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Shan T, Li Y, Ren B, Xian W, Chen D, Guo X, Li B, Cheng L. Dodecylmethylaminoethyl methacrylate inhibits Enterococcus faecalis in a pH-dependent manner. Dent Mater 2024; 40:1658-1668. [PMID: 39089903 DOI: 10.1016/j.dental.2024.07.030] [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: 06/21/2024] [Revised: 07/24/2024] [Accepted: 07/26/2024] [Indexed: 08/04/2024]
Abstract
OBJECTIVES Considering the correlation between survival microenvironment of E. faecalis and acidic pH value, this study aimed to investigate the potential of utilizing pH-responsive DMAEM monomers and their copolymers with resin-based root canal sealers to inhibit E. faecalis. METHODS Broth microdilution assay, crystal violet staining and qPCR were performed to evaluate antibacterial effects of DMAEM monomers against E. faecalis at different pH. Methacrylate-resin based root canal sealers were prepared and copolymerized with DMAEM. The flow, solubility, water sorption, apical sealing ability and cytotoxicity of sealers were investigated to optimize formulation. The anti-E. faecalis effects of DMAEM copolymers with sealers were evaluated by direct contact test, colony-forming unit counting and live/dead staining. RESULTS DMAEM monomers inhibited the growth, biofilm formation and virulence factors expression of E. faecalis in a concentration- and pH-dependent manner. Incorporation of 1.25 % and 2.5 % DMAEM into experimental sealers would not affect the flowability, solubility and periapical sealing ability (P > 0.05), but increased the water sorption of sealers (P < 0.01). Cells viability was higher than 90 % in both 1.25 % and 2.5 % DMAEM groups at pH 7.0. DMAEM copolymers with sealers reduced E. faecalis counts, inhibited biofilm formation and decreased live cells within the biofilm in response to pH values. SIGNIFICANCE DMAEM monomers and their copolymers with resin-based sealers possessed antibacterial and antibiofilm effects on E. faecalis in response to pH values. DMAEM is promising to inhibit intraradicular E. faecalis in response to its acidic survival environment and maintain low cytotoxicity under neutral conditions, ensuring their biosafety in case of inadvertent entry into periapical tissues.
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Affiliation(s)
- Tiantian Shan
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & West China School of Stomatology, Sichuan University, Chengdu 610041, China; Department of Operative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Yiling Li
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & West China School of Stomatology, Sichuan University, Chengdu 610041, China; Department of Operative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Biao Ren
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & West China School of Stomatology, Sichuan University, Chengdu 610041, China
| | - Wenpan Xian
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & West China School of Stomatology, Sichuan University, Chengdu 610041, China; Department of Operative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Ding Chen
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & West China School of Stomatology, Sichuan University, Chengdu 610041, China
| | - Xiao Guo
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & West China School of Stomatology, Sichuan University, Chengdu 610041, China; Department of Operative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Bolei Li
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & West China School of Stomatology, Sichuan University, Chengdu 610041, China; Department of Operative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Lei Cheng
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & West China School of Stomatology, Sichuan University, Chengdu 610041, China; Department of Operative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China.
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Lee D, Im J, Kim AR, Jun W, Yun CH, Han SH. Enterococcus Phage vB_EfaS_HEf13 as an Anti-Biofilm Agent Against Enterococcus faecalis. J Microbiol 2024; 62:683-693. [PMID: 38935316 DOI: 10.1007/s12275-024-00150-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 05/29/2024] [Accepted: 05/31/2024] [Indexed: 06/28/2024]
Abstract
Enterococcus faecalis is a Gram-positive bacterium that is frequently found in the periapical lesion of patients with apical periodontitis. Its biofilm formation in root canal is closely related to the development of refractory apical periodontitis by providing increased resistance to endodontic treatments. Phage therapy has recently been considered as an efficient therapeutic strategy in controlling various periodontal pathogens. We previously demonstrated the bactericidal capacities of Enterococcus phage vB_EfaS_HEf13 (phage HEf13) against clinically-isolated E. faecalis strains. Here, we investigated whether phage HEf13 affects biofilm formation and pre-formed biofilm of clinically-isolated E. faecalis, and its combinatory effect with endodontic treatments, including chlorhexidine (CHX) and penicillin. The phage HEf13 inhibited biofilm formation and disrupted pre-formed biofilms of E. faecalis in a dose- and time-dependent manner. Interestingly, phage HEf13 destroyed E. faecalis biofilm exopolysaccharide (EPS), which is known to be a major component of bacterial biofilm. Furthermore, combined treatment of phage HEf13 with CHX or penicillin more potently inhibited biofilm formation and disrupted pre-formed biofilm than either treatment alone. Confocal laser scanning microscopic examination demonstrated that these additive effects of the combination treatments on disruption of pre-formed biofilm are mediated by relatively enhanced reduction in thickness distribution and biomass of biofilm. Collectively, our results suggest that the effect of phage HEf13 on E. faecalis biofilm is mediated by its EPS-degrading property, and its combination with endodontic treatments more potently suppresses E. faecalis biofilm, implying that phage HEf13 has potential to be used as a combination therapy against E. faecalis infections.
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Affiliation(s)
- Dongwook Lee
- Department of Oral Microbiology and Immunology, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, 08826, Republic of Korea
| | - Jintaek Im
- Department of Oral Microbiology and Immunology, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, 08826, Republic of Korea
| | - A Reum Kim
- Department of Oral Microbiology and Immunology, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, 08826, Republic of Korea
| | - Woohyung Jun
- Department of Oral Microbiology and Immunology, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, 08826, Republic of Korea
| | - Cheol-Heui Yun
- Department of Agricultural Biotechnology, and Research Institute of Agriculture and Life Sciences, Seoul National University, Seoul, 08826, Republic of Korea
- Institutes of Green-Bio Science and Technology, Seoul National University, Pyeongchang, 25354, Republic of Korea
| | - Seung Hyun Han
- Department of Oral Microbiology and Immunology, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, 08826, Republic of Korea.
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Al-Sadah AY, AlEraky DM, Abuohashish HM, Atmeh AR. Evaluation of the antimicrobial efficacy of different nonsteroidal anti-inflammatory drugs alone or in combination with calcium hydroxide intracanal medicament: an in vitro study. Odontology 2024; 112:826-838. [PMID: 38265514 DOI: 10.1007/s10266-023-00892-z] [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: 06/12/2023] [Accepted: 12/19/2023] [Indexed: 01/25/2024]
Abstract
This study explored the antimicrobial effects of ketoprofen, piroxicam, and celecoxib alone or combined with calcium hydroxide (CH) against two strains of Enterococcus faecalis (E. faecalis) and assessed the influence of such combinations on the pH of CH. Minimum inhibitory concentrations (MICs) of the three tested NSAIDs were determined. Tested pastes were placed into wells punched in seeded agar plates and the bacterial inhibition zones were measured. Antibiofilm activity was assessed against 3 weeks of biofilm induced in bovine dentine blocks. The pH of the pastes was measured at four-time intervals. MIC values were 3.12, 25, and 25 mg/ml for ketoprofen, piroxicam, and celecoxib, respectively, and were similar for both bacterial strains except for celecoxib, which showed 8% growth at the highest tested concentration against vancomycin-resistant E. faecalis. Ketoprofen had the largest mean inhibition zone that was comparable to CH. None of the six tested pastes exhibited antibiofilm activity of a significant level in comparison to CH. A noticeable increase in the antibiofilm activity was found when 20% NSAIDs were added to CH while maintaining an alkaline pH. Ketoprofen was found to be the most effective among the tested NSAIDs. Although its effect was comparable to CH, adding ketoprofen at a ratio of 20% resulted in 50% higher antimicrobial action than CH alone. Accordingly, incorporating NSAIDs in inter-appointment dressing has the potential to utilize their anti-inflammatory, local analgesic, and antibacterial actions, which overcome the limitations of CH and improve the outcome of root canal treatment.
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Affiliation(s)
- Attika Y Al-Sadah
- Fellowship in Endodontic Program, Department of Restorative Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, 31441, Dammam, Saudi Arabia.
| | - Doaa M AlEraky
- Department of Biomedical Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, 31441, Dammam, Saudi Arabia
- Department of Microbiology and Immunology, College of Medicine, Gulf Medical University (GMU), Ajman, United Arab Emirates
| | - Hatem M Abuohashish
- Department of Biomedical Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, 31441, Dammam, Saudi Arabia
| | - Amre R Atmeh
- Department of Restorative Dentistry, Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
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Thammasitboon K, Teanpaisan R, Pahumunto N. Prevalence and virulence factors of haemolytic Enterococcus faecalis isolated from root filled teeth associated with periradicular lesions: A laboratory investigation in Thailand. Int Endod J 2024; 57:769-783. [PMID: 38483342 DOI: 10.1111/iej.14059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 11/26/2023] [Accepted: 02/21/2024] [Indexed: 05/07/2024]
Abstract
AIM Previous endodontic research has provided limited understanding of the prevalence and roles of haemolytic and non-haemolytic Enterococcus faecalis strains in root filled teeth. This study aimed to determine the prevalence of these strains in root filled teeth with periradicular lesions and investigate their associated virulence factors. METHODOLOGY A total of 36 root canal samples were collected from 36 subjects. The prevalence of E. faecalis was determined using culture and PCR methods. Antibiotic susceptibility of haemolytic and non-haemolytic E. faecalis strains was assessed using the broth dilution assay. The cytokine stimulation in periodontal ligament (PDL) cells and neutrophil migration were evaluated using real-time PCR and migration assay, respectively. Cell invasion ability of the strains was assessed using a cell culture model. Additionally, the virulence gene expression of the haemolytic and non-haemolytic strains was investigated using real-time PCR. The Mann-Whitney U and Spearman's ρ tests were used to examine the significant difference between the two strains and to analyse the correlation between phenotype and gene expression, respectively. RESULTS Enterococcus faecalis was detected in 33.3% and 88.9% of samples by culture and real-time PCR, respectively. Haemolytic strains were found in 36.4% of subjects. Non-haemolytic strains exhibited susceptibility to erythromycin and varying susceptibility to tetracycline, while all haemolytic strains were resistant to both antibiotics. Haemolytic strains significantly upregulated the expression of IL-8, OPG and RANKL in PDL cells (p < .05). Notably, the fold increases in these genes were higher: IL-8 (556.1 ± 82.9 vs. 249.6 ± 81.8), OPG (2.2 ± 0.5 vs. 1.3 ± 0.2) and RANKL (1.8 ± 0.3 vs. 1.2 ± 0.1). Furthermore, haemolytic strains had a greater effect on neutrophil migration (68.7 ± 15.2% vs. 46.9 ± 11.4%) and demonstrated a higher level of internalization into oral keratinocyte cells (68.6 ± 0.4% vs. 33.8 ± 0.5%) (p < .05). They also showed enhanced expression of virulence genes associated with haemolysin, surface proteins, collagen-binding and aggregation substances. Gelatinase activity was only detectable in non-haemolytic strains. CONCLUSIONS This study revealed that haemolytic strains E. faecalis possessed enhanced abilities in host invasion and a higher abundance of virulence factors, suggesting their potential contribution to more severe disease manifestations.
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Affiliation(s)
- Kewalin Thammasitboon
- Department of Conservative Dentistry, Faculty of Dentistry, Prince of Songkla University, Hat Yai, Thailand
- Research Center of Excellence for Oral Health, Faculty of Dentistry, Prince of Songkla University, Hat Yai, Thailand
| | - Rawee Teanpaisan
- Research Center of Excellence for Oral Health, Faculty of Dentistry, Prince of Songkla University, Hat Yai, Thailand
| | - Nuntiya Pahumunto
- Research Center of Excellence for Oral Health, Faculty of Dentistry, Prince of Songkla University, Hat Yai, Thailand
- Department of Oral Diagnostic Sciences, Faculty of Dentistry, Prince of Songkla University, Hat Yai, Thailand
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Madla-Cruz E, Villanueva-Pérez VD, De la Garza-Ramos MA, Flores-Treviño JJ, Rodríguez-Delgado I, López-Martinez F. An in vitro evaluation of endodontic sealers and an antibiotic to assess their antimicrobial effect against Enterococcus faecalis. Biomater Investig Dent 2024; 11:40646. [PMID: 38903776 PMCID: PMC11187975 DOI: 10.2340/biid.v11.40646] [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: 09/06/2023] [Accepted: 04/12/2024] [Indexed: 06/22/2024] Open
Abstract
Objective This study aimed to compare the antimicrobial effect of three endodontic sealers (AH Plus, Mineral trioxide aggregate [MTA] Fillapex, and BioRoot RCS) with and without amoxicillin against E. faecalis. Methodology Amoxicillin, equivalent to 10% of the sealers' total weight, was mixed with the sealers. Another batch was prepared without amoxicillin. The direct contact test (DCT) and the agar diffusion test were used to assess the antibacterial effect. Results were analysed using one-way analysis of variance (ANOVA), the F-test, and the Kruskal-Wallis test. Results AH Plus significantly suppressed E. faecalis without the addition of amoxicillin in the DCT (p = 0.011), while in the agar diffusion test, BioRoot RCS had a larger inhibition zone than the control (p < 0.001). When amoxicillin was added to the sealers, AH Plus (p = 0.003) and MTA Fillapex (p = 0.042) reduced E. faecalis growth. In contrast, all three sealers showed larger inhibition zones than the control (p = 0.001), with AH Plus displaying a larger inhibition zone than MTA Fillapex (p = 0.042) and BioRoot RCS (p = 0.032). Conclusions It was thus concluded that the addition of amoxicillin to endodontic sealers enhances their antimicrobial activity against E. faecalis.
