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Alquria TA, Acharya A, Tordik P, Griffin I, Martinho FC. Impact of root canal disinfection on the bacteriome present in primary endodontic infection: A next generation sequencing study. Int Endod J 2024; 57:1124-1135. [PMID: 38700876 DOI: 10.1111/iej.14074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 04/05/2024] [Accepted: 04/08/2024] [Indexed: 07/03/2024]
Abstract
AIM To investigate the bacteriome present in teeth with primary endodontic infection (PEI) and apical periodontitis (AP) and to determine quantitatively and qualitatively the impact of chemomechanical preparation (CMP) using 2.5% sodium hypochlorite NAOCl on the bacteriome found in PEI with AP using the Illumina MiSeq platform. METHODOLOGY Thirty-six paired samples from 18 patients were successfully sequenced and analysed. Samples were collected at two sampling times: before (s1) and after (s2) CMP using 2.5% NaOCl. The DNA was extracted from s1 and s2 samples and quantified using quantitative PCR (qPCR). All 36 samples were sequenced using the Illumina MiSeq platform. Raw V3-V4 amplicon sequencing data were processed with the DADA2 pipeline to generate amplicon sequence variants (ASVs). Alpha diversity metrics representing abundance (Chao1) and diversity and evenness (Shannon, Simpson) were computed. The paired-sample Wilcoxon's test was used to compare alpha diversity metrics and qPCR counts between s1 and s2. The PERMANOVA method (with 999 permutations) was applied to compare community composition between sample types (s1 versus s2) and between patient IDs. ALDEx2 (ANOVA-like differential expression tool for high-throughput sequencing data) to investigate differentially abundant taxa between s1 and s2. A paired-sample Wilcoxon's test was used to compare alpha diversity metrics and qPCR counts between s1 and s2. RESULTS The qPCR counts were significantly higher in s1 compared to s2 (p = .0007). The Chao1 index indicated no difference in alpha diversity (p < .7019); whereas Shannon (p = .0056) and Simpson (p = .02685) indexes showed higher values in s2. The PERMANOVA test using Adonis2 showed a significant effect of sample time on community composition (R2 = .0630, p = .012). Patient ID also showed a significant effect on community composition (R2 = .6961, p = .001). At the genus level, Dialister, Mogibacterium, Prevotella, and Olsenella were differentially enriched at s1, while Actinomyces, Stenotrophomonas_unclassified, Enterococcus_unclassified, and Actinomyces_unclassified were differentially enriched in s2. CONCLUSION The bacteriome present in teeth with PEI with AP is complex and diverse. CMP using 2.5% NaOCl showed a high quantitatively and qualitatively disinfectant impact on the bacteriome present in PEI with AP.
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Affiliation(s)
- Theeb Abdullah Alquria
- Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, Maryland, USA
| | - Aneesha Acharya
- Department of Periodontics and Oral Implantology, Dr D.Y. Patil Dental College and Hospital, Dr D Y Patil Vidyapeeth, Pune, India
- Periodontology and Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong SAR
| | - Patricia Tordik
- Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, Maryland, USA
| | - Ina Griffin
- Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, Maryland, USA
| | - Frederico C Martinho
- Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, Maryland, USA
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Nogueira APA, Grazziotin-Soares R, Leal AMM, Freitas Júnior SAG, Gonçalves BLL, Bauer J, Ferreira MC, Carvalho CN. Root Canal Dentin Microhardness after Contact with Antibiotic Medications: An In Vitro Study. Dent J (Basel) 2024; 12:201. [PMID: 39056988 PMCID: PMC11276266 DOI: 10.3390/dj12070201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 04/19/2024] [Accepted: 05/21/2024] [Indexed: 07/28/2024] Open
Abstract
Background: Antibiotic pastes used as intracanal medication in cases of revascularization therapy might cause negative effects on tooth properties, such as a reduction in dentin microhardness. This in vitro study investigated dentin microhardness in three different locations distancing from the canal lumen after 20 days of treatment with a tri-antibiotic paste (ciprofloxacin, metronidazole, and minocycline), and with a double-antibiotic paste (ciprofloxacin and metronidazole), with calcium hydroxide [Ca(OH)2] UltracalTM XS-treated dentin as comparison. Material and Methods: Human mandibular premolars (n = 48) had the root canals cleaned and shaped and were used to produce dentin slices. Dentin slices remained immersed in the medications for 20 days. The Knoop microhardness (KHN) test was performed before (baseline/Day-0) and after treatment (Day-20) with the medications. Indentations were made at 25 µm, 50 µm, and 100 µm distances from the root canal lumen. The KHN was compared intra-group using Wilcoxon's test. Independent groups were compared using Mann-Whitney's and Kruskal-Wallis' tests, at α = 5%. Results: The microhardness in all the tested groups was reduced at Day-20 in comparison with Day-0 (p < 0.001) (intra-group comparison/same distances). The Day-0 values were similar, and the Day-20 values were higher for the Ca(OH)2 group (p < 0.05) (comparison between groups/same distances). Conclusions: Calcium hydroxide for 20 days would be preferred rather than antibiotic pastes to minimize the expected reduction in dentin microhardness during regenerative procedures.
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Affiliation(s)
- Amanda Palmeira Arruda Nogueira
- School of Dentistry, CEUMA University, São Luís 65075-120, MA, Brazil; (A.P.A.N.); (A.M.M.L.); (S.A.G.F.J.); (B.L.L.G.); (M.C.F.)
| | - Renata Grazziotin-Soares
- Department of Oral Biological Medical Sciences, Faculty of Dentistry, University of British Columbia UBC, Vancouver, BC V6T 1Z4, Canada;
| | - Adriana Marques Mesquita Leal
- School of Dentistry, CEUMA University, São Luís 65075-120, MA, Brazil; (A.P.A.N.); (A.M.M.L.); (S.A.G.F.J.); (B.L.L.G.); (M.C.F.)
| | | | - Bruna Laís Lins Gonçalves
- School of Dentistry, CEUMA University, São Luís 65075-120, MA, Brazil; (A.P.A.N.); (A.M.M.L.); (S.A.G.F.J.); (B.L.L.G.); (M.C.F.)
| | - José Bauer
- Dental Materials Laboratory, School of Dentistry, University Federal of Maranhão (UFMA), São Luís 5085-582, MA, Brazil;
| | - Meire Coelho Ferreira
- School of Dentistry, CEUMA University, São Luís 65075-120, MA, Brazil; (A.P.A.N.); (A.M.M.L.); (S.A.G.F.J.); (B.L.L.G.); (M.C.F.)
| | - Ceci Nunes Carvalho
- School of Dentistry, CEUMA University, São Luís 65075-120, MA, Brazil; (A.P.A.N.); (A.M.M.L.); (S.A.G.F.J.); (B.L.L.G.); (M.C.F.)
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3
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Xiao S, Sun G, Huang S, Lin C, Li Y. Nanoarchitectonics-Based Materials as a Promising Strategy in the Treatment of Endodontic Infections. Pharmaceutics 2024; 16:759. [PMID: 38931881 PMCID: PMC11207628 DOI: 10.3390/pharmaceutics16060759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2024] [Revised: 05/19/2024] [Accepted: 05/29/2024] [Indexed: 06/28/2024] Open
Abstract
Endodontic infections arise from the interactive activities of microbial communities colonizing in the intricate root canal system. The present study aims to update the latest knowledge of nanomaterials, their antimicrobial mechanisms, and their applications in endodontics. A detailed literature review of the current knowledge of nanomaterials used in endodontic applications was performed using the PubMed database. Antimicrobial nanomaterials with a small size, large specific surface area, and high chemical activity are introduced to act as irrigants, photosensitizer delivery systems, and medicaments, or to modify sealers. The application of nanomaterials in the endodontic field could enhance antimicrobial efficiency, increase dentin tubule penetration, and improve treatment outcomes. This study supports the potential of nanomaterials as a promising strategy in treating endodontic infections.
