Antifungal Efficacy of 5.25% Sodium Hypochlorite, 2% Chlorhexidine Gluconate, and 17% EDTA With and Without an Antifungal Agent

Bactericidal Activity of Silver Nanoparticles on Oral Biofilms Related to Patients with and without Periodontal Disease

BACKGROUND AND OBJECTIVES

Periodontal disease (PD) is a multifactorial oral disease regularly caused by bacterial biofilms. Silver nanoparticles (AgNP) have offered good antimicrobial activity; moreover, there is no available scientific information related to their antimicrobial effects in biofilms from patients with PD. This study reports the bactericidal activity of AgNP against oral biofilms related to PD.

MATERIALS AND METHODS

AgNP of two average particle sizes were prepared and characterized. Sixty biofilms were collected from patients with (30 subjects) and without PD (30 subjects). Minimal inhibitory concentrations of AgNP were calculated and the distribution of bacterial species was defined by polymerase chain reaction.

RESULTS

Well-dispersed sizes of AgNP were obtained (5.4 ± 1.3 and 17.5 ± 3.4 nm) with an adequate electrical stability (-38.2 ± 5.8 and -32.6 ± 5.4 mV, respectively). AgNP showed antimicrobial activities for all oral samples; however, the smaller AgNP had significantly the most increased bactericidal effects (71.7 ± 39.1 µg/mL). The most resistant bacteria were found in biofilms from PD subjects (p < 0.05). P. gingivalis, T. denticola, and T. forsythia were present in all PD biofilms (100%).

CONCLUSIONS

The AgNP showed efficient bactericidal properties as an alternative therapy for the control or progression of PD.

Antibacterial and Antifungal Efficacy of Platelet-Rich Fibrin and Platelet-Rich Fibrin Matrix against Root Canal Microflora

Background:

Binding of such proteins with a developing fibrin mesh or to the extracellular matrix has the ability to create chemotactic gradients aiding the recruitment of stem cells, thereby, stimulating cell migration and differentiation this may promotes repair and regeneration. There is a unique concept in platelet concentrates called platelet-rich fibrin matrix (PRFM) which is processed using higher attraction without the utilization of bovine thrombin.

Aim and Objectives:

The aim of this study is to evaluate the antibacterial and antifungal effects of platelet-rich fibrin (PRF) and PRFM against root canal microflora.

Materials and Methods:

Blood samples were taken from 20 adults, age ranging from 20 to 40 years who were systemically healthy, nonsmokers with no symptoms of infection, or on antibiotics at least 3 months before experiments. The procedures and the protocols involved in the study were accepted by the Institutional Ethical Committee. Written informed consent was obtained from the donors and patients. Approximately 10 ml of blood was collected from each donor. 5 ml of blood was used for the preparation of PRF and 5 ml for PRFM.

Results:

The antifungal scores among the groups. The highest antifungal scores were seen in metapex followed by PRF and PRFM group. Kruskal–Wallis test was applied to check the statistical difference among the groups, and there was a statistically significant difference seen among the groups (P = 0.00). The antibacterial scores among the groups. The highest antibacterial scores were seen in Metapex followed by PRF group and PRFM group Kruskal–Wallis test was applied to check the statistical difference among the groups, and there was a statistically significant difference seen among the groups.

Conclusion:

PRF demonstrated antibacterial activity against passage isolates but had no antifungal efficacy. This antibacterial property may be a valuable adjunct when using PRF for regenerative procedures in endodontics. Both PRF and PRFM have to be analyzed for antimicrobial properties for extended duration and various other clinical strains with larger sample size.

Study of antibacterial and antifungal efficacy of platelet-rich fibrin and platelet-rich fibrin matrix

Background:

Platelet concentrates are extensively utilized in the medical and dental field to promote tissue regeneration. The profusion of endogenous growth factors in platelets α-granules transmit their use for enhanced wound healing. However, little attention has been given to study their antimicrobial potential. This study was conducted to assess the antibacterial and antifungal property of platelet-rich fibrin (PRF) and PRF matrix (PRFM).

Materials and Methodology:

Blood samples were obtained from 16 participants, PRF and PRFM were processed as per the protocol prescribed by Choukroun et al. and Lucarelli et al., respectively. The susceptibility test against microbiota in the root canal and Candida albicans was assessed through minimum inhibition zone by agar diffusion technique.

Results:

PRF showed an effective antibacterial property, however, did not perform well against C. albicans strains. PRFM did not show any antibacterial or antifungal properties.

Conclusions:

The antibacterial efficacy of PRF may prove beneficial when used in the revascularization procedure of immature necrotic teeth.

