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Shirani Lapari S, Zare Jahromi M, Tahmourespour A, Shirani AM. Comparison of the Enterococcus faecalis Colony Reduction Effect of Two Wavelengths of Diode Lasers With Three Methods of Root Canal Irrigation: An In Vitro Study. J Lasers Med Sci 2024; 15:e37. [PMID: 39193109 PMCID: PMC11348442 DOI: 10.34172/jlms.2024.37] [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: 11/19/2023] [Accepted: 05/28/2024] [Indexed: 08/29/2024]
Abstract
Introduction: The basis of successful root canal therapy is the reduction of microorganisms. The aim of this in vitro study was to compare the antibacterial effect of three different irrigation methods with two laser wavelengths on Enterococcus faecalis biofilm. Methods: Ninety-five single-canal teeth were prepared, sterilized, and divided randomly into a negative control, a positive control, and five test groups. They were inoculated with the standard strain of E. faecalis. The test groups were conventional irrigation (group 1), Passive ultrasonic irrigation (group 2), Gentle file finisher brush (group 3), 810 nm diode laser (group 4), and 980 nm diode laser (group 5). Microbial sampling, cultivation, and colony counting were done. Data were analyzed with the Kruskal-Wallis test and a negative binomial regression model. Results: There was a significant difference in the colony count between the groups (P<0.001). the 810 nm diode had the highest and the conventional irrigation group had the lowest reduction in the microbial load. Passive ultrasonic, 980 nm diode laser, and Gentle file finisher brush groups were also ranked respectively from the highest to the lowest in terms of decreasing effect on the number of colonies. Conclusion: The 810 nm diode laser and conventional irrigation were respectively the most and the least effective methods for reducing the number of E. faecalis colonies.
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Affiliation(s)
- Shiva Shirani Lapari
- Department of Endodontics, School of Dentistry, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
| | - Maryam Zare Jahromi
- Department of Endodontics, School of Dentistry, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
| | - Arezoo Tahmourespour
- Department of Microbiology, School of Dentistry, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
| | - Amir Mansour Shirani
- Department of Oral Medicine, School of Dentistry, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
- Fellowship of Laser Therapy in Dentistry, RWTH Aachen University, Aachen, Germany
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Souza MA, Steier L, Vanin GN, Zanella ML, Pizzi CM, Ferreira ER, Dallepiane FG, Piccolo NM, da Silva Koch J, Souza KR, Costa UMD, Dos Santos VV, Palatynska-Ulatowska A, de Figueiredo JAP. Antimicrobial action, cytotoxicity and erosive potential of hypochlorous acid obtained from an electrolytic device compared with sodium hypochlorite. Clin Oral Investig 2024; 28:282. [PMID: 38683234 DOI: 10.1007/s00784-024-05675-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Accepted: 04/21/2024] [Indexed: 05/01/2024]
Abstract
OBJECTIVES This study aimed to compare the antimicrobial action, cytotoxicity, cleaning ability, and erosion of dentine of hypochlorous acid (HClO) obtained from an electrolytic device at two different concentrations (Dentaqua) and three concentrations of sodium hypochlorite (NaOCl). METHODS Microbiological test-The root canals of sixty single-rooted extracted human teeth were inoculated with Enterococcus faecalis and divided into 6 groups (n = 10), according to decontamination protocol: DW (control); 1% NaOCl; 2.5% NaOCl; 5.25% NaOCl; 250 ppm HClO and 500 ppm HClO. The colony-forming units were counted to evaluate the decontamination potential of each group, calculating the reduction in bacterial percentage. Cytotoxicity test-Cytotoxicity was evaluated after inoculation of the same tested protocols in fibroblastic cells for 3 min, calculating the cell viability percentages. Specifical statistical analysis was performed (α = 5%). Cleaning ability and erosion-Fifty-six single-rooted bovine lower incisors were divided into seven groups of 8 roots each, being the test groups 1% NaOCl; 2.5% NaOCl; 5,25% NaOCl; 250 ppm HClO and 500 ppm HClO, and a negative and positive control. Negative control was not contaminated, and the other groups were inoculated with Enterococcus faecalis. SEM images were ranked as from the cleanest to the least clean. Erosion was also assessed, being ranked from the least to the most eroded dentine. RESULTS The highest bacterial reduction was observed in experimental groups, with no statistical differences between them (p > 0.05). The highest number of viable cells was observed in control group, followed by 250 ppm HClO and 500 ppm HClO groups, with statistical differences between them (p < 0.05). 1% NaOCl; 2.5% NaOCl; 5.25% NaOCl and 500 ppm HClO displayed the cleanest areas. All sodium hypochlorite groups displayed erosion with higher ranks with greater concentration, while hypochlorous acid did not display any erosion regardless the concentration. CONCLUSIONS It is possible to conclude that HClO obtained from an electrolytic device presented high antimicrobial activity and low cytotoxicity in both tested concentrations. 500 ppm HClO did not display erosion and showed great cleaning ability. CLINICAL RELEVANCE The use of 500 ppm hypochlorous acid may reduce unfavorable behavior of sodium hypochlorite whilst maintaining its antimicrobial action.
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Affiliation(s)
- Matheus Albino Souza
- School of Dentistry, Graduate Program in Dentistry, University of Passo Fundo - UPF. BR 285/São José, Prédio A7, Apto 2, Passo Fundo, RS, CEP: 9052-900, Brazil
| | - Liviu Steier
- School of Dental Medicine, University of Pennsylvania - UPENN, 240 South 40Th Street (40Th & Locust St.), Philadelphia, PA, ZIP19104, USA
| | - Gabriele Nichetti Vanin
- School of Dentistry, Graduate Program in Dentistry, University of Passo Fundo - UPF. BR 285/São José, Prédio A7, Apto 2, Passo Fundo, RS, CEP: 9052-900, Brazil
| | - Mylena Lazareti Zanella
- School of Dentistry, Graduate Program in Dentistry, University of Passo Fundo - UPF. BR 285/São José, Prédio A7, Apto 2, Passo Fundo, RS, CEP: 9052-900, Brazil
| | - Camila Monteiro Pizzi
- School of Dentistry, Graduate Program in Dentistry, University of Passo Fundo - UPF. BR 285/São José, Prédio A7, Apto 2, Passo Fundo, RS, CEP: 9052-900, Brazil
| | - Eduarda Rizzon Ferreira
- School of Dentistry, Graduate Program in Dentistry, University of Passo Fundo - UPF. BR 285/São José, Prédio A7, Apto 2, Passo Fundo, RS, CEP: 9052-900, Brazil
| | - Felipe Gomes Dallepiane
- School of Dentistry, Graduate Program in Dentistry, University of Passo Fundo - UPF. BR 285/São José, Prédio A7, Apto 2, Passo Fundo, RS, CEP: 9052-900, Brazil
| | - Nathan Mateus Piccolo
- School of Dentistry, Graduate Program in Dentistry, University of Passo Fundo - UPF. BR 285/São José, Prédio A7, Apto 2, Passo Fundo, RS, CEP: 9052-900, Brazil
| | - Jordana da Silva Koch
- Graduate Program in Dentistry, Oral Biology Lab, Federal University of Rio Grande do Sul - UFRGS, Rua Sarmento Leite 500 Sala 134, Porto Alegre, RS, CEP90050-170, Brazil
| | - Kellyn Rocca Souza
- Graduate Program in Dentistry, Oral Biology Lab, Federal University of Rio Grande do Sul - UFRGS, Rua Sarmento Leite 500 Sala 134, Porto Alegre, RS, CEP90050-170, Brazil
| | - Ubirajara Maciel da Costa
- School of Veterinary Medicine, State University of Santa Catarina - UDESC, Av. Luiz de Camões, 2090, Conta Dinheiro, Lages, SC, CEP: 88.520-000, Brazil
| | - Vanessa Valgas Dos Santos
- School of Medicine, University of Planalto Catarinense - UNIPLAC, Av. Mal. Castelo Branco 170, Lages, SC, CEP 88526-075, Brazil
| | - Aleksandra Palatynska-Ulatowska
- Department of Endodontics, Medical Faculty, Division of Dentistry, Medical University of Lödz, 251 Pomorska Street, Lödz, 92-213, Poland
| | - José Antônio Poli de Figueiredo
- Graduate Program in Dentistry, Oral Biology Lab, Federal University of Rio Grande do Sul - UFRGS, Rua Sarmento Leite 500 Sala 134, Porto Alegre, RS, CEP90050-170, Brazil.
