Disinfectants Used in Stomatology and SARS-CoV-2 Infection

The effect of different bioceramic root canal sealer removal protocols on the bond strength of composite to coronal dentin in diabetic and non-diabetic patients: an ex vivo study

BACKGROUND

Diabetes mellitus can alter the physical and mechanical properties of dentin, compromising bonding. Furthermore, residual sealer on dentin may inhibit the bond strength. The aim of this study was to evaluate and compare the effects of different cleaning protocols on the adhesive bond strength of composite to coronal dentin contaminated with a tricalcium silicate (TCS)based root canal sealer in diabetic and non-diabetic patients.

METHODS

Diabetic (n = 50) and non-diabetic (n = 50) teeth were randomly divided into two groups. Coronal dentin surface specimens were obtained. The samples were contaminated with a TCS based sealer and then divided into five subgroups, four different cleaning procedures (dry cotton, wet cotton, ultrasonic-15, ultrasonic-30) and a control group (n = 10). The samples were restored with composite. A standard shear bond strength (SBS) test was performed. All failures were categorized as adhesive, cohesive or mixed. Data were analyzed using Independent Samples t-test and One-Way Analysis of Variance at a significance level of p < 0.05.

RESULTS

SBS values ​​were lower in diabetic dentin group than in non-diabetic dentin group. Dry cotton showed the lowest SBS value in both main groups. Ultrasonic-15 and ultrasonic-30 groups showed equal SBS values ​​in the non-diabetic group (p = 0.001), while the highest SBS was seen in the ultrasonic-30 subgroup in the diabetic dentin group. The highest adhesive failure was observed in the diabetic dentin group, and the dominant failure type was mixed for both groups.

CONCLUSION

The use of dry cotton was an insufficient method for removing bioceramic root canal sealer residues from coronal dentin in both the diabetic and non-diabetic patients. 15 s of ultrasonic activation was effective for removing bioceramic root canal sealer remnants from the non-diabetic coronal dentin. However, for the coronal dentin in the diabetic group, 30-sec ultrasonic activation was the most effective method for removing bioceramic root canal sealer remnants.

New Insights Regarding the Use of Relevant Synthetic Compounds in Dentistry

Worldwide, synthetic compounds are used for both in-office and at-home dental care. They are a valuable resource for both prophylactic and curative treatments for various dental problems, such as tooth decay, periodontal diseases, and many more. They are typically preferred due to their broad range of actions and ability to produce targeted, rapid, and long-lasting effects. Using a 0.12% chlorhexidine mouthwash is capable of reducing the plaque index from 47.69% to 2.37% and the bleeding index from 32.93% to 6.28% after just 2 weeks. Mouthwash with 0.1% OCT is also highly effective, as it significantly lowered the median plaque index and salivary bacterial counts in 152 patients in 5 days compared to a control group (p < 0.0001), while also reducing the gingival index (p < 0.001). When povidone-iodine was used as an irrigant during the surgical removal of mandibular third molars in 105 patients, it resulted in notably lower pain scores after 2 days compared to a control group (4.57 ± 0.60 vs. 5.71 ± 0.45). Sodium hypochlorite is excellent for root canal disinfection, as irrigating with 1% NaOCl completely eliminated the bacteria from canals in 65% patients. A 0.05% CPC mouthwash proved effective for perioperative patient care, significantly decreasing gingival bleeding (p < 0.001) and suppressing Streptococcus levels even one week post-surgery. Lastly, a 6% H2O2 paint-on varnish and 6% H2O2 tray formulations successfully bleached the teeth of 40 patients, maintaining a noticeably whiter appearance up to the 6-month follow-up, with significant color differences from the baseline (p < 0.005). Synthetic compounds have a large research base, which also provides a greater awareness of their mechanism of action and potential adverse effects. For a better understanding of how they work, several methods and assays are performed. These are protocolary techniques through which a compound's efficacy and toxicity are established.

Comparative Evaluation of Disinfection Protocols for Dental Impressions in Prosthodontics

BACKGROUND

In prosthodontics, dental impressions are essential for creating precise dental restorations. However, these impressions are susceptible to microbial contamination, which can pose a risk of infection to patients. Consequently, effective disinfection methods are crucial to prevent postoperative infections. This study aims to evaluate the effectiveness of various disinfection techniques for dental impressions used in prosthodontics.

