
Endodontic infections arise from the interactive activities of microbial communities colonizing in the intricate root canal system. The present study aims to update the latest knowledge of nanomaterials, their antimicrobial mechanisms, and their applications in endodontics. A detailed literature review of the current knowledge of nanomaterials used in endodontic applications was performed using the PubMed database. Antimicrobial nanomaterials with a small size, large specific surface area, and high chemical activity are introduced to act as irrigants, photosensitizer delivery systems, and medicaments, or to modify sealers. The application of nanomaterials in the endodontic field could enhance antimicrobial efficiency, increase dentin tubule penetration, and improve treatment outcomes. This study supports the potential of nanomaterials as a promising strategy in treating endodontic infections.
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Affiliation(s)
- Suli Xiao
- Department of Endodontics, Stomatological Hospital of Xiamen Medical College, Xiamen 361003, China;
- Xiamen Key Laboratory of Stomatological Disease Diagnosis and Treatment, Xiamen 361003, China
| | - Guanwen Sun
- Department of Stomatology, Fujian Medical University Xiamen Humanity Hospital, Xiamen 361018, China;
| | - Shan Huang
- Department of Stomatology, Zhongshan Hospital Affiliated to Xiamen University, Xiamen 361005, China;
| | - Chen Lin
- Department of Endodontics, Stomatological Hospital of Xiamen Medical College, Xiamen 361003, China;
- Xiamen Key Laboratory of Stomatological Disease Diagnosis and Treatment, Xiamen 361003, China
| | - Yijun Li
- Department of Endodontics, Stomatological Hospital of Xiamen Medical College, Xiamen 361003, China;
- Xiamen Key Laboratory of Stomatological Disease Diagnosis and Treatment, Xiamen 361003, China
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3
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de Oliveira Neto RS, Souza TDM, Rosa SJ, Vivan RR, Alcalde MP, Honório HM, Duarte MAH. Biological response to endodontic treatment in one versus two-visit: a systematic review and meta-analysis of animal studies. Clin Oral Investig 2024; 28:173. [PMID: 38407663 DOI: 10.1007/s00784-024-05571-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 02/20/2024] [Indexed: 02/27/2024]
Abstract
OBJECTIVES To perform a systematic review of animal studies that compared the histopathological characteristics between teeth with apical periodontitis after endodontic treatment in one or two visits. MATERIALS AND METHODS This systematic review was registered on the International Prospective Register of Systematic Reviews (PROSPERO) - CRD42022340849. Studies were collected from PubMed/MEDLINE, LILACS, EMBASE, Livivo, SciELO, Web of Science, Scopus, and Cochrane Library and manual and gray literature searches. Animal studies that evaluated histological characteristics after endodontic treatment of teeth with apical periodontitis in one or two visits were included. Risk of bias analysis of the included studies was performed using the Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE) tool. Data synthesis of the included studies with quantitative data was performed, and meta-analysis was conducted with the Comprehensive Meta-Analysis software, using the random effects model and odds ratio (OR). RESULTS Eighteen studies met the inclusion criteria (Kappa = 0.891). Meta-analyses indicated values in inflammatory infiltrate intensity with effect size of 5.5% (95% CI: 0.020-0.148; p < 0.001), periodontal ligament thickness: 25.6% (95% CI: 0.134-0.487; p < 0.001), dentin resorption: 13% (95% CI: 0.015-1.141; p = 0.066), cementum resorption: 7.1% (95% CI: 0.015-0.325; p = 0.001), bone resorption: 1.4% (95% CI: 0.002-0.130; p < 0.001), mineralized tissue resorption: 42.8% (95% CI: 0.110-1.671; p = 0.222), biological apical sealing: 13.1% (95% CI: 0.055-0.314; p < 0.001), and presence of microorganisms: 10.3% (95% CI: 0.014-0.747; p = 0.025). CONCLUSIONS When considering animal studies, the two-visit endodontic treatment, using calcium hydroxide-based intracanal medication, resulted in better biological repair characteristics. CLINICAL RELEVANCE A two-visit endodontic treatment with calcium hydroxide-based intracanal medication yields superior histopathological outcomes.
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Affiliation(s)
- Raimundo Sales de Oliveira Neto
- Department of Operative Dentistry, Endodontics, and Dental Materials, Bauru School of Dentistry, University of São Paulo, Vila Universitária, Al. Octávio Pinheiro Brizolla 9-75, SP, Bauru, CEP: 17012-901, Brazil.
| | - Thais de Moraes Souza
- Department of Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo - USP, Bauru, Brazil
| | - Stefani Jovedi Rosa
- Department of Operative Dentistry, Endodontics, and Dental Materials, Bauru School of Dentistry, University of São Paulo, Vila Universitária, Al. Octávio Pinheiro Brizolla 9-75, SP, Bauru, CEP: 17012-901, Brazil
| | - Rodrigo Ricci Vivan
- Department of Operative Dentistry, Endodontics, and Dental Materials, Bauru School of Dentistry, University of São Paulo, Vila Universitária, Al. Octávio Pinheiro Brizolla 9-75, SP, Bauru, CEP: 17012-901, Brazil
| | - Murilo Priori Alcalde
- Department of Operative Dentistry, Endodontics, and Dental Materials, Bauru School of Dentistry, University of São Paulo, Vila Universitária, Al. Octávio Pinheiro Brizolla 9-75, SP, Bauru, CEP: 17012-901, Brazil
| | - Heitor Marques Honório
- Department of Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo - USP, Bauru, Brazil
| | - Marco Antonio Hungaro Duarte
- Department of Operative Dentistry, Endodontics, and Dental Materials, Bauru School of Dentistry, University of São Paulo, Vila Universitária, Al. Octávio Pinheiro Brizolla 9-75, SP, Bauru, CEP: 17012-901, Brazil
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Pessotti VP, Jiménez-Rojas LF, Alves FRF, Rôças IN, Siqueira JF. Post-treatment apical periodontitis associated with a missed root canal in a maxillary lateral incisor with two roots: A case report. AUST ENDOD J 2023; 49:380-385. [PMID: 35801358 DOI: 10.1111/aej.12657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 06/25/2022] [Indexed: 11/29/2022]
Abstract
Missed canals can be a common cause of persistent intraradicular infection and post-treatment apical periodontitis. This article reports on a rare case of a maxillary lateral incisor with two roots exhibiting symptomatic post-treatment apical periodontitis regardless of a radiographically adequate root canal treatment. The second root, which was only revealed by cone-beam computed tomography, had passed unnoticed during the first treatment, and its missed canal was the most likely cause of symptoms and treatment failure. Reintervention including the proper management of the extra root canal and retreatment of the main canal resulted in the resolution of symptoms and periradicular tissue healing. This case report reinforces the need for three-dimensional radiographic diagnosis to search for the cause of post-treatment disease and guide the decision-making process for proper management.
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Affiliation(s)
- Vanessa P Pessotti
- EndoChat Research Group, Rio de Janeiro, Brazil
- Private Practice, Vila Velha, Brazil
| | - Luis F Jiménez-Rojas
- EndoChat Research Group, Rio de Janeiro, Brazil
- Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, Brazil
| | - Flávio R F Alves
- Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, Brazil
- Department of Dental Research, Faculty of Dentistry, Iguaçu University (UNIG), Nova Iguaçu, Brazil
| | - Isabela N Rôças
- EndoChat Research Group, Rio de Janeiro, Brazil
- Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, Brazil
- Department of Dental Research, Faculty of Dentistry, Iguaçu University (UNIG), Nova Iguaçu, Brazil
| | - José F Siqueira
- EndoChat Research Group, Rio de Janeiro, Brazil
- Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, Brazil
- Department of Dental Research, Faculty of Dentistry, Iguaçu University (UNIG), Nova Iguaçu, Brazil
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Versiani MA, Martins J, Ordinola-Zapata R. Anatomical complexities affecting root canal preparation: a narrative review. Aust Dent J 2023; 68 Suppl 1:S5-S23. [PMID: 37984802 DOI: 10.1111/adj.12992] [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] [Accepted: 10/15/2023] [Indexed: 11/22/2023]
Abstract
A fundamental aspect of the Endodontic field is the knowledge of root canal anatomy. Using a variety of techniques, the internal and external anatomy of teeth have been extensively investigated throughout the past century. Recent improvements in three-dimensional computed tomography have enabled more detailed evaluations of root canal morphology in both clinical and laboratory settings. Essentially, researches have unveiled that the root canal constitutes a complex system, comprising not only the main root canal but also lateral components, including isthmuses, fins, accessory canals and apical ramifications. Undoubtedly, this intricate morphology poses a significant challenge when it comes to the process of shaping, cleaning and disinfecting the root canal system. This article aims to explore the anatomical aspects of the root canal system that impact the chemomechanical procedures.
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Affiliation(s)
- M A Versiani
- Dental Specialty Center, Brazilian Military Police, Belo Horizonte, Brazil
| | - Jnr Martins
- Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
- Grupo de Investigação em Bioquímica e Biologia Oral, Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
- Centro de Estudo de Medicina Dentária Baseada na Evidência (CEMDBE) - Cochrane Portugal, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
| | - R Ordinola-Zapata
- Endodontic Division, Department of Restorative Sciences, University of Minnesota School of Dentistry, Minneapolis, Minnesota, USA
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Gulabivala K, Ng YL. Factors that affect the outcomes of root canal treatment and retreatment-A reframing of the principles. Int Endod J 2023; 56 Suppl 2:82-115. [PMID: 36710532 DOI: 10.1111/iej.13897] [Citation(s) in RCA: 27] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 01/24/2023] [Accepted: 01/25/2023] [Indexed: 01/31/2023]
Abstract
This paper undertakes a broad and comprehensive synthesis of relevant clinical, biological, biomechanical, technical and healthcare services data to understand the factors affecting outcomes of periapical healing after root canal (re)treatment. The medical and dental evidence-based era (1980-present) is contextualized with the earlier evidence drive in endodontics (1911-1940) triggered by the focal infection era. The current evidence-based approach has a sharper focus on evidence quality and derivation of practice guidelines. Contrary views question whether guideline-driven, or expertise-development-driven endeavours would best serve outcome improvement in society. The endodontic discipline functions in a broad healthcare framework and sustains industrial, economic and trend pressures that may be deemed to influence outcomes. The nature of root canal treatment and the challenges in determining the factors that affect its outcomes is discussed. The factors potentially affecting periapical healing after root canal treatment are classified into pre-operative, intra-operative and postoperative groups. These categories subsume multiple elements with interactive influences, creating a complex picture, further confounded by some apparently surprising, counter-intuitive and contradictory findings. The technical versus biological conundrum in root canal treatment continues to cause cognitive dissonance. However, due reflection and cross-discipline-synthesis resolve the apparent data conflicts into a very simple, consistent and plausible picture of how root canal treatment works and the key factors that affect periapical healing. Root canal retreatment is considered mainly in the context of its differences from primary treatment as the majority of factors influencing outcomes are common to both. The exceptional difference is that retreatments have a proportionately reduced probability of healing by virtue of compromised apical root canal ramification access or modified host/infection interactions. Root canal (re)treatment outcomes are dominantly influenced by the nature of prior dynamic host/infection interaction (pre-operative patient factors) and how the direction of this dynamic is influenced by two factors: (1) the active efficacy of the operators' root canal treatment protocol to sustain a microbial ecological shift (intra-operative treatment factors) and dampen periapical inflammation; and (2) the passive ability of the functional tooth (and its restoration margin) to maintain its integrity to resist infection reversal (postoperative restorative factors).
