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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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Sedani S, Kriplani S, Thakare A, Patel A. The Hidden World Within: Microbial Dynamics in Root Canal Systems. Cureus 2024; 16:e60577. [PMID: 38894761 PMCID: PMC11184535 DOI: 10.7759/cureus.60577] [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: 02/06/2024] [Accepted: 05/18/2024] [Indexed: 06/21/2024] Open
Abstract
Several hundred different microbial taxa have made the oral cavity their home because of their evolution in multiple species communities within the special ecosystem. On the other hand, the dental pulp or internal tissue of the tooth is a connective tissue that is physiologically sterile and where any microbial infiltration is a harmful indication. It causes the pulp tissue to become inflamed, which leads to the death of the pulp and diffuses infection with inflammation to the peri-radicular tissues. Comprehending the biology of biofilms, the microbial makeup, and the host's reaction to infections in the pathobiology of root canal infections has received a lot of attention throughout the last few decades. Such comprehensive knowledge is required to design preventive medicines as well as clinically effective treatment regimens. Surprisingly, clinical approaches have concentrated more on radiographically perfecting channel preparation than on debridement of these intricate root canal systems, despite the clear realization that root canal infections are biofilm mediated. Since the present comprehension of the microbial etiopathogenesis of apical periodontitis highlights the significance of focusing on procedures such as "canal cleaning" and chemo-mechanical disinfection, the exclusive purpose of endodontic therapy is mainly missed while discussing "canal shaping." We thoroughly examine the state of our knowledge of the composition and functional traits of the root canal microbiome in this review. We also go into the difficulties with root canal disinfection and the cutting-edge approaches that try to solve these difficulties. In conclusion, we present essential guidance for prospective research areas, underscoring their significance as crucial considerations in the field of frontiers in oral health.
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Affiliation(s)
- Shweta Sedani
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Simran Kriplani
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Akash Thakare
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Aditya Patel
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Wenzler JS, Falk W, Frankenberger R, Braun A. Temporary Root Canal Obturation with a Calcium Hydroxide-Based Dressing: A Randomized Controlled Clinical Trial. Antibiotics (Basel) 2023; 12:1663. [PMID: 38136697 PMCID: PMC10740497 DOI: 10.3390/antibiotics12121663] [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: 10/18/2023] [Revised: 11/22/2023] [Accepted: 11/23/2023] [Indexed: 12/24/2023] Open
Abstract
Successful bacterial inactivation or elimination is essential for successful outcomes in endodontics. This study investigated the efficacy of a calcium hydroxide paste (Ca(OH)2) as a temporary medical dressing for 1 week after chemomechanical root canal treatment (CMRCT). Microbiological samples from 26 patients were collected after endodontic emergency treatment as follows: (1) removal of the provisional filling material; (2) CMRCT; (3) irrigation with sodium hypochlorite I (3%); (4) medicinal insertion of Ca(OH)2; and (5) irrigation with sodium hypochlorite II (3%). A microbiological examination was carried out after the specimens had been taken from the root canals via saline and sterile paper points. CMRCT resulted in a significant reduction in total bacterial load (TBL) in the root canal (p < 0.05). Additional irrigation (3) resulted in a further significant reduction in TBL (p < 0.05). In contrast, Ca(OH)2 medication did not prevent the bacterial load from returning to the previous level immediately after CMRCT, but did not increase above that level either (p < 0.05). However, the increase in TBL was significant (p < 0.05) in comparison with the disinfection groups (I/II). Administration of Ca(OH)2 for 1 week shows that in combination with an additional disinfection procedure, an increase in TBL must be expected, but not above the level of conditions after CMRCT.