MATERIALS AND METHODS

A total of 148 poured dental impressions were randomized into three disinfection groups: immersed in 0.5% sodium hypochlorite, 2% glutaraldehyde, or 0.2% chlorhexidine solution. The bacterial contamination was evaluated by direct colony-forming unit (CFU) counting, while the dimensional accuracy and surface detail duplication of each resin sample were determined as physical properties. Data were analyzed using SPSS version 23.0 (IBM Corp., Armonk, NY). Either analysis of variance (ANOVA) with the option for post-hoc or non-parametric tests was used to investigate and compare the efficacy of the better disinfection protocols where the p-value was considered significant if less than 0.05.

RESULTS

Glutaraldehyde showed the lowest mean CFU count (2.5 log10 CFUs), followed by sodium hypochlorite (3.2 log10 CFUs) and chlorhexidine (3.5 log10 CFUs). All disinfection protocols were able to significantly reduce microbial contamination when compared with the control group (p < 0.05). The results of the physical property assessment demonstrated acceptable dimensional accuracy in all tested protocols, with slight differences recorded between them regarding the reproduction of surface detail. More specifically, the mean dimensional deviation was in the range between 0.02 and 0.04 mm, while scores for surface detail reproduction ranged from 2 to 4. The ANOVA results revealed significant differences in microbial contamination levels (F(2, 145) = 5.72, p = 0.007) and dimensional accuracy (F(2, 145) = 3.45, p = 0.032) between the various disinfection protocols.

CONCLUSION

This study enlightens the effective sterilization protocol to be adopted in prosthodontics for dental impressions. Glutaraldehyde was most effective in microbial reduction, while sodium hypochlorite and chlorhexidine were equally effective. Therefore, clinicians must be vigilant in assessing the type of microbial flora that can be encountered during prosthodontic procedures while choosing disinfection protocols for patient safety and quality of impressions.

COVID-19 in Dental Practice Is Prevented by Eugenol Responsible for the Ambient Odor Specific to Dental Offices: Possibility and Speculation

Dental professionals routinely work in proximity to patients even when either or both of them have suspected or confirmed COVID-19. The oral cavity also serves as a reservoir for SARS-CoV-2 because the virus is present in and replicates in oral secretions (saliva and gingival crevicular fluid), oral tissues (salivary gland and periodontal tissue), and oral microenvironments (gingival sulcus and periodontal pocket). Despite a high risk of SARS-CoV-2 infection, the prevalence of COVID-19 in dentists, dental hygienists, dental assistants, and their patients was similar to that in the general population even during the pandemic. We propose that eugenol, which is responsible for the ambient odor specific to dental offices, could contribute to prevention of COVID-19 in dental settings. Eugenol is not only released from dental materials (filling, cement, and sealer) but is also aerosolized by dental procedures (grinding, polishing, and restoration). Such eugenol has been suggested to possess the potential to inhibit the infectivity and replication of SARS-CoV-2, the entry of SARS-CoV-2 into human cells by binding specifically to the viral spike protein, and the protease indispensable for SARS-CoV-2 replication. It has been shown that aerosolized eugenol acts on airborne viruses to reduce their loads. This review highlights a hypothesis that the environment of dental offices impregnated with eugenol suppresses SARS-CoV-2 airborne transmission and SARS-CoV-2 contagion between dental professionals and patients, preventing COVID-19 in dental practice. Anti-COVID-19 eugenol might give insights into the safe delivery of dental treatment and oral care in the COVID-19 era.

Effects of Chlorhexidine and Povidone-Iodine on the SARS-CoV-2 Load: A Systematic Review and Meta-analysis

The efficacy of mouthwash for reducing the viral load in patients with the novel coronavirus disease 2019 (COVID-19) remains unclear. This systematic review and meta-analysis comprehensively examined the effects of chlorhexidine (CHX) and povidone-iodine (PVP-I) on the viral load in patients with COVID-19. We performed methodological analysis, systematic review, and meta-analysis of included studies using the Comprehensive Meta-analysis Software. PubMed, EMBASE, Cochrane Library, and ProQuest were searched from December 1, 2019, to December 2, 2021. In total, we included 10 studies of 1,339 patients with COVID-19. Compared with the control group, both CHX and PVP-I significantly reduced the number of negative reverse-transcription polymerase chain reaction (RT-PCR) results (p<0.001) among COVID-19 patients. The CHX and PVP-I were effective on reducing the number of negative RT-PCR results in COVID-19 patients. Additional studies using adequate randomization methods and larger samples are warned.