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Affiliation(s)
- Kishor Gulabivala
- Unit of Endodontology, Department of Restorative Dentistry, UCL Eastman Dental Institute, University College London, London, UK
| | - Yuan Ling Ng
- Unit of Endodontology, Department of Restorative Dentistry, UCL Eastman Dental Institute, University College London, London, UK
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7
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Almeida GM, Carvalho VHM, Silva ÉBP, Cançado MAF, Barroso LS, Queiroz EL, An TL, Ribeiro APD, Carvalho-Junior JR, Leite AF. Periradicular repair after single- and two-visit root canal treatments using ultrasonic irrigant activation and calcium hydroxide dressing of teeth with apical periodontitis: study protocol for randomized controlled trials. Trials 2023; 24:23. [PMID: 36635764 PMCID: PMC9838070 DOI: 10.1186/s13063-022-07030-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 12/16/2022] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND In certain clinical situations, root canal treatment in teeth with apical periodontitis is performed in multiple visits, with the use of intracanal dressing between visits, aiming to reduce microorganisms and their by-products of the root canal system prior to filling. However, in recent years, discussions have been growing about the real need for the use of intracanal dressing in these cases. The use of ultrasonic activation of the auxiliary chemical substance has increased the potential for decontamination promoted during the chemomechanical preparation of the root canal. Thus, this study is designed to explore whether the use of intracanal dressing between visits during endodontic treatment favors periradicular repair in teeth with apical periodontitis. METHODS This is a randomized, prospective, double-blinded, controlled clinical trial designed to evaluate 3 distinct clinical approaches used during endodontic therapy: group 1-root canal treatment in a single visit (RCT-SV); group 2-root canal treatment in two visits with intracanal dressing (RCT-TVWD); and group 3-root canal treatment in two visits without intracanal dressing (RCT-TVWOD). A total of 150 adult patients aged 18 to 60, with at least one tooth diagnosed with asymptomatic apical periodontitis and periradicular lesion (confirmed with a cone beam computed tomography (CBCT)), will be randomized and will undergo one of the types of clinical approaches during endodontic therapy. Patients' postoperative pain levels will also be recorded in periods of 24, 48, and 72 h and 7 days. Subsequently, clinical findings and long-term follow-up evaluations, with periradicular repair, will be performed at 6 and 12 months by intraoral periapical radiograph (IOPAR) and CBCT at the 24-month follow-up. DISCUSSION This study will evaluate the periradicular repair of mandibular molar teeth with apical periodontitis, providing information about the efficacy, benefits, and safety of performing the endodontic treatment in a single and two visits, with and without the use of calcium hydroxide dressing. All endodontic therapy procedures will be performed under a dental operating microscope and using ultrasonic activation of auxiliary chemical substances. These results may contribute to changes in the clinical approaches adopted during endodontic therapy of teeth with apical periodontitis and reveal the potential of complementary approaches that aim to enhance the decontamination of the root canal system during the preparation stage. TRIAL REGISTRATION ClinicalTrials.gov NCT05256667. Registered on 24 February 2022.
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Affiliation(s)
- Gustavo M. Almeida
- grid.7632.00000 0001 2238 5157Postgraduate Program in Health Sciences, College of Health Sciences, University of Brasilia, Brasilia, Brazil
| | - Vitor Hugo M. Carvalho
- grid.7632.00000 0001 2238 5157Postgraduate Program in Health Sciences, College of Health Sciences, University of Brasilia, Brasilia, Brazil
| | - Érika B. P. Silva
- grid.7632.00000 0001 2238 5157Dental Trauma Project of Department of Dentistry, College of Health Sciences, University of Brasilia, Brasilia, Brazil
| | - Marco Antonio F. Cançado
- grid.7632.00000 0001 2238 5157Dental Trauma Project of Department of Dentistry, College of Health Sciences, University of Brasilia, Brasilia, Brazil
| | - Leonardo S. Barroso
- grid.412286.b0000 0001 1395 7782Postgraduate Program in Endodontics, University of Taubaté, Taubaté, Brazil
| | - Erica L. Queiroz
- grid.137628.90000 0004 1936 8753Department of Cariology and Comprehensive Care, New York University College of Dentistry, New York, USA
| | - Tien Li An
- grid.7632.00000 0001 2238 5157Department of Dentistry, College of Health Sciences, University of Brasilia, Brasilia, Brazil
| | - Ana Paula D. Ribeiro
- grid.15276.370000 0004 1936 8091Department of Restorative Dental Sciences, Division of Operative Dentistry, College of Dentistry, University of Florida, Gainesville, USA
| | - Jacy R. Carvalho-Junior
- grid.7632.00000 0001 2238 5157Dental Trauma Project of Department of Dentistry, College of Health Sciences, University of Brasilia, Brasilia, Brazil ,grid.7632.00000 0001 2238 5157Department of Dentistry, College of Health Sciences, University of Brasilia, Brasilia, Brazil
| | - André F. Leite
- grid.7632.00000 0001 2238 5157Postgraduate Program in Health Sciences, College of Health Sciences, University of Brasilia, Brasilia, Brazil ,grid.7632.00000 0001 2238 5157Department of Dentistry, College of Health Sciences, University of Brasilia, Brasilia, Brazil
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8
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Pereira RS, Guerra RC, Hochuli-Vieira E, Alves FRF. Cavernous sinus thrombosis followed by brain ischaemia in a type-1 diabetic patient: a persistent endodontic infection report. AUST ENDOD J 2022; 48:510-514. [PMID: 34637565 DOI: 10.1111/aej.12579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 08/12/2021] [Accepted: 09/26/2021] [Indexed: 12/14/2022]
Abstract
Central nervous system infections and cavernous sinus thrombosis are associated with high mortality rates and may be a consequence of oral infection propagation. A 24-year-old woman has attended a private dental office with a pain complaint in the upper right central incisor and had the endodontic treatment completed. However, the patient returned to the dental office reporting pain in the same tooth and the presence of swelling. Then, the root canal was retreated. After one week, the patient presented to a Basic Health Unit with a history of vomiting and convulsion crisis followed by loss of consciousness. A computed tomography exam showed cavernous sinus thrombosis and brain ischaemic areas. The present report describes a rare case of cavernous sinus thrombosis followed by brain ischaemia in a type-1 diabetic patient, associated with persistent endodontic infection, with subsequent patient's death.
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Affiliation(s)
- Rodrigo S Pereira
- Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, Brazil
| | - Raphael C Guerra
- LeFort Hospital, São Paulo, Brazil.,Metodista University, São Bernardo do Campo, São Paulo, Brazil
| | | | - Flávio R F Alves
- Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, Brazil
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9
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Rôças IN, Provenzano JC, Neves MS, Alves FR, Gonçalves LS, Siqueira JF. Effects of calcium hydroxide paste in different vehicles on bacterial reduction during treatment of teeth with apical periodontitis. J Endod 2022; 49:55-61. [DOI: 10.1016/j.joen.2022.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 09/29/2022] [Accepted: 10/14/2022] [Indexed: 11/07/2022]
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10
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Ersahan S, Hepsenoglu YE. Microbial analysis of endodontic infections in teeth with post-treatment apical periodontitis before and after medication. AUST ENDOD J 2022; 49:75-86. [PMID: 35239214 DOI: 10.1111/aej.12613] [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: 11/13/2021] [Accepted: 02/13/2022] [Indexed: 11/24/2022]
Abstract
This study aimed to determine the intraradicular microbiota of previously root canal-treated teeth with apical periodontitis and to investigate the antibacterial effectiveness of different intracanal medicaments. Sixteen patients with post-treatment apical periodontitis were allocated into two groups according to the intracanal medicament used: calcium hydroxide (CH) and 2% chlorhexidine gluconate gel (CHX) group. Total bacterial loads, as well as the amount of Enterococcus faecalis (E. faecalis) were determined before (S1) and after (S2) chemomechanical preparation and finally, after intracanal medication (S3) by means of ddPCR. The unpaired t test was used to compare parametric. S3-total bacteria copy number of the CH group was lower than the CHX group (p < 0.05). There was no statistical difference between the CHX- and the CH groups in terms of E.faecalis copy number (p > 0.05). But in terms of total bacteria, CH is better than CHX. Consequently, CH can be used to optimise the antibacterial efficiency of chemomechanical preparation in previously root canal-treated teeth with apical periodontitis.
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Affiliation(s)
- Seyda Ersahan
- Faculty of Dentistry, Department of Endodontics, Istanbul Medipol University, Istanbul, Turkey
| | - Yelda Erdem Hepsenoglu
- Faculty of Dentistry, Department of Endodontics, Istanbul Medipol University, Istanbul, Turkey
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11
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Radioimaging in the Evaluation of the Therapeutic Effect of the Vegetable Extract Obtained from Epilobium Parviflorum Schreb. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12030998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
For years, apical microleakage has been considered the main factor in endodontic failure therapy. Sealing abilities and antibacterial properties of root canal sealers and intracanal medicaments between appointments have been recognized as important factors for the success of endodontic treatment. Background: Apical periodontitis (AP) is an inflammatory disease around the apex of a tooth root. The microorganisms reach the pulp by dentinal tubules especially when there is an open cavity after a coronal fracture and the pulp is in contact with the septic oral environment. The aim of the study was to evaluate the dynamics of healing by recording periapical index (PAI), after two appointment endodontic procedure with commercial or experimental intracanal medicament. Methods: A total of 40 patients with primary chronic apical periodontitis requiring root canal treatment were assigned randomly into four groups according to the teeth medicated with dehydrated plant extract, calcium hydroxide, calcium hydroxide mixed with chlorhexidine (CHX) gel 2%, Walkhoff paste and obturated on a second visit, 7 days later. Patients were recalled at intervals of 3, 6, and 12 months to evaluate the treated teeth both clinically and radiographically for periapical healing. A 5-score scale PAI was used to evaluate stages of the periapical healing on a periapical radiography using a Kodak Dental imaging software provided by the radio-imagistic center. Results: Radiological evaluation revealed that the experimental intracanal medicament had a cumulative positive healing capacity by reducing the PAI as well as all resorbable pastes used in endodontic conventional therapy. Conclusions: The results suggest that the vegetable dry extract obtained from Epilobium parviflorum Schreb can be used as an inter-appointment medication among with the root canal filling for the positive effect on apical healing quantified by reducing the PAI.
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12
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GC/MS Profiling and Ex Vivo Antibacterial Activity of Salvadora persica (Siwak) against Enterococcus faecalis as Intracanal Medicament. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2021:6333867. [PMID: 34987597 PMCID: PMC8723863 DOI: 10.1155/2021/6333867] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 12/03/2021] [Accepted: 12/09/2021] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Salvadora persica L. (S. persica, Siwak) has been used for many centuries as oral hygiene tools, particularly in Saudi Arabia. This study aimed to assess the effectiveness of S. persica petroleum ether extract (SPE) as an intracanal bactericidal for endodontic treatment against Enterococcus faecalis. Calcium hydroxide Ca(OH)2 gold standard intracanal medicament was used for comparison. METHODS The gas chromatography mass spectrometry (GC/MS) analysis was carried out to identify the components of SPE. First, the consistency of SPE was accomplished according to ANSI/ADA specification no 57. Forty-five single-rooted mandibular premolars were infected with that of E. faecalis suspension. Colony-forming units (CFU) were counted before the medicaments' application (CFU-1) and after seven days of their applications (CFU-2). Group I: SPE, Group II: positive control Ca(OH)2, and Group III: saline solution negative control. The microdilution method was applied to determine minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) of SPE. RESULTS Thirty-two compounds were identified (89.09%), with main components of benzyl isothiocyanate (BITC) (33.32%) and steroids (34%). CFU before and after using SPE and Ca(OH)2 recorded a statistically significant reduction in bacterial count (P=0.006) and (P=0.01), respectively. There was an insignificant difference between CFU after using SPE and Ca(OH)2 (P=0.210). On the contrary, comparing both medicaments with the negative control saline group resulted in significant differences, (P=0.001) and (P=0.007), respectively. Moreover, the equality of minimum bactericidal concentration (MBC) and minimum inhibitory concentration (MIC) of SPE is recorded. CONCLUSION This finding could be referred to the high content of bactericidal BITC in synergism with other antimicrobial components, representing 70.71% of SPE. Thus, SPE is a good candidate as an intracanal medicament, which warrants further investigation.