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Affiliation(s)
- Johannes-Simon Wenzler
- Department of Operative Dentistry, Periodontology and Preventive Dentistry, Rheinisch-Westfälische Technische Hochschule University Hospital, Pauwelsstrasse 30, 52074 Aachen, Germany;
- Department of Operative Dentistry, Endodontics and Pediatric Dentistry, Campus Marburg, University Medical Center Giessen and Marburg, Georg-Voigt-Strasse 3, 35039 Marburg, Germany
| | - Wolfgang Falk
- Center for Oro-Dental Microbiology, Hamburger Chausse 25, 24220 Flintbek, Germany
| | - Roland Frankenberger
- Department of Operative Dentistry, Endodontics and Pediatric Dentistry, Campus Marburg, University Medical Center Giessen and Marburg, Georg-Voigt-Strasse 3, 35039 Marburg, Germany
| | - Andreas Braun
- Department of Operative Dentistry, Periodontology and Preventive Dentistry, Rheinisch-Westfälische Technische Hochschule University Hospital, Pauwelsstrasse 30, 52074 Aachen, Germany;
- Department of Operative Dentistry, Endodontics and Pediatric Dentistry, Campus Marburg, University Medical Center Giessen and Marburg, Georg-Voigt-Strasse 3, 35039 Marburg, Germany
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Alhadainy HA, Abdel-Karim AH, Fouad AF. Prevalence of Fusobacterium Species in Endodontic Infections Detected With Molecular Methods: Systematic Review and Meta-Analysis. J Endod 2023; 49:1249-1261. [PMID: 37611654 DOI: 10.1016/j.joen.2023.08.009] [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: 04/25/2023] [Revised: 07/24/2023] [Accepted: 08/13/2023] [Indexed: 08/25/2023]
Abstract
INTRODUCTION Endodontic infections are polymicrobial; however, investigating the role of bacterial species is critical because they may influence pathogenesis, the development of symptoms, or the persistence of disease. This systematic review aimed to determine the prevalence of Fusobacterium species and its association with different types of endodontic infections. METHODS MEDLINE (Ovid), PubMed, Scopus, Web of Science, and Cochrane Library databases were used as electronic databases to retrieve relevant studies. The studies were evaluated for eligibility criteria, and the certainty in evidence and risk of bias were evaluated using critical appraisal tools for prevalence studies from the Joanna Briggs Institute. Forty studies were selected for meta-analysis and statistically analyzed for the relationship between the prevalence of Fusobacterium species and both the presence of symptoms and the type of infections (primary vs secondary/persistent) using meta-regression analysis. RESULTS The prevalence of Fusobacterium spp. in endodontic infections ranged from 3%-100% (mean = 42.51%) in the 40 included studies. Calculated confidence intervals indicated that the presence of Fusobacterium spp. was not statistically associated with the presence of symptoms or with the type of infections (the set of 2 predictors was not significant; P < .05). CONCLUSIONS The prevalence of Fusobacterium infection, which was identified with molecular methods, was not significant for overall regression using both predictors (ie, symptoms [symptomatic vs asymptomatic] and types of infections [primary vs secondary/persistent]).
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Affiliation(s)
- Hatem A Alhadainy
- Division of Comprehensive Oral Health, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | | | - Ashraf F Fouad
- Department of Endodontics, University of Alabama at Birmingham, Birmingham, Alabama.
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Moryl M, Palatyńska-Ulatowska A, Maszewska A, Grzejdziak I, Dias de Oliveira S, Pradebon MC, Steier L, Różalski A, Poli de Figueiredo JA. Benefits and Challenges of the Use of Two Novel vB_Efa29212_2e and vB_Efa29212_3e Bacteriophages in Biocontrol of the Root Canal Enterococcus faecalis Infections. J Clin Med 2022; 11:6494. [PMID: 36362722 PMCID: PMC9658868 DOI: 10.3390/jcm11216494] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 10/29/2022] [Accepted: 10/30/2022] [Indexed: 01/14/2024] Open
Abstract
UNLABELLED Bacteriophage therapy has emerged as a strategy supplementing traditional disinfection protocols to fight biofilms. The aim of the study was to isolate the phages against E. faecalis and to characterize its biological features, morphology, and lytic activity in a formed biofilm model. METHODS E. faecalis ATCC 29212 strain was used for the trial. Two novel vB_Efa29212_2e and vB_Efa29212_3e virulent phages were isolated from urban wastewater and characterized. The E. faecalis biofilm was established in 15 bovine teeth for 21 days. Transmission (TEM) and scanning electron (SEM) microscopes with the colony-forming unit (CFU) counting were used for assessment. RESULTS Isolated phages differed in morphology. Taxonomy for vB_Efa29212_2e (Siphoviridae, Efquatovirus) and for vB_Efa29212_3e (Herelleviridae, Kochikohdavirus) was confirmed. Both phages were stable at a temperature range of 4-50 °C and showed a different tolerance to chemicals: 15% EDTA, 1-3% sodium hypochlorite, and chlorhexidine. SEM analysis showed distortion of bacteria cells after phage inoculation, which proved the lytic activity against E. faecalis. A 54.6% reduction in the E. faecalis biofilm confirmed bacteriophage efficacy against isolates in the ex vivo model. CONCLUSIONS Results strongly support the concept that phage therapy has a real therapeutic potential for the prevention and treatment of E. faecalis-associated infections.