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Affiliation(s)
- Elizabeth Madla-Cruz
- Universidad Autónoma de Nuevo Leon, Facultad de Odontología, Calle Dr. Aguirre Pequeño and Silao, Colonia Mitras Centro, Monterrey, Nuevo Leon, Mexico CP 64460
| | - Vanascheck Dasaev Villanueva-Pérez
- Universidad Autónoma de Nuevo Leon, Facultad de Odontología, Calle Dr. Aguirre Pequeño and Silao, Colonia Mitras Centro, Monterrey, Nuevo Leon, Mexico CP 64460
| | - Myriam A. De la Garza-Ramos
- Universidad Autónoma de Nuevo Leon, Facultad de Odontología, Calle Dr. Aguirre Pequeño and Silao, Colonia Mitras Centro, Monterrey, Nuevo Leon, Mexico CP 64460
| | - Jorge Jaime Flores-Treviño
- Universidad Autónoma de Nuevo Leon, Facultad de Odontología, Calle Dr. Aguirre Pequeño and Silao, Colonia Mitras Centro, Monterrey, Nuevo Leon, Mexico CP 64460
| | - Idalia Rodríguez-Delgado
- Universidad Autónoma de Nuevo Leon, Facultad de Odontología, Calle Dr. Aguirre Pequeño and Silao, Colonia Mitras Centro, Monterrey, Nuevo Leon, Mexico CP 64460
| | - Fanny López-Martinez
- Universidad Autónoma de Nuevo Leon, Facultad de Odontología, Calle Dr. Aguirre Pequeño and Silao, Colonia Mitras Centro, Monterrey, Nuevo Leon, Mexico CP 64460
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Falcão NPDS, Marceliano-Alves MF, Tavares SJO, Amoroso-Silva P, Neves ADA, Bastos LF, Lopes RT, Dantas WCF, Galhardi MPW, Marceliano EFV, Gomes CC. Shaping Ability of TRUShape and XP-endo Shaper in C-Shaped Canals Using 3D-Printed Replicas: A Micro-CT Study. Eur J Dent 2024; 18:544-550. [PMID: 37729930 PMCID: PMC11132770 DOI: 10.1055/s-0043-1772568] [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: 09/22/2023] Open
Abstract
OBJECTIVE This study compared the shaping ability of TRUShape and XP-endo Shaper systems on C-shaped root canals replicas using microcomputed tomography (micro-CT). MATERIAL AND METHODS Thirty three-dimensional replicas based on a mandibular second molar classified as C1 type I C-shaped canal were randomly divided into two groups (n = 15): TRUShape (G.TRU) and XP-endo Shaper (G.XP) and instrumented with each system according to the manufacturer's instructions. Changes in volume and surface and the unprepared area of the root canal were measured by scanning on micro-CT before and after instrumentation. RESULTS The unprepared areas were 39% in the G.TRU and 43% in the G.XP group with no significant difference between them (p > 0.05), but both the tested systems left a high percentage of unprepared root canal walls of C-shaped root canals. CONCLUSION TRUShape and XP-endo Shaper showed a high rate of unprepared areas with similar results after C-shaped root canals replicas for root canal preparation.
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Affiliation(s)
- Natália Pereira da Silva Falcão
- Department of Dentistry, Health Institute of Nova Friburgo (PPGO-ISNF), Fluminense Federal University (UFF), Nova Friburgo, RJ, Brazil
| | | | - Sandro Junio Oliveira Tavares
- Department of Dentistry, Health Institute of Nova Friburgo (PPGO-ISNF), Fluminense Federal University (UFF), Nova Friburgo, RJ, Brazil
| | - Pablo Amoroso-Silva
- Department of Dentistry, University of Grande Rio (UNIGRANRIO), Duque de Caxias, RJ, Brazil
| | - Aline de Almeida Neves
- Department of Pediatric Dentistry and Orthodontics, Rio de Janeiro Federal University, Rio de Janeiro, RJ, Brazil
| | - Luan Ferreira Bastos
- Department of Nuclear Energy, Rio de Janeiro Federal University, Rio de Janeiro, RJ, Brazil
| | - Ricardo Tadeu Lopes
- Department of Nuclear Energy, Rio de Janeiro Federal University, Rio de Janeiro, RJ, Brazil
| | | | | | | | - Cinthya Cristina Gomes
- Department of Endodontics, Faculty of Dentistry, Iguaçu University (UNIG), Nova Iguaçu, RJ, Brazil
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Aviv S, Alin Y, Neta L, Yael H, Lada Z, Avia FN, Diana R, Moti M, David P. Elimination of E. faecalis with NaOCl versus chlorhexidine gluconate from primary molar root canal systems: an ex vivo model study. Clin Oral Investig 2024; 28:265. [PMID: 38652209 PMCID: PMC11039510 DOI: 10.1007/s00784-024-05621-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 03/13/2024] [Indexed: 04/25/2024]
Abstract
OBJECTIVES This ex vivo human study aimed to evaluate the efficacy of NaOCl and chlorhexidine gluconate (CHG) irrigations in eliminating Enterococcus faecalis from the RCS of primary molars. MATERIALS AND METHODS Disinfected extracted primary molars were inoculated with E. faecalis for 24 h. Then, the RCS samples were then irrigated with either 2.5% NaOCl, 0.2% and 2% CHG, or sham saline. The samples were collected immediately after irrigation; and 24 h later, the bacterial viability and counts were measured using blood agar and qRT-PCR, respectively. Histological sections were used to measure E. faecalis penetration and viability in dentin tubules using fluorescence microscopy. RESULTS The recovery of viable E. faecalis after the irrigation of the primary molars showed more significant bactericidal effects of NaOCl and 0.2% and 2% CHG than of saline. Immediately after the irrigation, the NaOCl group showed the greatest reduction in E. faecalis; and 24 h later, all the groups had lower viable E. faecalis than the saline control. The bacterial penetration was also lowest in the NaOCl group, although there was no difference in bacterial viability in the tubules between the groups. CONCLUSION In primary teeth, NaOCl and CHG showed similar degrees of bacterial elimination efficacy in terms of E.faecalis. CLINICAL RELEVANCE Within the limitations of this study, NaOCl and CHG have the similar ability to perform endodontic irrigation of primary ex vivo teeth regarding the elimination of E.faecalis, but NaOCl penetrates dentin tubules better.
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Affiliation(s)
- Shmueli Aviv
- Department of Pediatric Dentistry, Faculty of Dental Medicine, Hadassah Medical Center, Hebrew University, P.O. Box 12272, Jerusalem, 91120, Israel
| | - Yaya Alin
- "Bina" Program, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
- In private practice, Jerusalem, Israel
| | - Lam Neta
- Department of Pediatric Dentistry, Faculty of Dental Medicine, Hadassah Medical Center, Hebrew University, P.O. Box 12272, Jerusalem, 91120, Israel
| | - Haim Yael
- Department of Pediatric Dentistry, Faculty of Dental Medicine, Hadassah Medical Center, Hebrew University, P.O. Box 12272, Jerusalem, 91120, Israel
| | - Zamsky Lada
- Department of Pediatric Dentistry, Faculty of Dental Medicine, Hadassah Medical Center, Hebrew University, P.O. Box 12272, Jerusalem, 91120, Israel
| | - Fux Noy Avia
- Department of Pediatric Dentistry, Faculty of Dental Medicine, Hadassah Medical Center, Hebrew University, P.O. Box 12272, Jerusalem, 91120, Israel
| | - Ram Diana
- Department of Pediatric Dentistry, Faculty of Dental Medicine, Hadassah Medical Center, Hebrew University, P.O. Box 12272, Jerusalem, 91120, Israel
| | - Moskovitz Moti
- Department of Pediatric Dentistry, Faculty of Dental Medicine, Hadassah Medical Center, Hebrew University, P.O. Box 12272, Jerusalem, 91120, Israel
| | - Polak David
- Department of Periodontology, Faculty of Dental Medicine, Hadassah Medical Center, Hebrew University, Jerusalem, Israel.
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Hernández SR, Siqueira JF, Voigt DD, Soimu G, Brasil SC, Provenzano JC, Mdala I, Alves FRF, Rôças IN. Bacteriologic Conditions of the Apical Root Canal System of Teeth with and without Posttreatment Apical Periodontitis: A Correlative Multianalytical Approach. J Endod 2024; 50:154-163. [PMID: 37977217 DOI: 10.1016/j.joen.2023.11.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 11/09/2023] [Accepted: 11/09/2023] [Indexed: 11/19/2023]
Abstract
INTRODUCTION This study used a correlative multianalytical approach to investigate the bacteriologic conditions in the apical root canal system of treated teeth with or without apical periodontitis and their correlation with the technical quality of the previous root canal obturation and the presence and volume of apical periodontitis lesions. METHODS Root apexes were obtained from recently extracted root canal-treated teeth with (n = 23) and without (n = 22) apical periodontitis lesions as demonstrated by cone-beam computed tomographic examination. The root apexes were sectioned and subjected to micro-computed tomographic (micro-CT) scanning. The specimens were cryopulverized, and DNA extracted from the powder was used as a template in real-time polymerase chain reaction assays to quantify total bacteria and members of the Streptococcus genus and Actinobacteria phylum. The bacteriologic findings were compared between the 2 groups and also evaluated for associations with cone-beam computed tomographic and micro-computed tomographic data. RESULTS Bacteria were detected in all apical canal samples except 1. The mean counts of total bacteria, streptococci, and actinobacteria did not differ significantly between teeth with or without apical periodontitis (P > .05). Streptococcus levels were significantly lower by 80% in the apical canals of teeth with small lesions compared with those without lesions (P < .05). The limit of filling >2 mm short was significantly associated with more total bacterial counts compared with canals filled 0-2 mm short (P < .05). An adequate coronal restoration was significantly associated with lesser counts of Streptococcus (P < .05). CONCLUSIONS Comparable bacterial loads were observed in the apical canal system of treated teeth with and without apical periodontitis, suggesting that factors other than only the total bacterial levels may also influence the development and progression of apical periodontitis. Bacteria were found in the apical canal in virtually all cases with a high prevalence of streptococci and actinobacteria. Streptococci counts were significantly higher in the apical canal of teeth with inadequate restorations and teeth with no lesions. Underfilled canals showed higher bacterial counts.
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Affiliation(s)
- Sandra R Hernández
- Postgraduate Program in Dentistry, University of Grande Rio, Rio de Janeiro, Rio de Janeiro, Brazil; Department of Endodontics, Faculty of Dentistry, Francisco Marroquín University, Guatemala City, Guatemala
| | - José F Siqueira
- Postgraduate Program in Dentistry, University of Grande Rio, Rio de Janeiro, Rio de Janeiro, Brazil; Department of Dental Research, Faculty of Dentistry, Iguaçu University, Nova Iguaçu, Rio de Janeiro, Brazil
| | - Danielle D Voigt
- Postgraduate Program in Dentistry, University of Grande Rio, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Giuliana Soimu
- Postgraduate Program in Dentistry, University of Grande Rio, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Sabrina C Brasil
- Postgraduate Program in Dentistry, University of Grande Rio, Rio de Janeiro, Rio de Janeiro, Brazil
| | - José C Provenzano
- Postgraduate Program in Dentistry, University of Grande Rio, Rio de Janeiro, Rio de Janeiro, Brazil; Department of Dental Research, Faculty of Dentistry, Iguaçu University, Nova Iguaçu, Rio de Janeiro, Brazil
| | - Ibrahimu Mdala
- Department of General Practice, University of Oslo, Oslo, Norway
| | - Flávio R F Alves
- Postgraduate Program in Dentistry, University of Grande Rio, Rio de Janeiro, Rio de Janeiro, Brazil; Department of Dental Research, Faculty of Dentistry, Iguaçu University, Nova Iguaçu, Rio de Janeiro, Brazil.
| | - Isabela N Rôças
- Postgraduate Program in Dentistry, University of Grande Rio, Rio de Janeiro, Rio de Janeiro, Brazil; Department of Dental Research, Faculty of Dentistry, Iguaçu University, Nova Iguaçu, Rio de Janeiro, Brazil
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Jakkrawanpithak P, Powattanasuk W, Sooppapipatt N, Pudla M, Srimaneekarn N, Buranachad N, Yuma S, Supa-Amornkul S. Efficacy of antiseptics for rubber dam sterilization prior to endodontic treatment. J Oral Sci 2024; 66:5-8. [PMID: 37853618 DOI: 10.2334/josnusd.23-0136] [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: 10/20/2023]
Abstract
PURPOSE This study investigated the efficacy of various antiseptics for disinfection of rubber dams used during endodontic treatment, the duration of disinfection effectiveness, and the disinfection protocol employed by dental schools in Thailand. METHODS The efficacy of 10% povidone-iodine, 1.5% tincture iodine and 70% ethyl alcohol in eliminating Enterococcus faecalis (E. faecalis) and Candida albicans (C. albicans) on the rubber dam was investigated. Time duration of disinfection was evaluated at 0, 30, 60, and 120 min. The two-step disinfection method adopted at Thai dental school was examined. Independent t-test or Kruskal-Wallis followed by a Dunnett's test was used for statistical analysis. RESULTS Among the three antiseptics, 10% povidone and 1.5% tincture iodine eradicated the microorganisms completely, whereas 70% ethyl alcohol did not achieve a statistically significant decrease. The duration of sterilization effectiveness was 120 min for 10% povidone-iodine, but bacteria were eliminated only at 0 min by 1.5% tincture iodine. The results also indicated that the two-step protocol scarcely eliminated the microorganisms. CONCLUSION The best antiseptic for rubber dam disinfection is 10% povidone-iodine, which remains effective for 120 min. The two-step protocol typically practiced in Thai dental schools needs to be updated. The use of 10% povidone-iodine alone is adequate for complete eradication of E. faecalis and C. albicans.
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Affiliation(s)
| | - Wifada Powattanasuk
- Mahidol International Dental School, Faculty of Dentistry, Mahidol University
| | | | - Matsayapan Pudla
- Department of Oral Microbiology, Faculty of Dentistry, Mahidol University
| | | | - Naiyana Buranachad
- Department of Advance General Dentistry, Faculty of Dentistry, Mahidol University
| | - Suraphong Yuma
- Department of Physics, Faculty of Science, Mahidol University
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10
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Jiang W, Zhang Y, Yan J, He Z, Chen W. Differences of protein expression in enterococcus faecalis biofilm during resistance to environmental pressures. Technol Health Care 2024; 32:371-383. [PMID: 38759062 PMCID: PMC11307051 DOI: 10.3233/thc-248033] [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] [Indexed: 05/19/2024]
Abstract
BACKGROUND Enterococcus faecalis biofilm was frequently found on the failed treated root canal wall, which survived by resisting disinfectant during endodontic treatment.Many researches have been conducted to explore the mechanisms of persistence of this pathogen in unfavorable conditions. However, no comprehensive proteomics studies have been conducted to investigate stress response in Enterococcus faecalis caused by alkali and NaOCl. OBJECTIVE Enterococcus faecalis (E.f) has been recognized as a main pathogen of refractory apical periodontitis, its ability to withstand environmental pressure is the key to grow in the environment of high alkaline and anti-bacterial drug that causes chronic infection in the root canal. This study aims to focus on the protein expression patterns of E.f biofilm under extreme pressure environment". METHODS Enterococcus faecalis biofilm model was established in vitro. Liquid Chromatograph-Mass Spectrometer (LC-MS/MS)-based label free quantitative proteomics approach was applied to compare differential protein expression under different environmental pressures (pH 10 and 5% sodium hypochlorite (NaOCl)). And then qPCR and Parallel Reaction Monitoring Verification (PRM) were utilized to verify the consequence of proteomics. RESULTS The number of taxa in this study was higher than those in previous studies, demonstrating the presence of a remarkable number of proteins in the groups of high alkaline and NaOCl. Proteins involved in ATP-binding cassette (ABC) transporter were significantly enriched in experimental samples. We identified a total of 15 highly expressed ABC transporters in the high alkaline environment pressure group, with 7 proteins greater than 1.5 times. CONCLUSIONS This study revealed considerable changes in expression of proteins in E.f biofilm during resistance to environmental pressures. The findings enriched our understanding of association between the differential expression proteins and environmental pressures.