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Zan R, Topcuoglu HS, Hubbezoglu I, Gorler O, Altunbas D, Ayhan M. Effect of different irrigation activation methods on non-infected dentinal tubule penetration of medicaments: A CLSM study. Niger J Clin Pract 2022; 25:895-902. [DOI: 10.4103/njcp.njcp_1932_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]
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14
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Siqueira JF, Rôças IN, Hernández SR, Brisson-Suárez K, Baasch AC, Pérez AR, Alves FRF. Dens invaginatus: clinical implications and antimicrobial endodontic treatment considerations. J Endod 2021; 48:161-170. [PMID: 34902355 DOI: 10.1016/j.joen.2021.11.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 10/27/2021] [Accepted: 11/29/2021] [Indexed: 02/07/2023]
Abstract
Dens invaginatus or dens in dente is a developmental dental anomaly resulting from an invagination of the enamel organ into the dental papilla during odontogenesis. Radiographically, it is usually seen as a radiolucent invagination surrounded by a radiopaque area (enamel) limited to the tooth crown or extending into the root. Because the invagination is opened to the oral cavity, it can retain saliva, food remnants, and bacteria. In conditions that the enamel lining of the invagination is naturally absent or lost due to caries, bacterial cells and products can diffuse from the invagination through the dentin tubules to reach the pulp and cause disease. Management of teeth with dens invaginatus include preventive sealing or filling of the invagination, or, if the pulp is affected, therapeutical options include vital pulp therapy, nonsurgical root canal treatment, apexification or regenerative endodontic procedures, periradicular surgery, intentional replantation, or extraction. It is recommended that the invagination be always approached, regardless of the type of dens invaginatus. The root canal should be treated whenever the pulp is irreversibly inflamed or necrotic. Endodontic management of teeth with dens invaginatus is often tricky because of its anatomical complexity, and special and customized strategies should be devised. This review discusses the endodontic implications of this anomaly and the current treatment recommendations based on anatomic, pathologic, and technologic considerations.
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Affiliation(s)
- José F Siqueira
- Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, RJ, Brazil; Department of Dental Research, Faculty of Dentistry, Iguaçu University (UNIG), Nova Iguaçu, RJ, Brazil; Endochat research group, Rio de Janeiro, RJ, Brazil
| | - Isabela N Rôças
- Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, RJ, Brazil; Department of Dental Research, Faculty of Dentistry, Iguaçu University (UNIG), Nova Iguaçu, RJ, Brazil; Endochat research group, Rio de Janeiro, RJ, Brazil
| | - Sandra R Hernández
- Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, RJ, Brazil; Endochat research group, Rio de Janeiro, RJ, Brazil; Department of Endodontics, Francisco Marroquín University, Guatemala City, Guatemala
| | - Karen Brisson-Suárez
- Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, RJ, Brazil; Endochat research group, Rio de Janeiro, RJ, Brazil
| | - Alessandra C Baasch
- Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, RJ, Brazil; Endochat research group, Rio de Janeiro, RJ, Brazil; Department of Endodontics, Santa María University, Caracas, Venezuela
| | - Alejandro R Pérez
- Department of Dental Research, Faculty of Dentistry, Iguaçu University (UNIG), Nova Iguaçu, RJ, Brazil; Endochat research group, Rio de Janeiro, RJ, Brazil; Department of Endodontics, University Rey Juan Carlos. Madrid, Spain
| | - Flávio R F Alves
- Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, RJ, Brazil; Department of Dental Research, Faculty of Dentistry, Iguaçu University (UNIG), Nova Iguaçu, RJ, Brazil.
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Activity of Two Antimicrobial Peptides against Enterococcus faecalis in a Model of Biofilm-Mediated Endodontic Infection. Antibiotics (Basel) 2021; 10:antibiotics10101220. [PMID: 34680801 PMCID: PMC8532894 DOI: 10.3390/antibiotics10101220] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 09/28/2021] [Accepted: 10/01/2021] [Indexed: 11/16/2022] Open
Abstract
Enterococcus faecalis is a common cause of biofilm-associated opportunistic infections, which are often difficult to treat. The formation of E. faecalis biofilms on the dentinal walls of the root canal is frequently the cause of endodontic treatment failure and secondary apical periodontitis. In a preliminary work, two recognized antifungal peptides, KP and L18R, showed antibacterial activity against planktonic E. faecalis cells at micromolar concentrations. Moreover, L18R proved to reduce the biomass in the early stage of E. faecalis biofilm development on polystyrene plates, while a qualitative biofilm inhibition was demonstrated on hydroxyapatite disks by confocal laser scanning microscopy (CLSM). The aim of this study was to better characterize the effect of both peptides on E. faecalis biofilm. A reduction in metabolic activity after peptide treatment was detected by Alamar Blue assay, while a remarkable impairment in the architecture of E. faecalis biofilms on hydroxyapatite disks, along with a significant reduction in viable bacteria, was caused mostly by L18R, as assessed by CLSM and scanning electron microscopy. The lack of cytotoxicity of the investigated peptides against L929 murine fibroblasts was also determined. Obtained results suggest L18R as a promising candidate for the development of new strategies for endodontic infection control.
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Jain RN, Abraham S, Karad RR, Najan HB, Vaswani SD, Torris A. Micro-computed tomographic analysis of the marginal adaptation of a calcium silicate-based cement to radicular dentin after removal of three different intracanal medicaments - An in vitro study. J Conserv Dent 2021; 23:598-603. [PMID: 34083916 PMCID: PMC8095688 DOI: 10.4103/jcd.jcd_561_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 12/13/2020] [Accepted: 12/29/2020] [Indexed: 11/04/2022] Open
Abstract
Context This study focuses on the marginal adaptation of a calcium silicate-based cement to the root dentin after retrieval of different intracanal medicaments. Aim This study compared the marginal adaptation of a calcium silicate-based cement to radicular dentin in the apical third of the root canal following the use of three different intracanal medicaments. Materials and Methods Forty single-rooted premolar teeth (n = 40) were decoronated 13 mm above the root apices; then, 3 mm of the root tips were resected to standardize the root length. Orthograde cleaning and shaping were done using the rotary files and apical enlargement using peeso reamers. Depending on the intracanal medicament used, the samples were equally divided into four groups: Group 1 - control, Group 2 - Metapex, Group 3 - triple antibiotic paste (TAP), and Group 4 - calcium hydroxide with Propolis. Subsequently, the medicament was removed and a 3 mm apical barrier of BiodentineTM was placed and later scanned using an ex vivo micro-computed tomography scanner. Statistical Analysis Used One-way ANOVA F-test and Tukey's post hoc test were used. Results Maximum adaptation was seen in control group (0.65) > Propolis (1.47) > TAP (4.37) > Metapex (5.25); a high statistically significant difference between the four groups was found (P < 0.001) with regard to the external voids between BiodentineTM and radicular dentin. Conclusion On comparison of the marginal adaptation of Biodentine to root canal dentin following the use of three different intracanal medicaments, maximum adaptation was seen in Group 1, followed by Group 4, Group 3, and Group 2.
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Affiliation(s)
- Ruchika Nirmal Jain
- Department of Conservative Dentistry and Endodontics, SMBT Dental College and Hospital, Sangamner, Maharashtra, India
| | - Sathish Abraham
- Department of Conservative Dentistry and Endodontics, SMBT Dental College and Hospital, Sangamner, Maharashtra, India
| | - Rohini Ramesh Karad
- Department of Conservative Dentistry and Endodontics, SMBT Dental College and Hospital, Sangamner, Maharashtra, India
| | - Harshal Balasaheb Najan
- Department of Conservative Dentistry and Endodontics, SMBT Dental College and Hospital, Sangamner, Maharashtra, India
| | - Sneha Dhruvkumar Vaswani
- Department of Conservative Dentistry and Endodontics, SMBT Dental College and Hospital, Sangamner, Maharashtra, India
| | - Arun Torris
- Polymer Science and Engineering Division, CSIR-National Chemical Laboratory, Pune, Maharashtra, India
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17
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Penha da Silva PJ, Marceliano-Alves MF, Provenzano JC, Dellazari RLA, Gonçalves LS, Alves FRF. Quality of Root Canal Filling Using a Bioceramic Sealer in Oval Canals: A Three-Dimensional Analysis. Eur J Dent 2021; 15:475-480. [PMID: 33535249 PMCID: PMC8382469 DOI: 10.1055/s-0040-1722095] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Objectives
The oval canals may be associated with inadequate debridement, which can affect the quality of the root canal filling, thus the treatment outcome. The aim of the present work was to compare the quality of oval canals fillings using EndoSequence BC sealer with the single-cone technique or cold lateral compaction.
Materials and Methods
Thirty-eight human single-rooted premolars with oval canals were instrumented to 1 mm from the apical foramen with hand nickel–titanium files, followed by circumferential filing with Hedstrom files. Teeth were paired into two groups based on their micro-computed tomography (CT) morphological parameters. Both groups were filled using EndoSequence BC sealer. The first used a single cone and the other with the cold lateral compaction technique. The voids volume was evaluated by micro-CT and the percentage was calculated for the total length and for the apical 5 mm of each canal. The Mann–Whitney U test was used to assess whether the surface area and obturation length differed significantly between the groups and to compare the percentage of voids for each technique.
Results
Both techniques resulted in less than 16% voids, with no statistically significant difference between them for the total canal length and for the apical 5 mm (
p
> 0.05).
Conclusions
The quality of the obturation performed with the single-cone technique was similar to that achieved with lateral compaction using EndoSequence BC sealer in oval canals.
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Affiliation(s)
| | | | | | | | | | - Flávio R F Alves
- Department of Endodontics, Iguaçu University, Nova Iguaçu, Brazil
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18
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Xiong B, Shirai K, Matsumoto K, Abiko Y, Furuichi Y. The potential of a surface pre-reacted glass root canal dressing for treating apical periodontitis in rats. Int Endod J 2020; 54:255-267. [PMID: 32961600 DOI: 10.1111/iej.13414] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 09/14/2020] [Indexed: 12/27/2022]
Abstract
AIM To evaluate the efficacy of a prototype root canal dressing containing surface pre-reacted glass-ionomer (S-PRG) fillers on repairing induced periapical lesions in a rat model. Calcium hydroxide [Ca(OH)2 ] was applied as a comparison in the healing process. METHODOLOGY The pulp chambers of the maxillary first molars in 64 male Wistar rats aged 16 weeks were opened to induce periapical lesions. After 28 days, the mesial canal of each tooth was prepared, irrigated with 2.5% sodium hypochlorite only (control group: irrigation) or followed by the respective dressing [Ca(OH)2 group, irrigation + Ca(OH)2 ; S-PRG group, irrigation + S-PRG] and restored with composite resin for 3 or 7 days (10/group). Four rats with healthy molars were used as blank controls. Descriptive analysis of the periapical radiographs, haematoxylin and eosin staining and immunohistochemical observation was performed 3 and 7 days after treatment. The periapical grey value, CD68 macrophages and osteoclasts (cathepsin-K) were quantified and statistically analysed with Tukey's honest significant difference test. A significant difference was achieved when P values were <0.05. RESULTS S-PRG and Ca(OH)2 dressings were associated with increased periapical grey values and inhibited osteoclast activity at 3 and 7 days; a significant difference in radiographic results and the number of osteoclasts was obtained at 3 and 7 days compared with the control group (P < 0.05). Reparative tissue was observed histologically in the space of the periapical resorbed necrotic area after S-PRG and Ca(OH)2 treatment for 3 and 7 days. The number of macrophages was significantly decreased at 3 and 7 days in the S-PRG and Ca(OH)2 specimens when compared with the controls (P < 0.05). CONCLUSIONS In a rat experimental model, the S-PRG root canal dressing was comparable to Ca(OH)2 in promoting the healing of experimentally induced periapical lesions. S-PRG paste has the potential to be used as an alternative intracanal dressing in teeth with apical periodontitis.