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Affiliation(s)
- Magdalena Moryl
- Department of Biology of Bacteria, Institute of Microbiology, Biotechnology and Immunology, Faculty of Biology and Environmental Protection, University of Lodz, 90-237 Lodz, Poland
| | | | - Agnieszka Maszewska
- Department of Biology of Bacteria, Institute of Microbiology, Biotechnology and Immunology, Faculty of Biology and Environmental Protection, University of Lodz, 90-237 Lodz, Poland
| | - Iwona Grzejdziak
- Department of Biology of Bacteria, Institute of Microbiology, Biotechnology and Immunology, Faculty of Biology and Environmental Protection, University of Lodz, 90-237 Lodz, Poland
| | - Silvia Dias de Oliveira
- Laboratory of Immunology and Microbiology, School of Health and Life Sciences, Pontifical Catholic University of Rio Grande do Sul–PUCRS, Porto Alegre 90619-900, Brazil
| | - Marieli Chitolina Pradebon
- Department of Morphological Sciences, Federal University of Rio Grande do Sul – UFRGS, Porto Allegre 90010-150, Brazil
| | - Liviu Steier
- Robert Schattner Center, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
- Federal University of Rio Grande do Sul—UFRGS, Porto Alegre 90035-003, Brazil
- Center for Transdisciplinary Research (CFTR), Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Chennai 602105, Tamil Nadu, India
| | - Antoni Różalski
- Department of Biology of Bacteria, Institute of Microbiology, Biotechnology and Immunology, Faculty of Biology and Environmental Protection, University of Lodz, 90-237 Lodz, Poland
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Nardello LCL, Pinheiro ET, Gavini G, Prado LC, Romero RX, Gomes BPFA, Skelton-Macedo MC. Nature and Prevalence of Bacterial Taxa Persisting after Root Canal Chemomechanical Preparation in Permanent Teeth: A Systematic Review and Meta-analysis. J Endod 2022; 48:572-596. [PMID: 35114271 DOI: 10.1016/j.joen.2022.01.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 01/15/2022] [Accepted: 01/21/2022] [Indexed: 01/05/2023]
Abstract
INTRODUCTION Culture-independent molecular studies have shown a broad spectrum of bacterial taxa that persist after chemomechanical procedures (CMP). Therefore, this study systematically reviewed these reports to explore the prevalence of bacteria in post-instrumentation samples of root canals from permanent teeth, especially of as-yet-uncultivated/difficult-to-culture bacteria. METHODS Electronic databases were searched from 2007 to January 2021. Clinical studies using culture-independent molecular methods to identify species-level taxa before and after CMP were included. Studies were critically appraised using the Joanna Briggs Institute Prevalence Critical Appraisal Checklist and the funnel plot analysis. The meta-analysis was performed on the prevalence of as-yet-uncultivated/difficult-to-culture bacterial taxa using RStudio. RESULTS A total of 3781 titles were screened, but only 20 studies were included. The most frequent species in post-instrumentation samples were Streptococcus spp., Leptotrichia buccalis, Fusobacterium nucleatum, and Capnocytophaga ochracea. The detection frequency of some species increased after CMP, including mainly Firmicutes members such as streptococci, Enterococcus faecium, Selenomonas noxia, and Solobacterium moorei. The prevalence (confidence interval) of difficult-to-culture species was as follows: Dialister invisus, 17% (7%-29%); Solobacterium moorei, 14% (8%-23%); Bacteroidaceae [G-1] bacterium HMT 272, 13% (5%-23%); and Filifactor alocis, 11% (3%-23%). CONCLUSIONS The prevalence of as-yet-uncultivated/difficult-to-culture bacterial taxa in post-instrumentation samples was low. The persistent species belonged mainly to the phylum Firmicutes, and streptococci were the major members. Future larger clinical studies on the composition of the whole bacterial community that persist after CMP are still necessary for a better understanding of bacterial interactions and their clinical significance in the treatment outcome.
