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Gupta I, Kaur M, Kanaparthy A, Satyabrata Nanda S, Pavagada Sreenivasalu PK, Vathsala N, Bhasin R. Evaluation of Antimicrobial Effectiveness of Root Canal Sealers Modified with Various Herbal Extracts against Candida Albicans and E Faecalis. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2024; 16:S130-S132. [PMID: 38595495 PMCID: PMC11001113 DOI: 10.4103/jpbs.jpbs_415_23] [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: 07/16/2023] [Revised: 07/23/2023] [Accepted: 07/24/2023] [Indexed: 04/11/2024] Open
Abstract
Objectives The aim of the study was to assess the effectiveness of ZOE-based, calcium hydroxide, and epoxy resin-based sealers on modification with three herbal extracts. Materials and Methods Methanolic extracts of selected herbs were combined with ZOE-based, calcium hydroxide, and epoxy resin-based sealers. Cultures were prepared from E. faecalis and C. albicans and agar plates prepared. Prepared mixtures were inoculated in punched holes, and inhibitory zones were measured. Results No statistical significance was obtained on comparing mean scores of test groups. Conclusion None of the combinations used was found to be significantly better than others.
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Affiliation(s)
- Ishan Gupta
- Specialist Endodontist, Sharjah Specialized Dental Centre (EHS), United Arab Emirates
| | - Manpreet Kaur
- Associate Professor, Department of Oral Pathology, Maharishi Markandeshwar College of Dental Sciences and Research (Deemed to be University) Mullana, Haryana, India
| | - Aruna Kanaparthy
- Professor, Department of Conservative Dentistry and Endodontics, College of Dental Sciences & Hospital, Amargadh, Gujarat, India
| | - Saswat Satyabrata Nanda
- Reader, Department of Conservative Dentistry, Institute of Dental Sciences, Shampur, Bhubaneswar, Odisha, India
| | - Pavan Kumar Pavagada Sreenivasalu
- Assistant Professor, Department of Restorative Dental Sciences, College of Dentistry, King Faisal University, PO Box 400, Al Asha-31982, Kingdom of Saudi Arabia
| | - N Vathsala
- Professor, Department of Conservative Dentistry & Endodontics, RVS Dental College & Hospital, Coimbatore, Tamil Nadu, India
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Amoroso-Silva P, Brasil SC, Pérez AR, Tolentino ES, Alves FRF, Siqueira JF, Rôças IN. Influence of sealer type on treatment outcome of teeth with apical periodontitis: a systematic review. Braz Dent J 2023; 34:1-21. [PMID: 38133464 PMCID: PMC10759954 DOI: 10.1590/0103-6440202305471] [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: 08/11/2023] [Accepted: 10/20/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND The purpose of this article was to Evaluate the influence of sealer on the outcome of non-surgical endodontic treatment or retreatment of permanent teeth with apical periodontitis (PROSPERO registration: CRD42020205951). METHODOLOGY A systematic review of original clinical studies was carried out following PRISMA guidelines to answer whether the type of sealer used in endodontic treatment or retreatment influences the repair of apical periodontitis determined by clinical and radiographic parameters. Electronic searches were performed in PubMed, Embase, Web of Science, Scopus, and the Cochrane Library database, until May 2023. Gray literature and a hand search of reference lists were also performed. The risk of bias was assessed using Cochrane RoB2 for randomized trials and the Newcastle-Ottawa Scale (NOS) for prospective and retrospective cohort and case-control studies. RESULTS Among 1046 studies, a total of 819 were selected by title and abstract, resulting in 23 for full-text review. In total, 11 studies met the inclusion criteria (1467 patients/teeth with apical periodontitis). The quality assessment using RoB2 included five randomized control trials, of which four had medium risk and one had a low risk of bias. According to the NOS scale, five studies were classified as low risk and one study was considered as medium risk of bias. The sealer type and obturation techniques varied, and the mean follow-up time was 3.7 years. Most studies used two-dimensional radiographic criteria to assess the treatment outcome sealers and not cements. Eight studies did not find significant differences when comparing cements. The healing rates ranged from 56.7% to 90%. CONCLUSIONS The results of this review support that the current endodontic sealers do not seem to influence the treatment outcome of permanent teeth with apical periodontitis. Although the studies had medium and low risk of bias, the results should be interpreted with caution. More randomized studies of long-term outcomes comparing filling materials are needed to strengthen this claim and allow for a meta-analysis.
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Affiliation(s)
- Pablo Amoroso-Silva
- Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, RJ, Brazil
| | - Sabrina C. Brasil
- Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, RJ, Brazil
| | | | - Elen S. Tolentino
- Department of Dentistry, State University of Maringá, Maringá, PR, Brazil
| | - Flávio R. F. Alves
- Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, RJ, Brazil
- Department of Dental Research, Faculty of Dentistry, Iguaçu University (UNIG), Nova Iguaçu, RJ, Brazil
| | - José F. Siqueira
- Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, RJ, Brazil
- Department of Dental Research, Faculty of Dentistry, Iguaçu University (UNIG), Nova Iguaçu, RJ, Brazil
| | - Isabela N. Rôças
- Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, RJ, Brazil
- Department of Dental Research, Faculty of Dentistry, Iguaçu University (UNIG), Nova Iguaçu, RJ, Brazil
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Suwartini T, Santoso J, Widyarman AS, Ratnasari D. Efficacy of Bioceramic and Calcium Hydroxide-Based Root Canal Sealers against Pathogenic Endodontic Biofilms: An In vitro Study. Contemp Clin Dent 2022; 13:322-330. [PMID: 36687000 PMCID: PMC9855266 DOI: 10.4103/ccd.ccd_198_21] [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: 03/08/2021] [Revised: 06/16/2021] [Accepted: 07/19/2021] [Indexed: 12/24/2022] Open
Abstract
Background Complete eradication of root canal pathogens cannot be predictably achieved by chemomechanical preparation and root canal disinfection. Therefore, an obturation material that has superior antimicrobial activity and sealing ability is required to inactivate residual microbes and prevent them from reentering the root canal system. Recently developed bioceramic root canal sealers are hydraulic cement which form calcium hydroxide during the hydration process. Like calcium hydroxide sealers, they exert an antimicrobial effect by releasing hydroxyl ions and increasing the pH. Objective The objective of this study was to evaluate and compare the antimicrobial activity of a calcium hydroxide-based sealer and two bioceramic sealers against Porphyromonas gingivalis, Enterococcus faecalis, and Candida albicans biofilms. Materials and Methods The sealers were dissolved in sterile saline to obtain supernatants. Biofilm formation assays, colony counting, and real-time polymerase chain reaction (PCR) were performed to evaluate the antimicrobial activity of each supernatant. The data were analyzed using one-way analysis of variance. Results All sealers exerted effects against all three microbial biofilms. The biofilm formation assays showed that the bioceramic sealers were more effective against P. gingivalis and E. faecalis biofilms. In contrast, colony counting and real-time PCR showed that the calcium hydroxide sealer was significantly more effective than the bioceramic sealers. All tests showed that the calcium hydroxide sealer was more effective against C. albicans, with the colony count and real-time PCR results showing statistically significant differences. Conclusion The calcium hydroxide-based sealer was more effective than the bioceramic sealers in eradicating pathogenic root canal biofilms.
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Affiliation(s)
- Tien Suwartini
- Department of Conservative Dentistry, Faculty of Dentistry, Universitas Trisakti, Jakarta, Indonesia
| | - Jessica Santoso
- Conservative Dentistry Postgraduate Program, Department of Conservative Dentistry, Faculty of Dentistry, Universitas Trisakti, Jakarta, Indonesia
| | - Armelia Sari Widyarman
- Department of Microbiology, Division of Oral Biology, Faculty of Dentistry, Universitas Trisakti, Jakarta, Indonesia
| | - Dina Ratnasari
- Department of Conservative Dentistry, Faculty of Dentistry, Universitas Trisakti, Jakarta, Indonesia
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Saavedra FM, Pelepenko LE, Boyle WS, Zhang A, Staley C, Herzberg MC, Marciano MA, Lima BP. In vitro physicochemical characterization of five root canal sealers and their influence on an ex vivo oral multi-species biofilm community. Int Endod J 2022; 55:772-783. [PMID: 35383959 PMCID: PMC9321831 DOI: 10.1111/iej.13742] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 03/14/2022] [Accepted: 03/30/2022] [Indexed: 11/29/2022]
Abstract
AIM To evaluate the physicochemical properties of five root canal sealers and assess their effect on an ex vivo dental plaque-derived polymicrobial community. METHODOLOGY Dental plaque-derived microbial communities were exposed to the sealers (AH Plus [AHP], GuttaFlow Bioseal [GFB], Endoseal MTA [ESM], Bio-C sealer [BCS] and BioRoot RCS [BRR]) for 3, 6 and 18 h. The sealers' effect on the biofilm biomass and metabolic activity was quantified using crystal violet (CV) staining and MTT assay, respectively. Biofilm community composition and morphology were assessed by denaturing gradient gel electrophoresis (DGGE), 16S rRNA sequencing and scanning electron microscopy. The ISO6876:2012 specifications were followed to determine the setting time, radiopacity, flowability and solubility. Obturated acrylic teeth were used to assess the sealers' effect on pH. Surface chemical characterization was performed using SEM with coupled energy-dispersive spectroscopy. Data normality was assessed using the Shapiro-Wilk test. One-way anova and Tukey's tests were used to analyze data from setting time, radiopacity, flowability and solubility. Two-way anova and Dunnett's tests were used for the data analysis from CV, MTT and pH. 16S rRNA sequencing data were analyzed for alpha (Shannon index and Chao analysis) and beta diversity (Bray-Curtis dissimilarities). Differences in community composition were evaluated by analysis of similarity (p < .05). RESULTS The sealers significantly influenced microbial community composition and morphology. All sealers complied with ISO6876:2012 requirements for setting time, radiopacity and flowability. Although only AHP effectively reduced the biofilm biomass, all sealers, except BRR, reduced biofilm metabolic activity. CONCLUSION Despite adequate physical properties, none of the sealers tested prevented biofilm growth. Significant changes in community composition were observed. If observed in vivo, these changes could affect intracanal microbial survival, pathogenicity and treatment outcomes.
