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Jose J, Teja KV, Silva EJNL, Janani K, Siddique R, Rossi-Fedele G. Centric versus eccentric engine-driven endodontic instrument design for microbial load reduction-A systematic review and meta-analysis of randomised clinical trials. AUST ENDOD J 2023; 49 Suppl 1:515-527. [PMID: 36514265 DOI: 10.1111/aej.12726] [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: 07/28/2022] [Revised: 11/09/2022] [Accepted: 11/24/2022] [Indexed: 12/15/2022]
Abstract
This systematic review assessed the clinical influence of centric and eccentric engine-driven instrument design for reduction in microbial load in infected root canal system. The literature search was conducted in electronic databases (PubMed, Cochrane Library, Scopus, Lilacs and Google Scholar) and grey literature till June 2022. The search strategy followed the PRISMA 2020 guidelines. Qualitative and quantitative synthesis was conducted based on the guidelines of the Cochrane Handbook. The risk of bias was assessed using the revised Cochrane criteria and quality of evidence was conducted using the Grading of Recommendation Assessment, Development and Evaluation tool. Out of 28 papers, only five papers met the inclusion criteria of this review. Studies showed reduction in microbial load after instrumentation using centric or eccentric instruments with no statistically significant difference in the meta-analysis. In conclusion, there is low-grade evidence suggesting that microbial reduction is similar using centric and eccentric instruments.
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Affiliation(s)
| | - Kavalipurapu Venkata Teja
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
| | - Emmanuel João Nogueira Leal Silva
- Department of Endodontics, School of Dentistry, Grande Rio University (UNIGRANRIO), Duque de Caxias, Brazil
- Department of Endodontics, School of Dentistry, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
| | - Krishnamachari Janani
- Department of Conservative Dentistry and Endodontics, SRM Dental College, Chennai, India
| | - Riluwan Siddique
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
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Saber SM, Alfadag AMA, Nawar NN, Plotino G, Hassanien EES. Instrumentation Kinematics Does Not Affect Bacterial Reduction, Post-Operative Pain and flare-ups: A Randomized Clinical Trial. Int Endod J 2022; 55:405-415. [PMID: 35100456 DOI: 10.1111/iej.13695] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 01/26/2022] [Accepted: 01/27/2022] [Indexed: 11/25/2022]
Abstract
AIM This randomized clinical trial aimed to assess the effect of instrumentation kinematics (reciprocation or continuous rotation) on bacterial reduction, post-operative pain and incidence of flare-ups after root canal treatment of single-rooted mandibular premolars with asymptomatic apical periodontitis. METHODOLOGY Sixty-six patients were included in this prospective, parallel, randomized clinical trial. Patients were randomly allocated into two groups (N=33) according to the kinematics of the shaping instrument: WaveOne Gold (WO) used in reciprocation or One Shape (OS) used in continuous rotation. Under complete asepsis, bacterial samples were taken before (S1) and after (S2) a standard cleaning and shaping protocol. Evaluation of bacterial reduction was done by both culture technique and quantitative real-time polymerase chain reaction (qPCR) analysis. Post-operative pain was evaluated using the visual analog scale (VAS) after 24, 48- and 72-hours following treatment, while flare-ups were recorded as a binary outcome (Yes/No). Independent and paired t-tests were used for inter and intragroup comparisons for bacterial count data respectively. For post-operative pain score, intergroup comparisons were analyzed using Mann-Whitney U test while intragroup comparisons were analyzed using Friedman test followed by pairwise comparisons utilizing Wilcoxon signed rank test with Bonferroni correction. The significance level was set at p≤0.05 within all tests. RESULTS All the allocated participants received the intervention and were analyzed. The comparison between culture and qPCR methods showed that qPCR analysis demonstrated significantly higher pre-instrumentation baseline bacterial count (p<0.05). The percentage of bacterial reduction, detected by either method, significantly decreased after instrumentation using either rotation or reciprocation kinematics (p<0.05). However, the difference between the WOG or OS files was statistically non-significant (p>0.05). The intra-group comparisons showed a significant reduction in post-operative pain with time (p<0.05) for both groups. However, the inter-group comparison demonstrated that the difference in post-operative pain after the use of either WOG or OS was statistically non-significant (p>0.05). The incidence of flare-ups between both groups was also not-significant (p=1). CONCLUSIONS Shaping kinematics, either rotation or reciprocation motions, had no impact on bacterial reduction and the incidence of post-operative pain and flare-ups after root canal preparation of single-rooted premolars with asymptomatic apical periodontitis.
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Affiliation(s)
- Shehabeldin Mohamed Saber
- Department of Endodontics, Ain Shams University, Cairo, Egypt.,Department of Endodontics, The British University, El-Shorouk city, Egypt
| | | | - Nawar Naguib Nawar
- Department of Endodontics, The British University, El-Shorouk city, Egypt
| | | | - Ehab El-Sayed Hassanien
- Department of Endodontics, Ain Shams University, Cairo, Egypt.,El-Galala University, El-Galala city, Egypt
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Zeng C, Everett J, Sidow S, Bergeron BE, Tian F, Ma J, Tay FR. In vitro evaluation of efficacy of two endodontic sonic-powered irrigant agitation systems in killing single-species intracanal biofilms. J Dent 2021; 115:103859. [PMID: 34706267 DOI: 10.1016/j.jdent.2021.103859] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 10/15/2021] [Accepted: 10/18/2021] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVE To evaluate the efficacy of two sonic-powered irrigation systems, EDDY and EndoActivator, in killing intracanal biofilms. METHODS Eighty-three instrumented, autoclaved single-rooted human premolars were inoculated with Enterococcus faecalis (ATCC-29212) for 21 days to generate mature, single-species biofilms. The teeth were devided into four groups: irrigation with saline (N = 11); irrigation with 2% NaOCl without agitation (N = 24); irrigation with 2% NaOCl with agitation by the EndoActivaor (N = 24); irrigation with 2% NaOCl with agitation by the EDDY (N = 24). Colony-forming unit (CFU) counts and XTT assay were used to evaluate bacterial load. Additional teeth were split into root-halves for fluorescence staining to examine the percentages of live/dead bacteria in the dentinal tubules present in different canal locations (coronal, mid-root and apical portions). RESULTS Agitation of 2% NaOCl by EDDY or EndoActivator reduced bacteria load more proficiently than the use of 2%NaOCl without agitation (p < 0.05). No significant difference was detected between the two sonic-powered irrigant agitation systems (p > 0.05). Confocal laser scanning microscopy indicated that both devices had better intratubular bacteria killing efficacy than the use of 2% NaOCl only in all parts of the canal space (p < 0.05), with no significant difference detected between EDDY and EndoActivator (p > 0.05). Elimination of intracanal and intratubular bacteria were less efficient in the apical portion of the canal space for all experimental groups. CONCLUSION The two sonic-powered irrigant activation systems demonstrated comparable intracanal bacteria reduction efficacy when 2% NaOCl was used for disinfecting E. faecalis biofilms in single-rooted teeth. CLINICAL SIGNIFICANCE With the use of 2% NaOCl as irrigant, the EDDY and EndoActivator sonic-powered irrigant agitation systems have improved and equivalent intracanal bacteria reduction efficacy but are incapable of completely killing all bacteria that resided within the dentinal tubules of root canals.