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Affiliation(s)
- Suli Xiao
- Department of Endodontics, Stomatological Hospital of Xiamen Medical College, Xiamen 361003, China;
- Xiamen Key Laboratory of Stomatological Disease Diagnosis and Treatment, Xiamen 361003, China
| | - Guanwen Sun
- Department of Stomatology, Fujian Medical University Xiamen Humanity Hospital, Xiamen 361018, China;
| | - Shan Huang
- Department of Stomatology, Zhongshan Hospital Affiliated to Xiamen University, Xiamen 361005, China;
| | - Chen Lin
- Department of Endodontics, Stomatological Hospital of Xiamen Medical College, Xiamen 361003, China;
- Xiamen Key Laboratory of Stomatological Disease Diagnosis and Treatment, Xiamen 361003, China
| | - Yijun Li
- Department of Endodontics, Stomatological Hospital of Xiamen Medical College, Xiamen 361003, China;
- Xiamen Key Laboratory of Stomatological Disease Diagnosis and Treatment, Xiamen 361003, China
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Zou X, Zheng X, Liang Y, Zhang C, Fan B, Liang J, Ling J, Bian Z, Yu Q, Hou B, Chen Z, Wei X, Qiu L, Chen W, He W, Xu X, Meng L, Zhang C, Chen L, Deng S, Lei Y, Xie X, Wang X, Yu J, Zhao J, Shen S, Zhou X, Yue L. Expert consensus on irrigation and intracanal medication in root canal therapy. Int J Oral Sci 2024; 16:23. [PMID: 38429299 PMCID: PMC10907616 DOI: 10.1038/s41368-024-00280-5] [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: 11/05/2023] [Revised: 12/22/2023] [Accepted: 01/03/2024] [Indexed: 03/03/2024] Open
Abstract
Chemical cleaning and disinfection are crucial steps for eliminating infection in root canal treatment. However, irrigant selection or irrigation procedures are far from clear. The vapor lock effect in the apical region has yet to be solved, impeding irrigation efficacy and resulting in residual infections and compromised treatment outcomes. Additionally, ambiguous clinical indications for root canal medication and non-standardized dressing protocols must be clarified. Inappropriate intracanal medication may present side effects and jeopardize the therapeutic outcomes. Indeed, clinicians have been aware of these concerns for years. Based on the current evidence of studies, this article reviews the properties of various irrigants and intracanal medicaments and elucidates their effectiveness and interactions. The evolution of different kinetic irrigation methods, their effects, limitations, the paradigm shift, current indications, and effective operational procedures regarding intracanal medication are also discussed. This expert consensus aims to establish the clinical operation guidelines for root canal irrigation and a position statement on intracanal medication, thus facilitating a better understanding of infection control, standardizing clinical practice, and ultimately improving the success of endodontic therapy.
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Affiliation(s)
- Xiaoying Zou
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China
- Center of Stomatology, Peking University Hospital, Beijing, China
| | - Xin Zheng
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yuhong Liang
- Department of Emergency, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China
| | - Chengfei Zhang
- Restorative Dental Sciences, Endodontics, Faculty of Dentistry, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, China
| | - Bing Fan
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Jingping Liang
- Department of Endodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Clinical Research Center for Oral Diseases; National Center for Stomatology; Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Junqi Ling
- Department of Operative Dentistry and Endodontics, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University & Guangdong Provincial Key Laboratory of Stomatology , Guangzhou, China
| | - Zhuan Bian
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Qing Yu
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Key Laboratory of Oral Diseases, Department of Operative Dentistry & Endodontics, School of Stomatology, The Fourth Military Medical University, Xián, China
| | - Benxiang Hou
- Center for Microscope Enhanced Dentistry, Beijing Stomatological Hospital, Capital Medical University, Beijing, China
| | - Zhi Chen
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Xi Wei
- Department of Operative Dentistry and Endodontics, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University & Guangdong Provincial Key Laboratory of Stomatology , Guangzhou, China
| | - Lihong Qiu
- Department of Endodontics, School of Stomatology, China Medical University, Shenyang, China
| | - Wenxia Chen
- College & Hospital of Stomatology, Guangxi Medical University, Nanning, China
| | - Wenxi He
- Department of Stomatology, Air Force Medical Center, The Air Force Medical University, Beijing, China
| | - Xin Xu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Liuyan Meng
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Chen Zhang
- Department of Endodontics, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing, China
| | - Liming Chen
- Department of Endodontics, Guiyang Stomatological Hospital, Guiyang, China
| | - Shuli Deng
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China
| | - Yayan Lei
- Department of Endodontics, the Affiliated Stomatological Hospital of Kunming Medical University, Kunming, China
| | - Xiaoli Xie
- Department of Endodontology, Hunan Xiangya Stomatological Hospital, Central South University, Changsha, China
| | - Xiaoyan Wang
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China
| | - Jinhua Yu
- Institute of Stomatology, Nanjing Medical University & Department of Endodontics, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
| | - Jin Zhao
- Department of Endodontics, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Song Shen
- Center of Stomatology, Peking University Hospital, Beijing, China
| | - Xuedong Zhou
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu, China.
| | - Lin Yue
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China.
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Wassel M, Radwan M, Elghazawy R. Direct and residual antimicrobial effect of 2% chlorhexidine gel, double antibiotic paste and chitosan- chlorhexidine nanoparticles as intracanal medicaments against Enterococcus faecalis and Candida albicans in primary molars: an in-vitro study. BMC Oral Health 2023; 23:296. [PMID: 37542254 PMCID: PMC10401786 DOI: 10.1186/s12903-023-02862-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 03/06/2023] [Indexed: 08/06/2023] Open
Abstract
BACKGROUND Thorough disinfection of root canals in primary molars may be complicated by the complex root canal morphology. This in-vitro study aimed to compare direct and residual antimicrobial effect of 2% chlorhexidine (CHX) gel, 500 mg/ml double antibiotic paste (DAP) and chitosan-chlorhexidine nanoparticles (CS-CHX NPs) as intracanal medicaments against Enterococcus faecalis (E. faecalis) and Candida albicans (C. albicans) in primary molars. METHODS Mesial roots of 63 mandibular second primary molars were infected with E. faecalis and C. albicans. Teeth were divided into 9 groups: Ia: (CS-CHX NPs), IIa: (CHX), IIIa: (DAP), IVa: chitosan nanoparticles (CSNPs) in which medicaments were placed for 3 days, groups Ib: (CS-CHX NPs), IIb: CHX, IIIb: (DAP), IVb: (CSNPs) in which medicaments were placed for 7 days, and Group V (control): teeth were infected, irrigated with saline, and sampled 3- and 7-days post-infection. Microbiological samples were obtained after infection, 3, and 7 days after medicament placement and 7 days after medicament removal for both time points. One-way ANOVA, Tukey's post hoc test and paired t-test were used at p < 0.05. RESULTS CS-CHX NPs had the highest anticandidal effect which was comparable to CHX and significantly higher than other medicaments (p < 0.001) at both time points. CS-CHX NPs had the highest effect against E. faecalis which was comparable to DAP and significantly higher than other medicaments (p < 0.001) at 3 days. All medicaments showed similar effect against E. faecalis after 7 days. The 7-days placement significantly increased the antimicrobial effect against both micro-organisms in all groups, except CS-CHX NPs which showed an insignificant increase. CS-CHX NPs showed the highest residual effect against both micro-organisms that increased with 7-days placement. CONCLUSION CSNPs and CHX combination showed a synergistic effect against both micro-organisms. CS-CHX NPs displayed a higher effect at a shorter period compared to other medicaments, yet its residual effect was higher with 7-days placement.
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Affiliation(s)
- Mariem Wassel
- Pediatric Dentistry and Dental Public Health Department, Faculty of Dentistry, Ain Shams University Cairo, Organization of African Unity St.-Abbasia-Cairo, 11566 Cairo, Egypt
| | - Mohamed Radwan
- Pediatric Dentistry and Dental Public Health Department, Faculty of Dentistry, Ain Shams University Cairo, Organization of African Unity St.-Abbasia-Cairo, 11566 Cairo, Egypt
| | - Reham Elghazawy
- Pediatric Dentistry and Dental Public Health Department, Faculty of Dentistry, Ain Shams University Cairo, Organization of African Unity St.-Abbasia-Cairo, 11566 Cairo, Egypt
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6
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Martinho FC, Corazza BJM, Khoury RD, Orozco EIF, Toia CC, Machado FP, Valera MC. Impact of N-acetylcysteine (NAC) and calcium hydroxide intracanal medications in primary endodontic infection: a randomized clinical trial. Clin Oral Investig 2023. [PMID: 35723751 DOI: 10.1007/s00784-022-04511-z.[e-pub]] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
OBJECTIVES This RCT investigated the impact of N-acetylcysteine (NAC) and calcium hydroxide [Ca(OH)2] intracanal medications (ICMs) in primary endodontic infection with apical periodontitis (PEIAP). MATERIALS AND METHODS Thirty-six teeth with PEIAP were randomly divided into groups according to the ICM: NAC, Ca(OH)2 + saline solution (SSL), and Ca(OH)2 + 2% chlorhexidine-gel (2% CHX-gel) (all, n = 12). Root canal samples (RCSs) were collected before (s1) and after instrumentation (s2) and after 14 days of ICM (s3). Chemomechanical preparation (CMP) was performed with a Reciproc file and 2.5% NaOCl. Checkerboard DNA-DNA hybridization was used to assess 40 target bacteria species. RESULTS At s1, bacterial DNA was detected in 100% of RCSs (36/36). All 40 bacterial species were found in PEIAP. The mean number of species per RCS was 17.92 ± 13.18. The most frequent bacteria were S. mitis (65%), E. nodatum (63%), E. faecalis (63%), F. nucl sp vicentii (58%), T. forsythia (58%), and F. periodonticum (56%). CMP reduced the mean number of species per RCS to 6.8 ± 2.36 (p < 0.05). At s3, the intragroup analysis revealed a broader antimicrobial activity for Ca (OH)2 + 2% CHX-gel and NAC than Ca(OH)2 + SSL (p < 0.05). NAC eliminated 8/12 bacteria species resistant to both Ca (OH)2 ICMs, including P. micra, P. nigrescens, T. denticola, A. israelii, P. endodontalis, P. acnes, C. ochracea, and E. corrodens. CONCLUSIONS Ca (OH)2 + 2% chlorhexidine gel (2% CHX gel) showed a greater bacterial elimination over the number of bacterial species; however, NAC eliminated 8/12 bacteria species resistant to both Ca (OH)2 ICMs (RBR-3xbnnn). CLINICAL RELEVANCE The use of intracanal medication with a broad antimicrobial activity can optimize root canal disinfection. Ca(OH)2 + 2% CHX gel and NAC showed a broader antimicrobial activity than Ca(OH)2 + SSL against endodontic pathogens in primary root canal infection. TRIAL REGISTRATION Brazilian Registry of Clinical Trials (REBEC), No. RBR-3xbnnn.
