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de Araújo LP, Immich F, da Rosa WLDO, da Silva AF, Lund RG, Piva E. Current perspectives on calcium silicate-based intracanal medicaments: A scoping review of clinical and laboratory evidence. J Dent 2024; 149:105311. [PMID: 39159742 DOI: 10.1016/j.jdent.2024.105311] [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: 06/29/2024] [Revised: 08/07/2024] [Accepted: 08/15/2024] [Indexed: 08/21/2024] Open
Abstract
OBJECTIVE Intracanal medicaments, primarily calcium hydroxide, play a significant role in optimizing root canal disinfection. Recently, calcium silicate-based intracanal medicaments have emerged as potential alternatives. This scoping review sought to map the available evidence concerning the clinical and laboratory properties of these bioceramic medicaments. DATA The study protocol was registered a priori (https://osf.io/rnyuv/) and a systematic search strategy using relevant MeSH terms was employed. SOURCES The search was conducted across databases including the Cochrane Library, EMBASE, PubMed/MEDLINE, SciVerse Scopus, and Web of Science. STUDY SELECTION Studies that investigated the clinical and laboratory properties of calcium silicate-based intracanal medicaments were included. CONCLUSIONS Out of 1008 potentially relevant articles, 15 met the inclusion criteria. The majority of the studies came from Brazil, primarily focusing on Bio-C Temp (Angelus). The studies revealed acceptable biocompatibility, alkaline pH, and high calcium ion release. However, they showed reduced antibacterial activity compared to conventional calcium hydroxide formulations. Tooth discoloration beyond clinically acceptable thresholds was also a significant concern. A single clinical case report exhibited potential for periapical healing and root development, though this evidence is very limited. While current evidence is preliminary, high-quality clinical trials are essential to determine their clinical efficacy and safety in endodontic treatments. CLINICAL RELEVANCE Calcium silicate-based intracanal medicaments have lower antibacterial activity and potential for tooth discoloration compared to conventional calcium hydroxide-based medicaments. Given the available evidence, they cannot be recommended for routine clinical practice.
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Affiliation(s)
| | - Felipe Immich
- Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas (UFPEL), Pelotas, RS, Brazil
| | | | - Adriana Fernandes da Silva
- Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas (UFPEL), Pelotas, RS, Brazil
| | - Rafael Guerra Lund
- Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas (UFPEL), Pelotas, RS, Brazil
| | - Evando Piva
- Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas (UFPEL), Pelotas, RS, Brazil
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Zhang S, Zhao Y, Lalsiamthara J, Peng Y, Qi L, Deng S, Wang Q. Current research progress on Prevotella intermedia and associated diseases. Crit Rev Microbiol 2024:1-18. [PMID: 39140115 DOI: 10.1080/1040841x.2024.2390594] [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: 12/23/2023] [Revised: 05/29/2024] [Accepted: 08/05/2024] [Indexed: 08/15/2024]
Abstract
Prevotella intermedia is a Gram-negative anaerobic bacterium that is a common pathogen of periodontitis. Recent studies have revealed that P. intermedia is closely associated with a variety of diseases involving multiple systems. Under the action of its virulence factors such as cysteine protease and adhesins, P. intermedia has the ability to bind and invade various host cells including gingival fibroblasts. It can also copolymerize a variety of pathogenic bacteria, leading to interference with the host's immune inflammatory response and causing various diseases. In this article, we review the progress of research on P. intermedia virulence factors and bacterial pathogenesis, and the correlation between P. intermedia and various diseases.
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Affiliation(s)
- Shuyang Zhang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
- Key Laboratory of Artificial Organs and Computational Medicine in Zhejiang Province, Key Laboratory of Pollution Exposure and Health Intervention of Zhejiang Province, Shulan International Medical College, Zhejiang Shuren University, Hangzhou, Zhejiang, China
| | - Yuheng Zhao
- College of Biology and Environmental Engineering, Zhejiang Shuren University, Hangzhou, China
| | - Jonathan Lalsiamthara
- Molecular Microbiology & Immunology, School of Medicine, Oregon Health & Science University, Portland, Oregon, USA
| | - Yan Peng
- Key Laboratory of Green Cleaning Technology& Detergent of Zhejiang Province, Hangzhou, China
| | - Linlong Qi
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
- Key Laboratory of Artificial Organs and Computational Medicine in Zhejiang Province, Key Laboratory of Pollution Exposure and Health Intervention of Zhejiang Province, Shulan International Medical College, Zhejiang Shuren University, Hangzhou, Zhejiang, China
| | - Shuli Deng
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
| | - Qingjing Wang
- Key Laboratory of Artificial Organs and Computational Medicine in Zhejiang Province, Key Laboratory of Pollution Exposure and Health Intervention of Zhejiang Province, Shulan International Medical College, Zhejiang Shuren University, Hangzhou, Zhejiang, China
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Artaza L, Campello AF, Soimu G, Alves FRF, Rôças IN, Siqueira JF. Outcome of nonsurgical root canal treatment of teeth with large apical periodontitis lesions: a retrospective study. J Endod 2024:S0099-2399(24)00441-2. [PMID: 39151889 DOI: 10.1016/j.joen.2024.08.003] [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: 07/10/2024] [Revised: 08/07/2024] [Accepted: 08/07/2024] [Indexed: 08/19/2024]
Abstract
INTRODUCTION This study reported on the outcome of the nonsurgical root canal treatment/retreatment of teeth with large apical periodontitis lesions. The influence of some variables on the prognosis was also evaluated. METHODS The study included 199 teeth with large apical periodontitis lesions from 184 patients, treated/retreated bya single operator. Most teeth were managed in a single visit using NaOCl irrigation. Cases were followed up periodically from >1 to 8 years. Treatment/retreatment outcome was evaluated by clinical and radiographic/tomographic criteria and categorized as healed, healing, or diseased. For statistical analysis, data were dichotomized in such a way that healing cases were considered as success in a loose criterion or failure in a rigid one. RESULTS Clinical/radiographic analyses revealed that 67% of the initial treatment cases were classified as healed, 22.5% as healing, and 11% as diseased. Treatment success rates were 89% (loose) and 67% (rigid). Variables that influenced the treatment outcome included previous abscess and antibiotic use, very large lesions (> 10 mm), and a sinus tract. The median follow-up time for treatment was 31.5 months. As for retreatment cases, 47% were healed, 32% were healing, and 21% were diseased. Retreatment success rates were 79% (loose) and 47% (rigid), in a median follow-up of 32 months. Cases evaluated by cone-beam computed tomography had higher failure rates. CONCLUSIONS Findings demonstrate that high favorable outcome rates can be achieved by nonsurgical root canal treatment or retreatment of teeth with large apical periodontitis lesions.
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Affiliation(s)
- Liliana Artaza
- Department of Endodontics, Grande Rio University (UNIGRANRIO), Rio de Janeiro, RJ, Brazil; Department of Endodontics, Maimonides University (UMAI), Buenos Aires, Argentina
| | - Andrea F Campello
- Department of Endodontics and Dental Research, Iguaçu University (UNIG), Nova Iguaçu, RJ, Brazil
| | - Giuliana Soimu
- Department of Endodontics, Grande Rio University (UNIGRANRIO), Rio de Janeiro, RJ, Brazil
| | - Flávio R F Alves
- Department of Endodontics, Grande Rio University (UNIGRANRIO), Rio de Janeiro, RJ, Brazil; Department of Endodontics and Dental Research, Iguaçu University (UNIG), Nova Iguaçu, RJ, Brazil.
| | - Isabela N Rôças
- Department of Endodontics, Grande Rio University (UNIGRANRIO), Rio de Janeiro, RJ, Brazil; Department of Endodontics and Dental Research, Iguaçu University (UNIG), Nova Iguaçu, RJ, Brazil
| | - José F Siqueira
- Department of Endodontics, Grande Rio University (UNIGRANRIO), Rio de Janeiro, RJ, Brazil; Department of Endodontics and Dental Research, Iguaçu University (UNIG), Nova Iguaçu, RJ, Brazil
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Gallas JA, Pelozo LL, Corona SAM, Shen Y, Haapasalo M, Sousa-Neto MD, Souza-Gabriel AE. Effect of pomegranate solution alone or combined with chlorhexidine against oral multispecies biofilm. Int Endod J 2024. [PMID: 39126293 DOI: 10.1111/iej.14135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 06/06/2024] [Accepted: 07/30/2024] [Indexed: 08/12/2024]
Abstract
AIM Natural bioactive products have been tested as alternative antimicrobial agents. This study evaluated the effect of Punica granatum extract (PGE) on oral multispecies biofilms. METHODOLOGY Lyophilized extracts from pomegranate peel were prepared, and the punicalagin content was assessed by ultra-performance liquid chromatography (UPLC). Oral multispecies biofilms from 2 donors were grown on four collagen-coated hydroxyapatite discs. After incubation for 7 days or 3 weeks, the biofilms were exposed to water (control), 2% CHX, 10% PGE, 20% PGE or 30% PGE for 3 min. The proportions of dead bacteria were assessed by the live/dead staining and confocal microscopy. After the analysis, the best PGE concentration (30%) was combined with CHX. The experimental phases were repeated using water, 2% CHX, 30% PGE and 30% PGE + 2% CHX. Five random areas of the biofilm on each disc were scanned, resulting in 20 scanned areas for each group. RESULTS Regarding the biofilm volume, no differences were found amongst solutions (p = .111). The PGE solution killed bacteria effectively in 1-week, 2-week and 3-week-old-plaque biofilms, ranging from 37 to 55.3%, depending on the PGE concentration. The 30% PGE (a) (p = .0009) had greater antibiofilm effectiveness than 2% CHX (b), which killed bacteria in the 25.2 to 48.7% range. The 10% and 20% PGE had intermediate values (ab), without significant differences from 30% PGE (p = 1.002). Water (c) had the lowest proportion of dead bacteria (p < .00001) in a range of 5 to 6.7% and lower effectiveness in killing bacteria (p < .05). The PGE alone or mixed with 2% CHX had greater anti-biofilm effectiveness than CHX (p < .05). The old plaque biofilms were more resistant than the 7-day-old plaque (p < .05). CONCLUSIONS The 30% PGE (alone or combined with CHX) exhibited a greater antibiofilm effect on oral multispecies biofilms grown on hydroxyapatite discs than 2% CHX.
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Affiliation(s)
- J A Gallas
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - L L Pelozo
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - S A M Corona
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Y Shen
- Division of Endodontics, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia, Canada
| | - M Haapasalo
- Division of Endodontics, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia, Canada
| | - M D Sousa-Neto
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - A E Souza-Gabriel
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
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Liu P, Luo Y, Liu R, Fan W, Fan B. Triton X-100 enhanced antibacterial effect of photodynamic therapy against Enterococcus faecalis infection: an in vitro study. Colloids Surf B Biointerfaces 2024; 240:113978. [PMID: 38810466 DOI: 10.1016/j.colsurfb.2024.113978] [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: 02/19/2024] [Revised: 05/07/2024] [Accepted: 05/17/2024] [Indexed: 05/31/2024]
Abstract
Photodynamic therapy (PDT) is an effective method for bacterial infection control in root canals of teeth with a broad-spectrum antibacterial activity. However, its application in root canal treatment is limited due to its inefficiency under hypoxic conditions and dentin staining. Triton X-100 (TX) shows great potential in enhancing the efficiency of antimicrobial agents through improving bacterial membrane permeability. The present study employed a combination of toluidine blue O (TB)-mediated PDT with TX to target the Enterococcus faecalis (E. faecalis), a bacterium with strong resistance to various antibacterial agents and mostly detected in infected root canals. PDT combined with TX showed enhanced antibacterial efficiency against both planktonic cells and biofilms of E. faecalis. At the same time, TX enhanced the antibacterial effect in dentinal tubules and reduced the incubation time. Mechanism studies revealed that TX improved reactive oxygen species (ROS) production through increasing the proportion of TB monomers. Additionally, increased membrane permeability and wettability were also observed. The findings demonstrated the PDT combined with TX could be used as a highly effective method for the root canal disinfection of teeth.
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Affiliation(s)
- Pei Liu
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, People's Republic of China
| | - Yi Luo
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, People's Republic of China
| | - Runze Liu
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, People's Republic of China
| | - Wei Fan
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, People's Republic of China.
| | - Bing Fan
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, People's Republic of China.
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Alquria TA, Acharya A, Tordik P, Griffin I, Martinho FC. Impact of root canal disinfection on the bacteriome present in primary endodontic infection: A next generation sequencing study. Int Endod J 2024; 57:1124-1135. [PMID: 38700876 DOI: 10.1111/iej.14074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 04/05/2024] [Accepted: 04/08/2024] [Indexed: 07/03/2024]
Abstract
AIM To investigate the bacteriome present in teeth with primary endodontic infection (PEI) and apical periodontitis (AP) and to determine quantitatively and qualitatively the impact of chemomechanical preparation (CMP) using 2.5% sodium hypochlorite NAOCl on the bacteriome found in PEI with AP using the Illumina MiSeq platform. METHODOLOGY Thirty-six paired samples from 18 patients were successfully sequenced and analysed. Samples were collected at two sampling times: before (s1) and after (s2) CMP using 2.5% NaOCl. The DNA was extracted from s1 and s2 samples and quantified using quantitative PCR (qPCR). All 36 samples were sequenced using the Illumina MiSeq platform. Raw V3-V4 amplicon sequencing data were processed with the DADA2 pipeline to generate amplicon sequence variants (ASVs). Alpha diversity metrics representing abundance (Chao1) and diversity and evenness (Shannon, Simpson) were computed. The paired-sample Wilcoxon's test was used to compare alpha diversity metrics and qPCR counts between s1 and s2. The PERMANOVA method (with 999 permutations) was applied to compare community composition between sample types (s1 versus s2) and between patient IDs. ALDEx2 (ANOVA-like differential expression tool for high-throughput sequencing data) to investigate differentially abundant taxa between s1 and s2. A paired-sample Wilcoxon's test was used to compare alpha diversity metrics and qPCR counts between s1 and s2. RESULTS The qPCR counts were significantly higher in s1 compared to s2 (p = .0007). The Chao1 index indicated no difference in alpha diversity (p < .7019); whereas Shannon (p = .0056) and Simpson (p = .02685) indexes showed higher values in s2. The PERMANOVA test using Adonis2 showed a significant effect of sample time on community composition (R2 = .0630, p = .012). Patient ID also showed a significant effect on community composition (R2 = .6961, p = .001). At the genus level, Dialister, Mogibacterium, Prevotella, and Olsenella were differentially enriched at s1, while Actinomyces, Stenotrophomonas_unclassified, Enterococcus_unclassified, and Actinomyces_unclassified were differentially enriched in s2. CONCLUSION The bacteriome present in teeth with PEI with AP is complex and diverse. CMP using 2.5% NaOCl showed a high quantitatively and qualitatively disinfectant impact on the bacteriome present in PEI with AP.
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Affiliation(s)
- Theeb Abdullah Alquria
- Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, Maryland, USA
| | - Aneesha Acharya
- Department of Periodontics and Oral Implantology, Dr D.Y. Patil Dental College and Hospital, Dr D Y Patil Vidyapeeth, Pune, India
- Periodontology and Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong SAR
| | - Patricia Tordik
- Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, Maryland, USA
| | - Ina Griffin
- Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, Maryland, USA
| | - Frederico C Martinho
- Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, Maryland, USA
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Wen YH, Lin YX, Zhou L, Lin C, Zhang L. The immune landscape in apical periodontitis: From mechanism to therapy. Int Endod J 2024. [PMID: 39087849 DOI: 10.1111/iej.14125] [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: 05/06/2024] [Revised: 07/04/2024] [Accepted: 07/12/2024] [Indexed: 08/02/2024]
Abstract
Apical periodontitis (AP) is featured by a persistent inflammatory response and alveolar bone resorption initiated by microorganisms, posing risks to both dental and systemic health. Nonsurgical endodontic treatment is the recommended treatment plan for AP with a high success rate, but in some cases, periapical lesions may persist despite standard endodontic treatment. Better comprehension of the AP inflammatory microenvironment can help develop adjunct therapies to improve the outcome of endodontic treatment. This review presents an overview of the immune landscape in AP, elucidating how microbial invasion triggers host immune activation and shapes the inflammatory microenvironment, ultimately impacting bone homeostasis. The destructive effect of excessive immune activation on periapical tissues is emphasized. This review aimed to systematically discuss the immunological basis of AP, the inflammatory bone resorption and the immune cell network in AP, thereby providing insights into potential immunotherapeutic strategies such as targeted therapy, antioxidant therapy, adoptive cell therapy and cytokine therapy to mitigate AP-associated tissue destruction.
