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Souza MA, Zanella ML, Vanin GN, Dallepiane FG, Pizzi CYM, Ferreira ER, Fuhr MCS, Piccolo NM, Palhano HS, da Silva Koch J, Souza KR, da Costa UM, Dos Santos VV, Steier L, Bertol CD, Figueiredo JAPD. Antimicrobial action and cytotoxicity of hypochlorous acid obtained from an innovative electrolytic device - An in vitro study. Arch Oral Biol 2024; 163:105966. [PMID: 38657440 DOI: 10.1016/j.archoralbio.2024.105966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 04/01/2024] [Accepted: 04/06/2024] [Indexed: 04/26/2024]
Abstract
OBJECTIVE This study evaluated the antimicrobial effect and cytotoxicity of hypochlorous acid(HClO) obtained from an innovative electrolytic device. DESIGN The root canals of fifty extracted human teeth were inoculated with Enterococcus faecalis and divided into 5 groups (n = 10): DW (control); 2% chlorhexidine gel(CHX); 2.5% sodium hypochlorite(NaOCl); 250 ppm HClO and 500 ppm HClO. The counting of colony forming units evaluated the decontamination potential of each group. Cytotoxicity was evaluated after inoculation of tested protocols in fibroblastic cells for 3 min, calculating the cell viability. Specific statistical analysis was performed (α = 5%). RESULTS The highest bacterial reduction was observed in experimental groups, with no statistical differences from each other (p > 0.05). The highest number of viable cells was observed in control group, followed by 250 ppm HClO and 500 ppm HClO groups, with statistical differences from each other (p < 0.05). CONCLUSIONS It could be concluded that HClO presented high antimicrobial activity and low cytotoxicity at both tested concentrations.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Jordana da Silva Koch
- School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Kellyn Rocca Souza
- School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | | | | | - Liviu Steier
- School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA; Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai, India
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Souza MA, Steier L, Vanin GN, Zanella ML, Pizzi CM, Ferreira ER, Dallepiane FG, Piccolo NM, da Silva Koch J, Souza KR, Costa UMD, Dos Santos VV, Palatynska-Ulatowska A, de Figueiredo JAP. Antimicrobial action, cytotoxicity and erosive potential of hypochlorous acid obtained from an electrolytic device compared with sodium hypochlorite. Clin Oral Investig 2024; 28:282. [PMID: 38683234 DOI: 10.1007/s00784-024-05675-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Accepted: 04/21/2024] [Indexed: 05/01/2024]
Abstract
OBJECTIVES This study aimed to compare the antimicrobial action, cytotoxicity, cleaning ability, and erosion of dentine of hypochlorous acid (HClO) obtained from an electrolytic device at two different concentrations (Dentaqua) and three concentrations of sodium hypochlorite (NaOCl). METHODS Microbiological test-The root canals of sixty single-rooted extracted human teeth were inoculated with Enterococcus faecalis and divided into 6 groups (n = 10), according to decontamination protocol: DW (control); 1% NaOCl; 2.5% NaOCl; 5.25% NaOCl; 250 ppm HClO and 500 ppm HClO. The colony-forming units were counted to evaluate the decontamination potential of each group, calculating the reduction in bacterial percentage. Cytotoxicity test-Cytotoxicity was evaluated after inoculation of the same tested protocols in fibroblastic cells for 3 min, calculating the cell viability percentages. Specifical statistical analysis was performed (α = 5%). Cleaning ability and erosion-Fifty-six single-rooted bovine lower incisors were divided into seven groups of 8 roots each, being the test groups 1% NaOCl; 2.5% NaOCl; 5,25% NaOCl; 250 ppm HClO and 500 ppm HClO, and a negative and positive control. Negative control was not contaminated, and the other groups were inoculated with Enterococcus faecalis. SEM images were ranked as from the cleanest to the least clean. Erosion was also assessed, being ranked from the least to the most eroded dentine. RESULTS The highest bacterial reduction was observed in experimental groups, with no statistical differences between them (p > 0.05). The highest number of viable cells was observed in control group, followed by 250 ppm HClO and 500 ppm HClO groups, with statistical differences between them (p < 0.05). 1% NaOCl; 2.5% NaOCl; 5.25% NaOCl and 500 ppm HClO displayed the cleanest areas. All sodium hypochlorite groups displayed erosion with higher ranks with greater concentration, while hypochlorous acid did not display any erosion regardless the concentration. CONCLUSIONS It is possible to conclude that HClO obtained from an electrolytic device presented high antimicrobial activity and low cytotoxicity in both tested concentrations. 500 ppm HClO did not display erosion and showed great cleaning ability. CLINICAL RELEVANCE The use of 500 ppm hypochlorous acid may reduce unfavorable behavior of sodium hypochlorite whilst maintaining its antimicrobial action.
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Affiliation(s)
- Matheus Albino Souza
- School of Dentistry, Graduate Program in Dentistry, University of Passo Fundo - UPF. BR 285/São José, Prédio A7, Apto 2, Passo Fundo, RS, CEP: 9052-900, Brazil
| | - Liviu Steier
- School of Dental Medicine, University of Pennsylvania - UPENN, 240 South 40Th Street (40Th & Locust St.), Philadelphia, PA, ZIP19104, USA
| | - Gabriele Nichetti Vanin
- School of Dentistry, Graduate Program in Dentistry, University of Passo Fundo - UPF. BR 285/São José, Prédio A7, Apto 2, Passo Fundo, RS, CEP: 9052-900, Brazil
| | - Mylena Lazareti Zanella
- School of Dentistry, Graduate Program in Dentistry, University of Passo Fundo - UPF. BR 285/São José, Prédio A7, Apto 2, Passo Fundo, RS, CEP: 9052-900, Brazil
| | - Camila Monteiro Pizzi
- School of Dentistry, Graduate Program in Dentistry, University of Passo Fundo - UPF. BR 285/São José, Prédio A7, Apto 2, Passo Fundo, RS, CEP: 9052-900, Brazil
| | - Eduarda Rizzon Ferreira
- School of Dentistry, Graduate Program in Dentistry, University of Passo Fundo - UPF. BR 285/São José, Prédio A7, Apto 2, Passo Fundo, RS, CEP: 9052-900, Brazil
| | - Felipe Gomes Dallepiane
- School of Dentistry, Graduate Program in Dentistry, University of Passo Fundo - UPF. BR 285/São José, Prédio A7, Apto 2, Passo Fundo, RS, CEP: 9052-900, Brazil
| | - Nathan Mateus Piccolo
- School of Dentistry, Graduate Program in Dentistry, University of Passo Fundo - UPF. BR 285/São José, Prédio A7, Apto 2, Passo Fundo, RS, CEP: 9052-900, Brazil
| | - Jordana da Silva Koch
- Graduate Program in Dentistry, Oral Biology Lab, Federal University of Rio Grande do Sul - UFRGS, Rua Sarmento Leite 500 Sala 134, Porto Alegre, RS, CEP90050-170, Brazil
| | - Kellyn Rocca Souza
- Graduate Program in Dentistry, Oral Biology Lab, Federal University of Rio Grande do Sul - UFRGS, Rua Sarmento Leite 500 Sala 134, Porto Alegre, RS, CEP90050-170, Brazil
| | - Ubirajara Maciel da Costa
- School of Veterinary Medicine, State University of Santa Catarina - UDESC, Av. Luiz de Camões, 2090, Conta Dinheiro, Lages, SC, CEP: 88.520-000, Brazil
| | - Vanessa Valgas Dos Santos
- School of Medicine, University of Planalto Catarinense - UNIPLAC, Av. Mal. Castelo Branco 170, Lages, SC, CEP 88526-075, Brazil
| | - Aleksandra Palatynska-Ulatowska
- Department of Endodontics, Medical Faculty, Division of Dentistry, Medical University of Lödz, 251 Pomorska Street, Lödz, 92-213, Poland
| | - José Antônio Poli de Figueiredo
- Graduate Program in Dentistry, Oral Biology Lab, Federal University of Rio Grande do Sul - UFRGS, Rua Sarmento Leite 500 Sala 134, Porto Alegre, RS, CEP90050-170, Brazil.
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Katle E, Zandi H, Pedersen D, Sunde PT, Torgersen GR, Ørstavik D. Radiographic outcome of endodontic treatment and retreatment of teeth with apical periodontitis using two different root canal irrigants. A prospective cohort study. Int Endod J 2024; 57:297-304. [PMID: 38205825 DOI: 10.1111/iej.14019] [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: 06/15/2023] [Revised: 12/01/2023] [Accepted: 12/27/2023] [Indexed: 01/12/2024]
Abstract
AIM The aim of this prospective cohort study was to compare the radiographic outcome of endodontic treatment and retreatment of teeth with apical periodontitis using either 1% sodium hypochlorite (NaOCl) or 2% chlorhexidine digluconate (CHX) for root canal irrigation. MATERIALS AND METHODS In the years from 2013 to 2015 standard irrigation varied by semester between NaOCl and CHX at the Department of Endodontics at the Faculty of Dentistry. During that time, 912 teeth received treatment for apical periodontitis in 744 patients, of whom 532 responded to the request for a 1-year follow-up. Only one tooth per person (the most distally located) were included; 285 teeth treated with NaOCl and 247 with CHX. One hundred cases were then randomly sampled from each irrigation group and analysed for outcome by periapical index (PAI) scoring using criteria for success, uncertain and failure. Clinical and other radiographic parameters were scored or recorded and analysed for associations with radiographic outcome using chi-square, ANOVA and regression analyses. RESULTS Success rates (PAI score 1 or 2 at control) were nearly identical for the two irrigation liquids. The use of irrigating solution also did not significantly influence the outcome in chi-square analyses of subgroups of teeth or regression analyses with other variables included. Ordinal regression analysis established that preoperative lesion size or preoperative PAI score were significantly associated with outcome, and teeth in the mandible had significantly better outcomes than in the maxilla. CONCLUSIONS No significant differences in the radiographic outcome using either 1% NaOCl or 2% CHX as irrigants were found. The outcome was better for teeth with small lesions or lower PAI scores at completion of treatment and for mandibular teeth.