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Affiliation(s)
- Laura C L Nardello
- Department of Dentistry, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
| | - Ericka T Pinheiro
- Department of Dentistry, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil.
| | - Giulio Gavini
- Department of Dentistry, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
| | - Laís C Prado
- Department of Dentistry, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
| | - Roberto X Romero
- Department of Dentistry, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
| | - Brenda P F A Gomes
- Department of Restorative Dentistry, Piracicaba Dental School, State University of Campinas, Piracicaba, SP, Brazil
| | - Mary C Skelton-Macedo
- Department of Dentistry, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
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Boutsioukis C, Arias-Moliz MT, Chávez de Paz LE. A critical analysis of research methods and experimental models to study irrigants and irrigation systems. Int Endod J 2022; 55 Suppl 2:295-329. [PMID: 35171506 PMCID: PMC9314845 DOI: 10.1111/iej.13710] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 02/07/2022] [Accepted: 02/08/2022] [Indexed: 11/28/2022]
Abstract
Irrigation plays an essential role in root canal treatment. The purpose of this narrative review was to critically appraise the experimental methods and models used to study irrigants and irrigation systems and to provide directions for future research. Studies on the antimicrobial effect of irrigants should use mature multispecies biofilms grown on dentine or inside root canals and should combine at least two complementary evaluation methods. Dissolution of pulp tissue remnants should be examined in the presence of dentine and, preferably, inside human root canals. Micro-omputed tomography is currently the method of choice for the assessment of accumulated dentine debris and their removal. A combination of experiments in transparent root canals and numerical modeling is needed to address irrigant penetration. Finally, models to evaluate irrigant extrusion through the apical foramen should simulate the periapical tissues and provide quantitative data on the amount of extruded irrigant. Mimicking the in vivo conditions as close as possible and standardization of the specimens and experimental protocols are universal requirements irrespective of the surrogate endpoint studied. Obsolete and unrealistic models must be abandoned in favour of more appropriate and valid ones that have more direct application and translation to clinical Endodontics.
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Affiliation(s)
- C Boutsioukis
- Department of Endodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - M T Arias-Moliz
- Department of Microbiology, Faculty of Dentistry, University of Granada, Granada, Spain
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Siqueira JF, Rôças IN. Present status and future directions - microbiology of endodontic infections. Int Endod J 2021; 55 Suppl 3:512-530. [PMID: 34958494 DOI: 10.1111/iej.13677] [Citation(s) in RCA: 85] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 12/22/2021] [Accepted: 12/26/2021] [Indexed: 11/29/2022]
Abstract
Apical periodontitis has a microbial aetiology and is one of the most common inflammatory diseases that affect humans. Fungi, archaea and viruses have been found in association with apical periodontitis, but bacteria are by far the most prevalent and dominant microorganisms in endodontic infections. Bacterial infection of the root canal system only occurs when the pulp is necrotic or was removed for previous treatment. In some specific cases, including acute and chronic abscesses, the bacterial infection may reach the periradicular tissues. Intracanal bacteria are usually observed as sessile multispecies communities (biofilms) attached to the dentinal root canal walls. Infection in the main root canal lumen can spread to other areas of the root canal system. Although more than 500 bacterial species have been detected in endodontic infections, a selected group of 20 to 30 species are most frequently detected and may be considered as the core microbiome. There is a high interindividual variability in the endodontic microbiome in terms of species composition and relative abundance. Obligate anaerobic species are more abundant in the intraradicular bacterial communities of teeth with primary apical periodontitis, while both anaerobes and facultatives dominate the communities in post-treatment apical periodontitis. Bacterial interactions play an essential role in determining the overall virulence of the community, which has been regarded as the unit of pathogenicity of apical periodontitis. This article reviews the microbiologic aspects of endodontic infections and provides perspectives for future research and directions in the field.