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Affiliation(s)
- Wei Jiang
- Department of Stomatology, Shanghai Hudong Hospital, Shanghai, China
| | - Youmeng Zhang
- Department of Stomatology, Shanghai Hudong Hospital, Shanghai, China
- Department of Stomatology, Eye and Ent Hospital of Fudan University, Shanghai, China
| | - Jie Yan
- Department of Stomatology, Shanghai Hudong Hospital, Shanghai, China
| | - Zhiyan He
- Shanghai Research Institute of Stomatology, Ninth People’s Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Weixu Chen
- Department of Stomatology, Eye and Ent Hospital of Fudan University, Shanghai, China
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11
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Ahlat M, Aydin C, Kaya S, Baysallar M. Identification of root canal microbiota profiles of periapical tissue diseases using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Anaerobe 2023; 84:102791. [PMID: 37925063 DOI: 10.1016/j.anaerobe.2023.102791] [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: 05/08/2023] [Revised: 10/20/2023] [Accepted: 10/23/2023] [Indexed: 11/06/2023]
Abstract
OBJECTIVES The purpose of this study was to identify microorganisms isolated from various periapical tissue diseases using Matrix-Assisted Laser Desorption Ionization Time-of-Flight Mass Spectrometry (MALDI-TOF-MS) and classify them via an unsupervised machine learning approach. METHODS A total of 150 patients with various apical conditions and teeth in need of endodontic retreatment were divided into five groups, including Retreatment, Acute Apical Abscess, Chronic Apical Abscess, Acute Apical Periodontitis, and Chronic Apical Periodontitis. Samples were collected from root canals using paper points after agitating with a #10 K file then microorganisms were identified using MALDI-TOF-MS. Data were analyzed using a hierarchical clustering method. Quadruple clusters and dendrograms were formed according to similarities and dissimilarities. RESULTS A total of 80 species were identified representative of six different phyla. The most similar microorganism species identified were: ''Enterococcus faecalis'' between 21 and 23-year-old female cases in Retreatment group; ''Lactobacillus rhamnosus'' between 20 and 18-year-old male cases in Symptomatic Apical Abscess cases; ''Lactobacillus paracasei'' between 26 and 40-year-old male cases in Asymptomatic Apical Abscess cases; ''Enterococcus faecalis'' between 48 and 50-year-old female cases in Symptomatic Apical Periodontitis cases; ''Lactobacillus rhamnosus'' between 48 and 60-year-old male cases in Asymptomatic Apical Periodontitis cases. CONCLUSIONS MALDI-TOF MS can be considered a fast and high-throughput screening technique for microbial species identification in endodontics. Thus, it will provide valuable data for future research designs regarding periapical tissue diseases. As the MALDI-TOF MS database expands and comprehensive data becomes available, the relationship between microbial profiles and disease progression will become increasingly apparent.
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Affiliation(s)
- Mete Ahlat
- University of Health Sciences, Gulhane Faculty of Dentistry, Department of Endodontics, Ankara, Turkey.
| | - Cumhur Aydin
- University of Health Sciences, Gulhane Faculty of Dentistry, Department of Endodontics, Ankara, Turkey.
| | - Sinem Kaya
- University of Health Sciences, Gulhane Faculty of Medicine, Department of Medical Microbiology, Ankara, Turkey.
| | - Mehmet Baysallar
- University of Health Sciences, Gulhane Faculty of Medicine, Department of Medical Microbiology, Ankara, Turkey.
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12
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Hu Q, Li T, Yang J, Peng Y, Liu Q, Liu N. Efficacy of photodynamic therapy in the treatment of oral candidiasis: a systematic review and meta-analysis. BMC Oral Health 2023; 23:802. [PMID: 37884914 PMCID: PMC10605952 DOI: 10.1186/s12903-023-03484-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 10/03/2023] [Indexed: 10/28/2023] Open
Abstract
OBJECTIVE To evaluate the clinical efficacy of photodynamic therapy (PDT) as an adjunct or alternative to traditional antifungal drugs in the treatment of oral candidiasis, and to provide evidence-based medical evidence for its use in the treatment of oral candidiasis. METHODS Computer combined with manual retrieval of China Academic Journals Full-text Database (CNKI), China Biomedical Literature Database (CBM), Chinese Science and Technology Journal Database (VIP), Wanfang Database, PubMed, Web of Science, Cochrane Library, Embase, Scopus retrieval for articles published before January 2023, basic information and required data were extracted according to the inclusion and exclusion criteria, and the Revman V5.4 software was used to conduct Meta-analysis of the included literature. RESULTS A total of 11 articles were included, 7 of which used nystatin as an antifungal drug, 2 of which were combined treatment of PDT and nystatin, 2 of the remaining 4 articles were treated with fluconazole, and 2 were treated with miconazole. Meta results showed that PDT was superior to nystatin in reducing the number of oral candida colonies in the palate of patients MD = -0.87, 95%CI = (-1.52,-0.23), P = 0.008, the difference was statistically significant, and the denture site MD = -1.03, 95%CI = (-2.21, -0.15), P = 0.09, the difference was not statistically significant; compared with the efficacy of fluconazole, RR = 1.01, 95%CI = (0.56,1.83), P = 0.96; compared with miconazole RR = 0.55, 95%CI = (0.38, 0.81), P = 0.002; PDT combined with nystatin RR = 1.27, 95%CI = (1.06, 1.52), P = 0.01; recurrence rate RR = 0.28, 95%CI = (0.09, 0.88), P = 0.03. CONCLUSIONS PDT was effective in the treatment of oral candidiasis; PDT was more effective than nystatin for the treatment of denture stomatitis in the palate, while there was no significant difference between the two for the denture site; The efficacy of PDT for oral candidiasis was similar to that of fluconazole; PDT was less effective than miconazole for oral candidiasis; Compared with nystatin alone, the combination of PDT and nystatin is more effective in treating oral candidiasis with less risk of recurrence.
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Affiliation(s)
- Qiaoyu Hu
- Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, School and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, 050017, China
| | - Ting Li
- Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, School and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, 050017, China
| | - Jiadi Yang
- Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, School and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, 050017, China
| | - Yanhui Peng
- Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, School and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, 050017, China
| | - Qing Liu
- Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, School and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, 050017, China.
| | - Na Liu
- Department of Preventive Dentistry, School and Hospital of Stomatology, Hebei Medical University, No. 383, Zhongshan East Road, Shijiazhuang, 050017, PR China.
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13
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Elashiry MM, Bergeron BE, Tay FR. Enterococcus faecalis in secondary apical periodontitis: Mechanisms of bacterial survival and disease persistence. Microb Pathog 2023; 183:106337. [PMID: 37683835 DOI: 10.1016/j.micpath.2023.106337] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 09/03/2023] [Accepted: 09/05/2023] [Indexed: 09/10/2023]
Abstract
Enterococcus faecalis is a commensal bacterium commonly found in the human gastrointestinal tract. However, in individuals with compromised immune systems, the pathogen can lead to severe illness. This opportunistic pathogen is associated with secondary apical diseases and is adept at resisting antibiotics and other forms of treatment because of its numerous virulence factors. Enterococcus faecalis is capable of disrupting the normal functions of immune cells, thereby hindering the body's ability to eradicate the infection. However, intensive research is needed in further understanding the adverse immunomodulatory effects of E. faecalis. Potential strategies specific for eradicating E. faecalis have proven beneficial in the treatment of persistent secondary apical periodontitis.
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Affiliation(s)
- Mohamed M Elashiry
- Department of Endodontics, Dental College of Georgia, Augusta University, Georgia, USA; Department of Endodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt.
| | - Brian E Bergeron
- Department of Endodontics, Dental College of Georgia, Augusta University, Georgia, USA
| | - Franklin R Tay
- Department of Endodontics, Dental College of Georgia, Augusta University, Georgia, USA
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14
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De Sarkar M, Mala K, Shenoy Mala S, Kabekkodu SP, Natarajan S, Shetty N, Madhav Kamath P, Thomas M. Antimicrobial efficacy of Kerr pulp canal sealer (EWT) in combination with 10% amoxicillin on Enterococcus faecalis: A confocal laser scanning microscopic study. F1000Res 2023; 12:725. [PMID: 37521769 PMCID: PMC10382784 DOI: 10.12688/f1000research.132047.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/10/2023] [Indexed: 04/02/2024] Open
Abstract
Background: Sealers with antimicrobial properties play an important role in endodontic therapy success especially against Enterococcus faecalis infection found in failed root canal therapy. Addition of antibiotic agents to endodontic sealers may show significant increase in their antibacterial properties both against anaerobic and aerobic microbes. The purpose of the present study was to evaluate antimicrobial efficacy of Kerr pulp canal sealer (EWT) in combination with 10% amoxicillin against E. faecalis and post-root canal treatment viability of Enterococcus faecalis on the first and seventh day. Methods: A total of 60 extracted human mandibular premolar teeth were decoronated after initial decontamination with 1% NaOCl. Root length standardized to 12 mm. Canal instrumentation was done using ProTaper Universal file system till size F2 using 5.25% NaOCl. It was then infected with a pure strain of E. faecalis for a period of four days. Obturation was done using plain sealer, (n=30) and sealer-antibiotic combination, (n=30). Half of the teeth were sectioned at 24 hours (S, SA) and other half were sectioned seven days after obturation (S7, SA7). All samples were stained with SYTO9 and propidium iodide for imaging under Confocal Laser Scanning microscope. Statistical analysis was performed with the statistical software SPSS v. 17.0 (SPSS for Windows; SPSS Inc, Chicago, IL). Data was analysed using One Way ANOVA and post hoc Tukey test to determine statistical significance with p value < 0.01 considered significant. Results: Statistically significant differences were observed in green to red ratio between group S (9.561976) and S7 (0.435418) (p < 0.01). There was no difference found between SA (mean of green to red ratio, (0.70431) and SA7 (mean of green to red ratio, 0.85184). Conclusions: Antibiotics added to the sealer effectively eradicated of E. faecalis 24 hours post-obturation. However, after seven days, plain sealer was as effective as sealer-antibiotic combination.
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Affiliation(s)
- Madhureema De Sarkar
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 575001, India
| | - Kundabala Mala
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 575001, India
| | - Suchitra Shenoy Mala
- Department of Microbiology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 575001, India
| | - Shama Prasada Kabekkodu
- Department of Cell and Molecular Biology, School of Life Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Srikant Natarajan
- Department of Oral Pathology and Microbiology, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 575001, India
| | - Neeta Shetty
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 575001, India
| | - Priyanka Madhav Kamath
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 575001, India
| | - Manuel Thomas
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 575001, India
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15
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De Sarkar M, Mala K, Shenoy Mala S, Kabekkodu SP, Natarajan S, Shetty N, Madhav Kamath P, Thomas M. Antimicrobial efficacy of Kerr pulp canal sealer (EWT) in combination with 10% amoxicillin on Enterococcus faecalis: A confocal laser scanning microscopic study. F1000Res 2023; 12:725. [PMID: 37521769 PMCID: PMC10382784 DOI: 10.12688/f1000research.132047.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/10/2023] [Indexed: 08/01/2023] Open
Abstract
Background: Sealers with antimicrobial properties play an important role in endodontic therapy success especially against Enterococcus faecalis infection found in failed root canal therapy. Addition of antibiotic agents to endodontic sealers may show significant increase in their antibacterial properties both against anaerobic and aerobic microbes. The purpose of the present study was to evaluate antimicrobial efficacy of Kerr pulp canal sealer (EWT) in combination with 10% amoxicillin against E. faecalis and post-root canal treatment viability of Enterococcus faecalis on the first and seventh day. Methods: A total of 60 extracted human mandibular premolar teeth were decoronated after initial decontamination with 1% NaOCl. Root length standardized to 12 mm. Canal instrumentation was done using ProTaper Universal file system till size F2 using 5.25% NaOCl. It was then infected with a pure strain of E. faecalis for a period of four days. Obturation was done using plain sealer, (n=30) and sealer-antibiotic combination, (n=30). Half of the teeth were sectioned at 24 hours (S, SA) and other half were sectioned seven days after obturation (S7, SA7). All samples were stained with SYTO9 and propidium iodide for imaging under Confocal Laser Scanning microscope. Statistical analysis was performed with the statistical software SPSS v. 17.0 (SPSS for Windows; SPSS Inc, Chicago, IL). Data was analysed using One Way ANOVA and post hoc Tukey test to determine statistical significance with p value < 0.01 considered significant. Results: Statistically significant differences were observed in green to red ratio between group S (9.561976) and S7 (0.435418) (p < 0.01). There was no difference found between SA (mean of green to red ratio, (0.70431) and SA7 (mean of green to red ratio, 0.85184). Conclusions: Antibiotics added to the sealer effectively eradicated of E. faecalis 24 hours post-obturation. However, after seven days, plain sealer was as effective as sealer-antibiotic combination.
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Affiliation(s)
- Madhureema De Sarkar
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 575001, India
| | - Kundabala Mala
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 575001, India
| | - Suchitra Shenoy Mala
- Department of Microbiology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 575001, India
| | - Shama Prasada Kabekkodu
- Department of Cell and Molecular Biology, School of Life Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Srikant Natarajan
- Department of Oral Pathology and Microbiology, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 575001, India
| | - Neeta Shetty
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 575001, India
| | - Priyanka Madhav Kamath
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 575001, India
| | - Manuel Thomas
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 575001, India
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16
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Seghayer I, Lee AHC, Cheung GSP, Zhang C. Effect of Passive Ultrasonic Irrigation, Er,Cr:YSGG Laser, and Photon-Induced Photoacoustic Streaming against Enterococcus faecalis Biofilms in the Apical Third of Root Canals. Bioengineering (Basel) 2023; 10:bioengineering10040490. [PMID: 37106677 PMCID: PMC10135464 DOI: 10.3390/bioengineering10040490] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/08/2023] [Accepted: 04/18/2023] [Indexed: 04/29/2023] Open
Abstract
PURPOSE This study aimed to compare the antibacterial effectiveness of passive ultrasonic irrigation (PUI), Er,Cr:YSGG laser (WTL), and photon-induced photoacoustic streaming (PIPS) using an Er:YAG laser against Enterococcus faecalis biofilms in the apical third of root canals. METHODS Root canals of 70 single-rooted human teeth were instrumented and infected with E. faecalis for 3 weeks to form biofilms. The samples were randomly divided into five groups as follows: (i) PUI + 3% NaOCl (n = 16); (ii) Er,Cr:YSGG laser (n = 16); (iii) PIPS + 3% NaOCl (n = 16); (iv) positive control group (n = 10); and (v) negative control group (n = 10). The bacterial content in the root canal was sampled using (a) the paper-point sampling method before (S1) and after (S2) treatment and (b) pulverising the apical 5 mm of the root. The number of bacteria recovered from each group was counted as colony-forming units (CFUs). The amount of reduction between the groups was compared with the Kruskal-Wallis test and post-test Dunn's multiple comparisons tests. The significance level was set at 5% (p < 0.05). RESULTS The samples from the paper-point sampling method showed that the amount of bacteria before (S1) and after treatment (S2) was significantly different between PIPS and WTL, as well as between the PUI and WTL groups. In contrast, no significant difference was found between the PIPS and PUI groups. From the pulverised samples, the results indicated no significant difference among all experimental groups in the amount of bacterial reduction in the apical 5 mm of the root. CONCLUSIONS PUI and PIPS showed a significantly greater reduction in bacterial content within the main root canal compared with the WTL. There was no difference among all experimental groups in the apical third of the root.