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Dede M, Basche S, Neunzehn J, Dannemann M, Hannig C, Kühne MT. Efficacy of Endodontic Disinfection Protocols in an E. faecalis Biofilm Model-Using DAPI Staining and SEM. J Funct Biomater 2023; 14:jfb14040176. [PMID: 37103266 PMCID: PMC10145082 DOI: 10.3390/jfb14040176] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 03/15/2023] [Accepted: 03/21/2023] [Indexed: 04/28/2023] Open
Abstract
The aim of this study was to investigate the antimicrobial efficacy of different disinfection protocols in a novel Enterococcus faecalis biofilm model based on a visualization method and to evaluate the potential alteration of dentinal surface. A total of 120 extracted human premolars were allocated to 6 groups with different irrigation protocols. The assessment of the effectiveness of each protocol and the alteration of dentinal surface were visualized by using SEM and fluorescence microscopy (DAPI). A dense E. faecalis biofilm with a penetration depth of 289 μm (medial part of the root canal) and 93 μm (apical part) validated that the biofilm model had been successfully implemented. A significant difference between the 3% NaOCl groups and all the other groups in both observed parts of the root canal (p < 0.05) was detected. However, the SEM analysis revealed that the dentinal surface in the 3% NaOCl groups was severely altered. The established biofilm model and the visualization method based on DAPI are appropriate for bacterial quantification and evaluation of the depth effect of different disinfection protocols in the root canal system. The combination of 3% NaOCl with 20% EDTA or MTAD with PUI allows the decontamination of deeper dentine zones within the root canal but simultaneously alters the dentinal surface.
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Affiliation(s)
- Maria Dede
- Policlinic of Operative and Pediatric Dentistry, Medical Faculty Carl Gustav Carus, TU Dresden, 01307 Dresden, Germany
- Department of Endodontics, School of Dentistry, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Sabine Basche
- Policlinic of Operative and Pediatric Dentistry, Medical Faculty Carl Gustav Carus, TU Dresden, 01307 Dresden, Germany
| | - Jörg Neunzehn
- Vertriebsgesellschaft GmbH, Geistlich Biomaterials, Schneidweg 5, 76534 Baden-Baden, Germany
| | - Martin Dannemann
- Faculty of Automotive Engineering, Institute of Energy and Transport Engineering, Westsächsische Hochschule Zwickau, 08056 Zwickau, Germany
| | - Christian Hannig
- Policlinic of Operative and Pediatric Dentistry, Medical Faculty Carl Gustav Carus, TU Dresden, 01307 Dresden, Germany
| | - Marie-Theres Kühne
- Policlinic of Operative and Pediatric Dentistry, Medical Faculty Carl Gustav Carus, TU Dresden, 01307 Dresden, Germany
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de Oliveira RA, Weissheimer T, Só GB, da Rosa RA, Souza MA, Ribeiro RG, Só MVR. Dentinal tubule penetration of sodium hypochlorite in root canals with and without mechanical preparation and different irrigant activation methods. Restor Dent Endod 2023; 48:e1. [PMID: 36875814 PMCID: PMC9982243 DOI: 10.5395/rde.2023.48.e1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 09/13/2022] [Accepted: 10/04/2022] [Indexed: 12/12/2022] Open
Abstract
Objectives This study evaluated the dentinal penetration depth of 2.5% sodium hypochlorite (NaOCl) in root canals with and without preparation and different irrigant activation protocols. Materials and Methods Sixty-three bovine mandibular incisors were randomly allocated to 6 groups (n = 10): G1, preparation + conventional needle irrigation (CNI); G2, preparation + passive ultrasonic irrigation (PUI); G3, preparation + Odous Clean (OC); G4, no preparation + CNI; G5, no preparation + PUI; G6, no preparation + OC; and CG (negative control; n = 3). Samples were filled with crystal violet for 72 hours. Irrigant activation was performed. Samples were sectioned perpendicularly along the long axis, 3 mm and 7 mm from the apex. Images of the root thirds of each block were captured with a stereomicroscope and analyzed with an image analysis software. One-way analysis of variance, followed by the Tukey post hoc test, and the Student's t-test were used for data analysis, with a significance level of 5%. Results The NaOCl penetration depth was similar when preparation was performed, regardless of the method of irrigation activation (p > 0.05). In the groups without preparation, G6 showed greater NaOCl penetration depth (p < 0.05). The groups without preparation had a greater NaOCl penetration depth than those with preparation (p = 0.0019). Conclusions The NaOCl penetration depth was similar in groups with root canal preparation. Without root canal preparation, OC allowed deeper NaOCl penetration. The groups without preparation had greater NaOCl penetration than those undergoing root canal preparation.
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Affiliation(s)
- Renata Aqel de Oliveira
- Department of Conservative Dentistry, School of Dentistry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Theodoro Weissheimer
- Department of Conservative Dentistry, School of Dentistry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Gabriel Barcelos Só
- Department of Conservative Dentistry, School of Dentistry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Ricardo Abreu da Rosa
- Department of Conservative Dentistry, School of Dentistry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Matheus Albino Souza
- Department of Endodontics, School of Dentistry, University of Passo Fundo (UPF), Passo Fundo, RS, Brazil
| | - Rodrigo Gonçalves Ribeiro
- Department of Endodontics, School of Dentistry, State University of Western Paraná (UNIOESTE), Cascavel, PR, Brazil
| | - Marcus Vinicius Reis Só
- Department of Conservative Dentistry, School of Dentistry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
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Takagi BAR, Kopper PMP, Luz L, Luisi SB, Scarparo RK. Apical extrusion of sodium hypochlorite in immature teeth: comparison of three different cleaning protocols. AUST ENDOD J 2022; 48:380-385. [PMID: 34617648 DOI: 10.1111/aej.12574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 08/02/2021] [Accepted: 09/26/2021] [Indexed: 12/14/2022]
Abstract
This study compared standard needle irrigation, passive ultrasonic irrigation, XP-Endo Finisher and Easy Clean in the apical extrusion of sodium hypochlorite (NaOCl) in a model simulating immature teeth. Ten bovine teeth were maintained in suspension in a container with the apical portion in contact with 0.2% agarose gel containing 0.1% metacresol purple. The canals were irrigated with 2.5% NaOCl, according to each irrigation protocol. After 3 min, apical extrusion of NaOCl was observed by the colour gel change when in contact with NaOCl. The containers were photographed, and the NaOCl extrusion area was measured. All protocols showed NaOCl extrusion, providing similar area (P > 0.05). Considering the similarity among the studied protocols, all of them can be considered during the endodontic treatment of immature teeth. Further studies on the particularities of immature teeth should be performed to evaluate cell viability, cleaning efficiency, disinfection capacity and dentin removal promoted by the irrigation protocols.
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Affiliation(s)
- Brenda Ai Refosco Takagi
- Consevative Dentistry Department, Dental School, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Patrícia Maria Poli Kopper
- Consevative Dentistry Department, Dental School, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.,Graduate Dentistry Program, Dental School, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Luciana Luz
- Consevative Dentistry Department, Dental School, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Simone Bonato Luisi
- Consevative Dentistry Department, Dental School, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Roberta Kochenborger Scarparo
- Consevative Dentistry Department, Dental School, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.,Graduate Dentistry Program, Dental School, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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Moryl M, Palatyńska-Ulatowska A, Maszewska A, Grzejdziak I, Dias de Oliveira S, Pradebon MC, Steier L, Różalski A, Poli de Figueiredo JA. Benefits and Challenges of the Use of Two Novel vB_Efa29212_2e and vB_Efa29212_3e Bacteriophages in Biocontrol of the Root Canal Enterococcus faecalis Infections. J Clin Med 2022; 11:6494. [PMID: 36362722 PMCID: PMC9658868 DOI: 10.3390/jcm11216494] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 10/29/2022] [Accepted: 10/30/2022] [Indexed: 01/14/2024] Open
Abstract
Bacteriophage therapy has emerged as a strategy supplementing traditional disinfection protocols to fight biofilms. The aim of the study was to isolate the phages against E. faecalis and to characterize its biological features, morphology, and lytic activity in a formed biofilm model. METHODS E. faecalis ATCC 29212 strain was used for the trial. Two novel vB_Efa29212_2e and vB_Efa29212_3e virulent phages were isolated from urban wastewater and characterized. The E. faecalis biofilm was established in 15 bovine teeth for 21 days. Transmission (TEM) and scanning electron (SEM) microscopes with the colony-forming unit (CFU) counting were used for assessment. RESULTS Isolated phages differed in morphology. Taxonomy for vB_Efa29212_2e (Siphoviridae, Efquatovirus) and for vB_Efa29212_3e (Herelleviridae, Kochikohdavirus) was confirmed. Both phages were stable at a temperature range of 4-50 °C and showed a different tolerance to chemicals: 15% EDTA, 1-3% sodium hypochlorite, and chlorhexidine. SEM analysis showed distortion of bacteria cells after phage inoculation, which proved the lytic activity against E. faecalis. A 54.6% reduction in the E. faecalis biofilm confirmed bacteriophage efficacy against isolates in the ex vivo model. CONCLUSIONS Results strongly support the concept that phage therapy has a real therapeutic potential for the prevention and treatment of E. faecalis-associated infections.