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Affiliation(s)
- Yuan-Hao Wen
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Yu-Xiu Lin
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Lu Zhou
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Chen Lin
- Department of Endodontics, Stomatological Hospital of Xiamen Medical College, Xiamen, China
| | - Lu Zhang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
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Siqueira JF, Silva WO, Romeiro K, Gominho LF, Alves FRF, Rôças IN. Apical root canal microbiome associated with primary and posttreatment apical periodontitis: A systematic review. Int Endod J 2024; 57:1043-1058. [PMID: 38634795 DOI: 10.1111/iej.14071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 02/21/2024] [Accepted: 03/30/2024] [Indexed: 04/19/2024]
Abstract
BACKGROUND Microorganisms colonizing the apical root canal system are conceivably the ones directly involved with the causation and maintenance of apical periodontitis. OBJECTIVES This article systematically reviews the reports on the microbiome occurring exclusively at the apical root canal of teeth with primary and posttreatment apical periodontitis. METHODS The electronic databases PubMed, Embase, Web of Science, Science Direct, and Proquest were searched up to August 2023. Clinical studies using culture and molecular microbiology methods to identify the microbial taxa present exclusively in the apical root canal segment of infected teeth with apical periodontitis were included. Studies were critically assessed using the Joanna Briggs Institute Critical Prevalence Assessment Checklist. RESULTS From 2277 articles initially detected, 52 were selected for full reading and 21 were eventually included in this review. Of these, molecular methods were used in 19 and culture in 2 studies. Ten studies evaluated primary infections, 8 evaluated posttreatment infections, and 3 included both. Cryopulverization of the apical root specimens was conducted in 11 studies. All studies evaluated the prevalence and diversity of bacteria, and only one also reported on fungi. Overall, the most frequent/abundant bacterial taxa found in the apical canal of primary infections were Pseudoramibacter alactolyticus, Olsenella uli, Fusobacterium species, Streptococcus species, Porphyromonas endodontalis, Prevotella species, Actinomyces species, Parvimonas micra, Treponema denticola, Synergistetes species, and an as-yet uncharacterized taxon. In posttreatment infections, the most prevalent/abundant bacterial taxa included species of Streptococcus, Enterococcus, Fusobacterium, Actinomyces, Pseudoramibacter, Pseudomonas, and Propionibacterium. At the phylum level, Firmicutes was the most represented. The average apical bacterial load ranged from 105 to 106 in primary infections and from 103 to 104 in posttreatment infections. DISCUSSION Microbial diversity in the apical part of the root canal system was examined encompassing data from both primary and posttreatment infections. Heterogeneity amongst the studies, especially in sample collection and microbial identification methods, is an important limitation that prevented a meta-analysis. CONCLUSIONS There is a pronounced bacterial diversity in the infected apical canal, with a high interindividual variability. Different microbiome compositions at the species/genus level are observed according to the infection type. REGISTRATION PROSPERO CRD42021275886.
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Affiliation(s)
- José F Siqueira
- Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, RJ, Brazil
- Department of Endodontics, Faculty of Dentistry, Iguaçu University (UNIG), Nova Iguaçu, RJ, Brazil
| | - Warley O Silva
- Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, RJ, Brazil
| | - Kaline Romeiro
- Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, RJ, Brazil
| | - Luciana F Gominho
- Department of Restorative Dentistry, Federal University of Paraíba (UFPB), João Pessoa, PB, Brazil
| | - Flávio R F Alves
- Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, RJ, Brazil
- Department of Endodontics, 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 Endodontics, Faculty of Dentistry, Iguaçu University (UNIG), Nova Iguaçu, RJ, Brazil
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Pinheiro ET, Karygianni L, Candeiro GTM, Vilela BG, Dantas LO, Pereira ACC, Gomes BPFA, Attin T, Thurnheer T, Russo G. Metatranscriptome and Resistome of the Endodontic Microbiome. J Endod 2024; 50:1059-1072.e4. [PMID: 38719087 DOI: 10.1016/j.joen.2024.03.015] [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: 11/07/2023] [Revised: 02/07/2024] [Accepted: 03/11/2024] [Indexed: 06/07/2024]
Abstract
INTRODUCTION In this study, we used metatranscriptomics for the first time to investigate microbial composition, functional signatures, and antimicrobial resistance gene expression in endodontic infections. METHODS Root canal samples were collected from ten teeth, including five primary and five persistent/secondary endodontic infections. RNA from endodontic samples was extracted, and RNA sequencing was performed on a NovaSeq6000 system (Illumina). Taxonomic analysis was performed using the Kraken2 bacterial database. Then, sequences with a taxonomic classification were annotated against the Universal Protein Knowledgebase for functional annotation and the Comprehensive Antibiotic Resistance Database for AR-like gene identification. RESULTS Proteobacteria, Bacteroidetes, Firmicutes, and Actinobacteria represented the dominant phyla, whereas Fusobacteria, Spirochetes, and Synergistetes were among the nondominant phyla. The top ten species were mainly represented by obligate (or quasiobligate) anaerobes, including Gram-negative (eg, Capnocytophaga sp. oral taxon 323, Fusobacterium nucleatum, Prevotella intermedia, Prevotella oris, Tannerella forsythia, and Tannerella sp. oral taxon HOT-286) and Gram-positive species (eg, Olsenella uli and Parvimonas micra). Transcripts encoding moonlighting proteins (eg, glycolytic proteins, translational elongation factors, chaperonin, and heat shock proteins) were highly expressed, potentially affecting bacterial adhesion, biofilm formation, host defense evasion, and inflammation induction. Endodontic bacteria expressed genes conferring resistance to antibiotic classes commonly used in dentistry, with a high prevalence and expression of tetracycline and lincosamide resistance genes. Antibiotic efflux and antibiotic target alteration/protection were the main resistance mechanisms. CONCLUSIONS Metatranscriptomics revealed the activity of potential endodontic pathogens, which expressed putative virulence factors and a wide diversity of genes potentially involved in AR.
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Affiliation(s)
- Ericka T Pinheiro
- Department of Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil; Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Zürich, Switzerland.
| | - Lamprini Karygianni
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Zürich, Switzerland
| | - George T M Candeiro
- Faculty of Dentistry, Christus University Center (Unichristus), Fortaleza, Ceará, Brazil
| | - Bruna G Vilela
- Department of Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Larissa O Dantas
- Department of Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Ana C C Pereira
- Department of Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Brenda P F A Gomes
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas - UNICAMP, Piracicaba, São Paulo, Brazil
| | - Thomas Attin
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Zürich, Switzerland
| | - Thomas Thurnheer
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Zürich, Switzerland
| | - Giancarlo Russo
- Functional Genomics Center Zurich, ETH-University of Zurich, Zürich, Switzerland (previous affiliation); EMBL Partnership Institute for Genome Editing Technologies, Life Sciences Center, Vilnius University, Vilnius, Lithuania; Institute of Bioscience, Life Sciences Center, Vilnius University, Vilnius, Lithuania
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10
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Park DH, Park OJ, Yoo YJ, Perinpanayagam H, Cho EB, Kim K, Park J, Noblett WC, Kum KY, Han SH. Microbiota Association and Profiling of Gingival Sulci and Root Canals of Teeth with Primary or Secondary/Persistent Endodontic Infections. J Endod 2024; 50:1124-1133. [PMID: 38768706 DOI: 10.1016/j.joen.2024.04.016] [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: 03/16/2024] [Revised: 04/10/2024] [Accepted: 04/29/2024] [Indexed: 05/22/2024]
Abstract
INTRODUCTION Microbiota associated with primary endodontic infection (PEI) and secondary/persistent endodontic infection (SPEI) must be characterized to elucidate pathogenesis in apical periodontitis and bacterial biomarkers identified for diagnostic and therapeutic applications. METHODS This study analyzed the microbial community profiles of root canals and gingival sulci (sulcus-E) for teeth with PEI (n = 10) or SPEI (n = 10), using the Illumina MiSeq platform. Bacterial samples from gingival sulci (sulcus-C) of healthy contralateral teeth served as controls. RESULTS There were 15 phyla, 177 genera, and 340 species identified. The number and diversity of bacteria in root canals did not differ significantly between PEI and SPEI. Proteobacteria, Firmicutes, Fusobacteria, Bacteroidetes, and Actinobacteria were the dominant phyla in both groups. At the genus level, Lancefieldella, Bifidobacterium, Stomatobaculum, and Schaalia were enriched in root canals with SPEI. Of significance, Lancefieldella was observed in both root canals and sulcus-E of teeth with SPEI. At the species level, Neisseria macacae, Streptococcus gordonii, Bifidobacterium dentium, Stomatobaculum longum, and Schaalia odontolytica were increased significantly in root canals with SPEI compared to PEI. Oribacterium species, Streptococcus salivarius, Lancefieldella parvula, Prevotella denticola, and Oribacterium asaccharolyticum were more abundant in sulcus-E of teeth with SPEI compared to PEI. CONCLUSIONS There were distinctive and differing predominant bacterial species associated with the root canals and gingival sulci between teeth with PEI and SPEI. Specific bacteria identified in sulcus-E and root canals of teeth with SPEI could serve as noninvasive diagnostic biomarkers for detecting SPEI.
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Affiliation(s)
- Dong Hyun Park
- Department of Oral Microbiology and Immunology, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Ok-Jin Park
- Department of Oral Microbiology and Immunology, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Yeon-Jee Yoo
- Department of Conservative Dentistry, Dental Research Institute, Seoul National University Dental Hospital, Seoul National University School of Dentistry, Seoul, Republic of Korea
| | - Hiran Perinpanayagam
- Division of Endodontics, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Canada
| | - Eun-Bee Cho
- Department of Conservative Dentistry, Dental Research Institute, Seoul National University Dental Hospital, Seoul National University School of Dentistry, Seoul, Republic of Korea
| | | | | | - W Craig Noblett
- Division of Endodontics, Department of Restorative Sciences, School of Dentistry, University of Minnesota, Minneapolis, Minnesota
| | - Kee-Yeon Kum
- Department of Conservative Dentistry, Dental Research Institute, Seoul National University Dental Hospital, Seoul National University School of Dentistry, Seoul, Republic of Korea.
| | - Seung Hyun Han
- Department of Oral Microbiology and Immunology, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea.
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11
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Tanomaru-Filho M, Lucchesi MB, Santos-Junior AO, Tavares KIMC, Pinto JC, Guerreiro-Tanomaru JM. Filling ability of ready-to-use or powder-liquid calcium silicate-based sealers after ultrasonic agitation. Braz Dent J 2024; 35:5802. [PMID: 39045989 PMCID: PMC11262770 DOI: 10.1590/0103-6440202405802] [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: 10/02/2023] [Accepted: 02/23/2024] [Indexed: 07/25/2024] Open
Abstract
This study evaluated the effect of ultrasonic agitation on the filling capacity of ready-to-use calcium silicate-based sealer Bio-C Sealer (BCS, Angelus, Paraná, Brazil) or powder-liquid BioRoot RCS (BR, Septodont, Saint-Maur-des-Fossés, France) using curved artificial canals by micro-computed tomography (micro-CT). Additionally, flow (mm) and flow area (mm2) were evaluated for both materials. Acrylic resin main canal (60° curvature and 5 mm radius, with 3 lateral canals in the cervical, middle, and apical thirds) were prepared up to size 40/.05 (Prodesign Logic, Brazil). The agitation method was used with ultrasonic tip (US, Irrisonic, Helse, Brazil): BCS, BCS/US, BR, and BR/US. All specimens were filled using the single-cone technique. The samples were scanned by micro-CT (8,74 µm) after obturation. The percentage of filling material and voids were calculated. Flow was evaluated based on ISO 6876/2012 standards (mm) and area (mm2). The data were statistically analyzed using ANOVA and Tukey tests (α = 0.05). BR/US showed lower percentage of filling material in the lateral canals than and, BCS/US (p<0.05). BR/US resulted in a higher percentage of voids than BR in the lateral apical third (p<0.05). BCS showed higher flow than BR (p<0.05). BCS and BR presented proper filling capacity in the simulated curved canals regardless of the use of ultrasonic agitation. However, BR/US showed more voids in the apical third. BCS demonstrates higher filling ability.
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Affiliation(s)
- Mário Tanomaru-Filho
- Department of Restorative Dentistry, School of Dentistry, UNESP - Universidade Estadual Paulista, Araraquara, SP, Brazil
| | - Maíra Bonassi Lucchesi
- Department of Restorative Dentistry, School of Dentistry, UNESP - Universidade Estadual Paulista, Araraquara, SP, Brazil
| | - Airton Oliveira Santos-Junior
- Department of Restorative Dentistry, School of Dentistry, UNESP - Universidade Estadual Paulista, Araraquara, SP, Brazil
| | | | - Jáder Camilo Pinto
- Departament of Dentistry - Centro Universitário Presidente Antônio Carlos - UNIPAC, Barbacena, MG, Brazil and Department of Dentistry - Centro Universitário Presidente Tancredo de Almeida Neves - UNIPTAN, São João del Rei, MG, Brazil
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12
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Yang S, Meng X, Zhen Y, Baima Q, Wang Y, Jiang X, Xu Z. Strategies and mechanisms targeting Enterococcus faecalis biofilms associated with endodontic infections: a comprehensive review. Front Cell Infect Microbiol 2024; 14:1433313. [PMID: 39091674 PMCID: PMC11291369 DOI: 10.3389/fcimb.2024.1433313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Accepted: 07/05/2024] [Indexed: 08/04/2024] Open
Abstract
Enterococcus faecalis is one of the main microorganisms that infects root canals, ranking among the most prevalent microorganisms associated with endodontic treatment failure. Given its pervasive presence in persistent endodontic infections, the successful elimination of Enterococcus faecalis is crucial for effective endodontic treatment and retreatment. Furthermore, Enterococcus faecalis can form biofilms - defense structures that microbes use to fight environmental threats. These biofilms confer resistance against host immune system attacks and antibiotic interventions. Consequently, the presence of biofilms poses a significant challenge in the complete eradication of Enterococcus faecalis and its associated disease. In response, numerous scholars have discovered promising outcomes in addressing Enterococcus faecalis biofilms within root canals and undertaken endeavors to explore more efficacious approaches in combating these biofilms. This study provides a comprehensive review of strategies and mechanisms for the removal of Enterococcus faecalis biofilms.
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Affiliation(s)
- Shipeng Yang
- Department of Endodontics, Hospital of Stomatology, Jilin University, Changchun, China
| | - Xiuping Meng
- Department of Endodontics, Hospital of Stomatology, Jilin University, Changchun, China
| | - Yuqi Zhen
- Department of Endodontics, Hospital of Stomatology, Jilin University, Changchun, China
| | - Quzhen Baima
- Department of Endodontics, Hospital of Stomatology, Jilin University, Changchun, China
| | - Yu Wang
- Department of Dental Implantology, Hospital of Stomatology, Jilin University, Changchun, China
| | - Xinmiao Jiang
- Department of Endodontics, Hospital of Stomatology, Jilin University, Changchun, China
| | - Zhibo Xu
- Department of Endodontics, Hospital of Stomatology, Jilin University, Changchun, China
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13
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Toledano-Osorio M, Osorio R, Bueno J, Vallecillo C, Vallecillo-Rivas M, Sanz M. Next-generation antibacterial nanopolymers for treating oral chronic inflammatory diseases of bacterial origin. Int Endod J 2024; 57:787-803. [PMID: 38340038 DOI: 10.1111/iej.14040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 01/15/2024] [Accepted: 01/27/2024] [Indexed: 02/12/2024]
Abstract
BACKGROUND 'Periodontitis' refers to periodontal destruction of connective tissue attachment and bone, in response to microorganisms forming subgingival biofilms on the root surface, while 'apical periodontitis' refers to periapical inflammatory processes occurring in response to microorganisms within the root canal system. The treatment of both diseases is based on the elimination of the bacterial challenge, though its predictability depends on the ability of disrupting these biofilms, what may need adjunctive antibacterial strategies, such as the next-generation antibacterial strategies (NGAS). From all the newly developed NGAS, the use of polymeric nanotechnology may pose a potential effective approach. Although some of these strategies have only been tested in vitro and in preclinical in vivo models, their use holds a great potential, and therefore, it is relevant to understand their mechanism of action and evaluate their scientific evidence of efficacy. OBJECTIVES To explore NGAS based on polymeric nanotechnology used for the potential treatment of periodontitis and apical periodontitis. METHOD A systemic search of scientific publications of adjunctive antimicrobial strategies using nanopolymers to treat periodontal and periapical diseases was conducted using The National Library of Medicine (MEDLINE by PubMed), The Cochrane Oral Health Group Trials Register, EMBASE and Web of Science. RESULTS Different polymeric nanoparticles, nanofibres and nanostructured hydrogels combined with antimicrobial substances have been identified in the periodontal literature, being the most commonly used nanopolymers of polycaprolactone, poly(lactic-co-glycolic acid) and chitosan. As antimicrobials, the most frequently used have been antibiotics, though other antimicrobial substances, such as metallic ions, peptides and naturally derived products, have also been added to the nanopolymers. CONCLUSION Polymeric nanomaterials containing antimicrobial compounds may be considered as a potential NGAS. Its relative efficacy, however, is not well understood since most of the existing evidence is derived from in vitro or preclinical in vivo studies.