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Affiliation(s)
- Ibrahim Seghayer
- Endodontology, Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Angeline H C Lee
- Endodontology, Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Gary S P Cheung
- Endodontology, Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Chengfei Zhang
- Endodontology, Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
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17
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Godoi-Jr EP, Bronzato JD, Francisco PA, Bícego-Pereira EC, Lopes EM, Passini MRZ, de-Jesus-Soares A, Almeida JFA, Marciano MA, Ferraz CCR, Gomes BPFA. Microbiological profile of root canals indicated for endodontic retreatment due to secondary endodontic infections or for prosthetic reasons. Clin Oral Investig 2023; 27:2049-2064. [PMID: 37002440 DOI: 10.1007/s00784-023-04947-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 03/07/2023] [Indexed: 04/03/2023]
Abstract
OBJECTIVE The objective of this study was to evaluate the microbiological profile of root canals indicated for endodontic retreatment due to secondary endodontic infections evidenced by the presence of chronic apical periodontitis (G1) or for prosthetic reasons, without clinical and radiographic signs of endodontic reinfection (G2). METHODS Microbiological samples were collected from thirty teeth (N=30) out of which 15 were indicated for retreatment due to the presence of chronic apical periodontitis (G1) and 15 were indicated exclusively for prosthetic reasons (G2). Samples were collected from root canals before (S1), after chemomechanical preparation (S2), and after 30 days of intracanal medication composed of calcium hydroxide and 2% chlorhexidine gel (S3). The molecular analysis was performed using Nested-PCR for the detection of 17 bacterial species. The efficacy of each stage of the retreatment in reducing the microbial load was verified by counting colony-forming units (CFU). The statistical analysis considered a significance level of 5%. RESULTS The results showed that bacteria were detected in 100% of the cases in S1, in both groups, by Nested PCR. The most frequently found species in S1 in both groups were Enterococcus faecalis, Fusobacterium nucleatum, Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, and Parvimonas micra. The microbial load of G1 was higher than G2 in the initial samples (S1). Endodontic retreatment was effective in reducing the microbial load in G1 and G2. Statistically significant associations were found between specific bacteria and clinical signs and symptoms. CONCLUSION It was concluded that the microbial community present in the root canal of teeth indicated for endodontic retreatment is mixed and heterogeneous. G1 and G2 differ in the number of species per case and microbial load. CLINICAL RELEVANCE Endodontic retreatment was effective in reducing the microbial load. Statistically significant associations were found between specific bacteria and clinical signs and symptoms.
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Affiliation(s)
- Ederaldo P Godoi-Jr
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas - UNICAMP, Piracicaba, SP, Brazil
| | - Juliana D Bronzato
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas - UNICAMP, Piracicaba, SP, Brazil
| | - Priscila A Francisco
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas - UNICAMP, Piracicaba, SP, Brazil
| | - Eloá C Bícego-Pereira
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas - UNICAMP, Piracicaba, SP, Brazil
| | - Erica M Lopes
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas - UNICAMP, Piracicaba, SP, Brazil
| | - Maicon R Z Passini
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas - UNICAMP, Piracicaba, SP, Brazil
| | - Adriana de-Jesus-Soares
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas - UNICAMP, Piracicaba, SP, Brazil
| | - José F A Almeida
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas - UNICAMP, Piracicaba, SP, Brazil
| | - Marina A Marciano
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas - UNICAMP, Piracicaba, SP, Brazil
| | - Caio C R Ferraz
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas - UNICAMP, Piracicaba, SP, Brazil
| | - Brenda P F A Gomes
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas - UNICAMP, Piracicaba, SP, Brazil.
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Parga A, Manoil D, Brundin M, Otero A, Belibasakis GN. Gram-negative quorum sensing signalling enhances biofilm formation and virulence traits in gram-positive pathogen Enterococcus faecalis. J Oral Microbiol 2023; 15:2208901. [PMID: 37187675 PMCID: PMC10177678 DOI: 10.1080/20002297.2023.2208901] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023] Open
Abstract
Acyl-homoserine lactones (AHLs) are typical quorum-sensing molecules of gram-negative bacteria. Recent evidence suggests that AHLs may also affect gram-positives, although knowledge of these interactions remains scarce. Here, we assessed the effect of AHLs on biofilm formation and transcriptional regulations in the gram-positive Enterococcus faecalis. Five E. faecalis strains were investigated herein. Crystal violet was employed to quantify the biomass formed, and confocal microscopy in combination with SYTO9/PI allowed the visualisation of biofilms' structure. The differential expression of 10 genes involved in quorum-sensing, biofilm formation and stress responses was evaluated using reverse-transcription-qPCR. The AHL exposure significantly increased biofilm production in strain ATCC 29212 and two isolates from infected dental roots, UmID4 and UmID5. In strains ATCC 29212 and UmID7, AHLs up-regulated the quorum-sensing genes (fsrC, cylA), the adhesins ace, efaA and asa1, together with the glycosyltransferase epaQ. In strain UmID7, AHL exposure additionally up-regulated two membrane-stress response genes (σV, groEL) associated with increased stress-tolerance and virulence. Altogether, our results demonstrate that AHLs promote biofilm formation and up-regulate a transcriptional network involved in virulence and stress tolerance in several E. faecalis strains. These data provide yet-unreported insights into E. faecalis biofilm responses to AHLs, a family of molecules long-considered the monopole of gram-negative signalling.
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Affiliation(s)
- Ana Parga
- Department of Microbiology and Parasitology, CIBUS-Faculty of Biology, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Daniel Manoil
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
- Division of cariology and endodontics, University Clinics of Dental Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- CONTACT Daniel Manoil Division of cariology and endodontics, University Clinics of Dental Medicine, Michel-Servet 1, Geneva1205, Switzerland
| | - Malin Brundin
- Division of Endodontics, Department of Odontology, Umeå University, Umeå, Sweden
| | - Ana Otero
- Department of Microbiology and Parasitology, CIBUS-Faculty of Biology, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Georgios N. Belibasakis
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
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19
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Xiang D, Dong PT, Cen L, Bor B, Lux R, Shi W, Yu Q, He X, Wu T. Antagonistic interaction between two key endodontic pathogens Enterococcus faecalis and Fusobacterium nucleatum. J Oral Microbiol 2023; 15:2149448. [DOI: 10.1080/20002297.2022.2149448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- Doudou Xiang
- Department of Operative Dentistry and Endodontics, School of Stomatology, The Fourth Military Medical University, Xi’an, Shaanxi, China
- Department of Microbiology, The Forsyth Institute, Cambridge, Massachusetts, USA
| | - Pu-Ting Dong
- Department of Microbiology, The Forsyth Institute, Cambridge, Massachusetts, USA
- Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Lujia Cen
- Department of Microbiology, The Forsyth Institute, Cambridge, Massachusetts, USA
| | - Batbileg Bor
- Department of Microbiology, The Forsyth Institute, Cambridge, Massachusetts, USA
- Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Renate Lux
- School of Dentistry, UCLA, Los Angeles, California, USA
| | - Wenyuan Shi
- Department of Microbiology, The Forsyth Institute, Cambridge, Massachusetts, USA
| | - Qing Yu
- Department of Operative Dentistry and Endodontics, School of Stomatology, The Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Xuesong He
- Department of Microbiology, The Forsyth Institute, Cambridge, Massachusetts, USA
- Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Tingxi Wu
- Department of Microbiology, The Forsyth Institute, Cambridge, Massachusetts, USA
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20
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Boschi G, Piccinelli G, Bonfanti C, Salgarello SA. Ex-vivo study about antimicrobial effectiveness of phytic acid against Enterococcus faecalis into root canals. Minerva Dent Oral Sci 2022; 71:299-307. [PMID: 36760199 DOI: 10.23736/s2724-6329.22.04614-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
BACKGROUND Endodontic failure is due to the persistence of microorganisms, especially Enterococcus faecalis, which have become resistant to disinfection measures. Sodium hypochlorite has been traditionally used, whereas phytic acid, a natural irrigant, needs to be further investigated. METHODS This ex-vivo study compared the antibacterial effectiveness of 0.9% saline solution, 5% sodium hypochlorite and 5% phytic acid against Enterococcus faecalis ATCC 29212 into the apical root canal third of 96 single-rooted extracted teeth, after 1-minute push-and-pull irrigation - a basic irrigation technique. Survived microorganisms were evaluated both through a traditional colony-forming-unit count and introducing the viability PCR, which precisely detects only DNA from intact cells: dead and damaged cells were excluded thanks to a propidium monoazide dye. RESULTS The culture methods showed that 5% sodium hypochlorite (median: 0 CFU/mL) has a significant greater antibacterial effectiveness (P<0.001) compared both to 0.9% saline solution (median: 4.76 CFU/mL) and 5% phytic acid (median: 0.25 CFU/mL). However, 5% phytic acid proved to be significantly more effective (P<0.001) than 0.9% saline solution. The viability PCR did not reveal a significant difference between 5% sodium hypochlorite (median: 4.12×104 survived bacteria) and 0.9% saline solution (median: 8.45×104 survived bacteria). Five percent phytic acid (median: 0.83×104 survived bacteria) was significantly more effective than both 0.9% saline solution (P<0.001) and 5% sodium hypochlorite (P<0.001). CONCLUSIONS The findings suggest that 5% phytic acid works against root canal bacteria even with a basic irrigation technique and viability PCR seems to lead to more reliable and sensitive data rather than the culture methods.
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Affiliation(s)
- Giulia Boschi
- School of Dentistry, Department of Medical and Surgery Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy -
| | - Giorgio Piccinelli
- Institute of Microbiology, Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Carlo Bonfanti
- Institute of Microbiology, Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Stefano A Salgarello
- School of Dentistry, Department of Medical and Surgery Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
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21
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Coaguila‐Llerena H, Ordinola‐Zapata R, Staley C, Dietz M, Chen R, Faria G. Multispecies biofilm removal by a multisonic irrigation system in mandibular molars. Int Endod J 2022; 55:1252-1261. [PMID: 35976101 PMCID: PMC9561058 DOI: 10.1111/iej.13813] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 06/12/2022] [Accepted: 08/11/2022] [Indexed: 01/09/2023]
Abstract
AIM The aim of the study was to assess biofilm removal efficacy of GentleWave System and passive ultrasonic irrigation (PUI). METHODOLOGY Twenty-two human mandibular molars with Vertucci's type II configuration in the mesial root were selected. Teeth were autoclaved, inoculated with dental plaque and incubated in a CDC biofilm reactor for two weeks. The mesial roots were instrumented up to 20.06 file (V-Taper) for the GentleWave group and up to 35.04 file (Vortex Blue) for PUI group. Irrigation was performed using GentleWave and PUI irrigation protocols (n = 11). Dentine debris on paper points samples were obtained for quantitative real-time polymerase chain reaction (qPCR) and 16S ribosomal RNA gene sequencing (next-generation aequencing-NGS). For qPCR, a non-parametric test (α = 0.05) was used. Next-generation sequencing data were analysed using mothur, with alpha diversity calculated as the Shannon and Chao1 indices and Bray-Curtis dissimilarities were used for beta diversity. Differences in alpha diversity and abundances of genera were evaluated using Kruskal-Wallis test. Differences in community composition were evaluated using analysis of similarity with Bonferroni correction for multiple comparisons. RESULTS Quantitative real-time polymerase chain reaction results showed that the reduction estimated in percentages for both groups was equivalent (p > .05). NGS analysis showed that both techniques promoted a significant reduction in reads and OTUs number (p < .05). Shannon alpha diversity and Chao1 index showed no differences between pre- or post-treatment samples for both groups (p > .05). Additionally, pre-treatment communities differed from post-treatment samples in both groups regarding bacterial taxa reduction (ANOSIM R = 0.50 and 0.55, p < .001). CONCLUSIONS Bacterial reduction in mesial roots of mandibular molars prepared to 35.04 with PUI was similar to those prepared to 20.06 with a multisonic irrigant activation system.
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Affiliation(s)
- Hernán Coaguila‐Llerena
- Department of Restorative Dentistry, Araraquara School of DentistrySão Paulo State University –UNESPSão PauloBrazil,Division of EndodonticsUniversity of Minnesota School of DentistryMinneapolisMinnesotaUSA
| | - Ronald Ordinola‐Zapata
- Division of EndodonticsUniversity of Minnesota School of DentistryMinneapolisMinnesotaUSA
| | - Christopher Staley
- Division of Basic & Translational Research, Department of SurgeryUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Matthew Dietz
- Division of Basic & Translational Research, Department of SurgeryUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Ruoqiong Chen
- Department of Diagnostic and Biological Sciences, School of DentistryUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Gisele Faria
- Department of Restorative Dentistry, Araraquara School of DentistrySão Paulo State University –UNESPSão PauloBrazil
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22
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Astorga J, Hernández M, Bravo D, Hoare A. Evaluation of PCR primers to identify Porphyromonas endodontalis in apical periodontitis clinical samples. Arch Microbiol 2022; 204:652. [PMID: 36173466 DOI: 10.1007/s00203-022-03260-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 09/02/2022] [Accepted: 09/15/2022] [Indexed: 11/02/2022]
Abstract
We aimed to evaluate whether two commonly used PCR primers are effective to identify P. endodontalis and discriminate from other prevalent black-pigmented bacteria in apical periodontitis (AP). Endodontic canal samples from patients with asymptomatic AP (n = 20) were collected and cultured in anaerobiosis. Two primer sets to detect P. endodontalis were selected from the literature and first analyzed for their specificity in silico; and then tested on clinical isolates in vitro and finally, in apical exudates ex vivo. The identity of P. endodontalis was verified by PCR and Sanger sequencing with universal primers for bacterial V3-V6 regions 16S rDNA. Only one primer set showed specificity only for P. endodontalis clones in silico and also was specific for P. endodontalis in vitro and ex vivo.