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Affiliation(s)
- Flavia M. Saavedra
- Department of Restorative DentistrySchool of Dentistry of PiracicabaState University of CampinasPiracicabaBrazil
- Department of Diagnostic and Biological SciencesSchool of DentistryUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Lauter E. Pelepenko
- Department of Restorative DentistrySchool of Dentistry of PiracicabaState University of CampinasPiracicabaBrazil
| | - William S. Boyle
- Department of Diagnostic and Biological SciencesSchool of DentistryUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Anqi Zhang
- Minnesota Dental Research Center for Biomaterials and Biomechanics (MDRCBB)School of DentistryUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Christopher Staley
- Division of Basic & Translational ResearchDepartment of SurgeryUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Mark C. Herzberg
- Department of Diagnostic and Biological SciencesSchool of DentistryUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Marina A. Marciano
- Department of Restorative DentistrySchool of Dentistry of PiracicabaState University of CampinasPiracicabaBrazil
| | - Bruno P. Lima
- Department of Diagnostic and Biological SciencesSchool of DentistryUniversity of MinnesotaMinneapolisMinnesotaUSA
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Liu H, Li H, Zhang L, Wang Z, Qian J, Yu M, Shen Y. In vitro evaluation of the antibacterial effect of four root canal sealers on dental biofilms. Clin Oral Investig 2022; 26:4361-4368. [PMID: 35137277 DOI: 10.1007/s00784-022-04399-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 02/03/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To dynamically evaluate the effect of four root canal sealers on the killing of biofilms within dentinal tubules. MATERIALS AND METHODS Dentin blocks were prepared for infection of the dentinal tubules. Enterococcus faecalis VP3-181 and multi-species bacteria from two donors were cultured. After 3 days of incubation, the infected dentin specimens were rinsed with sterile water for 1 min and subjected to treatment. Additionally, multi-species bacteria from donor 1 were incubated for 3 weeks to allow biofilm maturation and then the specimens were subjected to treatment. Gutta-percha-treated dentin specimens comprised the control group. A root canal sealer (bioceramic sealers: EndoSequence BC Sealer, ProRoot Endo Sealer, or GuttaFlow Bioseal; and a traditional silicone-based sealer: Guttaflow 2) was spread onto the canal walls of the dentin. The specimens were examined with confocal laser scanning microscopy at 7, 30, or 60 days. RESULTS In the 3-day-old biofilm group, the proportion of killed bacteria decreased significantly from the first 7 days of treatment to 60 days of treatment for all sealers (p < 0.05). In the 3-week-old biofilm group, 60 days of exposure to bioceramic sealers resulted in more significant dead bacteria than 7-day exposures of the biofilms (p < 0.05). Bioceramic sealers were more effective in killing bacteria than the GuttaFlow 2 sealer (p < 0.05). CONCLUSIONS Calcium silicate-based sealers showed good antimicrobial effects against biofilms within dentinal tubules, especially in the first week in young biofilms. There is no substantive antibacterial activity observed for the examined root canal sealers against young dentinal tubule biofilms. CLINICAL RELEVANCE The bioceramic root canal sealers examined demonstrate minimal additional antibacterial effects after long-term exposure to young biofilms.
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Affiliation(s)
- He Liu
- Department of Stomatology, Affiliated Hospital of Jining Medical University, Jining, People's Republic of China.,Division of Endodontics, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, 2199 Wesbrook Mall, Vancouver, V6T 1Z3, Canada
| | - Heng Li
- Department of Stomatology, Affiliated Hospital of Jining Medical University, Jining, People's Republic of China
| | - Lei Zhang
- Department of Stomatology, Affiliated Hospital of Jining Medical University, Jining, People's Republic of China
| | - Zhejun Wang
- Division of Endodontics, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, 2199 Wesbrook Mall, Vancouver, V6T 1Z3, Canada
| | - Junrong Qian
- Department of Stomatology, Affiliated Hospital of Jining Medical University, Jining, People's Republic of China
| | - Miao Yu
- Department of Periodontics, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510182, People's Republic of China.
| | - Ya Shen
- Division of Endodontics, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, 2199 Wesbrook Mall, Vancouver, V6T 1Z3, Canada.
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Khan A, Nikhil V, Pandey A, Chaturvedi P. Effectiveness of polyhexamethylene biguanide, chlorhexidine, and calcium hydroxide intracanal medicament against intraradicular mature polymicrobial biofilm: A microbiological study. J Conserv Dent 2022; 25:536-540. [PMID: 36506630 PMCID: PMC9733553 DOI: 10.4103/jcd.jcd_288_22] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 06/05/2022] [Accepted: 06/06/2022] [Indexed: 12/15/2022] Open
Abstract
Aim To compare the effectiveness of different intracanal medicaments against polymicrobial biofilm formed by Enterococcus faecalis, Staphylococcus aureus, and Candida albicans. Materials and Methods Eighty mature human roots with intraradicular polymicrobial biofilm were randomly assigned into four groups (n = 20). Intracanal medicaments 0.2% polyhexamethylene biguanide (PHMB), 2% chlorhexidine (CHX), and calcium hydroxide (CH) were applied into the root canals. Collected dentine samples were tested at 7th, 15th, and 30th day for microbial growth, and the colony-forming units per ml (CFU/ml) were determined. Results The CFU/ml data were analyzed using unpaired t-test and one-way ANOVA-F comparison test. All medicaments resulted in a significant reduction (P < 0.05) in microbial growth at all time intervals compared to the control group. CHX and PHMB showed a similar reduction in CFU/ml at 7th and 15th day but significantly more than CH at all time intervals. At 30th day, PHMB caused a significantly more reduction in CFU/ml than CHX. Conclusions All the three tested intracanal medicaments such as CH, CHX, and PHMB Gel were effective in reducing the microbial count. CH has a limited antimicrobial effect against the polymicrobial biofilm found inside the root canal. 2% CHX gel has a time-dependent antimicrobial effect. PHMB has a superior antimicrobial effect in comparison with CHX and CH.
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Affiliation(s)
- Aleena Khan
- Department of Conservative Dentistry and Endodontics, Subharti Dental College and Hospital, Swami Vivekanand Subharti University, Meerut, Uttar Pradesh, India
| | - Vineeta Nikhil
- Department of Conservative Dentistry and Endodontics, Subharti Dental College and Hospital, Swami Vivekanand Subharti University, Meerut, Uttar Pradesh, India,Address for correspondence: Dr. Vineeta Nikhil, Subharti Dental College and Hospital, Swami Vivekanand Subharti University, NH-58 Bypass Road, Meerut - 250 005, Uttar Pradesh, India. E-mail:
| | - Anita Pandey
- Department of Microbiology, Subharti Medical College and Hospital, Swami Vivekanand Subharti University, Meerut, Uttar Pradesh, India
| | - Priyanka Chaturvedi
- Department of Microbiology, Subharti Medical College and Hospital, Swami Vivekanand Subharti University, Meerut, Uttar Pradesh, India
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Assessment of Root Canal Sealers Loaded with Drug-Silica Coassembled Particles Using an In Vitro Tooth Model. J Endod 2021; 47:1775-1782. [PMID: 34425150 DOI: 10.1016/j.joen.2021.08.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 08/07/2021] [Accepted: 08/12/2021] [Indexed: 12/17/2022]
Abstract
INTRODUCTION The purpose of this study was to assess the antimicrobial activity of root canal sealers modified with novel highly loaded antimicrobial drug-silica coassembled particles (DSPs) on Enterococcus faecalis-infected root canal dentin. METHODS DSPs were synthesized through coassembly of silica and octenidine dihydrochloride (OCT) surfactant drug (35% w/w OCT). DSPs (1% wt of the total mass of the sealer) were mixed homogenously with either epoxy resin sealer (AH Plus [AH]; Dentsply Sirona, Tulsa, OK) or calcium silicate-based sealer (EndoSequence BC Sealer [BC]; Brasseler, Savannah, GA). To assess the antimicrobial activity of DSP-loaded sealers, the apical third of single-rooted teeth was obtained and infected with E. faecalis for 3 weeks followed by the application of experimental (DSP-loaded) sealers or corresponding controls for up to 28 days. Microbiological analysis and laser scanning confocal and scanning electron microscopy were used to determine the colony-forming unit (CFU)/mL, the percentage of live bacteria, and the intratubular bacterial and sealer penetrations. Factorial analysis of variance and Tukey post hoc tests were used to assess the antimicrobial effect of DSPs on different sealers. RESULTS All experimental groups showed significant reductions in CFUs at all-time points compared with positive controls (P < .05). The addition of DSPs to BC significantly reduced the CFUs (2.11 ± 0.13, 2.22 ± 0.19, and 2.25 ± 0.17 at 1, 7, and 28 days, respectively) compared with the unmodified sealer (3.21 ± 0.11, 4.3 ± 0.15, and 4.2 ± 0.2 at 0, 7, and 28 days). DSPs enhanced the antimicrobial performance of AH only at 1 day (4.21 ± 0.17 vs 5.19 ± 0.12, P < .05). AH and AH + DSPs showed higher bacterial viability compared with BC and BC + DSPs at all incubation periods (P < .05). CONCLUSIONS Loading endodontic sealers with DSPs had a material-dependent effect on the antimicrobial properties and could reduce the incidence of secondary infections.
