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Bourbour S, Darbandi A, Bostanghadiri N, Ghanavati R, Taheri B, Bahador A. Effects of Antimicrobial Photosensitizers of Photodynamic Therapy (PDT) to Treat Periodontitis. Curr Pharm Biotechnol 2024; 25:1209-1229. [PMID: 37475551 DOI: 10.2174/1389201024666230720104516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 06/07/2023] [Accepted: 06/20/2023] [Indexed: 07/22/2023]
Abstract
Antimicrobial photodynamic therapy or aPDT is an alternative therapeutic approach in which lasers and different photosensitizing agents are used to eradicate periodontopathic bacteria in periodontitis. Periodontitis is a localized infectious disease caused by periodontopathic bacteria and can destroy bones and tissues surrounding and supporting the teeth. The aPDT system has been shown by in vitro studies to have high bactericidal efficacy. It was demonstrated that aPDT has low local toxicity, can speed up dental therapy, and is cost-effective. Several photosensitizers (PSs) are available for each type of light source which did not induce any damage to the patient and are safe. In recent years, significant advances have been made in aPDT as a non-invasive treatment method, especially in treating infections and cancers. Besides, aPDT can be perfectly combined with other treatments. Hence, this survey focused on the effectiveness and mechanism of aPDT of periodontitis by using lasers and the most frequently used antimicrobial PSs such as methylene blue (MB), toluidine blue ortho (TBO), indocyanine green (ICG), malachite green (MG) (Triarylmethanes), erythrosine dyes (ERY) (Xanthenes dyes), rose bengal (RB) (Xanthenes dyes), eosin-Y (Xanthenes dyes), radachlorin group and curcumin. The aPDT with these PSs can reduce pathogenic bacterial loads in periodontitis. Therefore, it is clear that there is a bright future for using aPDT to fight microorganisms causing periodontitis.
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Affiliation(s)
- Samaneh Bourbour
- Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Atieh Darbandi
- Molecular Microbiology Research Center, Shahed University, Tehran, Iran
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Narjess Bostanghadiri
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Roya Ghanavati
- Department of Microbiology, Behbahan Faculty of Medical Sciences, Behbahan, Iran
| | - Behrouz Taheri
- Department of Medical Laboratory Sciences, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Abbas Bahador
- Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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2
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Fletcher R, Harrison W, Crighton A. Dental material allergies and oral soft tissue reactions. Br Dent J 2022; 232:620-625. [PMID: 35562454 DOI: 10.1038/s41415-022-4195-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 03/11/2022] [Indexed: 11/09/2022]
Abstract
Dental materials can cause reactions to the oral mucosa and present to the general dental practitioner. These are often referred to as 'allergies' but are frequently lichenoid reactions. Most of these are related to dental amalgam restorations and can be remedied by replacing the restoration with another suitable material. Other metals, including gold, palladium, nickel and chrome, have also been reported to trigger mucosal changes. Less commonly, issues arise from other restorative materials, including denture acrylics, composites and glass polyalkenoates. Reactions are also reported due to endodontic and sealing materials. It is unclear what role skin 'patch' testing has in managing dental material allergies. This article aims to give the practitioner a clearer picture of dental material allergy issues and how they should be approached in primary dental practice.
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Affiliation(s)
- Rosie Fletcher
- Department of Oral Medicine, Glasgow Dental Hospital and School, NHS Greater Glasgow and Clyde, Scotland, UK
| | - William Harrison
- Department of Oral Medicine, Glasgow Dental Hospital and School, NHS Greater Glasgow and Clyde, Scotland, UK
| | - Alexander Crighton
- Department of Oral Medicine, Glasgow Dental Hospital and School, NHS Greater Glasgow and Clyde, Scotland, UK.
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Dumani A, Ates AA, Ucan CS, Yilmaz S, Unal I, Yoldas O. The influence of MTAD and QMix on the accuracy of electronic apex locator in locating simulated perforations. Niger J Clin Pract 2022; 25:281-285. [PMID: 35295049 DOI: 10.4103/njcp.njcp_1444_21] [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: 11/04/2022]
Abstract
Aims and Background The aim of this study was to evaluate the accuracy of the electronic actual length in detecting artificial perforations of the root canal in the presence of saline solution (NaCl, (Eczacibasi, Istanbul, Turkey), chlorhexidine [CHX (Werax, Tunadent, Izmir, Turkey)], QMix (Dentsply Tulsa, Maillefer, Ballaigues, Switzerland), and MTAD (Dentsply, Tulsa Dental, Tulsa, OK, USA). Materials and Methods The root canals of 25 single-rooted extracted human teeth were perforated artificially in the middle section of the root. The actual lengths up to the perforation site were measured and then, the teeth were embedded in an alginate mold. Electronic measurements of the perforations were obtained by an electronic apex locator according to the manufacturers' recommendations under dry conditions and in the presence of NaCl, CHX, MTAD, and QMix using a #20 K-file. Each canal was irrigated with distilled water and then dried with paper points between the measurements. Statistical analyses were performed using the Friedman test and Spearman Rank correlation coefficient to assess the correlations between the measurement methods. Results Highest correlation between the actual length and the electronic measurement was observed under dry conditions and NaCl solution (r: 0.932, r: 0.940 respectively), and the least correlation was observed with MTAD solution (r: 0.697) using statistical analysis. Moreover, the accuracy of the electronic apex locator with different irrigation solutions was statistically different from each other (P = 0.001). Conclusion The most accurate electronic measurements of artificial perforation were obtained under dry conditions or with NaCl.
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Affiliation(s)
- A Dumani
- Department of Endodontics, Faculty of Dentistry, Cukurova University, Adana, Turkey
| | - A A Ates
- Department of Endodontics, Faculty of Dentistry, Istanbul Okan University, Istanbul, Turkey
| | - C S Ucan
- Department of Endodontics, Faculty of Dentistry, Cukurova University, Adana, Turkey
| | - S Yilmaz
- Department of Endodontics, Faculty of Dentistry, Cukurova University, Adana, Turkey
| | - I Unal
- Department of Biostatistics, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - O Yoldas
- Department of Endodontics, Faculty of Dentistry, Cukurova University, Adana, Turkey
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Abuljadayel J, Shafei J, Fairaq M, Mirza A, Samman AB, Abdulshakoor A, Jalal N, Ashgar S, Al-Said H. A comparative evaluation of the antimicrobial effect of six natural products in comparison to 2.5% sodium hypochlorite against Enterococcus faecalis: An in vitro study. SAUDI JOURNAL FOR HEALTH SCIENCES 2022. [DOI: 10.4103/sjhs.sjhs_149_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Sabantseva EG, Ivanova EV, Rabinovich IM. [Manifestations of allergic reactions occurring at a dental appointment]. STOMATOLOGIIA 2021; 100:29-32. [PMID: 35081697 DOI: 10.17116/stomat202110006229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To analyze the data of modern scientific literature to conduct a study on identifying the true allergic reaction at a dental appointment. MATERIAL AND METHODS The article is based on the study of materials from domestic and foreign research databases eLibrary, PubMed, Cochrane Database Systematic Reviews. The research period is 15 years. RESULTS Among dental materials, the most common allergens are local anesthetics, metal alloys, components of composite materials, latex. CONCLUSION If allergy is suspected, it is necessary to carefully collect an anamnesis and conduct a clinical examination of the patient with the involvement of specialist doctors, with the recommendation of skin tests and test subcutaneous provocation.
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Affiliation(s)
- E G Sabantseva
- Russian Medical Academy of Continuous Professional Education» of the Ministry of Healthcare of the Russian Federation, Moscow, Russia
| | - E V Ivanova
- Russian Medical Academy of Continuous Professional Education» of the Ministry of Healthcare of the Russian Federation, Moscow, Russia
- Moscow Regional Research and Clinical Institute, Moscow, Russia
| | - I M Rabinovich
- Russian Medical Academy of Continuous Professional Education» of the Ministry of Healthcare of the Russian Federation, Moscow, Russia
- Central Research Institute of Dentistry and Maxillofacial Surgery of Ministry of Health of the Russian Federation, Moscow, Russia
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Daood U, Parolia A, Matinlinna J, Yiu C, Ahmed HMA, Fawzy A. Properties of a modified quaternary ammonium silane formulation as a potential root canal irrigant in endodontics. Dent Mater 2020; 36:e386-e402. [PMID: 33010944 DOI: 10.1016/j.dental.2020.09.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 06/28/2020] [Accepted: 09/09/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVES Evaluate a new modified quaternary ammonium silane irrigant solution for its antimicrobial, cytotoxic and mechanical properties of dentine substrate. METHODS Root canal preparation was performed using stainless steel K-files™ and F4 size protaper with irrigation protocols of 6% NaOCl + 2% CHX; 3.5% QIS; 2% QIS and sterile saline. Biofilms were prepared using E. faecalis adjusted and allowed to grow for 3 days, treated with irrigants, and allowed to grow for 7 days. AFM was performed and surface free energy calculated. MC3T3 cells were infected with endo irrigant treated E. faecalis biofilms. Raman spectroscopy of biofilms were performed after bacterial re-growth on root dentine and exposed to different irrigation protocols and collagen fibers analysed collagen fibers using TEM. Antimicrobial potency against E. faecalis biofilms and cytoxicity against 3T3 NIH cells were also. Resin penetration and MitoTracker green were also evaluated for sealer penetration and mitochondrial viability. Data were analysed using One-way ANOVA, principal component analysis and post-hoc Fisher's least-significant difference. RESULTS Elastic moduli were maintained amongst control (5.5 ± 0.9) and 3.5% QIS (4.4 ± 1.1) specimens with surface free energy higher in QIS specimens. MC3T3 cells showed reduced viability in 6%NaOCl+2%CHX specimens compared to QIS specimens. DNA/purine were expressed in increased intensities in control and 6% NaOCl + 2% CHX specimens with bands around 480-490 cm-1 reduced in QIS specimens. 3.5% QIS specimens showed intact collagen fibrillar network and predominantly dead bacterial cells in confocal microscopy. 3.5% QIS irrigant formed a thin crust-type surface layer with cytoplasmic extensions of 3T3NIH spread over root dentine. Experiments confirmed MitoTracker accumulation in 3.5% treated cells. SIGNIFICANCE Novel QIS root canal irrigant achieved optimum antimicrobial protection inside the root canals facilitating a toxic effect against the Enterococcus faecalis biofilm. Root dentine substrates exhibited optimum mechanical properties and there was viability of fibroblastic mitochondria.