Antifungal Effect of Silver Nitrate on Prosthodontic Dentures

Background/Aim: Although there are studies about the antimicrobial activity of silver, there is no study evaluating it as a denture disinfectant. The purpose of this study was to explore the effectiveness of 6 disinfectant solutions (50% vinegar, 100% vinegar, 1% silver nitrate, 2% silver nitrate, %1 sodium hypochlorite, 0,12% chlorhexidine digluconate) in the disinfection of acrylic resin specimens contaminated in vitro by Candida albicans, as measured by residual colony-forming unit (CFU).

Material and Methods: 66 pieces of 10mmx2mm acrylic resin disc samples were prepared and incubated in 1x106 cell/ml suspension of C. albicans ATCC 18804 for 24 h (one of them as a control, n=11/group). The specimens were then transferred into tubes containing 10 ml of the tested disinfectants and kept for 10 minutes in the disinfectant. After washing with saline, the specimens were vortexed to remove the microorganisms adhered to the surfaces. Colony counting of the collected microorganisms was performed on Sabouroud dextrose medium using 10−1, 10−2 and 10−3 dilutions. The results were analysed using Kruskal-Wallis and Mann-Whitney U tests (p<0,05).

Results: The results showed that 1% sodium hypochlorite, %1 silver nitrate and 2% silver nitrate were the most effective against Candida Albicans (p<0,05), followed by 100% vinegar, 0,12% chlorhexidine digluconate and 50% vinegar (p<0,05).

Conclusions: Within the boundaries of this study, we conclude that 1% silver nitrate is a promising alternative disinfectant to 1% sodium hypochlorite and performs better compared to 0,12 % chlorhexidine gluconate, 50% and 100% vinegar.

Antimicrobial activity of endodontic sealers and medications containing chitosan and silver nanoparticles against Enterococcus faecalis

BACKGROUND

The main microorganism associated with the failure of endodontic treatments is Enterococcus faecalis. Although several endodontic therapeutics have demonstrated antimicrobial activity against E. faecalis, the antimicrobial effectiveness of chitosan (CsNPs) and silver nanoparticles (AgNPs) included into conventional endodontic sealers for endodontic therapies is still unclear.

AIM

The objective of this study was to evaluate the antibacterial activity increment (AAI) of endodontic sealers containing CsNPs and AgNPs as well as some chemical components against E. faecalis by direct contact assays.

METHODS

CsNPs and AgNPs were synthesized by reduction and ionic gelation methods, respectively. Nanoparticles were characterized by dynamic light scattering and energy dispersive X-ray analysis. The bactericidal activity was tested on monolayers on agar plates and collagen membrane surface assays against E. faecalis.

RESULTS

The size of CsNPs was 70.6±14.8 nm and zeta potential was 52.0±5.4 mV; the size of AgNPs was 54.2±8.5 nm, and zeta potential was -48.4±6.9 mV. All materials, single or combined, showed an AAI, especially when CsNPs, chlorhexidine (Chx), and the combination of CsNPs-Chx were added. However, the combination of CsNPs-Chx showed the highest (55%) AAI, followed by Chx (35.5%) and CsNPs (11.1%), respectively. There was a significant statistical difference in all comparisons (p < 0.05). Tubliseal (40%) and AH Plus (32%) sealants showed a higher AAI on E. faecalis in the monolayer test and collagen membrane assay analyzed by scanning electron microscopy.

CONCLUSIONS

Tubliseal and AH plus sealers combined with nanoparticles, especially CsNPs-Chx, could be used for conventional endodontic treatments in the control of E. faecalis bacteria.

Comparative Evaluation of the Antibacterial Efficacy of Aloe Vera, 3% Sodium Hypochlorite, and 2% Chlorhexidine Gluconate Against Enterococcus faecalis: An In Vitro Study

Aim

To compare the antibacterial efficacy of irrigants (aloe vera, 3% sodium hypochlorite (NaOCl), 2% chlorhexidine (CHX), and saline) against Enterococcus faecalis using the turbidometric analysis and colony count method.

Materials and methods

Eighty freshly extracted, single-rooted, human mandibular premolar teeth were taken. Access opening was done, instrumented, and autoclaved. Samples were inoculated with 10 µL of an Enterococcus faecalis (E. faecalis) bacterial suspension and incubated at 37^◦C for three days. Samples were divided into four groups of 20 teeth each based on the type of irrigating solution used. Group 1 was irrigated with 3% sodium hypochlorite; Group 2 with 2% chlorhexidine; group 3 with aloe vera; and Group 4 with 0.9% saline (the control group). Ten teeth from each group were subjected to a turbidity analysis by spectrophotometer and the remaining 10 teeth from each group were tested for colony-forming units (CFU)/mL. The plates were incubated at 37^◦C for 24 hours and CFU that were grown were counted using a bacterial colony counter. Results were subjected to an analysis of variance (ANOVA) followed by a post hoc Games-Howell test.