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Abou ElReash A, Hamama H, Comisi JC, Zaeneldin A, Xiaoli X. The effect of retrograde material type and surgical techniques on the success rate of surgical endodontic retreatment: systematic review of prospective randomized clinical trials. BMC Oral Health 2021; 21:375. [PMID: 34303365 PMCID: PMC8306275 DOI: 10.1186/s12903-021-01731-9] [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: 04/15/2021] [Accepted: 07/16/2021] [Indexed: 11/30/2022] Open
Abstract
Background Endodontic surgical procedures, when performed, require retrograde filling materials that are biocompatible, non-toxic, non-irritant, dimensionally stable, and ideally promote bone formation. Precise evaluation of retrograde filling materials in clinical trials is necessary to give holistic view for properties of material and potential outcome from its use. The purpose of this review is to evaluate the effect of retrograde material type and surgical techniques on the success rate of surgical endodontic retreatment. Methods An electronic search was performed in the time frame between 1st of January 2000 to 1st of September 2020 using database. Sources Web of Science, PubMed and redundant hand searches through their references. Seven inclusion–exclusion criteria were set for the selection and identification of relevant articles. Risk of bias was conducted for the included studies. Results Nine randomized clinical trials (RCTs) fulfilled the inclusion criteria for this systematic review. The outcome of this review revealed that none of the reviewed trials totally-fulfilled CONSORT 2010 criteria. Conclusions In light of the outcome of this review, there is no enough evidence to support the superiority of certain retrograde filling material or surgical technique over another in the success rate of surgical endodontics retreatment. The variety of methodologies and strategies, such as patient selection, the method of treatment and study analysis, led to doubtful credibility of the obtained clinical evidence. Further prospective randomized controlled clinical trials evaluating the specific effect of the various used materials are needed.
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Affiliation(s)
- Ashraf Abou ElReash
- Department of Endodontic, Xiangya School of Stomatology, Central South University, Xiangya Road No 72. Kaifu, Changsha, 410078, Hunan Province, China
| | - Hamdi Hamama
- Department of Operative Dentistry, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - John C Comisi
- Department of Oral Rehabilitation, Medical University of South Carolina, James B. Edwards College of Dental Medicine, Charleston, SC, USA
| | - Ahmed Zaeneldin
- Restorative Dental Sciences Department, Prince Philip Dental Hospital, The University of Hong Kong, Hong Kong, Hong Kong
| | - Xie Xiaoli
- Department of Endodontic, Xiangya School of Stomatology, Central South University, Xiangya Road No 72. Kaifu, Changsha, 410078, Hunan Province, China.
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Ismail IH, Al-Bayaty FH, Yusof EM, Gulam Khan HBS, Hamka FA, Azmi NA. Evaluation of antimicrobial effect of Malaysian geopropolis with Aloe vera against Enterococcus faecalis to be used as an intracanal medicament in endodontics. J Conserv Dent 2021; 23:489-496. [PMID: 33911359 PMCID: PMC8066667 DOI: 10.4103/jcd.jcd_528_20] [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: 10/13/2020] [Revised: 11/25/2020] [Accepted: 11/27/2020] [Indexed: 12/05/2022] Open
Abstract
Introduction: Enterococcus faecalis can be found in failed endodontic treatment (FET) even after performing primary endodontic treatment (PET). Calcium hydroxide (Ca(OH)2) cannot fully eliminate this microorganism during PET. Brazilian green propolis (bee glue) was found to be more effective against E. faecalis when compared to Ca(OH)2. A much less studied Malaysian geopropolis (MP) as well as Aloe vera (AV) is antibacterial but is unknown against E. faecalis. Objective: The objective of this study is to determine the antimicrobial effects of MP, AV, and MP + AV in comparison with Ca(OH)2 against E. faecalis, as an intracanal medicament. Materials and Methods: Antimicrobial activity of MP, AV, MP + AV, Ca(OH)2, and dimethyl sulfoxide was tested against E. faecalis using antimicrobial sensitivity testing, minimum inhibitory concentration (MIC), and minimum bactericidal concentration (MBC). The results were analyzed by Kruskal–Wallis test with Mann–Whitney post hoc test and repeated measures analysis of variance with Bonferroni post hoc test (P < 0.05). Results: For agar well-diffusion method, MP + AV gave maximum inhibition zone diameter (mean: 8.11 ± 0.015 mm), MP (mean: 6.21 ± 0.046 mm, Ca(OH)2 (mean: 5.5 ± 0.006), and AV (mean: 5.05 ± 0.012) with P < 0.05. MIC for MP + AV was 2 mg/ml, MP at 8 mg/ml, Ca(OH)2 at 8 mg/ml, and AV at 16 mg/ml. The MBC for MP + AV is at 4 mg/ml, MP at 16 mg/ml, Ca(OH)2 at 16 mg/ml, and AV at 32 mg/ml. Conclusion: The combination of MP and AV consistently showed better antimicrobial activity compared to MP and AV alone against E. faecalis. The findings suggest that MP and AV used in combination may be an ideal intracanal medicament in FET and PET.
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Affiliation(s)
- Ikmal Hisham Ismail
- Centre for Comprehensive Care Studies UiTM, Faculty of Dentistry, Universiti Teknologi MARA (UiTM), Selangor, Malaysia
| | - Fouad Hussain Al-Bayaty
- Centre for Periodontology Studies UiTM, Faculty of Dentistry, Universiti Teknologi MARA (UiTM), Selangor, Malaysia
| | - Eleena Mohd Yusof
- Centre for Restorative Dentistry Studies UiTM, Faculty of Dentistry, Universiti Teknologi MARA (UiTM), Selangor, Malaysia
| | | | - Farah Aminah Hamka
- Undergraduate Students, Faculty of Dentistry, Universiti Teknologi MARA (UiTM), Selangor, Malaysia
| | - Nur Amirah Azmi
- Undergraduate Students, Faculty of Dentistry, Universiti Teknologi MARA (UiTM), Selangor, Malaysia
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Rafi Shaik M, Sharaf MAF, Li X, Yousuf S, Pan SS. In vitro antimicrobial activity and comparison of the herbal extracts and sodium hypochlorite against primary plaque colonizers. FEMS Microbiol Lett 2021; 368:6136274. [PMID: 33587119 DOI: 10.1093/femsle/fnab017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 02/12/2021] [Indexed: 11/13/2022] Open
Abstract
NaClO is not suitable as a root canal irrigant because of its cytotoxicity. Good biocompatibility irrigants are required to have antibacterial activity. Many herbal products like Bee glue, Noni juice and Azadirachta indica have such properties. This study aims to investigate the possible effects of propolis, MCJ and Neem on bacterial infections and cytotoxicity in primary plaque colonizers. Direct contact and agar diffusion tests evaluated the antibacterial activity of herbal products against Fusobacterium, Candida albicans and Prevotella. The CCK 8 test determined the influence of these herbal products on the proliferation of human apical papilla stem cells (hSCAPs) and human periodontal fibroblasts (hPDLFs). A migration assay test was performed in addition to quantitative real-time PCR which measured osteogenic differentiation in hSCAPs. All herbal extracts tested in this study exhibited antibacterial activity comparable to NaClO against bacterial infections, while the strongest bacteriostatic effect was shown in the herbal treated group. These extracts had much weaker effects on the proliferation and migration of hSCAPs and hPDLFs as calculated by the CCK-8 assay against NaClO. Bee glue treatment had the most potent effect on osteogenic differentiation, followed by treatment with Noni juice and Azadirachta indica (Neem), while NaClO showed the lowest effect. For primary plaque colonizers of immature or advanced permanent teeth, Bee glue, Noni juice, and Azadirachta indica can be promising irrigants with good biocompatibility. Direct contact process and agar diffusion studies have tested the antibacterial activity against Fusobacterium, Candida albicans and Prevotella. The CCK 8 test determined the influence of these three plants on the proliferation of human apical papilla stem cells (hSCAPs) and human periodontal fibroblasts (hPDLFs). In order to examine migration ability, migration assay test was performed. Alizarin red staining, alkaline phosphatase (ALP) staining and quantitative real-time PCR measured osteo-/odontogenic differentiation in hSCAPs. All herbal extracts tested in this study exhibited antibacterial activity comparable to NaClO against bacterial infections, while the strongest bacteriostatic effect was shown in the treated group. These extracts had much weaker effects on the proliferation and migration of hSCAPs and hPDLFs as calculated by the CCK-8 assay against NaClO. Bee glue treatment had the most potent effect on osteo-odontogenic differentiation, followed by treatment with Noni juice and Azadirachta indica (Neem), while NaClO showed the lowest effect. For primary plaque colonizers of immature or advanced permanent teeth, Bee glue, Noni juice and Azadirachta indica (Neem) can be promising irrigants.