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Affiliation(s)
- Frederico C Martinho
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, 650 West Baltimore Street, 6th floor, Suite 6253, Baltimore, MD, 21201, USA.
| | - Bruna J M Corazza
- Department of Restorative Dentistry, Endodontic Division, Institute of Science and Technology, São Paulo State University - UNESP, São José dos Campos, São Paulo, Brazil
| | - Rayana D Khoury
- Department of Restorative Dentistry, Endodontic Division, Institute of Science and Technology, São Paulo State University - UNESP, São José dos Campos, São Paulo, Brazil
| | - Esteban I F Orozco
- Department of Restorative Dentistry, Endodontic Division, Institute of Science and Technology, São Paulo State University - UNESP, São José dos Campos, São Paulo, Brazil
| | - Cassia C Toia
- Department of Restorative Dentistry, Endodontic Division, Institute of Science and Technology, São Paulo State University - UNESP, São José dos Campos, São Paulo, Brazil
| | - Felipe P Machado
- Department of Restorative Dentistry, Endodontic Division, Institute of Science and Technology, São Paulo State University - UNESP, São José dos Campos, São Paulo, Brazil
| | - Marcia C Valera
- Department of Restorative Dentistry, Endodontic Division, Institute of Science and Technology, São Paulo State University - UNESP, São José dos Campos, São Paulo, Brazil
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7
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Martinho FC, Corazza BJM, Khoury RD, Orozco EIF, Toia CC, Machado FP, Valera MC. Impact of N-acetylcysteine (NAC) and calcium hydroxide intracanal medications in primary endodontic infection: a randomized clinical trial. Clin Oral Investig 2023; 27:817-826. [PMID: 35723751 DOI: 10.1007/s00784-022-04585-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 06/10/2022] [Indexed: 02/03/2023]
Abstract
OBJECTIVES This RCT investigated the impact of N-acetylcysteine (NAC) and calcium hydroxide [Ca(OH)2] intracanal medications (ICMs) in primary endodontic infection with apical periodontitis (PEIAP). MATERIALS AND METHODS Thirty-six teeth with PEIAP were randomly divided into groups according to the ICM: NAC, Ca(OH)2 + saline solution (SSL), and Ca(OH)2 + 2% chlorhexidine-gel (2% CHX-gel) (all, n = 12). Root canal samples (RCSs) were collected before (s1) and after instrumentation (s2) and after 14 days of ICM (s3). Chemomechanical preparation (CMP) was performed with a Reciproc file and 2.5% NaOCl. Checkerboard DNA-DNA hybridization was used to assess 40 target bacteria species. RESULTS At s1, bacterial DNA was detected in 100% of RCSs (36/36). All 40 bacterial species were found in PEIAP. The mean number of species per RCS was 17.92 ± 13.18. The most frequent bacteria were S. mitis (65%), E. nodatum (63%), E. faecalis (63%), F. nucl sp vicentii (58%), T. forsythia (58%), and F. periodonticum (56%). CMP reduced the mean number of species per RCS to 6.8 ± 2.36 (p < 0.05). At s3, the intragroup analysis revealed a broader antimicrobial activity for Ca (OH)2 + 2% CHX-gel and NAC than Ca(OH)2 + SSL (p < 0.05). NAC eliminated 8/12 bacteria species resistant to both Ca (OH)2 ICMs, including P. micra, P. nigrescens, T. denticola, A. israelii, P. endodontalis, P. acnes, C. ochracea, and E. corrodens. CONCLUSIONS Ca (OH)2 + 2% chlorhexidine gel (2% CHX gel) showed a greater bacterial elimination over the number of bacterial species; however, NAC eliminated 8/12 bacteria species resistant to both Ca (OH)2 ICMs (RBR-3xbnnn). CLINICAL RELEVANCE The use of intracanal medication with a broad antimicrobial activity can optimize root canal disinfection. Ca(OH)2 + 2% CHX gel and NAC showed a broader antimicrobial activity than Ca(OH)2 + SSL against endodontic pathogens in primary root canal infection. TRIAL REGISTRATION Brazilian Registry of Clinical Trials (REBEC), No. RBR-3xbnnn.
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Affiliation(s)
- Frederico C Martinho
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, 650 West Baltimore Street, 6th floor, Suite 6253, Baltimore, MD, 21201, USA.
| | - Bruna J M Corazza
- Department of Restorative Dentistry, Endodontic Division, Institute of Science and Technology, São Paulo State University - UNESP, São José dos Campos, São Paulo, Brazil
| | - Rayana D Khoury
- Department of Restorative Dentistry, Endodontic Division, Institute of Science and Technology, São Paulo State University - UNESP, São José dos Campos, São Paulo, Brazil
| | - Esteban I F Orozco
- Department of Restorative Dentistry, Endodontic Division, Institute of Science and Technology, São Paulo State University - UNESP, São José dos Campos, São Paulo, Brazil
| | - Cassia C Toia
- Department of Restorative Dentistry, Endodontic Division, Institute of Science and Technology, São Paulo State University - UNESP, São José dos Campos, São Paulo, Brazil
| | - Felipe P Machado
- Department of Restorative Dentistry, Endodontic Division, Institute of Science and Technology, São Paulo State University - UNESP, São José dos Campos, São Paulo, Brazil
| | - Marcia C Valera
- Department of Restorative Dentistry, Endodontic Division, Institute of Science and Technology, São Paulo State University - UNESP, São José dos Campos, São Paulo, Brazil
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8
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Silver Nanoparticles Alone or in Combination with Calcium Hydroxide Modulate the Viability, Attachment, Migration, and Osteogenic Differentiation of Human Mesenchymal Stem Cells. Int J Mol Sci 2022; 24:ijms24010702. [PMID: 36614148 PMCID: PMC9821315 DOI: 10.3390/ijms24010702] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 12/18/2022] [Accepted: 12/27/2022] [Indexed: 01/03/2023] Open
Abstract
This study aimed to evaluate the effect of silver nanoparticles (AgNPs) alone or in combination with calcium hydroxide (Ca(OH)2) on the proliferation, viability, attachment, migration, and osteogenic differentiation of human mesenchymal stem cells (hMSCs). Different concentrations of AgNPs alone or mixed with Ca(OH)2 were prepared. Cell proliferation was measured using AlamarBlue, and hMSCs attachment to dentin disks was evaluated using scanning electron microscopy. Live-dead imaging was performed to assess apoptosis. Wound healing ability was determined using the scratch-migration assay. To evaluate osteogenic differentiation, the expression of Runt-related transcription factor (RUNX2), Transforming growth factor beta-1 (TGF-β1), Alkaline Phosphatase (ALP), and Osteocalcin (OCN) were measured using real-time reverse transcriptase polymerase chain reaction. ALP staining and activity were also performed as indicators of osteogenic differentiation. AgNPs alone seemed to favor cell attachment. Lower concentrations of AgNPs enhanced cell proliferation. AgNP groups showed markedly less apoptosis. None of the medicaments had adverse effects on wound closure. The expression of TGF-β1 was significantly upregulated in all groups, and OCN was highly expressed in the AgNP groups. AgNPs 0.06% showed the most enhanced ALP gene expression levels, activity, and marked cytochemical staining. In conclusion, AgNPs positively affect hMSCs, making them a potential biomaterial for various clinical applications.