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Affiliation(s)
- José F Siqueira
- Department of Dental Research, Faculty of Dentistry, Iguaçu University (UNIG), Nova Iguaçu, RJ, and Department of Endodontics and Molecular Microbiology Laboratory, Faculty of Dentistry, Grande Rio University, Rio de Janeiro, RJ, Brazil
| | - Isabela N Rôças
- Department of Dental Research, Faculty of Dentistry, Iguaçu University (UNIG), Nova Iguaçu, RJ, and Department of Endodontics and Molecular Microbiology Laboratory, Faculty of Dentistry, Grande Rio University, Rio de Janeiro, RJ, Brazil
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Wenzler JS, Falk W, Frankenberger R, Braun A. Impact of Adjunctive Laser Irradiation on the Bacterial Load of Dental Root Canals: A Randomized Controlled Clinical Trial. Antibiotics (Basel) 2021; 10:antibiotics10121557. [PMID: 34943769 PMCID: PMC8698752 DOI: 10.3390/antibiotics10121557] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 12/16/2021] [Accepted: 12/17/2021] [Indexed: 11/25/2022] Open
Abstract
Successful root canal treatment depends on the adequate elimination of pathogenic bacteria. This study evaluated the effectiveness of a novel 445-nm semiconductor laser in reducing bacteria after chemomechanical root canal treatment. Microbiological specimens from 57 patients were collected after emergency endodontic treatment, in the following sequence: 1, removal of the temporary filling material; 2, chemomechanical treatment; 3, rinsing with sodium hypochlorite (3%) along with one of three adjuvant protocols (n = 19 in each group). The adjuvant procedures were: (a) sodium hypochlorite rinsing alone (3%); (b) laser irradiation; (c) combined sodium hypochlorite rinsing and laser irradiation. The diode laser was set to 0.59 W in continuous-wave mode (CW) for 4 × 10 s. After the flooding of the root canal with saline, specimens were collected using paper points and analyzed microbiologically. Statistically significant reductions in the bacterial load were observed in all three groups (p < 0.05): 80.5% with sodium hypochlorite rinsing alone and 58.2% with laser therapy. Both results were lower than with the combination of sodium hypochlorite rinsing and 445-nm laser irradiation, at 92.7% (p < 0.05). Additional disinfection of the root canal can thus be achieved with 445-nm laser irradiation after conventional chemical disinfection with sodium hypochlorite solution.
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Affiliation(s)
- Johannes-Simon Wenzler
- Department of Operative Dentistry, Periodontology and Preventive Dentistry, Rheinisch-Westfälische Technische Hochschule University Hospital, Pauwelsstrasse 30, 52074 Aachen, Germany;
- Department of Operative Dentistry, Endodontics and Pediatric Dentistry, Campus Marburg, University Medical Center Giessen and Marburg, Georg-Voigt-Str. 3, 35039 Marburg, Germany;
- Correspondence: ; Tel.: +49-(0)241-8037452
| | - Wolfgang Falk
- Center for Dental Microbiology, Bergstr. 26, 24103 Kiel, Germany;
| | - Roland Frankenberger
- Department of Operative Dentistry, Endodontics and Pediatric Dentistry, Campus Marburg, University Medical Center Giessen and Marburg, Georg-Voigt-Str. 3, 35039 Marburg, Germany;
| | - Andreas Braun
- Department of Operative Dentistry, Periodontology and Preventive Dentistry, Rheinisch-Westfälische Technische Hochschule University Hospital, Pauwelsstrasse 30, 52074 Aachen, Germany;
- Department of Operative Dentistry, Endodontics and Pediatric Dentistry, Campus Marburg, University Medical Center Giessen and Marburg, Georg-Voigt-Str. 3, 35039 Marburg, Germany;
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Arruda-Vasconcelos R, Barbosa-Ribeiro M, Louzada LM, Lemos BIN, de-Jesus-Soares A, Ferraz CCR, Almeida JFA, Marciano MA, Gomes BPFA. Efficacy of 6% Sodium Hypochlorite on Infectious Content of Teeth with Symptomatic Irreversible Pulpitis. J Endod 2021; 48:179-189. [PMID: 34921849 DOI: 10.1016/j.joen.2021.11.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 10/05/2021] [Accepted: 11/07/2021] [Indexed: 12/15/2022]
Abstract