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Affiliation(s)
- Mohammed Rafi Shaik
- Department of Chemistry, College of Science, King Saud University, P.O. Box 2455, Riyadh 11451, Kingdom of Saudi Arabia
| | - Mohammed A F Sharaf
- Department of Industrial Engineering, College of Engineering, King Saud University, P.O. Box 800, Riyadh-11421, Kingdom of Saudi Arabia
| | - Xianping Li
- Harbin Medical University, Institute of Biological Information Science and Technology, Heilongjiang Province, 150001, People's Republic of China
| | - Syed Yousuf
- Department of Chemistry, College of Science, King Saud University, P.O. Box 2455, Riyadh 11451, Kingdom of Saudi Arabia
| | - Su-Shuang Pan
- Harbin Medical University, Institute of Biological Information Science and Technology, Heilongjiang Province, 150001, People's Republic of China
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11
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Bose R, Ioannidis K, Foschi F, Bakhsh A, Kelly RD, Deb S, Mannocci F, Niazi SA. Antimicrobial Effectiveness of Calcium Silicate Sealers against a Nutrient-Stressed Multispecies Biofilm. J Clin Med 2020; 9:jcm9092722. [PMID: 32846942 PMCID: PMC7563851 DOI: 10.3390/jcm9092722] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 08/16/2020] [Accepted: 08/21/2020] [Indexed: 12/21/2022] Open
Abstract
Purpose: This study compared the antimicrobial efficacy of calcium silicate sealers (BioRoot RCS and Total Fill BC) and conventional sealers (AH Plus and Tubli-seal) against planktonic bacteria and a nutrient-stressed multispecies biofilm. Methods: Antimicrobial properties of freshly mixed sealers were investigated using the direct contact test (DCT) and a nutrient-stressed multispecies biofilm comprised of five endodontic strains. Antimicrobial activity was determined using quantitative viable counts and confocal laser scanning microscopy (CLSM) analysis with live/dead staining. The pH of the sealers was analysed over a period of 28 days in Hanks Balanced Salt Solution (HBSS). Analysis of variance (ANOVA) with Tukey tests and the Kruskal–Wallis test were used for data analysis with a significance of 5%. Results: All endodontic sealers exhibited significant antimicrobial activity against planktonic bacteria (p < 0.05). BioRoot RCS caused a significant reduction in viable counts of the biofilms compared to AH Plus and the control (p < 0.05), while no significant difference could be observed compared to TotalFill BC and Tubli-seal (p > 0.05). CLSM analysis showed that BioRoot RCS and TotalFill BC exhibited significant biofilm inhibition compared to Tubli-seal, AH Plus and the control (p < 0.05). BioRoot RCS presented with the highest microbial killing, followed by TotalFill BC and Tubli-seal. Alkalizing activity was seen from the onset by BioRoot RCS, TotalFill BC and AH Plus. After 28 days, BioRoot RCS demonstrated the highest pH in HBSS (pH > 12). Conclusions: Calcium silicate sealers exhibited effective antimicrobial properties. This was demonstrated by superior biofilm inhibition capacity and microbial killing, with strong alkalizing activity compared to epoxy-based and zinc oxide-eugenol-based sealers.
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Affiliation(s)
- Rahul Bose
- Centre for Host Microbiome Interactions, King’s College London Dental Institute, Floor 17, Tower Wing, Guy’s Dental Hospital, London Bridge, London SE1 9RT, UK; (R.B.); (K.I.); (F.F.); (A.B.); (R.D.K.); (S.D.); (F.M.)
| | - Konstantinos Ioannidis
- Centre for Host Microbiome Interactions, King’s College London Dental Institute, Floor 17, Tower Wing, Guy’s Dental Hospital, London Bridge, London SE1 9RT, UK; (R.B.); (K.I.); (F.F.); (A.B.); (R.D.K.); (S.D.); (F.M.)
| | - Federico Foschi
- Centre for Host Microbiome Interactions, King’s College London Dental Institute, Floor 17, Tower Wing, Guy’s Dental Hospital, London Bridge, London SE1 9RT, UK; (R.B.); (K.I.); (F.F.); (A.B.); (R.D.K.); (S.D.); (F.M.)
- Department of Therapeutic Dentistry I. M., Sechenov First Moscow State Medical University, 119146 Moscow, Russia
| | - Abdulaziz Bakhsh
- Centre for Host Microbiome Interactions, King’s College London Dental Institute, Floor 17, Tower Wing, Guy’s Dental Hospital, London Bridge, London SE1 9RT, UK; (R.B.); (K.I.); (F.F.); (A.B.); (R.D.K.); (S.D.); (F.M.)
- Department of Restorative Dentistry, Faculty of Dentistry, Umm Al-Qura University, Makkah 24381, Saudi Arabia
| | - Robert D. Kelly
- Centre for Host Microbiome Interactions, King’s College London Dental Institute, Floor 17, Tower Wing, Guy’s Dental Hospital, London Bridge, London SE1 9RT, UK; (R.B.); (K.I.); (F.F.); (A.B.); (R.D.K.); (S.D.); (F.M.)
| | - Sanjukta Deb
- Centre for Host Microbiome Interactions, King’s College London Dental Institute, Floor 17, Tower Wing, Guy’s Dental Hospital, London Bridge, London SE1 9RT, UK; (R.B.); (K.I.); (F.F.); (A.B.); (R.D.K.); (S.D.); (F.M.)
| | - Francesco Mannocci
- Centre for Host Microbiome Interactions, King’s College London Dental Institute, Floor 17, Tower Wing, Guy’s Dental Hospital, London Bridge, London SE1 9RT, UK; (R.B.); (K.I.); (F.F.); (A.B.); (R.D.K.); (S.D.); (F.M.)
| | - Sadia Ambreen Niazi
- Centre for Host Microbiome Interactions, King’s College London Dental Institute, Floor 17, Tower Wing, Guy’s Dental Hospital, London Bridge, London SE1 9RT, UK; (R.B.); (K.I.); (F.F.); (A.B.); (R.D.K.); (S.D.); (F.M.)
- Correspondence: ; Tel.: +44-(0)207188-1573
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Ricucci D, Grande NM, Plotino G, Tay FR. Histologic Response of Human Pulp and Periapical Tissues to Tricalcium Silicate-based Materials: A Series of Successfully Treated Cases. J Endod 2019; 46:307-317. [PMID: 31836137 DOI: 10.1016/j.joen.2019.10.032] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 10/27/2019] [Accepted: 10/29/2019] [Indexed: 12/12/2022]
Abstract
Pulpal/periapical responses of human teeth that are treated successfully with tricalcium silicate-based materials are extremely difficult to obtain because of the typical unavailability of these teeth for histologic examination. The present case series reports histologic and histobacteriologic findings of 3 human teeth that had undergone pulpotomy, orthograde retreatment, and apicoectomy/root-end filling using tricalcium silicate-based endodontic materials. The teeth were extracted after 34 days, 7 weeks, and 20 months, respectively, because of unusual circumstances. The extracted teeth were processed, paraffin embedded, sectioned, stained with hematoxylin-eosin or the modified Brown and Brenn technique, and examined with light microscopy. The recurrent observation for the 3 cases presented was the absence of inflammatory or foreign body reactions of the host tissues in contact with tricalcium silicate-based materials after different observation periods despite the identification of bacteria in dentinal tubules close to the site of operation. Wound healing was rapid with repair/regeneration of lost tissues with cementum and new bone trabeculae. Although the level of evidence for a case series is low because of the anecdotal nature of the reported episodes, the histologic results reported in the present case series illustrate the highly biocompatible and bioactive nature of the tricalcium silicate-based materials used in treating these cases.
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Affiliation(s)
| | | | | | - Franklin R Tay
- Department of Endodontics, The Dental College of Georgia, Augusta University, Augusta, Georgia
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ElReash AA, Hamama H, Eldars W, Lingwei G, Zaen El-Din AM, Xiaoli X. Antimicrobial activity and pH measurement of calcium silicate cements versus new bioactive resin composite restorative material. BMC Oral Health 2019; 19:235. [PMID: 31684929 PMCID: PMC6829974 DOI: 10.1186/s12903-019-0933-z] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Accepted: 10/21/2019] [Indexed: 01/16/2023] Open
Abstract
Background The purpose of this in vitro study is to compare the antimicrobial effect and pH of two calcium silicate cements Mineral trioxide aggregate high plasticity (Angelus PR, Brazil) and iRoot BP Plus (BioCeramix Inc., Vancouver, BC, Canada) and new bioactive restorative resin composite restorative material (ACTIVA, MA, Pulpdent, USA) against aerobic bacteria, strictly anaerobic bacteria and a yeast by using an agar diffusion test. Methods The materials were tested immediately after manipulation and were applied to the agar plates. Sodium hypochlorite (NaOCl) 5.25% was used as a positive control group. The dry filter paper acted as a negative control group for this study. The size of the inhibition zone for each material was measured after 12, 24 and 48 h. At the time of pH measurement; materials were prepared, crushed then dispersed in distilled water. Results The one-way Anova test revealed that iRoot BP Plus significantly showed superior antimicrobial efficacy compared to MTA-HP against the following species; Staphylococcus aureus, Streptococcus mutans, Enterococcus faecalis, Enterococcus faecium, Peptostreptococcus anaerobius and Candida albicans (P < 0.05). All of the tested materials did not show any antimicrobial effect against Porphyromonas gingivalis and Actinomyces israelii. The new bioactive resin composite material (ACTIVA) showed the least antimicrobial activity against the previously mentioned microorganisms except E. faecalis. NaOCl significantly showed the highest antimicrobial activity among the test group (P < 0.05). iRoot BP Plus was more alkaline (pH 12.1 ± 0.14/ 11.9 ± 0.25) in comparison to MTA-HP (pH 11.6 ± 0.16/ 11.2 ± 0.10) while ACTIVA was slightly acidic (pH 5.4 ± 0.09/ 6.5 ± 0.08). Conclusions According to the findings of this study, it was concluded that calcium silicate- based cements showed a potential antimicrobial activity mainly due to its high alkalinity. The new bioactive resin composite restorative material exhibits less antimicrobial activity due to its resinous ingredients and slightly acidic nature. Antimicrobial effect of calcium silicate cements against strictly anaerobic bacterial species is still questionable.