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Affiliation(s)
- Chang Zeng
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Joseph Everett
- The Dental College of Georgia, Augusta University, Augusta, GA, USA
| | - Stephanie Sidow
- The Dental College of Georgia, Augusta University, Augusta, GA, USA
| | - Brian E Bergeron
- The Dental College of Georgia, Augusta University, Augusta, GA, USA
| | - Fucong Tian
- The Dental College of Georgia, Augusta University, Augusta, GA, USA
| | - Jingzhi Ma
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Franklin R Tay
- The Dental College of Georgia, Augusta University, Augusta, GA, USA.
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Essential Oils as Alternatives for Root-Canal Treatment and Infection Control against Enterococcus faecalis—A Preliminary Study. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11041422] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Since natural alternatives are needed in dentistry for the treatment of root canal, where the standard irrigant is NaOCl with significant toxicity, the aim of the study was to assess the antibacterial properties of non-chemical root-canal irrigants (aqueous extracts of oregano, thyme, lemongrass, melaleuca and clove essential oils) against Enterococcus faecalis. For this, aqueous extracts of each essential oil (AqEO) were prepared. A solution of sodium hypochlorite (NaOCl) was used as a positive standard against which the antimicrobial effects of AqEO could be reported. The root canals of seven teeth were inoculated with 20 µL of Enterococcus faecalis ATCC29212 inoculum and incubated overnight at 37 °C. All the teeth canals were instrumented and were irrigated with the corresponding AqEO, NaOCl and saline solution, then rinsed with saline. Bacteriological samples for each canal post-instrumentation were collected with sterile paper points which were inoculated on culture media. A second processing followed the same methodology but involved only irrigation and no instrumentation. Using instrumentation, thyme and clove completely inhibited Enterococcus faecalis growth. Without instrumentation, clove and oregano AqEOs completely reduced the bacterial load as seen in direct inoculation, but bacterial growth was observed in all the samples after enrichment, except for NaOCl. Nevertheless, the turbidity of the enrichment media was lower for the samples irrigated with AqEOs than for control. In conclusion, AqEOs of thyme, oregano and clove showed a promising antibacterial effect, especially when teeth instrumentation was performed.
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Nasrabadi N, Jamali S, Vojoodi MG, Jamali M. The impact of Distinctive Root Canal Instrumentation Systems on Endotoxin Lessening from the Root Canal: A Systematic Review and Meta-Analysis. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2021. [DOI: 10.1590/pboci.2021.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Yared G, Ramli GA. Ex vivo ability of a noninstrumentation technique to disinfect oval-shaped canals. J Conserv Dent 2020; 23:10-14. [PMID: 33223634 PMCID: PMC7657432 DOI: 10.4103/jcd.jcd_306_20] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 07/14/2020] [Accepted: 07/15/2020] [Indexed: 12/26/2022] Open
Abstract
Context: Oval-shaped canals represent a challenge in endodontics. Infected tissue may remain in their recesses. This concern may be more critical with minimally instrumentation techniques. Aims: The present study evaluated the disinfection ability in oval-shaped canals of a noninstrumentation technique using ultrasonic agitation and intracanal heating of sodium hypochlorite (NaOCl) compared to rotary canal preparation and ultrasonic agitation with and without heating of NaOCl. Settings and Designs: Sixty extracted mandibular incisors were included. The teeth had pulp necrosis and apical periodontitis and oval-shaped canals. They were divided into three groups depending on the treatment protocol: (1) IHAN: intracanal heating and ultrasonic agitation of NaOCl only, (2) R-IHAN: Rotary preparation followed by IHAN, and (3) R-passive ultrasonic agitation (PUA): Rotary preparation and ultrasonic agitation of NaOCl. Methods: Root canal samples were taken before (S1) and after (S2) the endodontic procedures were completed and cultured anaerobically. Statistical Analysis Used: Wilcoxon tests were performed to compare colony-forming units (CFUs) before and after the endodontic procedures for the three groups. The percentage of variation of CFUs was compared among the three groups using Kruskal–Wallis tests, followed by Mann–Whitney U-tests. Results: All S1 samples were positive. All S2 samples showed bacterial growth in R-PUA compared to 17 in R-IHAN. None of the S2 samples in IHAN were positive. Bacteria reduction was significant in each group (P < 0.001). The percentage of bacteria reduction was highest for IHAN and lowest for R-PUA (P < 0.001). Conclusions: Intracanal heating and ultrasonic agitation of NaOCl without instrumentation completely eliminated bacteria from infected oval-shaped canals.