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AlGazlan AS, Auda SH, Balto H, Alsalleeh F. Antibiofilm Efficacy of Silver Nanoparticles Alone or Mixed with Calcium Hydroxide as Intracanal Medicaments; an Ex-Vivo Analysis. J Endod 2022; 48:1294-1300. [DOI: 10.1016/j.joen.2022.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 07/14/2022] [Accepted: 07/18/2022] [Indexed: 11/26/2022]
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Nardello LCL, Pinheiro ET, Gavini G, Prado LC, Romero RX, Gomes BPFA, Skelton-Macedo MC. Nature and Prevalence of Bacterial Taxa Persisting after Root Canal Chemomechanical Preparation in Permanent Teeth: A Systematic Review and Meta-analysis. J Endod 2022; 48:572-596. [PMID: 35114271 DOI: 10.1016/j.joen.2022.01.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 01/15/2022] [Accepted: 01/21/2022] [Indexed: 01/05/2023]
Abstract
INTRODUCTION Culture-independent molecular studies have shown a broad spectrum of bacterial taxa that persist after chemomechanical procedures (CMP). Therefore, this study systematically reviewed these reports to explore the prevalence of bacteria in post-instrumentation samples of root canals from permanent teeth, especially of as-yet-uncultivated/difficult-to-culture bacteria. METHODS Electronic databases were searched from 2007 to January 2021. Clinical studies using culture-independent molecular methods to identify species-level taxa before and after CMP were included. Studies were critically appraised using the Joanna Briggs Institute Prevalence Critical Appraisal Checklist and the funnel plot analysis. The meta-analysis was performed on the prevalence of as-yet-uncultivated/difficult-to-culture bacterial taxa using RStudio. RESULTS A total of 3781 titles were screened, but only 20 studies were included. The most frequent species in post-instrumentation samples were Streptococcus spp., Leptotrichia buccalis, Fusobacterium nucleatum, and Capnocytophaga ochracea. The detection frequency of some species increased after CMP, including mainly Firmicutes members such as streptococci, Enterococcus faecium, Selenomonas noxia, and Solobacterium moorei. The prevalence (confidence interval) of difficult-to-culture species was as follows: Dialister invisus, 17% (7%-29%); Solobacterium moorei, 14% (8%-23%); Bacteroidaceae [G-1] bacterium HMT 272, 13% (5%-23%); and Filifactor alocis, 11% (3%-23%). CONCLUSIONS The prevalence of as-yet-uncultivated/difficult-to-culture bacterial taxa in post-instrumentation samples was low. The persistent species belonged mainly to the phylum Firmicutes, and streptococci were the major members. Future larger clinical studies on the composition of the whole bacterial community that persist after CMP are still necessary for a better understanding of bacterial interactions and their clinical significance in the treatment outcome.
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Affiliation(s)
- Laura C L Nardello
- Department of Dentistry, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
| | - Ericka T Pinheiro
- Department of Dentistry, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil.
| | - Giulio Gavini
- Department of Dentistry, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
| | - Laís C Prado
- Department of Dentistry, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
| | - Roberto X Romero
- Department of Dentistry, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
| | - Brenda P F A Gomes
- Department of Restorative Dentistry, Piracicaba Dental School, State University of Campinas, Piracicaba, SP, Brazil
| | - Mary C Skelton-Macedo
- Department of Dentistry, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
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Tonini R, Salvadori M, Audino E, Sauro S, Garo ML, Salgarello S. Irrigating Solutions and Activation Methods Used in Clinical Endodontics: A Systematic Review. FRONTIERS IN ORAL HEALTH 2022; 3:838043. [PMID: 35174355 PMCID: PMC8841673 DOI: 10.3389/froh.2022.838043] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 01/06/2022] [Indexed: 12/03/2022] Open
Abstract
Background Ex vivo and in vitro studies have demonstrated the effectiveness of some irrigation protocols in reducing the bacterial load in the root canal system. However, standardized protocols have not yet been defined for the real clinical context due to many irrigation procedures available. Objective To evaluate the clinical endodontic protocols and limitations of irrigating solutions in the disinfection of the root canal system in patients with apical periodontitis. Methods PubMed, Scopus, Embase, Web of Science, and Cochrane databases were searched for randomized controlled trials (RCT) published until January 2021. Hand searching was also performed. Studies focused on evaluating the effectiveness of irrigating solutions and/or irrigation activation methods in reducing the bacterial load in the root canal system were considered. The Cochrane risk-of-bias tool for randomized trials (RoB2) was used to assess the quality of the studies. Results Four hundred and twenty eight published articles were identified. After removing the duplicate studies and analyzing full texts, seven RCTs were selected. Two studies compared pure NaOCl with some combination of NaOCl with HEDP and MTAD. Two studies analyzed the antibacterial efficacy of NaOCl and chlorhexidine (CHX). Three studies compared conventional needle irrigation with different irrigation activation methods (PUI, XP-endo finisher, F-file activator, EndoVac activator). The review attained a satisfactory methodology. The main results of each included study were described. Discussion Activation methods provide significantly higher biofilm reduction than conventional needle irrigation methods. Combinations of NaOCl with different chelating agents were ineffective in terms of antimicrobial, but it could potentially increase the risk of irrigant extrusion. However, the irrigating protocols were not carefully detailed, especially those regarding the irrigants application time or total volume. The existing literature lacks high-quality studies. The level of evidence is moderate. Conclusions The available data is too heterogeneous to compare and identify the superiority of specific valuable irrigation protocols in each clinical context. Application time, volume, and activation methods should be standardized to determine the optimal irrigating procedures to reduce the bacterial load and ensure higher predictability of the endodontic treatment. Systematic Review Registration (https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=218555), PROSPERO registration: CRD42020218555.
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Affiliation(s)
- Riccardo Tonini
- Department of Medical and Surgery Specialties, Radiological Sciences and Public Health, Dental School, University of Brescia, Brescia, Italy
| | - Matteo Salvadori
- Department of Medical and Surgery Specialties, Radiological Sciences and Public Health, Dental School, University of Brescia, Brescia, Italy
| | - Elisabetta Audino
- Department of Medical and Surgery Specialties, Radiological Sciences and Public Health, Dental School, University of Brescia, Brescia, Italy
| | - Salvatore Sauro
- Department of Dentistry, Dental Biomaterials and Minimally Invasive Dentistry, Cardenal Herrera-CEU University, Alfara del Patriarca, Spain
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Maria Luisa Garo
- Department of Medical and Surgery Specialties, Radiological Sciences and Public Health, Dental School, University of Brescia, Brescia, Italy
- *Correspondence: Maria Luisa Garo
| | - Stefano Salgarello
- Department of Medical and Surgery Specialties, Radiological Sciences and Public Health, Dental School, University of Brescia, Brescia, Italy
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Antimicrobial and cytotoxic activity of electrosprayed chitosan nanoparticles against endodontic pathogens and Balb/c 3T3 fibroblast cells. Sci Rep 2021; 11:24487. [PMID: 34966174 PMCID: PMC8716534 DOI: 10.1038/s41598-021-04322-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 12/21/2021] [Indexed: 11/28/2022] Open
Abstract
The aims of this study were to synthesize highly positively charged chitosan nanoparticles (Ch-Np) using the electrospraying technique, and to test their antimicrobial activity against endodontic pathogens, and cytotoxicity against fibroblast cells. Ch-Np were synthesized from low molecular weight chitosan (LMW-Ch) using the electrospraying technique, and characterized. The antimicrobial activity was evaluated against Streptococcus mutans, Enterococcus faecalis, and Candida albicans in their planktonic state using a Time-Kill Test performed by using broth micro-dilution technique, and against biofilm biomass using a microtiter plate biofilm assay. The cytotoxicity was evaluated using Balb/c 3T3 fibroblast cells with the standard MTT assay. Electrospraying of LMW-Ch produced Ch-Np with an average size of 200 nm, and a surface charge of 51.7 mV. Ch-Np completely eradicated S. mutans and E. faecalis in the planktonic state and showed fungistatic activity against C. albicans. Furthermore, it significantly reduced the biofilm biomass for all the tested microbial species [S. mutans (p = 0.006), E. faecalis (p < 0.0001), and C. albicans (p = 0.004)]. When tested for cytotoxicity using 3T3 cells, Ch-Np showed no cytotoxicity. In conclusion, the highly positively charged, colloidal dispersion of Ch-Np are effective as a biocompatible endodontic antimicrobial agent.
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Effect of Passive Ultrasonic Irrigation over Organic Tissue of Simulated Internal Root Resorption. Int J Dent 2021; 2021:3130813. [PMID: 34745262 PMCID: PMC8570868 DOI: 10.1155/2021/3130813] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 09/13/2021] [Accepted: 10/15/2021] [Indexed: 01/17/2023] Open
Abstract
This study aimed to evaluate the efficacy of passive ultrasonic irrigation (PUI) on dissolving the organic tissue inside simulated internal root resorption (IRR) using sodium hypochlorite (NaOCl) or chlorhexidine (CHX). A total of 40 human lower premolars were collected based on dimensional and morphological similarities. The roots were embedded in cylinders (3 cm diameter; 2.5 cm height) of self-cured acrylic resin, and then an IRR was simulated. The specimens were divided into 4 groups (n = 10) according to irrigation protocols: group 1: CHX + PUI; group 2: CHX; group 3: NaOCl + PUI; group 4: NaOCl. The total irrigation time was 150 s at a flow rate of 5 mL/min. A tissue mass of porcine palatine mucosa was used to simulate the organic tissue, it was weighed before and after the irrigation using an analytic balance, and the difference between both readings was calculated and transferred to percentage values. Data were submitted to statistical analysis using two-way ANOVA (factors: irrigant type and with/without PUI) and Tukey's test for multiple comparisons among the experimental groups (α = 0.05). There was a significant difference in both factors (irrigant: p=0.04; PUI: p ≤ 0.001). The groups that used PUI were more effective in dissolving the organic tissue of the IRR simulation than the groups without PUI. PUI is more effective than the syringe and needle irrigation in organic tissue dissolution.