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Affiliation(s)
- J Astorga
- Laboratory of Periodontal Biology, Faculty of Dentistry, Universidad de Chile, Olivos 943, 8380492, Independencia, 8380000, Santiago, Chile
| | - M Hernández
- Laboratory of Periodontal Biology, Faculty of Dentistry, Universidad de Chile, Olivos 943, 8380492, Independencia, 8380000, Santiago, Chile.,Department of Pathology and Oral Medicine, Faculty of Dentistry, Universidad de Chile, Olivos 943, 8380492, Independencia, 8380000, Santiago, Chile
| | - D Bravo
- Laboratory of Oral Microbiology, Department of Pathology and Oral Medicine, Faculty of Dentistry, Olivos 943, 8380492, Independencia, 8380000, Santiago, Chile
| | - A Hoare
- Laboratory of Oral Microbiology, Department of Pathology and Oral Medicine, Faculty of Dentistry, Olivos 943, 8380492, Independencia, 8380000, Santiago, Chile.
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23
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Evaluation of the Antibacterial Effect of Xylene, Chloroform, Eucalyptol, and Orange Oil on Enterococcus faecalis in Nonsurgical Root Canal Retreatment: An Ex Vivo Study. BIOMED RESEARCH INTERNATIONAL 2022; 2022:8176172. [PMID: 36193304 PMCID: PMC9525764 DOI: 10.1155/2022/8176172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 08/28/2022] [Accepted: 09/07/2022] [Indexed: 11/18/2022]
Abstract
Objectives The present ex vivo study is aimed at evaluating the antibacterial efficacy of chloroform, eucalyptol, orange oil, and xylene against E. faecalis biofilm during nonsurgical root canal retreatment. Materials and Methods Eighty single-rooted teeth were instrumented. The samples were autoclaved, infected with E. faecalis for 4 weeks, and obturated with gutta-percha. Then the teeth were randomly assigned to 4 groups (n = 20): (1) chloroform, (2) eucalyptol, (3) orange oil, and (4) xylene. In all of the groups, gutta-percha removal was conducted according to the same protocol although the solvent used in each group was different. Bacterial samples were collected after gutta-percha removal and following additional apical enlargement. Intergroup and intragroup analyses were conducted using one-way ANOVA combined with the post hoc Tukey test and the paired-sample t-test, respectively. Statistical significance was set to 0.05. Results All of the groups showed more than 99% bacterial load reduction. The least bacterial load after gutta-percha removal was observed in the chloroform group (p < 0.001). The orange oil group showed a significantly lower bacterial load compared to the eucalyptol group (p = 0.001), while it was not different from the xylene group (p = 0.953). The xylene group also had a significantly lower bacterial load compared with the eucalyptol group (p = 0.017). After apical enlargement, the chloroform group had a significantly lower bacterial load compared to the other groups. The comparison of bacterial load values before and after apical enlargement in the chloroform and eucalyptol groups showed a statistically significant difference (pcholoroform = 0.011, peucalyptol = 0.001). Conclusion Chloroform was the most effective solvent in terms of antimicrobial activity against E. faecalis followed by orange oil and xylene, which were not significantly different though, and eucalyptol. All of the solvents showed more than 99% bacterial load reduction. Chloroform and xylene revealed to be associated with favorable antibiofilm activity among the examined solvents.
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24
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Innate Immune Sensing of Nucleic Acid in Endodontic Infection. Int Endod J 2022; 55:1335-1346. [DOI: 10.1111/iej.13831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 09/07/2022] [Accepted: 09/08/2022] [Indexed: 11/26/2022]
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25
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Vatankhah M, Khosravi K, Zargar N, Shirvani A, Nekoofar MH, Dianat O. Antibacterial efficacy of antibiotic pastes versus calcium hydroxide intracanal dressing: A systematic review and meta-analysis of ex vivo studies. J Conserv Dent 2022; 25:463-480. [PMID: 36506621 PMCID: PMC9733540 DOI: 10.4103/jcd.jcd_183_22] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 05/15/2022] [Accepted: 05/20/2022] [Indexed: 12/15/2022] Open
Abstract
Background Conflicting findings on the potency of antibiotic pastes versus calcium hydroxide (CH) have been evident in the literature. Aims To compare the antibacterial efficacy of single antibiotic paste (SAP), double antibiotic paste (DAP), triple antibiotic paste (TAP), and modified TAP (mTAP) with CH on bacterial biofilms. Methods PubMed, Scopus, and Embase were comprehensively searched until August 23, 2021. The study protocol was registered in the PROSPERO. Ex vivo studies performed on Enterococcus faecalis or polymicrobial biofilms incubated on human/bovine dentin were selected. The quality of the studies was assessed using a customized quality assessment tool. Standardized mean difference (SMD) with a 95% confidence interval (CI) was calculated for the meta-analysis. Meta-regression models were used to identify the sources of heterogeneity and to compare the efficacy of pastes. Results The qualitative and quantitative synthesis included 40 and 23 papers, respectively, out of 1421 search results. TAP (SMD = -3.82; CI, -5.44 to -2.21; P < 0.001) and SAPs (SMD = -2.38; CI, -2.81 to - 1.94; P < 0.001) had significantly higher antibacterial efficacy compared to the CH on E. faecalis biofilm. However, no significant difference was found between the efficacy of DAP (SMD = -2.74; CI, -5.56-0.07; P = 0.06) or mTAP (SMD = -0.28; CI, -0.82-0.26; P = 0.31) and CH. Meta-regression model on E. faecalis showed that SAPs have similar efficacy compared to TAP and significantly better efficacy than DAP. On dual-species (SMD = 0.15; CI, -1.00-1.29; P = 0.80) or multi-species (SMD = 0.23; CI, -0.08-0.55; P = 0.15) biofilms, DAP and CH had similar efficacy. Conclusions Ex vivo evidence showed that antibiotic pastes were either superior or equal to CH. The studied SAPs had considerably higher or similar antibacterial effectiveness compared to DAP, CH, and TAP. Hence, combined antibiotic therapy was not necessarily required for root canal disinfection ex vivo.
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Affiliation(s)
- Mohammadreza Vatankhah
- Iranian Center for Endodontic Research, Research Institute of Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Kamyar Khosravi
- Iranian Center for Endodontic Research, Research Institute of Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nazanin Zargar
- Department of Endodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Armin Shirvani
- Iranian Center for Endodontic Research, Research Institute of Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Omid Dianat
- Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, Maryland, USA
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26
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Tan HC, Cheung GSP, Chang JWW, Zhang C, Lee AHC. Enterococcus faecalis Shields Porphyromonas gingivalis in Dual-Species Biofilm in Oxic Condition. Microorganisms 2022; 10:microorganisms10091729. [PMID: 36144331 PMCID: PMC9505435 DOI: 10.3390/microorganisms10091729] [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: 08/03/2022] [Revised: 08/23/2022] [Accepted: 08/25/2022] [Indexed: 11/26/2022] Open
Abstract
Aim: To develop a reproducible biofilm model consisting of Enterococcus faecalis (E. faecalis) and Porphyromonas gingivalis (P. gingivalis) and to evaluate the interaction between the two bacterial species. Methodology: E. faecalis and P. gingivalis were grown in mono-culture, sequential, and co-culture models for 96 h in a 96-well polystyrene microtiter plate under both aerobic and anaerobic conditions separately. The viability of the two bacterial species in the biofilms was quantified by polymerase chain reaction (qPCR). Biofilm thickness and protein contents were measured using confocal laser scanning microscopy (CLSM). Two-way analysis of variance (ANOVA) was performed to analyze cell viability and biofilm thickness among different culture models cultivated under either aerobic or anaerobic conditions. The level of significance was set at p < 0.05. Results: Different culture models tested did not show any significant difference between the viable cell counts of both E. faecalis and P. gingivalis cultivated under aerobic and anaerobic conditions (p > 0.05). Biofilm was significantly thicker (p < 0.05) in the co-culture models compared to the mono-culture and sequential models. Protein contents in the biofilms were more pronounced when both bacterial species were co-cultured under aerobic conditions. Conclusions: E. faecalis appeared to shield P. gingivalis and support its continued growth in oxic (aerobic) conditions. The co-culture model of E. faecalis and P. gingivalis produced a significantly thicker biofilm irrespective of the presence or absence of oxygen, while increased protein contents were only observed in the presence of oxygen.
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27
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Hussein NA, Soliman ZS, Edrees MF. Oral microbiota associated with gingiva of healthy, gingivitis and periodontitis cases. Microb Pathog 2022; 171:105724. [PMID: 35988883 DOI: 10.1016/j.micpath.2022.105724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 08/04/2022] [Accepted: 08/12/2022] [Indexed: 11/26/2022]
Abstract
Oral microbes coexist with each other in a symbiotic relationship or as commensals in healthy body. Teeth and oral cavity harbor diverse community of fungi and bacteria. This study focused on bacterial and fungal component of gingiva, where the last occupy little attention. In addition to study the antimicrobial activity of toothpastes, mouth washes and natural oils against microorganisms. Sixty swabs from outer surfaces of gingiva in healthy persons, as well as patients complaining of gingivitis and periodontitis were collected for fungal and bacterial analyses. Sensitivity of the isolated microorganisms to some pharmaceutical preparations and natural oils was also performed. Ten fungal and 9 bacterial species were identified. There is a highly significant variation in the frequency of Klebsiella pneumonia among healthy, gingivitis and periodontitis. Also, Candida tropicalis and cocci bacteria showed significant diversity among the three tested groups. Among pharmaceutical preparations (toothpastes and mouth washes) and natural oils, Paradontax, Hexitol and clove oil showed the best antimicrobial activity against tested fungal and bacterial strains. Although, minimum inhibition concentrations (MICs) of clove oil were high compared to Paradontax and Hexitol, nevertheless, it is highly recommended as both antifungal and antibacterial agent against oral pathogenic microorganisms, because it is a natural compound and nearly devoid of side effects.
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Affiliation(s)
- Nemmat A Hussein
- Botany and Microbiology Department, Faculty of Science, Assiut University, P.O. Box 71526, Assiut, Egypt; Assiut University Moubasher Mycological Centre (AUMC), Assiut University, P.O. Box 71526, Assiut, Egypt.
| | - Zeinab S Soliman
- Assiut University Moubasher Mycological Centre (AUMC), Assiut University, P.O. Box 71526, Assiut, Egypt
| | - Mohamed F Edrees
- Oral Medicine and Periodontology Department, Faculty of Dentistry, AL-Azhar University, Assiut Branch, Egypt
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28
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Thienngern P, Panichuttra A, Ratisoontorn C, Aumnate C, Matangkasombut O. Efficacy of chitosan paste as intracanal medication against Enterococcus faecalis and Candida albicans biofilm compared with calcium hydroxide in an in vitro root canal infection model. BMC Oral Health 2022; 22:354. [PMID: 35974361 PMCID: PMC9382833 DOI: 10.1186/s12903-022-02385-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 08/04/2022] [Indexed: 12/03/2022] Open
Abstract
Background Enterococcus faecalis and Candida albicans are frequently found in persistent endodontic infection and could remain in dentinal tubules despite intracanal medication with calcium hydroxide (Ca(OH)2), a commonly used medication. Thus, an effective and safe antimicrobial medication against such refractory infection is necessary in endodontic retreatment, so we aimed to test the efficacy of chitosan paste against these microorganisms compared with Ca(OH)2 in root canals of extracted human teeth. Methods Thirty-six sterilized human root samples prepared from extracted premolars and upper maxillary incisors were infected with E. faecalis for 14 days, while 32 were infected with C. albicans for 48 h, for mature biofilm formation. The samples were assigned to 6 groups of intracanal medications: Group 1: no medication (negative control); Group 2: 20% Polyethylene glycol (PEG); Group 3: 20% Propylene glycol (PG); Group 4: Ca(OH)2; Group 5: Chitosan + PEG; and Group 6: Chitosan + PG. After 7 days, intracanal surface dentin was harvested using Protaper next, resuspended, serially diluted and spread on Brain–Heart-Infusion agar (for E. faecalis) and Yeast Extract-Peptone-Dextrose agar (for C. albicans) for colony count. Antimicrobial efficacy was determined as percentage of remaining colony forming unit (CFUs) relative to negative control and analyzed using One-way ANOVA and post-hoc Games-Howell test. The significance level was set at 0.05. Results For E. faecalis, chitosan + PG had significantly higher antibacterial activity than Ca(OH)2 (P = 0.039). Chitosan + PEG and chitosan + PG medication significantly reduced viable bacteria compared with negative control, PEG and PG (P = 0.001, 0.003, 0.024, respectively for chitosan + PEG; P = 0.002, 0.003, 0.014, respectively for chitosan + PG). For C.albicans, chitosan + PEG and chitosan + PG were not significantly different from Ca(OH)2. However, Chitosan + PEG and chitosan + PG, but not Ca(OH)2, showed a significantly lower level of remaining CFUs compared with negative control (P = 0.013 and 0.005, respectively). Conclusion Chitosan paste showed better efficacy in reducing viable E. faecalis biofilm when compared to Ca(OH)2 after 7-day intracanal medication in this in vitro root canal model. It could also significantly reduce viable C. albicans, but was not significantly different from Ca(OH)2. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-022-02385-x.
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Affiliation(s)
- Pasika Thienngern
- Department of Operative Dentistry, Faculty of Dentistry, Chulalongkorn University, 34 Henri- Dunant Road, Wangmai, Patumwan, Bangkok, 10330, Thailand
| | - Anchana Panichuttra
- Department of Operative Dentistry, Faculty of Dentistry, Chulalongkorn University, 34 Henri- Dunant Road, Wangmai, Patumwan, Bangkok, 10330, Thailand.
| | - Chootima Ratisoontorn
- Department of Operative Dentistry, Faculty of Dentistry, Chulalongkorn University, 34 Henri- Dunant Road, Wangmai, Patumwan, Bangkok, 10330, Thailand
| | - Chuanchom Aumnate
- Metallurgy and Materials Science Research Institute, Chulalongkorn University, Soi Chula 12, Phayathai Road, Pathumwan, Bangkok, 10330, Thailand
| | - Oranart Matangkasombut
- Department of Microbiology and Center of Excellence on Oral Microbiology and Immunology, Faculty of Dentistry, Chulalongkorn University, 34 Henri- Dunant Road, Wangmai, Patumwan, Bangkok, 10330, Thailand. .,Research Laboratory of Biotechnoloty, Chulabhorn Research Institute, Kampangpetch 6 Rd, Laksi, Bangkok, 10120, Thailand.