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Affiliation(s)
- Magdalena Moryl
- Department of Biology of Bacteria, Institute of Microbiology, Biotechnology and Immunology, Faculty of Biology and Environmental Protection, University of Lodz, 90-237 Lodz, Poland
| | | | - Agnieszka Maszewska
- Department of Biology of Bacteria, Institute of Microbiology, Biotechnology and Immunology, Faculty of Biology and Environmental Protection, University of Lodz, 90-237 Lodz, Poland
| | - Iwona Grzejdziak
- Department of Biology of Bacteria, Institute of Microbiology, Biotechnology and Immunology, Faculty of Biology and Environmental Protection, University of Lodz, 90-237 Lodz, Poland
| | - Silvia Dias de Oliveira
- Laboratory of Immunology and Microbiology, School of Health and Life Sciences, Pontifical Catholic University of Rio Grande do Sul–PUCRS, Porto Alegre 90619-900, Brazil
| | - Marieli Chitolina Pradebon
- Department of Morphological Sciences, Federal University of Rio Grande do Sul – UFRGS, Porto Allegre 90010-150, Brazil
| | - Liviu Steier
- Robert Schattner Center, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
- Federal University of Rio Grande do Sul—UFRGS, Porto Alegre 90035-003, Brazil
- Center for Transdisciplinary Research (CFTR), Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Chennai 602105, Tamil Nadu, India
| | - Antoni Różalski
- Department of Biology of Bacteria, Institute of Microbiology, Biotechnology and Immunology, Faculty of Biology and Environmental Protection, University of Lodz, 90-237 Lodz, Poland
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Josic U, Mazzitelli C, Maravic T, Fidler A, Breschi L, Mazzoni A. Biofilm in Endodontics: In Vitro Cultivation Possibilities, Sonic-, Ultrasonic- and Laser-Assisted Removal Techniques and Evaluation of the Cleaning Efficacy. Polymers (Basel) 2022; 14:polym14071334. [PMID: 35406207 PMCID: PMC9003475 DOI: 10.3390/polym14071334] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 03/21/2022] [Accepted: 03/23/2022] [Indexed: 01/27/2023] Open
Abstract
Incomplete and inadequate removal of endodontic biofilm during root canal treatment often leads to the clinical failure. Over the past decade, biofilm eradication techniques, such as sonication of irrigant solutions, ultrasonic and laser devices have been investigated in laboratory settings. This review aimed to give an overview of endodontic biofilm cultivation methods described in papers which investigated sonic-, ultrasonic- and Er:Yag laser-assisted biofilm removal techniques. Furthermore, the effectiveness of these removal techniques was discussed, as well as methods used for the evaluation of the cleaning efficacy. In general, laser assisted agitation, as well as ultrasonic and sonic activation of the irrigants provide a more efficient biofilm removal compared to conventional irrigation conducted by syringe/needle. The choice of irrigant is an important factor for reducing the bacterial contamination inside the root canal, with water and saline being the least effective. Due to heterogeneity in methods among the reviewed studies, it is difficult to compare sonic-, ultrasonic- and Er:Yag laser-assisted techniques among each other and give recommendations for the most efficient method in biofilm removal. Future studies should standardize the methodology regarding biofilm cultivation and cleaning methods, root canals with complex morphology should be introduced in research, with the aim of simulating the clinical scenario more closely.
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Affiliation(s)
- Uros Josic
- Department for Biomedical and Neuromotor Sciences, University of Bologna-Alma Mater Studiorum, 40139 Bologna, Italy; (U.J.); (C.M.); (T.M.); (A.M.)
| | - Claudia Mazzitelli
- Department for Biomedical and Neuromotor Sciences, University of Bologna-Alma Mater Studiorum, 40139 Bologna, Italy; (U.J.); (C.M.); (T.M.); (A.M.)
| | - Tatjana Maravic
- Department for Biomedical and Neuromotor Sciences, University of Bologna-Alma Mater Studiorum, 40139 Bologna, Italy; (U.J.); (C.M.); (T.M.); (A.M.)
| | - Ales Fidler
- Dental Clinic, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia;
| | - Lorenzo Breschi
- Department for Biomedical and Neuromotor Sciences, University of Bologna-Alma Mater Studiorum, 40139 Bologna, Italy; (U.J.); (C.M.); (T.M.); (A.M.)
- Correspondence:
| | - Annalisa Mazzoni
- Department for Biomedical and Neuromotor Sciences, University of Bologna-Alma Mater Studiorum, 40139 Bologna, Italy; (U.J.); (C.M.); (T.M.); (A.M.)
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8
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Abidin T, Susilo D, Gani B. The effectiveness of nano-chitosan high molecular 0.2% as irrigant agent against Enterococcus faecalis with passive ultrasonic irrigant. J Conserv Dent 2022; 25:37-41. [PMID: 35722074 PMCID: PMC9200192 DOI: 10.4103/jcd.jcd_437_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 12/10/2021] [Accepted: 12/21/2021] [Indexed: 11/06/2022] Open
Abstract
Context: Enterococcus faecalis is the microorganism most frequently associated with failure of endodontic treatment. Chitosan is an irrigant in dentistry has the properties of biocompatibility, biodegradability, bioadhesion, and not toxic to human cells. Several studies have suggested the use of ultrasonics to enhancing the action of irrigants. Aims: The aim of the study was to investigate the bacterial growth and surface roughness of the root canal surface after irrigation and agitation with passive ultrasonic irrigant. Subjects and Methods: Experimental research with randomized block design obtained a sample size for each group of 9 samples with a total number of 27 teeth divided into three treatment groups. Statistical analysis used was one-way analysis of variance. Results: The irrigation material for nano-chitosan high molecular 0.2% with passive ultrasonic irrigation (PUI) activation was shown to cause lysis on surface of bacterial cell walls. There was no significant difference between the roughness values in all treatment groups. Conclusions: The irrigation of root canal treatment with 0.2% high molecular nano-chitosan with the addition of PUI activation had significant antibacterial activities against E. faecalis.
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Yang SE, Kim YM. Comparison of Anti-Bacterial Efficacy between Passive Ultrasonic Irrigation and 980 nm-GaAlAs Laser Application in Two Root Types. ACTA ACUST UNITED AC 2021; 57:medicina57060537. [PMID: 34071900 PMCID: PMC8229449 DOI: 10.3390/medicina57060537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 05/22/2021] [Accepted: 05/23/2021] [Indexed: 11/16/2022]
Abstract
Background and Objectives: The purpose of the present study was to investigate the anti-bacterial efficacy of passive ultrasonic irrigation (PUI) and a 980-nm-gallium-aluminum-arsenide (GaAlAs) laser using a real-time DNA-based quantitative polymerase chain reaction (qPCR) assay and scanning electron microscopy (SEM). Materials and Methods: Eighty-six extracted single- and double-rooted human teeth were used in the experiment. The following four experimental groups were evaluated, as well as a control group: group 1: single root + PUI (n = 20); group 2: single root + laser application (n = 20); group 3: double roots + PUI (n = 20); group 4: double roots + laser application (n =20); control group (n = 6): 3 single roots, 3 double roots. The qPCR assay was performed in three stages to evaluate the efficacy of the adjunctive method against Enterococcus faecalis. SEM analysis was also used to examine the microstructure of root canal surfaces. The data were statistically analyzed using the Friedman test and the Kruskal–Wallis test with Bonferroni adjustment. Results: The decrease in the DNA levels from S1 (before preparation) to S2 (just after preparation) was highly significant in all groups, and decreases in DNA levels from S2 to S3 (after incubation for 1 week) were found in all experimental groups except group 1. An inter-group analysis showed that PUI was significantly more effective in terms of antibacterial efficacy than GaAlAs laser irradiation in single root (p < 0.05). However, in double roots, experimental groups did not show significantly lower DNA levels than the control group (p > 0.05). SEM images showed that cleaning of the root canal surface and reduction of dentin debris were achieved only in single-rooted teeth when using PUI application. Conclusions: Two adjunctive methods were effective in reducing E. faecalis in single rooted tooth.