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Affiliation(s)
- Erik Katle
- Department of Endodontics, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway
| | - Homan Zandi
- Department of Endodontics, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway
| | | | - Pia Titterud Sunde
- Department of Endodontics, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway
| | - Gerald R Torgersen
- Department of Radiology, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway
| | - Dag Ørstavik
- Department of Endodontics, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway
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Weissheimer T, Pinto KP, da Silva EJNL, Hashizume LN, da Rosa RA, Só MVR. Disinfectant effectiveness of chlorhexidine gel compared to sodium hypochlorite: a systematic review with meta-analysis. Restor Dent Endod 2023; 48:e37. [PMID: 38053784 PMCID: PMC10695732 DOI: 10.5395/rde.2023.48.e37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 07/25/2023] [Accepted: 09/07/2023] [Indexed: 12/07/2023] Open
Abstract
This study aimed to compare the disinfectant ability of chlorhexidine (CHX) gel and sodium hypochlorite (NaOCl). Systematic searches were conducted from inception until December 8th, 2022 (MEDLINE/PubMed, Cochrane Library, Web of Science, Scopus, Embase, and Grey Literature databases). Only randomized clinical trials were included. The revised Cochrane risk of bias tools for randomized trials were used to assess the quality of studies. Meta-analyses were performed. The overall quality of evidence was assessed through the Grading of Recommendations Assessment, Development, and Evaluation tool. Six studies were included. Five had a low risk of bias and 1 had some concerns. Three studies assessed bacterial reduction. Two were included in the meta-analysis for bacterial reduction (mean difference, 75.03 [confidence interval, CI, -271.15, 421.22], p = 0.67; I2 = 74%); and 3 in the meta-analysis for cultivable bacteria after chemomechanical preparation (odds ratio, 1.03 [CI, 0.20, 5.31], P = 0.98; I2 = 49%). Five studies assessed endotoxin reduction. Three were included in a meta-analysis (mean difference, 20.59 [CI, -36.41, 77.59], p = 0.48; I2 = 74%). There seems to be no difference in the disinfectant ability of CHX gel and NaOCl, but further research is necessary.
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Affiliation(s)
- Theodoro Weissheimer
- Department of Endodontics, School of Dentistry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Karem Paula Pinto
- Department of Endodontics, School of Dentistry, Rio de Janeiro State University (UERJ), Rio de Janeiro, RJ, Brazil
| | - Emmanuel João Nogueira Leal da Silva
- Department of Endodontics, School of Dentistry, Rio de Janeiro State University (UERJ), Rio de Janeiro, RJ, Brazil
- Department of Endodontics, School of Dentistry, Grande Rio University (UNIGRANRIO), Rio de Janeiro, RJ, Brazil
| | - Lina Naomi Hashizume
- Department of Preventive and Social Dentistry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Ricardo Abreu da Rosa
- Department of Endodontics, School of Dentistry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Marcus Vinicius Reis Só
- Department of Endodontics, School of Dentistry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
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Choudhari S, S P, Venkata Teja K. Antimicrobial Efficacy of a Novel Automated Irrigation Device As Compared to Conventional Needle Irrigation Against Enterococcus faecalis: An In Vitro Study. Cureus 2023; 15:e45200. [PMID: 37842411 PMCID: PMC10576167 DOI: 10.7759/cureus.45200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 09/13/2023] [Indexed: 10/17/2023] Open
Abstract
Aim The present study aims to compare the antibacterial efficacy of a novel automated endodontic irrigation device with that of a manual irrigation technique. Materials and methods The present study considered 45 extracted single-rooted teeth. After sectioning the teeth, the specimens were inoculated with Enterococcus faecalis (E. faecalis) bacteria for three weeks. Instrumentation was done using ProTaper Gold rotary files to size 50 and 5% taper. Based on the irrigation protocol, the experimental samples were divided into Group I: control (normal saline irrigation) (n = 15); Group II: conventional needle irrigation (n = 15); and Group III: automated irrigation (n = 15). The irrigation in Group III was done using the automated irrigation device. After the experimental irrigation, the pre-weighted dentinal shaving was collected in Eppendorf tubes, diluted 10 times, and incubated in the Petri dish with tryptone soy agar (TSA) for 48 hours. Finally, the colony-forming unit (CFU) counts were assessed. IBM SPSS Statistics for Windows version 23.0 (Armonk, NY, USA, IBM Corp.) was used for data analysis. Intergroup comparisons were made using the non-parametric Kruskal-Wallis test. Results The mean CFU count (CFU/ml) for the groups was: Group 1 (normal saline irrigation): 3.67x101; Group 2 (manual irrigation): 2.69× 101; Group 3 (automated irrigation): 1.57× 101. A statistically significant reduction in E. faecalis CFU count was seen among the groups assessed (p<0.01). The automated irrigation group exhibited the most substantial reduction in E. faecalis CFU count. Group 2 showed a significant difference compared to Group 1 (p<0.05). Conclusions The novel automated endodontic irrigation device was superior to manual irrigation in reducing E. faecalis CFU counts. This indicates that the automated irrigation device has the potential to enhance bacterial elimination efficacy during endodontic treatment.
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Affiliation(s)
- Sahil Choudhari
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences (SIMATS) Saveetha University, Chennai, IND
| | - Pradeep S
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences (SIMATS) Saveetha University, Chennai, IND
| | - Kavalipurapu Venkata Teja
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences (SIMATS) Saveetha University, Chennai, IND
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Scelza MZ, Iorio NLPP, Scelza P, Póvoa HCC, Adeodato CSR, Souza ACN, Batista AC, Tavares S, Alves G. Cytocompatibility and antimicrobial activity of a novel endodontic irrigant combining citric acid and chlorhexidine. J Dent 2022; 125:104278. [PMID: 36058346 DOI: 10.1016/j.jdent.2022.104278] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 08/19/2022] [Accepted: 09/01/2022] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVES This study aimed to evaluate the antibacterial ability and cytocompatibility of a new irrigant solution for endodontic treatment composed of 10% citric acid (CA) and 1% chlorhexidine (CHX). METHODS Thirty-five extracted single-canal human teeth were selected and de-crowned. Canal systems (n = 7/group) were infected with Enterococcus faecalis for 4 weeks and subject to irrigation with 1% CHX; 10% CA; irrigating solution 10% CA associated with 1% CHX (CACHX); 2.5% NaOCl or sterile water (control). Microbiological samples were collected immediately and 18 h after irrigation (enriched samples). The canals were filled with culture medium post irrigation to verify the bacterial presence/absence qualitatively and quantitatively through colony counting (log10 CFU/mL). A multiparametric assay was performed after exposure of human periodontal ligament fibroblasts (HPdLF) to the test solutions. The Kruskal-Wallis test with Dunn´s post-test and Fisher's exact test were employed at the 95% confidence level to compare differences among groups. RESULTS All tested solutions were cytocompatible with human periodontal ligament fibroblasts. No difference was observed on antibacterial activity between 1% CHX, 10% CA, CACHX and 2.5% NaOCl (p > 0.05). Eighteen hours after irrigation, CACHX samples were the only that did not present E. faecalis in the root canal system. CONCLUSIONS The demonstrated good in vitro biocompatibility and elimination of E. faecalis suggest a potential use of 10% CA associated with 1% CHX as a solution for microbiological control during endodontic treatment. CLINICAL RELEVANCE Irrigants play an essential role during endodontic therapy. This irrigating solution, based on the association of 10% citric acid with 1% chlorhexidine, seems viable for clinical procedures.
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Affiliation(s)
- Miriam Zaccaro Scelza
- Endodontics Department and Laboratory of Experimental Culture Cell (LECCel), Faculty of Dentistry, Federal Fluminense University (UFF), Niteroi, RJ, Brazil.
| | - Natalia L P P Iorio
- Department of Basic Sciences, Federal Fluminense University (UFF), Nova Friburgo, Rio de Janeiro, Brazil
| | - Pantaleo Scelza
- Geriatric Dentistry Department, Faculty of Dentistry of Federal Fluminense University (UFF), Niteroi, RJ, Brazil
| | - Helvécio C C Póvoa
- Department of Basic Sciences, Federal Fluminense University (UFF), Nova Friburgo, Rio de Janeiro, Brazil
| | - Caroline S R Adeodato
- Post-graduation Program in Dentistry of Federal Fluminense University (UFF), Niteroi, RJ, Brazil
| | - Ana Carolina N Souza
- Department of Basic Sciences, Federal Fluminense University (UFF), Nova Friburgo, Rio de Janeiro, Brazil
| | - Ana Carolina Batista
- Clinical Research Unit of the Antonio Pedro Hospital, Fluminense Federal University, Niteroi, RJ, Brazil
| | - Sandro Tavares
- Post-graduation Program in Dentistry of Federal Fluminense University (UFF), Niteroi, RJ, Brazil
| | - Gutemberg Alves
- Clinical Research Unit of the Antonio Pedro Hospital, Fluminense Federal University, Niteroi, RJ, Brazil; Cell and Molecular Biology Department, Institute of Biology, Fluminense Federal University, Niteroi, Brazil
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Kurt SM, Demirci GK, Serefoglu B, Kaval ME, Çalışkan MK. USAGE OF CHLORHEXIDINE AS A FINAL IRRIGANT IN ONE-VISIT ROOT CANAL TREATMENT IN COMPARISON WITH CONVENTIONAL TWO-VISIT ROOT CANAL TREATMENT IN MANDIBULAR MOLARS: A RANDOMIZED CLINICAL TRIAL. J Evid Based Dent Pract 2022; 22:101759. [DOI: 10.1016/j.jebdp.2022.101759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 06/28/2022] [Accepted: 07/08/2022] [Indexed: 10/17/2022]
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Nirmala S, L.R S, Reddy N, Reddy SD, Chukka RR, Kumar K N. Antimicrobial Efficacy of Morinda citrifolia, Nisin, and 2% Chlorhexidine Against Enterococcus faecalis: An In-Vitro Study. Cureus 2022; 14:e23206. [PMID: 35449669 PMCID: PMC9012554 DOI: 10.7759/cureus.23206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2022] [Indexed: 11/22/2022] Open
Abstract
Aim The aim of this study was to evaluate and compare the antimicrobial activity of 2% chlorhexidine gluconate (2% CHX), Morinda citrifolia (M. citrifolia), and nisin (NI) all in gel forms against Enterococcus faecalis (E. faecalis)-infected root canals. Methodology Forty single-rooted mandibular premolars extracted for orthodontic reasons were decoronated and chemomechanical preparation of the root canal was performed. After sterilization, the samples were inoculated with E. faecalis for one week and grouped according to the medicament used namely, saline as the control group (Group-A), 2% CHX (Group-B), M. citrifolia (Group-C), and NI (Group-D). After 7days of incubation, in order to evaluate the effectiveness of the intracanal medicaments on the canal wall and its radicular dentin, the specimens dentin chips were retrieved and inoculated on brain heart infusion (BHI) blood agar plates from each tube and incubated at 37°C for 24 hours to obtain bacterial colony forming unit (CFU) count. The data was statistically analyzed using one-way ANOVA test and multiple comparisons among different groups were complemented by post hoc Tukey test. Results The CFU count indicating the number of viable bacterial colonies was found to be highest in Group-A (saline). Group-B (CHX 2%) showed the least CFUs followed by Group-D (NI) and Group-C (M. citrifolia). Conclusion In an attempt to overcome the disadvantages and toxic effects of a few commercially available intracanal medicaments and irrigants, the present study was aimed at using herbal extracts to evaluate and compare their antimicrobial efficacy with the commercially available medicaments against E. faecalis. Nisin was an effective antimicrobial agent and its action was found to be comparable with CHX.