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Affiliation(s)
- Manuel Toledano-Osorio
- Postgraduate Program of Specialization in Periodontology, Faculty of Dentistry, University Complutense of Madrid, Madrid, Spain
| | - Raquel Osorio
- Faculty of Dentistry, University of Granada, Granada, Spain
| | - Jaime Bueno
- Postgraduate Program of Specialization in Periodontology, Faculty of Dentistry, University Complutense of Madrid, Madrid, Spain
| | | | | | - Mariano Sanz
- ETEP (Etiology and Therapy of Periodontal and Peri-Implant Diseases) Research Group, University Complutense of Madrid, Madrid, Spain
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14
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Babeer A, Bukhari S, Alrehaili R, Karabucak B, Koo H. Microrobotics in endodontics: A perspective. Int Endod J 2024; 57:861-871. [PMID: 38761098 PMCID: PMC11324335 DOI: 10.1111/iej.14082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 04/28/2024] [Accepted: 04/29/2024] [Indexed: 05/20/2024]
Abstract
Microorganisms are the primary aetiological factor of apical periodontitis. The goal of endodontic treatment is to prevent and eliminate the infection by removing the microorganisms. However, microbial biofilms and the complex root canal anatomy impair the disinfection process. Effective and precise endodontic therapy could potentially be achieved using advanced multifunctional technologies that have the ability to access hard-to-reach surfaces and perform simultaneous biofilm killing, removal, and detection of microorganisms. Advances in microrobotics are providing novel therapeutic and diagnostic opportunities with high precision and efficacy to address current biofilm-related challenges in biomedicine. Concurrently, multifunctional magnetic microrobots have been developed to overcome the disinfection challenges of current approaches to disrupt, kill, and retrieve biofilms with the goal of enhancing the efficacy and precision of endodontic therapy. This article reviews the recent advances of microrobotics in healthcare and particularly advances to overcome disinfection challenges in endodontics, and provides perspectives for future research in the field.
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Affiliation(s)
- Alaa Babeer
- Department of Oral Biology, King Abdulaziz University, Jeddah 21589, Kingdom of Saudi Arabia
- Department of Endodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Sarah Bukhari
- Department of Endodontics, King Abdulaziz University, Jeddah 21589, Kingdom of Saudi Arabia
- Department of Endodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Rayan Alrehaili
- Department of Endodontics, King Abdulaziz University, Jeddah 21589, Kingdom of Saudi Arabia
| | - Bekir Karabucak
- Department of Endodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Hyun Koo
- Biofilm Research Labs, Department of Orthodontics, Divisions of Pediatric Dentistry and Community of Oral Health, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, United States
- Center for Innovation and Precision Dentistry, School of Dental Medicine, School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia, PA, USA
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15
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Berutti E, Pasqualini D, Scotti N, Mandras N, Roana J, Carpegna G, Palopoli P, Alovisi M. Confocal laser scanning evaluation of the influence of ledges on root canal disinfection. AUST ENDOD J 2024. [PMID: 38946230 DOI: 10.1111/aej.12871] [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: 11/12/2023] [Revised: 05/09/2024] [Accepted: 06/20/2024] [Indexed: 07/02/2024]
Abstract
The aim was to analyse the influence of an apical ledge on root canal disinfection. Forty-four single-rooted teeth were micro-CT scanned and inoculated with Enterococcus faecalis. In Group S shaping was performed with ProTaper Next (PTN) up to X3 at working length (WL). In Group L an apical ledge was created with K-Files #40 and shaping completed up to PTN X3. NaOCl 5% and EDTA 10% irrigant solutions were alternated. Confocal laser scanning microscope (CLSM) and viability staining were used to analyse the proportions of dead (red) and live (green) bacteria and penetration ability inside dentinal tubules. Data were analysed with the Mann-Whitney test with Bonferroni correction (p < 0.05). In Group L the amount of red fluorescence resulted significantly lower, and penetration ability was decreased in the apical and middle portion (p < 0.05). The presence of an apical ledge may negatively influence the disinfection both in the apical and middle third.
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Affiliation(s)
- Elio Berutti
- Department of Surgical Science, CIR-Dental School, University of Turin, Turin, Italy
| | - Damiano Pasqualini
- Department of Surgical Science, CIR-Dental School, University of Turin, Turin, Italy
| | - Nicola Scotti
- Department of Surgical Science, CIR-Dental School, University of Turin, Turin, Italy
| | - Narcisa Mandras
- Department of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - Janira Roana
- Department of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - Giorgia Carpegna
- Department of Surgical Science, CIR-Dental School, University of Turin, Turin, Italy
| | - Pietro Palopoli
- Department of Surgical Science, CIR-Dental School, University of Turin, Turin, Italy
| | - Mario Alovisi
- Department of Surgical Science, CIR-Dental School, University of Turin, Turin, Italy
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16
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Diouchi J, Marinković J, Nemoda M, El Rhaffari L, Toure B, Ghoul S. In Vitro Methods for Assessing the Antibacterial and Antibiofilm Properties of Essential Oils as Potential Root Canal Irrigants-A Simplified Description of the Technical Steps. Methods Protoc 2024; 7:50. [PMID: 39051264 PMCID: PMC11270344 DOI: 10.3390/mps7040050] [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: 04/19/2024] [Revised: 05/29/2024] [Accepted: 06/03/2024] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND Essential oils have gained in significance due to their various biological activities, and there is a growing demand for them in many industries. The present article focuses on the technical steps for an in vitro evaluation of the antibacterial and antibiofilm activities of essential oils for potential use as root canal irrigant in dentistry. METHODS The bioactivities of the essential oil were investigated through in vitro assays. The gram-positive bacterium Enterococcus faecalis was used as a micro-organism model. The antibacterial activity of the essential oil was assessed using the microdilution method, and resazurin staining to determine the minimal inhibition concentrations (MICs) and the minimal bactericidal concentrations (MBCs). The antibiofilm effect was evaluated spectrophotometrically at 570 nm using the microplate cultivation technique and crystal violet staining. CONCLUSIONS This article features a detailed in vitro protocol to facilitate the preparation of the essential oil samples, the bacterial suspension, and the methods used for assessment of the antibiofilm and antibacterial activities of the essential oil. The advantages of these approaches are presented in relation to the limits linked to the choice of the bacteria and the essential oil.
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Affiliation(s)
- Jihad Diouchi
- Health Sciences Research Center, International Faculty of Dental Medicine, College of Health Sciences, International University of Rabat, Technopolis Parc, Rocade of Rabat-Salé, Sala-Al Jadida 11100, Morocco; (B.T.); (S.G.)
| | - Jelena Marinković
- National Institute of the Republic of Serbia, ‘VINCA’ Institute of Nuclear Sciences, University of Belgrade, Mike Petrovica Alasa 12, 11000 Belgrade, Serbia; (J.M.); (M.N.)
| | - Milica Nemoda
- National Institute of the Republic of Serbia, ‘VINCA’ Institute of Nuclear Sciences, University of Belgrade, Mike Petrovica Alasa 12, 11000 Belgrade, Serbia; (J.M.); (M.N.)
| | - Lhoussaine El Rhaffari
- Laboratory of Bioactives, Health and Environment, Department of Biology, Faculty of Sciences, Moulay Ismail University of Meknes, Meknes 50050, Morocco;
| | - Babacar Toure
- Health Sciences Research Center, International Faculty of Dental Medicine, College of Health Sciences, International University of Rabat, Technopolis Parc, Rocade of Rabat-Salé, Sala-Al Jadida 11100, Morocco; (B.T.); (S.G.)
| | - Sonia Ghoul
- Health Sciences Research Center, International Faculty of Dental Medicine, College of Health Sciences, International University of Rabat, Technopolis Parc, Rocade of Rabat-Salé, Sala-Al Jadida 11100, Morocco; (B.T.); (S.G.)
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17
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Barazy R, Alafif H, Achour H, Al-Aloul A, Alsayed Tolibah Y. Can antimicrobial photodynamic therapy serve as an effective adjunct protocol for disinfecting the necrotic root canal system? A randomized controlled study. BDJ Open 2024; 10:53. [PMID: 38902230 PMCID: PMC11190140 DOI: 10.1038/s41405-024-00239-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 06/04/2024] [Accepted: 06/05/2024] [Indexed: 06/22/2024] Open
Abstract
BACKGROUND Bacterial infection plays an important role in persistent periapical lesions and inadequate disinfection of root canals is considered the biggest factor responsible for endodontic treatment failure. Antimicrobial Photodynamic Therapy (aPDT) has become the latest choice to eradicate microorganisms in root canals. OBJECTIVE This study aims to evaluate the effectiveness of Antimicrobial Photodynamic Therapy (aPDT) in bacterial count reduction compared to Passive Ultrasonic Activation (PUI) and Ca(OH)2 dressings. MATERIALS AND METHODS Forty-five anterior single canal teeth with medium-sized periapical lesions (2-5 mm) were divided into three groups according to the disinfecting technique (each group consists of 15 canals with 1:1:1 allocation ratio): Group A: Ca(OH)2 dressing. Group B: Passive Ultrasonic Activation (PUI). Group C: Antimicrobial Photodynamic Therapy (aPDT). Direct bacterial viable count method was used to count the colonies forming units (CFU) before and after the disinfecting and the bacterial count reduction was estimated, the statistical analysis was performed at a 95% confidence level using the Chi-square and Mann-Whitney U test. RESULTS aPDT showed no statistically significant difference when compared to passive ultrasonic irrigation (P > 0.05) but showed higher and more promising results when compared to Ca(OH)2 dressings (P < 0.05). CONCLUSIONS aPDT has the ability and effectiveness as a disinfecting technique in necrotic and infected root canals. CLINICAL SIGNIFICANCE OF THE STUDY The results of this clinical trial provide that aPDT can be considered an adjunct method for root canal disinfection with the same effectiveness as passive ultrasonic irrigation.
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Affiliation(s)
- Remy Barazy
- Department of Endodontics, Faculty of Dentistry, Damascus University, Damascus, Syrian Arab Republic
| | - Hisham Alafif
- Department of Endodontics, Faculty of Dentistry, Damascus University, Damascus, Syrian Arab Republic
| | - Hassan Achour
- Department of Endodontics, Faculty of Dentistry, Damascus University, Damascus, Syrian Arab Republic
| | - Ahmad Al-Aloul
- Department of Endodontics, Faculty of Dentistry, Al-Sham Private University, Damascus, Syrian Arab Republic
| | - Yasser Alsayed Tolibah
- Department of Pediatric Dentistry, Faculty of Dentistry, Damascus University, Damascus, Syrian Arab Republic.
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Marques C, Grenho L, Fernandes MH, Costa Lima SA. Improving the Antimicrobial Potency of Berberine for Endodontic Canal Irrigation Using Polymeric Nanoparticles. Pharmaceutics 2024; 16:786. [PMID: 38931907 PMCID: PMC11207060 DOI: 10.3390/pharmaceutics16060786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 05/15/2024] [Accepted: 06/06/2024] [Indexed: 06/28/2024] Open
Abstract
To address the challenges posed by biofilm presence and achieve a substantial reduction in bacterial load within root canals during endodontic treatment, various irrigants, including nanoparticle suspensions, have been recommended. Berberine (BBR), a natural alkaloid derived from various plants, has demonstrated potential applications in dentistry treatments due to its prominent antimicrobial, anti-inflammatory, and antioxidant properties. This study aimed to produce and characterize a novel polymeric nanoparticle of poly (lactic-co-glycolic acid) (PLGA) loaded with berberine and evaluate its antimicrobial activity against relevant endodontic pathogens, Enterococcus faecalis, and Candida albicans. Additionally, its cytocompatibility using gingival fibroblasts was assessed. The polymeric nanoparticle was prepared by the nanoprecipitation method. Physicochemical characterization revealed spheric nanoparticles around 140 nm with ca, -6 mV of surface charge, which was unaffected by the presence of BBR. The alkaloid was successfully incorporated at an encapsulation efficiency of 77% and the designed nanoparticles were stable upon 20 weeks of storage at 4 °C and 25 °C. Free BBR reduced planktonic growth at ≥125 μg/mL. Upon incorporation into PLGA nanoparticles, 20 μg/mL of [BBR]-loaded nanoparticles lead to a significant reduction, after 1 h of contact, of both planktonic bacteria and yeast. Sessile cells within biofilms were also considered. At 30 and 40 μg/mL, [BBR]-loaded PLGA nanoparticles reduced the viability of the sessile endodontic bacteria, upon 24 h of exposure. The cytotoxicity of BBR-loaded nanoparticles to oral fibroblasts was negligible. The novel berberine-loaded polymeric nanoparticles hold potential as a promising supplementary approach in the treatment of endodontic infections.
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Affiliation(s)
- Célia Marques
- IUCS-CESPU, University Institute of Health Sciences (IUCS), Advanced Polytechnic and University Cooperative (CESPU), CRL, 4585-116 Gandra, Portugal;
- LAQV, REQUIMTE, Department of Chemical Sciences, Faculty of Pharmacy, University of Porto, Rua de Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal
| | - Liliana Grenho
- BoneLab—Laboratory for Bone Metabolism and Regeneration, Faculty of Dental Medicine, University of Porto, 4200-393 Porto, Portugal; (L.G.); (M.H.F.)
| | - Maria Helena Fernandes
- BoneLab—Laboratory for Bone Metabolism and Regeneration, Faculty of Dental Medicine, University of Porto, 4200-393 Porto, Portugal; (L.G.); (M.H.F.)
| | - Sofia A. Costa Lima
- LAQV, REQUIMTE, ICBAS—School of Medicine and Biomedical Sciences, University of Porto, Rua de Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal
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19
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Xiao S, Sun G, Huang S, Lin C, Li Y. Nanoarchitectonics-Based Materials as a Promising Strategy in the Treatment of Endodontic Infections. Pharmaceutics 2024; 16:759. [PMID: 38931881 PMCID: PMC11207628 DOI: 10.3390/pharmaceutics16060759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2024] [Revised: 05/19/2024] [Accepted: 05/29/2024] [Indexed: 06/28/2024] Open
Abstract
Endodontic infections arise from the interactive activities of microbial communities colonizing in the intricate root canal system. The present study aims to update the latest knowledge of nanomaterials, their antimicrobial mechanisms, and their applications in endodontics. A detailed literature review of the current knowledge of nanomaterials used in endodontic applications was performed using the PubMed database. Antimicrobial nanomaterials with a small size, large specific surface area, and high chemical activity are introduced to act as irrigants, photosensitizer delivery systems, and medicaments, or to modify sealers. The application of nanomaterials in the endodontic field could enhance antimicrobial efficiency, increase dentin tubule penetration, and improve treatment outcomes. This study supports the potential of nanomaterials as a promising strategy in treating endodontic infections.
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Affiliation(s)
- Suli Xiao
- Department of Endodontics, Stomatological Hospital of Xiamen Medical College, Xiamen 361003, China;
- Xiamen Key Laboratory of Stomatological Disease Diagnosis and Treatment, Xiamen 361003, China
| | - Guanwen Sun
- Department of Stomatology, Fujian Medical University Xiamen Humanity Hospital, Xiamen 361018, China;
| | - Shan Huang
- Department of Stomatology, Zhongshan Hospital Affiliated to Xiamen University, Xiamen 361005, China;
| | - Chen Lin
- Department of Endodontics, Stomatological Hospital of Xiamen Medical College, Xiamen 361003, China;
- Xiamen Key Laboratory of Stomatological Disease Diagnosis and Treatment, Xiamen 361003, China
| | - Yijun Li
- Department of Endodontics, Stomatological Hospital of Xiamen Medical College, Xiamen 361003, China;
- Xiamen Key Laboratory of Stomatological Disease Diagnosis and Treatment, Xiamen 361003, China
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20
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Matos-Sousa JM, Chemelo VS, Frazão DR, Bittencourt LO, de Moura JDM, Mesquita CM, Marañón-Vásquez G, Fagundes NCF, Paranhos LR, Maia LC, Monteiro MC, Lima RR. Is there any association between the presence of biomarkers and apical periodontitis? A systematic review. Front Immunol 2024; 15:1366954. [PMID: 38840914 PMCID: PMC11150667 DOI: 10.3389/fimmu.2024.1366954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Accepted: 04/15/2024] [Indexed: 06/07/2024] Open
Abstract
This systematic review aimed to verify whether there is evidence of an association between apical periodontitis and the presence of systemic biomarkers. This study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses - PRISMA. For this, the acronym PECO was used; population (P) of adult humans exposed (E) to the presence of apical periodontitis, compared (C) to adult humans without apical periodontitis, and the outcome (O) of the presence of biomarkers was observed. The articles were searched in PubMed, Scopus, Web of Science, LILACS, Cochrane Library, OpenGray, and Google Scholar grey databases. Subsequently, studies were excluded based on title, abstract, and full article reading, following the eligibility criteria. The methodological quality of the selected studies was evaluated using the Newcastle-Ottawa qualifier. After exclusion, 656 studies were identified, resulting in 17 final articles that were divided into case-control, cross-sectional, and cohort studies. Eight studies were considered to have a low risk of bias, one had a medium risk of bias, and eight had a high risk of bias. In addition, 12 articles evaluated biomarkers in blood plasma, four evaluated them in saliva, and only one evaluated them in gingival crevicular fluid. The results of these studies indicated an association between apical periodontitis and the systemic presence of biomarkers. These markers are mainly related to inflammation, such as interleukins IL-1, IL-2, and IL-6, oxidative markers, such as nitric oxide and superoxide anions, and immunoglobulins IgG and IgM. Systematic review registration https://www.crd.york.ac.uk/prospero/, identifier (CRD42023493959).