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Affiliation(s)
- Ashraf Abou ElReash
- Department of Endodontic, Xiangya School of stomatology, Central South University, Xiangya Road No 72. Kaifu, Changsha, 410078, Hunan province, China
| | - Hamdi Hamama
- Department of Operative Dentistry, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Waleed Eldars
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Gong Lingwei
- Department of Endodontic, Xiangya School of stomatology, Central South University, Xiangya Road No 72. Kaifu, Changsha, 410078, Hunan province, China
| | - Ahmed M Zaen El-Din
- Department of Restorative Dentistry, Faculty of Oral and Dental Medicine, Delta University for Science and Technology, International Coastal Road, Gamasa, Mansoura, Egypt
| | - Xie Xiaoli
- Department of Endodontic, Xiangya School of stomatology, Central South University, Xiangya Road No 72. Kaifu, Changsha, 410078, Hunan province, China.
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The Antimicrobial Effect of Bioceramic Sealer on an 8-week Matured Enterococcus faecalis Biofilm Attached to Root Canal Dentinal Surface. J Endod 2019; 45:1047-1052. [DOI: 10.1016/j.joen.2019.04.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2018] [Revised: 04/07/2019] [Accepted: 04/08/2019] [Indexed: 11/19/2022]
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Razdan A, Benetti AR, Bjørndal L. Do in vitro solubility studies on endodontic sealers demonstrate a high level of evidence? A systematic review. Acta Odontol Scand 2019; 77:253-263. [PMID: 30849267 DOI: 10.1080/00016357.2018.1538535] [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: 10/27/2022]
Abstract
OBJECTIVE To systematically review the quality of evidence of available in vitro solubility studies on endodontic sealers according to prespecified evidence criteria. MATERIAL AND METHODS This systematic review was based on the PRISMA guidelines and the AMSTAR measurement tool. A systematic duplicate search of the literature on endodontic sealer solubility studies was conducted in PubMed and Embase databases (until 18 October 2017). Mapping terms to subject headings and free text terms were used and combined with hand searching before exclusion of duplicates. Studies specifically dealing with endodontic sealer solubility were selected. The evidence level was graded (low, medium or high) independently by two investigators following systematic data extraction in pilot forms, which was based on prespecified evidence criteria and the modified CONSORT checklist for in vitro studies on dental materials. RESULTS The search retrieved 1053 articles, from which 88 were assessed in full. From the 63 articles retained in the final analysis, 11 were classified as having moderate and 52 as low quality of evidence (0 high). The studies graded as low had low sample size (n < 10) and/or insufficient details to allow replicability. Most of the studies did not conform to the modified CONSORT checklist and did not include parameters considered relevant in the prespecified criteria. CONCLUSIONS Existing in vitro studies on the solubility of endodontic sealers do not demonstrate a high quality of evidence. Most of these studies do not present systematic reporting nor employ relevant parameters prespecified in our evidence criteria.
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Affiliation(s)
- Ankur Razdan
- Section of Cariology and Endodontics, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Section of Dental Materials, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Ana Raquel Benetti
- Section of Dental Materials, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Lars Bjørndal
- Section of Cariology and Endodontics, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Modeling Oral Multispecies Biofilm Recovery After Antibacterial Treatment. Sci Rep 2019; 9:804. [PMID: 30692576 PMCID: PMC6349915 DOI: 10.1038/s41598-018-37170-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 11/28/2018] [Indexed: 11/18/2022] Open
Abstract
Recovery of multispecies oral biofilms is investigated following treatment by chlorhexidine gluconate (CHX), iodine-potassium iodide (IPI) and Sodium hypochlorite (NaOCl) both experimentally and theoretically. Experimentally, biofilms taken from two donors were exposed to the three antibacterial solutions (irrigants), respectively, for 10 minutes. We observe that (a) live bacterial cell ratios decline for a week after the exposure and the trend then reverses beyond the week; after fifteen weeks, live bacterial cell ratios in biofilms fully return to their pretreatment levels; (b) NaOCl is shown as the strongest antibacterial agent for the oral biofilms; (c) multispecies oral biofilms from different donors showed no difference in their susceptibility to all the bacterial solutions. Guided by the experiment, a mathematical model for biofilm dynamics is developed, accounting for multiple bacterial phenotypes, quorum sensing, and growth factor proteins, to describe the nonlinear time evolutionary behavior of the biofilms. The model captures time evolutionary dynamics of biofilms before and after antibacterial treatment very well. It reveals the important role played by quorum sensing molecules and growth factors in biofilm recovery and verifies that the source of biofilms has a minimal effect to their recovery. The model is also applied to describe the state of biofilms of various ages treated respectively by CHX, IPI and NaOCl, taken from different donors. Good agreement with experimental data predicted by the model is obtained as well, confirming its applicability to modeling biofilm dynamics in general.
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17
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Kapralos V, Koutroulis A, Ørstavik D, Sunde PT, Rukke HV. Antibacterial Activity of Endodontic Sealers against Planktonic Bacteria and Bacteria in Biofilms. J Endod 2018; 44:149-154. [DOI: 10.1016/j.joen.2017.08.023] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2017] [Revised: 08/10/2017] [Accepted: 08/17/2017] [Indexed: 01/12/2023]
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18
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Estrela C, Pécora JD, Estrela CR, Guedes OA, Silva BS, Soares CJ, Sousa-Neto MD. Common Operative Procedural Errors and Clinical Factors Associated with Root Canal Treatment. Braz Dent J 2017; 28:179-190. [DOI: 10.1590/0103-6440201702451] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Accepted: 02/06/2017] [Indexed: 01/23/2023] Open
Abstract
Abstract Operative procedural errors must be well analyzed in order to avoid influence negatively the root canal treatment (RCT) prognosis. The successful RCT prevents tooth loss and avoids pain and apical periodontitis. This review aimed to categorize common operative procedure errors and clinical factors associated with RCT. Based on this, will be approached common errors of procedures within the clinical operative sequence: endodontic treatment planning, pulp and periapical disease diagnosis, anaesthesia, access cavity preparation, isolation with rubber dam, root canal preparation, root canal filling and retreatment, restoration of endodontically treated teeth, postoperative pain, follow up of endodontically treated teeth. The professional must remind that in each phase of RCT an operative error may have adverse implication on prognosis, and these errors characterize risk factors to failure. The knowledge of probable operative procedural errors and its consequences are essentials to avoid future problems to the tooth health.
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Ahangari Z, Mojtahed Bidabadi M, Asnaashari M, Rahmati A, Tabatabaei FS. Comparison of the Antimicrobial Efficacy of Calcium Hydroxide and Photodynamic Therapy Against Enterococcus faecalis and Candida albicans in Teeth With Periapical Lesions; An In Vivo Study. J Lasers Med Sci 2017; 8:72-78. [PMID: 28652899 DOI: 10.15171/jlms.2017.13] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Introduction: Elimination of pathological microflora of root canal systems is a major goal in endodontic treatment. This study aimed to compare the antimicrobial efficacy of calcium hydroxide as an intracanal medication and antibacterial photodynamic therapy (aPDT) against Enterococcus faecalis and Candida albicans in teeth with periapical (PA) lesions. Methods: This in vivo study was conducted on 20 patients with single-rooted mandibular premolar with previously failed endodontic treatment. This study was performed as a clinical trial (IRCTID: IRCT2016090429686N1). After conventional chemo-mechanical root canal preparation (hand and rotary instruments and 2.5% NaOCl), microbiological samples were obtained using sterile paper points, then stored in thioglycolate solution and transferred to a microbiology laboratory. Group 1 (n = 10) specimens underwent aPDT (diode laser 808 nm + 50 mg/mL methylene blue), while creamy calcium hydroxide paste was used in group 2 for a duration of 1 week. A control sample was taken with sterile paper points and F3 Protaper rotary file. The samples were dispersed in transport medium, serially diluted, and cultured on selective mediums to determine the number of colony forming units (CFUs). Data were analyzed by Mann-Whitney U test at 5% significance level. The significance level for all analyses was set at P < 0.05. Results: Number of CFU significantly decreased in both groups after the interventions (P < 0.001); however, there was no significant difference in the colony count between the 2 groups. Conclusion: aPDT and calcium hydroxide therapy showed the same antimicrobial efficacy on E. faecalis and C. albicans.