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Affiliation(s)
- B Xiong
- Division of Periodontology and Endodontology, Department of Oral Rehabilitation, School of Dentistry, Health Sciences University of Hokkaido, Hokkaido, Japan
| | - K Shirai
- Division of Periodontology and Endodontology, Department of Oral Rehabilitation, School of Dentistry, Health Sciences University of Hokkaido, Hokkaido, Japan
| | - K Matsumoto
- Division of Periodontology and Endodontology, Department of Oral Rehabilitation, School of Dentistry, Health Sciences University of Hokkaido, Hokkaido, Japan
| | - Y Abiko
- Division of Oral Medicine and Pathology, Department of Human Biology and Pathophysiology, School of Dentistry, Health Sciences University of Hokkaido, Hokkaido, Japan
| | - Y Furuichi
- Division of Periodontology and Endodontology, Department of Oral Rehabilitation, School of Dentistry, Health Sciences University of Hokkaido, Hokkaido, Japan
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Huang GTJ, Liu J, Zhu X, Yu Z, Li D, Chen CA, Azim AA. Pulp/Dentin Regeneration: It Should Be Complicated. J Endod 2020; 46:S128-S134. [PMID: 32950184 DOI: 10.1016/j.joen.2020.06.020] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Stem cell-mediated regenerative endodontics has reached the human clinical trial phase; however, many issues still exist that prevent such technology to be a widely used clinical practice. These issues are not straightforward and are complicated. They should be because pulp regeneration is dealing with a small dead-end space. In addition, when regeneration is needed, the space is often heavily infected. The true standard of pulp regeneration should be everything except generation of some fibrous connective tissue and amorphous mineral deposit. As of now, we are still far short of reaching the standard of complete vascularized and innervated pulp regeneration with newly formed tubular dentin in all types of teeth. Thus, we need to go back to the bench and use established animal models or create new animal models to tackle those issues. This article will address several key issues including the possibility of pulp regeneration in small canals of molar teeth by enhancing the neovascularization, and whether the organized tubular dentin can be generated on the canal walls. Data from our semi-orthotopic tooth fragment mouse model have shown that complete pulp regeneration using dental pulp stem cells (DPSCs) in small canal has been inconsistent because of limited blood supply. This inconsistency is similar in our orthotopic miniature swine model, although in some cases vascularized pulp-like tissue can be formed throughout the canal space after DPSC transplantation. Furthermore, no tubular dentin was observed in the orthotopic pulp regeneration, despite the fact that DPSCs have the capacity to generate some tubular dentin-like structure in the hydroxyapatite/tricalcium phosphate-mediated ectopic pulp/dentin formation model in mice. Potential strategies to be tested to address these regeneration issues are discussed herein.
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Affiliation(s)
- George T-J Huang
- University of Tennessee Health Science Center, College of Dentistry, Department of Bioscience Research, Memphis, Tennessee.
| | - Jie Liu
- University of Tennessee Health Science Center, College of Dentistry, Department of Bioscience Research, Memphis, Tennessee
| | - Xiaofei Zhu
- University of Tennessee Health Science Center, College of Dentistry, Department of Bioscience Research, Memphis, Tennessee; VIP Dental Service and Geriatric Dentistry, School and Hospital of Stomatology, Peking University, Beijing, China
| | - Zongdong Yu
- University of Tennessee Health Science Center, College of Dentistry, Department of Bioscience Research, Memphis, Tennessee
| | - Dong Li
- University of Tennessee Health Science Center, College of Dentistry, Department of Bioscience Research, Memphis, Tennessee
| | - Chao-An Chen
- University of Tennessee Health Science Center, College of Dentistry, Department of Bioscience Research, Memphis, Tennessee; Chi Mei Medical Center, Department of Endodontics, Liouying, Tainan, Taiwan
| | - Adham A Azim
- University of Tennessee Health Science Center, College of Dentistry, Department of Bioscience Research, Memphis, Tennessee; University at Buffalo, School of Dental Medicine, Division of Endodontics, Buffalo, New York
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20
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Dewi A, Upara C, Krongbaramee T, Louwakul P, Srisuwan T, Khemaleelakul S. Optimal antimicrobial concentration of mixed antibiotic pastes in eliminating Enterococcus faecalis from root dentin. AUST ENDOD J 2020; 47:273-280. [PMID: 32914516 DOI: 10.1111/aej.12437] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Revised: 07/02/2020] [Accepted: 08/08/2020] [Indexed: 11/28/2022]
Abstract
This study aims to identify the optimal concentrations of triple antibiotic paste (TAP), modified triple antibiotic paste (mTAP) and double antibiotic paste (DAP) that could completely eradicate Enterococcus faecalis in dentinal tubules. One hundred and ninety extracted human premolars inoculated with E. faecalis were medicated with calcium hydroxide and mixed antibiotic pastes (TAP, mTAP and DAP at 0.1, 1.25, 5, 10 and 20 mg mL-1 of each drug) for seven days before being frozen, pulverised and cultured. Specimens treated with the lowest concentration of the mixed antibiotics capable of eradicating E. faecalis were examined using scanning electron and confocal laser scanning microscopy to confirm the eradication of the microbial. TAP at 10 mg mL-1 of each drug was able to completely eliminate bacteria inside dentinal tubules, whereas mTAP and DAP required 20 mg mL-1 of each drug. Calcium hydroxide was not effective in eradicating E. faecalis inside dentinal tubules.
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Affiliation(s)
- Anat Dewi
- Division of Endodontics, Department of Restorative Dentistry and Periodontology, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand
| | - Chawin Upara
- School of Dentistry, Mae Fah Luang University, Chiang Rai, Thailand
| | - Tadkamol Krongbaramee
- Division of Endodontics, Department of Restorative Dentistry and Periodontology, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand
| | - Phumisak Louwakul
- Division of Endodontics, Department of Restorative Dentistry and Periodontology, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand
| | - Tanida Srisuwan
- Division of Endodontics, Department of Restorative Dentistry and Periodontology, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand
| | - Saengusa Khemaleelakul
- Division of Endodontics, Department of Restorative Dentistry and Periodontology, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand
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Amaral RR, Guimarães Oliveira AG, Braga T, Reher P, de Macêdo Farias L, Magalhães PP, Ferreira PG, Ilma de Souza Côrtes M. Quantitative Assessment of the Efficacy of Two Different Single-file Systems in Reducing the Bacterial load in Oval-Shaped Canals: A Clinical Study. J Endod 2020; 46:1228-1234. [PMID: 32653532 DOI: 10.1016/j.joen.2020.06.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 06/09/2020] [Accepted: 06/10/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION This randomized clinical study compared the in vivo antibacterial efficacy of Reciproc Blue (RB), XP-endo Shaper (XP-S), and XP-endo Shaper associated with XP-endo Finisher (XP-F) systems in infected oval-shaped root canals with primary apical periodontitis. METHODS In this study, 28 human teeth with a single root and a single canal were randomly assigned to 2 groups according to the instrumentation technique: group 1, RB (n = 14) and group 2, XP-endo (XP-S and XP-F, n = 14). The single-rooted teeth were prepared by reciprocating and rotary nickel-titanium instruments with 5.25% sodium hypochlorite irrigation. Samples were collected from the canal at the baseline (S1), after chemomechanical preparation (S2), and after XP-F instrumentation (S3). The DNA extracts were subjected to quantitative analysis for total bacterial counts by quantitative real-time polymerase chain reaction. The data were analyzed using the analysis of variance test, and the level of significance was set at 5%. RESULTS All samples tested positive for the presence of bacteria at baseline, and the bacterial counts substantially reduced after treatment procedures (P < .01). The results showed no statistical difference between RB and XP-S instrumentation with respect to the bacterial reduction (P > .05). A marked bacterial reduction was observed after the use of the XP-F instrument (P < .01). CONCLUSIONS The XP-S and RB systems sharply reduced the bacterial load in oval-shaped root canals with primary apical periodontitis. XP-F used as a supplementary instrument to chemomechanical preparation promoted a significantly higher bacterial reduction.
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Affiliation(s)
- Rodrigo Rodrigues Amaral
- School of Dentistry and Oral Health Griffith University, Gold Coast, Queensland, Australia; Department of Dentistry, Pontifícia Universidade Católica de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
| | - Anna Gabriella Guimarães Oliveira
- Laboratory of Oral Microbiology and Anaerobes, Department of Microbiology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Tiago Braga
- School of Dentistry and Oral Health Griffith University, Gold Coast, Queensland, Australia
| | - Peter Reher
- School of Dentistry and Oral Health Griffith University, Gold Coast, Queensland, Australia
| | - Luiz de Macêdo Farias
- Laboratory of Oral Microbiology and Anaerobes, Department of Microbiology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Paula Prazeres Magalhães
- Laboratory of Oral Microbiology and Anaerobes, Department of Microbiology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Pedro Gonçalves Ferreira
- Department of Dentistry, Pontifícia Universidade Católica de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Maria Ilma de Souza Côrtes
- Department of Dentistry, Pontifícia Universidade Católica de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Shanmugam S, PradeepKumar AR, Abbott PV, Periasamy R, Velayutham G, Krishnamoorthy S, Mahalakshmi K. Coronal Bacterial Penetration after 7 days in class II endodontic access cavities restored with two temporary restorations: A Randomised Clinical Trial. AUST ENDOD J 2020; 46:358-364. [PMID: 32568470 DOI: 10.1111/aej.12415] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 03/12/2020] [Accepted: 05/20/2020] [Indexed: 11/26/2022]
Abstract
The aim of this in vivo randomised clinical trial was to assess coronal bacterial penetration after placement of Cavit G and IRM temporary restorations in Class II endodontic access cavities. After completion of endodontic treatment, placement of an orifice seal and disinfection of the operating field, sterile cotton pellets were placed in the pulp chamber and the cavities were restored with Cavit G or IRM. After 7 days, coronal and proximal restoration thickness was measured by digital radiographs. Cotton pellet was evaluated by culture methods and polymerase chain reaction assay and bacterial species identified. Bacterial growth was observed in 5 of the 27 (18%) Cavit G samples and in 11 of the 27 (40%) IRM samples which was not significant. Coronal restoration thickness of 4-5 mm and proximal restoration thickness of more than 2.15 mm for Cavit G and 2.35 mm for IRM are recommended to prevent bacterial penetration over 7 days. Adequate restoration thickness is critical to prevent bacterial penetration.
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Affiliation(s)
- Sandhya Shanmugam
- Department of Conservative Dentistry and Endodontics, Thai Moogambigai Dental College and Hospital, Dr M.G.R. Educational and Research Institute, Chennai, Tamil Nadu, India
| | - Angambakkam Rajasekaran PradeepKumar
- Department of Conservative Dentistry and Endodontics, Thai Moogambigai Dental College and Hospital, Dr M.G.R. Educational and Research Institute, Chennai, Tamil Nadu, India
| | - Paul Vincent Abbott
- UWA Dental School, The University of Western Australia, Nedlands, WA, Australia
| | - Ravishankar Periasamy
- Department of Conservative Dentistry and Endodontics, Thai Moogambigai Dental College and Hospital, Dr M.G.R. Educational and Research Institute, Chennai, Tamil Nadu, India
| | - Gopikrishna Velayutham
- Dept of Conservative Dentistry & Endodontics, Sri Ramachandra Institute of Higher Education & Reasearch, Chennai, Tamil Nadu, India
| | - Sridevi Krishnamoorthy
- Department of Conservative Dentistry and Endodontics, Thai Moogambigai Dental College and Hospital, Dr M.G.R. Educational and Research Institute, Chennai, Tamil Nadu, India
| | - Krishnan Mahalakshmi
- Department of Microbiology, Sree Balaji Dental College and Hospital, Pallikaranai, Chennai, Tamil Nadu, India
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Šimundić Munitić M, Budimir A, Jakovljević S, Anić I, Bago I. Short-Term Antibacterial Efficacy of Three Bioceramic Root Canal Sealers Against Enterococcus Faecalis Biofilms. Acta Stomatol Croat 2020; 54:3-9. [PMID: 32523152 PMCID: PMC7233124 DOI: 10.15644/asc54/1/1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Objectives The aim of the study was to evaluate the antimicrobial efficacy of three bioceramic root canal sealers against Enterococcus faecalis (E. faecalis) biofilm. Material and methods E. faecalis bacterial suspension was grown on filter paper discs on agar plates. After the incubation period, the discs were covered with four different root canal sealers: 1) Premixing bioceramic root canal sealer (TotalFill BC Sealer); 2) Dual component bioceramic sealer (BioRoot RCS); 3) Mineral trioxide agreggate based sealer (MTA Fillapex); 4) Epoxy resin-based selar (AH Plus). After contact time of 60 minutes, the sealers were removed, and the discs were transferred into sterile tubes containing phosphate buffered saline. After serial dilutions, the aliquots of the suspension were cultivated for 24 hours. After the incubation period, the colony forming units (CFUs) were counted. Results There were no significant differences in antibacterial efficacy between the Total Fill BC Sealer and the AH Plus sealer (p=0.386). Both sealers showed better antibacterial efficacy compared to the BioRoot RCS and the MTA Fillapex (p<0.001). Conclusion The Total Fill BC Sealer and AH Plus had better antibacterial efficacy than the BioRoot RCS and the MTA Fillapex sealers.