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Affiliation(s)
- José Mário Matos-Sousa
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará, Belém-Pará, Brazil
| | - Victória Santos Chemelo
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará, Belém-Pará, Brazil
| | - Deborah Ribeiro Frazão
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará, Belém-Pará, Brazil
| | - Leonardo Oliveira Bittencourt
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará, Belém-Pará, Brazil
| | - João Daniel Mendonça de Moura
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará, Belém-Pará, Brazil
| | - Caio Melo Mesquita
- Department of Preventive and Social Dentistry, Faculty of Dentistry, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil
| | - Guido Marañón-Vásquez
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Luiz Renato Paranhos
- Department of Preventive and Social Dentistry, Faculty of Dentistry, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil
| | - Lucianne Cople Maia
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Rafael Rodrigues Lima
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará, Belém-Pará, Brazil
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Liu C, Li Y, Li Y, Li Z, Han G. Synergistic antibacterial effect of ginsenoside Rh2 and calcium hydroxide on Enterococcus faecalis. Odontology 2024:10.1007/s10266-024-00951-z. [PMID: 38762821 DOI: 10.1007/s10266-024-00951-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Accepted: 05/04/2024] [Indexed: 05/20/2024]
Abstract
Treatment of root canal infections becomes more challenging due to the extremely high tolerance of Enterococcus faecalis (E. faecalis) to calcium hydroxide (Ca(OH)2). Ginsenoside is a Chinese herbal extract that has been proven to have antimicrobial properties and synergistic activities. And this study evaluated the antibacterial activity of ginsenoside Rh2 in combination with Ca(OH)2 against E. faecalis and its preliminary mechanism of action. Broth microdilution method, checkerboard dilution method, time-inhibition curve, drug resistance assays, scanning electron microscopy, and biofilm inhibition and removal assays indicated that Rh2 in combination with Ca(OH)2 exhibited potent antibacterial activity against E. faecalis. Rh2 exerted significant in vitro antibacterial activity against E. faecalis, with a minimum inhibitory concentration (MIC) of 3.125 μg/mL and minimum bactericidal concentration (MBC) of 6.25 μg/mL, and significantly enhanced the susceptibility of E. faecalis to Ca(OH)2 (FICI = 0.5). Furthermore, cell membrane permeability assays, surface hydrophobicity assays, ATPase activity assays, and intra-biofilm extracellular polysaccharides (EPS) assays revealed that Rh2 and Ca(OH)2 synergistically inhibit bacteria mainly by increasing membrane permeability. Ultimately, cytotoxicity assays showed that Rh2 exhibited only low toxicity, the half maximal inhibitory concentration (IC50) of Rh2 was 19.75 μg/mL. This study confirmed the synergistic antibacterial activities of Rh2 and Ca(OH)2 against E. faecalis. Our findings indicate that the Rh2 and Ca(OH)2 combination may be a promising alternative approach to treating root canal infections.
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Affiliation(s)
- Chaoran Liu
- Department of Oral Geriatrics, Hospital of Stomatology, Jilin University, 1500# Qinghua Road, Chaoyang District, Changchun, 130021, People's Republic of China
- Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, Changchun, 130021, People's Republic of China
| | - Yang Li
- Key Laboratory of Molecular Enzyme Engineering, Ministry of Education, College of Life Sciences, Jilin University, Changchun, 130012, People's Republic of China
| | - Yanan Li
- Department of Oral Geriatrics, Hospital of Stomatology, Jilin University, 1500# Qinghua Road, Chaoyang District, Changchun, 130021, People's Republic of China
| | - Ze Li
- Department of Oral Geriatrics, Hospital of Stomatology, Jilin University, 1500# Qinghua Road, Chaoyang District, Changchun, 130021, People's Republic of China
| | - Guanghong Han
- Department of Oral Geriatrics, Hospital of Stomatology, Jilin University, 1500# Qinghua Road, Chaoyang District, Changchun, 130021, People's Republic of China.
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Donnermeyer D, Dust PC, Schäfer E, Bürklein S. Comparative Analysis of Irrigation Techniques for Cleaning Efficiency in Isthmus Structures. J Endod 2024; 50:644-650.e1. [PMID: 38382735 DOI: 10.1016/j.joen.2024.02.008] [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: 12/20/2023] [Revised: 02/06/2024] [Accepted: 02/12/2024] [Indexed: 02/23/2024]
Abstract
INTRODUCTION This study aimed to evaluate the removal of a biofilm-mimicking hydrogel from isthmus structures in a simulated complex root canal system consisting of 2 curved root canals by Laser-activated irrigation (LAI, AdvErl Evo, Morita) and mechanical activation techniques. METHODS A 3D-printed root canal model with 2 parallel root canals (60°-curvature, radius 5 mm, dimension 25/.06) with a total length of 20 mm connected via isthmuses (2.5 × 0.4 × 0.2 mm) at 5 mm and 8 mm from the apical endpoint and with lateral canals (diameter 0.2 mm) in all directions at 2, 5, and 8 mm from the apex was filled with a colored biofilm-mimicking hydrogel. Irrigation protocols under continuous irrigation with distilled water (3 × 20s per root canal; 3 ml/20s; n = 20) included conventional needle irrigation (=NI); manual agitation (=MA, gutta-percha point 25/.06); EndoActivator (=SAI-EA, 25/.04); EDDY (=SAI-E, 25/.04); ultrasonically-activated irrigation (=UAI) and LAI (Er:YAG-laser; P400FL tip at canal entrance; 25pps, 50 mJ, 300μs). Removal of the hydrogel was determined as a percentage via standardized photos through a microscope. Statistical analysis was performed using Kruskal-Wallis and Conover tests (P = .05). RESULTS Laser-activated irrigation (LAI) was associated with the greatest removal of hydrogel from the entire root canal system (P < .05), followed by SAI-E. No significant differences were reported for the coronal isthmus between LAI, SAI-E, NI, and MA (P > .05), but inferior results for SAI-EA and UAI (P < .05). In the apical isthmus, all techniques outperformed UAI (P < .05), with LAI, SAI-E, and NI showing the best results (P < .05). CONCLUSIONS Laser-activated irrigation (LAI) was superior to other irrigation techniques in the entire root canal system. SAI-E and NI performed comparable to LAI in the isthmuses.
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Affiliation(s)
- David Donnermeyer
- Department of Periodontology and Operative Dentistry, University of Münster, Münster, Germany
| | - Patricia Claire Dust
- Department of Periodontology and Operative Dentistry, University of Münster, Münster, Germany
| | - Edgar Schäfer
- Central Interdisciplinary Ambulance in the School of Dentistry, University of Münster, Münster, Germany
| | - Sebastian Bürklein
- Central Interdisciplinary Ambulance in the School of Dentistry, University of Münster, Münster, Germany.
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Guo X, Wang X, Shi J, Ren J, Zeng J, Li J, Li Y. A review and new perspective on oral bacteriophages: manifestations in the ecology of oral diseases. J Oral Microbiol 2024; 16:2344272. [PMID: 38698893 PMCID: PMC11064738 DOI: 10.1080/20002297.2024.2344272] [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: 12/20/2023] [Accepted: 04/12/2024] [Indexed: 05/05/2024] Open
Abstract
Objective To explore the manifestations of bacteriophages in different oral disease ecologies, including periodontal diseases, dental caries, endodontic infections, and oral cancer, as well as to propel phage therapy for safer and more effective clinical application in the field of dentistry. Methods In this literature review, we outlined interactions between bacteriophages, bacteria and even oral cells in the oral ecosystem, especially in disease states. We also analyzed the current status and future prospects of phage therapy in the perspective of different oral diseases. Results Various oral bacteriophages targeting at periodontal pathogens as Porphyromonas gingivalis, Fusobacterium nucleatum, Treponema denticola and Aggregatibacter actinomycetemcomitans, cariogenic pathogen Streptococcus mutans, endodontic pathogen Enterococcus faecalis were predicted or isolated, providing promising options for phage therapy. In the realm of oral cancer, aside from displaying tumor antigens or participating in tumor-targeted therapies, phage-like particle vaccines demonstrated the potential to prevent oral infections caused by human papillomaviruses (HPVs) associated with head-and-neck cancers. Conclusion Due to their intricate interactions with bacteria and oral cells, bacteriophages are closely linked to the progression and regression of diverse oral diseases. And there is an urgent need for research to explore additional possibilities of bacteriophages in the management of oral diseases.
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Affiliation(s)
- Xinyu Guo
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xiaowan Wang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jia Shi
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jiayi Ren
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Jumei Zeng
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Jinquan Li
- State Key Laboratory of Agricultural Microbiology, College of Biomedicine and Health, College of Food Science and Technology, Huazhong Agricultural University, Wuhan, China
| | - Yuqing Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Center for Archaeological Science, Sichuan University, Chengdu, China
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Chen J, Zhang H, Zhao T, Yu Y, Song J, Zhao Y, Alshawwa H, Zou X, Zhang Z. Oxygen Self-Supplied Nanoplatform for Enhanced Photodynamic Therapy against Enterococcus Faecalis within Root Canals. Adv Healthc Mater 2024; 13:e2302926. [PMID: 38273674 DOI: 10.1002/adhm.202302926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 01/10/2024] [Indexed: 01/27/2024]
Abstract
The successful treatment of persistent and recurrent endodontic infections hinges upon the eradication of residual microorganisms within the root canal system, which urgently needs novel drugs to deliver potent yet gentle antimicrobial effects. Antibacterial photodynamic therapy (aPDT) is a promising tool for root canal infection management. Nevertheless, the hypoxic microenvironment within the root canal system significantly limits the efficacy of this treatment. Herein, a nanohybrid drug, Ce6/CaO2/ZIF-8@polyethylenimine (PEI), is developed using a bottom-up strategy to self-supply oxygen for enhanced aPDT. PEI provides a positively charged surface, which enables precise targeting of bacteria. CaO2 reacts with H2O to generate O2, which alleviates the hypoxia in the root canal and serves as a substrate for Ce6 under 660 nm laser irradiation, leading to the successful eradication of planktonic Enterococcus faecalis (E. faecalis) and biofilm in vitro and, moreover, the effective elimination of mature E. faecalis biofilm in situ within the root canal system. This smart design offers a viable alternative for mitigating hypoxia within the root canal system to overcome the restricted efficacy of photosensitizers, providing an exciting prospect for the clinical management of persistent endodontic infection.
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Affiliation(s)
- Jiawen Chen
- Department of Endodontics, Jilin Provincial Key Laboratory of Oral Biomedical Engineering, School and Hospital of Stomatology, Jilin University, Changchun, 130021, P. R. China
| | - Hong Zhang
- Department of Endodontics, Jilin Provincial Key Laboratory of Oral Biomedical Engineering, School and Hospital of Stomatology, Jilin University, Changchun, 130021, P. R. China
| | - Tiancong Zhao
- College of Chemistry and Materials, Department of Chemistry and Laboratory of Advanced Materials, Shanghai Key Laboratory of Molecular Catalysis and Innovative Materials, State Key Laboratory of Molecular Engineering of Polymers, Collaborative Innovation Center of Chemistry for Energy Materials (2011-iChEM), Fudan University, Shanghai, 200433, P. R. China
| | - Yiyan Yu
- Department of Endodontics, Jilin Provincial Key Laboratory of Oral Biomedical Engineering, School and Hospital of Stomatology, Jilin University, Changchun, 130021, P. R. China
| | - Jiazhuo Song
- Department of Endodontics, Jilin Provincial Key Laboratory of Oral Biomedical Engineering, School and Hospital of Stomatology, Jilin University, Changchun, 130021, P. R. China
| | - Yuanhang Zhao
- Department of Endodontics, Jilin Provincial Key Laboratory of Oral Biomedical Engineering, School and Hospital of Stomatology, Jilin University, Changchun, 130021, P. R. China
| | - Hamed Alshawwa
- Department of Endodontics, Jilin Provincial Key Laboratory of Oral Biomedical Engineering, School and Hospital of Stomatology, Jilin University, Changchun, 130021, P. R. China
| | - Xinying Zou
- Department of Endodontics, Jilin Provincial Key Laboratory of Oral Biomedical Engineering, School and Hospital of Stomatology, Jilin University, Changchun, 130021, P. R. China
| | - Zhimin Zhang
- Department of Endodontics, Jilin Provincial Key Laboratory of Oral Biomedical Engineering, School and Hospital of Stomatology, Jilin University, Changchun, 130021, P. R. China
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Zhang X, Yang Z, Zhang D, Bai M. The role of Semaphorin 3A in oral diseases. Oral Dis 2024; 30:1887-1896. [PMID: 37771213 DOI: 10.1111/odi.14748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 09/11/2023] [Accepted: 09/13/2023] [Indexed: 09/30/2023]
Abstract
Semaphorin 3A (SEMA3A), also referred to as H-Sema III, is a molecule with significant biological importance in regulating physiological and pathological processes. However, its role in oral diseases, particularly its association with inflammatory immunity and alveolar bone remodeling defects, remains poorly understood. This comprehensive review article aims to elucidate the recent advances in understanding SEMA3A in the oral system, encompassing nerve formation, periodontitis, pulpitis, apical periodontitis, and oral squamous cell carcinoma. Notably, we explore its novel function in inflammatory immunomodulation and alveolar bone formation during oral infectious diseases. By doing so, this review enhances our comprehension of SEMA3A's role in oral biology and opens up possibilities for modulatory approaches and potential treatments in oral diseases.
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Affiliation(s)
- Xinyue Zhang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Zhenqi Yang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Demao Zhang
- Institute of Biomedical Engineering, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, China
| | - Mingru Bai
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
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Júnior RDSR, Bergamin BDO, Bastos AGR, Silva AMPD, Pires FR, Ferreira DDC, Armada L. Interleukin 17 expression in periapical lesions from elderly patients. SPECIAL CARE IN DENTISTRY 2024; 44:863-867. [PMID: 37814401 DOI: 10.1111/scd.12930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 09/20/2023] [Accepted: 09/27/2023] [Indexed: 10/11/2023]
Abstract
OBJECTIVE To compare the expression of IL-17 in periapical lesions (cysts and granulomas) among elderly individuals and adults. We selected 20 periapical lesions of the elderly (12 granulomas and eight cysts) and 20 periapical lesions of adults (12 granulomas and eight cysts). MATERIALS AND METHODS Immunohistochemistry was performed using a specific antibody for IL-17. The slides were subdivided into five high magnification fields and then the images were observed through an optical microscope. According to the number of positive markings for the antibody, grades were given, ranging from 0 to 2. RESULTS The results demonstrate that there was no statistical difference when comparing the expression of IL-17 between cysts and granulomas of both groups (study group: cysts 0.7 ± 0.21 × granulomas 0.96 ± 0.58, p = .61; control group: cysts 0.37 ± 0.16 × granulomas 0.31 ± 0.23, p = .27). The comparison between adult (control group) and elderly patients (study group) showed a statistical difference both in cysts (study group: 0.7 ± 0.21 × control group: 0.37 ± 0.16, p = .007) and in granulomas (study group: 0.96 ± 0.58 × control group: 0.31 ± 0.23, p = .0009), in which elderly patients had a higher expression of interleukin 17, in relation to adult patients. CONCLUSION We concluded that elderly patients have a higher expression of IL-17 in both cysts and granulomas, when compared to adult patients.
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Affiliation(s)
| | | | | | | | - Fábio Ramôa Pires
- Post-graduate Program in Dentistry, Estácio de Sá University, Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Luciana Armada
- Post-graduate Program in Dentistry, Estácio de Sá University, Rio de Janeiro, Rio de Janeiro, Brazil
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Pucinelli CM, da Silva RAB, Nelson-Filho P, Lima RB, Lucisano MP, Marchesan JT, da Silva LAB. The effects of NLRP3 inflammasome inhibition or knockout in experimental apical periodontitis induced in mice. Clin Oral Investig 2024; 28:285. [PMID: 38684528 DOI: 10.1007/s00784-024-05691-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 04/24/2024] [Indexed: 05/02/2024]
Abstract
OBJECTIVE To evaluate the effects of NLRP3 inflammasome inhibition or knockout in experimental apical periodontitis (AP) induced in mice. METHODS The experimental AP was induced by pulpal exposure. To evaluate NLRP3-specific inhibitor medication (MCC950), WT mice received intraperitoneal injections, while the control received PBS (n = 10). In addition, to evaluate NLRP3 knockout, 35 wild-type (WT) and 35 NLRP3-/- mice were divided into a control group (without pulpal exposure, n = 5) and three experimental groups: after 2, 14 and 42 days after pulpal exposure (n = 10). Microscopic and molecular analyzes were carried out using a significance level of 5%. RESULTS Exposure to MCC950 did not affect the periapical lesion size after 14 days (P = 0.584). However, exposed mice had a lower expression of IL-1β, IL-18 and caspase-1 (P = 0.010, 0.016 and 0.002, respectively). Moreover, NLRP3-/- mice showed a smaller periapical lesion after 14 and 42 days (P = 0.023 and 0.031, respectively), as well as a lower expression of IL-1β after 42 days (P < 0.001), of IL-18 and caspase-1 after 14 (P < 0.001 and 0.035, respectively) and 42 days (P = 0.002 and 0.002, respectively). NLRP3-/- mice also showed a lower mRNA for Il-1β, Il-18 and Casp1 after 2 (P = 0.002, 0.036 and 0.001, respectively) and 14 days (P = 0.002, 0.002 and 0.001, respectively). CONCLUSIONS NLRP3 inflammasome inhibition or knockout can attenuate the inflammatory events that result in the periapical lesion (AP) formation after pulpal exposure in mice. CLINICAL RELEVANCE The NLRP3 inflammasome may be a therapeutic target for AP, and new approaches may verify the impact of its inhibition (through intracanal medications or filling materials) on the bone repair process and treatment success.