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Souza MA, Palhano HS, Macci D, Broch GM, Tissiani L, Rauber BF, Cecchin D, Bervian J, de Almeida Gomes BPF, Gabrielli ES. Influence of ultrasonic activation on antimicrobial activity of a new final irrigant containing glycolic acid: An in vitro study. AUST ENDOD J 2021; 47:531-537. [PMID: 33901338 DOI: 10.1111/aej.12517] [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: 01/07/2021] [Revised: 03/19/2021] [Accepted: 04/11/2021] [Indexed: 11/29/2022]
Abstract
This study evaluated the influence of ultrasonic activation (US) on the antimicrobial activity of a new final irrigant containing glycolic acid (GA). Extracted teeth were used, being 70 to counting of colony-forming units (CFUs) and 35 to confocal laser scanning microscopy. Samples were inoculated with Enterococcus faecalis and divided into 7 groups: distilled water + US; 17% EDTA; Qmix; 17% GA; 17% EDTA + US; QMix + US; and 17% GA + US and kept in contact with test solution for 1 min in the groups with or no US. In the CFUs, the highest bacterial reduction was observed in QMix + US group, followed by QMix and GA + US. In the confocal evaluation, the lowest number of viable cells was observed in EDTA + US, with no statistical difference from QMix, QMix + US and GA + US (P > 0.05). The use of US improves the antimicrobial activity of EDTA and GA, being statistically different from the isolated use of these final irrigants in both evaluation tests.
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Affiliation(s)
| | | | - Dierro Macci
- School of Dentistry, University of Passo Fundo, Passo Fundo, RS, Brazil
| | | | - Luanda Tissiani
- School of Dentistry, University of Passo Fundo, Passo Fundo, RS, Brazil
| | | | - Doglas Cecchin
- School of Dentistry, University of Passo Fundo, Passo Fundo, RS, Brazil
| | - Juliane Bervian
- School of Dentistry, University of Passo Fundo, Passo Fundo, RS, Brazil
| | | | - Ezequiel Santin Gabrielli
- School of Dentistry, University of Passo Fundo, Passo Fundo, RS, Brazil.,School of Dentistry of Piracicaba, State University of Campinas, Piracicaba, SP, Brazil
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11
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Somacal DC, Manfroi FB, Monteiro MSG, Oliveira SD, Bittencourt HR, Borges GA, Spohr AM. Effect of pH Cycling Followed by Simulated Toothbrushing on the Surface Roughness and Bacterial Adhesion of Bulk-fill Composite Resins. Oper Dent 2020; 45:209-218. [DOI: 10.2341/19-012-l] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SUMMARY
The aim was to evaluate, in vitro, quantitatively and qualitatively, the effect of pH cycling and simulated toothbrushing on surface roughness (Ra) and bacterial adhesion (Cn) of bulk-fill composite resins. Thirty specimens of each composite resin, 5 mm wide and 4 mm high, were obtained: group 1 (control): Filtek Z250 (Z250); group 2: Filtek Bulk-Fill (FTK); group 3: Tetric N-Ceram Bulk-Fill (TTC); and group 4: Aura Bulk-Fill (AUR). After 24 hours, the specimens were polished and then alternated with demineralization/remineralization solutions for 15 cycles of 24 hours each at 37°C. Then the specimens were submitted to simulated toothbrushing. The Ra and Cn measurements were quantitatively analyzed in three stages: after polishing (Ra0 and Cn0), after pH cycling (Ra1 and Cn1), and after simulated toothbrushing (Ra2 and Cn2). The Ra values were submitted to two-way analysis of variance, followed by the Tukey test (α=0.05). The Kruskal-Wallis test, followed by multiple comparisons, was applied for Cn analysis. Surface topography and bacterial adhesion were observed by scanning electron microscopy (SEM). Z250, FTK, and TTC showed no significant change in Ra regardless of the treatment performed; AUR obtained increased Ra at Ra2 (p<0.05). FTK differed from the others at Cn0 and Cn1 (p<0.05). At Cn2, there was no difference among the composite resins. SEM images showed the exposure of fillers and microcavities at Ra1 and Ra2. There was greater bacterial adhesion at Cn1 for Z250 and FTK. It was concluded that the pH cycling caused surface degradation of all composite resins, which was potentiated by simulated toothbrushing. However, only AUR presented an increased Ra. Bacterial adhesion occurred on all composite resins after pH cycling; however, after simulated toothbrushing, adhesion of dispersed bacteria was similar for all the composite resin groups.
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Affiliation(s)
- DC Somacal
- Deise Caren Somacal, DDS, MS, Department of Restorative Dentistry, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - FB Manfroi
- Fernanda Borguetti Manfroi, DDS, MS, PhD, Department of Restorative Dentistry, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - MSG Monteiro
- Marina Silveira Gregis Monteiro, graduate student, Department of Immunology and Microbiology, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - SD Oliveira
- Sílvia Dias de Oliveira, MS, PhD, Department of Immunology and Microbiology, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - HR Bittencourt
- Hélio Radke Bittencourt, MS, PhD, Department of Statistics, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - GA Borges
- Gilberto Antonio Borges, DDS, MS, PhD, Department of Restorative Dentistry, Uberaba University, Uberaba, Brazil
| | - AM Spohr
- Ana Maria Spohr, PhD, Department of Dental Materials, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
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12
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Cho YS, Jung IY. Complete Healing of a Large Cystic Lesion Following Root Canal Treatment with Concurrent Surgical Drainage: A Case Report with 14-Year Follow-Up. J Endod 2019; 45:343-348. [DOI: 10.1016/j.joen.2018.12.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 12/04/2018] [Accepted: 12/06/2018] [Indexed: 12/20/2022]
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13
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El-Sayed H, Aly Y, Elgamily H, Nagy MM. A Promising Probiotic Irrigant: An In Vitro Study. Open Access Maced J Med Sci 2019; 7:407-411. [PMID: 30834012 PMCID: PMC6390147 DOI: 10.3889/oamjms.2019.074] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 12/01/2019] [Accepted: 12/02/2019] [Indexed: 01/12/2023] Open
Abstract
AIM: The present study aimed to investigate the inhibitory effect of Lactobacillus rhamnosus (B-445) as a probiotics irrigant on the growth of Enterococcus faecalis. METHODS: Forty-two extracted single human canal anterior teeth were prepared with rotary instrumentation and sterilised. Teeth were divided into 3 groups according to the type of irrigant, N = 14. Three experimental groups were inoculated with E. faecalis and cultured for 21 days before use; Group 1 was 2.5% NaOCl (positive control), Group 2 was saline (negative control), Group 3 was the experimental probiotic irrigant. Paper point sampling of the canals of each group was obtained before irrigation (S1), immediately after irrigation (S2) and after 24 hours (post irrigation samples) (S3) to determine remaining colony forming units for E. faecalis. Also, Colony counts for L. rhamnosus in Group 3 after immediate irrigation, as well as 24 hours post irrigation, was performed to determine the survival profile of these bacteria in infected root canal with E. faecalis. RESULTS: The NaOCl irrigant group had the lowest mean value of (log 10 CFU/mL) of E. faecalis after immediate irrigation and after 24 hrs post irrigation followed by the probiotic group, while the highest mean value was the saline group (P ≤ 0.001). The survival profile for L. rhamnosus in Group 3 after immediate irrigation and post-irrigation were slightly higher than for E. faecalis (P ≤ 0.001). CONCLUSION: Lactobacillus rhamnosus which revealed a potential inhibitory effect on the growth of Enterococcus faecalis, could be used as a new natural, safe probiotic irrigant agent.