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Affiliation(s)
- Zohre Ahangari
- Endodontic Department, School of Dentistry, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Maryam Mojtahed Bidabadi
- Endodontic Department, School of Dentistry, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Mohammad Asnaashari
- Laser Application in Medical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Afsaneh Rahmati
- Endodontic Department, School of Dentistry, Hamedan University of Medical Science, Hamedan, Iran
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Ricucci D, Rôças IN, Alves FRF, Loghin S, Siqueira JF. Apically Extruded Sealers: Fate and Influence on Treatment Outcome. J Endod 2015; 42:243-9. [PMID: 26725179 DOI: 10.1016/j.joen.2015.11.020] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Revised: 10/21/2015] [Accepted: 11/20/2015] [Indexed: 11/25/2022]
Abstract
INTRODUCTION This retrospective study evaluated cases of unintentional overfillings for the fate of the extruded sealers and their influence on treatment outcome. METHODS One hundred five teeth treated by a single operator and exhibiting overfillings in the postobturation radiograph were included in the study. Seventy-five teeth exhibited apical periodontitis lesions at the time of treatment. Sealers included Pulp Canal Sealer (Sybron Dental, Orange, CA), PCS Extended Working Time-EWT (Sybron Dental), Tubli-Seal (Sybron Endo), Endomethasone (Septodont, Saint-Maur-des-Fossés, France), AH Plus (DeTrey GmbH, Konstanz, Germany), and Apexit (Ivoclar Vivadent, Schaan, Lichtenstein). Recall radiographs were compared with immediate postobturation films for removal of the extruded material and status of the periradicular tissues. Data were grouped as 1-, 2- and >4-year recall and statistically analyzed using the chi-square and Fisher exact tests. RESULTS As for the sealers' fate, the only statistically significant differences at the 1-year recall were observed when comparing Tubli-Seal with AH Plus, Apexit, and Endomethasone (P < .05). At both the 2- and 4-year recalls, frequency of complete removal of AH Plus and Apexit was significantly lower when compared with all the other sealers (P < .05). No other significant differences were observed between groups. As for the influence on treatment outcome, there were no statistically significant differences between sealers at all follow-up periods (P > .05). Data from the >4-year recall revealed that 79% of the teeth with apical periodontitis lesions at the time of treatment had healed in comparison with 100% of the teeth with no apical periodontitis (P < .01). CONCLUSIONS Not all extruded sealers were predictably removed from the periradicular tissues. Treatment outcome was not significantly affected by the type of extruded sealer. A significantly better outcome was observed for teeth with no lesion in comparison with teeth with apical periodontitis.
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Affiliation(s)
| | - Isabela N Rôças
- Department of Endodontics, Faculty of Dentistry, Estácio de Sá University, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Flávio R F Alves
- Department of Endodontics, Faculty of Dentistry, Estácio de Sá University, Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - José F Siqueira
- Department of Endodontics, Faculty of Dentistry, Estácio de Sá University, Rio de Janeiro, Rio de Janeiro, Brazil
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22
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Ma J, Shen Y, Yang Y, Gao Y, Wan P, Gan Y, Patel P, Curtis A, Khakpour M, Haapasalo M. In Vitro Study of Calcium Hydroxide Removal from Mandibular Molar Root Canals. J Endod 2015; 41:553-8. [DOI: 10.1016/j.joen.2014.11.023] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2014] [Revised: 11/21/2014] [Accepted: 11/23/2014] [Indexed: 11/16/2022]
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Effect of Nanosilver Gel, Chlorhexidine Gluconate, and Camphorated Phenol on Enterococcus faecalis Biofilm. INTERNATIONAL SCHOLARLY RESEARCH NOTICES 2014; 2014:380278. [PMID: 27355067 PMCID: PMC4897455 DOI: 10.1155/2014/380278] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Revised: 07/25/2014] [Accepted: 07/25/2014] [Indexed: 11/18/2022]
Abstract
Aim. To assess the effectiveness of nanosilver gel (NSG) in comparison to chlorhexidine gluconate (CHX) and camphorated phenol (CP) against Enterococcus faecalis (E.f) biofilm. Methods and Materials. Two tests were done, methyl thiazolyl tetrazolium (MTT) assay and confocal laser scanning microscopy (CLSM) analysis, to determine the effectiveness of NSG, CHX, and CP on E.f biofilm. Polystyrene microtiter 96- and 6-well plates were used for MTT and CLSM, respectively. Nanosilver gel was in three concentrations (0.05%, 0.1%, and 0.2%), chlorhexidine gluconate used was 2%, and camphorated phenol and normal saline were as control. Analysis was done using one-way ANOVA; the post hoc test was run for multiple comparisons. The level of statistical significance was set at P < 0.05. Results. One-way ANOVA showed significant differences among groups (0.05% NSG and CP, 0.1% NSG and CP, 0.2% NSG and CP, 0.1% NSG and 2% CHX, 0.2% and NSG and 2% CHX) (P < 0.001) and also showed significant difference between groups (P < 0.001), f-ratio 87.823. A post hoc Tukey's test revealed no significant difference between chlorhexidine gluconate and 0.05% nanosilver gel (P > 0.05). Conclusions. 0.1% and 0.2% nanosilver gel is more effective on Enterococcus faecalis biofilm as compared to chlorhexidine gluconate and camphorated phenol.
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Wong S, Mundy L, Chandler N, Upritchard J, Purton D, Tompkins G. Antibacterial properties of root canal lubricants: A comparison with commonly used irrigants. AUST ENDOD J 2014; 40:111-5. [DOI: 10.1111/aej.12075] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Samantha Wong
- Sir John Walsh Research Institute; Faculty of Dentistry; University of Otago; Dunedin New Zealand
| | - Lance Mundy
- Sir John Walsh Research Institute; Faculty of Dentistry; University of Otago; Dunedin New Zealand
| | - Nicholas Chandler
- Sir John Walsh Research Institute; Faculty of Dentistry; University of Otago; Dunedin New Zealand
| | - Jenine Upritchard
- Sir John Walsh Research Institute; Faculty of Dentistry; University of Otago; Dunedin New Zealand
| | - David Purton
- Sir John Walsh Research Institute; Faculty of Dentistry; University of Otago; Dunedin New Zealand
| | - Geoffrey Tompkins
- Sir John Walsh Research Institute; Faculty of Dentistry; University of Otago; Dunedin New Zealand
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Wang Z, Shen Y, Haapasalo M. Dentin Extends the Antibacterial Effect of Endodontic Sealers against Enterococcus faecalis Biofilms. J Endod 2014; 40:505-8. [DOI: 10.1016/j.joen.2013.10.042] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2013] [Revised: 10/30/2013] [Accepted: 10/31/2013] [Indexed: 10/25/2022]
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26
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Neiva KG, Catalfamo DL, Holliday LS, Wallet SM, Pileggi R. Propolis decreases lipopolysaccharide-induced inflammatory mediators in pulp cells and osteoclasts. Dent Traumatol 2014; 30:362-367. [PMID: 24502251 DOI: 10.1111/edt.12096] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2013] [Indexed: 01/21/2023]
Abstract
BACKGROUND Intracanal medicaments are used to disinfect the root canal system, reduce interappointment pain and inflammation, and prevent resorption. Bacterial components such as lipopolysaccharide (LPS) are implicated in the development of pulpal and periapical inflammation and inducing osteoclastogenesis. Propolis is a natural, non-toxic substance collected from bee's wax that has been used for many years in folk medicine. Propolis has been demonstrated to have antibacterial and anti-inflammatory properties. Our previous studies have shown that propolis inhibits osteoclast maturation. However, the effect of propolis on the inflammatory response of pulp cells and osteoclasts has not been explored. AIM The purpose of this study was to evaluate whether propolis alters the inflammatory response of three endodontically relevant cell lines: mouse odontoblast-like cells (MDPC-23), macrophages (RAW264.7), and osteoclasts. MATERIAL AND METHODS Cells were exposed to 0-20 ug ml(-1) LPS to induce an inflammatory response, in the presence of propolis or vehicle control. Culture supernatants were collected after 6 and 24 h, and expression of multiple soluble mediators was determined using Luminex(®) multiplex technology. RESULTS Propolis was effective in reducing secretion of the LPS-induced inflammatory cyto/chemokines: IL-1α, IL-6, IL-12(p70), IL-15, G-CSF, TNF-α, MIP-1α, MCP-1, and IP-10. CONCLUSION Our results demonstrate that propolis suppresses the LPS-induced inflammatory response of key cells within the root canal system.
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Affiliation(s)
- Kathleen G Neiva
- Department of Endododntics, University of Florida College of Dentistry, Gainesville, FL, USA
| | - Dana L Catalfamo
- Department of Periodontology and Oral Biology, University of Florida College of Dentistry, Gainesville, FL, USA
| | - L Shannon Holliday
- Department of Orthodontics, University of Florida College of Dentistry, Gainesville, FL, USA
| | - Shannon M Wallet
- Department of Periodontology and Oral Biology, University of Florida College of Dentistry, Gainesville, FL, USA
| | - Roberta Pileggi
- Department of Endododntics, University of Florida College of Dentistry, Gainesville, FL, USA
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Franco V, Tosco E. The endodontic line: A clinical approach. GIORNALE ITALIANO DI ENDODONZIA 2013. [DOI: 10.1016/j.gien.2013.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Zamiran S, Jahromi MZ, Fathi M, Moghaddam G. An <i>in vitro</i> study on cleaning efficiency of Mtwo and BioRaCe rotary nickel-titanium instruments. Health (London) 2013. [DOI: 10.4236/health.2013.512277] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Mohammadi Z, Shalavi S, Yazdizadeh M. Antimicrobial activity of calcium hydroxide in endodontics: a review. Chonnam Med J 2012; 48:133-40. [PMID: 23323217 PMCID: PMC3539092 DOI: 10.4068/cmj.2012.48.3.133] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2012] [Revised: 09/25/2012] [Accepted: 09/26/2012] [Indexed: 11/06/2022] Open
Abstract
The purpose of endodontic therapy is to preserve the patient's natural teeth without compromising the patient's local or systemic health. Calcium hydroxide has been included in several materials and antimicrobial formulations that are used in several treatment modalities in endodontics, such as inter-appointment intracanal medicaments. The purpose of this article was to review the antimicrobial properties of calcium hydroxide in endodontics. Calcium hydroxide has a high pH (approximately 12.5-12.8) and is classified chemically as a strong base. The lethal effects of calcium hydroxide on bacterial cells are probably due to protein denaturation and damage to DNA and cytoplasmic membranes. Calcium hydroxide has a wide range of antimicrobial activity against common endodontic pathogens but is less effective against Enterococcus faecalis and Candida albicans. Calcium hydroxide is also a valuable anti-endotoxin agent. However, its effect on microbial biofilms is controversial.