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Hassan N, Diab A, Ahmed G. Post-operative Pain and Antibacterial Efficacy of Silver Nanoparticles Formulations Intracanal Medication: A Randomized Controlled Clinical Study. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.6503] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
AIM: To evaluate the effect of using combined calcium hydroxide/silver nanoparticles or silver nanoparticles (AgNPs) or calcium hydroxide (Ca(OH)2) individually as intracanal medications in reducing postoperative pain and intracanal bacterial count. MATERIALS AND METHODS: Thirty patients with necrotic mandibular anterior teeth were randomly divided into 3 groups; Ca(OH)2 + AgNPs or AgNPs gel (Intervention Groups) or Ca(OH)2 (Control Group). Patients received a standard 2-visit endodontic treatment and recorded their pain levels after 4, 24, 48, 72 and 96 hours following the first and second visit on a modified visual analogue scale (VAS). Intracanal bacterial counts were assessed using culturing before and after instrumentation and intracanal medication. Outcome data were statistically analyzed using Kruskal-Wallis and Fisher’s Exact tests to compare between the groups and Friedman’s test to assess the changes by time. RESULTS: At 24 hours interappointment the incidence of pain was statistically significant (P = .005) as well as at 48 hours (P = .001). There was a statistically significant difference between the mean percentage reduction of anaerobic bacterial counts in the three groups with the highest percentage in the Ca(OH)2 + AgNPs group at 98.9% followed by AgNPs group 98.5% and Ca(OH)2 at 85.3% (P <0.001). CONCLUSIONS: Combined calcium hydroxide/silver nanoparticles reduced the intracanal bacterial counts significantly, but adversely affected the interappointment pain. Based on that finding, this combination should be tested in different concentrations with different ratios to reach the most effective combination that reduce pain with high antibacterial efficacy.
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Vasavada K, Kapoor S. Evaluation of ozonized calcium hydroxide as an effective intracanal medicament during root canal procedures: an in vitro observational study. Med Gas Res 2021; 10:122-124. [PMID: 33004709 PMCID: PMC8086627 DOI: 10.4103/2045-9912.296042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Achieving thorough disinfection is regarded as one of the pillars in endodontics. Although calcium hydroxide (CH) is one of the routinely used intracanal medicament in endodontics; alternative approaches are gaining popularity to mitigate endodontic pathology. However, CH has to be tested for its dissociation which is a rate-limiting attribute essential for its therapeutic action. The dissociation of CH into OH– and Ca2+ depends on the vehicle used to prepare the paste. This in-vitro study evaluated the use of ozonized olive oil in facilitating calcium ion release and change in pH when combined with CH. Fifty single rooted extracted human mandibular premolars were instrumented with NiTi rotary files (40/6). The teeth were divided into two groups (n = 25 per group) on the basis of vehicle: olive oil (CH + olive oil) and ozonized olive oil (CH + ozonized olive oil) groups. Both olive and ozonized olive oil vehicles allowed the diffusion of ions. However, pastes prepared with ozonized oil showed more ion diffusion, with marked calcium ion release after 15 days and alkalinity was maintained for complete period of 15 days, depicting better support for CH action. The change in calcium ion release and alkalinity were statistically significant in ozonized oil vehicle compared to olive oil vehicle. The present in-vitro study supports the use of ozonized olive oil as a vehicle to be used with CH as an intracanal medicament, considering its anti-microbial potential and sustainable release of calcium ions. The study was approved by the Institutional Ethical Committee of Manubhai Patel Dental College (approval No. MPDC_130/CONS-25/17) on June 4, 2018.
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Affiliation(s)
- Kesha Vasavada
- Conservative Dentistry and Endodontics, Manubhai Patel Dental College and ORI, Vadodara, Gujarat, India
| | - Sonali Kapoor
- Conservative Dentistry and Endodontics, Manubhai Patel Dental College and ORI, Vadodara, Gujarat, India
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Teixeira FFC, Cardoso FGR, Ferreira NS, Gomes APM, Corazza BJM, Valera MC, Martinho FC. Clinical influence of calcium hydroxide intracanal medications on matrix metalloproteinases and tissue inhibitors of metalloproteinases in apical periodontitis. Clin Oral Investig 2021; 26:643-650. [PMID: 34255199 DOI: 10.1007/s00784-021-04042-z] [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: 01/21/2021] [Accepted: 06/21/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES This study investigated the influence of calcium hydroxide intracanal medications on the levels of metalloproteinases (MMPs) and their tissue inhibitors (TIMPs) in apical periodontitis (AP). MATERIALS AND METHODS Twenty primarily infected root canals with AP were randomly divided into two groups: Ca(OH)2 + sterile saline solution (SSL) group and Ca(OH)2 + 2% chlorhexidine gel (CHX gel) group. We collected samples from the periradicular tissue fluid (PTF) before (s1) and after 14 days of intracanal medication (s2). MMP-1, MMP-2, MMP-9, TIMP-1, and TIMP-2 were measured by ELISA assay. RESULTS MMP-1, MMP-2, MMP-9, TIMP-1, and TIMP-2 were detected in all PTF samples at s1 and s2 (20/20). At s1, MMP-2 and MMP-9 were detected at higher levels than MMP-1 (p < .05). Higher levels of TIMP-1 than TIMP-2 were found in AP (p < .05). Additionally, we detected higher MMP-1, MMP-2, and MMP-9 over TIMP-1 and TIMP-2 levels in AP (p < .05). At s2, Ca(OH)2 + SSL was as effective as Ca(OH)2 + 2% CHX gel in lowering the levels of MMP-1, MMP-2, and MMP-9 after 14 days of intracanal medication, with no significant difference between them (p > .05). Both Ca(OH) 2 intracanal medications had no significant impact on the levels of TIMP-1 and TIMP-2 (both p > .05). At s2, TIMP-1 levels were higher than TIMP-2 (p < .05). Moreover, there were positive correlations between the levels of MMP-1 and TIMP-1 and MMP-1 and TIMP-2 (p < .05). CONCLUSIONS Calcium hydroxide medications effectively lowered the levels of MMP-1, MMP-2, and MMP-9 in periapical tissues after 14 days of treatment, with no difference between them. Moreover, the calcium hydroxide intracanal medications tested here had no impact in TIMP-1 and TIMP-2 in periapical tissues. CLINICAL RELEVANCE MMPs and TIMPs play an essential role in the degradation of the extracellular matrix. The imbalance MMPs and TIMPs can cause periapical tissue destruction. Therefore, the reestablishment of the balance between activated MMPs and TIMPs with root canal therapy is essential to restore tissue homeostasis.
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Affiliation(s)
- Flavia F C Teixeira
- Department of Restorative Dentistry, Endodontic Division, São Paulo State University (Unesp), Institute of Science and Technology, São José dos Campos, Brazil
| | - Flavia G R Cardoso
- Department of Restorative Dentistry, Endodontic Division, São Paulo State University (Unesp), Institute of Science and Technology, São José dos Campos, Brazil
| | - Nadia S Ferreira
- Department of Restorative Dentistry, Endodontic Division, São Paulo State University (Unesp), Institute of Science and Technology, São José dos Campos, Brazil
| | - Ana P M Gomes
- Department of Restorative Dentistry, Endodontic Division, São Paulo State University (Unesp), Institute of Science and Technology, São José dos Campos, Brazil
| | - Bruna J M Corazza
- Department of Restorative Dentistry, Endodontic Division, São Paulo State University (Unesp), Institute of Science and Technology, São José dos Campos, Brazil
| | - Marcia C Valera
- Department of Restorative Dentistry, Endodontic Division, São Paulo State University (Unesp), Institute of Science and Technology, São José dos Campos, Brazil
| | - Frederico C Martinho
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, 650 West Baltimore Street, Baltimore, MD, 21201, USA.