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29
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Alfirdous RA, Alquiria TA, Jacinto RC, Martinho FC. A modified dentin infection model with Fluorescent Lipopolysaccharide and
LPS
sampling technique to compare
XP‐Endo
finisher and passive ultrasonic irrigation. Int Endod J 2022; 55:1081-1090. [DOI: 10.1111/iej.13804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 07/24/2022] [Accepted: 07/25/2022] [Indexed: 11/30/2022]
Affiliation(s)
- R. A. Alfirdous
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics University of Maryland School of Dentistry Baltimore Maryland USA
- Prince Abdulrahman Advanced Dental Institute Riyadh Kingdom of Saudi Arabia
| | - T. A. Alquiria
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics University of Maryland School of Dentistry Baltimore Maryland USA
- Prince Abdulrahman Advanced Dental Institute Riyadh Kingdom of Saudi Arabia
| | - R. C. Jacinto
- Division of Endodontics, Department of preventive and restorative dentistry School of Dentistry, Aracatuba São Paulo SP Brazil
| | - F. C. Martinho
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics University of Maryland School of Dentistry Baltimore Maryland USA
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30
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Nunes LP, Nunes GP, Ferrisse TM, Strazzi-Sahyon HB, Cintra LTÂ, Dos Santos PH, Sivieri-Araujo G. Antimicrobial photodynamic therapy in endodontic reintervention: A systematic review and meta-analysis. Photodiagnosis Photodyn Ther 2022; 39:103014. [PMID: 35840008 DOI: 10.1016/j.pdpdt.2022.103014] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 07/08/2022] [Accepted: 07/11/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND To evaluate the effectiveness of the use of antimicrobial photodynamic therapy (aPDT) in root canals disinfection in cases of endodontic retreatments. METHODS This Systematic Review was registered in PROSPERO (CRD42021260013) and followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). Searches were performed in the electronic databases PubMeb, Scopus, Web of Science, Embase, Web of Science, Clinical Trials and Cochrane Library. Methodological quality and risk of bias were assessed by the Cochrane Risk of Bias tool for randomized clinical trials (RCT) and by the Newcastle-Ottawa (NOS) qualifier for non-RCT (prospective) studies. Meta-analysis was performed using R software, version 3.6.3 with the "META" package assistant by the RStudio platform. The odds ratio (OR) measure of effect was calculated and the random effect model was applied with a 95% confidence interval, and heterogeneity tested by the I2 index. The certainty of evidence was rated using GRADE. RESULTS Regarding the 1513 studies screened, 10 met the eligibility criteria and were included, and 8 used in the quantitative synthesis. Meta-analysis showed that all of studies data presented a significant difference before and after of antimicrobial photodynamic therapy in the microbial load reduction in secondary endondontic infections (OR 0.15 [0.07; 0.32], p < 0.0001). Overall, the studies had a low risk of bias and, the analysis of evidence by GRADE assessment was rated as moderate. CONCLUSION It is suggested that aPDT is a beneficial and promising tool, showing efficacy in reducing the microbial load in cases of endodontic retreatment.
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Affiliation(s)
- Larissa Pereira Nunes
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University - UNESP, Rua José Bonifácio, 1193, Araçatuba, SP 16015-050, Brazil
| | - Gabriel Pereira Nunes
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University - UNESP, Rua José Bonifácio, 1193, Araçatuba, SP 16015-050, Brazil
| | - Túlio Morandin Ferrisse
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University (UNESP), Araraquara, SP, Brazil
| | - Henrico Badaoui Strazzi-Sahyon
- Department of Dental Materials and Prosthodontics, Araçatuba School of Dentistry, São Paulo State University - UNESP, Araçatuba, SP, Brazil
| | - Luciano Tavares Ângelo Cintra
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University - UNESP, Rua José Bonifácio, 1193, Araçatuba, SP 16015-050, Brazil
| | - Paulo Henrique Dos Santos
- Department of Dental Materials and Prosthodontics, Araçatuba School of Dentistry, São Paulo State University - UNESP, Araçatuba, SP, Brazil
| | - Gustavo Sivieri-Araujo
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University - UNESP, Rua José Bonifácio, 1193, Araçatuba, SP 16015-050, Brazil.
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Petean IBF, Silva-Sousa AC, Cronenbold TJ, Mazzi-Chaves JF, Silva LABD, Segato RAB, Castro GAPD, Kuchler EC, Paula-Silva FWG, Damião Sousa-Neto M. Genetic, Cellular and Molecular Aspects involved in Apical Periodontitis. Braz Dent J 2022; 33:1-11. [PMID: 36043561 PMCID: PMC9645190 DOI: 10.1590/0103-6440202205113] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 08/03/2022] [Indexed: 11/26/2022] Open
Abstract
The development, establishment and repair of apical periodontitis (AP) is
dependent of several factors, which include host susceptibility, microbial
infection, immune response, quality of root canal treatment and organism's
ability to repair. The understanding of genetic contributions to the risk of
developing AP and presenting persistent AP has been extensively explored in
modern Endodontics. Thus, this article aims to provide a review of the
literature regarding the biochemical mediators involved in immune response
signaling, osteoclastogenesis and bone neoformation, as the genetic components
involved in the development and repair of AP. A narrative review of the
literature was performed through a PUBMED/MEDLINE search and a hand search of
the major AP textbooks. The knowledge regarding the cells, receptors and
molecules involved in the host's immune-inflammatory response during the
progression of AP added to the knowledge of bone biology allows the
identification of factors inherent to the host that can interfere both in the
progression and in the repair of these lesions. The main outcomes of studies
evaluated in the review that investigated the correlation between genetic
polymorphisms and AP in the last five years, demonstrate that genetic factors of
the individual are involved in the success of root canal treatment. The
discussion of this review gives subsides that may help to glimpse the
development of new therapies based on the identification of therapeutic targets
and the development of materials and techniques aimed at acting at the molecular
level for clinical, radiographic and histological success of root canal
treatment.
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Affiliation(s)
- Igor Bassi Ferreira Petean
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Brazil
| | - Alice Corrêa Silva-Sousa
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Brazil
| | | | | | - Lea Assed Bezerra da Silva
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Raquel Assed Bezerra Segato
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | | | - Erika Calvano Kuchler
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.,Department of Orthodontics, University of Regensburg, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany
| | | | - Manoel Damião Sousa-Neto
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Brazil
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Schick F, Lechner J, Notter F. Linking Dentistry and Chronic Inflammatory Autoimmune Diseases – Can Oral and Jawbone Stressors Affect Systemic Symptoms of Atopic Dermatitis? A Case Report. Int Med Case Rep J 2022; 15:323-338. [PMID: 35782227 PMCID: PMC9242433 DOI: 10.2147/imcrj.s367434] [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: 03/30/2022] [Accepted: 06/09/2022] [Indexed: 11/23/2022] Open
Abstract
Background This case report demonstrates the value of ultrasound measurements, and immunological and toxicological diagnostics in addition to current x-ray imaging procedures to diagnose hidden oral and maxillofacial infections. Using a clear scheme shows the procedure of the authors’ steps. The positive impact on the patient’s dermatological clinical picture is shown. Functional regeneration using metal-free ceramic implants and autologous bone augmentation is demonstrated. After a healing period, a postoperative control took place. Question Are chronic inflammatory and chronic toxic stressors from the oral region affecting the patient’s state of health and dermatological symptoms? Patients and Methods A 52 year old female suffering from neurodermatitis, who had been therapy-resistant for several years, was rehabilitated by oral surgery and prosthetics. Radiological examinations with orthopantomogram (OPG) and three-dimensional imaging (DVT/CBCT) were inconclusive for possible jawbone inflammatory sites. Immunological, toxicological diagnostics and trans-alveolar bone densitometry with ultrasound (TAU), were able to show immunological and toxicological stressors and areas of reduced bone density. Bone densitometry with ultrasound raised the suspicion of silent inflammations in the jawbone with potentially increased cytokine levels. Results For the patient incompatible materials, teeth with increased toxin exposure and surrounding softened, fatty, ischaemic bone was removed. Histologies and cytokine profiles were obtained. The resulting defects were functionally regenerated using ceramic implants and autologous augmentation. The cytokine profiles showed significantly elevated RANTES/CCL5, confirming the need for surgical intervention. The patient’s atopic dermatitis improved significantly in this case. Summary Individualized immunological and toxicological diagnostics and trans-alveolar bone density bone densitometry with ultrasound (TAU) identified immunological and toxicological stressors as well as reduced bone density with increased cytokine levels. A therapy-resistant neurodermatitis improved significantly after treatment. Conclusion This case report illustrates the need for patient-specific and individualized examinations that link dentistry more closely with other medical conditions in order to clarify possible interactions.
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Affiliation(s)
- Fabian Schick
- Clinic for Integrative Dentistry, Munich, Germany
- Correspondence: Fabian Schick, Clinic for Integrative Dentistry, Gruenwalder Str. 10A, Munich, 81547, Germany, Tel +49 89 697 00 55, Email
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Roda-Casanova V, Pérez-González A, Zubizarreta-Macho A, Faus-Matoses V. Influence of Cross-Section and Pitch on the Mechanical Response of NiTi Endodontic Files under Bending and Torsional Conditions—A Finite Element Analysis. J Clin Med 2022; 11:jcm11092642. [PMID: 35566767 PMCID: PMC9101501 DOI: 10.3390/jcm11092642] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 05/03/2022] [Accepted: 05/05/2022] [Indexed: 11/16/2022] Open
Abstract
In this article, the effects of cross-section and pitch on the mechanical response of NiTi endodontic files is studied by means of finite element analyses. The study was conducted over a set of eight endodontic rotary files, whose geometry was obtained from combinations of two cross-sections(square and triangular) and four pitches. Each file was subjected to bending and torsional analyses, simulating the testing conditions indicated in the ISO 3630 Standard, in order to assess their stiffness and mechanical strength. The results indicate that endodontic files with a square cross-section have double the stiffness of those with triangular cross-sections, both in terms of bending and torsion. For both loading modes, endodontic files with a triangular cross-section can undergo larger deformations before overload failure than those with a square cross-section: up to 20% more in bending and 40% in torsion. Moreover, under equivalent boundary conditions, endodontic files with triangular cross-sections present a higher fatigue life than those with square cross-sections: up to more than 300% higher for small pitches. The effect of pitch on the stiffness and strength of the file is smaller than that of the cross-section shape, but smaller pitches could be beneficial when using a triangularcross-section, as they increase the bending flexibility, fatigue life, and torsion stiffness. These results suggest a clinical recommendation for the use of files with a triangular-shaped cross-section and a small pitch in order to minimize ledging and maximize fatigue life. Finally, in this study, we reveal the sensitivity of the orientation of files with respect to the bending direction, which must be taken into account when designing, reporting, and interpreting test results under such loading conditions.
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Affiliation(s)
- Victor Roda-Casanova
- Department of Mechanical Engineering and Construction, Universitat Jaume I, 12071 Castelló de la Plana, Spain; (V.R.-C.); (A.P.-G.)
| | - Antonio Pérez-González
- Department of Mechanical Engineering and Construction, Universitat Jaume I, 12071 Castelló de la Plana, Spain; (V.R.-C.); (A.P.-G.)
| | - Alvaro Zubizarreta-Macho
- Department of Dentistry, Alfonso X el Sabio University, 28691 Madrid, Spain
- Department of Orthodontics, University of Salamanca, 37008 Salamanca, Spain
- Correspondence:
| | - Vicente Faus-Matoses
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain;
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Hydroalcoholic Leaf Extract of Punica granatum, alone and in Combination with Calcium Hydroxide, Is Effective against Mono- and Polymicrobial Biofilms of Enterococcus faecalis and Candida albicans. Antibiotics (Basel) 2022; 11:antibiotics11050584. [PMID: 35625228 PMCID: PMC9138113 DOI: 10.3390/antibiotics11050584] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 01/26/2022] [Accepted: 01/30/2022] [Indexed: 12/04/2022] Open
Abstract
Failures in endodontic treatments are mostly associated with the difficulty in eradicating microbes of the root canal system, highlighting the need to develop novel effective antimicrobials. Punica granatum (pomegranate) leaf hydroalcoholic extract may be a potential alternative in canal dressing, owing to its antimicrobial properties. The objective of this study was to evaluate the antimicrobial activity of hydroalcoholic leaf extract of Punica granatum (HEPg) alone or in combination with calcium hydroxide (Ca(OH)2) against Enterococcus faecalis and Candida albicans in isolation and in mono- and polymicrobial biofilms. Microdilution tests in broth and assays for inhibition of biofilm formation were carried out to evaluate the antimicrobial properties of HEPg and HEPg + Ca(OH)2 against Enterococcus faecalis and Candida albicans. The cytotoxicity of HEPg in HaCaT cells was evaluated by MTT assay. HEPg and HEPg + Ca(OH)2 exerted significant antimicrobial activity against planktonic cells and mono- and polymicrobial biofilms. The combination of Punica granatum extract with Ca(OH)2 appears to be a promising alternative in endodontic treatments, which could be tested in vivo to confirm the efficacy of this mixture in disinfecting root canal systems.
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Faus-Matoses V, Pérez García R, Faus-Llácer V, Faus-Matoses I, Alonso Ezpeleta Ó, Albaladejo Martínez A, Zubizarreta-Macho Á. Comparative Study of the SEM Evaluation, EDX Assessment, Morphometric Analysis, and Cyclic Fatigue Resistance of Three Novel Brands of NiTi Alloy Endodontic Files. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074414. [PMID: 35410096 PMCID: PMC8998441 DOI: 10.3390/ijerph19074414] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 03/31/2022] [Accepted: 04/04/2022] [Indexed: 02/04/2023]
Abstract
In this study, we compare and analyze the scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDX), morphometry and cyclic fatigue resistance of Endogal, PathMax, and Smarttrack novel brands of nickel−titanium (NiTi) alloy endodontic files. Material and Methods: Thirty sterile NiTi endodontic rotary files were randomly selected and assigned to one of the following study groups: A: 25.08 F2 Endogal (EDG) (n = 10); B: 25.08 F2 Path Max Pro (PMP) (n = 10); and C: 25.06 Smarttrack (ST) (n = 10). Dynamic cyclic fatigue tests were conducted using a cyclic fatigue device in stainless steel artificial root canal systems with an apical diameter of 250 µm, curvature angle of 60°, radius of curvature of 3 mm, and taper of 6%. Additionally, we analyzed the NiTi endodontic rotary files using EDX, SEM, and morphometry after micro-CT scanning. The results were analyzed using Weibull statistical analysis and ANOVA testing. Results: SEM, EDX, and morphometric analyses showed differences between the three novel brands of NiTi endodontic rotary files. Moreover, statistically significant differences were observed between the number of cycles to failure and time to failure of the three novel brands of NiTi endodontic rotary files (p < 0.001). Conclusions: Smarttrack NiTi alloy endodontic reciprocating files display greater resistance to cyclic fatigue than Endogal and Path Max Pro NiTi alloy endodontic rotary files, due to the reciprocating movement and metallurgical composition.
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Affiliation(s)
- Vicente Faus-Matoses
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain; (V.F.-M.); (R.P.G.); (V.F.-L.)
| | - Raúl Pérez García
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain; (V.F.-M.); (R.P.G.); (V.F.-L.)
| | - Vicente Faus-Llácer
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain; (V.F.-M.); (R.P.G.); (V.F.-L.)
| | - Ignacio Faus-Matoses
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain; (V.F.-M.); (R.P.G.); (V.F.-L.)