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Pacheco-Yanes J, Gazzaneo I, Campello AF, Marceliano-Alves MF, Estrela C, Bueno MR, Lopes RT, Rôças IN, Alves FRF, Siqueira JF. Planned Apical Preparation Using Cone-Beam Computed Tomographic Measures: A Micro-Computed Tomographic Proof of Concept in Human Cadavers. J Endod 2021; 48:280-286. [PMID: 34871632 DOI: 10.1016/j.joen.2021.11.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 10/12/2021] [Accepted: 11/29/2021] [Indexed: 10/19/2022]
Abstract
INTRODUCTION This study assessed the amount of unprepared surface areas at the apical 4-mm segment of the root canal after a planned preparation based on cone-beam computed tomography (CBCT) measurements. METHODS Eighteen posterior mandible segments were obtained from cadavers and scanned using CBCT and micro-computed tomographic (micro-CT) imaging. CBCT images were used to measure the largest initial canal diameter from 29 root canals of premolars at 1, 2, 3, and 4 mm short of the apical foramen. Each measurement was used to select a master apical instrument with size/taper that was 1 diameter larger to prepare the apical 4 mm of each particular root canal. A post-preparation micro-CT scan was obtained, and the unprepared canal areas were calculated. RESULTS A very high amount of surface areas over the apical 4 mm of the root canal was included in the final preparation (mean >90%). The unprepared areas ranged from as low as 3.7% to a maximum of 14.6% (mean and median, 9.2% and 9.1%, respectively). CONCLUSIONS The proposed planned apical root canal preparation resulted in optimized root canal shaping with a substantial amount of prepared surface areas. The protocol used also resulted in a conservative canal enlargement using final instruments that were 1 size larger than the initial largest canal diameter.
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Affiliation(s)
- Juan Pacheco-Yanes
- Faculty of Dentistry, Department of Dental Research, Iguaçu University (UNIG), Nova Iguaçu, Rio de Janeiro, Brazil
| | - Isbelia Gazzaneo
- Faculty of Dentistry, Department of Dental Research, Iguaçu University (UNIG), Nova Iguaçu, Rio de Janeiro, Brazil
| | - Andrea F Campello
- Faculty of Dentistry, Department of Dental Research, Iguaçu University (UNIG), Nova Iguaçu, Rio de Janeiro, Brazil
| | - Marília F Marceliano-Alves
- Faculty of Dentistry, Department of Dental Research, Iguaçu University (UNIG), Nova Iguaçu, Rio de Janeiro, Brazil
| | - Carlos Estrela
- School of Dentistry, Department of Endodontics, Federal University of Goiás, Goiânia, Brazil
| | | | - Ricardo T Lopes
- Department of Nuclear Energy, Rio de Janeiro Federal University, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Isabela N Rôças
- Faculty of Dentistry, Department of Dental Research, Iguaçu University (UNIG), Nova Iguaçu, Rio de Janeiro, Brazil; Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, Rio de Janeiro, Brazil
| | - Flávio R F Alves
- Faculty of Dentistry, Department of Dental Research, Iguaçu University (UNIG), Nova Iguaçu, Rio de Janeiro, Brazil; Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, Rio de Janeiro, Brazil.
| | - José F Siqueira
- Faculty of Dentistry, Department of Dental Research, Iguaçu University (UNIG), Nova Iguaçu, Rio de Janeiro, Brazil; Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, Rio de Janeiro, Brazil
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Nosrat A, Bolhari B, Saber Tahan S, Dianat O, Dummer PMH. Revitalizing previously treated teeth with open apices: A case report and a literature review. Int Endod J 2021; 54:1782-1793. [PMID: 34003516 DOI: 10.1111/iej.13570] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 05/11/2021] [Accepted: 05/13/2021] [Indexed: 12/14/2022]
Abstract
Revitalizing the root canals of previously treated teeth with open apices is appealing to clinicians and patients. However, there are fundamental differences in the microbiome and the microenvironment between a canal with a primary endodontic infection and a canal with a persistent endodontic infection. The aims of this report are to report a case where a previously treated tooth with an open apex and a large apical radiolucency was treated successfully using regenerative endodontic treatment (RET) and to review and critically appraise the literature on procedures and outcomes of RET that result in revitalization of canal(s) in previously treated teeth with open apices. A maxillary central incisor with poor-quality root filling, a large apical radiolucency and an open apex was retreated using RET using platelet-rich fibrin as the scaffold. After 24 months, there was complete healing of the periapical lesion and obvious radiographic signs of apical root closure. Electronic searches were performed in MEDLINE, Scopus and Embase, and the baseline, procedural and outcome data of qualified articles were collected. An assessment tool was developed to rate the quality of evidence reported in these case report/series. Nine articles, three case series and six case reports, with a total of 17 teeth of all types, were included in the reports identified. The age of patients ranged from 7 to 48 years (mean: 19.4 years). The recall period ranged from 12 to 72 months (mean: 29 months). All 17 teeth survived and were functional with healing/healed outcomes. "Apical closure" was the most common radiographic finding regarding root development. The quality of evidence using the new assessment tool was rated "Excellent" in three case reports but only "Fair" in the other six articles. The present case report, as well as the review of the literature, suggests that revitalizing the root canal system of teeth with open apices and post-treatment disease using RET is a potentially valid treatment option. However, more clinical studies with higher levels of evidence and higher quality of evidence are required to confirm the viability of this treatment approach.
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Affiliation(s)
- Ali Nosrat
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, Maryland, USA.,Private Practice, Centreville Endodontics, Centreville, Virginia, USA
| | - Behnam Bolhari
- Department of Endodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Shima Saber Tahan
- Department of Endodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Omid Dianat
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, Maryland, USA
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11
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Alves FRF, Marceliano-Alves MF, Souza ACD, Campello AF. Mucosal Fenestration After 2% Chlorhexidine Extrusion Used in Substitution of Sodium Hypochlorite: A Case Report. Eur J Dent 2020; 14:511-516. [PMID: 32818998 PMCID: PMC7440936 DOI: 10.1055/s-0040-1714173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
This report describes a case of sodium hypochlorite (NaOCl) and chlorhexidine (CHX) extrusion through the apical foramen, causing acute pain, swelling and mucosal fenestration. A 62-year-old woman was referred for endodontic treatment in the first left maxillary premolar with a diagnosis of necrotic pulp. After the root canal irrigation with 2.5% NaOCl, the patient felt a burning sensation and pain. Discrete swelling and redness were noted in the patient’s face at the end of the session. Antibiotic and corticosteroids were prescribed. In the next appointment, 2% CHX was used, but another episode of extrusion occurred, with a sudden acute pain and intense swelling within a few minutes after the injection. After 2 weeks, the patient exhibited a left-side facial swelling extending anterior and inferior to the left zygomatic arch and superior to the body of the mandible. Oral antibiotic and anti-inflammatory drugs were administered. After 10 days, the swelling had completely diminished, but a mucosal fenestration and tooth mobility were verified. A cone beam CT was requested and showed a periapical lesion involving both buccal and palatal roots. After a prosthetic evaluation, the tooth extraction was indicated. One week after tooth removal, the mucosa was completely healed.
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Affiliation(s)
- Flávio Rodrigues Ferreira Alves
- Department of Endodontics, Iguaçu University, Nova Iguaçu, Rio de Janeiro, Brazil.,Post Graduation Program, Grande Rio University (UNIGRANRIO), Duque de Caxias, Rio de Janeiro, Brasil
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12
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Kukreti H, Li FC, Singh K, Sodhi R, Kishen A. Efficacy of bioactive nanoparticles on tissue-endotoxin induced suppression of stem cell viability, migration and differentiation. Int Endod J 2020; 53:859-870. [PMID: 32068891 DOI: 10.1111/iej.13283] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 02/15/2020] [Accepted: 02/17/2020] [Indexed: 12/22/2022]
Abstract
AIM To characterize a lipopolysaccharide (LPS)-treated dentine tissue model (LPS dentine) to analyse the efficacy of polycationic chitosan nanoparticles (CSnp) and/or dexamethasone conjugate chitosan nanoparticles (Dex-CSnp) on the viability/differentiation potential of stem cells from apical papilla (SCAP) when exposed to LPS dentine. A further aim was to understand the effect of macrophage-dependent inflammation on SCAP migration in the presence of LPS dentine. METHODOLOGY A total of 88 dentine slabs were used. TOF-SIMS analysis was performed amongst the LPS-treated and untreated dentine groups (n = 2/group). The study was conducted using four dentine groups: no treatment (control); LPS treatment only; LPS treatment followed by CSnp conditioning; and LPS treatment followed by Dex-CSnp conditioning groups. SCAP adherence, viability, differentiation and biomineralization potential on dentine from different groups were studied using fluorescent and scanning electron microscopy. Inflammation by macrophages in response to LPS dentine was quantified, and effect on SCAP migration was analysed. Statistical analysis was performed using Student's t-test with a significance level of P < 0.05. RESULT TOF-SIMS analysis confirmed LPS contamination. LPS dentine affected SCAP viability but not adherence to dentine (P < 0.001). Conditioning of LPS dentine with either nanoparticles improved SCAP viability (P < 0.01) and rescued other LPS related adverse effects on SCAPs, such as F-actin disruption, decrease in differentiation/biomineralization potential. IL-6 produced by macrophages in response to LPS-treated dentine impeded SCAP migration (P < 0.001), diminished on CSnp and Dex-CSnp conditioning groups (P < 0.01). CONCLUSION This study developed an LPS-dentine model and highlighted the ability of CSnp and Dex-CSnp to promote stem cell viability, migration, differentiation potential and reduce inflammation, providing an environment conducive for tissue regeneration/repair.
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Affiliation(s)
- H Kukreti
- Faculty of Dentistry, Dental Research Institute, University of Toronto, Toronto, Ontario, Canada
| | - F-C Li
- Faculty of Dentistry, Dental Research Institute, University of Toronto, Toronto, Ontario, Canada
| | - K Singh
- Faculty of Dentistry, Dental Research Institute, University of Toronto, Toronto, Ontario, Canada
| | - R Sodhi
- Ontario Centre for the Characterization of Advanced Materials (OCCAM), Department of Chemical Engineering and Applied Chemistry, University of Toronto, Toronto, Ontario, Canada
| | - A Kishen
- Faculty of Dentistry, Dental Research Institute, University of Toronto, Toronto, Ontario, Canada
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13
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Ex vivo comparison of antibacterial efficacy of conventional chemomechanical debridement alone and in combination with light-activated disinfection and laser irradiation against Enterococcus faecalis biofilm. Photodiagnosis Photodyn Ther 2020; 29:101648. [PMID: 31904552 DOI: 10.1016/j.pdpdt.2019.101648] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 12/21/2019] [Accepted: 12/30/2019] [Indexed: 12/23/2022]
Abstract
BACKGROUND AND OBJECTIVES Intracanal disinfection plays an important role in endodontic treatment success. Enterococcus faecalis (E. faecalis) is a resistant microorganism responsible for endodontic infections. We aimed to assess the bactericidal effects of three disinfection methods on E. faecalis biofilm. MATERIALS AND METHODS Fifty-five freshly extracted single-rooted human teeth were evaluated. A barbed broach was used to extract the pulp tissue. No further root canal preparation was performed. Specimens were sterilized with gamma radiation, and inoculated with E. faecalis suspension. They were then incubated for 4 days and 4 weeks. Biofilm formation was confirmed using a scanning electron microscope (SEM). The teeth were randomly assigned to three subgroups (n = 7) to assess the antimicrobial efficacy of the following three disinfection methods against immature (4-day) and mature (4-week) biofilms: the conventional chemomechanical debridement (CCMD), CCMD + light-activated disinfection (LAD; 810 nm, 0.3 W, 120 J/cm2) with indocyanine Green (EmunDo) as photosensitizer and CCMD + diode laser irradiation (810 nm, 2 W). The teeth were then longitudinally split into two halves and the colony count was reported as colony forming units (CFUs) to assess bacterial viability after each disinfection protocol. RESULTS None of the disinfection methods could completely remove the biofilm. CCMD + LAD caused the highest and CCMD + diode laser caused the lowest reduction in biofilm. Antibacterial efficacy was significantly lower against the mature (4-week) biofilm compared with immature (4-day) biofilm in all groups (P < 0.05). CONCLUSION All three disinfection methods were effective for partial elimination of E. faecalis biofilm. But CCMD + LAD was significantly more efficacious in decreasing both mature and immature biofilms.