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Affiliation(s)
- Ghassan Yared
- Private Practice, Lebanese University, Beirut, Lebanon
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Siddique R, Ranjan M, Jose J, Srivastav A, Rajakeerthi R, Kamath A. Clinical Quantitative Antibacterial Potency of Garlic-Lemon Against Sodium Hypochlorite in Infected Root Canals: A Double-blinded, Randomized, Controlled Clinical Trial. J Int Soc Prev Community Dent 2020; 10:771-778. [PMID: 33437712 PMCID: PMC7791589 DOI: 10.4103/jispcd.jispcd_287_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 09/17/2020] [Accepted: 09/25/2020] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Sodium hypochlorite for endodontic treatment has been shown to exhibit significant antimicrobial properties, with adverse effects such as sodium hypochlorite accidents. Natural irrigants have shown significant antimicrobial action and the added advantage of being biocompatible. This study proposes an alternative intracanal irrigant made from Garlic-Lemon (Ga-Li) extract. AIM To evaluate the antimicrobial action of 1.8% Garlic-Lemon (Ga-Li) mixture in contrast to 3% sodium hypochlorite in a tooth diagnosed with asymptomatic apical periodontitis. MATERIALS AND METHODS Thirty patients were randomly allocated into two groups: Group A, 3% sodium hypochlorite and Group B, 1.8% Garlic-Lemon. Single- or multirooted teeth root canals were instrumented and prepared by using ProTaper Gold. Root canal samples were taken both pre- and postinstrumentation. These samples were subjected to DNA extraction, amplification, and quantification by using a real-time polymerase chain reaction (qPCR). RESULTS Samples before preparation (S1) were tested positive for microbial presence, with mean numbers of 7.0 ×107 and 12.4 ×107 bacterial cells for the sodium hypochlorite and Garlic-Lemon groups, respectively. Postpreparation (S2), in sodium hypochlorite and Garlic-Lemon groups, bacterial counts were still present with mean counts seen at 27.4 ×105 and 7.7 ×105 bacterial cells, respectively. Intergroup comparison resulted in a statistically insignificant difference (P > 0.05). CONCLUSION Garlic-Lemon has shown microbial load reduction that is as effective as sodium hypochlorite, with the highest mean bacterial reduction percentage. The results of the present randomized, controlled clinical trial suggest that Garlic-Lemon is a potential new alternative as an endodontic irrigant.
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Affiliation(s)
- Riluwan Siddique
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India
| | - Manish Ranjan
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India
| | - Jerry Jose
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India
| | - Ankita Srivastav
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India
| | - Rajamohan Rajakeerthi
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India
| | - Ajith Kamath
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India
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Nardello LC, Vilela BG, Fernandes FS, Bruno FP, Carvalho AP, Cazares RX, Nascimento LC, Honório HM, Ando ES, Mayer MP, Gavini G, Pinheiro ET. Analysis of Active Bacteria Persisting after Chemomechanical Procedures: An RNA- and DNA-based Molecular Study. J Endod 2020; 46:1570-1576. [DOI: 10.1016/j.joen.2020.08.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 07/31/2020] [Accepted: 08/07/2020] [Indexed: 12/26/2022]
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Fischer NG, Münchow EA, Tamerler C, Bottino MC, Aparicio C. Harnessing biomolecules for bioinspired dental biomaterials. J Mater Chem B 2020; 8:8713-8747. [PMID: 32747882 PMCID: PMC7544669 DOI: 10.1039/d0tb01456g] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Dental clinicians have relied for centuries on traditional dental materials (polymers, ceramics, metals, and composites) to restore oral health and function to patients. Clinical outcomes for many crucial dental therapies remain poor despite many decades of intense research on these materials. Recent attention has been paid to biomolecules as a chassis for engineered preventive, restorative, and regenerative approaches in dentistry. Indeed, biomolecules represent a uniquely versatile and precise tool to enable the design and development of bioinspired multifunctional dental materials to spur advancements in dentistry. In this review, we survey the range of biomolecules that have been used across dental biomaterials. Our particular focus is on the key biological activity imparted by each biomolecule toward prevention of dental and oral diseases as well as restoration of oral health. Additional emphasis is placed on the structure-function relationships between biomolecules and their biological activity, the unique challenges of each clinical condition, limitations of conventional therapies, and the advantages of each class of biomolecule for said challenge. Biomaterials for bone regeneration are not reviewed as numerous existing reviews on the topic have been recently published. We conclude our narrative review with an outlook on the future of biomolecules in dental biomaterials and potential avenues of innovation for biomaterial-based patient oral care.
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Affiliation(s)
- Nicholas G Fischer
- Minnesota Dental Research Center for Biomaterials and Biomechanics, University of Minnesota, 16-250A Moos Tower, 515 Delaware St. SE, Minneapolis, Minnesota 55455, USA.
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Siddique R, Nivedhitha MS, Ranjan M, Jacob B, Solete P. Comparison of antibacterial effectiveness of three rotary file system with different geometry in infected root canals before and after instrumentation-a double-blinded randomized controlled clinical trial. BDJ Open 2020; 6:8. [PMID: 32550007 PMCID: PMC7280230 DOI: 10.1038/s41405-020-0035-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 03/12/2020] [Accepted: 03/22/2020] [Indexed: 01/13/2023] Open
Abstract
Introduction To compare the antibacterial effectiveness of three rotary file systems i.e., ProTaper Next, ProTaper Gold and XP-endo Shaper in root canals of teeth with asymptomatic apical periodontitis by using the real-time polymerase chain reaction. Materials and methods Root canals from single or multi-rooted teeth (straight canals) with necrotic pulps and asymptomatic apical periodontitis were instrumented using either ProTaper Next (n = 20), ProTaper Gold (n = 20) and XP-endo Shaper (n = 20) under irrigation with 3% sodium hypochlorite. Samples obtained before and after instrumentation were subjected to DNA extraction, amplification and quantitation of total amount of bacteria by using the real-time polymerase chain reaction. Results Samples were taken before preparation (S1) were positive for presence of bacteria, with mean numbers of 9.94 × 107, 20.4 × 107 and 9.20 × 107 bacterial cells for the ProTaper Next, ProTaper Gold and XP-endo Shaper groups, respectively. After preparation (S2) with ProTaper Next, ProTaper Gold, and XP-endo Shaper, root canals still had bacteria with mean counts of 11.8 × 105, 87.2 × 105 and 4.52 × 105 bacterial cells, respectively. Both XP-endo Shaper (99.50%) and ProTaper Next (98.81%) were effective in reducing total bacterial count, and there was no statistically significant difference between them (P > 0.05). XP-endo Shaper succeeded in reducing total bacterial count than ProTaper Gold (95.72%) and there exists statistically significant difference between them (P < 0.05). Conclusions XP-endo Shaper was highly effective in reducing total bacterial count from root canals of teeth with asymptomatic apical periodontitis than ProTaper Gold. ProTaper Next also showed improved microbial reduction percentage as compared with ProTaper Gold.