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Affiliation(s)
| | - Ana Budimir
- Department of Clinical and Molecular Microbiology, Clinical Hospital Centre Zagreb, Croatia
| | - Suzana Jakovljević
- Department of Materials, Faculty of Engineering and Naval Architecture, University of Zagreb, Croatia
| | - Ivica Anić
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Croatia
| | - Ivona Bago
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Croatia
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Cleaning, Shaping, and Disinfecting Abilities of 2 Instrument Systems as Evaluated by a Correlative Micro–computed Tomographic and Histobacteriologic Approach. J Endod 2020; 46:846-857. [DOI: 10.1016/j.joen.2020.03.017] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 02/28/2020] [Accepted: 03/13/2020] [Indexed: 12/14/2022]
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Alsubait S, Alsaad N, Alahmari S, Alfaraj F, Alfawaz H, Alqedairi A. The effect of intracanal medicaments used in Endodontics on the dislocation resistance of two calcium silicate-based filling materials. BMC Oral Health 2020; 20:57. [PMID: 32070302 PMCID: PMC7029461 DOI: 10.1186/s12903-020-1044-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Accepted: 02/10/2020] [Indexed: 11/10/2022] Open
Abstract
Background Intracanal medicaments can be used in various endodontic conditions including multiple visit endodontics after trauma or in regenerative endodontics. These medicaments should be removed from the root canal before the placement of the filling or repair material. The aim of the present study was to evaluate the effect of prior calcium hydroxide (Ca(OH)2) and modified triple antibiotic paste (mTAP) placement on the push-out bond strength of TotalFill BC fast set putty (BC fast set putty) to root dentin when compared to mineral trioxide aggregate (MTA). Methods The root canals of 45 extracted mandibular premolars were prepared to a standardized internal diameter (1.5 mm). The specimens were randomly assigned to 3 groups according to the intracanal medicament used: mTAP (a mixture of metronidazole, ciprofloxacin, and cefaclor), Ca(OH)2, and no intracanal medicament. After 1 week, the medicaments were removed, and the middle third of the roots were cut into two transverse sections (2.0 ± 0.05) (n = 90 slices). Thereafter, the specimens were divided into two subgroups (n = 45 each): MTA or BC putty. After 1 week, the push-out test was performed and failure mode was evaluated. The data were statistically analyzed using two-way ANOVA and Tukey’s post hoc. Results The application of the intracanal medicament did not significantly affect the bond strength of BC putty (p > .05). For MTA, the prior application of Ca(OH)2 or mTAP significantly decreased the dislocation resistance (p < .05). Specimens in the MTA subgroups showed an almost equal number of cohesive and mixed types of failure while the majority of the specimens in the BC putty subgroups revealed the cohesive type. Conclusions Ca(OH)2 and mTAP promoted lower bond strength of MTA to root dentin compared to the control group. However, the BC fast set putty bond strength to dentin was not affected by prior medication with Ca(OH)2 or mTAP.
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Affiliation(s)
- Sara Alsubait
- Division of Endodontics, Department of Restorative Dental Science, College of Dentistry, King Saud University, Riyadh, Saudi Arabia.
| | | | - Sumayyah Alahmari
- Endodontic Residency Program, Saudi Commission for Health Specialist, Riyadh, Saudi Arabia
| | | | - Hussam Alfawaz
- Division of Endodontics, Department of Restorative Dental Science, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Abdullah Alqedairi
- Division of Endodontics, Department of Restorative Dental Science, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
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Baruwa AO, Martins JN, Meirinhos J, Pereira B, Gouveia J, Quaresma SA, Monroe A, Ginjeira A. The Influence of Missed Canals on the Prevalence of Periapical Lesions in Endodontically Treated Teeth: A Cross-sectional Study. J Endod 2020; 46:34-39.e1. [DOI: 10.1016/j.joen.2019.10.007] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Revised: 09/30/2019] [Accepted: 10/07/2019] [Indexed: 11/17/2022]
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Šimundić Munitić M, Poklepović Peričić T, Utrobičić A, Bago I, Puljak L. Antimicrobial efficacy of commercially available endodontic bioceramic root canal sealers: A systematic review. PLoS One 2019; 14:e0223575. [PMID: 31622387 PMCID: PMC6797114 DOI: 10.1371/journal.pone.0223575] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Accepted: 09/24/2019] [Indexed: 11/25/2022] Open
Abstract
Background Recently, a new generation of bioceramic root canal sealers has been introduced onto the market. Many in vitro studies have investigated the antimicrobial properties of these sealers, but their comparative efficacy in antimicrobial activity is still unknown. Methodology Three electronic databases were searched: MEDLINE and Embase via the OvidSP platform, and Web of Science, up to June 25, 2019. Studies were included irrespective of study design, type of publication and language. Reporting quality was assessed by two authors independently. Meta-analysis was not performed due to studies being highly heterogeneous. Results We included 37 studies that analysed the antimicrobial effects of bioceramic sealers. Most of them used a planktonic cell model, with the exception of nine studies which used biofilms. It was not possible to make direct comparison of results from studies and to give a clear conclusion about the comparative antimicrobial activity of these materials because the studies used heterogeneous sources and ages of microorganisms, setting and contact times of sealers, and antimicrobial tests. Furthermore, some materials showed completely different results when tested with different methods. Conclusions In conclusion, multiple in vitro studies have shown that bioceramic sealers may have various degrees of antimicrobial activity. However, it is still impossible to make conclusions about their comparative efficacy and to recommend the use of one over another in clinical practice because the studies available were conducted in different ways, which makes meta-analysis futile. A uniform methodological approach, consistent definitions and studies on humans are urgently needed in this field of research so that recommendations for practice can be made.
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Affiliation(s)
- Marija Šimundić Munitić
- Department of Endodontics and Restorative Dentistry, Dental Polyclinic Split; School of Dental Medicine, University of Split, Split, Croatia
- * E-mail:
| | - Tina Poklepović Peričić
- Department of Research in Biomedicine and Health, School of Medicine, University of Split, Split, Croatia
| | - Ana Utrobičić
- Cochrane Croatia, Central Medical Library, School of Medicine, University of Split, Split, Croatia
| | - Ivona Bago
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Livia Puljak
- Department of Evidence Based Medicine and Health Care, Catholic University of Croatia, Zagreb, Zagreb, Croatia
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Prado LC, Gavini G, Silveira ADC, Nakamura VC, Mayer MPA, Pinheiro ET. Comparison of rRNA-based reverse transcription PCR and rDNA-based PCR for the detection of streptococci in root canal infections. J Appl Oral Sci 2019; 27:e20180256. [PMID: 31365706 PMCID: PMC6690712 DOI: 10.1590/1678-7757-2018-0256] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 02/26/2019] [Indexed: 11/21/2022] Open
Abstract
Objective The rDNA-based method is unable to distinguish between alive and dead cells. Alternatively, bacterial viability can be assessed by molecular methods based on ribosomal RNA (rRNA). Therefore, this study aimed to detect viable streptococci in root canal samples using rRNA-based reverse transcription polymerase chain reaction (RT-PCR), compared to an rDNA-based PCR assay. Methodology Microbiological root canal samples were obtained from 32 teeth with primary endodontic infections before (S1) and after chemomechanical preparation (S2), and after removal of intracanal medication (S3). RNA and DNA were extracted, and complementary DNA (cDNA) was synthesized from RNA using RT reaction. cDNA and genomic DNA were subjected to PCR with primers complementary to the 16S rRNA sequences of Streptococcus spp. McNemar’s test was used to compare the detection rate of both assays (P<0.05). Results Streptococci were detected in 28.12% (9/32) and 37.5% (12/32) of S1 samples using rRNA- and rDNA-based PCR assays, respectively. In contrast, they were detected in only 6.25% (2/32) of S2 samples using rRNA-based RT-PCR, compared to 15.62% (5/32) using rDNA-based PCR. Finally, in S3 samples, streptococci were not detected by rRNA, whereas rDNA-based PCR still detected the bacteria in 12.5% (4/32) of the samples. The total number of PCR-positive reactions in the rDNA-based PCR was higher than in the rRNA-based assay (P<0.05). Conclusions The rRNA-based RT-PCR showed a lower detection rate of streptococci when compared to the rDNA-based PCR, suggesting that the latter may have detected dead cells of streptococci in root canal samples.
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Affiliation(s)
- Laís Cunha Prado
- Universidade de São Paulo, Faculdade de Odontologia, São Paulo, SP, Brasil
| | - Giulio Gavini
- Universidade de São Paulo, Faculdade de Odontologia, São Paulo, SP, Brasil
| | | | | | - Marcia Pinto Alves Mayer
- Universidade de São Paulo, Faculdade de Odontologia, Instituto de Ciências Biomédicas, São Paulo, SP, Brasil
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Wu S, Liu Y, Zhang H, Lei L. The Susceptibility to Calcium Hydroxide Modulated by the Essential walR Gene Reveals the Role for Enterococcus faecalis Biofilm Aggregation. J Endod 2019; 45:295-301.e2. [PMID: 30803536 DOI: 10.1016/j.joen.2018.11.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 11/09/2018] [Accepted: 11/21/2018] [Indexed: 02/05/2023]
Abstract
INTRODUCTION Enterococcus faecalis is considered a predominant pathogen for persistent periapical infections and in addition is reportedly resistant to calcium hydroxide medication. The WalRK 2-component system of E. faecalis is essential for environmental adaptation, survival, and virulence. The goal of this study was to investigate the potential roles of walR in the regulation of biofilm aggregation, alkaline stress, and susceptibility to calcium hydroxide (CH) medication. METHODS Antisense walR RNA (aswalR) overexpression strains were constructed. Exopolysaccharide (EPS) production and bacterial viability of E. faecalis biofilms were evaluated by confocal laser scanning microscopy. Quantitative real-time polymerase chain reaction was used to investigate the expressions of virulent factor genes. The proportion of viable bacteria and EPS production in dentin were assessed after CH medication. RESULTS We showed that walR interference by aswalR RNA leads to a reduction in the dextran-dependent aggregation in E. faecalis biofilm. The overexpression of aswalR reduced the transcripts of the virulence genes and alkaline stress tolerance ability. Furthermore, the down-regulation of walR sensitized E. faecalis in infected canals to CH medication associated with inhibiting EPS synthesis. CONCLUSIONS The data suggest a role for the walR regulator in the susceptibility to CH associated with dispelling the EPS matrix, which could be explored as a potential supplementary therapy for the management of root canal infection.
