Use of Photosensitizer, Glutaraldehyde, alcohol and Ultrasonics in disinfection of polished and rough surfaces of self-curing polymethyl methacrylate denture base material

The efficacy of antimicrobial photodynamic therapy in the disinfection of coronal and radicular dentine of primary teeth: A systematic review and meta-analysis

BACKGROUND

Optimal endodontic disinfection by means of conventional root canal treatment of primary teeth remains a challenge. Recently, antimicrobial photodynamic therapy (aPDT) has been proposed as an adjunct to conventional endodontic treatment for microbial disinfection. The purpose of this review is to critically appraise and synthesize the currently-available evidence about the antimicrobial efficacy of aPDT (antimicrobial photodynamic therapy) when used as an adjunct to traditional root canal therapy.

MATERIALS AND METHODS

The focused question was ''In primary teeth needing root canal treatment (participants), is adjunct aPDT (intervention) more effective in disinfecting coronal and radicular dentine (outcomes) than root canal treatment alone (control)?'. The electronic research databases PubMED/Medline, ISI Web of Knowledge, Embase and CENTRAL (Cochrane Central Register of Controlled Trials) using relevant keyword phrases including 'antimicrobial photodynamic therapy', 'primary teeth', 'deciduous teeth', and 'endodontic treatment'. Original studies that described endodontic treatment of primary teeth or dentine using aPDT in comparison to conventional endodontic treatment were included. Case reports, reviews and other non-comparative studies were excluded. The literature search and quality assessment were carried out by two reviewers independently.

RESULTS

Ultimately, 9 studies were included in this review. Overall, majority of the studies concluded that adjunct aPDT improves the antimicrobial efficacy of conventional root canal therapy. However, several sources of bias were found in the studies.

CONCLUSION

Within the limitations of the studies, it is concluded that aPDT is a suitable adjunct to improve the disinfection of conventional root canal treatment. However, future studies should focus on the clinical outcomes, in relation to the reduction of microbial counts to ascertain the efficacy of aPDT in disinfection of primary dentine.

Influence of Contemporary Photoactivated Disinfection on the Mechanical Properties and Antimicrobial Activity of PMMA Denture Base: A Systematic Review and Meta Analysis

PURPOSE

The present study aimed to perform a systematic review and meta-analysis to investigate the effectiveness of the contemporary photoactivated disinfection methods on the mechanical features and/or antimicrobial activity of polymethyl methacrylate (PMMA) dentures bases.

METHODS

THE FOCUSED RESEARCH QUESTION WAS: : "What is the effect of contemporary photoactivated disinfection methods as compared to conventional disinfection protocols on the mechanical features and/or antimicrobial activity of PMMA dentures bases?". An electronic literature search was carried out by the author and a senior librarian specialized in health sciences on Web of Science, PubMed, and Scopus. In vitro investigations evaluating the antimicrobial and/or mechanical effects of photoactivated disinfectants as compared to conventional chemical disinfectants on the microbes formed on PMMA denture bases were included. Meta-analysis was performed for calculating the standard mean difference (SMD) with a 95% confidence interval.

RESULTS

Four out of eight studies concluded that photoactivated disinfectants, including riboflavin-mediated photodynamic therapy (PDT), hematoporphyrin-mediated PDT, poly-L-glycolic acid loaded with methylene blue, Erbium, chromium-doped yttrium, scandium, gallium, and garnet (Er,Cr:YSGG) laser, erbium-doped yttrium-aluminum-garnet (Er:YAG) laser, and chitosan-mediated PDT, demonstrated a significant reduction in colony-forming unit per milliliter (CFU/mL) of exposed viable colonies of Escherichia coli (E. coli), Streptococcus mutans (S. mutans), Staphylococcus aureus (S. aureus), and Candida albicans (C. albicans) comparable to the conventionally used chemical disinfectants of PMMA denture bases. Contrarily, two studies concluded that the PMMA denture base colonized with C. albicans and disinfected with conventional chemical disinfectants showed the greatest anti-fungal efficaciousness. All the included studies concluded that the application of photoactivated disinfectants does not negatively impact the mechanical features of the PMMA denture bases colonized with microbes including E. coli, S. mutans, S. aureus, and C. albicans. The meta-analysis revealed statistically significant reduction in C. albicans counts (CFU/mL [Log10]) (p < 0.00001) and improvement in the flexural strength (p = 0.0002) of PMMA-based denture base after the application of conventional disinfectants, while a statistically significant improvement in the fracture strength of PMMA-based denture base was observed after the application of photoactivated disinfectants (p = 0.03).