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14
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Cymerman JJ, Nosrat A. Regenerative Endodontic Treatment as a Biologically Based Approach for Non-Surgical Retreatment of Immature Teeth. J Endod 2020; 46:44-50. [DOI: 10.1016/j.joen.2019.10.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 08/07/2019] [Accepted: 10/09/2019] [Indexed: 12/16/2022]
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15
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Zandi H, Petronijevic N, Mdala I, Kristoffersen AK, Enersen M, Rôças IN, Siqueira JF, Ørstavik D. Outcome of Endodontic Retreatment Using 2 Root Canal Irrigants and Influence of Infection on Healing as Determined by a Molecular Method: A Randomized Clinical Trial. J Endod 2019; 45:1089-1098.e5. [DOI: 10.1016/j.joen.2019.05.021] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Revised: 05/15/2019] [Accepted: 05/28/2019] [Indexed: 11/30/2022]
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16
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Prado LC, Gavini G, Silveira ADC, Nakamura VC, Mayer MPA, Pinheiro ET. Comparison of rRNA-based reverse transcription PCR and rDNA-based PCR for the detection of streptococci in root canal infections. J Appl Oral Sci 2019; 27:e20180256. [PMID: 31365706 PMCID: PMC6690712 DOI: 10.1590/1678-7757-2018-0256] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 02/26/2019] [Indexed: 11/21/2022] Open
Abstract
Objective The rDNA-based method is unable to distinguish between alive and dead cells. Alternatively, bacterial viability can be assessed by molecular methods based on ribosomal RNA (rRNA). Therefore, this study aimed to detect viable streptococci in root canal samples using rRNA-based reverse transcription polymerase chain reaction (RT-PCR), compared to an rDNA-based PCR assay. Methodology Microbiological root canal samples were obtained from 32 teeth with primary endodontic infections before (S1) and after chemomechanical preparation (S2), and after removal of intracanal medication (S3). RNA and DNA were extracted, and complementary DNA (cDNA) was synthesized from RNA using RT reaction. cDNA and genomic DNA were subjected to PCR with primers complementary to the 16S rRNA sequences of Streptococcus spp. McNemar’s test was used to compare the detection rate of both assays (P<0.05). Results Streptococci were detected in 28.12% (9/32) and 37.5% (12/32) of S1 samples using rRNA- and rDNA-based PCR assays, respectively. In contrast, they were detected in only 6.25% (2/32) of S2 samples using rRNA-based RT-PCR, compared to 15.62% (5/32) using rDNA-based PCR. Finally, in S3 samples, streptococci were not detected by rRNA, whereas rDNA-based PCR still detected the bacteria in 12.5% (4/32) of the samples. The total number of PCR-positive reactions in the rDNA-based PCR was higher than in the rRNA-based assay (P<0.05). Conclusions The rRNA-based RT-PCR showed a lower detection rate of streptococci when compared to the rDNA-based PCR, suggesting that the latter may have detected dead cells of streptococci in root canal samples.
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Affiliation(s)
- Laís Cunha Prado
- Universidade de São Paulo, Faculdade de Odontologia, São Paulo, SP, Brasil
| | - Giulio Gavini
- Universidade de São Paulo, Faculdade de Odontologia, São Paulo, SP, Brasil
| | | | | | - Marcia Pinto Alves Mayer
- Universidade de São Paulo, Faculdade de Odontologia, Instituto de Ciências Biomédicas, São Paulo, SP, Brasil
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Ballal NV, Gandhi P, Shenoy PA, Shenoy Belle V, Bhat V, Rechenberg D, Zehnder M. Safety assessment of an etidronate in a sodium hypochlorite solution: randomized double‐blind trial. Int Endod J 2019; 52:1274-1282. [DOI: 10.1111/iej.13129] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 04/12/2019] [Indexed: 11/28/2022]
Affiliation(s)
- N. V. Ballal
- Department of Conservative Dentistry and Endodontics Manipal College of Dental Sciences Manipal Academy of Higher Education Manipal Karnataka India
| | - P. Gandhi
- Department of Conservative Dentistry and Endodontics Manipal College of Dental Sciences Manipal Academy of Higher Education Manipal Karnataka India
| | - P. A. Shenoy
- Department of Microbiology Kasturba Medical College Manipal, Manipal Academy of Higher Education Manipal Karnataka India
| | - V. Shenoy Belle
- Department of Biochemistry Kasturba Medical College Manipal, Manipal Academy of Higher Education Manipal Karnataka India
| | - V. Bhat
- Department of Biochemistry Kasturba Medical College Manipal, Manipal Academy of Higher Education Manipal Karnataka India
| | - D.‐K. Rechenberg
- Department of Preventive Dentistry, Periodontology and Cariology University of Zürich Zürich Switzerland
| | - M. Zehnder
- Department of Preventive Dentistry, Periodontology and Cariology University of Zürich Zürich Switzerland
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Comparison study of root canal disinfection by cold plasma jet and photodynamic therapy. Photodiagnosis Photodyn Ther 2019; 26:327-333. [PMID: 31026615 DOI: 10.1016/j.pdpdt.2019.04.023] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 03/02/2019] [Accepted: 04/22/2019] [Indexed: 01/30/2023]
Abstract
INTRODUCTION This study evaluated and compared the antibacterial effect of plasma and photodynamic therapy (PDT) in root canals infected with Enterococcus faecalis. METHODS One hundred single-rooted extracted human teeth (no treatment) were selected and sterilized. Root canals of teeth were prepared with the crown-down technique and contaminated with Enterococcus faecalis after sterilization, and incubated for one week. To investigate the effect of disinfection, 60 specimens were randomly selected for three disinfection groups: He and He/O2 plasma (n = 20) in 5-s groups (control, 2, 4, 6 and 8 min treatments) and PDT (n = 20) in 2-s groups (control and PDT treatment). Next, for comparison, 40 remaining teeth were divided into four groups: control, 8 min He plasma, 8 min He/O2, and PDT. Results of antibacterial action were reported by CFU/mL analysis and the structural changes of biofilm were evaluated by SEM. RESULTS All groups showed a significant reduction of bacteria after treatment, and He/O2 plasma was more effective against E. faecalis, followed by PDT and He plasma respectively, further confirmed by SEM. CONCLUSION He/O2 plasma is a strong sterilization method against E. faecalis biofilm and can, therefore, be an effective therapy in endodontics.
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Moreira RN, Pinto EB, Galo R, Falci SGM, Mesquita AT. Passive ultrasonic irrigation in root canal: systematic review and meta-analysis. Acta Odontol Scand 2019; 77:55-60. [PMID: 30264624 DOI: 10.1080/00016357.2018.1499960] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVE To investigate whether there are differences between the root canal disinfection, comparing the passive ultrasonic irrigation technique with the conventional technique. MATERIALS AND METHODS The following electronic databases were searched: Pubmed; VHL; Web of Sciences and OVID with no publication date restriction. The study's quality evaluation was carried out using the Handbook by Cochrane. The online research identified 5464 studies. From the nine studies selected for a full reading of the text, five were included in the present systematic review. Meta-analysis was performed in three articles, which evaluated the root canal's cleanness through microbiological analysis. RESULTS Only one article concluded that the ultrasonic passive irrigation showed a better performance compared with the conventional irrigation. None of the articles analyzed presented a low risk of bias in all domains. According to the results of the meta-analysis, there was no statistical difference between the groups (OR = 0.34, IC 95%: 0.10-1.19). CONCLUSIONS The level of evidence comparing the two techniques is fragile since in all studies some type of bias was observed which may interfere in the results and conclusions.
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Affiliation(s)
- Rafaela Nogueira Moreira
- Department of Dentistry, Federal University of Jequitinhonha e Mucuri Vallyes, Diamantina, Brazil
| | | | - Rodrigo Galo
- Department of Dentistry, Federal University of Jequitinhonha e Mucuri Vallyes, Diamantina, Brazil
| | | | - Ana Terezinha Mesquita
- Department of Dentistry, Federal University of Jequitinhonha e Mucuri Vallyes, Diamantina, Brazil
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Goud S, Aravelli S, Dronamraju S, Cherukuri G, Morishetty P. Comparative Evaluation of the Antibacterial Efficacy of Aloe Vera, 3% Sodium Hypochlorite, and 2% Chlorhexidine Gluconate Against Enterococcus faecalis: An In Vitro Study. Cureus 2018; 10:e3480. [PMID: 30648031 PMCID: PMC6318086 DOI: 10.7759/cureus.3480] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Aim To compare the antibacterial efficacy of irrigants (aloe vera, 3% sodium hypochlorite (NaOCl), 2% chlorhexidine (CHX), and saline) against Enterococcus faecalis using the turbidometric analysis and colony count method. Materials and methods Eighty freshly extracted, single-rooted, human mandibular premolar teeth were taken. Access opening was done, instrumented, and autoclaved. Samples were inoculated with 10 µL of an Enterococcus faecalis (E. faecalis) bacterial suspension and incubated at 37◦C for three days. Samples were divided into four groups of 20 teeth each based on the type of irrigating solution used. Group 1 was irrigated with 3% sodium hypochlorite; Group 2 with 2% chlorhexidine; group 3 with aloe vera; and Group 4 with 0.9% saline (the control group). Ten teeth from each group were subjected to a turbidity analysis by spectrophotometer and the remaining 10 teeth from each group were tested for colony-forming units (CFU)/mL. The plates were incubated at 37◦C for 24 hours and CFU that were grown were counted using a bacterial colony counter. Results were subjected to an analysis of variance (ANOVA) followed by a post hoc Games-Howell test. Results All the tested irrigating solutions demonstrated an antibacterial effect against E. faecalis. The greatest antimicrobial effects were observed in samples treated with 2% CHX (p<0.001). No statistically significant difference was found between 3% NaOCl and aloe vera (p > 0.001) against E. faecalis. Conclusion Two percent chlorhexidine exhibited good antimicrobial efficacy against E. faecalis. Three percent NaOCl and aloe vera showed a similar antimicrobial efficacy against E. faecalis. Aloe vera can be used as an antibacterial agent in novel drugs for the treatment of bacterial diseases.