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Affiliation(s)
- Hoda El-Sayed
- National Research Centre, Dairy Science Department (Microbiology Lab.), Food Industries and Nutrition Division, Giza, Egypt
| | - Yousra Aly
- National Research Centre, Restorative Dentistry and Dental Material Department, Giza, Egypt
| | - Hanaa Elgamily
- National Research Centre, Restorative Dentistry and Dental Material Department, Giza, Egypt
| | - Mohamed M Nagy
- Endodontic Department, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
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14
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Iandolo A, Dagna A, Poggio C, Capar I, Amato A, Abdellatif D. Evaluation of the actual chlorine concentration and the required time for pulp dissolution using different sodium hypochlorite irrigating solutions. J Conserv Dent 2019; 22:108-113. [PMID: 31142977 PMCID: PMC6519176 DOI: 10.4103/jcd.jcd_165_19] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Introduction: The goal of root canal treatment is to shape and clean the endodontic space, reducing the bacterial load and removing the pulp tissue. Obviously, the action of the endodontic instruments is limited to the main canals, regardless of the complexity of the endodontic space. Consequently, finding the best possible cleaning technique, which can be obtained chemically using irrigation solutions, is a fundamental aid in endodontic therapy. One of the most commonly used root canal irrigants is sodium hypochlorite (NaOCl), available in various commercial formulations. The effectiveness of NaOCl is undeniable. However, the action of dissolution of the pulp tissue is merely dependent on the concentration and the characteristics of the irrigant itself. Aim: The aim of this study is to evaluate the effective concentration of different commercial formulas of NaOCl, by evaluating the percentage of total chlorine in each product. The dissolution capacity of the pulp tissue of each of the tested products was then analyzed by measuring the required time. Materials and Methods: Three commercial types of NaOCl were selected for this study: 5% NaOCl (ACE, Procter and Gamble), 5% NaOCl (N5, Simit Dental), and 6% NaOCl (CanalPro, Coltene). For each product, 10 packages were used, from which samples of the product were taken and 30 ml × 5 ml tubes were filled. All samples were divided into three groups and were analyzed using the DIN EN ISO 7393-2 method and the percentage of total chlorine (expressed as a percentage) was calculated. Forty samples of vital pulp were obtained from teeth freshly extracted for periodontal reasons and stored in physiological solution. In order to unify the size and weight of the samples (0.0001 mg), a microtome and a precision balance (Pro Explorer Ohaus) were used. Each sample, carefully examined by stereomicroscope (×40), was placed in artificial plastic containers and submerged in 0.1 ml of irrigating solution at room temperature (26°C). A fourth control group used saline solution as irrigant. Simultaneously with the insertion of the irrigating solution, a digital stopwatch was activated and the time necessary for the complete dissolution of the pulp sample was measured. The data obtained was subjected to statistical analysis. Results: The average percentages of chlorine detected for each group were: 4.26% (ACE), 5.16% (N5), and 5.97% (CanalPro). The Kruskal–Wallis test showed statistically significant differences between the different commercial formulations of hypochlorite (P < 0.05). CanalPro showed the lowest values, whereas ACE showed the highest values of dissolution time of the pulp. Discussion: The analysis of the total chlorine percentage found that the actual concentration of the NaOCl in the samples is close to the values declared by the manufacturers both in the case of N5 and CanalPro. On the contrary, the concentration detected in the samples of common bench bleach (ACE) is significantly lower, which has average values <5%. This explains the longer time taken for the complete dissolution of the pulp tissue. The average dissolution time of the pulp samples was in fact inversely proportional to the concentration detected in the tested irrigants and hence that a lower time corresponds to a higher concentration.
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Affiliation(s)
- Alfredo Iandolo
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Naples, Italy
| | - Alberto Dagna
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, Section of Dentistry, Endodontic Unit, University of Pavia, Pavia, Italy
| | - Claudio Poggio
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, Section of Dentistry, Endodontic Unit, University of Pavia, Pavia, Italy
| | - Ismail Capar
- Ismail CAPAR, Private Practice, Istanbul, Turkey
| | - Alessandra Amato
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Naples, Italy
| | - Dina Abdellatif
- Department of Endodontics, Faculty of Dentistry, University of Alexandria, Alexandria, Egypt
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15
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Swimberghe RCD, Coenye T, De Moor RJG, Meire MA. Biofilm model systems for root canal disinfection: a literature review. Int Endod J 2018; 52:604-628. [PMID: 30488449 DOI: 10.1111/iej.13050] [Citation(s) in RCA: 106] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 11/20/2018] [Indexed: 12/13/2022]
Abstract
The aim of this review was to present an overview of laboratory root canal biofilm model systems described in the endodontic literature and to critically appraise the various factors that constitute these models. The electronic databases MEDLINE, Web of Science and EMBASE were searched up to and including December 2016 to identify laboratory studies using endodontic biofilm models. The following search terms were used in various combinations: biofilm, root canal, in vitro, endodontic, bacteria, root canal infection model, colony-forming unit. Only English papers from journals with an impact factor were selected. The records were screened by two reviewers, and full-text articles were assessed according to pre-defined criteria. The following data were extracted from the included studies: the microbial composition of the biofilm, the substrate, growth conditions, validation and quantification. Seventy-seven articles met the inclusion criteria. In the majority (86%) of the studies, a monospecies biofilm was cultured. In two studies, a dual-species biofilm was grown; others cultivated a multispecies biofilm, containing at least three species. Enterococcus faecalis was the most frequently used test species (in 79% of all studies, 92% of the monospecies studies). Four studies used an inoculum derived directly from the oral cavity. Human dentine was the most frequently used substratum (88% of the studies). Incubation times differed considerably, ranging from one to seventy days. The most common quantification method (in 87% of the studies) was bacterial culturing, followed by microscopy techniques. The variation in laboratory root canal biofilm model systems is notable. Because of substantial variation in experimental parameters, it is difficult to compare results between studies. This demonstrates the need for a more standardized approach and a validated endodontic biofilm model.
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Affiliation(s)
- R C D Swimberghe
- Department of Restorative Dentistry & Endodontology, Dental School, Ghent University, Gent, Belgium
| | - T Coenye
- Laboratory of Pharmaceutical Microbiology, Ghent University, Gent, Belgium
| | - R J G De Moor
- Department of Restorative Dentistry & Endodontology, Dental School, Ghent University, Gent, Belgium
| | - M A Meire
- Department of Restorative Dentistry & Endodontology, Dental School, Ghent University, Gent, Belgium
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16
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Froughreyhani M, Salemmilani A, Mozafari A, Hosein-Soroush M. Effect of electric currents on antibacterial effect of chlorhexidine against Entrococcus faecalis biofilm: An in vitro study. J Clin Exp Dent 2018; 10:e1223-e1229. [PMID: 30697382 PMCID: PMC6343980 DOI: 10.4317/jced.55369] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 11/02/2018] [Indexed: 11/08/2022] Open
Abstract
Background This in vitro study was mainly aimed to evaluate the effect of high-frequency alternating currents (AC) applied by an electronic apex locator (EAL) on the antibacterial properties of chlorhexidine (CHX) on E. faecalis biofilm. Material and Methods The root canals of 120 extracted human single-rooted teeth were prepared using Gates-Glidden drills and hand K-files. After contaminating the root canals with E. faecalis, they were incubated for 60 days. Then, the teeth were randomly divided into six experimental groups (n=20). Group 1, 2% CHX; group 2, normal saline (NS) with direct current (DC); group 3, normal saline (NS) with high-frequency alternating current (AC); group 4, 2% CHX with DC; group 5, 2% CHX with AC; group 6, control (normal saline). The samples were collected from the root canal walls of 16 teeth in each group and 1:10 serial dilutions were prepared and added to Muller-Hinton agar (MHA) plates and incubated at 37°C for 48 h. The longitudinal sections of the other 4 teeth used to observe under a scanning electron microscope (SEM). A classic colony counting technique was used for counting the vital E. faecalis bacteria in MHA. Two-way ANOVA was used for statistical analysis of the data. The level of significance was set at P<0.05. Results The electric current significantly changed the colony-forming units (CFU) values (P<0.001). According to pair-wise comparisons, the highest CFU difference was observed between the AC group and the group without electric current (P<0.001); furthermore, the difference between the DC group and the group without electric current was not significant (P=0.823). Conclusions The highest bioelectric effect occurred with the use of high-frequency alternating electric current in the form of an apex locator with CHX as a canal irrigant. Key words:Biofilm, Chlorhexidine, Direct current, Electric current, Enterococcus faecalis.