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Affiliation(s)
- Riluwan Siddique
- Saveetha Dental College, Poonamalle High Road, Chennai, Tamil Nadu 600056 India
| | | | - Manish Ranjan
- Saveetha Dental College, Poonamalle High Road, Chennai, Tamil Nadu 600056 India
| | - Benoy Jacob
- Saveetha Dental College, Poonamalle High Road, Chennai, Tamil Nadu 600056 India
| | - Pradeep Solete
- Saveetha Dental College, Poonamalle High Road, Chennai, Tamil Nadu 600056 India
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Šimundić Munitić M, Budimir A, Jakovljević S, Anić I, Bago I. Short-Term Antibacterial Efficacy of Three Bioceramic Root Canal Sealers Against Enterococcus Faecalis Biofilms. Acta Stomatol Croat 2020; 54:3-9. [PMID: 32523152 PMCID: PMC7233124 DOI: 10.15644/asc54/1/1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Objectives The aim of the study was to evaluate the antimicrobial efficacy of three bioceramic root canal sealers against Enterococcus faecalis (E. faecalis) biofilm. Material and methods E. faecalis bacterial suspension was grown on filter paper discs on agar plates. After the incubation period, the discs were covered with four different root canal sealers: 1) Premixing bioceramic root canal sealer (TotalFill BC Sealer); 2) Dual component bioceramic sealer (BioRoot RCS); 3) Mineral trioxide agreggate based sealer (MTA Fillapex); 4) Epoxy resin-based selar (AH Plus). After contact time of 60 minutes, the sealers were removed, and the discs were transferred into sterile tubes containing phosphate buffered saline. After serial dilutions, the aliquots of the suspension were cultivated for 24 hours. After the incubation period, the colony forming units (CFUs) were counted. Results There were no significant differences in antibacterial efficacy between the Total Fill BC Sealer and the AH Plus sealer (p=0.386). Both sealers showed better antibacterial efficacy compared to the BioRoot RCS and the MTA Fillapex (p<0.001). Conclusion The Total Fill BC Sealer and AH Plus had better antibacterial efficacy than the BioRoot RCS and the MTA Fillapex sealers.
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Affiliation(s)
| | - Ana Budimir
- Department of Clinical and Molecular Microbiology, Clinical Hospital Centre Zagreb, Croatia
| | - Suzana Jakovljević
- Department of Materials, Faculty of Engineering and Naval Architecture, University of Zagreb, Croatia
| | - Ivica Anić
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Croatia
| | - Ivona Bago
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Croatia
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Race J, Zilm P, Ratnayake J, Fitzsimmons T, Marchant C, Cathro P. Efficacy of laser and ultrasonic-activated irrigation on eradicating a mixed-species biofilm in human mesial roots. AUST ENDOD J 2019; 45:317-324. [PMID: 30623530 DOI: 10.1111/aej.12334] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2018] [Indexed: 12/16/2022]
Abstract
This study investigated the efficacy of Er,Cr:YSGG laser and ultrasonic activated irrigation on eradicating a mixed-species biofilm grown in root canals with complex anatomy. The biofilm was grown over 4-weeks in the root canals of decoronated human mandibular molar teeth. Control roots received no further treatment. The remaining roots were chemomechanically prepared using different irrigating protocols: 4% NaOCl and 15% EDTAC with ultrasonic activated irrigation and laser activated irrigation using power settings of 0.5 W and 0.75 W. Cellular viability was determined using serial plating. One tooth from each group was subjected to qualitative SEM analysis. Quantification by culturing revealed significant differences between control group and all other treatment groups. This study demonstrated that chemomechanical irrigation with laser and ultrasonic activated irrigation significantly reduced the bacterial load from complex root canal systems; however, there were no significant differences found between the experimental groups.
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Affiliation(s)
- Jonathan Race
- School of Dentistry, Faculty of Health Science, The University of Adelaide, Adelaide, South Australia, Australia
| | - Peter Zilm
- School of Dentistry, Faculty of Health Science, The University of Adelaide, Adelaide, South Australia, Australia
| | | | - Tracy Fitzsimmons
- School of Dentistry, Faculty of Health Science, The University of Adelaide, Adelaide, South Australia, Australia
| | - Ceilidh Marchant
- School of Dentistry, Faculty of Health Science, The University of Adelaide, Adelaide, South Australia, Australia
| | - Peter Cathro
- School of Dentistry, Faculty of Health Science, The University of Adelaide, Adelaide, South Australia, Australia.,Faculty of dentistry, The University of Otago, Dunedin, New Zealand
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Siddique R, Nivedhitha MS. Effectiveness of rotary and reciprocating systems on microbial reduction: A systematic review. J Conserv Dent 2019; 22:114-122. [PMID: 31142978 PMCID: PMC6519186 DOI: 10.4103/jcd.jcd_523_18] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Introduction: The role of microorganism and their products in the initiation, propagation, and persistence of periradicular periodontitis has been established. One of the major goals of the treatment of infected root canals of teeth with apical periodontitis is to promote maximal reduction in the intracanal bacterial populations. Engine-driven nickel-titanium instruments possess the latest generation of root canal instruments. The possible benefit of rotary instrumentation over other instrumentation techniques regarding cleaning and disinfecting effects would be irrigant warming and/or turbulence caused by the mechanical rotation of instruments. Furthermore, reciprocating instrument has been introduced for root canal preparation. It has been shown that instruments subjected to reciprocation have increased resistance to fatigue and longer usual life when combined with instruments used in continuous rotation motion. The reciprocating system uses single-file instrumentation technique which can shape and clean the canal in a shorter period and together with the lesser amount of antimicrobial agent. Objective: The objective of this study is to compare and evaluate the microbial reduction of rotary and reciprocating systems on microbial reduction. Search Strategy: A search was performed in Electronic databases (i.e., PubMed, Cochrane library, Science direct, Lilac, Sigle) using following search terms alone and in combination by means of PubMed search builder from January 1985 to December 2017. Selection Criteria: Studies were selected if they met the following criteria: In vivo studies comparing rotary and reciprocating system in asymptomatic apical periodontitis patients. Main Results: The results showed that the reciprocating system exerted an almost similar antibacterial effect when compared with the rotary system. Conclusion: The present systematic review does not provide concrete evidence to show increased antibacterial efficacy of reciprocating system as compared to the rotary system. Furthermore, clinical trials are required to evaluate the efficacy of various instrumentation systems in reducing bacteria from the root canal system.