INTRODUCTION The objective of this study was to monitor the effects of chemomechanical preparation (CMP) performed with 6% sodium hypochlorite and calcium hydroxide-based intracanal medication (ICM) on the levels and diversity of bacteria, endotoxins (LPS) and lipoteichoic acid (LTA) in root canals of teeth with symptomatic irreversible pulpitis. METHODS Samples were collected from ten teeth with symptomatic irreversible pulpitis before CMP (S1), after CMP (S2) and after ICM (S3). The levels of bacteria, LPS and LTA were assessed by using checkerboard DNA-DNA hybridisation, LAL Pyrogent 5000 and enzyme linked immunosorbent assay (ELISA), respectively. Wilcoxon's test, repeated measures ANOVA and Tukey's post-hoc test were used for statistical analysis at a significance level of 5%. RESULTS Forty species were detected at S1. Two species were eliminated after CMP and five after ICM. Resistant and pain-related species were detected in the root canals. Higher levels of culturable bacteria were detected at S1. However, CMP and ICM effectively reduced the microbial load in the root canals. Higher levels of LPS and LTA were detected at S1. CMP was effective in reducing both LPS and LTA (P < 0.05). ICM produced additional reduction in the levels of LPS (P > 0.05) and LTA (P < 0.05). CONCLUSION Chemomechanical preparation using 6% sodium hypochlorite and calcium hydroxide-based intracanal medication were effective in reducing the levels of bacteria, endotoxins and lipoteichoic acid in teeth with vital pulp and irreversibly inflamed pulp.
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Affiliation(s)
- Rodrigo Arruda-Vasconcelos
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas - UNICAMP, Piracicaba, SP, Brazil
| | - Marlos Barbosa-Ribeiro
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas - UNICAMP, Piracicaba, SP, Brazil; School of Dentistry, University of Pernambuco (UPE), Arcoverde, PE, Brazil
| | - Lidiane M Louzada
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas - UNICAMP, Piracicaba, SP, Brazil
| | - Beatriz I N Lemos
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas - UNICAMP, Piracicaba, SP, Brazil
| | - Adriana de-Jesus-Soares
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas - UNICAMP, Piracicaba, SP, Brazil
| | - Caio C R Ferraz
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas - UNICAMP, Piracicaba, SP, Brazil
| | - José F A Almeida
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas - UNICAMP, Piracicaba, SP, Brazil
| | - Marina A Marciano
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas - UNICAMP, Piracicaba, SP, Brazil
| | - Brenda P F A Gomes
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas - UNICAMP, Piracicaba, SP, Brazil.
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Weissman A, Wigler R, Blau-Venezia N, Goldberger T, Kfir A. Healing after surgical retreatment at four time points: A retrospective study. Int Endod J 2021; 55:145-151. [PMID: 34687565 DOI: 10.1111/iej.13653] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 10/21/2021] [Indexed: 12/19/2022]
Abstract
AIM To evaluate the outcome of surgical retreatment at four time points, that is 6, 12, 24 and 48 months post-operatively, and to search for prognostic factors that may affect the outcome. METHODOLOGY Clinical records and intraoral periapical radiographs were collected from patients who had undergone surgical retreatment between 2009 and 2015 and attended 6-, 12-, 24- and 48-month follow-up visits. Surgical retreatment was performed by one endodontist and involved minimal root-end resection and maximal length root-end preparation using prebent ultrasonic files. Outcomes were categorized as complete, incomplete, uncertain or unsatisfactory healing, based on clinical and radiographic findings. The complete and incomplete categories were pooled and considered successes, while uncertain and unsatisfactory outcomes were considered failures. Changes in healing outcome were analysed using the McNemar-Bowker test, and prognostic factors were analysed using univariate analysis. RESULTS The study cohort included 297 patients with 384 teeth. The overall success rate after 48 months was 90.6% compared with 88.5%, 93% and 92.4% after 6, 12 and 24 months respectively. Age, gender, presence of isthmus and length of canal preparation had no significant influence on the outcome. Lesion size and tooth type had a significant influence only after 6 and 12 months, respectively, with no significant differences at other time points. Fifty per cent of the teeth classified as unsatisfactory or uncertain healing at the 6 months follow-up improved to incomplete or complete healing after 12 months. None of the cases classified as unsatisfactory healing after 12 months subsequently improved, and only 2 cases that were classified as uncertain healing after 12 months improved after 24 months. CONCLUSIONS Surgical retreatment was found to be a predictable procedure with a high success rate of 90.6% after 4 years. Over the follow-up periods, only a minor regression in the success rate was found. The 12 months follow-up results closely indicated the long-term outcome of surgical retreatment.