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Affiliation(s)
- Umer Daood
- Division of Clinical Dentistry, School of Dentistry, International Medical University Kuala Lumpur, 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000 Bukit Jalil, Wilayah Persekutuan Kuala Lumpur, Malaysia.
| | - Abhishek Parolia
- Division of Clinical Dentistry, School of Dentistry, International Medical University Kuala Lumpur, 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000 Bukit Jalil, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | - Jukka Matinlinna
- Dental Materials Science, Applied Oral Sciences, Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Sai Ying Pun, Hong Kong SAR, China
| | - Cynthia Yiu
- Pediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital, 34 Hospital Road, Pokfulam, Hong Kong, China Hong Kong Special Administrative Region
| | - Hany Mohamed Aly Ahmed
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Amr Fawzy
- UWA Dental School, University of Western Australia, Nedlands, WA 6009, Australia
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Wen C, Kong Y, Zhao J, Li Y, Yu M, Zeng S, Shi Z, Jiang Q. Efficacy of the photon-initiated photoacoustic streaming combined with different solutions on Enterococcus faecalis in the root canals. Microsc Res Tech 2020; 83:647-657. [PMID: 32064716 DOI: 10.1002/jemt.23455] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 01/01/2020] [Accepted: 01/24/2020] [Indexed: 01/12/2023]
Abstract
This study aimed to evaluate the efficacy of different irrigation solutions used in photon-initiated photoacoustic streaming (PIPS) or conventional needle irrigation (CNI) for eradication of Enterococcus faecalis from artificial root canals. Altogether, 240 artificial root canal samples were included. The models were split and incubated for 2 days to allow formation of E. faecalis biofilm. The models were randomly divided into two groups (n = 120): CNI and laser-activated irrigation (LAI). Each group was divided into six subgroups according to different irrigation solutions: distilled water, 1% sodium hypochlorite (NaOCl), 2% NaOCl, 5.25% NaOCl, MTAD, and chlorhexidine, respectively. After irrigation, half of the samples (n = 10) were assessed immediately, and the other half of the samples (n = 10) were incubated for 6 hr. Bacterial suspensions were obtained from all samples before and after irrigation, and after incubation, and were quantified adenosine 5'-triphosphate (ATP) assay kit. The biofilms were examined using fluorescent microscopy and analyzed by Image Pro Plus software. Significant reduction of ATP, average fluorescence density after irrigation, and growth after incubation was obtained in LAI group than in CNI group (p < .05). LAI can improve bacteriostasis effect of 2% NaOCl (p < .05). PIPS improved the antibacterial effect of the 2% NaOCl used in root canal therapy.
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Affiliation(s)
- Cheng Wen
- Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Yuanyuan Kong
- Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Jian Zhao
- Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Yang Li
- Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Miao Yu
- Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Sujuan Zeng
- Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Zhan Shi
- Human Biology Program, University of Toronto, Toronto, Ontario, Canada
| | - Qianzhou Jiang
- Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
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Hsieh SC, Teng NC, Chu CC, Chu YT, Chen CH, Chang LY, Hsu CY, Huang CS, Hsiao GYW, Yang JC. The Antibacterial Efficacy and In Vivo Toxicity of Sodium Hypochlorite and Electrolyzed Oxidizing (EO) Water-Based Endodontic Irrigating Solutions. MATERIALS (BASEL, SWITZERLAND) 2020; 13:E260. [PMID: 31936078 PMCID: PMC7013798 DOI: 10.3390/ma13020260] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 01/01/2020] [Accepted: 01/03/2020] [Indexed: 11/24/2022]
Abstract
The objective of this study was to evaluate the antibacterial efficacy against Enterococcus faecalis and Streptococcus mutans and in vivo toxicity using embryonic zebrafish assays of sodium hypochlorite (NaOCl) and electrolyzed oxidizing (EO) water (containing hypochlorous acid (HOCl))-based root canal irrigating solutions. METHODOLOGY Using 100 μL microbial count of 1 × 108 cfu/mL Enterococcus faecalis to mix with each 10 mL specimen of NaOCl or HOCl for designed time periods. The above protocol was also repeated for Streptococcus mutans. The concentration of viable microorganisms was estimated based on each standardized inoculum using a plate-count method. Zebrafish embryo assays were used to evaluate acute toxicity. RESULTS All the HOCl or NaOCl treatment groups showed > 99.9% antibacterial efficacy against Enterococcus faecalis and Streptococcus mutans. Zebrafish embryos showed almost complete dissolution in 1.5% NaOCl within 5 min. Both survival rates after being treated with 0.0125% and 0.0250% HOCl for 0.5 min or 1.0 min were similar to that of E3 medium. CONCLUSIONS Both NaOCl and HOCl revealed similar antibacterial efficacy (> 99.9%) against Enterococcus faecalis and Streptococcus mutans. While 1.5% NaOCl fully dissolved the Zebrafish embryos, both 0.0125% and 0.0250% HOCl showed little in vivo toxicity, affirming its potential as an alternative irrigation solution for vital pulp therapy.
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Affiliation(s)
- Sung-Chih Hsieh
- School of Dentistry, Taipei Medical University, Taipei 110-52, Taiwan; (S.-C.H.); (N.-C.T.); (C.-S.H.); (G.Y.-W.H.)
| | - Nai-Chia Teng
- School of Dentistry, Taipei Medical University, Taipei 110-52, Taiwan; (S.-C.H.); (N.-C.T.); (C.-S.H.); (G.Y.-W.H.)
| | - Chia Chun Chu
- Graduate Institute of Nanomedicine and Medical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei 110-52, Taiwan; (C.C.C.); (Y.-T.C.); (C.-H.C.); (L.-Y.C.); (C.-Y.H.)
| | - You-Tai Chu
- Graduate Institute of Nanomedicine and Medical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei 110-52, Taiwan; (C.C.C.); (Y.-T.C.); (C.-H.C.); (L.-Y.C.); (C.-Y.H.)
| | - Chung-He Chen
- Graduate Institute of Nanomedicine and Medical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei 110-52, Taiwan; (C.C.C.); (Y.-T.C.); (C.-H.C.); (L.-Y.C.); (C.-Y.H.)
| | - Liang-Yu Chang
- Graduate Institute of Nanomedicine and Medical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei 110-52, Taiwan; (C.C.C.); (Y.-T.C.); (C.-H.C.); (L.-Y.C.); (C.-Y.H.)
| | - Chieh-Yun Hsu
- Graduate Institute of Nanomedicine and Medical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei 110-52, Taiwan; (C.C.C.); (Y.-T.C.); (C.-H.C.); (L.-Y.C.); (C.-Y.H.)
| | - Ching-Shuan Huang
- School of Dentistry, Taipei Medical University, Taipei 110-52, Taiwan; (S.-C.H.); (N.-C.T.); (C.-S.H.); (G.Y.-W.H.)
| | - Grace Ying-Wen Hsiao
- School of Dentistry, Taipei Medical University, Taipei 110-52, Taiwan; (S.-C.H.); (N.-C.T.); (C.-S.H.); (G.Y.-W.H.)
| | - Jen-Chang Yang
- Graduate Institute of Nanomedicine and Medical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei 110-52, Taiwan; (C.C.C.); (Y.-T.C.); (C.-H.C.); (L.-Y.C.); (C.-Y.H.)