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Martinho FC, Leite FRM, Arruda-Vasconcelos R, Louzada LM, Darveau RP, Gomes BPFA. Influence of Bacterial Profiles in Cytokine and Clinical Features of Endodontic Disease. J Endod 2021; 47:1265-1271. [PMID: 34015415 DOI: 10.1016/j.joen.2021.04.026] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 04/26/2021] [Accepted: 04/29/2021] [Indexed: 12/28/2022]
Abstract
INTRODUCTION We verified the association between selected bacterial profiles and levels of cytokines, chemokines, and the expression of signs and symptoms of primary endodontic infection with apical periodontitis. METHODS Samples were collected from 21 root canals, and macrophages were stimulated for 24 hours. Tumor necrosis factor alpha (TNF-α), interleukin (IL)-6, IL-10, IL-12p70, interferon gamma, and chemokine (C-C motif) ligand 2 (CCL2) were measured using cytometric bead array. We investigated the overlapping networks between cytokines and chemokines with regression analysis. Checkerboard DNA-DNA hybridization was used to assess 40 target bacteria species. Using factor analysis, bacterial species aggregated in 2 factors. The association of bacteria species-based factors on cytokine and chemokine levels and clinical features was estimated with regression analysis. RESULTS A negative relationship between IL-10 (anti-inflammatory cytokine) and CCL2, TNF-α, and IFN-γ (proinflammatory cytokines) (all P < .05) was observed. CCL2 was positively correlated with TNF-α (P < .01). Thirty-eight bacteria species were detected in primary endodontic infection with apical periodontitis. The first bacteria species-based factor was associated with the size of the radiolucent area (coefficient = 15.42) and tenderness to percussion/pain on palpation (coefficient = 20.79). The second factor was associated with CCL2 levels (coefficient = 1.28). CONCLUSIONS Different bacterial profiles can be differentially related to the expression of inflammatory proteins and the experience of clinical features.
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Affiliation(s)
- Frederico C Martinho
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil; Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, Maryland.
| | - Fabio R M Leite
- Department of Dentistry and Oral Health, Section for Periodontology, Aarhus University, Aarhus, Denmark
| | - Rodrigo Arruda-Vasconcelos
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil
| | - Lidiane M Louzada
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil
| | - Richard P Darveau
- Department of Periodontics, University of Washington, Seattle, Washington
| | - Brenda P F A Gomes
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil.
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Banci HA, Strazzi-Sahyon HB, Duarte MAH, Cintra LTA, Gomes-Filho JE, Chalub LO, Berton SA, de Oliveira VHD, dos Santos PH, Sivieri-Araujo G. Influence of photodynamic therapy on bond strength and adhesive interface morphology of MTA based root canal sealer to different thirds of intraradicular dentin. Photodiagnosis Photodyn Ther 2020; 32:102031. [DOI: 10.1016/j.pdpdt.2020.102031] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 09/20/2020] [Accepted: 09/28/2020] [Indexed: 11/16/2022]
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Resolution of Nasal Sinus Tract after Endodontic Therapy: A Case Report with Microbial Analysis. J Endod 2020; 47:327-334. [PMID: 33065178 DOI: 10.1016/j.joen.2020.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 10/01/2020] [Accepted: 10/04/2020] [Indexed: 11/20/2022]
Abstract
This case report describes the resolution of a 20-year misdiagnosed nasal sinus tract after root canal therapy with multiple sessions of calcium hydroxide (Ca[OH]2) intracanal medication. Clinical evaluation, including diagnostic testing and sinus tract tracing, was performed followed by a cone-beam computed tomographic scan and 3-dimensional reconstruction of the apical lesion. Bacteria and endotoxin analyses were performed from the nasal sinus tract and paired root canal infection before (s1) and after instrumentation (s2) and after 7 (s3), 14 (s4), and 21 (s5) days of Ca(OH)2 medication. The bacteria analysis was performed using the checkerboard DNA-DNA hybridization method and endotoxin quantified by the limulus amebocyte lysate method. A similar microbiota profile was found in the sinus tract and paired root canal infection. No target bacterial species were detected in the root canal at s2, s3, and s5. In contrast, Actinomyces israellii and Eubacterium nodatum were detected at s4. Differences in bacterial detection were found between s1 × s2, s3 × s4, and s4 × s5 (all P < .05). Endotoxin was detected in the root canal at all sampling times. Differences in the levels of endotoxin were found between s1 × s2, s2 × s3, and s3 × s4 (all P < .05).The bacterial analysis revealed similar microbiota profiles present in the nasal sinus tract and paired root canal infection with the participation of a wide variety of gram-positive and -negative species. Additionally, root canal therapy with multiple sessions of Ca(OH)2 intracanal medication for 21 days was effective in disinfecting the root canal system and resolving the nasal sinus tract.
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Corazza BJM, Martinho FC, Khoury RD, Toia CC, Orozco EIF, Prado RF, Machado FP, Valera MC. Clinical influence of calcium hydroxide and N-acetylcysteine on the levels of resolvins E1 and D2 in apical periodontitis. Int Endod J 2020; 54:61-73. [PMID: 32896000 DOI: 10.1111/iej.13403] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 08/28/2020] [Accepted: 09/01/2020] [Indexed: 01/17/2023]
Abstract
AIM To investigate the presence of resolvins E1 (RvE1) and D2 (RvD2) in teeth with primary endodontic infections and apical periodontitis, and to assess the influence of calcium hydroxide medication [Ca(OH)2 ], in association with 2% chlorhexidine gel (2% CHX gel), and N-acetylcysteine (NAC) on the levels of RvE1 and RvD2 in periapical tissues. METHODOLOGY Thirty-six single-rooted teeth with primary endodontic infections and apical periodontitis were selected and randomly divided into three groups according to the medication: [Ca(OH)2 ] + saline solution (SSL) [Ca(OH)2 + SSL group] (n = 12), Ca(OH)2 + 2% chlorhexidine gel [Ca(OH)2 + 2% CHX gel group] (n = 12) and NAC [NAC group] (n = 12). Samples were collected from the periapical interstitial fluid at two different sampling times: before (S1) and after 14 days of intracanal medications (S2). Resolvins were measured using the enzyme-linked immunosorbent assay. Data were analysed using paired t-test, Wilcoxon test and Kruskal-Wallis test, followed by Dunn's post hoc test; all statistical tests were performed at a significance level of 5%. RESULTS RvE1 and RvD2 were detected in 100% of the samples (36/36) at S1 and S2. Ca(OH)2 medication did not increase the levels of RvE1 or RvD2 (both P > 0.05); however, NAC significantly increased the levels of RvE1 and RvD2 after 14 days of treatment (P < 0.05). CONCLUSIONS RvE1 and RvD2 were detected in periapical tissues from teeth with root canal infections. Moreover, calcium hydroxide medication did not increase the levels of resolvins in apical periodontitis. In contrast, the use of NAC intracanal medication significantly increased the levels of RvE1 and RvD2 after 14 days of treatment.
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Affiliation(s)
- B J M Corazza
- Department of Restorative Dentistry, Endodontic Division, Institute of Science and Technology, São Paulo State University - UNESP, São José dos Campos, São Paulo, Brazil
| | - F C Martinho
- Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, MD, USA
| | - R D Khoury
- Department of Restorative Dentistry, Endodontic Division, Institute of Science and Technology, São Paulo State University - UNESP, São José dos Campos, São Paulo, Brazil
| | - C C Toia
- Department of Restorative Dentistry, Endodontic Division, Institute of Science and Technology, São Paulo State University - UNESP, São José dos Campos, São Paulo, Brazil
| | - E I F Orozco
- Department of Restorative Dentistry, Endodontic Division, Institute of Science and Technology, São Paulo State University - UNESP, São José dos Campos, São Paulo, Brazil
| | - R F Prado
- Department of Restorative Dentistry, Endodontic Division, Institute of Science and Technology, São Paulo State University - UNESP, São José dos Campos, São Paulo, Brazil
| | - F P Machado
- Department of Restorative Dentistry, Endodontic Division, Institute of Science and Technology, São Paulo State University - UNESP, São José dos Campos, São Paulo, Brazil
| | - M C Valera
- Department of Restorative Dentistry, Endodontic Division, Institute of Science and Technology, São Paulo State University - UNESP, São José dos Campos, São Paulo, Brazil
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21
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Lemos SS, Cesar DE, ProcÓpio SW, Machado FC, Ribeiro LC, Ribeiro RA. Qualitative and quantitative molecular analysis of bacteria in root canals of primary teeth with pulp necrosis. Braz Oral Res 2020; 34:e093. [PMID: 32785473 DOI: 10.1590/1807-3107bor-2020.vol34.0093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 05/18/2020] [Indexed: 11/21/2022] Open
Abstract
Information about bacterial diversity, such as the number of each species in the root canals of primary teeth, contributes to improving our effective management of infections of endodontic origin in primary teeth. This study made a qualitative and quantitative assessment of the bacteria in the root canals of primary teeth with necrotic pulp, using the fluorescence in situ hybridization (FISH) technique. Thirty-one primary teeth with pulp necrosis from 31 children were evaluated using the FISH technique, to detect the presence and density of Aggregatibacter actinomycetemcomitans, Campylobacter rectus, Enterococcus faecalis, Fusobacterium nucleatum, Porphyromonas gingivalis, Prevotella intermedia, Prevotella nigrescens, Streptococcus, Streptococcus mutans, Streptococcus sobrinus, Tannerella forsythia and Treponema denticola. Descriptive measures explained the data related to density, and Student's t-test assessed the differences among the densities of each bacterium, according to signs and symptoms. The bacterial density was paired and correlated. All bacteria tested were detected and identified in all the samples. The average number of bacterial individuals from each species ranged from 1.9 x 108 cells/mL (S. mutans) to 3.1 x 108 cells/mL (F. nucleatum) (p > 0.05). The sum of the mean counts of each bacterium represented almost 80% of the entire microbial community. Patients with pain had significantly more T. denticola, and those with edema showed a greater density of Streptococcus and P. nigrescens (p < 0.05). This study revealed that all 12 bacteria evaluated were found in all primary teeth with pulp necrosis. There was no predominance among the species studied; all species had a similar number of individuals.