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Affiliation(s)
- Amir Weissman
- Department of Endodontology, The Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ronald Wigler
- Department of Endodontology, The Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Nuphar Blau-Venezia
- Department of Endodontology, The Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tomer Goldberger
- Department of Endodontology, The Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Anda Kfir
- Department of Endodontology, The Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
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12
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Trusek A, Kijak E. Drug Carriers Based on Graphene Oxide and Hydrogel: Opportunities and Challenges in Infection Control Tested by Amoxicillin Release. MATERIALS 2021; 14:ma14123182. [PMID: 34207735 PMCID: PMC8228297 DOI: 10.3390/ma14123182] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 06/06/2021] [Accepted: 06/07/2021] [Indexed: 12/13/2022]
Abstract
Graphene oxide (GO) was proposed as an efficient carrier of antibiotics. The model drug, amoxicillin (AMOX), was attached to GO using a peptide linker (Leu-Leu-Gly). GO-AMOX was dispersed in a hydrogel to which the enzyme responsible for releasing AMOX from GO was also added. The drug molecules were released by enzymatic hydrolysis of the peptide bond in the linker. As the selected enzyme, bromelain, a plant enzyme, was used. The antibacterial nature of the carrier was determined by its ability to inhibit the growth of the Enterococcus faecalis strain, which is one of the bacterial species responsible for periodontal and root canal diseases. The prepared carrier contained only biocompatible substances, and the confirmation of its lack of cytotoxicity was verified based on the mouse fibrosarcoma cell line WEHI 164. The proposed type of preparation, as a universal carrier of many different antibiotic molecules, can be considered as a suitable solution in the treatment of inflammation in dentistry.
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Affiliation(s)
- Anna Trusek
- Group of Micro, Nano and Bioprocess Engineering, Department of Chemistry, Wroclaw University of Science and Technology, Wybrzeże Wyspiańskiego 27, 50-370 Wroclaw, Poland
- Correspondence: (A.T.); (E.K.)
| | - Edward Kijak
- Department of Dental Prosthetics, Wroclaw Medical University, Krakowska 26, 50-425 Wroclaw, Poland
- Correspondence: (A.T.); (E.K.)
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Quantitative Analysis of Candidate Endodontic Pathogens and Their Association with Cause and Symptoms of Apical Periodontitis in a Sudanese Population. Eur Endod J 2021; 6:50-55. [PMID: 33762533 PMCID: PMC8056810 DOI: 10.14744/eej.2020.52297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Objective: To investigate the prevalence of key endodontic pathogens and their association with the clinical features and the cause of apical periodontitis. Methods: The study population included patients referred to Khartoum Dental teaching Hospital, Sudan for endodontic treatment. Samples were collected from single-rooted teeth carious or traumatised teeth with clinical and radiographic evidence of apical periodontitis. The endodontic pathogens Porphyromonas endodontalis, Fusobacterium nucleatum and Treponema denticola were quantified by real time polymerase chain reaction (qPCR). The prevalence of each species was identified at both a low detection threshold (>50 bacteria) and a high detection threshold (>1000 bacteria). Results: 75 patients (mean age 30.1 yrs SD 10.1) were included in the analysis. The most prevalent bacterium at both the low and high threshold was F. nucleatum followed by T. denticola at the low threshold and P. endodontalis at the high threshold. There was no association with symptoms at the low detection threshold, but at high threshold P. endodontalis was associated with swelling, adjusted odds ratio (OR), 9.32 95%CI 1.11- 78.66, P=0.04. All species were more prevalent in apical periodontitis due to caries only at the low detection threshold, OR=5.01 (P=0.006) for T. denticola; 4.84 (P=0.01) for F. nucleatum; and 3.62 (P=0.03) for P. endodontalis. Conclusion: There was a high prevalence of the F. nucleatum, T. denticola and P. endodontalis in apical periodontitis associated with caries. None of these bacterial were associated with pain but the presence of P. endodontalis at high levels was associated with swelling.