- Research Center of Biomedical Device, Taipei Medical University, Taipei 110-52, Taiwan
- International Ph.D. Program in Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei 110-52, Taiwan
- Research Center of Digital Oral Science and Technology, Taipei Medical University, Taipei 110-52, Taiwan
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Comparison of the Antibacterial Efficacy of Commiphora molmol and Sodium Hypochlorite as Root Canal Irrigants against Enterococcus faecalis and Fusobacterium nucleatum. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2019; 2019:6916795. [PMID: 31354857 PMCID: PMC6637688 DOI: 10.1155/2019/6916795] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 05/20/2019] [Indexed: 12/02/2022]
Abstract
Objective The investigation aims to compare antimicrobial efficacy of the extract of Commiphora molmol,
against Enterococcus faecalis and Fusobacterium nucleatum, with sodium hypochlorite (NaOCl). Design T
he dehydrated oleo-gum resin of Commiphora molmol was extracted by using 70% ethanol and was suspended in 99.8%
dimethyl sulfoxide (DMSO) as a dissolving agent in a 1:2 volume to produce an aqueous solution at room temperature. Agar-well diffusion
and broth microdilution methods assay were utilized to determine both the antimicrobial activity and minimum inhibitory concentration,
of alcoholic extract of Commiphora molmol against E. faecalis and F. nucleatum.
The values of the inhibition zones were determined based on the concentration of the investigated material. One hundred and
forty extracted human premolar teeth were instrumented and immersed in bacterial suspension of E. faecalis or F. nucleatum
(70 teeth in each species suspension). Prepared teeth were then immersed in the myrrh extract solution, 2.5% NaOCl, DMSO, or
Cefotaxime and incubated for 30 and 60 minutes. Results The largest inhibition zone diameter for both bacterial species was
obtained by the 100mg/100μL concentration. The minimum inhibitory concentration (MIC) was 0.03mg/300μL for both
E. faecalis and F. nucleatum. The minimum bactericidal concentration (MBC) results showed that 0.03mg/μL
myrrh extract and 2.5% sodium hypochlorite significantly reduced bacterial growth at both 30 and 60 minutes of different treatments of root canals,
compared to DMSO group (negative control) and the antibiotic group (positive group). Conclusion Myrrh extract was proven to
have considerable antibacterial activity against both F. nucleatum and E. faecalis.
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Ajeti NN, Pustina-Krasniqi T, Apostolska S. The Effect of Gaseous Ozone in Infected Root Canal. Open Access Maced J Med Sci 2018; 6:389-396. [PMID: 29531611 PMCID: PMC5839455 DOI: 10.3889/oamjms.2018.102] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Revised: 10/30/2017] [Accepted: 01/31/2018] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES During the treatment of chronic apical periodontitis and pulp necrosis the main role is to irrigate the root canal. AIM The aim of this in vivo study was to irrigate with 0.9% NaCl (Natrium Chloride), 2.5 % NaOCl (Sodium Hypochlorite Solution, Sigma Aldrich - Germany) and 2% CHX (Chlorhexidine Digluconate Solution, Sigma Aldrich - Spain) combined with Gaseous Ozone (Prozone WH, Austria). MATERIAL AND METHODS This study was realised in the University Dentistry Clinical Centre of Kosovo (UDCCK), respectively in the Department of Endodontic and Dental Pathology, Dental Branch, Faculty of Medicine, Prishtina, Kosovo. The 40 subjects involved in this study belonged to both genders, in age between 15 -65 years. The sample selection was randomised. The retroalveolar radiography for each patient was taken in the suspected tooth. As a therapeutic plan the authors decided to disinfect the root canal with the irrigants, as follows: 2.5 % NaOCl, 2 % CHX and gaseous ozone. RESULTS The statistical analyses were based on Kruskal - Vallis test, X - test, DF = 3, r < 0.01. In the isolated average number of the aerobe and anaerobe bacteria colonies, when gaseous ozone was used, there was the significant statistical difference. CONCLUSIONS When gaseous ozone was combined with irrigants 0.9%, 2.5 % NaOCl and 2% CHX, it was concluded that the number of colonies of aerobic and anaerobic bacteria was reduced.
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Affiliation(s)
- Nova Nexhmije Ajeti
- Department of Endodontic and Dental Pathology, Dental Branch, Faculty of Medicine, University of Prishtina, Prishtina, Kosovo
| | - Teuta Pustina-Krasniqi
- Department of Prosthetic Dentistry, Dental Branch, Faculty of Medicine, University of Prishtina (UP), Vice Rector for International Affairs in UP, Prishtina, Kosovo
| | - Sonja Apostolska
- Department of Endodontic and Dental Pathology, Dental Faculty, University of Skopje, Skopje, Republic of Macedonia
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Borzini L, Condò R, De Dominicis P, Casaglia A, Cerroni L. Root Canal Irrigation: Chemical Agents and Plant Extracts Against Enterococcus faecalis. Open Dent J 2016; 10:692-703. [PMID: 28217184 PMCID: PMC5299586 DOI: 10.2174/1874210601610010692] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Revised: 10/12/2016] [Accepted: 11/02/2016] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND There are various microorganisms related to intra and extra-radicular infections and many of these are involved in persistent infections. Bacterial elimination from the root canal is achieved by means of the mechanical action of instruments and irrigation as well as the antibacterial effects of the irrigating solutions. Enterococcus faecalis can frequently be isolated from root canals in cases of failed root canal treatments. Antimicrobial agents have often been developed and optimized for their activity against endodontic bacteria. An ideal root canal irrigant should be biocompatible, because of its close contact with the periodontal tissues during endodontic treatment. Sodium hypoclorite (NaOCl) is one of the most widely recommended and used endodontic irrigants but it is highly toxic to periapical tissues. OBJECTIVES To analyze the literature on the chemotherapeutic agent and plant extracts studied as root canal irrigants. In particularly, the study is focused on their effect on Enterococcus faecalis. METHOD Literature search was performed electronically in PubMed (PubMed Central, MEDLINE) for articles published in English from 1982 to April 2015. The searched keywords were "endodontic irrigants" and "Enterococcus faecalis" and "essential oil" and "plant extracts". RESULTS Many of the studied chemotherapeutic agents and plant extracts have shown promising results in vitro. CONCLUSION Some of the considered phytotherapic substances, could be a potential alternative to NaOCl for the biomechanical treatment of the endodontic space.
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Affiliation(s)
- Letizia Borzini
- Department of Clinical Science and Translational Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Roberta Condò
- Department of Clinical Science and Translational Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Paolo De Dominicis
- Department of Clinical Science and Translational Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Adriano Casaglia
- Department of Clinical Science and Translational Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Loredana Cerroni
- Department of Clinical Science and Translational Medicine, University of Rome "Tor Vergata", Rome, Italy
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Hongyan L, Jian X, Baorong Z, Yue J, Minhua L, Yilang L, Jing Z. [Accidental injection of sodium hypochlorite in inferior alveolar nerve block anesthesia]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2016; 34:657-658. [PMID: 28318172 DOI: 10.7518/hxkq.2016.06.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Sodium hypochlorite (NaClO) has been widely used in clinical practice as one of the most efficient root canal irrigants. Its properties include broad-spectrum antimicrobial activity and ability to dissolve necrotic tissues. However, when used improperly, NaClO can cause a series of adverse reactions, such as mucosal inflammation, irritation, or injury. This paper presents a case of accidental injection of NaClO in inferior alveolar nerve block anesthesia.
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Affiliation(s)
- Li Hongyan
- Dept. of Dental Center, Aviation General Hospital of China Medical University, Beijing Institute of Translation Medicine, China Academy of Science, Beijing 100012, China;School of Stomatology, Weifang Medical University, Weifang 261053, China
| | - Xu Jian
- Dept. of Dental Center, Aviation General Hospital of China Medical University, Beijing Institute of Translation Medicine, China Academy of Science, Beijing 100012, China
| | - Zhang Baorong
- Dept. of Dental Center, Aviation General Hospital of China Medical University, Beijing Institute of Translation Medicine, China Academy of Science, Beijing 100012, China
| | - Jia Yue
- Dept. of Dental Center, Aviation General Hospital of China Medical University, Beijing Institute of Translation Medicine, China Academy of Science, Beijing 100012, China
| | - Liu Minhua
- Dept. of Dental Center, Aviation General Hospital of China Medical University, Beijing Institute of Translation Medicine, China Academy of Science, Beijing 100012, China
| | - Luo Yilang
- Dept. of Dental Center, Aviation General Hospital of China Medical University, Beijing Institute of Translation Medicine, China Academy of Science, Beijing 100012, China
| | - Zhao Jing
- Dept. of Dental Center, Aviation General Hospital of China Medical University, Beijing Institute of Translation Medicine, China Academy of Science, Beijing 100012, China
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Syed M, Chopra R, Sachdev V. Allergic Reactions to Dental Materials-A Systematic Review. J Clin Diagn Res 2015; 9:ZE04-9. [PMID: 26557634 PMCID: PMC4625353 DOI: 10.7860/jcdr/2015/15640.6589] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Accepted: 08/24/2015] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Utility of various dental materials ranging from diagnosis to rehabilitation for the management of oral diseases are not devoid of posing a potential risk of inducing allergic reactions to the patient, technician and dentist. This review aims to develop a systematic approach for the selection and monitoring of dental materials available in the market thereby giving an insight to predict their risk of inducing allergic reactions. MATERIALS AND METHODS Our data included 71 relevant articles which included 60 case reports, 8 prospective studies and 3 retrospective studies. The source of these articles was Pub Med search done with the following terms: allergies to impression materials, sodium hypochlorite, Ledermix paste, zinc oxide eugenol, formaldehyde, Latex gloves, Methyl methacrylate, fissure sealant, composites, mercury, Nickel-chromium, Titanium, polishing paste and local anaesthesia. All the relevant articles and their references were analysed. The clinical manifestations of allergy to different dental materials based on different case reports were reviewed. RESULTS After reviewing the literature, we found that the dental material reported to cause most adverse reactions in patients is amalgam and the incidence of oral lichenoid reactions adjacent to amalgam restorations occur more often than other dental materials. CONCLUSION The most common allergic reactions in dental staff are allergies to latex, acrylates and formaldehyde. While polymethylmethacrylates and latex trigger delayed hypersensitivity reactions, sodium metabisulphite and nickel cause immediate reactions. Over the last few years, due to the rise in number of patients with allergies from different materials, the practicing dentists should have knowledge about documented allergies to known materials and thus avoid such allergic manifestations in the dental clinic.