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Affiliation(s)
- Carolina Maschietto Pucinelli
- Department of Pediatric Dentistry (DCI), School of Dentistry of Ribeirão Preto, University of São Paulo (FORP/USP), Avenida do Café, s/n, Vila Monte Alegre, Ribeirão Preto, São Paulo, Brazil
| | - Raquel Assed Bezerra da Silva
- Department of Pediatric Dentistry (DCI), School of Dentistry of Ribeirão Preto, University of São Paulo (FORP/USP), Avenida do Café, s/n, Vila Monte Alegre, Ribeirão Preto, São Paulo, Brazil
- Graduate Program in Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Paulo Nelson-Filho
- Department of Pediatric Dentistry (DCI), School of Dentistry of Ribeirão Preto, University of São Paulo (FORP/USP), Avenida do Café, s/n, Vila Monte Alegre, Ribeirão Preto, São Paulo, Brazil
- Graduate Program in Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Ricardo Barbosa Lima
- Department of Pediatric Dentistry (DCI), School of Dentistry of Ribeirão Preto, University of São Paulo (FORP/USP), Avenida do Café, s/n, Vila Monte Alegre, Ribeirão Preto, São Paulo, Brazil.
- Graduate Program in Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
| | - Marília Pacífico Lucisano
- Department of Pediatric Dentistry (DCI), School of Dentistry of Ribeirão Preto, University of São Paulo (FORP/USP), Avenida do Café, s/n, Vila Monte Alegre, Ribeirão Preto, São Paulo, Brazil
- Graduate Program in Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Julie Teresa Marchesan
- Department of Periodontology, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Léa Assed Bezerra da Silva
- Department of Pediatric Dentistry (DCI), School of Dentistry of Ribeirão Preto, University of São Paulo (FORP/USP), Avenida do Café, s/n, Vila Monte Alegre, Ribeirão Preto, São Paulo, Brazil
- Graduate Program in Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
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Putrino A, Marinelli E, Galeotti A, Ferrazzano GF, Ciribè M, Zaami S. A Journey into the Evolution of Human Host-Oral Microbiome Relationship through Ancient Dental Calculus: A Scoping Review. Microorganisms 2024; 12:902. [PMID: 38792733 PMCID: PMC11123932 DOI: 10.3390/microorganisms12050902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 04/23/2024] [Accepted: 04/27/2024] [Indexed: 05/26/2024] Open
Abstract
One of the most promising areas of research in palaeomicrobiology is the study of the human microbiome. In particular, ancient dental calculus helps to reconstruct a substantial share of oral microbiome composition by mapping together human evolution with its state of health/oral disease. This review aims to trace microbial characteristics in ancient dental calculus to describe the evolution of the human host-oral microbiome relationship in oral health or disease in children and adults. Following the PRISMA-Extension for Scoping Reviews guidelines, the main scientific databases (PubMed, Scopus, Lilacs, Cochrane Library) have been drawn upon. Eligibility criteria were established, and all the data collected on a purpose-oriented collection form were analysed descriptively. From the initial 340 records, only 19 studies were deemed comprehensive enough for the purpose of this review. The knowledge of the composition of ancient oral microbiomes has broadened over the past few years thanks to increasingly well-performing decontamination protocols and additional analytical avenues. Above all, metagenomic sequencing, also implemented by state-of-the-art bioinformatics tools, allows for the determination of the qualitative-quantitative composition of microbial species associated with health status and caries/periodontal disease. Some microbial species, especially periodontal pathogens, do not appear to have changed in history, while others that support caries disease or oral health could be connected to human evolution through lifestyle and environmental contributing factors.
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Affiliation(s)
- Alessandra Putrino
- Dentistry Unit, Management Innovations, Diagnostics and Clinical Pathways, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (A.G.); (M.C.)
| | - Enrico Marinelli
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 04100 Latina, Italy;
| | - Angela Galeotti
- Dentistry Unit, Management Innovations, Diagnostics and Clinical Pathways, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (A.G.); (M.C.)
- U.N.-E.U. INTERNATIONAL RESEARCH PROJECT ON HUMAN HEALTH-ORAL HEALTH SECTION, 1200 Géneve, Switzerland;
| | - Gianmaria Fabrizio Ferrazzano
- U.N.-E.U. INTERNATIONAL RESEARCH PROJECT ON HUMAN HEALTH-ORAL HEALTH SECTION, 1200 Géneve, Switzerland;
- UNESCO Chair in Health Education and Sustainable Development, Dentistry Section, University of Naples “Federico II”, 80138 Naples, Italy
- East-Asian-Pacific International Academic Consortium
| | - Massimiliano Ciribè
- Dentistry Unit, Management Innovations, Diagnostics and Clinical Pathways, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (A.G.); (M.C.)
| | - Simona Zaami
- Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Sapienza University of Rome, 00161 Rome, Italy;
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Machado R, Moreira G, Comparin D, Barroso AP, Nascimento J, Ferraz CCR, Ignácio SA, da Fonseca Roberti Garcia L, Amaral RR, Shadid D, da Silva Neto UX. Postoperative pain after single-visit root canal treatments in necrotic teeth comparing instruments' kinematics and apical instrumentation limits - a prospective randomized multicenter clinical trial. BMC Oral Health 2024; 24:481. [PMID: 38643087 PMCID: PMC11032596 DOI: 10.1186/s12903-024-04225-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 04/04/2024] [Indexed: 04/22/2024] Open
Abstract
OBJECTIVES This prospective randomized multicenter clinical trial (PRMCT) investigated postoperative pain after single-visit root canal treatments in teeth affected by pulp necrosis (PN), and asymptomatic apical periodontitis (AAP) (with apical radiolucent areas) or normal periradicular tissues (without apical radiolucent areas) comparing different instruments' kinematics and apical instrumentation limits. METHODS Before chemomechanical preparation, 240 patients/teeth were randomly distributed into four groups (n = 60) according to the instruments' kinematics (rotary or reciprocating) and apical instrumentation limits (with or without intentional foraminal enlargement [IFE]). After that, specimens were submitted to the same irrigation and obturation techniques, and the patients were referred to undergo the definitive restorations. No medication was prescribed, but the patients were instructed to take either paracetamol (750 mg every 6 h for three days) or ibuprofen (600 mg every 6 h for three days) in pain cases. Postoperative pain incidence and levels were assessed at 24-, 48-, and 72 h following treatment completion according to a verbal rating scale (VRS) following a score. The Kolmogorov-Smirnov test was applied to assess the normality of the data. Mann-Whitney U, Chi-square, Friedman's ANOVA, and Friedman's multiple 2 to 2 comparison tests were employed to identify potential significant statistical differences among the variables in the study groups (P < .05). RESULTS Significant statistical differences were only observed among the groups considering tooth, periradicular status, and the occurrence of overfilling (sealer extrusion) (P < 0.00). Patients with teeth instrumented through rotary kinematics and without IFE experienced lower rates of postoperative pain; however, this difference was relevant only at 24 h (P < 0.05). CONCLUSIONS Postoperative pain was lower after using a rotary file system (Profile 04) inserted up to the apical constriction (AC). However, this finding was just statistically meaningful at 24 h. TRIAL REGISTRATION This PRMCT was approved by the Human Research Ethics Committee of the Paranaense University - UNIPAR, Francisco Beltrão, PR, Brazil (CAAE. 46,774,621.6.0000.0109) on 02/09/2021. It was registered at The Brazilian Registry of Clinical Trials - ReBEC (RBR-3r967t) on 01/06/2023, was performed according to the Principles of the Helsinki Declaration and is reported following the Consolidated Standards of Reporting Trials Statement.
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Affiliation(s)
- Ricardo Machado
- College of Dentistry, Department of Restorative Sciences, Division of Endodontics, Health Sciences Center, University of Oklahoma - COD/OUHSC, Oklahoma City, Oklahoma, USA.
| | - Guilherme Moreira
- Clinical Practice Limited to Endodontics, Francisco Beltrão, Paraná, Brazil
| | - Daniel Comparin
- Clinical Practice Limited to Endodontics, Cunha Porã and Francisco Beltrão, Paraná, Brazil
| | - Arthur Pimentel Barroso
- Piracicaba Dental School, Department of Restorative Dentistry, Division of Endodontics, State University of Campinas - FOP/UNICAMP, Piracicaba, São Paulo, Brazil
| | - Jaqueline Nascimento
- School of Dentistry, Department of Endodontics, Pontifical Catholic University of Paraná - PUC/PR, Curitiba, Paraná, Brazil
| | - Caio Cézar Randi Ferraz
- Piracicaba Dental School, Department of Restorative Dentistry, Division of Endodontics, State University of Campinas - FOP/UNICAMP, Piracicaba, São Paulo, Brazil
| | - Sérgio Aparecido Ignácio
- School of Dentistry, Department of Statistics, Pontifical Catholic University of Paraná - PUC/PR, Curitiba, Paraná, Brazil
| | - Lucas da Fonseca Roberti Garcia
- Department of Dentistry, Division of Endodontics, Federal University of Santa Catarina - UFSC, Florianópolis, Santa Catarina, Brazil
| | | | - David Shadid
- College of Dentistry, Department of Restorative Sciences, Division of Endodontics, Health Sciences Center, University of Oklahoma - COD/OUHSC, Oklahoma City, Oklahoma, USA
| | - Ulisses Xavier da Silva Neto
- School of Dentistry, Department of Endodontics, Pontifical Catholic University of Paraná - PUC/PR, Curitiba, Paraná, Brazil
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Boreak N, Alrajab EA, Nahari RA, Najmi LE, Masmali MA, Ghawi AA, Al Moaleem MM, Alhazmi MY, Maqbul AA. Unveiling Therapeutic Potential: Targeting Fusobacterium nucleatum's Lipopolysaccharide Biosynthesis for Endodontic Infections-An In Silico Screening Study. Int J Mol Sci 2024; 25:4239. [PMID: 38673822 PMCID: PMC11049844 DOI: 10.3390/ijms25084239] [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: 03/04/2024] [Revised: 04/02/2024] [Accepted: 04/10/2024] [Indexed: 04/28/2024] Open
Abstract
Complex microbial communities have been reported to be involved in endodontic infections. The microorganisms invade the dental pulp leading to pulpitis and initiating pulp inflammation. Fusobacterium nucleatum is a dominant bacterium implicated in both primary and secondary endodontic infections. Drugs targeting the molecular machinery of F. nucleatum will minimize pulp infection. LpxA and LpxD are early acyltransferases involved in the formation of lipid A, a major component of bacterial membranes. The identification of leads which exhibit preference towards successive enzymes in a single pathway can also prevent the development of bacterial resistance. A stringent screening strategy utilizing physicochemical and pharmacokinetic parameters along with a virtual screening approach identified two compounds, Lomefloxacin and Enoxacin, with good binding affinity towards the early acyltransferases LpxA and LpxD. Lomefloxacin and Enoxacin, members of the fluoroquinolone antibiotic class, exhibit wide-ranging activity against diverse bacterial strains. Nevertheless, their effectiveness in the context of endodontic treatment requires further investigation. This study explored the potential of Lomefloxacin and Enoxacin to manage endodontic infections via computational analysis. Moreover, the compounds identified herein serve as a foundation for devising novel combinatorial libraries with enhanced efficacy for endodontic therapeutic strategies.
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Affiliation(s)
- Nezar Boreak
- College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia; (E.A.A.); (R.A.N.); (L.E.N.); (M.A.M.); (A.A.G.); (M.M.A.M.); (M.Y.A.); (A.A.M.)
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31
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Mariano LSS, Nakamura-Silva R, Macedo LMDD, Oliveira-Silva MD, Goulart RDS, Pelisson M, Vespero EC, Silva-Sousa YTC, Pitondo-Silva A. Identification and antimicrobial susceptibility profile of bacteria isolated from primary endodontic infections. Braz Oral Res 2024; 38:e024. [PMID: 38597544 DOI: 10.1590/1807-3107bor-2024.vol38.0024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 10/03/2023] [Indexed: 04/11/2024] Open
Abstract
This study aimed to identify and characterize the antimicrobial susceptibility profile of bacteria found in primary endodontic infections in the teeth of patients treated at the Dental Clinic of the University of Ribeirão Preto, São Paulo, Brazil. From September to December 2019, samples were obtained from 21 patients with primary endodontic infections. The collections were carried out in triplicate using paper cones placed close to the total length of the root canal. Bacterial isolation was performed in Brain Heart Infusion agar, Blood agar, and other selective culture media cultured at 37°C for up to 48 h under aerobiosis and microaerophilic conditions. The bacterial species were identified using the Vitek 2 automated system. The disk diffusion method on agar Müeller-Hinton was used to assess antimicrobial susceptibility with the recommended antimicrobials for each identified bacterial species. A total of 49 antibiotics were evaluated. Fifteen of the 21 samples collected showed bacterial growth, and 17 bacterial isolates were found. There were 10 different bacterial species identified: Enterococcus faecalis (four isolates), Streptococcus mitis/oralis (three isolates), Streptococcus anginosus (three isolates) being the most common, followed by Staphylococcus epidermidis, Enterococcus faecium, Streptococcus constellatus, Streptococcus alactolyticus, Enterobacter cloacae, Klebsiella variicola, and Providencia rettgeri (one isolate of each species). The analysis demonstrated significant susceptibility to most of the tested antibiotics. However, some Enterococcus isolates resisted the antibiotic's erythromycin, ciprofloxacin, and tetracycline. A Staphylococcus epidermidis isolate was characterized as multidrug-resistant. Five Streptococcus isolates were non-susceptible to all antibiotics tested.
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Affiliation(s)
| | - Rafael Nakamura-Silva
- Universidade de Ribeirão Preto, Postgraduate Program in Environmental Technology, Universidade de Ribeirão Preto, Ribeirão Preto, Brazil
| | | | - Mariana de Oliveira-Silva
- Universidade de Ribeirão Preto, Postgraduate Program in Environmental Technology, Universidade de Ribeirão Preto, Ribeirão Preto, Brazil
| | - Rafael da Silva Goulart
- Universidade de Ribeirão Preto, Postgraduate Program in Dentistry, Ribeirão Preto, SP, Brazil
| | - Marsileni Pelisson
- Universidade Estadual de Londrina, Department of Pathology, Clinical and Toxicological Analysis, Londrina, PR, Brazil
| | - Eliana Carolina Vespero
- Universidade Estadual de Londrina, Department of Pathology, Clinical and Toxicological Analysis, Londrina, PR, Brazil
| | | | - André Pitondo-Silva
- Universidade de Ribeirão Preto, Postgraduate Program in Dentistry, Ribeirão Preto, SP, Brazil
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Lou Y, Sun Z, Ma H, Cao D, Sun M, Wang Q, Wang J, Zhuo Q, Tao R, Ying B, Liu Y, Yu M, Wang H. Odontogenic infections in the antibiotic era: approach to diagnosis, management, and prevention. Infection 2024; 52:301-311. [PMID: 37926767 DOI: 10.1007/s15010-023-02117-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 10/13/2023] [Indexed: 11/07/2023]
Abstract
PURPOSE The prevalence of odontogenic infections remains one of the highest in the world. If untreated, odontogenic infections can break through the limitation, disseminate to other organs or spaces, and cause high mortality rates. However, it is still difficult to rapidly target limited or disseminated infections in clinical practice. The type of disseminated odontogenic infections and the responsible bacteria have not been described in detail. METHODS Search databases (e.g., PubMed, MEDLINE, Web of Science, Embase) for reports published from 2018.1 to 2022.9. Use search strategies: ("odontogenic infections" OR "pulpitis" OR "periapical lesions" OR "periodontal diseases") AND ("disseminated infections" OR "complication"). RESULTS Fourteen different types of disseminated odontogenic infections, most of which are polymicrobial infections, can spread through the body either direct or through hematogenous diffusion. Multiple microbial infections can be more invasive in the transmission of infection. Secondary infections are commonly associated with bacteria like Fusobacterium spp., Streptococcus spp., Peptostreptococcus spp., Prevotella spp., and Staphylococcus spp. Antibiotics with broad-spectrum activity are fundamental as first-line antimicrobial agents based on the microorganisms isolated from disseminated infections. CONCLUSION This review elaborates on the epidemiology, microorganisms, risk factors, and dissemination routes, and provides evidence-based opinions on the diagnosis, multidisciplinary management, and prevention of odontogenic infections for dentists and clinicians.