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Affiliation(s)
- Samira Salomão Lemos
- Postgraduate Program in Dentistry, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil
| | - Dionéia Evangelista Cesar
- Department of Ecology and Molecular Biology of Microorganisms, Biological Sciences Institute, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil
| | - Stefânia Werneck ProcÓpio
- Postgraduate Program in Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Fernanda Campos Machado
- Department of Social and Child Dentistry, School of Dentistry, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil
| | - Luiz Claudio Ribeiro
- Department of Statistics, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil
| | - Rosangela Almeida Ribeiro
- Department of Social and Child Dentistry, School of Dentistry, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil
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22
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Primary versus post-treatment apical periodontitis: microbial composition, lipopolysaccharides and lipoteichoic acid levels, signs and symptoms. Clin Oral Investig 2020; 24:3169-3179. [PMID: 31933111 DOI: 10.1007/s00784-019-03191-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 12/27/2019] [Indexed: 12/18/2022]
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23
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Orozco EIF, Toia CC, Cavalli D, Khoury RD, Cardoso FGDR, Bresciani E, Valera MC. Effect of passive ultrasonic activation on microorganisms in primary root canal infection: a randomized clinical trial. J Appl Oral Sci 2019; 28:e20190100. [PMID: 31800872 PMCID: PMC6886399 DOI: 10.1590/1678-7757-2019-0100] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 07/16/2019] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE This clinical study sought to evaluate the effectiveness of passive ultrasonic activation (PUA) in eliminating microorganisms in primary endodontic infection (PEI) after instrumentation of root canals using microbiological culture and checkerboard DNA-DNA hybridization. METHODOLOGY Twenty root canals with PEI and apical periodontitis were selected. The root canals were instrumented and then randomly divided into 2 groups, according to the irrigation method: PUA and conventional needle irrigation (CNI). Microbiological samples were collected before instrumentation (S1), after instrumentation (S2) and after irrigation with 17% EDTA (S3). The samples were subjected to anaerobic culture technique and checkerboard DNA-DNA hybridization analysis. RESULTS A statistically significant difference was found between CNI (23.56%) and PUA (98.37%) regarding the median percentage values for culturable bacteria reduction (p<0.05). In the initial samples, the most frequently detected species was S. constellatus (50%), and after root canal treatment was E. faecalis (50%). CONCLUSION Both treatments significantly decreased the number of bacterial species compared with the initial sample. However, no statistical difference in the total microbial load between PUA and CNI groups was detected. The number of cultivable anaerobic bacteria reduced significantly using PUA, and the bacterial composition and number of bacterial species after using either CNI or PUA was similar.
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Affiliation(s)
- Esteban Isai Flores Orozco
- Universidade Estadual Paulista (UNESP), Instituto de Ciências e Tecnologia, Departamento de Odontologia Restauradora, São José dos Campos, São Paulo, Brasil
| | - Cassia Cestari Toia
- Universidade Estadual Paulista (UNESP), Instituto de Ciências e Tecnologia, Departamento de Odontologia Restauradora, São José dos Campos, São Paulo, Brasil
| | - Daiana Cavalli
- Universidade Estadual Paulista (UNESP), Instituto de Ciências e Tecnologia, Departamento de Odontologia Restauradora, São José dos Campos, São Paulo, Brasil
| | - Rayana Duarte Khoury
- Universidade Estadual Paulista (UNESP), Instituto de Ciências e Tecnologia, Departamento de Odontologia Restauradora, São José dos Campos, São Paulo, Brasil
| | - Flávia Goulart da Rosa Cardoso
- Universidade Estadual Paulista (UNESP), Instituto de Ciências e Tecnologia, Departamento de Odontologia Restauradora, São José dos Campos, São Paulo, Brasil
| | - Eduardo Bresciani
- Universidade Estadual Paulista (UNESP), Instituto de Ciências e Tecnologia, Departamento de Odontologia Restauradora, São José dos Campos, São Paulo, Brasil
| | - Marcia Carneiro Valera
- Universidade Estadual Paulista (UNESP), Instituto de Ciências e Tecnologia, Departamento de Odontologia Restauradora, São José dos Campos, São Paulo, Brasil
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24
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Cardoso FGDR, Martinho FC, Ferreira NDS, Prado RFD, Manhães-Júnior LRC, Rocco MA, Valera MC. Correlation Between Volume of Root Canal, Cultivable Bacteria, Bacterial Complexes and Endotoxins in Primary Infection. Braz Dent J 2019; 30:117-122. [PMID: 30970053 DOI: 10.1590/0103-6440201902239] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 11/14/2018] [Indexed: 11/22/2022] Open
Abstract
This clinical study was conducted to correlate the levels of endotoxins and culturable bacteria found in primary endodontic infection (PEI) with the volume of root canal determined by using Cone Beam Computed Tomography (CBCT); and to evaluate the bacterial diversity correlating with clinical features. Twenty patients with PEI were selected and clinical features were recorded. The volume (mm3) of root canal was determined by CBCT analysis. Root canal samples were analyzed by using kinetic LAL-assay test to determine the levels of endotoxins and anaerobic technique to determine the bacterial count (CFU/mL). DNA was extracted from all samples to determine bacterial diversity and quantified by using Checkerboard-DNA-DNA- Hybridization. Culturable bacteria and endotoxins were detected in 100% of the root canal samples. Linear regression analysis revealed a correlation between root canal volume and presence of anaerobic bacteria (p<0.05). Positive correlations were found between bacteria species and presence of different clinical features (p<0.05). After grouping the bacteria species into bacterial complexes, positive associations were found between green, orange and red complexes with presence of sinus tract (p<0.05). This clinical study revealed that larger root canals hold higher levels of culturable bacteria in PEI. Thus, the interaction of different virulent bacteria species in complexes seems to play an important role in the development of clinical features.
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Affiliation(s)
- Flávia Goulart da Rosa Cardoso
- Department of Restorative Dentistry, Institute of Science and Technology, UNESP - Univ Estadual Paulista, São José dos Campos, SP, Brazil.,Department of Dentistry, Endodontic Division, University of Taubaté - UNITAU, Taubaté, SP, Brazil
| | - Frederico Canato Martinho
- Department of Restorative Dentistry, Institute of Science and Technology, UNESP - Univ Estadual Paulista, São José dos Campos, SP, Brazil.,Department of Advanced Oral Science & Therapeutics, Endodontic Division, University of Maryland, School of Dentistry, Maryland, USA
| | - Nádia de Souza Ferreira
- Department of Restorative Dentistry, Institute of Science and Technology, UNESP - Univ Estadual Paulista, São José dos Campos, SP, Brazil.,Department of Semiology, UFPel - Universidade Federal de Pelotas, School of Dentistry, Pelotas, RS, Brazil
| | - Renata Falchete do Prado
- Department of Restorative Dentistry, Institute of Science and Technology, UNESP - Univ Estadual Paulista, São José dos Campos, SP, Brazil
| | | | - Marco Antônio Rocco
- Department of Radiology, Institute of Science and Technology, UNESP - Univ Estadual Paulista, São José dos Campos, SP, Brazil
| | - Marcia Carneiro Valera
- Department of Restorative Dentistry, Institute of Science and Technology, UNESP - Univ Estadual Paulista, São José dos Campos, SP, Brazil
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25
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Pandey SH, Patni PM, Jain P, Sanwatsarkar G, Bardia C. Cysteamine improves the bactericidal efficacy of intra-canal medicaments against Enterococcus faecalis. Med Pharm Rep 2018; 91:448-451. [PMID: 30564022 PMCID: PMC6296715 DOI: 10.15386/cjmed-926] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Accepted: 06/21/2018] [Indexed: 01/21/2023] Open
Abstract
Aim The aim of this study was to compare the antimicrobial efficacy of cysteamine, calcium hydroxide[Ca(OH)2], triple antibiotic paste (TAP), chlorhexidine (CHX) and their combinations against Enterococcus faecalis (E. Faecalis). Methods The E. Faecalis eradication capacity of cysteamine, Calcium hydroxide (Ca[OH]2), TAP, CHX, and their combinations was tested on E. Faecalis by Kirby Brauer disc diffusion method. Results Cysteamine in combination with TAP was able to completely eradicate E. Faecalis within 24 hours. Ca(OH)2 was unable to show its effect on E. Faecalis in the given time. Conclusion Cysteamine increased the E. Faecalis eradicating capacity of TAP and also showed positive results when used in combination with Ca(OH)2, which if used alone was unable to show any action in 24 hours.