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Affiliation(s)
- Meena Syed
- Post Graduate Student, Department of Pedodontics, ITS-CDSR Centre for Dental studies and Research, Muradnagar, Ghaziabad, Uttar Pradesh, India
| | - Radhika Chopra
- Associate Professor, Department of Pedodontics and Preventive Dentistry, ITS-CDSR Centre for Dental studies and Research, Muradnagar, Ghaziabad, Uttar Pradesh, India
| | - Vinod Sachdev
- Professor, HOD and Principal, Department of Pedodontics and Preventive Dentistry, ITS-CDSR Centre for Dental studies and Research, Muradnagar, Ghaziabad, Uttar Pradesh, India
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Inadvertent apical extrusion of sodium hypochlorite with evaluation by dental volumetric tomography. Case Rep Dent 2015; 2015:247547. [PMID: 25883812 PMCID: PMC4390169 DOI: 10.1155/2015/247547] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Revised: 03/10/2015] [Accepted: 03/15/2015] [Indexed: 11/18/2022] Open
Abstract
This case report describes the tissue injury caused by inadvertently extruded NaOCl through the apical constriction. A 56-year-old female patient with complaints of pain, swelling, and ecchymosis on the left side of her face was referred to our clinic. The symptoms had emerged following root canal treatment of the maxillary left first premolar, and a soft tissue complication due to apical extrusion of NaOCl was diagnosed. Antibiotics and analgesics were prescribed. DVT images revealed that the buccal root apex had perforated the maxillary bone. The patient was followed up every other day and became asymptomatic on the 10th day. Endodontic therapy was completed with routine procedures. Determining working length precisely and following irrigation protocols meticulously are indispensable to prevent this type of complication. 3D visualization of the affected area may reveal the cause of the incident.
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15
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Hatton J, Walsh S, Wilson A. Management of the sodium hypochlorite accident: a rare but significant complication of root canal treatment. BMJ Case Rep 2015; 2015:bcr-2014-207480. [PMID: 25809429 DOI: 10.1136/bcr-2014-207480] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
A 66-year-old female patient presented to the accident and emergency department, 3 h following a dental appointment. Significant right-sided facial swelling, bruising and pain were present. The patient had been sent by her general dental practitioner with a covering letter explaining that a hypochlorite accident had occurred during root canal treatment of the upper right first premolar tooth. An iatrogenic perforation was suspected. The patient was admitted under the care of the maxillofacial team and intravenous antibiotics, analgesia and steroids were administered. The patient was prepared for the possibility of requiring surgical intervention under a general anaesthetic. No nerve injury was encountered and the periorbital tissues were spared. A full recovery was made by the patient with no surgical intervention required but significant bruising and swelling were present up to 4 weeks following the incident.
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Affiliation(s)
- Jonathan Hatton
- Department of Maxillofacial Unit, Western Sussex Hospital's Trust, Chichester, West Sussex, UK
| | - Stephen Walsh
- Department of Maxillofacial Unit, Western Sussex Hospital's Trust, Chichester, West Sussex, UK
| | - Alan Wilson
- Department of Maxillofacial Unit, Western Sussex Hospital's Trust, Chichester, West Sussex, UK
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16
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Kumar ND, Kalluru RS, Ahmed S, Abhilashini A, Jayaprakash T, Garlapati R, Sowmya B, Reddy KN. Comparison of the Antibacterial Efficacy of Manuka Honey Against E.faecalis and E.coli - An In vitro Study. J Clin Diagn Res 2014; 8:ZC29-31. [PMID: 25302263 PMCID: PMC4190789 DOI: 10.7860/jcdr/2014/9676.4738] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2014] [Accepted: 06/12/2014] [Indexed: 11/24/2022]
Abstract
AIM To compare the antibacterial efficacy of Manuka honey against E.faecalis and E.coli. MATERIALS AND METHODS Escherichia coli (ATCC-25922) and Enterococcus faecalis (ATCC-29212) were separately inoculated in the nutrient broth and incubated at 37(o)C for 24-48 hrs. Bacterial samples were kept in contact with each disinfectant solution for varying intervals of time. Once the test time had elapsed 10μL of the bacterial dilutions were plated on Mueller-Hinton agar and incubated for 24-48 hrs at 37°C to estimate the density. Study of the disinfection process with respect to time and Modeling was done. RESULTS The mean value of the antimicrobial activity of Manuka honey against E.coli and E.faecalis are 1.55 and 0.36 respectively and are relatively higher. It shows that there is a significant difference among the various root canal disinfectant groups against E. coli and E. feacalis. (p<0.001) CONCLUSION: Manuka honey is shown to be a potential root canal disinfectant against gram positive and gram negative bacterial pathogens.
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Affiliation(s)
- N Deepak Kumar
- Senior Lecturer, Department of Conservative Dentistry and Endodontics, RVS College of Dental Sciences, Coimbatore, Tamil Nadu, India
| | - Rama S Kalluru
- Senior Lecturer, Department of Conservative Dentistry and Endodontics, Sibar Institute of Dental Sciences, Guntur, Andhra Pradesh, India
| | - Shafie Ahmed
- Professor, Department of Conservative Dentistry and Endodontics, Raja Muthaiah Dental College, Chidambaram, Tamil Nadu, India
| | - A Abhilashini
- Senior Lecturer, Department of Pedodontics, RVS College of Dental Sciences, Coimbatore, Tamil Nadu, India
| | - Thumu Jayaprakash
- Professor, Department of Conservative Dentistry and Endodontics, St.Joseph Dental College, Eluru, Andhra Pradesh, India
| | - Roopadevi Garlapati
- Senior Lecturer, Department of Conservative Dentistry and Endodontics, Kamineni Institute of Dental Sciences, Narketpally, Andhra Pradesh, India
| | - Butti Sowmya
- Lecturer, Department of Pedodontics, at Sibar Institute of Dental Sciences, Guntur, Andhra Pradesh, India
| | - K Narasimha Reddy
- Reader, Department of Conservative Dentistry and Endodontics, Sibar Institute of Dental Sciences, Guntur, India
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17
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Regalado Farreras DC, Puente CG, Estrela C. Sodium Hypochlorite Chemical Burn in an Endodontist's Eye during Canal Treatment Using Operating Microscope. J Endod 2014; 40:1275-9. [DOI: 10.1016/j.joen.2014.01.026] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Revised: 01/08/2014] [Accepted: 01/16/2014] [Indexed: 11/28/2022]
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18
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Zarra T, Lambrianidis T. Skin reactions amongst Greek endodontists: a national questionnaire survey. Int Endod J 2014; 48:390-8. [DOI: 10.1111/iej.12327] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Accepted: 05/28/2014] [Indexed: 11/28/2022]
Affiliation(s)
- T. Zarra
- Department of Endodontology; Dental School; Aristotle University of Thessaloniki; Thessaloniki Greece
| | - T. Lambrianidis
- Department of Endodontology; Dental School; Aristotle University of Thessaloniki; Thessaloniki Greece
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19
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Kaufman AY, Solomonov M, Galieva D, Abbott PV. Allergic reaction to the tetracycline component of Ledermix paste: a case report. Int Endod J 2014; 47:1090-7. [DOI: 10.1111/iej.12252] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Accepted: 01/18/2014] [Indexed: 11/29/2022]
Affiliation(s)
- A. Y. Kaufman
- Endodontics and Dental Traumatology Department; Graduate School of Dentistry; Rambam Health Care Campus; Haifa Israel
| | - M. Solomonov
- Department of Endodontics; Sheba Hospital; Tel Hashomer Israel
| | - D. Galieva
- Department of Therapeutic Stomatology; Moscow State University of Medicine and Dentistry; Moscow Russia
| | - P. V. Abbott
- School of Dentistry; The University of Western Australia; Perth WA Australia
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20
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Eldeniz AU, Guneser MB, Akbulut MB. Comparative antifungal efficacy of light-activated disinfection and octenidine hydrochloride with contemporary endodontic irrigants. Lasers Med Sci 2013; 30:669-75. [PMID: 23884903 DOI: 10.1007/s10103-013-1387-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Accepted: 07/01/2013] [Indexed: 11/24/2022]
Abstract
The aim of this study was to evaluate the antifungal effects of light-activated disinfection (LAD) in comparison with contemporary root canal irrigation solutions: sodium hypochlorite and 2% chlorhexidine gluconate and a new wound antiseptic, octenidine hydrochloride. Seventy extracted teeth having single root canals were contaminated with Candida albicans for 14 days. The samples were divided into five experimental (n = 10) and two control (positive and negative) groups (n = 10): (1) LAD with toluidine blue O, (2) octenidine hydrochloride (OCT), (3) 2.5% sodium hypochlorite (2.5% NaOCl), (4) 5.25% sodium hypochlorite (5.25% NaOCl) and (5) 2% chlorhexidine. Five millilitres of each test solution was applied for 3 min, and irradiation time used for LAD was 30 s. After treatment, the dentin chips were collected from inner canal walls into vials containing phosphate buffered saline, vortexed, serially diluted, seeded on Tryptic Soy Agar plates and incubated (37 °C, 48 h). The number of colony-forming units was then counted. Differences between LAD group and positive control group were statistically significant (P < 0.05). All Candida cells were totally eliminated in root canals irrigated with OCT, 2.5% NaOCl, 5.25% NaOCl and 2% chlorhexidine groups (CFU = 0). Within the limitations of this ex vivo study, LAD had minimal antimicrobial effect on C. albicans when used 30 s, and further modifications in LAD protocol are required to improve its antifungal capability. A new wound antiseptic, octenidine hydrochloride, demonstrated better potential than LAD in elimination of Candida albicans cells and may be a promising alternative to NaOCl and chlorhexidine solutions in future.