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Affiliation(s)
- Soujanya Goud
- Conservative Dentistry and Endodontics, Army College of Dental Sciences, Secunderabad, IND
| | - Swathi Aravelli
- Conservative Dentistry and Endodontics, Mallareddy Dental College for Women, Hyderabad, IND
| | - Savitri Dronamraju
- Conservative Dentistry & Endodontics, Mallareddy Institute of Dental Sciences, Hyderabad, IND
| | | | - Pradeep Morishetty
- Conservative Dentistry & Endodontics, Lenora Institute of Dental Sciences, Rajahmundry, IND
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Siqueira Junior JF, Rôças IDN, Marceliano-Alves MF, Pérez AR, Ricucci D. Unprepared root canal surface areas: causes, clinical implications, and therapeutic strategies. Braz Oral Res 2018; 32:e65. [PMID: 30365606 DOI: 10.1590/1807-3107bor-2018.vol32.0065] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 06/06/2018] [Indexed: 11/21/2022] Open
Abstract
Chemomechanical preparation is intended to clean, disinfect, and shape the root canal. This step is of utmost importance during treatment of infected teeth with apical periodontitis, because treatment outcome depends on how effectively the clinician eliminates bacteria, their products, and necrotic tissue that would serve as substrate for bacterial regrowth. Nonetheless, curvatures and complex internal anatomical variations of the root canal system can pose a high degree of difficulty in reaching these goals. In infected teeth, bacteria may persist not only in difficult-to-reach areas such as isthmuses, ramifications, dentinal tubules, and recesses from C-shaped or oval/flattened canals, but also in areas of the main canal wall that remain untouched by instruments. If bacteria withstand chemomechanical procedures, there is an augmented risk for post-treatment apical periodontitis. This article discloses the reasons why some areas remain unprepared by instruments and discusses strategies to circumvent this issue and enhance infection control during endodontic treatment/retreatment of teeth with apical periodontitis.
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Affiliation(s)
| | - Isabela das Neves Rôças
- Universidade Estácio de Sá, Faculty of Dentistry, Department of Endodontics, Rio de Janeiro, RJ, Brazil
| | | | - Alejandro Ron Pérez
- Universidade Estácio de Sá, Faculty of Dentistry, Department of Endodontics, Rio de Janeiro, RJ, Brazil
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22
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Nogo-Zivanovic D, Bjelovic L, Ivanovic V, Kanjevac T, Tanaskovic I. Consideration of the Therapeutic Potential of Irrigants in Endodontic Therapy. SERBIAN JOURNAL OF EXPERIMENTAL AND CLINICAL RESEARCH 2018. [DOI: 10.1515/sjecr-2016-0095] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Abstract
The main objective of endodontic treatment is to remove vital and necrotic remnants of pulp tissue and microorganisms and their toxic products from the root canal. During chemo-mechanical endodontic preparation, a smear layer is formed on the wall of the canals. Due to an inability to remove all tissue remnants and the smear layer from the root canal by mechanical instrumentation, it is necessary to use irrigation to ensure sufficient cleaning and disinfection of the largest part of the root canalicular system. The most commonly used irrigants are sodium hypochlorite (Na-OCl), ethylenediaminetetraacetic acid (EDTA), citric acid and chlorhexidine (CHX). Recently, the irrigants QMix and MTAD have been introduced to the market. They are a mixture of different components having antimicrobial, organolytic and mineralytic effects on canal detritus and the smear layer. This review article investigates irrigants in terms of the nature of their effect, their efficiency, optimal concentration, and method of use, and the interactions between the irrigants most commonly used in endodontic therapy are discussed, with special emphasis on QMix and MTAD.
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Affiliation(s)
- Dajana Nogo-Zivanovic
- Department for Restorative Dentistry and Endodontics, Faculty of Medicine , University of East Sarajevo , Foca , Bosnia and Herzegovina
| | - Ljiljana Bjelovic
- Department for Restorative Dentistry and Endodontics, Faculty of Medicine , University of East Sarajevo , Foca , Bosnia and Herzegovina
| | - Vladimir Ivanovic
- Department of Restorative Odontology and Endodontics, School of Dental Medicine , University of Belgrade , Belgrade , Serbia
| | - Tatjana Kanjevac
- Department of Preventive and Pediatric Dentistry, Faculty of Medical Sciences , University of Kragujevac , Kragujevac , Serbia
| | - Irena Tanaskovic
- Department of Histology and Embryology, Faculty of Medical Sciences , University of Kragujevac , Kragujevac , Serbia
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Neelakantan P, Herrera DR, Pecorari VGA, Gomes BPFA. Endotoxin levels after chemomechanical preparation of root canals with sodium hypochlorite or chlorhexidine: a systematic review of clinical trials and meta-analysis. Int Endod J 2018; 52:19-27. [DOI: 10.1111/iej.12963] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 06/06/2018] [Indexed: 11/28/2022]
Affiliation(s)
- P. Neelakantan
- Faculty of Dentistry; The University of Hong Kong; Hong Kong
| | - D. R. Herrera
- Department of Restorative Dentistry; Endodontics Division; Piracicaba Dental School; State University of Campinas-UNICAMP; Piracicaba SP Brazil
| | - V. G. A. Pecorari
- Dental Research Division; School of Dentistry; Paulista University; São Paulo SP Brazil
| | - B. P. F. A. Gomes
- Department of Restorative Dentistry; Endodontics Division; Piracicaba Dental School; State University of Campinas-UNICAMP; Piracicaba SP Brazil
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Suguro H, Takeichi O, Hayashi M, Okamura T, Hira A, Hirano Y, Ogiso B. Microcomputed tomographic evaluation of techniques for warm gutta-percha obturation. J Oral Sci 2018; 60:165-169. [PMID: 29657249 DOI: 10.2334/josnusd.17-0092] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Transparent epoxy resin root canal models were used to evaluate vertical condensation techniques for obturating lateral canals. The root canal model was configured with a straight main root canal and four right-angled lateral canals at 1.0 and 3.0 mm from the apex. Root canal obturation was performed with Thermafil, Obtura II, or NT condenser. Obturation volume in lateral canals was measured by three-dimensional microcomputed tomography, and one-way analysis of variance was used to analyze differences between groups. Lateral canals at 1.0 and 3.0 mm were uniformly filled by all obturation methods. Among the three obturation methods, Thermafil resulted in the highest obturation volumes for all lateral canals.
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Affiliation(s)
- Hisashi Suguro
- Department of Endodontics, Nihon University School of Dentistry.,Division of Advanced Dental Treatment, Dental Research Center, Nihon University School of Dentistry
| | - Osamu Takeichi
- Department of Endodontics, Nihon University School of Dentistry.,Division of Advanced Dental Treatment, Dental Research Center, Nihon University School of Dentistry
| | - Makoto Hayashi
- Department of Endodontics, Nihon University School of Dentistry.,Division of Advanced Dental Treatment, Dental Research Center, Nihon University School of Dentistry
| | - Teinosuke Okamura
- Division of Applied Oral Sciences, Nihon University Graduate School of Dentistry
| | - Akiko Hira
- Division of Applied Oral Sciences, Nihon University Graduate School of Dentistry
| | - Yoriyuki Hirano
- Division of Applied Oral Sciences, Nihon University Graduate School of Dentistry
| | - Bunnai Ogiso
- Department of Endodontics, Nihon University School of Dentistry.,Division of Advanced Dental Treatment, Dental Research Center, Nihon University School of Dentistry
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Miçooğulları Kurt S, Çalışkan MK. Efficacy of chlorhexidine as a final irrigant in one-visit root canal treatment: a prospective comparative study. Int Endod J 2018; 51:1069-1076. [PMID: 29603299 DOI: 10.1111/iej.12931] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Accepted: 03/24/2018] [Indexed: 11/29/2022]
Abstract
AIM To evaluate postoperative pain and radiographic evidence of periapical healing in teeth with apical periodontitis treated in one visit with an additional final irrigation using 2% chlorhexidine (CHX) and to compare the results with conventional two-visit root canal treatment (RCT) with an intracanal calcium hydroxide (CH) dressing as a control group. METHODOLOGY Ninety asymptomatic maxillary anterior teeth with periapical lesions were treated by a single operator. Root canals were prepared using the step-back technique with manual instrumentation with 2.5% NaOCl and 5% EDTA as irrigants. Half of the teeth were randomly assigned to the one-visit (OV) group and received an additional final rinse with 2% CHX before canal filling. The other teeth were treated in two visits (TV) with a CH paste made by mixing CH powder and distilled water as an interappointment dressing. All patients were recalled and investigated clinically and radiographically for 24 months. Postoperative pain at 24-48 h and changes in apical bone density indicating radiographic healing were evaluated statistically using the Mann-Whitney U-test followed by the Friedman and the Wilcoxon tests (α = 0.05). RESULTS There were no significant differences between two groups regarding the incidence of postoperative pain at 24 h (OV group 50% no pain, 47.6% mild, 2.4% moderate pain/TV group 55% no pain, 42.5% mild, 2.5% moderate pain) and at 48 h (OV group 95% no pain, 5% mild pain/TV group 98% no pain, 2% mild pain). None of the patients reported severe postoperative pain, swelling and/or flare-ups during the follow-up period. There was no significant difference in the radiographic healing rates (OV group 97.6% PAI 1 and/or PAI 2 and 2.4% PAI 3/TV group 95% PAI 1 and/or PAI 2 and 5% PAI 3; P > 0.05). CONCLUSION Both groups provided favourable and similar postoperative pain and periapical healing rates at 24 months. Thus, one-visit RCT with a final rinse with 2% CHX is an acceptable alternative to two-visit RCT with CH as temporary dressing in maxillary anterior teeth.
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Affiliation(s)
- S Miçooğulları Kurt
- Department of Endodontology, School of Dentistry, Ege University, Bornova, İzmir, Turkey
| | - M K Çalışkan
- Department of Endodontology, School of Dentistry, Ege University, Bornova, İzmir, Turkey
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Microbial Analysis of Endodontic Infections in Root-filled Teeth with Apical Periodontitis before and after Irrigation Using Pyrosequencing. J Endod 2018; 44:372-378. [DOI: 10.1016/j.joen.2017.11.019] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2017] [Revised: 10/10/2017] [Accepted: 11/20/2017] [Indexed: 01/01/2023]
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Abstract
Pediatric dentistry provides primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, together with special health care needs. This specialty encompasses a variety of skills, disciplines, procedures and techniques that share a common origin with other dental specialties however these have been modified and reformed to the distinctive requirements of infants, children, adolescents and special health care needs. Disciplines comprise of behavior guidance, care of the medically and developmentally compromised and disabled patient, supervision of orofacial growth and development, caries prevention, sedation, pharmacological management, and hospital dentistry including other traditional fields of dentistry. The skills apply to the ever-changing stages of dental, physical, and psychosocial development for treating conditions and diseases distinctive to growing individuals. Hence with the changing scope of practice it is imperative that the clinician stays updated with the current evidence based trends in practice, collaborates with other disciplines and Imparts quality oral health care tailored to the specific needs of every child.