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Affiliation(s)
- Sanket Hans Pandey
- Conservative Dentistry and Endodontics Department, Madhya Pradesh Medical Science University, India
| | - Pallav Mahesh Patni
- Conservative Dentistry and Endodontics Department, Madhya Pradesh Medical Science University, India
| | - Pradeep Jain
- Conservative Dentistry and Endodontics Department, Madhya Pradesh Medical Science University, India
| | - Gauri Sanwatsarkar
- Conservative Dentistry and Endodontics Department, Madhya Pradesh Medical Science University, India
| | - Chinki Bardia
- Conservative Dentistry and Endodontics Department, Madhya Pradesh Medical Science University, India
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26
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Dornelles NB, Collares FM, Genari B, de Souza Balbinot G, Samuel SMW, Arthur RA, Visioli F, Guterres SS, Leitune VCB. Influence of the addition of microsphere load amoxicillin in the physical, chemical and biological properties of an experimental endodontic sealer. J Dent 2018; 68:28-33. [DOI: 10.1016/j.jdent.2017.10.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 10/24/2017] [Accepted: 10/24/2017] [Indexed: 01/07/2023] Open
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27
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Prado ACC, De Barros PP, Santos JDD, De Oliveira LD, Carvalho CAT, Valera MC, Jorge AOC, Junqueira JC. Enterococcus faecium and Enterococcus faecalis in endodontic infections: antibiotic resistance profile and susceptibility to photodynamic therapy. ACTA ACUST UNITED AC 2017. [DOI: 10.1007/s41547-017-0011-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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28
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Rabello DG, Corazza BJ, Ferreira LL, Santamaria MP, Gomes AP, Martinho FC. Does supplemental photodynamic therapy optimize the disinfection of bacteria and endotoxins in one-visit and two-visit root canal therapy? A randomized clinical trial. Photodiagnosis Photodyn Ther 2017; 19:205-211. [DOI: 10.1016/j.pdpdt.2017.06.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 05/24/2017] [Accepted: 06/11/2017] [Indexed: 11/27/2022]
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29
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Cavalli D, Toia CC, Flores Orozco EI, Khoury RD, Cardoso FGDR, Alves MC, Carvalho CAT, Valera MC. Effectiveness in the Removal of Endotoxins and Microbiological Profile in Primary Endodontic Infections Using 3 Different Instrumentation Systems: A Randomized Clinical Study. J Endod 2017; 43:1237-1245. [DOI: 10.1016/j.joen.2017.03.032] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Revised: 03/20/2017] [Accepted: 03/20/2017] [Indexed: 11/17/2022]
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30
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Valverde ME, Baca P, Ceballos L, Fuentes MV, Ruiz-Linares M, Ferrer-Luque CM. Antibacterial efficacy of several intracanal medicaments for endodontic therapy. Dent Mater J 2017; 36:319-324. [PMID: 28228624 DOI: 10.4012/dmj.2016-102] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The antibacterial efficacy of intracanal medicaments for 2 and 7 days, in open apex root canals contaminated with Enterococcus faecalis biofilms was compared. One hundred and thirty-eight standardized uniradicular human roots were inoculated with E. faecalis. Colony forming units (CFU) were recorded before and after medication. Samples were divided in two (2/7 days), and subdivided (n=8/group): triple antibiotic paste (TAP); double antibiotic paste (DAP); dental base paste (DBP), consisting of calcium hydroxide, propylene glycol and calcium carbonate; DBP+0.2% chlorhexidine (CHX); DBP+0.2% cetrimide (CTR); DBP+0.2% CHX+0.2% CTR; 2.5% sodium hypochlorite (NaOCl); and distilled water. At both periods TAP, DAP, DBP+0.2% CHX, DBP+0.2% CTR and DBP+0.2% CHX+0.2% CTR exhibited no growth (NG) of E. faecalis. Distilled water and 2.5% NaOCl obtained the lowest CFU reduction. No growth with DBP was reached only at 7 days. CHX and/or CTR pastes were as effective as DAP and TAP. A 2-day period provided an effective disinfection.
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Affiliation(s)
- Marta E Valverde
- Stomatology Area, Health Sciences Faculty, Rey Juan Carlos University
| | - Pilar Baca
- Department of Stomatology, School of Dentistry, University of Granada
| | - Laura Ceballos
- Stomatology Area, Health Sciences Faculty, Rey Juan Carlos University
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31
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Carvalho AS, Oliveira LDD, Cardoso FGDR, Oliveira FED, Valera MC, Carvalho CAT. Limewater and Polymyxin B Associated with NaOCl for Endotoxin Detoxification in Root Canal with Necrotic Pulp. Braz Dent J 2016; 27:573-577. [DOI: 10.1590/0103-6440201600934] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 06/15/2016] [Indexed: 11/22/2022] Open
Abstract
Abstract This clinical study investigated the effects of endodontic treatment by using different irrigants (limewater + NaOCl and polymyxin B + NaOCl) and intracanal medication on endotoxins in teeth with primary endodontic infection and radiographically visible apical periodontitis. Thirty-three teeth with necrotic pulp and periapical lesions from different patients were selected for this study. Samples were collected after the coronal opening (S1) and after instrumentation (S2). Root canals were divided in 3 groups (n = 11) according to the irrigant combination used: NaOCl + LW: 2.5% NaOCl + calcium hydroxide solution (0.14%, limewater); NaOCl + PmB: 2.5% NaOCl + 10.000 UI/mL polymyxin B; 2.5% NaOCl (control). The third sampling (S3) was performed after ethylenediaminetetraacetic acid and the fourth (S4) after samples got 14 days with intracanal medication with 2% chlorhexidine gel + calcium hydroxide. Endotoxins (lipopolysaccharide) were quantified by chromogenic Limulus amebocyte lysate (LAL). Endotoxins were detected in all root canals after the coronal opening (S1). NaOCl + PmB group presented the greatest endotoxin reduction after instrumentation (76.17%), similar to NaOCl + LW group (67.64%, p<0.05) and different from NaOCl group (42.17%, p<0.05). After intracanal medication period (S4), there was significant increase of endotoxins neutralization. It was concluded that NaOCl + PmB promoted the greatest reduction of endotoxin levels, followed by NaOCl + LW. Intracanal medications had no significant complementary role in the reduction of endotoxins at the end of the treatment
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32
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Sun X, Wang S, Yang Y, Luo C, Hou B. Study of invasion and colonization of E. faecalis in microtubes by a novel device. Biomed Microdevices 2016; 18:82. [PMID: 27540728 DOI: 10.1007/s10544-016-0108-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Enterococcus faecalis (E. faecalis) is a species that has frequently been isolated from root canal of patients suffering from persistent periodontitis. To a great degree, the resistance of E. faecalis to irrigating solutions and intracanal medicaments is due to its invasion into the dentinal tubules. In this study, we developed a device to observe the dynamic process of the bacterial invasion into microtubes. According to the diameter of the dentinal tubules and other microstructures in the root canals, we designed four different size microtubes with different lengths in this device. As expected, E. faecalis is able to steadily grow in this device and penetrate into the microtubes, and a continuous observation is achieved. We found that the depth and speed of bacterial penetration, the extent of colonization and the arrangement of the bacteria in the microtubes are strongly influenced by the size of the microtube. The length of the microtube also influences the speed and depth of the bacterial invasion. Bacteria in microtubes with a similar diameter to the real dentinal tubules showed a discontinuous distribution, which is consistent with the final bacterial distribution in the native dentinal tubules. Considering the device's advantages such as its ability to provide real-time observations, its ability to be modified as necessary, and its standardized operation, it has great potential to be widely used as a platform for the observation of the interaction of different bacteria during an invasion course and to test the efficacy of new antibacterial agents in dentistry.
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Affiliation(s)
- Xiaoqiang Sun
- Department of Endodontics, School of Stomatology, Capital Medical University, Beijing, China
| | - Shujing Wang
- State Key Laboratory for Artificial Microstructures and Mesoscopic Physics, School of Physics, Peking University, Beijing, China.,Center for Quantitative Biology, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China
| | - Yue Yang
- Department of Endodontics, School of Stomatology, Capital Medical University, Beijing, China
| | - Chunxiong Luo
- State Key Laboratory for Artificial Microstructures and Mesoscopic Physics, School of Physics, Peking University, Beijing, China. .,Center for Quantitative Biology, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China.
| | - Benxiang Hou
- Department of Endodontics, School of Stomatology, Capital Medical University, Beijing, China.
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