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Affiliation(s)
- Z Mohammadi
- Department of Endodontics, School of Dentistry, Hamedan University of Medical Sciences, Hamedan, Iran. ; Iranian Center for Endodontic Research (ICER), Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Tavares WLF, de Brito LCN, Henriques LCF, Teles FRF, Teles RP, Vieira LQ, Ribeiro Sobrinho AP. Effects of calcium hydroxide on cytokine expression in endodontic infections. J Endod 2012; 38:1368-71. [PMID: 22980179 DOI: 10.1016/j.joen.2012.06.036] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2012] [Revised: 06/29/2012] [Accepted: 06/30/2012] [Indexed: 01/02/2023]
Abstract
INTRODUCTION The use of calcium hydroxide is an effective step in killing bacteria that remain after cleaning and shaping procedures. It also induces hard-tissue formation and is effective for stopping inflammatory exudates. METHODS The aim of this study was to assay and to compare the influence of calcium hydroxide on periapical interstitial fluid from human root canals. The mRNA expression levels of the cytokines interferon (IFN)-γ, tumor necrosis factor-α, interleukin (IL)-1β, IL-17A, and IL-10 as well as the chemokine MCP-1 were assayed by real-time polymerase chain reaction immediately after root canal cleaning and 15 days later. RESULTS Levels of IL-1β, IFN-γ, IL-10, and the chemokine CCL2/MCP-1 were increased in teeth without endodontic dressings. With calcium hydroxide interappointment dressings, no statistically significant changes were observed in cytokine mRNA expression. However, when comparing teeth that received the medication with those that did not, expression levels of IL-1β, IFN-γ, and IL-10 were statistically lower in those teeth that received calcium hydroxide. CONCLUSIONS Analyses of cytokines and the chemokine CCL-2/MCP-1 demonstrated the benefits of calcium hydroxide as a root canal dressing because it impedes the increase of all mediators during the experimental time.
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Day PF, Gregg TA, Ashley P, Welbury RR, Cole BO, High AS, Duggal MS. Periodontal healing following avulsion and replantation of teeth: a multi-centre randomized controlled trial to compare two root canal medicaments. Dent Traumatol 2011; 28:55-64. [PMID: 21988960 DOI: 10.1111/j.1600-9657.2011.01053.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Non-setting calcium hydroxide (Ultracal XS(®) ) is recommended by the International Association of Dental Traumatology as the initial medicament following avulsion and replantation for mature teeth. There is experimental evidence to suggest Ledermix(®) , placed as an alternative inter-visit dressing may improve periodontal healing. AIM This study investigated, using a multi-centre randomized controlled trial, the effect of two root canal medicaments, Ledermix(®) and Ultracal XS(®) , on periodontal healing of avulsed and replanted teeth. MATERIAL AND METHODS Children were recruited if they fulfilled all inclusion criteria. Treatment followed a standardized protocol. Assessment of periodontal healing or ankylosis was made clinically and radiographically by an experienced, 'blinded', clinician at 12months. RESULTS Over 200 patients were assessed for eligibility at five centres. Twenty-nine patients were eligible for inclusion. Final analysis involved 22 patients with 27 teeth. Ankylosis was detected in four of the 12 teeth in the Ledermix(®) group and nine of 15 in the Ultracal XS(®) group. No significant difference between medicaments was found in the proportion of teeth or patients showing periodontal healing. DISCUSSION There was no significant difference in periodontal healing between the two medicaments at either a tooth or patient level. The numbers recruited fell short of an estimated power calculation. For patients meeting the inclusion criteria and completing the trial, periodontal healing was seen in 52% of teeth at the 12-month assessment between both groups. The only factor found to significantly influence the periodontal outcome was dry time.
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Affiliation(s)
- Peter F Day
- Leeds Dental Institute, Leeds Belfast Children's Hospital, Belfast Eastman Dental Institute, London, UK.
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Mohammadi Z, Dummer PMH. Properties and applications of calcium hydroxide in endodontics and dental traumatology. Int Endod J 2011; 44:697-730. [PMID: 21535021 DOI: 10.1111/j.1365-2591.2011.01886.x] [Citation(s) in RCA: 339] [Impact Index Per Article: 26.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Calcium hydroxide has been included within several materials and antimicrobial formulations that are used in a number of treatment modalities in endodontics. These include, inter-appointment intracanal medicaments, pulp-capping agents and root canal sealers. Calcium hydroxide formulations are also used during treatment of root perforations, root fractures and root resorption and have a role in dental traumatology, for example, following tooth avulsion and luxation injuries. The purpose of this paper is to review the properties and clinical applications of calcium hydroxide in endodontics and dental traumatology including its antibacterial activity, antifungal activity, effect on bacterial biofilms, the synergism between calcium hydroxide and other agents, its effects on the properties of dentine, the diffusion of hydroxyl ions through dentine and its toxicity. Pure calcium hydroxide paste has a high pH (approximately 12.5-12.8) and is classified chemically as a strong base. Its main actions are achieved through the ionic dissociation of Ca(2+) and OH(-) ions and their effect on vital tissues, the induction of hard-tissue deposition and the antibacterial properties. The lethal effects of calcium hydroxide on bacterial cells are probably due to protein denaturation and damage to DNA and cytoplasmic membranes. It has a wide range of antimicrobial activity against common endodontic pathogens but is less effective against Enterococcus faecalis and Candida albicans. Calcium hydroxide is also an effective anti-endotoxin agent. However, its effect on microbial biofilms is controversial.
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Affiliation(s)
- Z Mohammadi
- Department of Endodontics, Hamedan University of Medical Sciences, Hamedan, Iran.
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Boutsioukis C, Lambrianidis T, Kastrinakis E. Irrigant flow within a prepared root canal using various flow rates: a Computational Fluid Dynamics study. Int Endod J 2009; 42:144-55. [PMID: 19134043 DOI: 10.1111/j.1365-2591.2008.01503.x] [Citation(s) in RCA: 123] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIM To study using computer simulation the effect of irrigant flow rate on the flow pattern within a prepared root canal, during final irrigation with a syringe and needle. METHODOLOGY Geometrical characteristics of a side-vented endodontic needle and clinically realistic flow rate values were obtained from previous and preliminary studies. A Computational Fluid Dynamics (CFD) model was created using FLUENT 6.2 software. Calculations were carried out for five selected flow rates (0.02-0.79 mL sec(-1)) and velocity and turbulence quantities along the domain were evaluated. RESULTS Irrigant replacement was limited to 1-1.5 mm apical to the needle tip for all flow rates tested. Low-Reynolds number turbulent flow was detected near the needle outlet. Irrigant flow rate affected significantly the flow pattern within the root canal. CONCLUSIONS Irrigation needles should be placed to within 1 mm from working length to ensure fluid exchange. Turbulent flow of irrigant leads to more efficient irrigant replacement. CFD represents a powerful tool for the study of irrigation.
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Affiliation(s)
- C Boutsioukis
- Department of Endodontology, Dental School, Aristotle University of Thessaloniki, Thessaloniki, Greece.
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Antibacterial properties of four endodontic sealers. J Endod 2008; 34:735-8. [PMID: 18498902 DOI: 10.1016/j.joen.2008.03.012] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2008] [Revised: 03/15/2008] [Accepted: 03/16/2008] [Indexed: 11/21/2022]
Abstract
The purpose of this study was to evaluate the antimicrobial effects of root canal sealers. The direct contact test (DCT) was used to assess the antibacterial properties of AH plus, Apexit Plus, Epiphany SE, and RoekoSeal when in contact with Enterococcus faecalis. The materials were examined immediately after setting and 1, 2, 7, and 14 days after aging in phosphate-buffered-saline. Statistical analysis with two-way analysis of variance, one-way analysis of variance, and Tukey multiple comparison was applied to the data. Apexit Plus had a short-term antibacterial effect of 1 day on E. faecalis, whereas Epiphany SE enhanced bacterial growth for at least 7 days. AH plus and RoekoSeal were ineffective.
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Boutsioukis C, Lambrianidis T, Kastrinakis E, Bekiaroglou P. Measurement of pressure and flow rates during irrigation of a root canal ex vivo with three endodontic needles. Int Endod J 2007; 40:504-13. [PMID: 17326784 DOI: 10.1111/j.1365-2591.2007.01244.x] [Citation(s) in RCA: 93] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM To monitor ex vivo intra-canal irrigation with three endodontic needles (25, 27 and 30 gauge) and compare them in terms of irrigant flow rate, intra-barrel pressure, duration of irrigation and volume of irrigant delivered. METHODOLOGY A testing system was constructed to allow measurement of selected variables with pressure and displacement transducers during ex vivo intra-canal irrigation with a syringe and three different needles (groups A, B, C) into a prepared root canal. Ten specialist endodontists performed the irrigation procedure. Each operator performed ten procedures with each needle. Data recorded by the transducers were analysed using Friedman's test, Wilcoxon Signed Rank test, Mann-Whitney U-test and Kendall's T(b) test. The level of significance was set to 95%. RESULTS Significant differences were detected among the three needles for most variables. Duration of delivery and flow rates significantly decreased as the needle diameter increased, whilst pressure increased up to 400-550 kPa. Gender of the operator had a significant impact on the results. Experience of the operators (years) were negatively correlated to volume of irrigant (all groups), to the duration of delivery (groups A, B) and to the average flow rate (group A). CONCLUSIONS Finer diameter needles require increased effort to deliver the irrigant and result in higher intra-barrel pressure. The syringe and needles used tolerated the pressure developed. Irrigant flow rate should be considered as a factor directly influencing flow beyond the needle. Wide variations of flow rate were observed among operators. Syringe irrigation appears difficult to standardize and control.