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Affiliation(s)
- Ayce Unverdi Eldeniz
- Department of Endodontics, Faculty of Dentistry, University of Selcuk, Konya, Turkey
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21
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Mallineni SK, Nuvvula S, Matinlinna JP, Yiu CK, King NM. Biocompatibility of various dental materials in contemporary dentistry: a narrative insight. ACTA ACUST UNITED AC 2012; 4:9-19. [PMID: 23255468 DOI: 10.1111/j.2041-1626.2012.00140.x] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2012] [Accepted: 03/08/2012] [Indexed: 11/27/2022]
Abstract
In the past few decades, there has been an increase in demand for safety evaluation and control of dental materials used daily in dentistry; however, this task is difficult and cumbersome. Dental materials that are passive and do not react with the oral environment will be more stable and have superior durability. It is expected that dental materials will be universally accepted and will not cause harm or injury to the surrounding structures in the oral cavity. This is an entirely negative approach to the material tolerance and biocompatibility, and hides the possibility that some positive gains can be achieved. Side-effects of dental materials are believed to be rare, and generally, those that have been reported are mild. There are wide varieties of materials used in dentistry, which include liners, irrigants, intracanal filling materials, intracanal medicaments, prosthetic materials, restorative materials, subgingival implants, and mouth rinses. Therefore, in this study, the biocompatibility of various commonly-used clinical materials used in contemporary dentistry was discussed.
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Affiliation(s)
- Sreekanth K Mallineni
- Department of Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Pokfulam, Hong Kong.
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22
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Shin HS, Yang WK, Kim MR, Ko HJ, Cho KM, Park SH, Kim JW. Accuracy of Root ZX in teeth with simulated root perforation in the presence of gel or liquid type endodontic irrigant. Restor Dent Endod 2012; 37:149-54. [PMID: 23431125 PMCID: PMC3569399 DOI: 10.5395/rde.2012.37.3.149] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2012] [Revised: 06/22/2012] [Accepted: 07/09/2012] [Indexed: 12/02/2022] Open
Abstract
Objectives To evaluate the accuracy of the Root ZX in teeth with simulated root perforation in the presence of gel or liquid type endodontic irrigants, such as saline, 5.25% sodium hypochlorite (NaOCl), 2% chlorhexidine liquid, 2% chlorhexidine gel, and RC-Prep, and also to determine the electrical conductivities of these endodontic irrigants. Materials and Methods A root perforation was simulated on twenty freshly extracted teeth by means of a small perforation made on the proximal surface of the root at 4 mm from the anatomic apex. Root ZX was used to locate root perforation and measure the electronic working lengths. The results obtained were compared with the actual working length (AWL) and the actual location of perforations (AP), allowing tolerances of 0.5 or 1.0 mm. Measurements within these limits were considered as acceptable. Chi-square test or the Fisher's exact test was used to evaluate significance. Electrical conductivities of each irrigant were also measured with an electrical conductivity tester. Results The accuracies of the Root ZX in perforated teeth were significantly different between liquid types (saline, NaOCl) and gel types (chlorhexidine gel, RC-Prep). The accuracies of electronic working lengths in perforated teeth were higher in gel types than in liquid types. The accuracy in locating root perforation was higher in liquid types than gel types. 5.25% NaOCl had the highest electrical conductivity, whereas 2% chlorhexidine gel and RC-Prep gel had the lowest electrical conductivities among the five irrigants. Conclusions Different canal irrigants with different electrical conductivities may affect the accuracy of the Root ZX in perforated teeth.
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Affiliation(s)
- Hyeong-Soon Shin
- Department of Conservative Dentistry, Ulsan University Asan Medical Center, Seoul, Korea
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23
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Bosch-Aranda ML, Canalda-Sahli C, Figueiredo R, Gay-Escoda C. Complications following an accidental sodium hypochlorite extrusion: A report of two cases. J Clin Exp Dent 2012; 4:e194-8. [PMID: 24558554 PMCID: PMC3917647 DOI: 10.4317/jced.50767] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2011] [Accepted: 01/05/2012] [Indexed: 11/27/2022] Open
Abstract
Sodium hypochlorite (NaOCl) is the most commonly used solution in root canal treatments, as it is a low-cost method that displays a very effective antimicrobial activity against microbiota of infected root canals. However, this solution can cause complications especially due to its cytotoxic features. When this solution is injected into the adjacent tissues, the patient usually experiences intense pain, and an urgent treatment should be implemented in order to prevent a long-term sequelae.
This paper describes the clinical features of two patients that experienced an accidental extrusion of NaOCl after endodontic treatment of varying severity and with different treatments. Furthermore, it shows the long-term neurologic injuries that this type of accidents may cause and a treatment protocol for these situations will be suggested.
Key words:Nerve damage, root canal irrigation, root canal treatment, sodium hypochlorite.
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Affiliation(s)
- María L Bosch-Aranda
- DDS. Fellow of the Postgraduate Oral Surgery and Orofacial Implantology, School of Dentistry, University of Barcelona (Spain)
| | - Carlos Canalda-Sahli
- DDS, MD, PhD. Professor of Endodontics, School of Dentistry, University of Barcelona (Spain). Researcher of the IDIBELL Institute. Barcelona (Spain)
| | - Rui Figueiredo
- DDS. Associate Professor of Oral Surgery. Professor of the Master of Oral Surgery and Orofacial Implantology. School of Dentistry of the University of Barcelona. Researcher of the IDIBELL Institute. Barcelona (Spain)
| | - Cosme Gay-Escoda
- DDS, MD, PhD. Chairman and Professor of Oral and Maxillofacial Surgery. Director of the Master of Oral Surgery and Orofacial Implantology. School of Dentistry of the University of Barcelona. Coordinator/Researcher of the IDIBELL Institute. Oral and Maxillofacial Surgeon of the Teknon Medical Center, Barcelona (Spain)
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Tirali RE, Bodur H, Ece G. In vitro antimicrobial activity of sodium hypochlorite, chlorhexidine gluconate and octenidine dihydrochloride in elimination of microorganisms within dentinal tubules of primary and permanent teeth. Med Oral Patol Oral Cir Bucal 2012; 17:e517-22. [PMID: 22143724 PMCID: PMC3476099 DOI: 10.4317/medoral.17566] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2011] [Accepted: 04/24/2011] [Indexed: 11/24/2022] Open
Abstract
The aim of this study was to evaluate the effectiveness of different irrigation solutions at different time intervals for the elimination of E.faecalis and C.albicans penetrated into the dentine tubules of primary and permanent teeth in vitro.