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Affiliation(s)
- Riluwan Siddique
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - Malli Sureshbabu Nivedhitha
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
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14
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Siqueira Junior JF, Rôças IDN, Marceliano-Alves MF, Pérez AR, Ricucci D. Unprepared root canal surface areas: causes, clinical implications, and therapeutic strategies. Braz Oral Res 2018; 32:e65. [PMID: 30365606 DOI: 10.1590/1807-3107bor-2018.vol32.0065] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 06/06/2018] [Indexed: 11/21/2022] Open
Abstract
Chemomechanical preparation is intended to clean, disinfect, and shape the root canal. This step is of utmost importance during treatment of infected teeth with apical periodontitis, because treatment outcome depends on how effectively the clinician eliminates bacteria, their products, and necrotic tissue that would serve as substrate for bacterial regrowth. Nonetheless, curvatures and complex internal anatomical variations of the root canal system can pose a high degree of difficulty in reaching these goals. In infected teeth, bacteria may persist not only in difficult-to-reach areas such as isthmuses, ramifications, dentinal tubules, and recesses from C-shaped or oval/flattened canals, but also in areas of the main canal wall that remain untouched by instruments. If bacteria withstand chemomechanical procedures, there is an augmented risk for post-treatment apical periodontitis. This article discloses the reasons why some areas remain unprepared by instruments and discusses strategies to circumvent this issue and enhance infection control during endodontic treatment/retreatment of teeth with apical periodontitis.
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Affiliation(s)
| | - Isabela das Neves Rôças
- Universidade Estácio de Sá, Faculty of Dentistry, Department of Endodontics, Rio de Janeiro, RJ, Brazil
| | | | - Alejandro Ron Pérez
- Universidade Estácio de Sá, Faculty of Dentistry, Department of Endodontics, Rio de Janeiro, RJ, Brazil
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Abstract
Newer research tools and basic science knowledge base have allowed the exploration of endodontic diseases in the pulp and periapical tissues in novel ways. The use of next generation sequencing, bioinformatics analyses, genome-wide association studies, to name just a few of these innovations, has allowed the identification of hundreds of microorganisms and of host response factors. This review addresses recent advances in endodontic microbiology and the host response and discusses the potential for future innovations in this area.
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Affiliation(s)
- Ashraf F Fouad
- Department of Endodontics, School of Dentistry, University of North Carolina at Chapel Hill, 1098 First Dental Building, CB# 7450, Chapel Hill, NC 27599-7450, USA.
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16
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ZHANG Y, CHEN Y, HU Y, HUANG F, XIAO Y. Quaternary ammonium compounds in dental restorative materials. Dent Mater J 2018; 37:183-191. [DOI: 10.4012/dmj.2017-096] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Yu ZHANG
- The Affiliated Stomatological Hospital of Kunming Medical University
| | - Yinyan CHEN
- Department of Stomatology, Kunming General Hospital of Chengdu Military Command, Teaching Hospital of Kunming Medical University
- Kunming Municipal Stomatological Hospital
| | - Yuntong HU
- Department of Stomatology, Kunming General Hospital of Chengdu Military Command, Teaching Hospital of Kunming Medical University
| | - Fang HUANG
- Department of Stomatology, Kunming General Hospital of Chengdu Military Command, Teaching Hospital of Kunming Medical University
| | - Yuhong XIAO
- Department of Stomatology, Kunming General Hospital of Chengdu Military Command, Teaching Hospital of Kunming Medical University
- Center for Dental Research, School of Dentistry, Loma Linda University
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17
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Holland R, Gomes JE, Cintra LTA, Queiroz ÍODA, Estrela C. Factors affecting the periapical healing process of endodontically treated teeth. J Appl Oral Sci 2017; 25:465-476. [PMID: 29069143 PMCID: PMC5804382 DOI: 10.1590/1678-7757-2016-0464] [Citation(s) in RCA: 88] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 03/11/2017] [Indexed: 12/20/2022] Open
Abstract
Tissue repair is an essential process that reestablishes tissue integrity and regular function. Nevertheless, different therapeutic factors and clinical conditions may interfere in this process of periapical healing. This review aims to discuss the important therapeutic factors associated with the clinical protocol used during root canal treatment and to highlight the systemic conditions associated with the periapical healing process of endodontically treated teeth. The antibacterial strategies indicated in the conventional treatment of an inflamed and infected pulp and the modulation of the host's immune response may assist in tissue repair, if wound healing has been hindered by infection. Systemic conditions, such as diabetes mellitus and hypertension, can also inhibit wound healing. The success of root canal treatment is affected by the correct choice of clinical protocol. These factors are dependent on the sanitization process (instrumentation, irrigant solution, irrigating strategies, and intracanal dressing), the apical limit of the root canal preparation and obturation, and the quality of the sealer. The challenges affecting the healing process of endodontically treated teeth include control of the inflammation of pulp or infectious processes and simultaneous neutralization of unpredictable provocations to the periapical tissue. Along with these factors, one must understand the local and general clinical conditions (systemic health of the patient) that affect the outcome of root canal treatment prediction.
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Affiliation(s)
- Roberto Holland
- Universidade Estadual Paulista, Faculdade de Odontologia de Araçatuba, Departamento de Odontologia Restauradora, Araçatuba, SP, Brasil
| | - João Eduardo Gomes
- Universidade Estadual Paulista, Faculdade de Odontologia de Araçatuba, Departamento de Odontologia Restauradora, Araçatuba, SP, Brasil
| | - Luciano Tavares Angelo Cintra
- Universidade Estadual Paulista, Faculdade de Odontologia de Araçatuba, Departamento de Odontologia Restauradora, Araçatuba, SP, Brasil
| | - Índia Olinta de Azevedo Queiroz
- Universidade Estadual Paulista, Faculdade de Odontologia de Araçatuba, Departamento de Odontologia Restauradora, Araçatuba, SP, Brasil
| | - Carlos Estrela
- Universidade Federal de Goiás, Faculdade de Odontologia, Departamento de Ciências Estomatológicas, Goiânia, GO, Brasil
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18
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Nakamura VC, Pinheiro ET, Prado LC, Silveira AC, Carvalho APL, Mayer MPA, Gavini G. Effect of ultrasonic activation on the reduction of bacteria and endotoxins in root canals: a randomized clinical trial. Int Endod J 2017; 51 Suppl 1:e12-e22. [PMID: 28439928 DOI: 10.1111/iej.12783] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Accepted: 04/20/2017] [Indexed: 02/01/2023]
Abstract
AIM This randomized clinical trial aimed to compare the effectiveness of ultrasonic activation with that of nonactivated irrigation on the removal of bacteria and endotoxin from root canals. METHODOLOGY Fifty patients with necrotic pulps and asymptomatic apical periodontitis were randomly allocated into two groups according to the final irrigation protocol after root canal preparation: Group UI - ultrasonic irrigation (n = 25) and Group NI - needle irrigation (n = 25). The root canals were medicated with calcium hydroxide for 14 days. Microbiological sampling was performed before (S1) and after the root canal preparation (S2), after the irrigation protocols (S3) and after the removal of the intracanal medication (S4). Total bacteria counts were determined by qPCR and the endotoxin levels by the limulus amebocyte lysate assay. Intragroup analyses were performed using the Wilcoxon test for related samples, whereas intergroup analyses were performed using the Mann-Whitney U-test (P < 0.05). RESULTS All S1 samples were positive for bacteria, with median numbers of 1.49 × 106 and 8.55 × 105 bacterial cells for the UI and NI groups, respectively. This number significantly decreased in S2 samples (UI: 1.41 × 104 ; NI: 3.53 × 104 ; both with P < 0.001). After final irrigation protocols, there was a significant decrease in bacterial load from S2 to S3 samples in both groups (UI: 4.29 × 103 ; NI: 1.08 × 104 ; P < 0.01). Intergroup analysis revealed a significant difference between irrigation methods regarding bacterial counts in S3 samples (P < 0.05). In contrast, no significant differences were observed between groups for endotoxin levels (P > 0.05). CONCLUSIONS Ultrasonic activation was more effective than nonactivated irrigation for reducing the number of bacteria but not the endotoxin levels in root canals of teeth with apical periodontitis.