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Effect of different diode laser wavelengths on root dentin decontamination infected with Enterococcus faecalis. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2017; 176:1-8. [DOI: 10.1016/j.jphotobiol.2017.09.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Revised: 08/25/2017] [Accepted: 09/11/2017] [Indexed: 01/15/2023]
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Antibiofilm Efficacy of Positively Charged Imidazolium-Based Silver Nanoparticles in Enterococcus faecalis Using Quantitative Real-Time PCR. Jundishapur J Microbiol 2017. [DOI: 10.5812/jjm.55616] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Guneser MB, Akbulut MB, Eldeniz AU. Antibacterial effect of chlorhexidine-cetrimide combination, Salvia officinalis plant extract and octenidine in comparison with conventional endodontic irrigants. Dent Mater J 2017; 35:736-741. [PMID: 27725511 DOI: 10.4012/dmj.2015-159] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The aim of the present study was to compare the antimicrobial effect of sodium hypochlorite (NaOCl), 2% chlorhexidine (CHX), a CHX/cetrimide solution (CHX+CTR), octenidine hydrochloride (OCT) and Salvia officinalis plant extract against Enterococcus faecalis. Seventy decoronated single-rooted human teeth were infected and divided into 6 test (n=10) and 2 control groups (n=5) (negative, sterile samples and positive, infected samples). Following irrigants were then applied to test groups: 2.5% NaOCl, 5.25% NaOCl, CHX, CHX+CTR, S. officinalis extract and OCT. The dentin chips were obtained from inner root canal walls and analyzed by counting the number of colony forming units (CFU). The 2.5% NaOCl, 5.25% NaOCl, CHX and OCT groups presented no bacterial growth (CFU=0). S. officinalis and CHX+CTR groups reduced the number of E. faecalis cells but could not eliminate all. OCT may have potential as an endodontic irrigant in treatment of infected root canals.
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Chen A. 2016 ASE undergraduate essay competition candidate information. AUST ENDOD J 2017. [PMID: 28620977 DOI: 10.1111/aej.12202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The aim of this review is to discuss the role of medicaments and materials used in teeth undergoing root canal treatment and how they affect the overall prognosis of root canal treated teeth. Irrigants, medicaments and materials play a vital role in RCT. They reduce the overall microbial load within the root canal system, help reduce inter-appointment pain, and induce apexification during RCT of permanent teeth with immature apices. In addition, they also help create a hermetic coronal and periradicular seal to entomb any residual microorganisms within the canals and prevent future ingress of contaminants into the root canal system and subsequent reinfection. Whilst the role of various materials in RCT has been thoroughly investigated, the available literature and longitudinal clinical studies evaluating the affect of such materials on the prognosis of RCT is scarce, and requires further investigation.
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Affiliation(s)
- Alice Chen
- La Trobe University, Melbourne, Victoria, Australia
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Chlorhexidine Prevents Root Dentine Mineral Loss and Fracture Caused by Calcium Hydroxide over Time. Int J Dent 2017; 2017:1579652. [PMID: 28539937 PMCID: PMC5429930 DOI: 10.1155/2017/1579652] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Revised: 03/15/2017] [Accepted: 03/29/2017] [Indexed: 11/17/2022] Open
Abstract
Purpose. To evaluate the mineral ion loss of root dentine after treatment with 2% chlorhexidine solution (CHX) and to compare its yield and flexural strength (fs) after exposure to calcium hydroxide [Ca(OH)2]. Materials and Methods. Dentine bars (DB) were made from 90 roots of bovine incisors and randomized into three groups: GControl: distilled/deionized water (DDW), GNaOCl: 2.5% sodium hypochlorite + 17% EDTA, and GCHX: CHX + DDW. The release of phosphate (PO4) and calcium (Ca) ions was measured by spectrophotometry. The DB were exposed to Ca(OH)2 paste for 0, 30, 90, and 180 days. DB were subjected to the three-point bending test to obtain yield and fs values. The fracture patterns were evaluated (20x). Data were analyzed using Kruskal-Wallis and Dunn's post hoc tests or one- and two-way ANOVA followed by Tukey's post hoc test (α = 0.05). Results. GCHX showed lower PO43− and Ca2+ ionic release than GNaOCl (p < 0.001). For yield and fs, GCHX > GNaOCl in all periods (p < 0.001), except for yield strength values on 90 days (p = 0.791). A larger frequency of vertical fractures was observed in GNaOCl and that of oblique fractures in GCHX (p < 0.05). Conclusions. CHX prevented PO43− and Ca2+ loss and showed a tendency to preserve the yield and fs of root dentine over time following exposure to Ca(OH)2 paste.
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Farzaneh S, Parirokh M, Nakhaee N, Abbott PV. Effect of two different concentrations of sodium hypochlorite on postoperative pain following single-visit root canal treatment: a triple-blind randomized clinical trial. Int Endod J 2017; 51 Suppl 1:e2-e11. [DOI: 10.1111/iej.12749] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Accepted: 01/25/2017] [Indexed: 11/28/2022]
Affiliation(s)
- S. Farzaneh
- Oral and Dental Diseases Research Center; Kerman University of Medical Sciences; Kerman Iran
| | - M. Parirokh
- Endodontology Research Center; Kerman University of Medical Sciences; Kerman Iran
| | - N. Nakhaee
- Neuroscience Research Center; Kerman University of Medical Sciences; Kerman Iran
| | - P. V. Abbott
- School of Dentistry; University of Western Australia; Perth Australia
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Khallaf ME. Effect of two contemporary root canal sealers on root canal dentin microhardness. J Clin Exp Dent 2017; 9:e67-e70. [PMID: 28149466 PMCID: PMC5268113 DOI: 10.4317/jced.53052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Accepted: 05/28/2016] [Indexed: 11/13/2022] Open
Abstract
Background Successful root canal treatment depends on proper cleaning, disinfecting and shaping of the root canal space. Pulpless teeth have lower dentin microhardness value compared to that of vital teeth. A material which can cause change in dentin composition may affect the microhardness. Thus the aim of this study was to evaluate and compare the effect of two root canal sealers on dentin microhardness. Material and Methods Forty two single rooted teeth were selected and divided into 3 equal groups; Apexit, iRootSP and control groups (n=14) Each group was then divided into 2 subgroups according to the post evaluation period; 1 week and 2 months (n=7). Root canal procedure was done in the experimental groups and obturation was made using either; Apexit, iRootSP or left unprepared and unobturated in the control group. Roots were sectioned transversely into cervical, middle and apical segments. The three sections of each root were mounted in a plastic chuck with acrylic resin. The coronal dentin surfaces of the root segments werepolished. Microhardness of each section was measured at 500 µm and 1000 µm from the canal lumen. Results Four way-ANOVA revealed that different tested sealer materials, canal third, measuring distance from the pulp and time as independent variables had statistically non significant effect on mean microhardness values (VHN) at p≤0.001. Among iRootSP groups there was a statistically significant difference between iRoot SP at coronal root portion (87.79±17.83) and iRoot SP at apical root portion (76.26±9.33) groups where (p=0.01). IRoot SP at coronal canal third had higher statistically significant mean microhardness value (87.79±17.83) compared to Apexit at coronal third (73.61±13.47) where (p=0.01). Conclusions Root canal sealers do not affect dentin microhardness. Key words:Root canal, dentin, sealers, microhardness, bioceramic.
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Affiliation(s)
- Maram E Khallaf
- Researcher at Restorative and Dental Materials Research department, National Research centre, Giza. Egypt
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35
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Herrera DR, Martinho FC, de-Jesus-Soares A, Zaia AA, Ferraz CCR, Almeida JFA, Gomes BPFA. Clinical efficacy of EDTA ultrasonic activation in the reduction of endotoxins and cultivable bacteria. Int Endod J 2016; 50:933-940. [PMID: 27775835 DOI: 10.1111/iej.12713] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Accepted: 10/20/2016] [Indexed: 12/18/2022]
Abstract
AIM This clinical study was conducted to investigate the influence of 17% ethylenediaminetetraacetic acid (EDTA) ultrasonic activation after chemomechanical preparation (CMP) on eliminating/reducing oral bacterial lipopolysaccharides (known as endotoxins) and cultivable bacteria in teeth with pulp necrosis and apical periodontitis. METHODOLOGY Samples were taken from 24 root canals at several clinical periods: S1 - before CMP; S2 - after CMP; S3 - after EDTA: G1 - with ultrasonic activation (n = 12) and G2 - without ultrasonic activation (n = 12). Root canals were instrumented using Mtwo rotary files. Culture techniques were used to determine the number of colony-forming units (CFU). Limulus amebocyte lysate (LAL) was used to measure endotoxin levels. Friedman's and Wilcoxon signed-rank tests were used to compare the amount of bacteria and endotoxin levels in each period (P < 0.05). RESULTS Endotoxins and cultivable bacteria were recovered in 100% of the initial samples (S1). CMP was effective in reducing endotoxins and bacterial load (all with P < 0.05). Higher values of endotoxin reduction were achieved with EDTA ultrasonic activation [G1, 0.02 EU mL-1 (range 0.01-0.75)] compared with the no activation group [G2, 1.13 EU mL-1 (range 0.01-8.34)] (P < 0.05). Regarding bacterial reduction, no statistically significant difference was found in S3, regardless of the group (G1, G2, P > 0.05). CONCLUSIONS Chemomechanical preparation was effective in reducing bacteria and endotoxins, but could not completely eliminate them. The ultrasonic activation of EDTA was effective in further reducing endotoxin levels in the root canals of teeth with pulp necrosis and apical periodontitis.