CONCLUSION

According to the systematic review (qualitative synthesis), photoactivated disinfectants demonstrated comparable mechanical features and antimicrobial activity of PMMA dentures bases to conventional chemical disinfectants suggesting their potential to be utilized as an alternative to conventional chemical disinfectants. However, the meta-analysis (quantitative synthesis) revealed that the application of conventional disinfectants demonstrated better outcomes related to antimicrobial activity and flexural strength of PMMA-based denture based.

Efficacy of curcumin-mediated photodynamic therapy for root canal therapy procedures: A systematic review

BACKGROUND

This systematic review aimed to investigate the effectiveness of CUR-mediated PDT (Curcumin mediated PDT) as an adjunct to conventional chemo-mechanical debridement and/or standard PDT of the RC system with endodontic infections.

METHODS

The focused research question was: "Whether the application Curcumin mediated PDT as an adjunct is more effective than the traditional chemo-mechanical debridement and/or standard PDT of the RC system alone for improving antibacterial and/or mechanical features among subjects undergoing RCT?". An electronic literature search was performed in Scopus, PubMed, and Web of Science. In vitro reports utilizing Curcumin mediated PDT as an adjunct to conventional chemo-mechanical debridement considering permanent dentition assessing the antibacterial and/or mechanical effect were included.

RESULTS

Eighteen articles were included in the review, out of which 13 studies assessed the antibacterial activity, while 5 evaluated the mechanical properties. Most of the studies concluded that Curcumin mediated PDT had a significant antibacterial activity than the conventional chemo-mechanical debridement and/or standard PDT. Four of the five studies suggested that Curcumin mediated PDT had no impact on the push-out bond strength of root dentin. Furthermore, the significant heterogeneity in the data from the included studies did not permit the author to carry out a meta-analysis.

CONCLUSION

There is potential for application of Curcumin mediated PDT as an adjunct to the conventional chemo-mechanical debridement and/or standard PDT in reducing the bacterial load, however, Curcumin mediated PDT has minimal effect on enhancing the pushout bond strength of fiber posts to radicular dentin. Moreover, clinical studies are required to provide a more conclusive opinion on the efficacy of Curcumin mediated PDT for RCT procedures.

Fracture strength of Er,Yag laser treated PMMA denture-based polymer (DBP) colonized with C. albicans, S. aureus, S.mutans, and E.coli

AIM

To assess and equate the efficacy of different disinfection protocols autoclave, chlorhexidine (CHX), PDT utilizing Rose Bengal (RB), chitosan, and Er, Yag laser and their effect on fracture strength of PMMA denture-based polymer (DBP) colonized with C. Albicans, S. aureus, S.mutans, and E.coli.

MATERIAL AND METHODS

A total of 50 (n = 10) PMMA DBP were manufactured and adulterated with the American Type Culture Collection (ATCC) of diverse microbial colonies inhabited by C. Albicans, S. aureus, S.mutans, and E.coli. The specimens were subjected to different denture disinfection approaches by randomly distributing in into five groups i.e., Er, Yag laser, RB, autoclave, CHX, and Chitosan, respectively for appraising antimicrobial effectiveness. PMMA fracture load was also assessed and statistical analysis was performed for CFU/mL (log10) of exposed C. Albicans, S. aureus, S.mutans, and E.coli by one-way ANOVA and Tukey's multiple comparison test at a significance level of p < 0.05.

RESULTS

Intergroup comparison disclosed that denture disinfection with Er, Yag laser, autoclave, Chitosan, and CHX (control) validated comparable antimicrobial efficacy to denture against all inspected CFU/mL (log10) (p>0.05). The intragroup comparison revealed that DBP sanitization with Er, Yag laser, autoclave, Chitosan, RB, and CHX substantiated equivalent effective antimicrobial efficacy in plummeting CFU/mL (log10) of S. mutans and E. coli (p>0.05) but in consideration to S.aureus and C.albicans, all groups resulted in declining their count except 5µm RB activated by PDT(p < 0.05). No significant difference was perceived in fracture load of PMMA denture base among Er, Yag laser, RB, chitosan, and CHX (control) (p > 0.05) except autoclave decontamination procedure that indicated the least fracture strength of DBP when disinfected (p < 0.05).

CONCLUSION

Er, Yag laser, and Chitosan activated by PDT have the potential to be used as an alternative to chlorhexidine for disinfecting Polymethyl methacrylate denture base as they demonstrated the highest antimicrobial efficacy against E. coli, C. Albicans, S aureus, and S. mutans with optimal fracture load.