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Affiliation(s)
- Mohammad Froughreyhani
- Associate Professor. Department of Endodontics, Dental and Periodontal Research Center, Faculty of Dentistry, Tabriz University of Medical Sciences
| | - Amin Salemmilani
- Associate Professor. Department of Endodontics, Dental and Periodontal Research Center, Faculty of Dentistry, Tabriz University of Medical Sciences
| | - Aysan Mozafari
- Post-graduate Student. Department of Endodontics, Dental and Periodontal Research Center, Faculty of Dentistry, Tabriz University of Medical Sciences
| | - Mohammad Hosein-Soroush
- Associate Professor. Department of Endodontics, Dental and Periodontal Research Center, Faculty of Dentistry, Tabriz University of Medical Sciences
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17
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Faria G, Viola KS, Coaguila-Llerena H, Oliveira LRA, Leonardo RT, Aranda-García AJ, Guerreiro-Tanomaru JM. Penetration of sodium hypochlorite into root canal dentine: effect of surfactants, gel form and passive ultrasonic irrigation. Int Endod J 2018; 52:385-392. [PMID: 30220093 DOI: 10.1111/iej.13015] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 09/11/2018] [Indexed: 11/29/2022]
Abstract
AIM To assess the penetration of sodium hypochlorite (NaOCl) gel or NaOCl solutions with surfactants, and the effect of passive ultrasonic irrigation (PUI) on penetration into dentinal tubules. METHODOLOGY Bovine incisor root canals were instrumented, the roots sectioned and the dentine blocks obtained were stained with crystal violet. Dentine blocks (n = 10 per group) were exposed to 3% NaOCl gel or 3% NaOCl solution for 10 and 20 min. Other dentine blocks (n = 10 per group) were exposed to Chlor-Extra (6% NaOCl + surfactant), 6% NaOCl, 2.5% NaOCl with 0.2% cetrimide and 2.5% NaOCl for 10 and 20 min. The penetration depth of irrigants into dentinal tubules was measured in micrometres by viewing the bleached crystal violet under a stereomicroscope. Additionally, bovine incisor root canals, instrumented and stained with crystal violet, were distributed into two groups (n = 10) and irrigated with 2.5% NaOCl with PUI or conventional syringe irrigation (CSI). The penetration depth of irrigants into dentinal tubules was assessed 3 and 7 mm from the apex. Statistical analysis was performed by ANOVA and Tukey tests (α = 0.05). RESULTS There was significantly greater penetration of 3% NaOCl solution into dentinal tubules compared with the gel form (P < 0.05). There was no difference (P > 0.05) between 6% NaOCl and Chlor-Extra, and between 2.5% NaOCl and 2.5% NaOCl + cetrimide. PUI significantly increased the penetration depth of NaOCl into dentinal tubules when compared with CSI (P < 0.05). CONCLUSIONS In extracted bovine incisors, NaOCl gel penetrated less into dentinal tubules than NaOCl solution. The addition of surfactants did not increase the penetration depth. The use of PUI significantly increased NaOCl penetration into dentinal tubules.
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Affiliation(s)
- G Faria
- Department of Restorative Dentistry, Araraquara School of Dentistry, UNESP - São Paulo State University, São Paulo, Brazil
| | - K S Viola
- Department of Restorative Dentistry, Araraquara School of Dentistry, UNESP - São Paulo State University, São Paulo, Brazil
| | - H Coaguila-Llerena
- Department of Restorative Dentistry, Araraquara School of Dentistry, UNESP - São Paulo State University, São Paulo, Brazil
| | - L R A Oliveira
- Department of Restorative Dentistry, Araraquara School of Dentistry, UNESP - São Paulo State University, São Paulo, Brazil
| | - R T Leonardo
- Department of Restorative Dentistry, Araraquara School of Dentistry, UNESP - São Paulo State University, São Paulo, Brazil
| | | | - J M Guerreiro-Tanomaru
- Department of Restorative Dentistry, Araraquara School of Dentistry, UNESP - São Paulo State University, São Paulo, Brazil
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18
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Souza MA, Tumelero Dias C, Zandoná J, Paim Hoffmann I, Sanches Menchik VH, Palhano HS, Bertol CD, Rossato-Grando LG, Cecchin D, de Figueiredo JAP. Antimicrobial activity of hypochlorite solutions and reciprocating instrumentation associated with photodynamic therapy on root canals infected with Enterococcus faecalis – An in vitro study. Photodiagnosis Photodyn Ther 2018; 23:347-352. [DOI: 10.1016/j.pdpdt.2018.07.015] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 07/08/2018] [Accepted: 07/23/2018] [Indexed: 10/28/2022]
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19
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Dal Bello Y, Mezzalira GI, Jaguszewski LA, Hoffmann IP, Menchik VHS, Cecchin D, Souza MA. Effectiveness of calcium and sodium hypochlorite in association with reciprocating instrumentation on decontamination of root canals infected with Enterococcus faecalis. AUST ENDOD J 2018; 45:92-97. [PMID: 30113742 DOI: 10.1111/aej.12289] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2018] [Indexed: 12/01/2022]
Abstract
The aim of this study was to evaluate the antimicrobial activity of sodium and calcium hypochlorite utilising reciprocating instrumentation. Sixty root canals were inoculated with E. faecalis for 14 days. Samples were divided into six groups according to decontamination protocol: G1: no treatment, G2: distilled water, G3: 2.5% sodium hypochlorite, G4: 2.5% calcium hypochlorite, G5: 5.25% sodium hypochlorite and G6: 5.25% calcium hypochlorite. Instrumentation was performed with Wave One reciprocating system (Dentsply Sirona Endodontics, York, PA, USA) in groups G2 to G6. Colony-forming units (CFUs) counting was performed and the data were subjected to Anova and Tukey (α = 0.05). Group 1 and 2 showed the highest mean contamination, with a significant difference between them (P < 0.05). Groups 3, 4, 5 and 6 showed the lowest contamination means with no significant difference between them (P < 0.05). Sodium and calcium hypochlorite, in association with reciprocating instrumentation, can be an effective decontamination protocol in root canals infected with E. faecalis.
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Affiliation(s)
- Yuri Dal Bello
- School of Dentistry, University of Passo Fundo, Passo Fundo, RS, Brazil
| | - Gean I Mezzalira
- School of Dentistry, University of Passo Fundo, Passo Fundo, RS, Brazil
| | | | - Igor P Hoffmann
- School of Dentistry, University of Passo Fundo, Passo Fundo, RS, Brazil
| | | | - Doglas Cecchin
- School of Dentistry, University of Passo Fundo, Passo Fundo, RS, Brazil
| | - Matheus A Souza
- School of Dentistry, University of Passo Fundo, Passo Fundo, RS, Brazil
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20
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Hartmann RC, Neuvald L, Barth V, Figueiredo JAP, Oliveira SD, Scarparo RK, Waltrick SB, Rossi‐Fedele G. Antimicrobial efficacy of 0.5% peracetic acid and EDTA with passive ultrasonic or manual agitation in an
Enterococcus faecalis
biofilm model. AUST ENDOD J 2018; 45:57-63. [DOI: 10.1111/aej.12279] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/08/2018] [Indexed: 11/27/2022]
Affiliation(s)
- Rafael C. Hartmann
- Pontifical Catholic University of Rio Grande do Sul Porto Alegre Brazil
- Brazilian Association of Dentistry section Rio Grande do Sul Porto Alegre Brazil
| | - Lilian Neuvald
- Brazilian Association of Dentistry section Rio Grande do Sul Porto Alegre Brazil
| | - Valdir Barth
- Pontifical Catholic University of Rio Grande do Sul Porto Alegre Brazil
| | - Jose Antônio Poli Figueiredo
- Pontifical Catholic University of Rio Grande do Sul Porto Alegre Brazil
- Federal University of Rio Grande do Sul Porto Alegre Brazil
| | | | | | - Silvana Beltrami Waltrick
- Pontifical Catholic University of Rio Grande do Sul Porto Alegre Brazil
- Brazilian Association of Dentistry section Rio Grande do Sul Porto Alegre Brazil
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21
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Maden M, Ertuğrul İF, Orhan EO, Erik CE, Yetiş CÇ, Tuncer Y, Kahriman M. Enhancing antibacterial effect of sodium hypochlorite by low electric current-assisted sonic agitation. PLoS One 2017; 12:e0183895. [PMID: 28854274 PMCID: PMC5576683 DOI: 10.1371/journal.pone.0183895] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Accepted: 08/13/2017] [Indexed: 11/18/2022] Open
Abstract
Background This research focused on the effects of low electric current (μE)-assisted sonic agitation of sodium hypochlorite on Enterococcus faecalis infected human root dentin. Methods Extracted human canine roots were instrumented, sterilized, and experimentally contaminated with E. faecalis. After incubation for 21 days, the presence of the biofilm was confirmed by scanning electron microscopy (n = 3). Roots were randomly divided into seven groups according to decontamination procedures: G1: no treatment; G2: sterile saline; G3: 5.25% sodium hypochlorite; G4: passive ultrasonic irrigation; G5: EndoActivator (Dentsply Tulsa Dental Specialties, Tulsa, OK) agitation (EA); G6: μE agitation; and G7: μE-assisted sonic agitation. Fixed μE amperage and intensities were applied in G6 and G7. Following microbial sampling, bacterial colonies were counted using the direct plating method. Results Biofilm was not eradicated in any sample. The μE-assisted sonic agitation of sodium hypochlorite revealed the lowest cfu values (p<0.05), whereas there were no significant differences among the passive ultrasonic irrigation, EndoActivator and μE agitation alone (p>0.05). Conclusions Based on available evidence, the following conclusions were drawn: The μE-assisted sonic agitation increased the antibiofilm efficiency of sodium hypochlorite than passive ultrasonic irrigation and EndoActivator. The μE-assisted sonic agitation on 5.25% sodium hypochlorite is not capable to eradicate biofilms at 10mA energy level in 60s.