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Affiliation(s)
- V C Nakamura
- Discipline of Endodontic, Department of Dentistry, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
| | - E T Pinheiro
- Discipline of Endodontic, Department of Dentistry, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
| | - L C Prado
- Discipline of Endodontic, Department of Dentistry, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
| | - A C Silveira
- Discipline of Endodontic, Department of Dentistry, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
| | - A P L Carvalho
- Discipline of Endodontic, Department of Dentistry, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
| | - M P A Mayer
- Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, Brazil
| | - G Gavini
- Discipline of Endodontic, Department of Dentistry, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
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19
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Krokidis A, Bonfanti C, Cerutti A, Barabanti N, Zinelis S, Panopoulos P. Comparative analysis of SAF, Protaper Next and BT-Race in eliminating Enterococcus faecalis
from long oval canals: An ex vivo
study. AUST ENDOD J 2016; 43:110-114. [DOI: 10.1111/aej.12177] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Andreas Krokidis
- Department of Endodontics; School of Dentistry; National and Kapodistrian University of Athens; Athens Greece
| | - Carlo Bonfanti
- Laboratory of Microbiology; School of Medicine; University of Brescia; Brescia Italy
| | - Antonio Cerutti
- Department of Restorative Dentistry; School of Dentistry; University of Brescia; Brescia Italy
| | - Nicola Barabanti
- Department of Restorative Dentistry; School of Dentistry; University of Brescia; Brescia Italy
| | - Spyros Zinelis
- Department of Biomaterials; School of Dentistry; National and Kapodistrian University of Athens; Athens Greece
| | - Panos Panopoulos
- Department of Endodontics; School of Dentistry; National and Kapodistrian University of Athens; Athens Greece
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20
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Rôças IN, Provenzano JC, Neves MA, Siqueira JF. Disinfecting Effects of Rotary Instrumentation with Either 2.5% Sodium Hypochlorite or 2% Chlorhexidine as the Main Irrigant: A Randomized Clinical Study. J Endod 2016; 42:943-7. [DOI: 10.1016/j.joen.2016.03.019] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Revised: 03/24/2016] [Accepted: 03/25/2016] [Indexed: 01/28/2023]
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21
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Figdor D, Brundin M. Contamination Controls for Analysis of Root Canal Samples by Molecular Methods: An Overlooked and Unsolved Problem. J Endod 2016; 42:1003-8. [PMID: 27236203 DOI: 10.1016/j.joen.2016.04.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 04/18/2016] [Accepted: 04/19/2016] [Indexed: 10/21/2022]
Abstract
INTRODUCTION It has been almost 20 years since molecular methods were first described for the analysis of root canal microbial flora. Contamination control samples are essential to establish DNA decontamination before taking root canal samples, and this review assessed those studies. METHODS Using PubMed, a search was conducted for studies using molecular microbial analysis for the investigation of endodontic samples. Studies were grouped according to the cleaning protocol, acquisition methods, and processing of control samples taken to check for contamination. RESULTS Of 136 studies applying molecular analysis to root canal samples, 21 studies performed surface cleaning and checking nucleotide decontamination with contamination control samples processed by polymerase chain reaction. Only 1 study described disinfection, sampling from the access cavity, and processing by polymerase chain reaction and reported the result; that study reported that all samples contained contaminating bacterial DNA. CONCLUSIONS Cleaning, disinfection, and checking for contamination are basic scientific prerequisites for this type of investigation; yet, this review identifies it as an overlooked issue. On the basis of this review, we call for improved scientific practice in this field.
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Affiliation(s)
- David Figdor
- Department of Microbiology, Monash University, Melbourne, Australia
| | - Malin Brundin
- Department of Odontology/Endodontics, Faculty of Medicine, Umeå University, Umeå, Sweden.
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22
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Clinical Antibacterial Effectiveness of Root Canal Preparation with Reciprocating Single-instrument or Continuously Rotating Multi-instrument Systems. J Endod 2016; 42:25-9. [DOI: 10.1016/j.joen.2015.09.019] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Revised: 09/15/2015] [Accepted: 09/29/2015] [Indexed: 11/19/2022]
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23
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Del Carpio-Perochena A, Monteiro Bramante C, Hungaro Duarte M, Bombarda de Andrade F, Zardin Graeff M, Marciano da Silva M, Cavalini Cavenago B, Lucas Fernandes S. Effect of Temperature, Concentration and Contact Time of Sodium Hypochlorite on the Treatment and Revitalization of Oral Biofilms. J Dent Res Dent Clin Dent Prospects 2015; 9:209-15. [PMID: 26889356 PMCID: PMC4753028 DOI: 10.15171/joddd.2015.038] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2014] [Accepted: 09/13/2015] [Indexed: 12/24/2022] Open
Abstract
Background and aims. Increasing the temperature of sodium hypochlorite (NaOCl) enhances its dissolution
and antibacterial properties. However, the high resistance of multi-species biofilms could
restrict the effect of the solution regardless of its temperature, enabling the long-term
recovery of the surviving bacteria. The aim of this study was to investigate if the
increase of temperature of NaOCl improves its antibacterial and dissolution ability on
oral biofilms and if the post-treatment remaining bacteria were capable of growing in a
nutrient-rich medium. Materials and methods. Forty dentin blocks were infected
intra-orally for 48 hours. Then, the specimens were treated with 1% and 2.5% NaOCl at room
temperature (22ºC) and body temperature (37ºC) for 5 and 20 min. The percentage of live
cells and the biovolume were measured pre- (control) and post-treatment and after the
biofilm revitalization. Four confocal ‘stacks’ were chosen from random areas of each
sample. Statistical analysis was performed using Kruskal-Wallis and Dunn tests.