Results

All the tested irrigating solutions demonstrated an antibacterial effect against E. faecalis. The greatest antimicrobial effects were observed in samples treated with 2% CHX (p<0.001). No statistically significant difference was found between 3% NaOCl and aloe vera (p > 0.001) against E. faecalis.

Conclusion

Two percent chlorhexidine exhibited good antimicrobial efficacy against E. faecalis. Three percent NaOCl and aloe vera showed a similar antimicrobial efficacy against E. faecalis. Aloe vera can be used as an antibacterial agent in novel drugs for the treatment of bacterial diseases.

Comparison of Different Irrigants in the Removal of Endotoxins and Cultivable Microorganisms from Infected Root Canals

This study was conducted to compare the effectiveness of different irrigants used to remove endotoxins and cultivable microorganisms during endodontic therapy. Forty root canals were contaminated and divided into groups according to the irrigant: 2% NaOCl + surfactant, 2% CHX, 2.5% NaOCl, and pyrogen-free saline solution (control). Samples were collected after root canal contamination (S1), after instrumentation (S2), and 7 days after instrumentation (S3). Microorganisms and endotoxins were recovered from 100% of the contaminated root canals (S1). At S2, 2% NaOCl + surfactant, 2% CHX, and 2.5% NaOCl were able to completely eliminate cultivable microorganisms. At S3, both 2% CHX and 2.5% NaOCl were effective in preventing C. albicans and E. coli regrowth, but E. faecalis was still detected. No microorganism species was recovered from root canals instrumented with 2% NaOCl + surfactant. At S2, a higher percentage value of endotoxin reduction was found for 2% NaOCl + surfactant (99.3%) compared to 2% CHX (98.9%) and 2.5% NaOCl (97.18%) (p < 0.05). Moreover, at S3, 2% NaOCl + surfactant (100%) was the most effective irrigant against endotoxins. All irrigants tested were effective in reducing microorganisms and endotoxins from root canals. Moreover, 2% NaOCl + surfactant was the most effective irrigant against endotoxins and regrowth of microorganisms.

Comparative evaluation of antimicrobial efficacy of QMix™ 2 in 1, sodium hypochlorite, and chlorhexidine against Enterococcus faecalis and Candida albicans

Aim/Objective:

The aim of this study is to compare the antimicrobial efficacy of QMix™ 2 in 1, sodium hypochlorite (NaOCl), and chlorhexidine (CHX) against Enterococcus faecalis and Candida albicans.

Materials and Methods:

Eighty freshly extracted, single-rooted human mandibular premolar teeth were instrumented and autoclaved. Samples were divided into two groups of 40 teeth each based on the type of microorganism used. Group I was inoculated with E. faecalis and Group II with C. albicans and incubated for 3 days. Each group was subdivided into four subgroups based on the type of irrigant used. Group IA, IIA, 5.25% NaOCl; Group IB, IIB, 2% CHX; Group IC, IIC, QMix™ 2 in 1; and Group ID, IID, 0.9% saline (the control group). Ten microliters of the sample from each canal was taken and was placed on Brain Heart Infusion agar and Sabouraud dextrose agar. The plates were incubated at 37°C for 24 h and colony forming units (CFUs) that were grown were counted. Data was analyzed with analysis of variance (ANOVA) followed by post-hoc Games-Howell test.

Results:

The greatest antimicrobial effects were observed in samples treated with QMix™ 2 in 1 (P < 0.001). No statistical significant difference was found between 5.25% NaOCl and 2% CHX (P > 0.001) against E. faecalis and C. albicans.

Conclusion:

QMix™ 2 in 1 demonstrated significant antimicrobial efficacy against E. faecalis and C. albicans.

Antifungal activity of several root canal sealers against Candida albicans

OBJECTIVE

The purpose of this in vitro study was to evaluate the antifungal activity of several root canal sealers (iRoot SP, MTA Fillapex and GuttaFlow) against Candida albicans and compare them to that of AH Plus Jet.

MATERIALS AND METHODS

A 10 μL fungi in suspension was allowed to directly contact the sealers, which were freshly mixed or allowed to set for 1 or 7 days. Fresh media was then added and survival of fungi was determined by using 10-fold serial dilution and inoculated onto agar plates. After incubation for 48 h, colony-forming units (CFU) were calculated and their log10 values converted. The data were analyzed using ANOVA and Tukey tests (α = 0.05).