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Affiliation(s)
- Murat Maden
- Department of Endodontics, Faculty of Dentistry, Süleyman Demirel University, Isparta, Turkey
| | - İhsan Furkan Ertuğrul
- Department of Endodontics Dentistry, Faculty of Dentistry, Pamukkale University, Denizli, Turkey
| | - Ekim Onur Orhan
- Department of Endodontics, Faculty of Dentistry, Eskişehir Osmangazi University, Eskişehir, Turkey
- * E-mail:
| | - Cevat Emre Erik
- Department of Endodontics, Faculty of Dentistry, Süleyman Demirel University, Isparta, Turkey
| | - Ceylan Çağıl Yetiş
- Department of Pediatric Dentistry, Faculty of Dentistry, Süleyman Demirel University, Isparta, Turkey
| | - Yasin Tuncer
- Department of Food Engineering, Faculty of Engineering and Architect, Süleyman Demirel University, Isparta, Turkey
| | - Mesud Kahriman
- Department of Electronics and Communication, Faculty of Engineering & Architect, Süleyman Demirel University, Isparta, Turkey
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Silva Almeida LH, Moraes RR, Morgental RD, Pappen FG. Are Premixed Calcium Silicate–based Endodontic Sealers Comparable to Conventional Materials? A Systematic Review of In Vitro Studies. J Endod 2017; 43:527-535. [DOI: 10.1016/j.joen.2016.11.019] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Revised: 11/22/2016] [Accepted: 11/23/2016] [Indexed: 10/20/2022]
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Effectiveness of final decontamination protocols against Enterococcus faecalis and its influence on bond strength of filling material to root canal dentin. Photodiagnosis Photodyn Ther 2017; 17:92-97. [DOI: 10.1016/j.pdpdt.2016.11.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Revised: 10/24/2016] [Accepted: 11/11/2016] [Indexed: 01/23/2023]
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Guerreiro-Tanomaru JM, Chávez-Andrade GM, de Faria-Júnior NB, Watanabe E, Tanomaru-Filho M. Effect of Passive Ultrasonic Irrigation on Enterococcus faecalis from Root Canals: An Ex Vivo Study. Braz Dent J 2017; 26:342-6. [PMID: 26312969 DOI: 10.1590/0103-6440201300022] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Accepted: 04/17/2015] [Indexed: 11/22/2022] Open
Abstract
Endodontic irrigation aims to clean and disinfect the root canal system. Passive ultrasonic irrigation (PUI) is based on the use of an ultrasound-activated instrument into the root canal filled with irrigant. The aim of this study was to evaluate, ex vivo, the effectiveness of PUI in eliminating Enterococcus faecalis from root canals. Seventy-five extracted human single-root teeth were used. After root canal preparation, specimens were inoculated with E. faecalis and incubated at 37 °C for 21 days. Specimens were distributed into five groups (n=15), according to the irrigation method: PUI + saline solution (PUI/SS); PUI + 1% NaOCl (PUI/NaOCl); conventional needle irrigation (CNI) + saline solution (CNI/SS); CNI + 1% NaOCl (CNI/NaOCl); No irrigation (control). Microbiological samples were collected at three time points: initial (21 days after inoculation), post-irrigation (immediately after irrigation), and final (7 days after irrigation). Data were obtained in CFU mL-1 and subjected to analysis by ANOVA and Tukey's tests at 5% significance level. The post-irrigation samples did not demonstrate statistical difference between PUI/SS and CNI/SS nor between PUI/NaOCl and CNI/NaOCl (p>0.05), but PUI/NaOCl and CNI/NaOCl had lower CFU mL-1 number than the other groups (p>0.05). Statistically significant difference was observed between the initial and post-irrigation samples and between the post-irrigation and final samples (p<0.05) in all groups, except in the control. The final samples of all groups presented bacterial counts similar to the initial samples. PUI or CNI with 1% NaOCl contribute to disinfection, but are unable to eradicate E. faecalis from the root canal system.
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Affiliation(s)
| | | | | | - Evandro Watanabe
- Department of Dentistry, School of Dentistry of Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, BR
| | - Mário Tanomaru-Filho
- Araraquara Dental School, Department of Restorative Dentistry, Universidade Estadual Paulista, Araraquara, SP, BR
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Cherian B, Gehlot PM, Manjunath MK. Comparison of the Antimicrobial Efficacy of Octenidine Dihydrochloride and Chlorhexidine with and Without Passive Ultrasonic Irrigation - An Invitro Study. J Clin Diagn Res 2016; 10:ZC71-7. [PMID: 27504415 DOI: 10.7860/jcdr/2016/17911.8021] [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] [Received: 11/20/2015] [Accepted: 04/03/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Elimination of microorganisms from infected root canals is a complicated task. Numerous measures have been described to reduce the microbial load in the root canal system, including the use of various instrumentation techniques, irrigation regimens and intracanal medicaments. The drawbacks of few commonly used irrigants include toxic and harmful side effects, microbial resistance to antimicrobial agents and staining. Hence there is a need for alternative agents which are nontoxic, effective and safe. AIM To compare and evaluate antimicrobial effects of 2% Chlorhexidine (CHX) versus 0.1% Octenidine Dihydrochloride (OCT) as root canal irrigant with and without passive ultrasonic irrigation against Enterococcus faecalis (E. faecalis) in vitro and to evaluate the depth of penetration of irrigant solution into the dentinal tubules at the junction of middle and apical third. MATERIALS AND METHODS Forty eight freshly extracted, single rooted human mandibular premolars were decoronated and root specimen standardized to 14mm. Biofilm of E. faecalis (strain ATCC 29212) was grown for seven days and the specimens were divided into four groups (n=12) based on irrigation protocol : Group I- Conventional Syringe Irrigation (CSI) with 2% CHX, Group II- CSI + 0.1% OCT, Group III-Passive Ultrasonic Irrigation (PUI) + 2% CHX and Group IV- PUI+ 0.1% OCT. Dentin shavings were collected at two depths (200μm and 400μm) and total number of colony forming units were determined. The data were statistically analyzed using ANOVA, Scheffes multiple comparison of means and paired t-test (p<0.05). RESULTS Group III and IV (PUI) showed significant difference compared to Group I and II (CSI) both at 200μm and 400μm (p=0.000). For Group III and Group IV no significant differences were found at 200μm and 400μm (p=1.000 and 0.363 respectively), however significant difference was found between data at 200μm and 400μm for all the four groups (p=0.000). CONCLUSION Octenidine (0.1%) was more effective than 2% Chlorhexidine against E. faecalis both at 200μm and 400μm. Passive ultrasonic irrigation proved to enhance the antimicrobial action of the irrigants.