The 4 mm primary and permanent teeth sections were sterilized and contaminated with a mixture of E.faecalis and C.albicans strains. After the application of different irrigation solutions (Sodium hypochlorite, Chlorhexidine gluconate, Octenidine Dihydrochloride, saline) to the contaminated tooth sections according to study groups, neutralizers were applied for inactivation of the solutions after 30 sec, 1 min and 5 min. Dentine shavings were placed into TSB and 10µL from each tube was inoculated on agar plates, followed by an incubation period of 24h at 37°C. The colonies were counted macroscopically. The results were compared by using Kruskal-Wallis and Mann Whitney U tests, with a significance level at p<0.05.
Among the irrigation solutions that were tested against E.faecalis on primary and permanent teeth, the most effective one was found as 5-minute application of 0.1% Octenidine Dihydrochloride. The antibacterial effects of the tested solutions on the same time periods against C.albicans revealed no significant difference.
There were no statistically significant differences between primary and permanent teeth with respect to the antimicrobial activity of the tested solutions. Moreover, Octenidine Dihydrochloride may be used as an alternative endodontic irrigant.
Key words:Chlorhexidine gluconate, dentine tubules, irrigation solutions, Octenidine Dihydrochloride, Sodium hypochlorite.
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Affiliation(s)
- Resmiye-Ebru Tirali
- Department of Pediatric Dentistry, Faculty of Dentistry, University of Baskent, Ankara, Turkey.
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25
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Tirali RE, Bodur H, Sipahi B, Sungurtekin E. Evaluation of the antimicrobial activities of chlorhexidine gluconate, sodium hypochlorite and octenidine hydrochloride in vitro. AUST ENDOD J 2010; 39:15-8. [PMID: 23551508 DOI: 10.1111/j.1747-4477.2010.00266.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The objective of this study was to compare the antimicrobial activity of sodium hypochlorite (NaOCl), chlorhexidine gluconate (CHX) and octenidine hydrochloride (OCT) in different concentrations against endodontic pathogens in vitro. Agar diffusion procedure was used to determine the antimicrobial activity of the tested materials. Enterococcus faecalis, Candida albicans and the mixture of these were used for this study. In the agar diffusion test, 5.25% NaOCl exhibited better antimicrobial effect than the other concentrations of NaOCl for all strains. All concentrations of OCT were effective against C. albicans and E. faecalis. Some 0.2% CHX was ineffective on all microorganisms. Antibacterial effectiveness of all experimental solutions decreased on the mixture of all strains. Decreasing concentrations of NaOCl resulted in significantly reduced antimicrobial effect.
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Affiliation(s)
- Resmiye E Tirali
- Department of Pediatric Dentistry, Faculty of Dentistry, University of Baskent, Ankara, Turkey.
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26
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Hope CK, Garton SG, Wang Q, Burnside G, Farrelly PJ. A direct comparison between extracted tooth and filter-membrane biofilm models of endodontic irrigation using Enterococcus faecalis. Arch Microbiol 2010; 192:775-81. [PMID: 20652229 DOI: 10.1007/s00203-010-0604-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2010] [Revised: 06/21/2010] [Accepted: 07/03/2010] [Indexed: 11/26/2022]
Abstract
Endodontic restorations often fail due to inadequate disinfection of the root canal even though the antimicrobial irrigants used have been shown to be capable of killing the bacterium frequently implicated in this complication, Enterococcus faecalis (Ef). Extracted human teeth were root-prepared and filled with a liquid culture of Ef. Following incubation, the root canals were irrigated with 1% sodium hypochlorite (NaOCl), electrochemically activated water or saline control. Irrigation was modelled using an electronic pipette to deliver the solutions at a reproducible flow velocity. A series of parallel experiments employed a membrane biofilm model that was directly immersed into irrigant. Experimental conditions where contiguous between the extracted tooth model and biofilm model wherever possible. After 60 s of exposure, 1% NaOCl effectively sterilised the biofilm model, whereas log 3.36 viable Ef where recoverable from the analogous extracted tooth model, the other irrigants proved ineffective. Biofilms of Ef were susceptible to concentrations of irrigant that proved ineffective in the tooth model. NaOCl was the most effective biocide in either case. This suggests that the biofilm modality of bacterial growth may not be the most important factor for the recalcitrance of root canal infections during endodontic irrigation; it is more likely due to the inability of the irrigant to access the infection.
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Affiliation(s)
- Christopher K Hope
- School of Dental Sciences, University of Liverpool, Liverpool L69 3GN, UK.
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27
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Tirali RE, Turan Y, Akal N, Karahan ZC. In vitro antimicrobial activity of several concentrations of NaOCl and Octenisept in elimination of endodontic pathogens. ACTA ACUST UNITED AC 2009; 108:e117-20. [DOI: 10.1016/j.tripleo.2009.07.012] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2009] [Revised: 07/03/2009] [Accepted: 07/06/2009] [Indexed: 11/30/2022]
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Kuştarci A, Sümer Z, Altunbaş D, Koşum S. Bactericidal effect of KTP laser irradiation against Enterococcus faecalis compared with gaseous ozone: an ex vivo study. ACTA ACUST UNITED AC 2009; 107:e73-9. [PMID: 19426912 DOI: 10.1016/j.tripleo.2009.01.048] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2008] [Revised: 01/21/2009] [Accepted: 01/28/2009] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The objective of this study was to evaluate the antimicrobial activity of potassium-titanyl-phosphate (KTP) laser and gaseous ozone in experimentally infected root canals. STUDY DESIGN Eighty single-rooted teeth with straight canals were selected. After preparation and sterilization, the specimens were inoculated with 10 microL Enterococcus faecalis for 24 hours at 37 degrees C. The contaminated roots were divided into 2 experimental groups, 1 negative control group, and 1 positive control group of 20 teeth each: Group 1, KTP laser group; Group 2, gaseous ozone group; Group 3, sodium hypochlorite group (NaOCl) (negative control); and Group 4, saline group (positive control). Sterile paper points used to sample bacteria from the root canals were transferred to tubes containing 5 mL of brain heart infusion broth. Then 10-microL suspension was inoculated onto blood agar plates. The colonies of bacteria were counted and data were analyzed statistically using Kruskal-Wallis 1-way analysis of variance and Mann-Whitney U tests. RESULTS There were statistically significant differences between all groups (P < .05). The saline group had the highest number of remaining microorganisms. Complete sterilization was achieved in the 2.5% NaOCl group. The KTP laser and gaseous ozone did not completely sterilize the root canals. CONCLUSION Both KTP laser and gaseous ozone have a significant antibacterial effect on infected root canals, with the gaseous ozone being more effective than the KTP laser. However, 2.5% NaOCl was superior in its antimicrobial abilities compared with KTP laser and gaseous ozone.
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Affiliation(s)
- Alper Kuştarci
- Cumhuriyet University, School of Dentistry, Department of Endodontics, Sivas, Turkey.
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29
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de Sermeño RF, da Silva LAB, Herrera H, Herrera H, Silva RAB, Leonardo MR. Tissue damage after sodium hypochlorite extrusion during root canal treatment. ACTA ACUST UNITED AC 2009; 108:e46-9. [PMID: 19442541 DOI: 10.1016/j.tripleo.2008.12.024] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2008] [Accepted: 12/17/2008] [Indexed: 11/17/2022]
Abstract
Sodium hypochlorite solution is toxic to vital tissues, causing severe effects if extruded during endodontic treatment. This paper presents a report on the tissue damage related to inadvertent extrusion of concentrated sodium hypochlorite solution during root canal treatment. A 65-year-old woman was referred with moderate pain, ecchymosis, and severe swelling of the right side of the face. These symptoms appeared immediately after a root canal treatment of the maxillary right canine, which had been started 21 hours earlier. It was diagnosed as air emphysema related to sodium hypochlorite solution extravasation during the endodontic treatment. To avoid this, an initial radiograph should be taken to determine the correct canal working length and confirm root canal integrity.
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Affiliation(s)
- Ruth Fuentes de Sermeño
- Department of Pediatric Dentistry, Preventive and Community Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
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Motta MV, Chaves-Mendonca MAL, Stirton CG, Cardozo HF. Accidental injection with sodium hypochlorite: report of a case. Int Endod J 2009; 42:175-82. [PMID: 19134046 DOI: 10.1111/j.1365-2591.2008.01493.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
AIM A case is reported in which sodium hypochlorite (NaOCl) was mistaken for anaesthetic solution and infiltrated into the buccal mucosa during routine root canal treatment. SUMMARY A 1.5% sodium hypochlorite solution, kept in an anaesthetic cartridge, was inadvertently injected in the buccal mucosa of a 56-year-old female during routine root canal treatment. Soft tissue necrosis, labial ptosis and paraesthesia occurred shortly after the injection. Tissues healed with scarring and lip paraesthesia persisted for 3 years. KEY LEARNING POINTS * NaOCl is highly irritant when introduced into oral tissues. * NaOCl solutions should not be kept in anaesthetic cartridges. * Accidents with NaOCl should be carefully assessed and when appropriate active hospital treatment should be sought. * Early recognition of NaOCl accidents may avert potentially more serious outcomes.