Statistical significance was defined at P <0.05. Results. All the NaOCl groups were effective in dissolving
the biofilm at any temperature, concentration and contact time without statistical
differences among them (P >0.05). The 1%-NaOCl for 5min was not able to significantly
kill the bacteria, regardless of its temperature and contact time (P >0.05). Conclusion. The temperature variation of the NaOCl was not
relevant in killing or dissolving bacterial biofilms. Twenty-four hours of reactivation
did not appear to be enough time to induce a significant bacterial growth.
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Affiliation(s)
- Aldo Del Carpio-Perochena
- Doctor of Sciences, Department of Endodontics, Bauru Dental School of Bauru, University of São Paulo, Bauru, São Paulo, Brazil
| | - Clovis Monteiro Bramante
- Associate Professor, Department of Endodontics, Bauru Dental School of Bauru, University of São Paulo, Bauru, São Paulo, Brazil
| | - Marco Hungaro Duarte
- Associate Professor, Department of Endodontics, Bauru Dental School of Bauru, University of São Paulo, Bauru, São Paulo, Brazil
| | - Flaviana Bombarda de Andrade
- Associate Professor, Department of Endodontics, Bauru Dental School of Bauru, University of São Paulo, Bauru, São Paulo, Brazil
| | - Marcia Zardin Graeff
- Laboratory Specialist, Integrated Research Centre (CIP), Bauru Dental School of Bauru, University of São Paulo, Bauru, São Paulo, Brazil
| | - Marina Marciano da Silva
- Doctor of Sciences, Department of Endodontics, Bauru Dental School of Bauru, University of São Paulo, Bauru, São Paulo, Brazil
| | - Bruno Cavalini Cavenago
- Doctor of Sciences, Department of Endodontics, Bauru Dental School of Bauru, University of São Paulo, Bauru, São Paulo, Brazil
| | - Samuel Lucas Fernandes
- Master of Sciences, Department of Endodontics, Bauru Dental School of Bauru, University of São Paulo, Bauru, São Paulo, Brazil
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Moshari AA, Akhlaghi NM, Rahimifard N, Darmiani S. Reduction of Enterococcus faecalis in curved root canals after various sizes and tapers of canal preparation. J Conserv Dent 2015; 18:306-9. [PMID: 26180416 PMCID: PMC4502127 DOI: 10.4103/0972-0707.159733] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Revised: 04/22/2015] [Accepted: 05/30/2015] [Indexed: 11/25/2022] Open
Abstract
Aims: The aim of this study was to evaluate the reduction of Enterococcus faecalis in curved root canals after various sizes and tapers of the canal preparation. Materials and Methods: Mandibular first molars (n = 103) with curved mesiobuccal canals were divided into one control (n = 5) and 7 experimental (n = 14) groups, were inoculated with E. faecalis (ATTC 29212) and prepared with the following RaCe files (FKG Dentaire) as master apical file: Groups: 25.04, 25.06, 30.04, 30.06, 35.04, 35.06 and 40.06. All the experimental groups were irrigated with 2 mL of 1% sodium hypochlorite during instrumentation and finally rinsed with 17% ethylenediaminetetraacetic acid (EDTA) (2 mL) followed by 5.25% NaOCl (2 mL) and sterile distilled water. Colony counting was performed after incubation. Statistical Analysis Used: Resulting data were analyzed using one-way ANOVA and Tukey's post-hoc test, (P < 0.05). Results and Conclusions: All the experimental groups showed significant bacterial reduction (P < 0.001). Although the greater the size/taper or both led to more decreased amount of bacteria, differences between the groups with the identical size and different tapers, and among the groups with the same taper and different sizes were not significant. Based on this study, 25.04 along with using 2 mL of 1% NaOCl during instrumentation, and using 17% EDTA and 5.25% NaOCl as final rinse successively after the termination of preparation, can effectively reduce intra-canal bacteria and preserve root structure.
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Affiliation(s)
- Amir Abbas Moshari
- Department of Endodontic, Dental Branch, Islamic Azad University, Tehran, Iran
| | | | - Nahid Rahimifard
- Food and Drug Control Laboratories, Food and Drug Laboratories Research Centre, Ministry of Health and Medical Education, Tehran, Iran
| | - Soheila Darmiani
- Dental Research Center Department, Dental Faculty, Birjand University of Medical Sciences, Birjand, Iran
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25
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Bortoluzzi EA, Carlon D, Meghil MM, El-Awady AR, Niu L, Bergeron BE, Susin L, Cutler CW, Pashley DH, Tay FR. Efficacy of 3D conforming nickel titanium rotary instruments in eliminating canal wall bacteria from oval-shaped root canals. J Dent 2015; 43:597-604. [DOI: 10.1016/j.jdent.2015.01.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2014] [Revised: 01/02/2015] [Accepted: 01/05/2015] [Indexed: 11/26/2022] Open
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Aminoshariae A, Kulild J. Master apical file size - smaller or larger: a systematic review of microbial reduction. Int Endod J 2014; 48:1007-22. [PMID: 25387434 DOI: 10.1111/iej.12410] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Accepted: 11/07/2014] [Indexed: 01/21/2023]
Abstract
The purpose of this systematic review was to determine, in patients undergoing root canal treatment, whether apical enlargement of canals affected microbial reduction. A PICO (population, intervention, comparison and outcome) strategy was developed to identify previously published studies dealing with apical size of canal and microbial reduction. The MEDLINE, Embase, Cochrane and PubMed databases were searched. Additionally, the bibliographies of all relevant articles and textbooks were manually searched. Based on inclusion and exclusion criteria, two reviewers independently selected the relevant articles. Due to the variety of methodologies and different techniques used to measure outcome for master apical file enlargement, it was not possible to standardize the research data and to apply a meta-analysis. Seven articles were identified that met the inclusion criteria. Five of the seven articles generally concluded that canal enlargement reduced bioburden in the root canal system. Two articles reported no difference in canals enlarged to size 25 or 40. The results of the systematic review confirmed that more evidence-based research in this area is needed. With the limited information currently available, the best current available clinical evidence suggests that contemporary chemomechanical debridement techniques with canal enlargement techniques do not eliminate bacteria during root canal treatment at any size.