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Affiliation(s)
- Bastin Cherian
- Post Graduate Student, Department of Conservative Dentistry and Endodontics, JSS Dental College and Hospital , Mysore, Karnataka, India
| | - Paras Mull Gehlot
- Reader, Department of Conservative Dentistry and Endodontics, JSS Dental College and Hospital , Mysore, Karnataka, India
| | - Mysore Krishnaswamy Manjunath
- Professor and Head, Department of Conservative Dentistry and Endodontics, JSS Dental College and Hospital , Mysore, Karnataka, India
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Antibacterial Efficacy of Calcium Hypochlorite with Vibringe Sonic Irrigation System on Enterococcus faecalis: An In Vitro Study. BIOMED RESEARCH INTERNATIONAL 2016; 2016:8076131. [PMID: 27218106 PMCID: PMC4863093 DOI: 10.1155/2016/8076131] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Accepted: 04/10/2016] [Indexed: 11/20/2022]
Abstract
Aim. The purpose of this study was to compare the in vitro efficacy of calcium hypochlorite (Ca[OCl]2) and sodium hypochlorite (NaOCl) associated with sonic (Vibringe) irrigation system in root canals which were contaminated with Enterococcus faecalis. Material and Methods. The root canals of 84 single-rooted premolars were enlarged up to a file 40, autoclaved, inoculated with Enterococcus faecalis, and incubated for 21 days. The samples were divided into 7 groups according to the irrigation protocol: G0: no treatment; G1: distilled water; G2: 2.5% NaOCl; G3: 2.5% Ca(OCl)2; G4: distilled water with sonic activation; G5: 2.5% NaOCl with sonic activation; and G6: 2.5% Ca(OCl)2 with sonic activation. Before and after decontamination procedures microbiological samples were collected and the colony-forming units were counted and the percentages of reduction were calculated. Results. Distilled water with syringe irrigation and sonic activation groups demonstrated poor antibacterial effect on Enterococcus faecalis compared to other experimental groups (p < 0.05). There was no statistically significant difference between syringe and sonic irrigation systems with Ca(OCl)2 and NaOCl. Conclusion. The antimicrobial property of Ca(OCl)2 has been investigated and compared with that of NaOCl. Both conventional syringe irrigation and sonic irrigation were found effective at removing E. faecalis from the root canal of extracted human teeth.
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Pladisai P, Ampornaramveth RS, Chivatxaranukul P. Effectiveness of Different Disinfection Protocols on the Reduction of Bacteria in Enterococcus faecalis Biofilm in Teeth with Large Root Canals. J Endod 2016; 42:460-4. [PMID: 26830428 DOI: 10.1016/j.joen.2015.12.016] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Revised: 12/16/2015] [Accepted: 12/16/2015] [Indexed: 10/22/2022]
Abstract
INTRODUCTION This study compared the effectiveness of different disinfection protocols in reducing bacteria in an Enterococcus faecalis biofilm in teeth with large root canals. METHODS Fifty-five roots were prepared from human mandibular premolars with large single root canals, and 50 roots were infected with E. faecalis for 21 days. Four roots were observed using scanning electron microscopy to verify biofilm formation. The remaining specimens were assigned into 5 experimental groups and a sterile control group: mechanical instrumentation using files size 60-90 and 2.5% sodium hypochlorite (NaOCl) (MI-N), irrigation with 2.5% NaOCl (IR-N), irrigation with 2.5% NaOCl using intermittent passive ultrasonic irrigation (PUI-N), irrigation with normal saline, and no intervention (initial). After root canal disinfection, dentin specimens were collected for microbial analysis. Mean colony forming units were determined and compared between groups using 1-way analysis of variance. RESULTS The lowest number of intracanal bacteria (24.5 colony-forming units/mL) was recovered from the MI-N group followed by the PUI-N and IR-N groups. The irrigation with normal saline group did not show a significant reduction compared with the initial group. However, there were significant differences between groups (P < .01). The remaining bacteria in the PUI-N group was 4.5-fold lower compared with the IR-N group; however, it was 1862-fold higher compared with the MI-N group. CONCLUSIONS MI-N was the most effective method to disinfect large root canals. Although ultrasonic activation enhanced the efficacy of root canal irrigation, it could not substitute for mechanical instrumentation even in large root canals with unlimited irrigant access to the apical portion.
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Affiliation(s)
- Patinee Pladisai
- Department of Operative Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | | | - Pavena Chivatxaranukul
- Department of Operative Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.
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Tanomaru-Filho M, Miano LM, Chávez-Andrade GM, Torres FFE, Leonardo RDT, Guerreiro-Tanomaru JM. Cleaning of Root Canal System by Different Irrigation Methods. J Contemp Dent Pract 2015; 16:859-63. [PMID: 26718291 DOI: 10.5005/jp-journals-10024-1771] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE The aim of this study was to compare the cleaning of main and lateral canals using the irrigation methods: negative pressure irrigation (EndoVac system), passive ultrasonic irrigation (PUI) and manual irrigation (MI). MATERIALS AND METHODS Resin teeth were used. After root canal preparation, four lateral canals were made at 2 and 7 mm from the apex. Root canals were filled with contrast solution and radiographed pre- and post-irrigation using digital radiographic system [radiovisiography (RVG)]. The irrigation protocols were: MI1-manual irrigation [22 G needle at 5 mm short of working length-WL]; MI2-manual irrigation (30G needle at 2 mm short of WL); PUI; EV1-EndoVac (microcannula at 1 mm short of WL); EV2-Endovac (microcannula at 3 mm short of WL). The obtained images, initial (filled with contrast solution) and final (after irrigation) were analyzed by using image tool 3.0 software. Statistical analysis was performed by analysis of variance (ANOVA) and Tukey tests (5% significance level). RESULTS EV1 and EV2, followed by PUI showed better cleaning capacity than manual irrigation (MI1 and MI2) (p < 0.05). CONCLUSION Negative pressure irrigation and PUI promoted better cleaning of main and simulated lateral canals. CLINICAL SIGNIFICANCE Conventional manual irrigation technique may promote less root canal cleaning in the apical third. For this reason, the search for other irrigation protocols is important, and EndoVac and PUI are alternatives to contribute to irrigation effectiveness.
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Affiliation(s)
- Mário Tanomaru-Filho
- Professor, Department of Restorative Dentistry, Araraquara Dental School, UNESP-Univ Estadual Paulista, , Rua Humaita 1680 Centro CEP 14801-903, Araraquara, Sao Paulo, Brazil Phone: +55-16-3301-6390, e-mail:
| | - Lucas Martinati Miano
- Department of Restorative Dentistry, Araraquara Dental School, UNESP-Univ Estadual Paulista, Araraquara, Sao Paulo, Brazil
| | | | | | - Renato de Toledo Leonardo
- Department of Restorative Dentistry, Araraquara Dental School, UNESP-Univ Estadual Paulista, Araraquara, Sao Paulo, Brazil
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Ghinzelli GC, Souza MA, Cecchin D, Farina AP, de Figueiredo JAP. Influence of ultrasonic activation on photodynamic therapy over root canal system infected with Enterococcus faecalis – an in vitro study. Photodiagnosis Photodyn Ther 2014; 11:472-8. [DOI: 10.1016/j.pdpdt.2014.07.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2014] [Revised: 07/21/2014] [Accepted: 07/23/2014] [Indexed: 10/24/2022]
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Comparative Evaluation of Calcium Hypochlorite and Sodium Hypochlorite Associated with Passive Ultrasonic Irrigation on Antimicrobial Activity of a Root Canal System Infected with Enterococcus faecalis: An In Vitro Study. J Endod 2014; 40:1953-7. [DOI: 10.1016/j.joen.2014.08.025] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Revised: 08/04/2014] [Accepted: 08/29/2014] [Indexed: 11/22/2022]
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Shen Y, Gao Y, Lin J, Ma J, Wang Z, Haapasalo M. Methods and models to study irrigation. ACTA ACUST UNITED AC 2013. [DOI: 10.1111/etp.12029] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Evaluation of Antibacterial Effects by Atmospheric Pressure Nonequilibrium Plasmas against Enterococcus faecalis Biofilms In Vitro. J Endod 2012; 38:545-9. [DOI: 10.1016/j.joen.2011.10.021] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2011] [Revised: 10/23/2011] [Accepted: 10/26/2011] [Indexed: 11/21/2022]
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