- Correspondence:
| | - Óscar Alonso Ezpeleta
- Department of Endodontics, School of Health Sciences, University of Zaragoza, 22006 Zaragoza, Spain;
| | - Alberto Albaladejo Martínez
- Department of Surgery, Faculty of Medicine and Dentistry, University of Salamanca, 37008 Salamanca, Spain; (A.A.M.); or (Á.Z.-M.)
| | - Álvaro Zubizarreta-Macho
- Department of Surgery, Faculty of Medicine and Dentistry, University of Salamanca, 37008 Salamanca, Spain; (A.A.M.); or (Á.Z.-M.)
- Department of Endodontics, Faculty of Health Sciences, Alfonso X El Sabio University, 28691 Madrid, Spain
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Solomonov M, Levy DH, Yaya A, Ben Itzhak J, Polak D. Antimicrobial evaluation of polytetrafluoroethylene used as part of temporary restorations: An ex vivo study. AUST ENDOD J 2022; 48:98-104. [PMID: 35267229 DOI: 10.1111/aej.12617] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 11/30/2021] [Accepted: 02/28/2022] [Indexed: 11/28/2022]
Abstract
The use of polytetrafluoroethylene (PTFE) tape as the base layer of temporary restorations had gained popularity mainly due to the ease of manipulation. The aim of this study was to assess whether this method changes the potential for bacterial growth and leakage of temporary restorations. The direct contact test and live/dead fluorescent staining were used for comparing Enterococcus faecalis growth and biofilm formation on PTFE, composite, intermediate restorative material (IRM) and Coltosol F. Confocal laser scanning microscopy was employed to evaluate E. faecalis penetration through 2 mm of PTFE, IRM or Coltosol F placed on the bottom of the pulp chamber and into radicular dentinal tubules in extracted maxillary third molars. The results demonstrated that E. faecalis grows on and penetrates through PTFE significantly more than it does with IRM and Coltosol F, revealing its comparably reduced overall antimicrobial sealing ability when placed as the base part of temporary restorations.
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Affiliation(s)
- Michael Solomonov
- Department of Endodontics, IDF Medical Corps, Sheba Medical Center, Tel Hashomer, Tel Aviv, Israel
| | - Dan Henry Levy
- Department of Endodontics, IDF Medical Corps, Sheba Medical Center, Tel Hashomer, Tel Aviv, Israel
| | - Alin Yaya
- Department of Periodontics, Faculty of Dentistry, Hadassah Medical Center, Jerusalem, Israel
| | - Joe Ben Itzhak
- Department of Endodontics, IDF Medical Corps, Sheba Medical Center, Tel Hashomer, Tel Aviv, Israel
| | - David Polak
- Department of Periodontics, Faculty of Dentistry, Hadassah Medical Center, Jerusalem, Israel
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A Novel Digital Technique to Analyze the Wear of CM-Wire NiTi Alloy Endodontic Reciprocating Files: An In Vitro Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063203. [PMID: 35328891 PMCID: PMC8951034 DOI: 10.3390/ijerph19063203] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 02/28/2022] [Accepted: 03/01/2022] [Indexed: 12/10/2022]
Abstract
The present study seeks to describe a novel digital measurement technique for analyzing the wear volume of controlled memory (CM)-wire NiTi alloy endodontic reciprocating files after clinical use. Material and Methods: Ten CM-wire NiTi endodontic reciprocating files were randomly used in ten first upper molar teeth within four root canals. The CM-wire NiTi alloy endodontic reciprocating files were subjected to preoperative and postoperative micro-computed tomography (micro-CT) scans to obtain accurate digital imaging and communication on medicine (DICOM) digital files, which were segmented using intensity-based thresholding and an exclusive OR (XOR) logical operation (Boolean algebra logical operator) to obtain a mask of the location to localize and quantify the wear volume of the CM-wire NiTi alloy endodontic reciprocating files. Gage repeatability and reproducibility statistical analysis was applied to assess the reproducibility and repeatability of this measurement technique. Results: The analysis showed a repeatability and reproducibility of 0.00% for the digital measurement technique used to analyze the wear volume of CM-wire NiTi alloy endodontic reciprocating files after clinical use. Wear was mostly identified at the tip and cutting edges of the CM-wire NiTi alloy endodontic reciprocating files. Conclusions: This novel digital measurement technique is a repeatable, reproducible, and accurate method of quantifying the wear volume of CM-wire NiTi alloy endodontic reciprocating files after clinical use.
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In Vitro Evaluation of the Antibacterial Activity of EndoSeal MTA, iRoot SP, and AH Plus against Planktonic Bacteria. MATERIALS 2022; 15:ma15062012. [PMID: 35329464 PMCID: PMC8950277 DOI: 10.3390/ma15062012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 02/24/2022] [Accepted: 02/28/2022] [Indexed: 11/17/2022]
Abstract
This study aimed to investigate the antibacterial activity of three endodontic sealers, AH Plus, iRoot SP, and EndoSeal MTA, against four planktonic bacteria species. The antibacterial activity of the three endodontic sealers was assessed using a modified direct contact test. Bacteria suspension of Actinomycoses viscosus, Enterococcus faecalis, Staphylococcus aureus, and Streptococcus mutans were left in contact with the sealers that were pre-set or set for 1, 3, 7, and l4 days for an hour. Freshly mixed AH Plus and EndoSeal MTA were highly effective against all four tested bacteria as no surviving bacteria were recovered after treatment. Meanwhile, freshly mixed iRoot SP was not able to kill all bacteria, regardless of the species, demonstrating a weak antibacterial effect. After 24 h, AH Plus lost its antibacterial activity. EndoSeal MTA showed a strong and extended bactericidal effect against S. aureus and S. mutans for 3 days and A. viscosus for 7 days. In conclusion, fresh AH Plus and EndoSeal MTA exhibited a potent effect against all four bacteria species. EndoSeal MTA remained effective after setting when tested against A. viscosus, S. aureus, and S. mutans. Among all tested sealers, iRoot SP demonstrates the weakest antibacterial activity.
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Weber MT, Alkhafaji Y, Pioch A, Trips E, Basche S, Dannemann M, Kilistoff A, Hannig C, Sterzenbach T. Quantification of Bacterial DNA from Infected Human Root Canals Using qPCR and DAPI after Disinfection with Established and Novel Irrigation Protocols. MATERIALS 2022; 15:ma15051911. [PMID: 35269141 PMCID: PMC8912041 DOI: 10.3390/ma15051911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 02/23/2022] [Accepted: 02/25/2022] [Indexed: 02/05/2023]
Abstract
The removal of bacterial infections within the root canal system is still a challenge. Therefore, the cleansing effect of established and new irrigation-protocols (IP) containing silver diamine fluoride (SDF) 3.8% on the whole root canal system was analyzed using quantitative PCR (qPCR) and 4′,6-diamidino-phenylindole-(DAPI)-staining. Extracted human premolars were instrumented up to F2 (ProTaper Gold) under NaCl 0.9% irrigation and incubated with Enterococcus faecalis for 42 days. Subsequently, different ultrasonically agitated IP were applied to the roots: control (no irrigation), 1. NaOCl 3%, EDTA 20%, CHX 2%, 2. NaOCl 3%, EDTA 20%, 3. NaOCl 3%, EDTA 20%, SDF 3.8%, 4. SDF 3.8%, and 5. NaCl 0.9%. One half of the root was investigated fluorescent-microscopically with DAPI. The other half was grinded in a cryogenic mill and the bacterial DNA was quantified with qPCR. The qPCR results showed a statistically significant reduction of bacteria after the application of IP 1, 2, and 3 compared to the control group. While IP 4 lead to a bacterial reduction which was not significant, IP 5 showed no reduction. These data corresponded with DAPI staining. With qPCR a new molecular-biological method for the investigation of the complete root canal system was implemented. The novel IP 3 had an equally good cleansing effect as the already established IP.
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Affiliation(s)
- Marie-Theres Weber
- Clinic of Operative and Pediatric Dentistry, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Germany; (Y.A.); (A.P.); (S.B.); (C.H.); (T.S.)
- Correspondence: ; Tel.: +49-351-458-7456
| | - Yousef Alkhafaji
- Clinic of Operative and Pediatric Dentistry, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Germany; (Y.A.); (A.P.); (S.B.); (C.H.); (T.S.)
| | - Anne Pioch
- Clinic of Operative and Pediatric Dentistry, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Germany; (Y.A.); (A.P.); (S.B.); (C.H.); (T.S.)
| | - Evelyn Trips
- Coordination Center for Clinical Studies Dresden, Medical Faculty Carl Gustav Carus, Technical University Dresden, Fetscherstraße 74, 01309 Dresden, Germany;
| | - Sabine Basche
- Clinic of Operative and Pediatric Dentistry, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Germany; (Y.A.); (A.P.); (S.B.); (C.H.); (T.S.)
| | - Martin Dannemann
- Faculty of Automotive Engineering, Institute of Energy and Transport Engineering, Westsächsische Hochschule Zwickau, Scheffelstraße 39, 08012 Zwickau, Germany;
| | - Alan Kilistoff
- Faculty of Medicine & Dentistry, University of Alberta, 11405 87th Ave NW, Edmonton, AB T6G 1C9, Canada;
| | - Christian Hannig
- Clinic of Operative and Pediatric Dentistry, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Germany; (Y.A.); (A.P.); (S.B.); (C.H.); (T.S.)
| | - Torsten Sterzenbach
- Clinic of Operative and Pediatric Dentistry, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Germany; (Y.A.); (A.P.); (S.B.); (C.H.); (T.S.)
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Improving the microbial sampling and analysis of secondary infected root canals by passive ultrasonic irrigation. Clin Oral Investig 2022; 26:4575-4586. [PMID: 35218427 PMCID: PMC9203407 DOI: 10.1007/s00784-022-04424-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 02/19/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE The persistence of pathogenic microorganisms in root canals is the most common reason for the failure of root canal treatment and the necessity of a root filling treatment, which results in an uncertain prognosis due to technical complexity and the variety of highly adaptable microorganisms. This study evaluated the effect of passive ultrasonic irrigation (PUI) on the outcome of the microbial analysis of root canal-treated teeth with persistent or recurrent apical inflammation in vivo. MATERIALS AND METHODS Sample collection was performed after root filling removal (sample S1, control group) and after PUI with NaCl (sample S2) using sterile paper points. In total, 19 samples were obtained. Quantification was performed by means of serial dilution of the samples. Subcultivated pure cultures were identified using MALDI-TOF MS complemented by the Vitek-2-System or PCR, followed by sequencing of the 16S rRNA gene. The results of the samples (S1 and S2) were evaluated regarding their bacterial count and composition. RESULTS The total count of bacteria and the number of aerobic/facultative anaerobic microorganisms significantly increased in the S2-samples after application of PUI. The number of obligate anaerobic microorganisms showed an increase after PUI, although it was not significant. We detected 12 different aerobic/facultative anaerobic microorganisms before PUI, and in 21 cases after PUI. Two different obligate anaerobic microorganisms were found in S1 samples compared to nine different species in S2 samples. CONCLUSIONS PUI is a powerful method for detaching bacteria in infected root canals and enables a more precise analysis of the etiology of persistent endodontic infections. CLINICAL RELEVANCE This study indicates that PUI exerts a positive cleansing effect and adds to the accessibility of microorganisms during the application of bactericidal rinsing solution in root canal treatments.
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Wong J, Manoil D, Näsman P, Belibasakis GN, Neelakantan P. Microbiological Aspects of Root Canal Infections and Disinfection Strategies: An Update Review on the Current Knowledge and Challenges. FRONTIERS IN ORAL HEALTH 2022; 2:672887. [PMID: 35048015 PMCID: PMC8757850 DOI: 10.3389/froh.2021.672887] [Citation(s) in RCA: 63] [Impact Index Per Article: 31.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 05/17/2021] [Indexed: 02/06/2023] Open
Abstract
The oral cavity is the habitat of several hundreds of microbial taxa that have evolved to coexist in multispecies communities in this unique ecosystem. By contrast, the internal tissue of the tooth, i.e., the dental pulp, is a physiologically sterile connective tissue in which any microbial invasion is a pathological sign. It results in inflammation of the pulp tissue and eventually to pulp death and spread of inflammation/infection to the periradicular tissues. Over the past few decades, substantial emphasis has been placed on understanding the pathobiology of root canal infections, including the microbial composition, biofilm biology and host responses to infections. To develop clinically effective treatment regimens as well as preventive therapies, such extensive understanding is necessary. Rather surprisingly, despite the definitive realization that root canal infections are biofilm mediated, clinical strategies have been focused more on preparing canals to radiographically impeccable levels, while much is left desired on the debridement of these complex root canal systems. Hence, solely focusing on "canal shaping" largely misses the point of endodontic treatment as the current understanding of the microbial aetiopathogenesis of apical periodontitis calls for the emphasis to be placed on "canal cleaning" and chemo-mechanical disinfection. In this review, we dissect in great detail, the current knowledge on the root canal microbiome, both in terms of its composition and functional characteristics. We also describe the challenges in root canal disinfection and the novel strategies that attempt to address this challenge. Finally, we provide some critical pointers for areas of future research, which will serve as an important area for consideration in Frontiers in Oral Health.
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Affiliation(s)
- Jasmine Wong
- Discipline of Endodontology, Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - Daniel Manoil
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institute, Huddinge, Sweden
| | - Peggy Näsman
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institute, Huddinge, Sweden
| | - Georgios N Belibasakis
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institute, Huddinge, Sweden
| | - Prasanna Neelakantan
- Discipline of Endodontology, Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
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42
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He X, Jin S, Fan W, Fan B. Synergistic In Vitro Antimicrobial Activity of Triton X-100 and Metformin against Enterococcus faecalis in Normal and High-Glucose Conditions. Microorganisms 2022; 10:microorganisms10010124. [PMID: 35056573 PMCID: PMC8780305 DOI: 10.3390/microorganisms10010124] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 12/22/2021] [Accepted: 01/05/2022] [Indexed: 02/04/2023] Open
Abstract
The prevention and treatment of oral diseases is more difficult in diabetic patients with poorly controlled blood glucose levels. This study aims to explore an effective, low-cytotoxicity medication for root canal treatment in diabetic patients. The antibacterial effect of the combination of Triton X-100 (TX-100) and metformin (Met) on Enterococcus faecalis (E. faecalis) was evaluated by determining the minimum inhibitory concentration (MIC), minimum bactericidal concentration required to kill 99% bacteria (MBC99) and by conducting dynamic time-killing assays. While the antibiofilm activity was measured by crystal violet (CV) assay, field emission scanning electron microscope (FE-SEM), confocal laser scanning microscope (CLSM) and colony-forming unit (CFU) counting assays. The expression of relative genes was evaluated by real-time quantitative polymerase chain reaction (RT-qPCR), and the cytotoxicity of the new combination on MC3T3-E1 cell was also tested. Results showed that the antibacterial and antibiofilm activities of Met could be significantly enhanced by very low concentrations of TX-100 in both normal and high-glucose conditions, with a much lower cytotoxicity than 2% chlorhexidine (CHX). Thus, the TX-100 + Met combination may be developed as a promising and effective root canal disinfectant for patients with diabetes.