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Affiliation(s)
- A Aminoshariae
- Department of Endodontics, Case School of Dental Medicine, Cleveland, OH, USA
| | - J Kulild
- Dental School, UMKC, Kansas City, MO, USA
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27
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Aminoshariae A, Kulild JC. Master apical file size - smaller or larger: a systematic review of healing outcomes. Int Endod J 2014; 48:639-47. [DOI: 10.1111/iej.12370] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Accepted: 08/07/2014] [Indexed: 11/24/2022]
Affiliation(s)
- A. Aminoshariae
- Department of Endodontics; Case School of Dental Medicine; Cleveland OH USA
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28
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Antibiofilm Effects of Endodontic Sealers Containing Quaternary Ammonium Polyethylenimine Nanoparticles. J Endod 2014; 40:1167-71. [DOI: 10.1016/j.joen.2013.12.021] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2013] [Revised: 12/17/2013] [Accepted: 12/18/2013] [Indexed: 10/25/2022]
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29
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Rôças IN, Neves MAS, Provenzano JC, Siqueira JF. Susceptibility of as-yet-uncultivated and difficult-to-culture bacteria to chemomechanical procedures. J Endod 2013; 40:33-7. [PMID: 24331987 DOI: 10.1016/j.joen.2013.07.022] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Revised: 07/28/2013] [Accepted: 07/30/2013] [Indexed: 02/04/2023]
Abstract
INTRODUCTION A significant portion of the bacteria taking part of the microbiome associated with apical periodontitis still remain to be cultivated and phenotypically characterized. This molecular study evaluated the prevalence of selected as-yet-uncultivated and difficult-to-culture bacterial taxa in infected root canals and their susceptibility to chemomechanical procedures. METHODS Root canals of single-rooted teeth with apical periodontitis were prepared using rotary nickel-titanium instruments and 2.5% sodium hypochlorite as the irrigant. DNA extracts from samples taken before (S1) and after (S2) chemomechanical preparation were surveyed for the presence of 7 as-yet-uncultivated phylotypes and 1 difficult-to-culture species using end-point polymerase chain reaction. Samples were also subjected to quantitative analysis of total bacteria and levels of the 2 most prevalent taxa. RESULTS Bacteroidaceae sp. HOT-272 (24%) and Fretibacterium fastidiosum (20%) were the most prevalent taxa in S1. Their mean counts in S1 were 8.25 × 10(3) and 2.13 × 10(3) rRNA gene copies, corresponding to 0.18% and 0.55% of the total bacteria. Chemomechanical debridement promoted a highly statistically significant reduction in total bacterial counts (P < .001), but 64% of the canals were still positive for bacterial presence. Of the target taxa, only Bacteroidaceae sp. HOT-272 and F. fastidiosum were detected in S2 (each one in 1 sample). The reduction in counts of both taxa was also highly significant (P < .001). CONCLUSIONS Findings confirmed that several as-yet-uncultivated and difficult-to-grow bacterial taxa can participate in the microbiome associated with apical periodontitis. Two of them were found in relatively high prevalence but rarely as a dominant species. Chemomechanical procedures were highly effective in completely eliminating these taxa or at least substantially reducing their numbers.
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Affiliation(s)
- Isabela N Rôças
- Department of Endodontics and Molecular Microbiology Laboratory, Faculty of Dentistry, Estácio de Sá University, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Mônica A S Neves
- Department of Endodontics and Molecular Microbiology Laboratory, Faculty of Dentistry, Estácio de Sá University, Rio de Janeiro, Rio de Janeiro, Brazil
| | - José C Provenzano
- Department of Endodontics and Molecular Microbiology Laboratory, Faculty of Dentistry, Estácio de Sá University, Rio de Janeiro, Rio de Janeiro, Brazil
| | - José F Siqueira
- Department of Endodontics and Molecular Microbiology Laboratory, Faculty of Dentistry, Estácio de Sá University, Rio de Janeiro, Rio de Janeiro, Brazil.
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30
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Ferrer-Luque CM, Bejarano I, Ruiz-Linares M, Baca P. Reduction in Enteroccocus faecalis counts - a comparison between rotary and reciprocating systems. Int Endod J 2013; 47:380-6. [PMID: 23980811 DOI: 10.1111/iej.12158] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Accepted: 06/30/2013] [Indexed: 11/30/2022]
Abstract
AIM To compare the chemomechanical reduction and regrowth of Enterococcus faecalis between rotary and reciprocating systems in root canal preparation. METHODOLOGY Seventy-six single-rooted human mandibular premolars were selected and standardized to 15 mm in length. Root canals were enlarged up to a size 25 K-file and irrigated with distilled water and then were infected with E. faecalis for 4 weeks. The specimens were divided into 3 groups (n = 24) for instrumentation with Mtwo, Twisted File and WaveOne. Each group was further divided into two subgroups (n = 12) according to the irrigant used: distilled water or 5.25% sodium hypochlorite (NaOCl). Before and after rotary preparation, microbiological samples were collected using three sterilized paper points, and efficacy was expressed as reduction in percentage. The proportion of grown samples for 60 days was evaluated using nonparametric Kaplan-Meier survival analysis. Differences amongst groups were tested using the log-rank test at a significance level of 0.05. RESULTS In the main root canal, the percentage reduction in the distilled water and 5.25% NaOCl groups ranged from 95.9% to 100%, with no significant differences amongst the three systems (P > 0.05). The bacterial regrowth in NaOCl groups revealed that Mtwo had the lowest number of samples regrown at 60 days, giving statistically significant differences with respect to Twisted File (P = 0.029) and WaveOne (P = 0.005). CONCLUSIONS Reciprocating and rotary systems resulted in similar percentage reduction in E. faecalis when using either distilled water or 5.25% NaOCl solution. Over time, the Mtwo system was more effective regarding disinfection.
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Affiliation(s)
- C M Ferrer-Luque
- Department of Stomatology, School of Dentistry, University of Granada, Granada, Spain
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