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Affiliation(s)
- D R Herrera
- Department of Restorative Dentistry, Endodontics Division, Piracicaba Dental School, State University of Campinas - UNICAMP, Piracicaba, SP, Brazil
| | - F C Martinho
- Department of Restorative Dentistry, Endodontics Division, Piracicaba Dental School, State University of Campinas - UNICAMP, Piracicaba, SP, Brazil.,Department of Restorative Dentistry, Endodontic Division, São Jose dos Campos Dental School, State University of São Paulo, UNESP, Sao Jose dos Campos, SP, Brazil
| | - A de-Jesus-Soares
- Department of Restorative Dentistry, Endodontics Division, Piracicaba Dental School, State University of Campinas - UNICAMP, Piracicaba, SP, Brazil
| | - A A Zaia
- Department of Restorative Dentistry, Endodontics Division, Piracicaba Dental School, State University of Campinas - UNICAMP, Piracicaba, SP, Brazil
| | - C C R Ferraz
- Department of Restorative Dentistry, Endodontics Division, Piracicaba Dental School, State University of Campinas - UNICAMP, Piracicaba, SP, Brazil
| | - J F A Almeida
- Department of Restorative Dentistry, Endodontics Division, Piracicaba Dental School, State University of Campinas - UNICAMP, Piracicaba, SP, Brazil
| | - B P F A Gomes
- Department of Restorative Dentistry, Endodontics Division, Piracicaba Dental School, State University of Campinas - UNICAMP, Piracicaba, SP, Brazil
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Zandi H, Rodrigues RC, Kristoffersen AK, Enersen M, Mdala I, Ørstavik D, Rôças IN, Siqueira JF. Antibacterial Effectiveness of 2 Root Canal Irrigants in Root-filled Teeth with Infection: A Randomized Clinical Trial. J Endod 2016; 42:1307-13. [DOI: 10.1016/j.joen.2016.06.006] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 06/07/2016] [Accepted: 06/09/2016] [Indexed: 02/02/2023]
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Gupta-Wadhwa A, Wadhwa J, Duhan J. Comparative evaluation of antimicrobial efficacy of three herbal irrigants in reducing intracanal E. faecalis populations: An in vitro study. J Clin Exp Dent 2016; 8:e230-5. [PMID: 27398170 PMCID: PMC4930629 DOI: 10.4317/jced.52339] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Accepted: 12/09/2015] [Indexed: 11/08/2022] Open
Abstract
Background The present study aimed to evaluate the intracanal bacterial reduction promoted by chemomechanical preparation using three different herbal extracts named Ocimum sanctum (OS), Cinnamomum zeylanicum (CZ), Syzygium aromaticum (SA) against Enterococcus faecalis. Material and Methods Root canals from extracted teeth were contaminated with Enterococcus faecalis ATCC 29212 for 7 days and then randomly distributed into 3 experimental groups of 10 teeth each: which includes conventional irrigation with OS, CZ and SA. The control groups included 5 teeth each consisting of NaOCl (positive control) and distilled water (negative control). Samples taken before and after chemomechanical procedures were cultured, and the colony-forming units (CFUs) were counted. Bacterial identification was performed using Polymerase chain reaction technique. The statistical analyses were performed with various tests. Results Reduction in the intracanal bacterial populations was highly significant for all the experimental groups. CZ and SA showed 80 to 85% intracanal bacterial reduction while O. Sanctum revealed only 70 to 75 % reduction. NaOCl showed 96 to 100 % bacterial reduction on the other hand distilled water showed very minimal bacterial reduction i.e 10 to 16%. Conclusions Cinnamomum zeylanicum, Syzygium aromaticum and Ocimum sanctum showed intracanal bacterial reduction against Enterococcus faecalis. The 3 experimental groups were less effective in terms of intracanal bacterial reduction as compare to NaOCl but more effective than distilled water. Key words:Antimicrobial activity, Cinnamomum zeylanicum, Enterococcus faecalis, Ocimum sanctum, Syzygium aromaticum, herbal extracts.
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Affiliation(s)
- Alpa Gupta-Wadhwa
- Senior resident. Department of Conservative Dentistry & Endodontics, Post Graduate Institute of Dental Sciences, Rohtak
| | - Jitesh Wadhwa
- Senior lecturer. Department of Orthodontics, Inderprastha Dental College, Sahibabad
| | - Jigyasa Duhan
- Professor. Department of Conservative Dentistry & Endodontics, Post Graduate Institute of Dental Sciences, Rohtak
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Gokturk H, Bayram E, Bayram HM, Aslan T, Ustun Y. Effect of double antibiotic and calcium hydroxide pastes on dislodgement resistance of an epoxy resin-based and two calcium silicate-based root canal sealers. Clin Oral Investig 2016; 21:1277-1282. [PMID: 27287499 DOI: 10.1007/s00784-016-1877-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 06/06/2016] [Indexed: 02/04/2023]
Abstract
OBJECTIVES The purpose of the present study was to determine the dislodgement resistance of AH Plus, MTA Fillapex, and Total Fill BC sealer to root canal dentin walls following placement of calcium hydroxide (CH) or double antibiotic paste (DAP) medicaments. MATERIALS AND METHODS Root canals of 90 single-rooted human mandibular premolar teeth were instrumented with Reciproc rotary instruments to a size R50. The teeth were randomly divided into two experimental groups: those receiving an intracanal medicament with either CH or DAP and a control group (n = 30). After 3 weeks, the medicaments were removed by irrigation with 5 mL of 2.5 % NaOCl, 5 mL 17 % EDTA, and 5 mL distilled water under sonic agitation. Each group was then subdivided into three subgroups (n = 10), and the canals were filled with either AH Plus, MTA Fillapex, or Total Fill BC sealer. After 1 week, a push-out test was applied to the specimens and the results were analyzed using one-way analysis of variance (ANOVA) and post hoc Tamhane's tests. RESULTS Regardless of the type of intracanal medicament used, Total Fill BC Sealer and MTA Fillapex showed the highest and lowest bond strength, respectively (P < 0.05). The use or absence of medicaments did not significantly affect the dislodgment resistance of root canal fillings (P > 0.05). Prior CH placement improved dislodgement resistance of all sealers without statistical difference (P > 0.05). Adhesive failure between core and sealer was the most frequent failure mode. CONCLUSIONS Prior application of CH or DAP did not significantly affect the adhesion of the AH Plus, MTA Fillapex, and Total Fill BC Sealers. CLINICAL RELEVANCE There is a little information about the influence of antibiotic medicaments on the bond strength of root canal sealer. These findings suggest that the use of DAP does not affect the adhesion strength of AH Plus, MTA Fillapex, and Total Fill BC Sealers.
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Affiliation(s)
- Hakan Gokturk
- Department of Endodontics, Faculty of Dentistry, Gaziosmanpaşa University, 60100, Tokat, Turkey.
| | - Emre Bayram
- Department of Endodontics, Faculty of Dentistry, Gaziosmanpaşa University, 60100, Tokat, Turkey
| | - Huda Melike Bayram
- Department of Endodontics, Faculty of Dentistry, Gaziosmanpaşa University, 60100, Tokat, Turkey
| | - Tugrul Aslan
- Department of Restorative Dentistry and Endodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
| | - Yakup Ustun
- Department of Restorative Dentistry and Endodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
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Rôças IN, Provenzano JC, Neves MA, Siqueira JF. Disinfecting Effects of Rotary Instrumentation with Either 2.5% Sodium Hypochlorite or 2% Chlorhexidine as the Main Irrigant: A Randomized Clinical Study. J Endod 2016; 42:943-7. [DOI: 10.1016/j.joen.2016.03.019] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Revised: 03/24/2016] [Accepted: 03/25/2016] [Indexed: 01/28/2023]
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Mohammadi Z, Jafarzadeh H, Shalavi S. Antimicrobial efficacy of chlorhexidine as a root canal irrigant: a literature review. J Oral Sci 2016; 56:99-103. [PMID: 24930745 DOI: 10.2334/josnusd.56.99] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Use of an appropriate root canal irrigant is essential during endodontic treatment, due to the complex and unpredictable anatomy of the root canal system and limitations in the mechanical instrumentation techniques used to obtain a clean, bacteria-free canal. Several irrigants, such as sodium hypochlorite, chlorhexidine, hydrogen peroxide, and normal saline, have been proposed as canal system irrigants in endodontic treatment. The widely used endodontic irrigant chlorhexidine is a positively charged lipophilic/hydrophobic molecule that interacts with phospholipids and lipopolysaccharides on the bacterial cell membrane. In endodontics, its mode of antibacterial activity is determined by its concentration (0.2% or 2%). This article reviews findings from available endodontic studies on the antibacterial, antifungal, and antibiofilm activities of chlorhexidine.
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Affiliation(s)
- Zahed Mohammadi
- Iranian Center for Endodontic Research, Shahid Beheshti University of Medical Sciences
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Rico-Romano C, Zubizarreta-Macho Á, Baquero-Artigao MR, Mena-Álvarez J. An analysis in vivo of intracanal bacterial load before and after chemo-mechanical preparation: A comparative analysis of two irrigants and two activation techniques. J Clin Exp Dent 2016; 8:e9-e13. [PMID: 26855714 PMCID: PMC4739376 DOI: 10.4317/jced.52585] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2015] [Accepted: 09/14/2015] [Indexed: 11/28/2022] Open
Abstract
Background The goals of this randomized double-blind trial were to assess the antimicrobial activity in vivo of Sodium hypochlorite (NaOCl) vs. chlorhexidine gluconate (CHX) used in combination either with EndoActivator® or IRRI S® files in patients with apical periodontitis. Material and Methods A total of 120 patients with apical periodontitis (in single or multiple root canals) were randomly assigned to the four irrigation protocols outlined below: Group A: 5.25% sodium hypochlorite (NaOCl) + EndoActivator®; Group B: 5.25% NaOCl + IRRI S® files; Group C: 2% chlorhexidine gluconate (CHX) + EndoActivator®; Group D: 2% CHX + IRRI S® files. Paper points were used to collect microbiological samples before (1A samples) and after (1B samples) irrigation. Viable colony-forming units (CFU) were quantified twice: (1) without speciation, and (2) only for Enterococcus Faecalis(EF). Statistical analysis was performed using SPSS 22.0 for Windows. Results No significant differences were observed between NaOCl and CHX in the reduction of CFU; in fact, reduction was < 93% for the two irrigants. Conversely, statistically significant differences were found between the two activation techniques (sonic and ultrasonic) in the reduction of Enterococcus Faecalis(EF). Thus, the effectiveness of ultrasonic activation was significantly higher (< 93%; p=0.012) as compared to sonic activation. Following the combination of the two irrigants with the two activation techniques (groups A, B, C and D), significant differences were observed between group A and B (p=0.025) in the reduction of EF populations, reaching up to 94%. Conclusions NaClO and CHX are effective in reducing intracanal bacterial load. Ultrasonic activation is the most effective activation technique in reducing EF populations. Key words:Chlorhexidine gluconate, sodium hypochlorite, ultrasonic irrigation, sonic irrigation, apical periodontitis, Enterococcus faecalis.