Extrusion bond strength of glass fiber post to radicular dentin after final irrigation using MTAD, EDTA, Pineapple peel extract, and riboflavin

INTRODUCTION

The present study aims to determine the effect of different post-space final irrigants ethylenediaminetetraacetic acid (EDTA), a mixture of Doxycycline citric acid and detergent (MTAD), Riboflavin (RF) and Pineapple peel extract (PPE) on the bond integrity of GFPs bonded to radicular dentin.

MATERIALS AND METHODS

Crowns of forty human mandibular premolars teeth were sectioned up to cementoenamel junction CEJ. Root canal treatment was performed. Gates Glidden drills were used to retrieve gutta-percha from the canal. All the specimens were randomly divided into four groups based on the final irrigant used. Group 1 (NaOCl with EDTA), group 2 NaOCl+ MTAD, group 3 NaOCl+RF and group 4 NaOCl+PPE. Cementation of glass fiber posts (GFPs) was performed using self-etch dual-cure resin cement. Sectioning was performed using a slow-speed saw from the coronal, middle, and apical third under constant water irrigation. A universal testing machine was used to assess push-out bond strength (PBS) and failure mode was evaluated using a Stereomicroscope at 40x magnification. One-way analysis of variance (ANOVA) and Tukey multiple comparison tests were used for statistical analysis (p=0.05).

RESULTS

Group 4 (2.5% NaOCl+ PPE) displayed the highest PBS at all three root levels (Cervical: 11.22±0.74 MPa, Middle: 8.99±0.97MPa, and Apical: 6.00±0.88 MPa). However, Group 1 (2.5% NaOCl+17% EDTA) demonstrated the lowest EBS (Cervical: 9.25±0.17 MPa, Middle: 7.01±1.84 MPa, and Apical: 4.41±0.17 MPa). Inter-group comparison displayed that PBS to be comparable between group 1 and group 3 (2.5% NaOCl+ Riboflavin) (Cervical: 9.74±0.41 MPa, Middle: 7.44±1.18 MPa, and Apical: 4.21±0.05 MPa) (p > 0.05). Whereas, group 2 (1.3% NaOCl+ MTAD) (Cervical: 9.32±1.36 MPa, Middle: 7.17±1.75 MPa, and Apical: 4.85±0.19 MPa) and group 4 demonstrated comparable values of PBS (p >0.05).

CONCLUSION

Pineapple peel extract and a mixture of Doxycycline citric acid and a detergent when used as a final irrigant demonstrated better bond integrity of GFPs to radicular dentin at all three levels coronal, middle and apical.

Efficacy of contemporary agents on disinfection and surface roughness of polyetheretherketone implant abutments

AIM

The present study was designed to estimate the disinfection and surface roughness (Ra) of colonized (E. coli, C. albicans, S.aureus, and S. mutans) PEEK implant abutment disinfected with PDT, chemical, and herbal agents.

MATERIAL AND METHODS

The American Type Culture Collection (ATCC) inoculated E.coli, C.albicans, S.mutans, and S.aureus in an in-vitro scenario using 60 PEEK implant abutment samples provided by the manufacturer. Following that, the samples were distributed in four disinfection methods categories - group 1: 5mM Rose Bengal PS (RB), group 2: ultrasonic disinfection (UD), group 3: 2% glutaraldehyde (GaH), and group 4: tea tree oil (TTO). To scrutinize the data and compare the means and standard deviations of CFU/mL (log10) for exposed E. coli, Candida albicans, S.aureus, and S.mutans, a two-way ANOVA and Tukey's multiple comparison test were performed.

RESULTS

Specimens treated with 2% GaH, UD, and TTO validated a significant reduction in E. coli, C. albicans, S aureus, and S. mutans CFU/mL (log10) colonies. Intragroup assessment designated that there is no reduction in CFU/mL (log10) of E.coli and C.albicans when PEEK implant abutment specimens are irradiated with 5Mm RB. A decline is seen in values of S. aureus, and S. mutans microbial strains on treatment with all four cleansers while the computation of C.albicans and E.coli colonies unveiled significant reduction with GaH, UD, and TTO except RB (p<0.05). The results of Ra showed that PEEK fabricated implant abutment specimens, when treated with UD (3.472±0.561μm), displayed a significantly higher Ra value as compared to other analyzed cleansing methods.

CONCLUSION

. Disinfection with 2% glutaraldehyde and Tea tree oil showed maximum antimicrobial efficacy and lower Ra values for PEEK implant abutments colonized with bacterial strains of E.coli, C.albicans, S.aureus, and S.mutans.