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Affiliation(s)
- M V Motta
- Faculdade de Odontologia, Departamento de Odontologia Social, Universidade de São Paulo, São Paulo, Brazil
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31
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Pelka M, Petschelt A. Permanent mimic musculature and nerve damage caused by sodium hypochlorite: a case report. ACTA ACUST UNITED AC 2008; 106:e80-3. [DOI: 10.1016/j.tripleo.2008.05.003] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2008] [Accepted: 05/02/2008] [Indexed: 11/26/2022]
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Evaluation of Morinda citrifolia as an Endodontic Irrigant. J Endod 2008; 34:66-70. [DOI: 10.1016/j.joen.2007.09.016] [Citation(s) in RCA: 87] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2007] [Revised: 09/24/2007] [Accepted: 09/28/2007] [Indexed: 11/22/2022]
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34
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Spencer HR, Ike V, Brennan PA. Review: the use of sodium hypochlorite in endodontics — potential complications and their management. Br Dent J 2007; 202:555-9. [PMID: 17496870 DOI: 10.1038/bdj.2007.374] [Citation(s) in RCA: 102] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2006] [Indexed: 11/09/2022]
Abstract
Aqueous sodium hypochlorite (bleach) solution is widely used in dental practice during root canal treatment. Although it is generally regarded as being very safe, potentially severe complications can occur when it comes into contact with soft tissue. This paper discusses the use of sodium hypochlorite in dental treatment, reviews the current literature regarding hypochlorite complications, and considers the appropriate management for a dental practitioner when faced with a potentially adverse incident with this agent.
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Oliveira DP, Barbizam JVB, Trope M, Teixeira FB. In vitro antibacterial efficacy of endodontic irrigants against Enterococcus faecalis. ACTA ACUST UNITED AC 2007; 103:702-6. [PMID: 17368057 DOI: 10.1016/j.tripleo.2006.11.007] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2006] [Revised: 10/31/2006] [Accepted: 11/04/2006] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The objective of this study was to compare the in vitro antimicrobial activity of 2% chlorhexidine gel against Enterococcus faecalis with sodium hypochlorite in 2 different concentrations (1.5% and 5.25%). STUDY DESIGN Eighty human lower premolars with single root canals were prepared, autoclaved, and infected for 7 days with E. faecalis monocultures. The roots were then separated into 5 experimental groups according to the irrigant solution used during the standardized preparation. To assess the antimicrobial action of the irrigant solutions, 3 microbial samples were taken: S1--initial (before the biomechanical preparation), S2--posttreatment (immediately after the biomechanical preparation), and S3--final (7 days after the biomechanical preparation). The microbiological samples were plated to count the colony-forming units (CFU). RESULTS The 2% chlorhexidine gel and 5.25% sodium hypochlorite significantly reduced the E. faecalis CFU in the posttreatment and final microbiological samples. The 1.5% sodium hypochlorite also reduced the E. faecalis CFU immediately after the root canal instrumentation, but the E. faecalis CFU increased in the final sample showing no statistical difference from the control group. CONCLUSION The 2% chlorhexidine gluconate gel and 5.25% sodium hypochlorite were effective in eliminating E. faecalis even 7 days after the instrumentation; moreover, the higher the concentration of sodium hypochlorite the better its antimicrobial action.
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Affiliation(s)
- Daniel P Oliveira
- University of North Carolina School of Dentistry, Chapel Hill, NC, USA
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36
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HÜLSMANN MICHAEL, RÖDIG TINA, NORDMEYER SABINE. Complications during root canal irrigation. ACTA ACUST UNITED AC 2007. [DOI: 10.1111/j.1601-1546.2009.00237.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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37
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Murray PE, Garcia-Godoy F, Hargreaves KM. Regenerative endodontics: a review of current status and a call for action. J Endod 2007; 33:377-90. [PMID: 17368324 DOI: 10.1016/j.joen.2006.09.013] [Citation(s) in RCA: 507] [Impact Index Per Article: 29.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2006] [Revised: 09/10/2006] [Accepted: 09/18/2006] [Indexed: 12/16/2022]
Abstract
Millions of teeth are saved each year by root canal therapy. Although current treatment modalities offer high levels of success for many conditions, an ideal form of therapy might consist of regenerative approaches in which diseased or necrotic pulp tissues are removed and replaced with healthy pulp tissue to revitalize teeth. Researchers are working toward this objective. Regenerative endodontics is the creation and delivery of tissues to replace diseased, missing, and traumatized pulp. This review provides an overview of regenerative endodontics and its goals, and describes possible techniques that will allow regenerative endodontics to become a reality. These potential approaches include root-canal revascularization, postnatal (adult) stem cell therapy, pulp implant, scaffold implant, three-dimensional cell printing, injectable scaffolds, and gene therapy. These regenerative endodontic techniques will possibly involve some combination of disinfection or debridement of infected root canal systems with apical enlargement to permit revascularization and use of adult stem cells, scaffolds, and growth factors. Although the challenges of introducing endodontic tissue engineering therapies are substantial, the potential benefits to patients and the profession are equally ground breaking. Patient demand is staggering both in scope and cost, because tissue engineering therapy offers the possibility of restoring natural function instead of surgical placement of an artificial prosthesis. By providing an overview of the methodological issues required to develop potential regenerative endodontic therapies, we hope to present a call for action to develop these therapies for clinical use.
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Affiliation(s)
- Peter E Murray
- Department of Endodontics, College of Dental Medicine, Nova Southeastern University, Fort Lauderdale, FL 33328, USA.
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38
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Gursoy UK, Bostanci V, Kosger HH. Palatal mucosa necrosis because of accidental sodium hypochlorite injection instead of anaesthetic solution. Int Endod J 2006; 39:157-61. [PMID: 16454797 DOI: 10.1111/j.1365-2591.2006.01067.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIM A case is reported in which sodium hypochlorite (NaOCl) was inadvertently injected into the palatal mucosa instead of local anaesthetic solution. SUMMARY An adult male was referred to the University clinic 15 days after an inadvertent NaOCl injection into the palatal mucosa. Soft tissue necrosis was evident, without obvious bony involvement. Tissues healed without scarring within 30 days. No surgical intervention was required. KEY LEARNING POINTS NaOCl is highly irritant when extruded into vital tissues.--Dentists should be careful to avoid the misuse of NaOCl, and should check the nature of any agent before injecting it into patients.--NaOCl should not be dispensed in a way that could allow it to be mistaken for local anaesthetic solutions.--The well-perfused tissues of the oral cavity have considerable healing ability.
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Affiliation(s)
- U K Gursoy
- Faculty of Dentistry, Department of Periodontology, Cumhuriyet University, 58140 Sivas, Turkey.
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Abstract
A case of accidental skin injury caused by leakage of sodium hypochlorite solution from the rubber dam during root canal preparation is reported. After placement of a rubber dam and initiation of root canal treatment, the patient complained of a burning sensation with sodium hypochlorite irrigation. The complaints were ignored by the practitioner, and a skin rash developed on and around the patient's chin, followed by scab formation. The patient required medical treatment with topical Hamamelis virginiana extract for 2 weeks, with full recovery.
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Affiliation(s)
- Ahmet Serper
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
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42
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Ercan E, Ozekinci T, Atakul F, Gül K. Antibacterial Activity of 2% Chlorhexidine Gluconate and 5.25% Sodium Hypochlorite in Infected Root Canal: In Vivo Study. J Endod 2004; 30:84-7. [PMID: 14977302 DOI: 10.1097/00004770-200402000-00005] [Citation(s) in RCA: 120] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
In this study, the antibacterial activity of the different antibacterial solutions using as root canal irrigant was compared in the teeth with pulpal necrosis and with periapical pathosis. Thirty root canals of incisors and premolars of 20 patients were used. Before and after the root canal preparation, two canal samples were obtained by a harvesting method using a sterile paper point in the first appointment. During the biomechanical preparation, both irrigant solutions were used for each tooth which were randomly divided into two groups. Last samples were also obtained before the root filling procedure. Samples obtained from the root canals were subjected to microbiologic processing, including anaerobic incubation on trypticase soy agar for 5 to 7 days. After counting of CFU on the plates, we concluded that both chlorhexidine gluconate and sodium hypochlorite were significantly effective to reduce the microorganisms in the teeth with necrotic pulp, periapical pathologies, or both, and could be used successfully as an irrigant solution.
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Affiliation(s)
- Ertuğrul Ercan
- Dental Faculty, Department of Operative Dentistry, University of Dicle, Diyarbakir City, Turkey.