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Affiliation(s)
| | | | - Wei Fan
- Correspondence: (W.F.); (B.F.); Tel.: +86-27-8768-6210 (W.F.)
| | - Bing Fan
- Correspondence: (W.F.); (B.F.); Tel.: +86-27-8768-6210 (W.F.)
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43
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Chianca GC, Antunes LAA, Ornellas PO, Neves FPG, Póvoa HCC, Iorio NLPP. Virulence of Lactobacillus spp. misidentified as Enterococcus faecalis from children's carious dentine. Acta Odontol Scand 2022; 80:21-28. [PMID: 34107230 DOI: 10.1080/00016357.2021.1934534] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Objective: This study aimed to search for Enterococcus faecalis in children's deep carious dentine and characterize their virulence traits.Material and Methods: Eight isolates from 15 carious molars identified by 16S rDNA species-specific PCR as E. faecalis were included. These eight isolates were subject to identification by MALDI-TOF and characterized regarding: (i) bacterial aggregation and biofilm formation on polystyrene and glass, with/without saliva, as single or dual-species (associated to Streptococcus mutans); (ii) environmental pH measurement before and after 24 h incubation; (iii) acidogenicity; (iv) gelatinase production; (v) macrophage adherence; and (vi) toxicity towards Caenorhabditis elegans. Statistical analyses were performed using two-way ANOVA/Tukey or Fisher's exact tests.Results: All isolates initially identified as E. faecalis by PCR were correctly identified as Lactobacillus by MALDI-TOF, being designated as Lactobacillus misidentified as Enterococcus (LME). These isolates produced biofilm in the presence of saliva and in the dual-species assays. Bacterial aggregation was only observed in the dual-species model. After 24 h, environmental pH dropped from 7.5 to 4.5 for seven of eight isolates, and to 4.0 in all dual-species models. LME isolates were acidogenic, none of them produced gelatinase or adhered to macrophages, but all presented toxicity towards C. elegans.Conclusions: No E. faecalis were identified in the children's caries lesions. All LME isolates presented important virulence traits, including biofilm formation and high acidogenicity, which cause enamel demineralization, that might increase the risk of dental caries in children carrying LME. Thus, the correct identification and in-depth virulence characterization of microorganisms isolated from dental caries are important to understand the dynamics of this disease.
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Affiliation(s)
- Gabriela Ceccon Chianca
- Department of Basic Science, Universidade Federal Fluminense (UFF), Nova Friburgo, Rio de Janeiro, Brazil
- Faculdade de Farmácia, Universidade Estácio de Sá (UNESA), Nova Friburgo, Rio de Janeiro, Brazil
| | - Lívia Azeredo Alves Antunes
- Department of Specific Formation, Universidade Federal Fluminense (UFF), Nova Friburgo, Rio de Janeiro, Brazil
| | - Pâmela Oliveira Ornellas
- Department of Specific Formation, Universidade Federal Fluminense (UFF), Nova Friburgo, Rio de Janeiro, Brazil
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44
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Hazar E, Sağlam B, Ulusoy-Atasoy Ö, Koçak M, Koçak S. Evaluation of irrigation techniques in the removal of root canal filling material: Micro-CT and SEM study. BALKAN JOURNAL OF DENTAL MEDICINE 2022. [DOI: 10.5937/bjdm2202075h] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Background/Aim: This study aimed to compare the different irrigation activation methods in retreatment of oval-shaped root canals. Material and Methods: Forty distal canals from mandibular molars were filled. After the removal of filling material, specimens were assigned to four groups as follows; control, passive ultrasonic irrigation (PUI), self-adjusting file (SAF), and XP-endo Finisher (XPF). The amount of residual filling material was assessed by micro-computed tomography (micro-CT) and root canal walls were examined by using scanning electrom microscopy (SEM). Data were analyzed using the Kruskal-Wallis and Dunn test. Results: None of the activation techniques removed root canal remnants completely. The amount of filling material significantly decreased in all activation techniques compared to the control group (p<0.05). There was no significant difference between the PUI, SAF, and XPF groups in the micro-CT analysis (p>0.05). SEM evaluation showed higher scores in the apical region in all groups (p<0.05). Conclusions: The use of activation methods reduces the amount of residual filling material.
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45
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Assessing the Iatrogenic Contribution to Contamination During Root Canal Treatment. J Endod 2022; 48:479-486. [DOI: 10.1016/j.joen.2022.01.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 12/22/2021] [Accepted: 01/13/2022] [Indexed: 12/14/2022]
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46
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Siqueira JF, Rôças IN. Present status and future directions - microbiology of endodontic infections. Int Endod J 2021; 55 Suppl 3:512-530. [PMID: 34958494 DOI: 10.1111/iej.13677] [Citation(s) in RCA: 105] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 12/22/2021] [Accepted: 12/26/2021] [Indexed: 11/29/2022]
Abstract
Apical periodontitis has a microbial aetiology and is one of the most common inflammatory diseases that affect humans. Fungi, archaea and viruses have been found in association with apical periodontitis, but bacteria are by far the most prevalent and dominant microorganisms in endodontic infections. Bacterial infection of the root canal system only occurs when the pulp is necrotic or was removed for previous treatment. In some specific cases, including acute and chronic abscesses, the bacterial infection may reach the periradicular tissues. Intracanal bacteria are usually observed as sessile multispecies communities (biofilms) attached to the dentinal root canal walls. Infection in the main root canal lumen can spread to other areas of the root canal system. Although more than 500 bacterial species have been detected in endodontic infections, a selected group of 20 to 30 species are most frequently detected and may be considered as the core microbiome. There is a high interindividual variability in the endodontic microbiome in terms of species composition and relative abundance. Obligate anaerobic species are more abundant in the intraradicular bacterial communities of teeth with primary apical periodontitis, while both anaerobes and facultatives dominate the communities in post-treatment apical periodontitis. Bacterial interactions play an essential role in determining the overall virulence of the community, which has been regarded as the unit of pathogenicity of apical periodontitis. This article reviews the microbiologic aspects of endodontic infections and provides perspectives for future research and directions in the field.
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Affiliation(s)
- José F Siqueira
- Department of Dental Research, Faculty of Dentistry, Iguaçu University (UNIG), Nova Iguaçu, RJ, and Department of Endodontics and Molecular Microbiology Laboratory, Faculty of Dentistry, Grande Rio University, Rio de Janeiro, RJ, Brazil
| | - Isabela N Rôças
- Department of Dental Research, Faculty of Dentistry, Iguaçu University (UNIG), Nova Iguaçu, RJ, and Department of Endodontics and Molecular Microbiology Laboratory, Faculty of Dentistry, Grande Rio University, Rio de Janeiro, RJ, Brazil
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47
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Ali NT, El-Boghdadi RM, Ibrahim AM, Amin SAW. Clinical and microbiological effects of ultrasonically activated irrigation versus syringe irrigation during endodontic treatment: a systematic review and meta-analysis of randomized clinical trials. Odontology 2021; 110:419-433. [PMID: 34729673 DOI: 10.1007/s10266-021-00671-8] [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: 08/11/2021] [Accepted: 10/19/2021] [Indexed: 11/26/2022]
Abstract
This study aimed to systematically review clinical and microbiology-related effects of ultrasonically activated irrigation (UAI) compared to syringe irrigation (SI) during endodontic treatment. Electronic databases searching and manual searching were conducted. Only randomized clinical trials (RCTs) were included comparing UAI to SI. The RoB 2.0 Cochrane tool was used for risk-of-bias (RoB) assessment. The main outcomes were postoperative pain, treatment failure, and microbiology-related outcomes. Qualitative and quantitative analyses, wherever applicable, were performed. Risk ratios (RR) and [standardized] mean differences {[S]MD} were calculated for dichotomous and continuous outcomes, respectively. Certainty of evidence (CoE) was assessed using GRADE tool. Ten RCTs were included. UAI reduced pain incidence within the first 24 h (RR 0.50, 95% CI 0.35-0.71, 308 teeth) and microbial counts (SMDpooled - 0.40, 95% CI [- 0.78, - 0.02], I2 = 0%, 126 teeth) than SI in non-vital teeth with apical periodontitis (AP). Both groups, however, had similar effects regarding pain intensity, lipopolysaccharide amounts, and the incidence of rescue-analgesic intake, treatment failure, and microbial presence (p > 0.05). CoE ranged from low to very low. Very limited evidence suggests that UAI could reduce postoperative-pain risk within the first 24 h and microbial counts for non-vital teeth with AP compared to SI. Most meta-analyses, however, are based on very few studies, mostly low-powered, with an overall very-low-to-low CoE. Further well-designed, larger RCTs are, thus, required.
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Affiliation(s)
- Noha Tawfik Ali
- Department of Endodontics, Faculty of Dentistry, Cairo University, 11 ElSaraya Street, ElManyal, Cairo, 11553, Egypt
| | - Randa Mohamed El-Boghdadi
- Department of Endodontics, Faculty of Dentistry, Cairo University, 11 ElSaraya Street, ElManyal, Cairo, 11553, Egypt
| | - Ahmed Mohamed Ibrahim
- Department of Endodontics, Faculty of Dentistry, Cairo University, 11 ElSaraya Street, ElManyal, Cairo, 11553, Egypt
| | - Suzan Abdul Wanees Amin
- Department of Endodontics, Faculty of Dentistry, Cairo University, 11 ElSaraya Street, ElManyal, Cairo, 11553, Egypt.
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48
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Siqueira JF, Rôças IN. A critical analysis of research methods and experimental models to study the root canal microbiome. Int Endod J 2021; 55 Suppl 1:46-71. [PMID: 34714548 DOI: 10.1111/iej.13656] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 10/22/2021] [Accepted: 10/27/2021] [Indexed: 12/15/2022]
Abstract
Endodontic microbiology deals with the study of the microbial aetiology and pathogenesis of pulpal and periradicular inflammatory diseases. Research in endodontic microbiology started almost 130 years ago and since then has mostly focussed on establishing and confirming the infectious aetiology of apical periodontitis, identifying the microbial species associated with the different types of endodontic infections and determining the efficacy of treatment procedures in eradicating or controlling infection. Diverse analytical methods have been used over the years, each one with their own advantages and limitations. In this review, the main features and applications of the most used technologies are discussed, and advice is provided to improve study designs in order to properly address the scientific questions and avoid setbacks that can compromise the results. Finally, areas of future research are described.
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Affiliation(s)
- José F Siqueira
- Department of Endodontics and Molecular Microbiology Laboratory, Faculty of Dentistry, Grande Rio University, Rio de Janeiro, Brazil.,Department of Dental Research, Faculty of Dentistry, Iguaçu University (UNIG), Nova Iguaçu, Brazil
| | - Isabela N Rôças
- Department of Endodontics and Molecular Microbiology Laboratory, Faculty of Dentistry, Grande Rio University, Rio de Janeiro, Brazil.,Department of Dental Research, Faculty of Dentistry, Iguaçu University (UNIG), Nova Iguaçu, Brazil
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Comparison of Apical Extrusion of Bacteria After Glide Path Preparation Between Manual K File, One G Rotary, and WaveOne Gold Glider Reciprocation Preparations. Eur Endod J 2021; 6:221-225. [PMID: 34650017 PMCID: PMC8461488 DOI: 10.14744/eej.2021.30602] [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] [Indexed: 11/20/2022] Open
Abstract
Objective: To compare the amount of apically extruded bacteria between hand-filed preparations, rotary and reciprocation glide path preparations in curved canals of extracted teeth infected with Enterococcus faecalis. Methods: Forty mandibular first molar teeth were decoronated, fitted into rubber stoppers and fixed onto glass vials. The mesiobuccal canals from mandibular first molar teeth were infected with Enterococcus faecalis, then randomly assigned to one of five groups for glide path preparation: manual stainless-steel file (K-files), rotary file (One G), reciprocating file (WaveOne Gold Glider) and two control groups. After glide path preparation, 0.01 mL of saline was taken from the experimental vials. The solution was plated on tryptic soy agar and colonies of bacteria were counted as colony-forming units. The results were analysed statistically using Kruskal-Wallis and post hoc Mann-Whitney U tests. Results: The manual K-file group was associated with significantly more bacteria extrusion compared to the rotary and reciprocating groups (P<0.05). However, no significant difference occurred between rotary and reciprocation instruments. Conclusion: All instrumentation techniques resulted in a measurable amount of apical extrusion of bacteria. Manual K-files extruded the highest quantity of bacteria compared to One G rotary file and WaveOne Gold Glider reciprocation file during glide path preparation.
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50
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Influence of the Geometrical Cross-Section Design on the Dynamic Cyclic Fatigue Resistance of NiTi Endodontic Rotary Files-An In Vitro Study. J Clin Med 2021; 10:jcm10204713. [PMID: 34682836 PMCID: PMC8537992 DOI: 10.3390/jcm10204713] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 10/07/2021] [Accepted: 10/11/2021] [Indexed: 11/21/2022] Open
Abstract
The aim of this study was to analyze and compare the influence of the geometrical cross-section design on the dynamic cyclic fatigue resistance of NiTi endodontic rotary files. Materials and Methods: Forty sterile endodontic rotary files were selected and distributed into the following study groups: A: 25.06 double S-shaped cross-section NiTi alloy endodontic rotary files (Mtwo) (n = 10); B: 20.04 rectangular cross-section NiTi alloy endodontic rotary files (T Pro E1) (n = 10); C: 25.04 convex triangular cross-section NiTi alloy endodontic rotary files (T Pro E2) (n = 10); and D: 25.06 triangular cross-section NiTi alloy endodontic rotary files (T Pro E4) (n = 10). A cyclic fatigue device was used to conduct the static cyclic fatigue tests with stainless steel artificial root canal systems with 200 µm and 250 µm apical diameter, 60° curvature angle, 3 mm radius of curvature, 20 mm length, and 4% and 8% taper. The results were analyzed using the ANOVA test and Weibull statistical analysis. Results: All the pairwise comparisons presented statistically significant differences between the time to failure and number of cycles to failure for the cross-section design study groups (p < 0.001). Conclusions: the double S-shaped cross-section of Mtwo NiTi endodontic files shows higher cyclic fatigue resistance than the rectangular cross-section of T Pro E1 NiTi endodontic files, the convex triangular cross-section of T Pro E2 NiTi endodontic files, and the triangular cross-section of T Pro E4 NiTi endodontic files.
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