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Affiliation(s)
- Shizhou Wu
- State Key Laboratory of Oral Diseases, Department of Preventive Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China; West China Hospital, Sichuan University, Chengdu, China; Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, Maryland
| | - Yunjie Liu
- West China School of Public Health, Sichuan University, Chengdu, China
| | - Hui Zhang
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, China
| | - Lei Lei
- State Key Laboratory of Oral Diseases, Department of Preventive Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
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Prada I, Micó-Muñoz P, Giner-Lluesma T, Micó-Martínez P, Muwaquet-Rodríguez S, Albero-Monteagudo A. Update of the therapeutic planning of irrigation and intracanal medication in root canal treatment. A literature review. J Clin Exp Dent 2019; 11:e185-e193. [PMID: 30805124 PMCID: PMC6383907 DOI: 10.4317/jced.55560] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 01/21/2019] [Indexed: 11/30/2022] Open
Abstract
Background The success of endodontic treatment derives from the complete elimination of microorganisms capable of causing an intraradicular or extraradicular infection. To achieve a more effective eradication of these microorganisms, endodontic instrumentation must always be implemented with abundant irrigation, which has to achieve chemical, mechanical and biological effects. The irrigators most used today are NaOCl, CHX and EDTA, released into the ducts through different techniques such as syringe, manual agitation, positive or negative apical pressure, sonic or ultrasonic activation, PIPS and PDT. The objective of this review is to update the different irrigating solutions and intracanal disinfection drugs, as well as to establish an irrigation protocol in the endodontic treatment. Material and Methods Systematic search of scientific articles in the databases PubMed, Medline and Google Scholar, with the following keywords Endodontic, Infection, Failure, Irrigation, Retreatment and Irrigation protocol. The exclusion criteria were “case report” articles and articles with a publication date prior to 2000. Results 48 articles that met the inclusion criteria were analyzed. Comparing the different articles it can be seen that the NaOCl is the “gold standard” in terms of immediate antimicrobial efficacy, followed by the CHX that has a long-term antibacterial effect. As an intra-conductive drug it is advisable to use the combination of Ca(OH)2 with CPMC. Conclusions The most adequate irrigation protocol consists of using 2.5% NaOCl activated with ultrasound followed by a final wash with 7% MA or 0.2% CTR combined with 2% CHX. Key words:Endodontic failure, endodontic infection, enterococcus faecalis, endodontic retreatment, irrigation, sodium hipoclorite, irrigation protocol.
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Affiliation(s)
- Ilaria Prada
- Licensed Dentist at Universidad Europea de Valencia, España
| | - Pedro Micó-Muñoz
- Endodontic and restorative dentistry Titular Professor, Universidad Europea de Valencia, España
| | - Teresa Giner-Lluesma
- Endodontic and restorative dentistry Associate Professor, Universidad Europea de Valencia, España
| | - Pablo Micó-Martínez
- Licensed Dentist at Universidad Europea de Valencia. Periodontology and Osteointegration Master at Universidad de Valencia, España
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Kamath S, Shetty R, Shetty S, Nighot N, Ramnani K, Bhujbal D. Efficacy of XP-Endo finisher in removal of calcium hydroxide from root canal system: A systematic review. JOURNAL OF THE INTERNATIONAL CLINICAL DENTAL RESEARCH ORGANIZATION 2019. [DOI: 10.4103/jicdro.jicdro_15_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Tong Z, Zhang Y, Wei X. The effect of human serum and dentin powder alone or in combination on the antibacterial activity of sodium hypochlorite against Enterococcus faecalis. Arch Oral Biol 2019; 97:72-76. [DOI: 10.1016/j.archoralbio.2018.10.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 09/21/2018] [Accepted: 10/07/2018] [Indexed: 10/28/2022]
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CRESPO MP, PEREIRA KDF, KUGA MC, PORTO TS, ARMADA L. Alkalizing potential and calcium release of residues from intracanal dressing containing calcium hydroxide. REVISTA DE ODONTOLOGIA DA UNESP 2018. [DOI: 10.1590/1807-2577.11018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract Introduction If the restoration, that seal the root canal from oral environment, failed or solubilize, the intracanal dressing could be partially removed, decreasing the efficiency of calcium hydroxide (CH). Objective To evaluate the alkalizing potential and calcium ions release of intracanal residues from different medications, in different periods. Materials and method Human incisors were endodontically instrumented and randomly divided (n=10). The root canals were filled with: G1⎯Calcium hydroxide (CH); G2⎯CH with 0.4% chlorhexidine digluconate (CHC); G3⎯CH with camphorated paramonochlorophenol and glycerin (HPG); G4⎯CH was maintained during all experiment, as positive control group (PC) and G5⎯ No medication was performed in the negative control group (NC). The specimens were immersed in distilled water for 7 days. The intracanal dressing was removed from the experimental groups using F1 instrument (Protaper). The teeth were stored in distilled water for 24 hours, 7, 14 and 28 days. pH value and calcium ions released were evaluated and the data were submitted to ANOVA one-way and Tukey tests. Result All experimental groups presented lower alkalizing potential and calcium ions release than PC (P<0.05). No significant difference was found among the experimental groups, regardless of the period (P>0.05). Conclusion The alkalizing potential and calcium ions release of residues from different intracanal dressing, in different periods, were similar and lower than the positive control group, that the medication was maintained inside the root canal, encouraging the replacement of intracanal dressing when the restoration fail.
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Siqueira Junior JF, Rôças IDN, Marceliano-Alves MF, Pérez AR, Ricucci D. Unprepared root canal surface areas: causes, clinical implications, and therapeutic strategies. Braz Oral Res 2018; 32:e65. [PMID: 30365606 DOI: 10.1590/1807-3107bor-2018.vol32.0065] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 06/06/2018] [Indexed: 11/21/2022] Open
Abstract
Chemomechanical preparation is intended to clean, disinfect, and shape the root canal. This step is of utmost importance during treatment of infected teeth with apical periodontitis, because treatment outcome depends on how effectively the clinician eliminates bacteria, their products, and necrotic tissue that would serve as substrate for bacterial regrowth. Nonetheless, curvatures and complex internal anatomical variations of the root canal system can pose a high degree of difficulty in reaching these goals. In infected teeth, bacteria may persist not only in difficult-to-reach areas such as isthmuses, ramifications, dentinal tubules, and recesses from C-shaped or oval/flattened canals, but also in areas of the main canal wall that remain untouched by instruments. If bacteria withstand chemomechanical procedures, there is an augmented risk for post-treatment apical periodontitis. This article discloses the reasons why some areas remain unprepared by instruments and discusses strategies to circumvent this issue and enhance infection control during endodontic treatment/retreatment of teeth with apical periodontitis.
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Affiliation(s)
| | - Isabela das Neves Rôças
- Universidade Estácio de Sá, Faculty of Dentistry, Department of Endodontics, Rio de Janeiro, RJ, Brazil
| | | | - Alejandro Ron Pérez
- Universidade Estácio de Sá, Faculty of Dentistry, Department of Endodontics, Rio de Janeiro, RJ, Brazil
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Arruda ME, Neves MA, Diogenes A, Mdala I, Guilherme BP, Siqueira JF, Rôças IN. Infection Control in Teeth with Apical Periodontitis Using a Triple Antibiotic Solution or Calcium Hydroxide with Chlorhexidine: A Randomized Clinical Trial. J Endod 2018; 44:1474-1479. [DOI: 10.1016/j.joen.2018.07.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 06/28/2018] [Accepted: 07/02/2018] [Indexed: 01/03/2023]
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Pereira TC, da Silva Munhoz Vasconcelos LR, Graeff MSZ, Ribeiro MCM, Duarte MAH, de Andrade FB. Intratubular decontamination ability and physicochemical properties of calcium hydroxide pastes. Clin Oral Investig 2018; 23:1253-1262. [DOI: 10.1007/s00784-018-2549-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 06/27/2018] [Indexed: 10/28/2022]
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Zeng C, Willison J, Meghil MM, Bergeron BE, Cutler CW, Tay FR, Niu L, Ma J. Antibacterial efficacy of an endodontic sonic-powered irrigation system: An in vitro study. J Dent 2018; 75:105-112. [PMID: 29908290 DOI: 10.1016/j.jdent.2018.06.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 06/09/2018] [Accepted: 06/11/2018] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE To evaluate the efficacy of EDDY, a new sonic-powered irrigation system, in reducing intracanal bacteria load. METHODS Thirty-eight instrumented, autoclaved single-rooted human premolars were inoculated with Enterococcus faecalis (ATCC-29212) for 21 days. Two teeth were used as negative control without bacterial contamination. For the bacteria-inoculated teeth, 6 were used as positive control without irrigation. The remaining 30 teeth were randomly divided into 2 groups (N = 15), using 3% NaOCl as irrigant: (A) 30-gauge syringe needle irrigation (SNI), (B) EDDY (VDW, Munich, Germany). Twelve teeth per group and 4 teeth in the positive control were evaluated for bacterial reduction using MTT assay. The remaining teeth were split for BacLight LIVE/DEAD staining to examine the percentages of live/dead bacteria present in the dentinal tubules from different canal locations (coronal, mid-root and apical portions of the canal space) using confocal laser scanning microscopy (CLSM). RESULTS MTT assay indicated that both SNI and EDDY significantly reduced overall intracanal bacterial load compared with the positive control, with no significant difference between the two techniques. CLSM indicated that EDDY had better intratubular bacterial killing efficacy than SNI in the coronal and mid-root portions of the canal space only but not in the apical portion. In all canal locations (coronal, mid-root apical), both systems failed to eliminate bacteria that proliferated deep within the dentinal tubules. CONCLUSION With the use of 3% NaOCl, sonic-powered irrigant activation with EDDY tips did not provide additional advantage over SNI in killing Enterococcus faecalis from deep intraradicular dentin. CLINICAL SIGNIFICANCE Both the sonic-powered root canal irrigant activation system and syringe needle irrigation can reduce intracanal bacteria load but are incapable of completely killing all bacteria that resided deep within the dentinal tubules of root canals infected with Enterococcus faecalis.
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Affiliation(s)
- Chang Zeng
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jon Willison
- The Dental College of Georgia, Augusta University, Augusta, GA, USA
| | - Mohamed M Meghil
- The Dental College of Georgia, Augusta University, Augusta, GA, USA
| | - Brian E Bergeron
- The Dental College of Georgia, Augusta University, Augusta, GA, USA
| | | | - Franklin R Tay
- The Dental College of Georgia, Augusta University, Augusta, GA, USA; Department of Prosthodontics, School of Stomatology, Fourth Military Medical University, Xi'an, China.
| | - Lina Niu
- The Dental College of Georgia, Augusta University, Augusta, GA, USA; Department of Prosthodontics, School of Stomatology, Fourth Military Medical University, Xi'an, China.
| | - Jingzhi Ma
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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Novel Chlorhexidine-Loaded Polymeric Nanoparticles for Root Canal Treatment. J Funct Biomater 2018; 9:jfb9020029. [PMID: 29673188 PMCID: PMC6023436 DOI: 10.3390/jfb9020029] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 04/04/2018] [Accepted: 04/13/2018] [Indexed: 11/17/2022] Open
Abstract
Persistence of microorganisms in dentinal tubules after root canal chemo-mechanical preparation has been well documented. The complex anatomy of the root canal and dentinal buffering ability make delivery of antimicrobial agents difficult. This work explores the use of a novel trilayered nanoparticle (TNP) drug delivery system that encapsulates chlorhexidine digluconate, which is aimed at improving the disinfection of the root canal system. Chlorhexidine digluconate was encapsulated inside polymeric self-assembled TNPs. These were self-assembled through water-in-oil emulsion from poly(ethylene glycol)-b-poly(lactic acid) (PEG-b-PLA), a di-block copolymer, with one hydrophilic segment and another hydrophobic. The resulting TNPs were physicochemically characterized and their antimicrobial effectiveness was evaluated against Enterococcus faecalis using a broth inhibition method. The hydrophilic interior of the TNPs successfully entrapped chlorhexidine digluconate. The resulting TNPs had particle size ranging from 140–295 nm, with adequate encapsulation efficiency, and maintained inhibition of bacteria over 21 days. The delivery of antibacterial irrigants throughout the dentinal matrix by employing the TNP system described in this work may be an effective alternative to improve root canal disinfection.