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Affiliation(s)
- C Boutsioukis
- Department of Endodontology, Dental School, Aristotle University of Thessaloniki, Thessaloniki, Greece.
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Erdemir A, Eldeniz AU, Ari H, Belli S, Esener T. The influence of irrigating solutions on the accuracy of the electronic apex locator facility in the Tri Auto ZX handpiece. Int Endod J 2007; 40:391-7. [PMID: 17309740 DOI: 10.1111/j.1365-2591.2007.01234.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM To determine the influence of various irrigating solutions on the accuracy of the electronic apex locator facility in the Tri Auto ZX handpiece. METHODOLOGY One hundred and forty teeth with single canals and mature apices, scheduled for extraction for either periodontal or prosthetic reasons in 76 patients were used. Following informed written consent local anaesthesia was administered, access cavities were prepared and pulp tissue removed. The teeth were then randomly divided into seven groups according to the irrigating solutions used. The root canal length measurements were completed using the Tri Auto ZX handpiece with automatic reverse function in the presence of one or other of the following solutions: 0.9% saline, 2.5% NaOCl, 3% H(2)O(2), 0.2% chlorhexidine, 17% EDTA, Ultracaine D-S or in the absence of an irrigating solution (control). Files were immobilized in the access cavity with composite resin. After extraction, the apical regions of the teeth were exposed and the file tips examined under a stereomicroscope. Distances between the file tips and the apical constriction were measured (mm) and analysed using a one-way anova and post hoc Tukey test. RESULTS Mean distances from the apical constriction to the file tip were longer in the 0.9% saline group (P<0.05). There was no statistically significant difference on file tip position between the other solutions. CONCLUSIONS Tri Auto ZX gave reliable results with all irrigating solutions apart from in the presence of 0.9% saline.
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Affiliation(s)
- A Erdemir
- Department of Endodontics, Faculty of Dentistry, Kirikkale University, Kirikkale, Turkey.
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Athanassiadis B, Abbott PV, Walsh LJ. The use of calcium hydroxide, antibiotics and biocides as antimicrobial medicaments in endodontics. Aust Dent J 2007; 52:S64-82. [PMID: 17546863 DOI: 10.1111/j.1834-7819.2007.tb00527.x] [Citation(s) in RCA: 182] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Bacteria have been implicated in the pathogenesis and progression of pulp and periapical diseases. The primary aim of endodontic treatment is to remove as many bacteria as possible from the root canal system and then to create an environment in which any remaining organisms cannot survive. This can only be achieved through the use of a combination of aseptic treatment techniques, chemomechanical preparation of the root canal, antimicrobial irrigating solutions and intracanal medicaments. The choice of which intracanal medicament to use is dependent on having an accurate diagnosis of the condition being treated, as well as a thorough knowledge of the type of organisms likely to be involved and their mechanisms of growth and survival. Since the disease is likely to have been caused by the presence of bacteria within the root canal, the use of an antimicrobial agent is essential. Many medicaments have been used in an attempt to achieve the above aims but no single preparation has been found to be completely predictable or effective. Commonly used medicaments include calcium hydroxide, antibiotics, non-phenolic biocides, phenolic biocides and iodine compounds. Each has advantages and disadvantages, and further research is required to determine which is best suited for root canal infections.
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Affiliation(s)
- B Athanassiadis
- School of Dentistry, The University of Western Australia, Nedlands
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HAAPASALO MARKUS, ENDAL UNNI. Internal inflammatory root resorption: the unknown resorption of the tooth. ACTA ACUST UNITED AC 2006. [DOI: 10.1111/j.1601-1546.2008.00226.x] [Citation(s) in RCA: 69] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Wu MK, Dummer PMH, Wesselink PR. Consequences of and strategies to deal with residual post-treatment root canal infection. Int Endod J 2006; 39:343-56. [PMID: 16640632 DOI: 10.1111/j.1365-2591.2006.01092.x] [Citation(s) in RCA: 120] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Bacterial sampling of prepared root canals is used to determine the presence and character of the remaining microbiota. However, it is likely that current sampling techniques only identify organisms in the main branches of the root canal system whereas it is unlikely that they can sample areas beyond the apical end-point of preparation and filling, or in lateral canals, canal extensions, apical ramifications, isthmuses and within dentinal tubules. Thus, it may be impossible by current techniques to identify residual post-treatment root canal infection. In histologic observations of root apices, bacteria have been found in inaccessible inter-canal isthmuses and accessory canals often in the form of biofilms. There is no in vivo evidence to support the assumption that these bacteria can be entombed effectively in the canal system by the root filling and thus be rendered harmless. As a consequence of this residual root infection, post-treatment apical periodontitis, which may be radiographically undetectable, may persist or develop as a defence mechanism to prevent the systemic spread of bacteria and/or their byproducts to other sites of the body. Histologic observation of root apices with surrounding bone removed from either patients or human cadavers has demonstrated that post-treatment apical periodontitis is associated with 50-90% of root filled human teeth. Thus, if the objective of root canal treatment is to eliminate apical periodontitis at a histological level, current treatment procedures are inadequate. It is essential that our knowledge of the local and systemic consequences of both residual post-treatment root infection and post-treatment apical periodontitis be improved. The continued development of treatments that can effectively eliminate root infection is therefore a priority in clinical endodontic research. Post-treatment disease following root canal treatment is most often associated with poor quality procedures that do not remove intra-canal infection; this scenario can be corrected via a nonsurgical approach. However, infection remaining in the inaccessible apical areas, extraradicular infection including apically extruded dentine debris with bacteria present in dentinal tubules, true radicular cysts, and foreign body reactions require a surgical intervention.
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Affiliation(s)
- M-K Wu
- Department of Cariology Endodontology Pedodontology, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands.
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Abstract
AIM To test the null hypothesis that Carisolv is no more effective than 1% sodium hypochlorite in cleaning uninstrumented, immature root canals. METHODOLOGY A total of 240 uniform, immature ovine incisors were decoronated at the CEJ level and randomly divided into four groups of 60. After gross pulp extirpation, canals were flooded with normal saline (negative control), 1% NaOCl, Carisolv or 5% NaOCl (positive control) and incubated for 10 min (group 1), 20 min (group 2), 30 min (group 3) or 30 min, refreshing irrigant at 10 and 20 min (group 4). SEM photomicrographs of canal wall debris in the apical, middle and coronal thirds were scored against a 5-point scale. Internal consistency was assessed by kappa statistics. Debris scores for different irrigant regimes at different canal levels were analysed by non-parametric tests (P < 0.05). RESULTS Canals were consistently cleaner in the coronal and middle than apical thirds. NaOCl (5%) was consistently most effective. Carisolv and NaOCl (1%) were no more effective than normal saline in group 1 (P > 0.05), but significantly more effective than normal saline in groups 2 (middle and apical 1/3), 3 and 4 (P < 0.05). Carisolv and NaOCl (1%) had comparable activity in groups 1, 2 (middle and apical thirds) and 3, but NaOCl (1%) was significantly more effective than Carisolv in group 4 (coronal and middle thirds). CONCLUSIONS 1. The ovine incisor model presents opportunities to investigate irrigation regimes under controlled ex-vivo conditions. 2.NaOCl (5%) remains the most effective irrigant for rapid debris removal in immature root canals. 3. Carisolv cleans pulp debris from the walls of immature root canals as effectively as NaOCl (1%) during static, unrefreshed wall contact for between 20 and 30 min. 4. Refreshment of NaOCl (1%) enhances its cleaning ability above that of Carisolv.
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Affiliation(s)
- S Rahman
- School of Dental Sciences, Newcastle University, Framlington Place, Newcastle-upon-Tyne NE2 4BW, UK
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Siqueira JF. Reaction of periradicular tissues to root canal treatment: benefits and drawbacks. ACTA ACUST UNITED AC 2005. [DOI: 10.1111/j.1601-1546.2005.00134.x] [Citation(s) in RCA: 68] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Abstract
Tooth retention has increased significantly in older adults, and dentists are now challenged by the need to preserve critical teeth. There will be a need to consider endodontic therapy, and this paper describes how successful endodontics can be provided for elderly patients. Strategic treatment planning is essential, and preservation of key teeth will facilitate satisfactory oral function for elderly patients. These teeth may be important in achieving and maintaining an intact anterior dental arch, for removable partial denture retention or preservation of alveolar bone. In some cases, this can only be achieved if endodontic procedures are undertaken. When infection of a root canal is present, there is no reason why good quality endodontic therapy should not work in a healthy elderly patient. Elimination of infection can be challenging in narrow root canals, and a systematic approach for improving access into and negotiating these canals is outlined.
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Affiliation(s)
- P Finbarr Allen
- Department of Restorative Dentistry, University Dental School and Hospital, Wilton, Cork, Ireland.
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