RESULTS

Freshly mixed AH Plus Jet totally inhibited the growth of fungi and showed the highest antifungal activity. GuttaFlow did not show any significant antifungal activity at all times. Freshly mixed iRoot SP and MTA Fillapex were found to be antifungal. Statistical differences were found between freshly mixed and set samples (p < 0.05) in favor of the former, except GuttaFlow. No statistically significant differences were found among the tested sealers at the 1 and 7-day samples (p > 0.05).

CONCLUSIONS

Fresh AH Plus Jet had very potent antifungal activity. All sealers, except GuttaFlow, exhibited antifungal activity when freshly mixed.

Antimicrobial activity of calcium hydroxide and chlorhexidine on intratubular Candida albicans

This study investigated the efficacy of calcium hydroxide and chlorhexidine gel for the elimination of intratubular Candida albicans (C. albicans). Human single-rooted teeth contaminated with C. albicans were treated with calcium hydroxide, 2% chlorhexidine gel, calcium hydroxide plus 2% chlorhexidine gel, or saline (0.9% sodium chloride) as a positive control. The samples obtained at depths of 0–100 and 100–200 µm from the root canal system were analyzed for C. albicans load by counting the number of colony forming units and for the percentage of viable C. albicans using fluorescence microscopy. First, the antimicrobial activity of calcium hydroxide and the 2% chlorhexidine gel was evaluated by counting the number of colony forming units. After 14 days of intracanal medication, there was a significant decrease in the number of C. albicans colony forming units at a depth of 0–100 µm with chlorhexidine treatment either with or without calcium hydroxide compared with the calcium hydroxide only treatment. However, there were no differences in the number of colony forming units at the 100–200 µm depth for any of the medications investigated. C. albicans viability was also evaluated by vital staining techniques and fluorescence microscopy analysis. Antifungal activity against C. albicans significantly increased at both depths in the chlorhexidine groups with and without calcium hydroxide compared with the groups treated with calcium hydroxide only. Treatments with only chlorhexidine or chlorhexidine in combination with calcium hydroxide were effective for elimination of C. albicans.

The effect of temperature and contact time of sodium hypochlorite on human roots infected with Enterococcus faecalis and Candida albicans

The aim of this study was to evaluate the effectiveness of 2.5 % NaOCl at different temperature and time intervals on Enterococcus faecalis and Candida albicans-infected human roots. A total of 112 root cylinders prepared from extracted single-rooted humans were infected by E. faecalis (Group A, n = 56) or C. albicans (Group B, n = 56); 3 root cylinders served as negative controls. Both groups were further divided into 6 subgroups according to three contact times (30 s, 1 min, 5 min) with NaOCl at two different temperatures (25 or 37 °C). Microorganism growth was controlled at the 24th and 48th hours. Statistical analysis was performed using the Chi-square test. While NaOCl at 25 °C for 5 min was the most effective irrigation regimen to eliminate E. faecalis (p < 0.001), NaOCl at 37 °C for 5 min exhibited significantly superior antifungal properties (p < 0.05). At the same contact times, difference in the temperature of NaOCl did not affect the growth of either E. faecalis or C. albicans. As a result, the irrigation time of NaOCl was more effective than the temperature to eliminate E. faecalis, while pre-heating of NaOCl to 37 °C increased its effectiveness on C. albicans at 5 min contact time.

Randomized study of minocycline and edetic acid as a locking solution for central line (port-a-cath) in children with cancer

BACKGROUND

Contamination of central catheters is frequent, and biofilm perpetuates infections. Heparin does not protect against infections because it has no antibiotic action. Minocycline and edetic acid (M-EDTA), a potent calcium chelating agent that destroys bacterial and fungal cell membrane and disrupts biofilm, may be an alternative to allow the associated antibiotic to act locally at a high and safe concentration.

METHODS

Fifty children with cancer and a port-a-cath were followed up: 26 received heparin (group 1) and 24 M-EDTA (group 2). A total of 762 serial prospective blood cultures were obtained, 387 from group 1 and 375 from group 2.

RESULTS

In group 1 (heparin), 19 blood cultures were positive, and infection incidence was 73.1% (19/26 ports). In group 2 (M-EDTA), 5 blood cultures were positive, and the incidence rate was 20.8% (5/24 ports).

CONCLUSION

M-EDTA, compared with heparin, prevents and treats catheter infections, and is a promising alternative to decrease sepsis during chemotherapy.