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Plutzer B, Zilm P, Ratnayake J, Cathro P. Comparative efficacy of endodontic medicaments and sodium hypochlorite againstEnterococcus faecalisbiofilms. Aust Dent J 2018; 63:208-216. [DOI: 10.1111/adj.12580] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/04/2017] [Indexed: 11/28/2022]
Affiliation(s)
- B Plutzer
- School of Dentistry; Faculty of Health Science; The University of Adelaide; Adelaide South Australia Australia
| | - P Zilm
- School of Dentistry; Faculty of Health Science; The University of Adelaide; Adelaide South Australia Australia
| | - J Ratnayake
- University of Otago; Faculty of Dentistry; Dunedin Otago New Zealand
| | - P Cathro
- School of Dentistry; Faculty of Health Science; The University of Adelaide; Adelaide South Australia Australia
- University of Otago; Faculty of Dentistry; Dunedin Otago New Zealand
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da Silva CC, Chaves Júnior SP, Pereira GLD, Fontes KBFDC, Antunes LAA, Póvoa HCC, Antunes LS, Iorio NLPP. Antimicrobial Photodynamic Therapy Associated with Conventional Endodontic Treatment: A Clinical and Molecular Microbiological Study. Photochem Photobiol 2018; 94:351-356. [DOI: 10.1111/php.12869] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 11/12/2017] [Indexed: 12/17/2022]
Affiliation(s)
- Caroline C. da Silva
- Department of Basic Science; Fluminense Federal University; Nova Friburgo, Rio de Janeiro Brazil
| | - Sérgio P. Chaves Júnior
- Department of Basic Science; Fluminense Federal University; Nova Friburgo, Rio de Janeiro Brazil
| | - Gabriela L. D. Pereira
- Department of Basic Science; Fluminense Federal University; Nova Friburgo, Rio de Janeiro Brazil
| | - Karla B. F. da C. Fontes
- Department of Specific Formation; Fluminense Federal University; Nova Friburgo, Rio de Janeiro Brazil
| | - Lívia A. A. Antunes
- Department of Specific Formation; Fluminense Federal University; Nova Friburgo, Rio de Janeiro Brazil
| | - Helvécio C. C. Póvoa
- Department of Basic Science; Fluminense Federal University; Nova Friburgo, Rio de Janeiro Brazil
| | - Leonardo S. Antunes
- Department of Specific Formation; Fluminense Federal University; Nova Friburgo, Rio de Janeiro Brazil
| | - Natalia L. P. P. Iorio
- Department of Basic Science; Fluminense Federal University; Nova Friburgo, Rio de Janeiro Brazil
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Gokturk H, Ozkocak I, Buyukgebiz F, Demir O. Effectiveness of various irrigation protocols for the removal of calcium hydroxide from artificial standardized grooves. J Appl Oral Sci 2017; 25:290-298. [PMID: 28678948 PMCID: PMC5482252 DOI: 10.1590/1678-7757-2016-0414] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Accepted: 10/17/2016] [Indexed: 12/05/2022] Open
Abstract
Objective The aim of this study was to investigate the ability of laser-activated irrigation (LAI), XP-endo Finisher, CanalBrush, Vibringe, passive ultrasonic irrigation (PUI), and conventional syringe irrigation systems on the removal of calcium hydroxide (CH) from simulated root canal irregularities. Material and Methods The root canals of one hundred and five extracted single-rooted teeth were instrumented using Reciproc rotary files up to size R40. The teeth were split longitudinally. Two of the three standard grooves were created in the coronal and apical section of one segment, and another in the middle part of the second segment. The standardized grooves were filled with CH and the root halves were reassembled. After 14 days, the specimens were randomly divided into 7 experimental groups (n=15/group). CH was removed as follows: Group 1: beveled needle irrigation; Group 2: double side-vented needle irrigation; Group 3: CanalBrush; Group 4: XP-endo Finisher; Group 5: Vibringe; Group 6: PUI; Group 7: LAI. The amount of remaining CH in the grooves was scored under a stereomicroscope at 20× magnification. Statistical evaluation was performed using Kruskal–Wallis and Bonferroni-Correction Mann–Whitney U tests. Results Groups 1 and 2 were the least efficient in eliminating CH from the grooves. Groups 6 and 7 eliminated more CH than the other protocols; however, no significant differences were found between these two groups (P>.05). Conclusions Nevertheless, none of the investigated protocols were able to completely remove all CH from all three root regions. LAI and PUI showed less residual CH than the other protocols from artificial grooves.
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Affiliation(s)
- Hakan Gokturk
- Gaziosmanpasa University, Faculty of Dentistry, Department of Endodontics, Tokat, Turkey
| | - Ismail Ozkocak
- Gaziosmanpasa University, Faculty of Dentistry, Department of Endodontics, Tokat, Turkey
| | - Feyzi Buyukgebiz
- Gaziosmanpasa University, Faculty of Dentistry, Department of Endodontics, Tokat, Turkey
| | - Osman Demir
- Gaziosmanpasa University, Faculty of Medicine, Department of Biostatistics, Tokat, Turkey
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Gokturk H, Ozkocak I, Buyukgebiz F, Demir O. An in vitro evaluation of various irrigation techniques for the removal of double antibiotic paste from root canal surfaces. J Appl Oral Sci 2017; 24:568-574. [PMID: 28076461 PMCID: PMC5161255 DOI: 10.1590/1678-775720160286] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Accepted: 08/01/2016] [Indexed: 12/04/2022] Open
Abstract
Objective The aim of this study was to investigate the effectiveness of conventional syringe irrigations, passive ultrasonic irrigation (PUI), Vibringe, CanalBrush, XP-endo Finisher, and laser-activated irrigation (LAI) systems in removing double antibiotic paste (DAP) from root canals. Material and Methods One hundred five extracted single-rooted teeth were instrumented. The roots were split longitudinally. Three standard grooves were created and covered with DAP. The roots were distributed into seven groups: Group 1, beveled needle irrigation; Group 2, double side-vented needle irrigation; Group 3, CanalBrush; Group 4, XP-endo Finisher; Group 5, Vibringe; Group 6, PUI; Group 7, LAI. The amount of remaining DAP was scored under a stereomicroscope. Results Group 4, Group 6, and Group 7 removed significantly more DAP than the other protocols in the coronal region. Group 7 was more efficient in the middle region; however, no significant difference was found between Group 7 and Group 6. No differences were found between groups in the apical region either, except for the comparisons between groups 7 and 2, and groups 2 and 3. Conclusions None of the investigated protocols were able to completely remove the DAP from the grooves. The Vibringe and XP-endo Finisher systems showed results similar to those of conventional needle irrigation.
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Affiliation(s)
- Hakan Gokturk
- - Gaziosmanpasa University, Faculty of Dentistry, Department of Endodontics, Tokat, Turkey
| | - Ismail Ozkocak
- - Gaziosmanpasa University, Faculty of Dentistry, Department of Endodontics, Tokat, Turkey
| | - Fevzi Buyukgebiz
- - Gaziosmanpasa University, Faculty of Dentistry, Department of Endodontics, Tokat, Turkey
| | - Osman Demir
- - Gaziosmanpasa University, Faculty of Medicine, Department of Biostatistics, Tokat, Turkey
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Lei L, Shao M, Yang Y, Mao M, Yang Y, Hu T. Exopolysaccharide dispelled by calcium hydroxide with volatile vehicles related to bactericidal effect for root canal medication. J Appl Oral Sci 2016; 24:487-495. [PMID: 27812619 PMCID: PMC5083026 DOI: 10.1590/1678-775720160014] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 06/26/2016] [Indexed: 02/05/2023] Open
Abstract
Objective: Enterococcus faecalis is the dominant microbial species responsible for persistent apical periodontitis with ability to deeply penetrate into the dentin. Exopolysaccharides (EPS) contribute to the pathogenicity and antibiotic resistance of E. faecalis. Our aim was to investigate the antimicrobial activity of calcium hydroxide (CH), camphorated parachlorophenol (CMCP), and chlorhexidine (CHX) against E. faecalis in dentinal tubules. Material and Methods: Decoronated single-canal human teeth and semicylindrical dentin blocks were incubated with E. faecalis for 3 weeks. Samples were randomly assigned to six medication groups for 1 week (n=10 per group): CH + 40% glycerin-water solution (1:1, wt/vol); CMCP; 2% CHX; CH + CMCP (1:1, wt/vol); CH + CMCP (2:3, wt/vol); and saline. Bacterial samples were collected and assayed for colony-forming units. After dentin blocks were split longitudinally, confocal laser scanning microscopy was used to assess the proportion of viable bacteria and EPS production in dentin. Results: CMCP exhibited the best antimicrobial activity, while CH was the least sensitive against E. faecalis (p<0.05). CHX showed similar antimicrobial properties to CH + CMCP (1:1, wt/vol) (p>0.05). CH combined with CMCP inhibited EPS synthesis by E. faecalis, which sensitized biofilms to antibacterial substances. Moreover, increasing concentrations of CMCP decreased EPS matrix formation, which effectively sensitized biofilms to disinfection agents. Conclusion: The EPS matrix dispelled by CH paste with CMCP may be related to its bactericidal effect; the visualization and analysis of EPS formation and microbial colonization in dentin may be a useful approach to verify medicaments for antimicrobial therapy.
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Affiliation(s)
- Lei Lei
- Sichuan University, West China Hospital of Stomatology, Department of Operative Dentistry and Endodontics, State Key Laboratory of Oral Diseases, Sichuan, China.,The Forsyth Institute, Department of Microbiology, Cambridge, United States
| | - Meiying Shao
- Sichuan University, College of Life Sciences, State Key Laboratory of Oral Diseases, Sichuan, China
| | - Yan Yang
- Sichuan University, West China Hospital of Stomatology, Department of Operative Dentistry and Endodontics, State Key Laboratory of Oral Diseases, Sichuan, China
| | - Mengying Mao
- Sichuan University, West China Hospital of Stomatology, Department of Operative Dentistry and Endodontics, State Key Laboratory of Oral Diseases, Sichuan, China
| | - Yingming Yang
- Sichuan University, West China Hospital of Stomatology, Department of Preventive Dentistry, Sichuan, China
| | - Tao Hu
- Sichuan University, West China Hospital of Stomatology, Department of Operative Dentistry and Endodontics, State Key Laboratory of Oral Diseases, Sichuan, China.,Sichuan University, West China Hospital of Stomatology, Department of Preventive Dentistry, Sichuan, China
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Toljan I, Bago I, Jurič, Anić I. Eradication of Intracanal Enterococcus Faecalis Biofilm by Passive Ultrasonic Irrigation and RinsEndo System. Acta Stomatol Croat 2016; 50:14-22. [PMID: 27688422 DOI: 10.15644/asc50/1/3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
AIM The aim of the study was to compare the antimicrobial efficacy of three irrigation techniques after the use of standardized volume of NaOCl and with standardized time and irrigation. METHODOLOGY Forty-eight single rooted teeth were inoculated with an Enterococcus faecalis suspension for 24 h. The remaining six canals served as negative controls. The 36 root canals were randomly distributed into three experimental groups; group 1, conventional syringe irrigation; group 2, automated-dynamic irrigation (RinsEndo); group 3, passive ultrasonic irrigation (PUI). In the first protocol, the standardized volume of 3% NaOCl (20 mL) was used and in the second protocol, and standardized irrigation time (45 seconds) was used. Samples from root canals were cultured and the colony-forming units (CFUs) were counted. RESULTS When the volume of the irrigant was standardized, RinsEndo was more effective than PUI (p<0.01). When the irrigation time was standardized, there were no significant differences between any irrigation techniques (p>0.05). The RinsEndo group had the highest percentage of minimal counts of E. faecalis CFUs. CONCLUSIONS RinsEndo was more effective than PUI only when the volume of the irrigant was standardized. However, the RinsEndo provided higher bacterial reduction in both protocols when using the least amount of the irrigant and providing longer contact time.