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Affiliation(s)
- Cristina Rico-Romano
- Associate Professor. Master's Degree in Clinical Endodontics and Periapical Microsurgery. Faculty of Health Sciences. Alfonso X el Sabio University. Madrid, Spain
| | - Álvaro Zubizarreta-Macho
- Associate Professor. Master's Degree in Clinical Endodontics and Periapical Microsurgery. Faculty of Health Sciences. Alfonso X el Sabio University. Madrid, Spain
| | | | - Jesús Mena-Álvarez
- Head Academic Master Degree in Endodontics. Faculty of Health Sciences. Alfonso X el Sabio University. Madrid, Spain
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HERRERA DR, DURAND-RAMIREZ JE, FALCÃO A, SILVA EJLND, SANTOS EBD, GOMES BPFDA. Antimicrobial activity and substantivity of Uncaria tomentosa in infected root canal dentin. Braz Oral Res 2016; 30:e61. [DOI: 10.1590/1807-3107bor-2016.vol30.0061] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Accepted: 01/11/2016] [Indexed: 11/22/2022] Open
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Nielsen HK, Garcia J, Væth M, Schlafer S. Comparison of Riboflavin and Toluidine Blue O as Photosensitizers for Photoactivated Disinfection on Endodontic and Periodontal Pathogens In Vitro. PLoS One 2015; 10:e0140720. [PMID: 26469348 PMCID: PMC4607437 DOI: 10.1371/journal.pone.0140720] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Accepted: 09/28/2015] [Indexed: 11/18/2022] Open
Abstract
Photoactivated disinfection has a strong local antimicrobial effect. In the field of dentistry it is an emerging adjunct to mechanical debridement during endodontic and periodontal treatment. In the present study, we investigate the effect of photoactivated disinfection using riboflavin as a photosensitizer and blue LED light for activation, and compare it to photoactivated disinfection with the widely used combination of toluidine blue O and red light. Riboflavin is highly biocompatible and can be activated with LED lamps at hand in the dental office. To date, no reports are available on the antimicrobial effect of photoactivated disinfection using riboflavin/blue light on oral microorganisms. Planktonic cultures of eight organisms frequently isolated from periodontal and/or endodontic lesions (Aggregatibacter actinomycetemcomitans, Candida albicans, Enterococcus faecalis, Escherischia coli, Lactobacillus paracasei, Porphyromonas gingivalis, Prevotella intermedia and Propionibacterium acnes) were subjected to photoactivated disinfection with riboflavin/blue light and toluidine blue O/red light, and survival rates were determined by CFU counts. Within the limited irradiation time of one minute, photoactivated disinfection with riboflavin/blue light only resulted in minor reductions in CFU counts, whereas full kills were achieved for all organisms when using toluidine blue O/red light. The black pigmented anaerobes P. gingivalis and P. intermedia were eradicated completely by riboflavin/blue light, but also by blue light treatment alone, suggesting that endogenous chromophores acted as photosensitizers in these bacteria. On the basis of our results, riboflavin cannot be recommended as a photosensitizer used for photoactivated disinfection of periodontal or endodontic infections.
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Affiliation(s)
| | - Javier Garcia
- Department of Dentistry, HEALTH, Aarhus University, Aarhus, 8000, Denmark
| | - Michael Væth
- Department of Biostatistics, HEALTH, Aarhus University, Aarhus, 8000, Denmark
| | - Sebastian Schlafer
- Department of Dentistry, HEALTH, Aarhus University, Aarhus, 8000, Denmark
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Zargar N, Dianat O, Asnaashari M, Ganjali M, Zadsirjan S. The Effect of Smear Layer on Antimicrobial Efficacy of Three Root Canal Irrigants. IRANIAN ENDODONTIC JOURNAL 2015. [PMID: 26213540 PMCID: PMC4509126 DOI: 10.7508/iej.2015.03.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Introduction: One of the main goals of endodontic treatment is to decrease the harboring bacteria within the root canal system and dentinal tubules. This experimental study attempted to investigate the antibacterial efficacy of three root canal irrigants in the presence and absence of smear layer (SL). Methods and Materials: A total of 210 sound extracted human single-rooted teeth were prepared. After creating the SL and its removal in half of the samples, they were infected with Candida albicans (C. albicans) and Actinomyces israelii (A. israelii). A total of 180 specimen were used to assess the antimicrobial efficacy of the three irrigants in presence and absence of SL, 24 specimen were placed in the positive and negative controls, 2 samples were utilized for scanning electron microscopy (SEM) analysis and 2 were used for Gram staining. Then, they were exposed to irrigants including 2.61% sodium hypochlorite (NaOCl), 0.2% chlorhexidine gluconate (CHX) and 1% povidone-iodine (PI) for 5, 30 and 60 min. Presence/absence of test microorganisms was determined by incubation of specimens in test tubes containing brain-heart infusion (BHI) broth and then measuring the colony forming units (CFU) on BHI agar. A cumulative logistic model was used to analyze the ordinal response. Results: The 2.61% solution of NaOCl was significantly more effective than 0.2% CHX and the latter was more efficient than 1% PI for decreasing fungal and microbial infection of dentinal tubules in the presence and absence of SL. Conclusion: The presence of smear layer decreased the efficacy of antimicrobial irrigants. The minimum time required for elimination of fungal/microbial infection was 30 min.
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Affiliation(s)
- Nazanin Zargar
- Department of Endodontics, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Omid Dianat
- Iranian Center for Endodontic Research (ICER), Research Institute of Dental Sciences, Department of Endodontics, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Asnaashari
- Department of Endodontics, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mojtaba Ganjali
- Department of Endodontics, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saeede Zadsirjan
- Department of Endodontics, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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45
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Tu YY, Yang CY, Chen RS, Chen MH. Effects of chlorhexidine on stem cells from exfoliated deciduous teeth. J Formos Med Assoc 2015; 114:17-22. [DOI: 10.1016/j.jfma.2012.12.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2012] [Revised: 11/29/2012] [Accepted: 12/10/2012] [Indexed: 10/26/2022] Open
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46
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Küçükyilmaz E, Savas S, Saygili G, Uysal B. Assessment of apically extruded debris and irrigant produced by different nickel-titanium instrument systems. Braz Oral Res 2014; 29:1-6. [PMID: 25387860 DOI: 10.1590/1807-3107bor-2015.vol29.0002] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2014] [Accepted: 08/13/2014] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to evaluate the preparation time and the amounts of apically extruded debris and irrigant using different nickel-titanium instrumentation systems. Forty-five extracted single-rooted mandibular premolar teeth were selected and divided into three groups. The root canals were instrumented according to the manufacturers' instructions, using a reciprocating single-file system, a single-file rotary system and a multiple-file rotary system. Bidistilled water was used as the irrigant solution. The apically extruded debris and irrigant were collected into preweighed Eppendorf tubes. The amounts of extruded debris and irrigant were assessed with a precision micro-balance. The Eppendorf tubes were incubated at 37°C for 15 days. After the incubation period, they were weighed again to assess the debris extrusion. The time required to prepare the canals was also recorded. The results were statistically analyzed using MANOVA and Bonferroni's adjustment. Considering the apically extruded debris and irrigant, there were no statistically significant differences among the groups (p > 0.05). The Reciproc group produced the highest debris (0.000632 ± 0.000162 gr) and irrigant (0.844587 ± 0.437814 ml) extrusion values. While the least extruded debris was observed with OneShape (0,000431 ± 0,000171 gr), the least extruded irrigant was observed with ProTaper system (0.564147 ± 0.370596 ml). Instrumentation was faster using the Reciproc than the other two instruments (70.27 ± 13.38 s) (p < 0.05). All of the instrumentation systems used in this study produced apical debris and irrigant extrusion. The reciprocating single-file system tended to produce more debris and irrigant extrusion, compared with the rotary systems. Considering the preparation time, the single-file systems appeared to be advantageous due to their working time.
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Affiliation(s)
- Ebru Küçükyilmaz
- Department of Pediatric Dentistry, Faculty of Dentistry, Izmir Katip Celebi University, Izmir, Turkey
| | - Selcuk Savas
- Department of Pediatric Dentistry, Faculty of Dentistry, Izmir Katip Celebi University, Izmir, Turkey
| | - Gokhan Saygili
- Department of Endodontic, Faculty of Dentistry, Izmir Katip Celebi University, Izmir, Turkey
| | - Banu Uysal
- Department of Endodontic, Faculty of Dentistry, Izmir Katip Celebi University, Izmir, Turkey
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47
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Tissue response to root canal irrigation systems in dogs’ teeth with apical periodontitis. Clin Oral Investig 2014; 19:1147-56. [DOI: 10.1007/s00784-014-1340-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2014] [Accepted: 10/14/2014] [Indexed: 11/26/2022]
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48
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Zhang L, Ning C, Zhou T, Liu X, Yeung KWK, Zhang T, Xu Z, Wang X, Wu S, Chu PK. Polymeric nanoarchitectures on Ti-based implants for antibacterial applications. ACS APPLIED MATERIALS & INTERFACES 2014; 6:17323-17345. [PMID: 25233376 DOI: 10.1021/am5045604] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Because of the excellent mechanical properties and good biocompatibility, titanium-based metals are widely used in hard tissue repair, especially load-bearing orthopedic applications. However, bacterial infection and complication during and after surgery often causes failure of the metallic implants. To endow titanium-based implants with antibacterial properties, surface modification is one of the effective strategies. Possessing the unique organic structure composed of molecular and functional groups resembling those of natural organisms, functionalized polymeric nanoarchitectures enhance not only the antibacterial performance but also other biological functions that are difficult to accomplish on many conventional bioinert metallic implants. In this review, recent advance in functionalized polymeric nanoarchitectures and the associated antimicrobial mechanisms are reviewed.
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Affiliation(s)
- Long Zhang
- Hubei Collaborative Innovation Center for Advanced Organic Chemical Materials, Ministry-of-Education Key Laboratory for the Green Preparation and Application of Functional Materials, Hubei Province Key Laboratory of Industrial Biotechnology, Faculty of Materials Science & Engineering, Hubei University , Wuhan, China
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Parahitiyawa NB, Chu FCS, Leung WK, Yam WC, Jin LJ, Samaranayake LP. Clonality of bacterial consortia in root canals and subjacent gingival crevices. ACTA ACUST UNITED AC 2014; 6:32-9. [DOI: 10.1111/jicd.12070] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2013] [Accepted: 03/31/2014] [Indexed: 10/24/2022]
Affiliation(s)
- Nipuna B. Parahitiyawa
- Department of Oral Bio-Sciences; Faculty of Dentistry and Department of Microbiology; The University of Hong Kong; Hong Kong SAR China
| | - Frederick C. S. Chu
- Department of Comprehensive Dental Care; Faculty of Dentistry and Department of Microbiology; The University of Hong Kong; Hong Kong SAR China
| | - Wai K. Leung
- Department of Periodontology; Faculty of Dentistry and Department of Microbiology; The University of Hong Kong; Hong Kong SAR China
| | - Wing C. Yam
- Li Ka Shing Faculty of Medicine; The University of Hong Kong; Hong Kong SAR China
| | - Li Jian Jin
- Department of Periodontology; Faculty of Dentistry and Department of Microbiology; The University of Hong Kong; Hong Kong SAR China
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50
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Kandil HE, Labib AH, Alhadainy HA. Effect of different irrigant solutions on microhardness and smear layer removal of root canal dentin. ACTA ACUST UNITED AC 2014. [DOI: 10.1016/j.tdj.2014.03.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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