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43
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Vianna ME, Gomes BPFA, Berber VB, Zaia AA, Ferraz CCR, de Souza-Filho FJ. In vitro evaluation of the antimicrobial activity of chlorhexidine and sodium hypochlorite. ACTA ACUST UNITED AC 2004; 97:79-84. [PMID: 14716261 DOI: 10.1016/s1079-2104(03)00360-3] [Citation(s) in RCA: 189] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The aim of this study was to investigate in vitro the antimicrobial activity of 0.2%, 1%, and 2% chlorhexidine gluconate (CHX gel and CHX liquid), against endodontic pathogens and compare the results with the ones achieved by 0.5%, 1%, 2.5%, 4%, and 5.25% sodium hypochlorite (NaOCl). A broth dilution test was performed, and the timing for irrigants to kill microbial cells was recorded and statistically analyzed. Both 2.0% gel and liquid formulations eliminated Staphylococcus aureus and Candida albicans in 15 seconds, whereas the gel formulation killed Enterococcus faecalis in 1 minute. All tested irrigants eliminated Porphyromonas endodontalis, Porphyromonas gingivalis, and Prevotella intermedia in 15 seconds. The timing required for 1.0% and 2.0% CHX liquid to eliminate all microorganisms was the same required for 5.25% NaOCl. The antimicrobial action is related to type, concentration, and presentation form of the irrigants as well as the microbial susceptibility.
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Affiliation(s)
- Morgana Eli Vianna
- Department of Restorative Dentistry, Piracicaba Dental School, State University of Campinas, SP, Brazil
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44
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45
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Weber CD, McClanahan SB, Miller GA, Diener-West M, Johnson JD. The Effect of Passive Ultrasonic Activation of 2% Chlorhexidine or 5.25% Sodium Hypochlorite Irrigant on Residual Antimicrobial Activity in Root Canals. J Endod 2003; 29:562-4. [PMID: 14503827 DOI: 10.1097/00004770-200309000-00005] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Ninety-four single-canal roots were prepared using the step-down technique. Forty-two canals were irrigated with 2% chlorhexidine, 42 canals with 5.25% sodium hypochlorite (NaOCl), and 10 control canals with phosphate-buffered saline (PBS). The chlorhexidine and NaOCl groups were each then equally divided into a final irrigation group and a 1-min passive ultrasonic irrigation group. Canals were enlarged with a Parapost drill. The apical 3-5 mm was covered with nail polish. Canals were rinsed with PBS, dried, refilled with PBS, and stored. At 6 h, 20 microl of fluid was pipetted from each canal and placed into wells on agar plates, which were inoculated with Streptococcus sanguinis. The plates were incubated, and zones of inhibition were measured. Sampling was repeated at 24, 48, 72, 96, 120, 144, and 168 h. Residual antimicrobial activity with 2% chlorhexidine was statistically significantly superior to 5.25% NaOCl with irrigation alone and with final passive ultrasonic activation (p < 0.001). Chlorhexidine experimental groups demonstrated residual antimicrobial activity for as long as 168 h.
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Abstract
Eusol (an abbreviation for Edinburgh University solution), consisting of aqueous boric acid and calcium hypochlorite, is widely used in the management of open wounds left to heal by secondary intention (1).
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47
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Ferguson DB, Marley JT, Hartwell GR. The effect of chlorhexidine gluconate as an endodontic irrigant on the apical seal: long-term results. J Endod 2003; 29:91-4. [PMID: 12597704 DOI: 10.1097/00004770-200302000-00001] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The purpose of this study was to determine whether chlorhexidine gluconate (0.12%), used as an endodontic irrigating solution, would affect the apical seal of three root canal cements. One hundred, extracted, human, single-canal teeth were divided into 9 experimental groups of 10 teeth each, in addition to a positive and negative control group of 5 teeth each. The teeth were decoronated at the level of the CEJ, accessed, instrumented to a Master apical file #50, irrigated with either sterile saline, 5.25% NaOCl, or 0.12% chlorhexidine gluconate, and dried using paper points. Obturation was accomplished using lateral condensation and one of three endodontic sealers: Roth's 811, AH 26, or Sealapex. Postobturation apical leakage was measured at 270- and 360-day observation periods using the fluid filtration method. Using the mixed-model repeated-measures ANOVA test with Tukey's honest significance difference multiple comparison procedure, the results showed the saline-Sealapex combination had significantly more leakage (p < 0.05) than either the Peridex-Sealapex or saline-Roth's combinations at 270 days. No other significant differences were noted between any sealer-irrigant combination at 270 days. The saline-Sealapex combination had significantly more leakage than the saline-Roth's combination at 360 days. No other significant differences were noted at 360 days. Under the conditions of this study, chlorhexidine gluconate irrigant did not adversely affect the apical seal of three root canal cements at 270 and 360 days.
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48
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Hauman CHJ, Love RM. Biocompatibility of dental materials used in contemporary endodontic therapy: a review. Part 1. Intracanal drugs and substances. Int Endod J 2003; 36:75-85. [PMID: 12657150 DOI: 10.1046/j.1365-2591.2003.00631.x] [Citation(s) in RCA: 84] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Irrigation solutions and intracanal medicaments are used within the root canal to clean and aid in disinfecting the dentinal walls. Although these materials are intended to be contained within the root canal, they invariably contact the periapical tissues, either through inadvertent extrusion through the apex or leaching. This paper is a review on the methodology involved in biocompatibility testing followed by a discussion on biocompatibility of contemporary intracanal drugs and substances used in endodontics.
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Affiliation(s)
- C H J Hauman
- Department of Oral Rehabilitation, School of Dentistry, University of Otago, Dunedin, New Zealand.
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49
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Marley JT, Ferguson DB, Hartwell GR. Effects of chlorhexidine gluconate as an endodontic irrigant on the apical seal: short-term results. J Endod 2001; 27:775-8. [PMID: 11771589 DOI: 10.1097/00004770-200112000-00016] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The aim of this study was to ascertain whether chlorhexidine gluconate (0.12%), used as an endodontic irrigating solution would affect the apical seal obtained when using three different root canal cements. One hundred extracted human single-canal teeth were divided into 9 experimental groups of 10 teeth each and a positive and negative group of 5 teeth each. The teeth were decoronated at the level of the cementoenamel junction, then accessed, instrumented to a Master Apical File #50, irrigated with either sterile saline, 5.25% NaOCl or 0.12% chlorhexidine gluconate, and dried using paper points. Obturation was accomplished using lateral condensation and 1 of 3 endodontic sealers: Roth's 811, AH26, or Sealapex. At 90 and 180 days after obturation apical leakage was measured using the fluid filtration method. Using the ANOVA test the results showed no significant difference in seal related to the irrigant at both the 90- and 180-day observation periods.
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Affiliation(s)
- J T Marley
- Department of Endodontics, Virginia Commonwealth University School of Dentistry, Richmond 23298-0566, USA
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50
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Gomes BP, Ferraz CC, Vianna ME, Berber VB, Teixeira FB, Souza-Filho FJ. In vitro antimicrobial activity of several concentrations of sodium hypochlorite and chlorhexidine gluconate in the elimination of Enterococcus faecalis. Int Endod J 2001; 34:424-8. [PMID: 11556507 DOI: 10.1046/j.1365-2591.2001.00410.x] [Citation(s) in RCA: 287] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
AIM The aim of this study was to assess, in vitro, the effectiveness of several concentrations of NaOCl (0.5%, 1%, 2.5%, 4% and 5.25%) and two forms of chlorhexidine gluconate (gel and liquid) in three concentrations (0.2%, 1% and 2%) in the elimination of E. faecalis. METHODOLOGY A broth dilution test using 24-well cell culture plates was performed and the time taken for the irrigants to kill bacterial cells was recorded. Isolated 24 h colonies of pure cultures of E. faecalis grown on 10% sheep blood plus Brain Heart Infusion (BHI) agar plates were suspended in sterile 0.85% NaCI solution. The cell suspension was adjusted spectrophotometrically to match the turbidity of a McFarland 0.5 scale. One mL of each tested substance was placed on the bottom of wells of 24-well cell culture plates (Corning, NY), including the control group (sterile saline). Six wells were used for each time period and irrigant concentration. Two mL of the bacterial suspension were ultrasonically mixed for 10 s with the irrigants and placed in contact with them for 10, 30, and 45 s; 1, 3, 5, 10, 20, and 30 min; and 1 and 2 h. After each period of time, 1 mL from each well was transferred to tubes containing 2 mL of freshly prepared BHI + neutralizers in order to prevent a residual action of the irrigants. All tubes were incubated at 37 degrees C for 7 days. The tubes considered to have positive growth were those which presented medium turbidity during the incubation period. Data were analysed statistically by the Kruskal-Wallis test. with the level of significance set at P < 0.05. RESULTS All irrigants were effective in killing E. faecalis. but at different times. Chlorhexidine in the liquid form at all concentrations tested (0.2%, 1% and 2%) and NaOCI (5.25%) were the most effective irrigants. However, the time required by 0.2% chlorhexidine liquid and 2% chlorhexidine gel to promote negative cultures was only 30 s and 1 min, respectively. CONCLUSIONS Even though all tested irrigants possessed antibacterial activity, the time required to eliminate E. faecalis depended on the concentration and type of irrigant used.
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Affiliation(s)
- B P Gomes
- Endodontic Unit, School of Dentistry of Piracicaba, State University of Campinas-UNICAMP, SP, Brazil.
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