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Affiliation(s)
- Yiting Lou
- School of Stomatology, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, Zhejiang, China
| | - Zheyuan Sun
- School of Stomatology, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, Zhejiang, China
| | - Haiying Ma
- School of Stomatology, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, Zhejiang, China
| | - Danna Cao
- Department of Stomatology, The First Affiliated Hospital of Ningbo University, Ningbo, 315000, Zhejiang, China
| | - Mouyuan Sun
- School of Stomatology, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, Zhejiang, China
| | - Qianting Wang
- School of Stomatology, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, Zhejiang, China
| | - Jingyu Wang
- School of Stomatology, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, Zhejiang, China
| | - Qunhao Zhuo
- Department of Stomatology, The First Affiliated Hospital of Ningbo University, Ningbo, 315000, Zhejiang, China
| | - Ran Tao
- Department of Biomedical Sciences, Texas A&M University School of Dentistry, Dallas, TX, USA
| | - Binbin Ying
- Department of Stomatology, The First Affiliated Hospital of Ningbo University, Ningbo, 315000, Zhejiang, China.
| | - Yu Liu
- School of Stomatology, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, Zhejiang, China.
| | - Mengfei Yu
- School of Stomatology, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, Zhejiang, China.
| | - Huiming Wang
- School of Stomatology, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, Zhejiang, China
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Liu H, Nio S, Shen Y. Sodium hypochlorite against Enterococcus faecalis biofilm in dentinal tubules: effect of concentration, temperature, and exposure time. Odontology 2024; 112:390-398. [PMID: 37646916 DOI: 10.1007/s10266-023-00850-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 08/18/2023] [Indexed: 09/01/2023]
Abstract
This study aimed to evaluate the effectiveness of two sodium hypochlorite concentrations at different exposure times and temperatures against Enterococcus faecalis biofilms of varying ages in human dentinal tubules. Dentin blocks were infected with E. faecalis for either 3 days or 3 weeks of incubation. Subsequently, the samples were exposed to sterile water, 2%, and 5.25% sodium hypochlorite for 3 and 10 min at 20 °C and 60 °C . Viability staining and confocal laser scanning microscopy were used to assess the proportion of killed bacteria in the dentinal tubules after exposure. There are no significant differences in the efficacy of E. faecalis killing between 2% sodium hypochlorite at 60 °C for various exposure times and 5.25% sodium hypochlorite at different temperatures or exposure times (P > 0.05). When both solutions were compared at the same temperatures with a 10-min exposure time, no significant differences in the effectiveness of E. faecalis killing between 2% and 5.25% sodium hypochlorite were observed (P > 0.05). To optimize the effectiveness of sodium hypochlorite in killing E. faecalis while minimizing potential damage to root dentin and soft tissue, clinicians should prioritize increasing the temperature or exposure time of sodium hypochlorite, rather than raising its concentration.
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Affiliation(s)
- He Liu
- Division of Endodontics, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, 2199 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Stefanie Nio
- Division of Endodontics, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, 2199 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Ya Shen
- Division of Endodontics, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, 2199 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada.
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Arduino PG, Alovisi M, Petti S. Herpes simplex virus type 1 in periapical pathoses: Systematic review and meta-analysis. Oral Dis 2024; 30:865-876. [PMID: 37338057 DOI: 10.1111/odi.14645] [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: 01/18/2023] [Revised: 05/18/2023] [Accepted: 06/01/2023] [Indexed: 06/21/2023]
Abstract
OBJECTIVES The objective of this systematic review and meta-analysis of observational studies was to assess whether herpes simplex virus type 1 (HSV-1) can infect endodontic periapical lesions. MATERIALS AND METHODS Studies with cross-sectional design investigating HSV-1 in periapical tissues of patients with symptomatic and asymptomatic acute and chronic apical periodontitis were searched through MEDLINE, Scopus, Embase, Web of Science, and Google Scholar. Pooled HSV-1 prevalence proportion with 95% confidence interval (95CI) in periapical lesions was assessed with both fixed-effect and random-effects models, with/without adjustment for study quality and publication bias. Result robustness was investigated through sensitivity and subgroup analyses. RESULTS Literature search, performed twice, provided 84 items, and eight remained for the meta-analysis; globally, there were 194 patients mostly adults. The pooled HSV-1 prevalence proportions, assessed with various methods, were 6.9% (95CI, 3.8-11.3%, fixed-effect); 6.8% (95CI, 3.6-11.0%, random-effects); 8.1% (95CI, 4.4-14.5%, quality-adjusted); and 4.8% (95CI, 2.0-11.4%; adjusted for small-study effect). CONCLUSIONS The results indicated that HSV-1 can colonize the periapical tissues of 3%-11% patients with periapical diseases. Such data do not imply a causative role of HSV-1 in disease development and advancement. Well-designed and large-sized prospective cohort studies should be added in the literature panorama.
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Affiliation(s)
- Paolo G Arduino
- Department of Surgical Science, CIR-Dental School, University of Turin, Turin, Italy
| | - Mario Alovisi
- Department of Surgical Science, CIR-Dental School, University of Turin, Turin, Italy
| | - Stefano Petti
- Department of Public Health and Infectious Disease, Sapienza University, Rome, Italy
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Sanz-Serrano D, Mercade M, Ventura F, Sánchez-de-Diego C. Engineering a Microphysiological Model for Regenerative Endodontic Studies. BIOLOGY 2024; 13:221. [PMID: 38666833 PMCID: PMC11048264 DOI: 10.3390/biology13040221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 03/25/2024] [Accepted: 03/26/2024] [Indexed: 04/28/2024]
Abstract
Dental pulp infections are common buccal diseases. When this happens, endodontic treatments are needed to disinfect and prepare the root canal for subsequent procedures. However, the lack of suitable in vitro models representing the anatomy of an immature root canal hinders research on regenerative events crucial in endodontics, such as regenerative procedures. This study aimed to develop a 3D microphysiological system (MPS) to mimic an immature root canal and assess the cytotoxicity of various irrigating solutions on stem cells. Utilizing the Dental Stem Cells SV40 (DSCS) cell line derived from human apical papilla stem cells, we analyzed the effects of different irrigants, including etidronic acid. The results indicated that irrigating solutions diminished cell viability in 2D cultures and influenced cell adhesion within the microphysiological device. Notably, in our 3D studies in the MPS, 17% EDTA and 9% 1-hydroxyethylidene-1, 1-bisphosphonate (HEBP) irrigating solutions demonstrated superior outcomes in terms of DSCS viability and adherence compared to the control. This study highlights the utility of the developed MPS for translational studies in root canal treatments and suggests comparable efficacy between 9% HEBP and 17% EDTA irrigating solutions, offering potential alternatives for clinical applications.
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Affiliation(s)
- Diana Sanz-Serrano
- Department of Dentistry, Universitat de Barcelona, 08907 L’Hospitalet de Llobregat, Spain; (D.S.-S.); (M.M.)
- The Bellvitge Biomedical Research Institute (IDIBELL), 08908 L’Hospitalet de Llobregat, Spain;
| | - Montse Mercade
- Department of Dentistry, Universitat de Barcelona, 08907 L’Hospitalet de Llobregat, Spain; (D.S.-S.); (M.M.)
- The Bellvitge Biomedical Research Institute (IDIBELL), 08908 L’Hospitalet de Llobregat, Spain;
| | - Francesc Ventura
- The Bellvitge Biomedical Research Institute (IDIBELL), 08908 L’Hospitalet de Llobregat, Spain;
- Departament de Ciències Fisiològiques, Universitat de Barcelona, The Bellvitge Biomedical Research Institute (IDIBELL), 08907 L’Hospitalet de Llobregat, Spain
| | - Cristina Sánchez-de-Diego
- Department of Biomedical Engineering, University of Wisconsin–Madison, 550 Engineering Dr, Madison, WI 53706, USA
- Department of Pathology & Laboratory Medicine, University of Wisconsin–Madison, 1111 Highland Avenue, Madison, WI 53705, USA
- Carbone Cancer Center, University of Wisconsin–Madison, 1111 Highland Avenue, Madison, WI 53705, USA
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Matoso FB, Montagner F, Grecca FS, Rampelotto PH, Kopper PMP. Microbial composition and diversity in intraradicular biofilm formed in situ: New concepts based on next-generation sequencing. Mol Oral Microbiol 2024. [PMID: 38497440 DOI: 10.1111/omi.12462] [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: 11/07/2023] [Accepted: 02/26/2024] [Indexed: 03/19/2024]
Abstract
This study aimed to characterize the taxonomic composition of intraradicular multispecies biofilms (IMBs) formed in situ in a model to reproduce clinical conditions. Twelve palatal roots of maxillary molars had its canals prepared. Two roots were randomly selected to sterility control. Ten intraoral prosthetic appliances with lateral slots were fabricated. The roots were positioned in the slots with the canal access open to the oral cavity. Eight volunteers wore the appliance for 21 days, and two wore it at two different time points. One root from each appliance was removed and stored at -20°C until DNA extraction and sequencing (n = 10). Biofilm was analyzed using next-generation sequencing and bioinformatics. The V4 hyper-variable region of the 16SrRNA gene was amplified and sequenced. For data analyses, the mothur pipeline was used for 16SrRNA processing, and subsequent analyses of the sequence dataset were performed in R using the MicrobiomeAnalyst R package. The taxonomy-based analysis of bacterial communities identified 562 operational taxonomic units (OTUs), which belonged to 93 genera, 44 families, and 8 phyla. Bacterial colonization was different for each biofilm, and samples did not have the same group of bacteria. Alpha and beta diversity analysis revealed some general patterns of sample clustering. A core microbiome of prevalent OTUs and genera was identified. IMBs were heterogeneous when analyzed individually, but some diversity patterns were found after sample clustering. The experimental model seemed to reproduce the actual biofilm composition in endodontic infections, which suggests that it may be used to evaluate disinfection protocols.
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Affiliation(s)
- Felipe Barros Matoso
- Graduate Program in Dentistry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Francisco Montagner
- Graduate Program in Dentistry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Fabiana Soares Grecca
- Graduate Program in Dentistry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Pabulo Henrique Rampelotto
- Bioinformatics and Biostatistics Core Facility, Institute of Basic Health Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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Duarte Faria F, Cantiga-Silva C, Cardoso CDBM, da Silva Machado NE, de Oliveira PHC, Justo MP, Goto J, de Castilho Jacinto R, Sivieri-Araújo G, Cintra LTA. Influence of systemic antibiotic therapy on the development and progression of induced apical periodontitis in Wistar rats. Odontology 2024:10.1007/s10266-024-00908-2. [PMID: 38457086 DOI: 10.1007/s10266-024-00908-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 01/29/2024] [Indexed: 03/09/2024]
Abstract
The aim of this study was to investigate the influence of systemic antibiotic therapy on the development and progression of induced apical periodontitis (AP) in Wistar rats. Fifty-six rats were submitted to pulp exposure of the lower left first molar for the induction of AP. On the same day, intraperitoneal antibiotic therapy was administered once a day, for 15 days, until euthanasia. The groups were formed according to the different treatments (n = 8): C-control; GEN-treated with gentamicin (10 mg/Kg); AC-treated with amoxicillin (100 mg/Kg); MZ-treated with metronidazole (40 mg/Kg); AMP-treated with ampicillin (100 mg/Kg); AMC group-treated with amoxicillin + clavulanic acid (100 mg/kg); CLI-treated with clindamycin (60 mg/kg). After euthanasia, the jaws were collected and processed for (1) histological and histometric analysis using hematoxylin and eosin staining, (2) analysis of collagen fibers using Picrosirius Red staining and (3) bacteriological analysis using Brown-Brenn staining. The data were analyzed statistically (p < 0.05). AP induction was confirmed in all groups. The AMC group had the lower intensity of inflammatory infiltrate (p = 0.028) and less periapical bone resorption compared to control (p = 0.006). Regarding collagen maturation, PSR staining revealed a predominance of mature collagen fibers in all groups. The AC and AMC groups had the lower amount of mature fibers and the highest amount of immature fibers, compared to all other groups (p < 0.001). All groups showed bacterial contamination; however, the AC and AMC groups showed a lower extent of bacterial contamination compared to the control (p < 0.001). It can be concluded that systemic antibiotic therapy influences the development and progression of induced AP.
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Affiliation(s)
- Flávio Duarte Faria
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), José Bonifácio, 1193, Vila Mendonça, Araçatuba, SP, 16015-050, Brazil
| | - Cristiane Cantiga-Silva
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), José Bonifácio, 1193, Vila Mendonça, Araçatuba, SP, 16015-050, Brazil
| | - Carolina de Barros Morais Cardoso
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), José Bonifácio, 1193, Vila Mendonça, Araçatuba, SP, 16015-050, Brazil
| | - Nathália Evelyn da Silva Machado
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), José Bonifácio, 1193, Vila Mendonça, Araçatuba, SP, 16015-050, Brazil
| | - Pedro Henrique Chaves de Oliveira
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), José Bonifácio, 1193, Vila Mendonça, Araçatuba, SP, 16015-050, Brazil
| | - Mariana Pagliusi Justo
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), José Bonifácio, 1193, Vila Mendonça, Araçatuba, SP, 16015-050, Brazil
| | - Juliana Goto
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), José Bonifácio, 1193, Vila Mendonça, Araçatuba, SP, 16015-050, Brazil
| | - Rogério de Castilho Jacinto
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), José Bonifácio, 1193, Vila Mendonça, Araçatuba, SP, 16015-050, Brazil
| | - Gustavo Sivieri-Araújo
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), José Bonifácio, 1193, Vila Mendonça, Araçatuba, SP, 16015-050, Brazil
| | - Luciano Tavares Angelo Cintra
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), José Bonifácio, 1193, Vila Mendonça, Araçatuba, SP, 16015-050, Brazil.
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Zhao J, Wu S, Huang Y, Zhao Y, Liu H, Jiang Q, Shen Y, Chen M. Comparation of the effectiveness of conventional needle irrigation and photon-induced photoacoustic streaming with sodium hypochorite in the treatment of teeth with apical periodontitis: a randomized clinical trial. BMC Oral Health 2024; 24:293. [PMID: 38431616 PMCID: PMC10909256 DOI: 10.1186/s12903-024-04055-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 02/20/2024] [Indexed: 03/05/2024] Open
Abstract
Photon-initiated photoacoustic streaming (PIPS) with an Er: YAG laser has been introduced in root canal treatment to improve irrigation and facilitate the removal of bacteria in the root canal system. This study aimed to compare the antibacterial effectiveness of two different root canal irrigation techniques, conventional needle irrigation (CNI) and PIPS, using 1% sodium hypochlorite (NaOCl), in the treatment of teeth with apical periodontitis. Sixty patients with a total of sixty teeth affected by apical periodontitis were included in this study. The teeth underwent root canal therapy, and after mechanical instrumentation, they were randomly assigned to two groups (n = 30) based on the final irrigation protocol: CNI or PIPS with 1% NaOCl. Bacterial suspensions in the root canals were evaluated using Adenosine 5'-triphosphate (ATP) assay kit after mechanical instrumentation and after final irrigation. Then, a follow-up was conducted after 7 days. The results revealed that final irrigation significantly reduced ATP values in both the CNI and PIPS groups (P < 0.001). The ATP values after final irrigation was greater in the CNI group compared to the PIPS group (P < 0.001). After a 7-day follow-up, percussion tenderness and fistula were significantly resolved in both groups (P < 0.05). A multivariate linear regression model was used to identify the factors that influence post irrigation ATP values. The analysis demonstrated that pre-operative percussion tenderness (P = 0.006), the presence of a fistula (P < 0.001) and the method used in the final irrigation (P < 0.001) had a significant impact on the ATP value after final irrigation. These results indicate that employing PIPS with 1% NaOCl as the final irrigation protocol exhibited superior antibacterial effectiveness and has the potential to enhance clinical outcomes in the treatment of teeth afflicted with apical periodontitis.
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Affiliation(s)
- Jian Zhao
- Department of Endodontics, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medical, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, 510182, Guangdong, China
| | - Shengxuan Wu
- Department of Endodontics, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medical, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, 510182, Guangdong, China
| | - Yuting Huang
- Department of Endodontics, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medical, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, 510182, Guangdong, China
| | - Yuxuan Zhao
- Department of Endodontics, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medical, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, 510182, Guangdong, China
| | - He Liu
- Division of Endodontics, Faculty of Dentistry, University of British Columbia, Vancouver, BC, V6T 1Z3, Canada
| | - Qianzhou Jiang
- Department of Endodontics, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medical, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, 510182, Guangdong, China.
| | - Ya Shen
- Division of Endodontics, Faculty of Dentistry, University of British Columbia, Vancouver, BC, V6T 1Z3, Canada.
| | - Minle Chen
- Department of Stomatology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, Guangdong, China.