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Affiliation(s)
| | - Ivona Bago
- Private Dental Polyclinic, Zagreb, Croatia
| | - Jurič
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Croatia
| | - Ivica Anić
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Croatia
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Eymirli A, Nagas E, Uyanik MO, Cehreli ZC. Effect of Laser-Activated Irrigation with Ethylene Diaminetetraacetic Acid and Phytic Acid on the Removal of Calcium Hydroxide and Triple Antibiotic Paste from Root Dentin. Photomed Laser Surg 2016; 35:43-48. [PMID: 27623238 DOI: 10.1089/pho.2016.4146] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVE This study assessed the efficacy of erbium, chromium:yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser-activated irrigation (LAI) of ethylene diaminetetraacetic acid (EDTA) and phytic acid on the removal of calcium hydroxide (CH) and triple antibiotic paste (TAP) from root canals. BACKGROUND DATA Although some studies investigated the efficacy of LAI of EDTA irrigation, no study has been conducted to investigate the efficacy of LAI of phytic acid in the removal of CH and TAP from root dentin. MATERIALS AND METHODS Root canals of extracted maxillary incisors (n = 80) were instrumented using rotary files and thereafter were split longitudinally. Following preparation of a standardized groove in the apical region of one root half, the roots were randomly divided into two groups according to the intracanal medicaments placed into the grooves: (1) CH and (2) TAP. The roots were reassembled, and the specimens were further assigned into four groups (n = 10/group) defined by the final irrigation solution (EDTA and phytic acid) and irrigation technique (needle irrigation and LAI) used for removal of the medicaments. The data were analyzed statistically using Kruskal-Wallis and Mann-Whitney U tests. RESULTS For both EDTA and phytic acid, LAI was more efficient than needle irrigation in removing both CH and TAP (p < 0.05), but none of the tested techniques completely removed CH. Irrespective of the tested irrigation solutions and techniques, significantly less TAP remained in canals (p = 0.0001), with TAP being completely removed by LAI. Irrigation with phytic acid showed better removal efficacy than EDTA in the absence of statistical significance. CONCLUSIONS Er,Cr:YSGG LAI of EDTA and phytic acid completely removed TAP and effectively reduced CH on root dentin.
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Affiliation(s)
- Ayhan Eymirli
- 1 Department of Endodontics, Faculty of Dentistry, Hacettepe University , Ankara, Turkey
| | - Emre Nagas
- 1 Department of Endodontics, Faculty of Dentistry, Hacettepe University , Ankara, Turkey
| | - Mehmet Ozgur Uyanik
- 1 Department of Endodontics, Faculty of Dentistry, Hacettepe University , Ankara, Turkey
| | - Zafer Cavit Cehreli
- 2 Department of Pediatric Dentistry, Faculty of Dentistry, Hacettepe University , Ankara, Turkey
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Zandi H, Rodrigues RC, Kristoffersen AK, Enersen M, Mdala I, Ørstavik D, Rôças IN, Siqueira JF. Antibacterial Effectiveness of 2 Root Canal Irrigants in Root-filled Teeth with Infection: A Randomized Clinical Trial. J Endod 2016; 42:1307-13. [DOI: 10.1016/j.joen.2016.06.006] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 06/07/2016] [Accepted: 06/09/2016] [Indexed: 02/02/2023]
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Gupta-Wadhwa A, Wadhwa J, Duhan J. Comparative evaluation of antimicrobial efficacy of three herbal irrigants in reducing intracanal E. faecalis populations: An in vitro study. J Clin Exp Dent 2016; 8:e230-5. [PMID: 27398170 PMCID: PMC4930629 DOI: 10.4317/jced.52339] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Accepted: 12/09/2015] [Indexed: 11/08/2022] Open
Abstract
Background The present study aimed to evaluate the intracanal bacterial reduction promoted by chemomechanical preparation using three different herbal extracts named Ocimum sanctum (OS), Cinnamomum zeylanicum (CZ), Syzygium aromaticum (SA) against Enterococcus faecalis. Material and Methods Root canals from extracted teeth were contaminated with Enterococcus faecalis ATCC 29212 for 7 days and then randomly distributed into 3 experimental groups of 10 teeth each: which includes conventional irrigation with OS, CZ and SA. The control groups included 5 teeth each consisting of NaOCl (positive control) and distilled water (negative control). Samples taken before and after chemomechanical procedures were cultured, and the colony-forming units (CFUs) were counted. Bacterial identification was performed using Polymerase chain reaction technique. The statistical analyses were performed with various tests. Results Reduction in the intracanal bacterial populations was highly significant for all the experimental groups. CZ and SA showed 80 to 85% intracanal bacterial reduction while O. Sanctum revealed only 70 to 75 % reduction. NaOCl showed 96 to 100 % bacterial reduction on the other hand distilled water showed very minimal bacterial reduction i.e 10 to 16%. Conclusions Cinnamomum zeylanicum, Syzygium aromaticum and Ocimum sanctum showed intracanal bacterial reduction against Enterococcus faecalis. The 3 experimental groups were less effective in terms of intracanal bacterial reduction as compare to NaOCl but more effective than distilled water. Key words:Antimicrobial activity, Cinnamomum zeylanicum, Enterococcus faecalis, Ocimum sanctum, Syzygium aromaticum, herbal extracts.
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Affiliation(s)
- Alpa Gupta-Wadhwa
- Senior resident. Department of Conservative Dentistry & Endodontics, Post Graduate Institute of Dental Sciences, Rohtak
| | - Jitesh Wadhwa
- Senior lecturer. Department of Orthodontics, Inderprastha Dental College, Sahibabad
| | - Jigyasa Duhan
- Professor. Department of Conservative Dentistry & Endodontics, Post Graduate Institute of Dental Sciences, Rohtak
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Gokturk H, Bayram E, Bayram HM, Aslan T, Ustun Y. Effect of double antibiotic and calcium hydroxide pastes on dislodgement resistance of an epoxy resin-based and two calcium silicate-based root canal sealers. Clin Oral Investig 2016; 21:1277-1282. [PMID: 27287499 DOI: 10.1007/s00784-016-1877-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 06/06/2016] [Indexed: 02/04/2023]
Abstract
OBJECTIVES The purpose of the present study was to determine the dislodgement resistance of AH Plus, MTA Fillapex, and Total Fill BC sealer to root canal dentin walls following placement of calcium hydroxide (CH) or double antibiotic paste (DAP) medicaments. MATERIALS AND METHODS Root canals of 90 single-rooted human mandibular premolar teeth were instrumented with Reciproc rotary instruments to a size R50. The teeth were randomly divided into two experimental groups: those receiving an intracanal medicament with either CH or DAP and a control group (n = 30). After 3 weeks, the medicaments were removed by irrigation with 5 mL of 2.5 % NaOCl, 5 mL 17 % EDTA, and 5 mL distilled water under sonic agitation. Each group was then subdivided into three subgroups (n = 10), and the canals were filled with either AH Plus, MTA Fillapex, or Total Fill BC sealer. After 1 week, a push-out test was applied to the specimens and the results were analyzed using one-way analysis of variance (ANOVA) and post hoc Tamhane's tests. RESULTS Regardless of the type of intracanal medicament used, Total Fill BC Sealer and MTA Fillapex showed the highest and lowest bond strength, respectively (P < 0.05). The use or absence of medicaments did not significantly affect the dislodgment resistance of root canal fillings (P > 0.05). Prior CH placement improved dislodgement resistance of all sealers without statistical difference (P > 0.05). Adhesive failure between core and sealer was the most frequent failure mode. CONCLUSIONS Prior application of CH or DAP did not significantly affect the adhesion of the AH Plus, MTA Fillapex, and Total Fill BC Sealers. CLINICAL RELEVANCE There is a little information about the influence of antibiotic medicaments on the bond strength of root canal sealer. These findings suggest that the use of DAP does not affect the adhesion strength of AH Plus, MTA Fillapex, and Total Fill BC Sealers.
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Affiliation(s)
- Hakan Gokturk
- Department of Endodontics, Faculty of Dentistry, Gaziosmanpaşa University, 60100, Tokat, Turkey.
| | - Emre Bayram
- Department of Endodontics, Faculty of Dentistry, Gaziosmanpaşa University, 60100, Tokat, Turkey
| | - Huda Melike Bayram
- Department of Endodontics, Faculty of Dentistry, Gaziosmanpaşa University, 60100, Tokat, Turkey
| | - Tugrul Aslan
- Department of Restorative Dentistry and Endodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
| | - Yakup Ustun
- Department of Restorative Dentistry and Endodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
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Synthesis and Characterization of New Chlorhexidine-Containing Nanoparticles for Root Canal Disinfection. MATERIALS 2016; 9:ma9060452. [PMID: 28773576 PMCID: PMC5456790 DOI: 10.3390/ma9060452] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 05/19/2016] [Accepted: 05/30/2016] [Indexed: 11/17/2022]
Abstract
Root canal system disinfection is limited due to anatomical complexities. Better delivery systems of antimicrobial agents are needed to ensure efficient bacteria eradication. The purpose of this study was to design chlorhexidine-containing nanoparticles that could steadily release the drug. The drug chlorhexidine was encapsulated in poly(ethylene glycol)–block–poly(l-lactide) (PEG–b–PLA) to synthesize bilayer nanoparticles. The encapsulation efficiency was determined through thermogravimetric analysis (TGA), and particle characterization was performed through microscopy studies of particle morphology and size. Their antimicrobial effect was assessed over the endodontic pathogen Enterococcus faecalis. The nanoparticles ranged in size from 300–500 nm, which is considered small enough for penetration inside small dentin tubules. The nanoparticles were dispersed in a hydrogel matrix carrier system composed of 1% hydroxyethyl cellulose, and this hydrogel system was observed to have enhanced bacterial inhibition over longer periods of time. Chlorhexidine-containing nanoparticles demonstrate potential as a drug carrier for root canal procedures. Their size and rate of release may allow for sustained inhibition of bacteria in the root canal system.
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Gill GS, Bhuyan AC, Kalita C, Das L, Kataki R, Bhuyan D. Single Versus Multi-visit Endodontic Treatment of Teeth with Apical Periodontitis: An in vivo Study with 1-year Evaluation. Ann Med Health Sci Res 2016; 6:19-26. [PMID: 27144072 PMCID: PMC4849111 DOI: 10.4103/2141-9248.180265] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background: Apical periodontitis (AP) is one of the most prevalent diseases of the teeth. Treatment of AP is based on the removal of the cause, i.e., bacteria from the root canals. Achievement of adequate bacterial eradication in one appointment treatment remains a controversy. Aim: This prospective study was conducted with the objective to compare the periapical healing of teeth with AP treated in (a) single visit versus (b) two visits, either with or without Vitapex as an intracanal medicament. Subjects and Methods: Patients were selected randomly from the Department of Conservative Dentistry and Endodontics. Forty-three patients (81 teeth) met the inclusion criteria, i.e., AP (both symptomatic and asymptomatic) visible radiographically size ≥2 mm × 2 mm, not suffering from any immune-compromising disease, age between 16 and 65 years and tooth not accessed previously. Patients were randomly divided into three groups, i.e., single-visit group (Group 1), multi-visit group without any intracanal medicament (Group 2), and multi-visit group with Vitapex as interim intracanal medicament (Group 3). Comparison was done radiographically using periapical index (PAI). The primary outcome measure was the change in periapical radiolucency after 1 year assessed by PAI scores. The Mann-Whitney U-test was used to evaluate differences between groups at baseline (immediate postoperative) and at the 12-month follow-up evaluation. Change in PAI score for each group from baseline to 12-month follow-up evaluation was tested with the Wilcoxon signed rank test. The secondary outcome measures, proportion of teeth in each group that could be considered improved (decreased PAI score) or healed (PAI <2), were assessed with the Chi-square test. Results: No statistically significant difference in periapical healing was found between three groups. Conclusion: After 1-year evaluation, no difference in periapical healing was found between single-visit treatment and multi-visit treatment groups with the given sample size.
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Affiliation(s)
- G S Gill
- Department of Conservative Dentistry and Endodontics, JCD Dental College, Sirsa, Haryana, India
| | - A C Bhuyan
- Department of Conservative Dentistry and Endodontics, Regional Dental College, Guwahati, Assam, India
| | - C Kalita
- Department of Conservative Dentistry and Endodontics, Regional Dental College, Guwahati, Assam, India
| | - L Das
- Department of Conservative Dentistry and Endodontics, Regional Dental College, Guwahati, Assam, India
| | - R Kataki
- Department of Conservative Dentistry and Endodontics, Regional Dental College, Guwahati, Assam, India
| | - D Bhuyan
- Department of Conservative Dentistry and Endodontics, Regional Dental College, Guwahati, Assam, India
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