The effect of disinfectants and antiseptics on co- and cross-selection of resistance to antibiotics in aquatic environments and wastewater treatment plants

The outbreak of the SARS-CoV-2 pandemic led to increased use of disinfectants and antiseptics (DAs), resulting in higher concentrations of these compounds in wastewaters, wastewater treatment plant (WWTP) effluents and receiving water bodies. Their constant presence in water bodies may lead to development and acquisition of resistance against the DAs. In addition, they may also promote antibiotic resistance (AR) due to cross- and co-selection of AR among bacteria that are exposed to the DAs, which is a highly important issue with regards to human and environmental health. This review addresses this issue and provides an overview of DAs structure together with their modes of action against microorganisms. Relevant examples of the most effective treatment techniques to increase the DAs removal efficiency from wastewater are discussed. Moreover, insight on the resistance mechanisms to DAs and the mechanism of DAs enhancement of cross- and co-selection of ARs are presented. Furthermore, this review discusses the impact of DAs on resistance against antibiotics, the occurrence of DAs in aquatic systems, and DA removal mechanisms in WWTPs, which in principle serve as the final barrier before releasing these compounds into the receiving environment. By recognition of important research gaps, research needs to determine the impact of the majority of DAs in WWTPs and the consequences of their presence and spread of antibiotic resistance were identified.

Utilizing the Potential of Antimicrobial Peptide LL-37 for Combating SARS-COV- 2 Viral Load in Saliva: an In Silico Analysis

Limiting the spread of virus during the recent pandemic outbreak was a major challenge. Viral loads in saliva, nasopharyngeal and oropharyngeal swabs were the major cause for droplet transmission and aerosols. Saliva being the major contributor for the presence of viral load is the major key factor; various mouthwashes and their combination were analyzed and utilized in health care centers to hamper the spread of virus and decrease viral load. The compositions of these mouthwashes to an extent affected the viral load and thereby transmission, but there is always a scope for other protocols which may provide better results. Here we evaluated the potential of antimicrobial peptide LL-37 in decreasing the viral load of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) through an in silico work and evidence from other studies. This narrative review highlighted a brief nonsystematic methodology to include the selected articles for discussion. Accessible electronic databases (Medline, Scopus, Web of Science, SciELO, and PubMed) were used to find studies that reported the salivary viral load of SARS-CoV-2 published between December 2019 and June 2021. The following keywords were utilized for brief searching of the databases: "saliva," "viral load," and "SARS-CoV-2." Articles in English language, in vitro cell-line studies, ex vivo studies, and clinical trials explaining the viral load of SARS-CoV-2 in saliva and strategies to decrease viral load were included in this review. The search was complemented by manual searching of the reference lists of included articles and performing a citation search for any additional reviews. The antiviral potential of cationic host defense peptide LL-37 was evaluated using computational approaches providing in silico evidence. The analysis of docking studies and the display of positive interfacial hydrophobicity of LL-37 resulting in disruption of COVID-19 viral membrane elucidate the fact that LL-37 could be effective against all variants of SARS-CoV-2. Further experimental studies would be needed to confirm the binding of the receptor-binding domain with LL-37. The possibility of using it in many forms further to decrease the viral load by disrupting the viral membrane is seen.

Functionalized Masks: Powerful Materials against COVID-19 and Future Pandemics

The outbreak of COVID-19 revealed the vulnerability of commercially available face masks. Without having antibacterial/antiviral activities, the current masks act only as filtering materials of the aerosols containing microorganisms. Meanwhile, in surgical masks, the viral and bacterial filtration highly depends on the electrostatic charges of masks. These electrostatic charges disappear after 8 h, which leads to a significant decline in filtration efficiency. Therefore, to enhance the masks' protection performance, fabrication of innovative masks with more advanced functions is in urgent demand. This review summarizes the various functionalizing agents which can endow four important functions in the masks including i) boosting the antimicrobial and self-disinfectant characteristics via incorporating metal nanoparticles or photosensitizers, ii) increasing the self-cleaning by inserting superhydrophobic materials such as graphenes and alkyl silanes, iii) creating photo/electrothermal properties by forming graphene and metal thin films within the masks, and iv) incorporating triboelectric nanogenerators among the friction layers of masks to stabilize the electrostatic charges and facilitating the recharging of masks. The strategies for creating these properties toward the functionalized masks are discussed in detail. The effectiveness and limitation of each method in generating the desired properties are well-explained along with addressing the prospects for the future development of masks.