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Huang D, Wang X, Liang J, Ling J, Bian Z, Yu Q, Hou B, Chen X, Li J, Ye L, Cheng L, Xu X, Hu T, Wu H, Guo B, Su Q, Chen Z, Qiu L, Chen W, Wei X, Huang Z, Yu J, Lin Z, Zhang Q, Yang D, Zhao J, Pan S, Yang J, Wu J, Pan Y, Xie X, Deng S, Huang X, Zhang L, Yue L, Zhou X. Expert consensus on difficulty assessment of endodontic therapy. Int J Oral Sci 2024; 16:22. [PMID: 38429281 PMCID: PMC10907570 DOI: 10.1038/s41368-024-00285-0] [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: 12/29/2023] [Accepted: 01/19/2024] [Indexed: 03/03/2024] Open
Abstract
Endodontic diseases are a kind of chronic infectious oral disease. Common endodontic treatment concepts are based on the removal of inflamed or necrotic pulp tissue and the replacement by gutta-percha. However, it is very essential for endodontic treatment to debride the root canal system and prevent the root canal system from bacterial reinfection after root canal therapy (RCT). Recent research, encompassing bacterial etiology and advanced imaging techniques, contributes to our understanding of the root canal system's anatomy intricacies and the technique sensitivity of RCT. Success in RCT hinges on factors like patients, infection severity, root canal anatomy, and treatment techniques. Therefore, improving disease management is a key issue to combat endodontic diseases and cure periapical lesions. The clinical difficulty assessment system of RCT is established based on patient conditions, tooth conditions, root canal configuration, and root canal needing retreatment, and emphasizes pre-treatment risk assessment for optimal outcomes. The findings suggest that the presence of risk factors may correlate with the challenge of achieving the high standard required for RCT. These insights contribute not only to improve education but also aid practitioners in treatment planning and referral decision-making within the field of endodontics.
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Affiliation(s)
- Dingming Huang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Operative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xiaoyan Wang
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China
| | - Jingping Liang
- Department of Endodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Clinical Research Center for Oral Diseases, National Center for Stomatology, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Junqi Ling
- Department of Operative Dentistry and Endodontics, Hospital of Stomatology, Guanghua, School of Stomatology, Sun Yat-Sen University & Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Zhuan Bian
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Qing Yu
- Department of Operative Dentistry & Endodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, China
| | - Benxiang Hou
- Department of Endodontics, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing, China
| | - Xinmei Chen
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Operative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jiyao Li
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Operative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Ling Ye
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Operative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Lei Cheng
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Operative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xin Xu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Operative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Tao Hu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Preventive Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Hongkun Wu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Geriatric dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Bin Guo
- Department of Stomatology, First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Qin Su
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Operative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Zhi Chen
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Lihong Qiu
- Department of Endodontics, School of Stomatology, China Medical University, Shenyang, China
| | - Wenxia Chen
- College of Stomatology, Hospital of Stomatology, Guangxi Medical University, Nanning, China
| | - Xi Wei
- Department of Operative Dentistry and Endodontics, Hospital of Stomatology, Guanghua, School of Stomatology, Sun Yat-Sen University & Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Zhengwei Huang
- Department of Endodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Clinical Research Center for Oral Diseases, National Center for Stomatology, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Jinhua Yu
- Department of Endodontics, School and Hospital of Stomatology, Nanjing Medical University, Nanjing, China
| | - Zhengmei Lin
- Department of Operative Dentistry and Endodontics, Hospital of Stomatology, Guanghua, School of Stomatology, Sun Yat-Sen University & Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Qi Zhang
- Department of Endodontics, Stomatological Hospital and Dental School of Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, China
| | - Deqin Yang
- Department of Endodontics, Stomatological Hospital of Chongqing Medical University, Chongqing, China
| | - Jin Zhao
- Department of Endodontics, First Affiliated Hospital of Xinjiang Medical University, and College of Stomatology of Xinjiang Medical University, Urumqi, China
| | - Shuang Pan
- Department of Endodontics, Schoolof Stomatology, First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Jian Yang
- Department of Endodontics, The Affiliated Stomatological Hospital of Nanchang University, Nanchang, China
| | - Jiayuan Wu
- Key Laboratory of Oral Disease Research, School of Stomatology, Zunyi Medical University, Zunyi, China
| | - Yihuai Pan
- Department of Endodontics, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China
| | - Xiaoli Xie
- Department of Cariology and Endodontics, Xiangya Stomatological School, Central South University, Changsha, China
| | - Shuli Deng
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
| | - Xiaojing Huang
- School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - Lan Zhang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Operative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Lin Yue
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China.
| | - Xuedong Zhou
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Operative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
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Pauletto G, Guerim PHF, Barbosa AB, Lopes LQS, Bier CAS, Marquezan PK. Efficacy of calcium hypochlorite in disinfection of gutta-percha cones contaminated with Candida albicans. Braz J Microbiol 2024; 55:403-410. [PMID: 38225531 PMCID: PMC10920541 DOI: 10.1007/s42770-024-01255-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 01/08/2024] [Indexed: 01/17/2024] Open
Abstract
This study aimed to compare the efficacy of 2.5% sodium hypochlorite (NaOCl), 2.5% calcium hypochlorite [Ca(OCl)2], and 2% chlorhexidine (CHX) in the rapid disinfection of gutta-percha cones contaminated with Candida albicans. The minimum inhibitory and minimum fungicidal concentrations of each solution for C. albicans were determined and the ability of each solution to destroy and inhibit biofilm in culture wells was tested. In addition, ninety-eight gutta-percha cones contaminated with the fungal suspension were disinfected according to the type of solution (2.5% NaOCl, 2.5% Ca(OCl)2 or 2% CHX) in its different application methods (without agitation, ultrasonic agitation or agitation with Easy Clean), and regarding the exposure time to each irrigating solution (1 or 5 min). Next, the samples were checked for turbidity and evaluation of viable colonies. The compounds that showed the best performance in biofilm destruction were NaOCl and Ca(OCl)2 at a concentration of 2xMIC (p < 0.001). Regarding inhibited biofilm, the only compound that was effective at all MIC concentrations tested was 2.5% Ca(OCl)2 (p < 0.0001). Regarding the viable colonies, all solutions were effective concerning the control group, for all application methods, in 1 and 5 min (p < 0.05). The densitometer reading showed that CHX was the only effective solution in all application methods performed (p < 0.05). The results demonstrate that all tested solutions were effective in the rapid decontamination of cones contaminated with C. albicans.
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Affiliation(s)
- Guilherme Pauletto
- Post-Graduate Program in Oral Science, Faculty of Dentistry, Federal University of Santa Maria (UFSM), Roraima Avenue #1000, T Street, Building 26F, Room 2383, Santa Maria, Rio Grande Do Sul State, 97.105-900, Brazil.
| | - Pedro Henrique Fortes Guerim
- Graduate Program in Dentistry, Faculty of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande Do Sul State, Brazil
| | - Arthur Brites Barbosa
- Graduate Program in Dentistry, Faculty of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande Do Sul State, Brazil
| | - Leonardo Quintana Soares Lopes
- Post-Graduate Program in Pharmaceutical Sciences, Faculty of Pharmacy, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande Do Sul State, Brazil
| | - Carlos Alexandre Souza Bier
- Post-Graduate Program in Oral Science, Faculty of Dentistry, Federal University of Santa Maria (UFSM), Roraima Avenue #1000, T Street, Building 26F, Room 2383, Santa Maria, Rio Grande Do Sul State, 97.105-900, Brazil
| | - Patrícia Kolling Marquezan
- Department of Microbiology and Parasitology, Faculty of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande Do Sul State, Brazil
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Yang X, Chen X, Zhang Y, Huang L, Chen D, Zeng Q, Qiu X. Clinical outcomes of endodontic microsurgery in complicated cases with large or through-and-through lesions: a retrospective longitudinal study. Clin Oral Investig 2024; 28:172. [PMID: 38400913 DOI: 10.1007/s00784-024-05557-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 02/12/2024] [Indexed: 02/26/2024]
Abstract
OBJECTIVES To investigate the clinical outcomes of endodontic microsurgery in complicated cases presenting with large or through-and-through lesions. MATERIALS AND METHODS We retrospectively collected and analyzed preoperative, intraoperative, and follow-up data from 143 complicated cases that underwent endodontic microsurgery. Clinical outcomes were assessed in terms of tooth survival and surgery success. Cox regression analysis was used to evaluate the survival rate and identify associated risk factors. Additionally, the success rate was compared across different postoperative periods, and potential factors contributing to surgical failure were identified through binary logistic regression. RESULTS The overall survival and success rates were 93.0% and 91.7%, respectively. The Cox regression model identified four risk factors affecting tooth survival, including apicoectomy of four teeth (HR = 35.488; P = 0.0002), an open apex observed on preoperative radiographs (HR = 6.300; P = 0.025), the performance of guided tissue regeneration technique (HR = 8.846; P = 0.028), and a palatal surgical approach (HR = 8.685; P = 0.030). The success rate demonstrated an initial increase in the early postoperative period (from 0.5 to 2 years; P = 5.8124e-30), followed by stabilization (from 2 to 9 years; P = 0.298). Surgery success rate significantly declined when apicoectomy involved four teeth (OR = 109.412; P = 0.002). CONCLUSIONS Endodontic microsurgery demonstrates satisfactory outcomes in complicated cases, maintaining a stable success rate after two years. However, tooth survival and surgery success are significantly compromised when apicoectomy involves four teeth. Factors such as guided tissue regeneration, an open apex, and the palatal surgical approach are associated with an increased risk of tooth extraction. CLINICAL RELEVANCE Despite achieving acceptable outcomes in complicated cases, endodontic microsurgery is adversely affected by the apicoectomy of four teeth.
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Affiliation(s)
- Xiaoxia Yang
- Department of Endodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, No. 366 South Jiangnan Avenue, Haizhu District, Guangzhou, 510280, China
| | - Xuan Chen
- Department of Endodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, No. 366 South Jiangnan Avenue, Haizhu District, Guangzhou, 510280, China
| | - Yinchun Zhang
- Department of Endodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, No. 366 South Jiangnan Avenue, Haizhu District, Guangzhou, 510280, China
| | - Lei Huang
- Department of Endodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, No. 366 South Jiangnan Avenue, Haizhu District, Guangzhou, 510280, China
| | - Dongjie Chen
- Department of Endodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, No. 366 South Jiangnan Avenue, Haizhu District, Guangzhou, 510280, China
| | - Qinfang Zeng
- Department of Endodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, No. 366 South Jiangnan Avenue, Haizhu District, Guangzhou, 510280, China
| | - Xiaoling Qiu
- Department of Endodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, No. 366 South Jiangnan Avenue, Haizhu District, Guangzhou, 510280, China.
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Amaral RR, Love RM, Braga T, Souza Côrtes MI, Rachid CTCC, Rôças IN, Siqueira JF. Impact of root canal preparation using two single-file systems on the intra-radicular microbiome of teeth with primary apical periodontitis. Clin Oral Investig 2024; 28:139. [PMID: 38332365 PMCID: PMC10853323 DOI: 10.1007/s00784-024-05544-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 02/05/2024] [Indexed: 02/10/2024]
Abstract
OBJECTIVES This study aimed to describe the effects of two single-file systems on the diversity of the endodontic microbiome of teeth with primary asymptomatic apical periodontitis. MATERIALS AND METHODS The root canals from single-rooted teeth with apical periodontitis were prepared using either the Reciproc Blue (RB) or the XP-endo Shaper (XPS) instrument system. The latter was followed by a supplementary step with the XP-endo Finisher (XPF) instrument. For irrigation, 5.25% sodium hypochlorite was used. Root canal samples were taken at the baseline (S1), after preparation (S2), and after the supplementary step (S3). DNA was extracted and subjected to high-throughput sequencing using the MiSeq Illumina platform. RESULTS Samples from 10 teeth from the RB and 7 from the XPS group were subjected to DNA sequencing. Initial samples differed significantly from post-preparation samples in bacterial diversity, with no significant difference when comparing the two instrument systems. The most dominant phyla in S2 were Bacteroidetes, Proteobacteria, Firmicutes, Fusobacteria, and Actinobacteria. The same phyla were found to dominate baseline samples and samples taken after using XPF, but with differences in the ranking of the most dominant ones. At the genus level, the most dominant genera identified after RB instrumentation were Bacteroidaceae [G-1], Fusobacterium, and Staphylococcus, while the most dominant genera after XPS instrumentation were Fusobacterium and Porphyromonas. These genera were also dominant in the initial samples. CONCLUSIONS Both treatment protocols had measurable effects on the root canal microbial diversity, with no significant differences between them. Most of the dominant taxa involved in the primary infection and probably in the aetiology of apical periodontitis were eliminated or substantially reduced. CLINICAL RELEVANCE The most dominant taxa that persisted after instrumentation were Fusobacterium, Porphyromonas, Staphylococcus, and Bacteroidaceae [G-1].
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Affiliation(s)
- Rodrigo Rodrigues Amaral
- College of Medicine and Dentistry, James Cook University, 1/14-88 McGregor Rd, Building D1, 2nd Floor, Campus Smithfield, Smithfield, Cairns, QLD, 4878, Australia.
| | - Robert M Love
- School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia
| | - Tiago Braga
- School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia
| | - Maria I Souza Côrtes
- Department of Dentistry, Pontifícia Universidade Católica de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Caio T C C Rachid
- Laboratory of Biotechnology and Microbial Ecology, Institute of Microbiology Prof. Paulo de Góes, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Isabela N Rôças
- Department of Dental Research, Faculty of Dentistry, Iguaçu University (UNIG), Nova Iguaçu, RJ, Brazil
| | - José F Siqueira
- Department of Dental Research, Faculty of Dentistry, Iguaçu University (UNIG), Nova Iguaçu, RJ, Brazil
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Hernández SR, Siqueira JF, Voigt DD, Soimu G, Brasil SC, Provenzano JC, Mdala I, Alves FRF, Rôças IN. Bacteriologic Conditions of the Apical Root Canal System of Teeth with and without Posttreatment Apical Periodontitis: A Correlative Multianalytical Approach. J Endod 2024; 50:154-163. [PMID: 37977217 DOI: 10.1016/j.joen.2023.11.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 11/09/2023] [Accepted: 11/09/2023] [Indexed: 11/19/2023]
Abstract
INTRODUCTION This study used a correlative multianalytical approach to investigate the bacteriologic conditions in the apical root canal system of treated teeth with or without apical periodontitis and their correlation with the technical quality of the previous root canal obturation and the presence and volume of apical periodontitis lesions. METHODS Root apexes were obtained from recently extracted root canal-treated teeth with (n = 23) and without (n = 22) apical periodontitis lesions as demonstrated by cone-beam computed tomographic examination. The root apexes were sectioned and subjected to micro-computed tomographic (micro-CT) scanning. The specimens were cryopulverized, and DNA extracted from the powder was used as a template in real-time polymerase chain reaction assays to quantify total bacteria and members of the Streptococcus genus and Actinobacteria phylum. The bacteriologic findings were compared between the 2 groups and also evaluated for associations with cone-beam computed tomographic and micro-computed tomographic data. RESULTS Bacteria were detected in all apical canal samples except 1. The mean counts of total bacteria, streptococci, and actinobacteria did not differ significantly between teeth with or without apical periodontitis (P > .05). Streptococcus levels were significantly lower by 80% in the apical canals of teeth with small lesions compared with those without lesions (P < .05). The limit of filling >2 mm short was significantly associated with more total bacterial counts compared with canals filled 0-2 mm short (P < .05). An adequate coronal restoration was significantly associated with lesser counts of Streptococcus (P < .05). CONCLUSIONS Comparable bacterial loads were observed in the apical canal system of treated teeth with and without apical periodontitis, suggesting that factors other than only the total bacterial levels may also influence the development and progression of apical periodontitis. Bacteria were found in the apical canal in virtually all cases with a high prevalence of streptococci and actinobacteria. Streptococci counts were significantly higher in the apical canal of teeth with inadequate restorations and teeth with no lesions. Underfilled canals showed higher bacterial counts.
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Affiliation(s)
- Sandra R Hernández
- Postgraduate Program in Dentistry, University of Grande Rio, Rio de Janeiro, Rio de Janeiro, Brazil; Department of Endodontics, Faculty of Dentistry, Francisco Marroquín University, Guatemala City, Guatemala
| | - José F Siqueira
- Postgraduate Program in Dentistry, University of Grande Rio, Rio de Janeiro, Rio de Janeiro, Brazil; Department of Dental Research, Faculty of Dentistry, Iguaçu University, Nova Iguaçu, Rio de Janeiro, Brazil
| | - Danielle D Voigt
- Postgraduate Program in Dentistry, University of Grande Rio, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Giuliana Soimu
- Postgraduate Program in Dentistry, University of Grande Rio, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Sabrina C Brasil
- Postgraduate Program in Dentistry, University of Grande Rio, Rio de Janeiro, Rio de Janeiro, Brazil
| | - José C Provenzano
- Postgraduate Program in Dentistry, University of Grande Rio, Rio de Janeiro, Rio de Janeiro, Brazil; Department of Dental Research, Faculty of Dentistry, Iguaçu University, Nova Iguaçu, Rio de Janeiro, Brazil
| | - Ibrahimu Mdala
- Department of General Practice, University of Oslo, Oslo, Norway
| | - Flávio R F Alves
- Postgraduate Program in Dentistry, University of Grande Rio, Rio de Janeiro, Rio de Janeiro, Brazil; Department of Dental Research, Faculty of Dentistry, Iguaçu University, Nova Iguaçu, Rio de Janeiro, Brazil.
| | - Isabela N Rôças
- Postgraduate Program in Dentistry, University of Grande Rio, Rio de Janeiro, Rio de Janeiro, Brazil; Department of Dental Research, Faculty of Dentistry, Iguaçu University, Nova Iguaçu, Rio de Janeiro, Brazil
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Singh S, Bolla N. Endocator-paradigm shift in the evaluation of microbial load in root canals. JOURNAL OF CONSERVATIVE DENTISTRY AND ENDODONTICS 2024; 27:111-112. [PMID: 38463470 PMCID: PMC10923219 DOI: 10.4103/jcde.jcde_8_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 01/10/2024] [Indexed: 03/12/2024]
Affiliation(s)
- Shishir Singh
- Department of Conservative Dentistry and Endodontics, Terna Dental College, Nerul, Navi Mumbai, Maharashtra, India
| | - Nagesh Bolla
- Department of Conservative Dentistry and Endodontics, Sibar Dental College, Guntur, Andhra Pradesh, India
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Alghofaily M, Alfraih J, Alsaud A, Almazrua N, Sumague TS, Auda SH, Alsalleeh F. The Effectiveness of Silver Nanoparticles Mixed with Calcium Hydroxide against Candida albicans: An Ex Vivo Analysis. Microorganisms 2024; 12:289. [PMID: 38399693 PMCID: PMC10891542 DOI: 10.3390/microorganisms12020289] [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: 12/06/2023] [Revised: 01/19/2024] [Accepted: 01/26/2024] [Indexed: 02/25/2024] Open
Abstract
INTRODUCTION The purpose of this study was to assess the antifungal activity of silver nanoparticles (AgNPs) in combination with calcium hydroxide (Ca(OH)2) against Candida albicans (C. albicans). METHODS AgNPs was mixed with pure Ca(OH)2 powder in an aqueous base. A standard suspension (1 × 108 bacterial cells/mL) of C. albicans was prepared in a 96-well plate and incubated on shaker at 37 °C in 100% humidity to allow fungal biofilm formation in infected dentin slices (n = 98). The minimum inhibitory concentration (MIC) and minimum fungicidal concentration (MFC) of AgNPs alone or with Ca(OH)2 were determined. The samples were separately placed in 24-well tissue culture plates and divided into three experimental groups (0.03, 0.04, and 0.06) and three control groups; negative (saline) and positive chlorhexidine gel and Ca(OH)2. Quantitative measurements of fungal activity by XTT colorimetric assay and qualitative measurements using confocal laser microscopy and scanning electron microscopy were performed. RESULTS The cell viability of C. albicans in the experimental groups was significantly reduced compared to the negative control group. The combination of (AgNPs (0.04%) and Ca(OH)2) was the most potent against C. albicans. CONCLUSIONS The findings demonstrated that combining silver nanoparticles with Ca(OH)2 was more effective against C. albicans biofilm compared to Ca(OH)2 alone, suggesting a combing effect.
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Affiliation(s)
- Maha Alghofaily
- Restorative Dental Sciences, College of Dentistry, King Saud University, Riyadh 11461, Saudi Arabia;
| | - Jood Alfraih
- College of Dentistry, King Saud University, Riyadh 11461, Saudi Arabia; (J.A.); (N.A.)
| | - Aljohara Alsaud
- College of Dentistry, King Saud University, Riyadh 11461, Saudi Arabia; (J.A.); (N.A.)
| | - Norah Almazrua
- College of Dentistry, King Saud University, Riyadh 11461, Saudi Arabia; (J.A.); (N.A.)
| | - Terrence S. Sumague
- Molecular and Cell Biology Laboratory, Prince Naif Bin AbdulAziz Health Research Center, College of Dentistry, King Saud University, Riyadh 11461, Saudi Arabia;
| | - Sayed H. Auda
- Department of Pharmaceutics, College of Pharmacy, King Saud University, Riyadh 11461, Saudi Arabia;
| | - Fahd Alsalleeh
- Restorative Dental Sciences, College of Dentistry, King Saud University, Riyadh 11461, Saudi Arabia;
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Gong Q, Lv X, Liao C, Liang A, Luo C, Wu J, Zhou Y, Huang Y, Tong Z. Single-cell RNA sequencing combined with proteomics of infected macrophages reveals prothymosin-α as a target for treatment of apical periodontitis. J Adv Res 2024:S2090-1232(24)00031-6. [PMID: 38237771 DOI: 10.1016/j.jare.2024.01.018] [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: 10/12/2023] [Revised: 12/22/2023] [Accepted: 01/12/2024] [Indexed: 02/03/2024] Open
Abstract
INTRODUCTION Chronic apical periodontitis (CAP) is a common infectious disease of the oral cavity. Immune responses and osteoclastogenesis of monocytes/macrophages play a crucial role in CAP progression, and this study want to clarify role of monocytes/macrophages in CAP, which will contribute to treatment of CAP. OBJECTIVES We aim to explore the heterogeneity of monocyte populations in periapical lesion of CAP tissues and healthy control (HC) periodontal tissues by single-cell RNA sequencing (scRNA-seq), search novel targets for alleviating CAP, and further validate it by proteomics and in vitro and in vivo evaluations. METHODS ScRNA-seq was used to analyze the heterogeneity of monocyte populations in CAP, and proteomics of THP-1-derived macrophages with porphyromonas gingivalis infection were intersected with the differentially expressed genes (DEGs) of macrophages between CAP and HC tissues. The upregulated PTMA (prothymosin-α) were validated by immunofluorescence staining and quantitative real time polymerase chain reaction. We evaluated the effect of thymosin α1 (an amino-terminal proteolytic cleavage product of PTMA protein) on inflammatory factors and osteoclast differentiation of macrophages infected by P. gingivalis. Furthermore, we constructed mouse and rat mandibular bone lesions caused by apical periodontitis, and estimated treatment of systemic and topical administration of PTMA for CAP. Statistical analyses were performed using GraphPad Prism software (v9.2) RESULTS: Monocytes were divided into seven sub-clusters comprising monocyte-macrophage-osteoclast (MMO) differentiation in CAP. 14 up-regulated and 21 down-regulated genes and proteins were intersected between the DEGs of scRNA-seq data and proteomics, including the high expression of PTMA. Thymosin α1 may decrease several inflammatory cytokine expressions and osteoclastogenesis of THP-1-derived macrophages. Both systemic administration in mice and topical administration in the pulp chamber of rats alleviated periapical lesions. CONCLUSIONS PTMA upregulation in CAP moderates the inflammatory response and prevents the osteoclastogenesis of macrophages, which provides a basis for targeted therapeutic strategies for CAP.
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Affiliation(s)
- Qimei Gong
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China; Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China; Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Xiaomin Lv
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China; Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China; Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Chenxi Liao
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China; Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China; Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Ailin Liang
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China; Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China; Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Cuiting Luo
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China; Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China; Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Jie Wu
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China; Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China; Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yanling Zhou
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China; Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China; Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yihua Huang
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China; Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China; Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China.
| | - Zhongchun Tong
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China; Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China; Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China.
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Mota ME, Franco JB, Alves FA, Moreira MS. Precision dentistry in patients undergoing hematopoietic stem cell transplantation. Oral Dis 2024. [PMID: 38217442 DOI: 10.1111/odi.14866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 11/20/2023] [Accepted: 12/29/2023] [Indexed: 01/15/2024]
Affiliation(s)
- Maria Emília Mota
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Juliana Bertoldi Franco
- Division of Dentistry of the Clinics Hospital of the University of São Paulo School of Medicine, São Paulo, Brazil
| | - Fábio Abreu Alves
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
- Department of Stomatology, A.C. Camargo Cancer Center, São Paulo, Brazil
| | - Maria Stella Moreira
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
- Department of Stomatology, A.C. Camargo Cancer Center, São Paulo, Brazil
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Santi L, Berger M, Guimarães JA, Calegari-Alves YP, Vainstein MH, Yates JR, Beys-da-Silva WO. Proteomic profile of Cryptococcus gattii biofilm: Metabolic shift and the potential activation of electron chain transport. J Proteomics 2024; 290:105022. [PMID: 37838096 DOI: 10.1016/j.jprot.2023.105022] [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: 02/28/2023] [Revised: 09/22/2023] [Accepted: 10/03/2023] [Indexed: 10/16/2023]
Abstract
Cryptococcus gattii is a primary pathogenic fungus that causes pneumonia. This species is also responsible for an outbreak in Vancouver, Canada, and spreading to the mainland and United States. The use of medical devices is often complicated by infections with biofilm-forming microbes with increased resistance to antimicrobial agents and host defense mechanisms. This study investigated the comparative proteome of C. gattii R265 (VGIIa) grown under planktonic and biofilm conditions. A brief comparison with C. neoformans H99 biofilm and the use of different culture medium and surface were also evaluated. Using Multidimensional Protein Identification Technology (MudPIT), 1819 proteins were identified for both conditions, where 150 (8.2%) were considered differentially regulated (up- or down-regulated and unique in biofilm cells). Overall, the proteomic approach suggests that C. gattii R265 biofilm cells are maintained by the induction of electron transport chain for reoxidation, and by alternative energy metabolites, such as succinate and acetate. SIGNIFICANCE: Since C. gattii is considered a primary pathogen and is one of the most virulent and less susceptible to antifungals, understanding how biofilms are maintained is fundamental to search for new targets to control this important mode of growth that is difficult to eradicate.
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Affiliation(s)
- Lucélia Santi
- Faculty of Pharmacy, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil; Post-Graduation Program of Cellular and Molecular Biology, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil; Center of Experimental Research, Clinical Hospital of Porto Alegre, Porto Alegre, RS, Brazil.
| | - Markus Berger
- Center of Experimental Research, Clinical Hospital of Porto Alegre, Porto Alegre, RS, Brazil; Tick-Pathogen Transmission Unit, Laboratory of Bacteriology, National Institute of Allergy and Infectious Diseases, Hamilton, MT, United States
| | - Jorge A Guimarães
- Center of Experimental Research, Clinical Hospital of Porto Alegre, Porto Alegre, RS, Brazil
| | - Yohana Porto Calegari-Alves
- Post-Graduation Program of Cellular and Molecular Biology, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Marilene H Vainstein
- Post-Graduation Program of Cellular and Molecular Biology, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - John R Yates
- Department of Molecular Medicine, Scripps Research, La Jolla, CA, United States
| | - Walter O Beys-da-Silva
- Faculty of Pharmacy, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil; Post-Graduation Program of Cellular and Molecular Biology, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil; Center of Experimental Research, Clinical Hospital of Porto Alegre, Porto Alegre, RS, Brazil
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Wang Y, Lei L, Huang J, Cai Z, Huang X. Sonic-assisted antibacterial photodynamic therapy: a strategy for enhancing lateral canal disinfection. BMC Oral Health 2024; 24:5. [PMID: 38166876 PMCID: PMC10762957 DOI: 10.1186/s12903-023-03801-6] [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: 10/16/2023] [Accepted: 12/19/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Bacterial infections in lateral canals pose challenges for root canal treatment. This in vitro study aims to evaluate the antibacterial efficacy of sonic-assisted methylene blue mediated antimicrobial photodynamic therapy (MB-aPDT) against Enterococcus faecalis (E. faecalis) in infected lateral canals. METHODS Sixty-five premolars infected with E. faecalis in lateral canals were randomly divided into five groups (n = 13) and treated with : (1) 5.25% NaOCl (positive control); (2) Saline (negative control); (3) Sonic-assisted MB-aPDT; (4) 3% NaOCl + MB-aPDT; (5) 3% NaOCl + sonic-assisted MB-aPDT, respectively. The antibacterial efficacy was evaluated by the colony- counting method (CCM) and scanning electronic microscope (SEM). RESULTS Both 5.25% NaOCl and the 3% NaOCl + sonic-assisted MB-aPDT exhibited the most effective while comparable antibacterial effects without significant statistical difference (P > 0.05). Furthermore, the antibacterial effect of the 3% NaOCl + MB-aPDT group was significantly higher compared to that of the sonic-assisted MB-aPDT group (P < 0.05). The SEM results demonstrated notable morphological alterations in E. faecalis across all experimental groups, except for the negative control group. CONCLUSION The concentration of NaOCl can be reduced to a safe level while preserving its antibacterial efficacy through the synergism with the sonic-assisted MB-aPDT in this study.
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Affiliation(s)
- Yanhuang Wang
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350002, PR China
| | - Lishan Lei
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350002, PR China
| | - Jing Huang
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350002, PR China
| | - Zhiyu Cai
- Department of Stomatology, Fujian Medical University Union Hospital, Fuzhou, 350002, PR China.
| | - Xiaojing Huang
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350002, PR China.
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Adarshan S, Sree VSS, Muthuramalingam P, Nambiar KS, Sevanan M, Satish L, Venkidasamy B, Jeelani PG, Shin H. Understanding Macroalgae: A Comprehensive Exploration of Nutraceutical, Pharmaceutical, and Omics Dimensions. PLANTS (BASEL, SWITZERLAND) 2023; 13:113. [PMID: 38202421 PMCID: PMC10780804 DOI: 10.3390/plants13010113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 12/17/2023] [Accepted: 12/28/2023] [Indexed: 01/12/2024]
Abstract
Driven by a surge in global interest in natural products, macroalgae or seaweed, has emerged as a prime source for nutraceuticals and pharmaceutical applications. Characterized by remarkable genetic diversity and a crucial role in marine ecosystems, these organisms offer not only substantial nutritional value in proteins, fibers, vitamins, and minerals, but also a diverse array of bioactive molecules with promising pharmaceutical properties. Furthermore, macroalgae produce approximately 80% of the oxygen in the atmosphere, highlighting their ecological significance. The unique combination of nutritional and bioactive attributes positions macroalgae as an ideal resource for food and medicine in various regions worldwide. This comprehensive review consolidates the latest advancements in the field, elucidating the potential applications of macroalgae in developing nutraceuticals and therapeutics. The review emphasizes the pivotal role of omics approaches in deepening our understanding of macroalgae's physiological and molecular characteristics. By highlighting the importance of omics, this review also advocates for continued exploration and utilization of these extraordinary marine organisms in diverse domains, including drug discovery, functional foods, and other industrial applications. The multifaceted potential of macroalgae warrants further research and development to unlock their full benefits and contribute to advancing global health and sustainable industries.
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Affiliation(s)
- Sivakumar Adarshan
- Department of Biotechnology, Alagappa University, Karaikudi 630003, Tamil Nadu, India;
| | - Vairavel Sivaranjani Sivani Sree
- Department of Biotechnology, Karunya Institute of Technology and Sciences, Coimbatore 641114, Tamil Nadu, India; (V.S.S.S.); (K.S.N.); (M.S.)
| | - Pandiyan Muthuramalingam
- Division of Horticultural Science, College of Agriculture and Life Sciences, Gyeongsang National University, Jinju 52725, Republic of Korea;
- Department of Oral and Maxillofacial Surgery, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha Dental College and Hospitals, Saveetha University, Chennai 600077, Tamil Nadu, India;
| | - Krishnanjana S Nambiar
- Department of Biotechnology, Karunya Institute of Technology and Sciences, Coimbatore 641114, Tamil Nadu, India; (V.S.S.S.); (K.S.N.); (M.S.)
| | - Murugan Sevanan
- Department of Biotechnology, Karunya Institute of Technology and Sciences, Coimbatore 641114, Tamil Nadu, India; (V.S.S.S.); (K.S.N.); (M.S.)
| | - Lakkakula Satish
- Applied Phycology and Biotechnology Division, Marine Algal Research Station, CSIR—Central Salt and Marine Chemicals Research Institute, Mandapam 623519, Tamil Nadu, India;
| | - Baskar Venkidasamy
- Department of Oral and Maxillofacial Surgery, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha Dental College and Hospitals, Saveetha University, Chennai 600077, Tamil Nadu, India;
| | - Peerzada Gh Jeelani
- Department of Biotechnology, Microbiology & Bioinformatics, National College Trichy, Tiruchirapalli 620001, Tamil Nadu, India;
| | - Hyunsuk Shin
- Division of Horticultural Science, College of Agriculture and Life Sciences, Gyeongsang National University, Jinju 52725, Republic of Korea;
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