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14
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Galicia JC, Guzzi PH, Giorgi FM, Khan AA. Predicting the response of the dental pulp to SARS-CoV2 infection: a transcriptome-wide effect cross-analysis. Genes Immun 2020; 21:360-363. [PMID: 33011745 PMCID: PMC7532735 DOI: 10.1038/s41435-020-00112-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 08/29/2020] [Accepted: 09/21/2020] [Indexed: 12/15/2022]
Abstract
Pulpitis, inflammation of the dental pulp, is a disease that often necessitates emergency dental care. While pulpitis is considered to be a microbial disease primarily caused by bacteria, viruses have also been implicated in its pathogenesis. Here, we determined the expression of the SARS-CoV2 receptor, angiotensin converting enzyme 2 (ACE2) and its associated cellular serine protease TPMRSS2 in the dental pulp under normal and inflamed conditions. Next, we explored the relationship between the SARS-CoV-2/human interactome and genes expressed in pulpitis. Using existing datasets we show that both ACE2 and TPMRSS2 are expressed in the dental pulp and, that their expression does not change under conditions of inflammation. Furthermore, Master Regulator Analysis of the SARS-CoV2/human interactome identified 75 relevant genes whose expression values are either up-regulated or down-regulated in both the human interactome and pulpitis. Our results suggest that the dental pulp is vulnerable to SARS-CoV2 infection and that SARS-CoV-2 infection of the dental pulp may contribute to worse outcomes of pulpitis.
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Affiliation(s)
- Johnah C Galicia
- Department of Endodontics, Arthur A. Dugoni School of Dentistry, University of the Pacific, San Francisco, CA, 94103, USA
| | - Pietro H Guzzi
- Department of Surgical and Medical Sciences, Magna Graecia University, Campus S. Venuta, Catanzaro, 88100, Italy
| | - Federico M Giorgi
- Department of Pharmacy and Biotechnology, University of Bologna, Bologna, 40126, Italy
| | - Asma A Khan
- Department of Endodontics, School of Dentistry, University of Texas Health and Sciences Center, San Antonio, TX, 78229, USA.
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15
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Lemos SS, Cesar DE, ProcÓpio SW, Machado FC, Ribeiro LC, Ribeiro RA. Qualitative and quantitative molecular analysis of bacteria in root canals of primary teeth with pulp necrosis. Braz Oral Res 2020; 34:e093. [PMID: 32785473 DOI: 10.1590/1807-3107bor-2020.vol34.0093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 05/18/2020] [Indexed: 11/21/2022] Open
Abstract
Information about bacterial diversity, such as the number of each species in the root canals of primary teeth, contributes to improving our effective management of infections of endodontic origin in primary teeth. This study made a qualitative and quantitative assessment of the bacteria in the root canals of primary teeth with necrotic pulp, using the fluorescence in situ hybridization (FISH) technique. Thirty-one primary teeth with pulp necrosis from 31 children were evaluated using the FISH technique, to detect the presence and density of Aggregatibacter actinomycetemcomitans, Campylobacter rectus, Enterococcus faecalis, Fusobacterium nucleatum, Porphyromonas gingivalis, Prevotella intermedia, Prevotella nigrescens, Streptococcus, Streptococcus mutans, Streptococcus sobrinus, Tannerella forsythia and Treponema denticola. Descriptive measures explained the data related to density, and Student's t-test assessed the differences among the densities of each bacterium, according to signs and symptoms. The bacterial density was paired and correlated. All bacteria tested were detected and identified in all the samples. The average number of bacterial individuals from each species ranged from 1.9 x 108 cells/mL (S. mutans) to 3.1 x 108 cells/mL (F. nucleatum) (p > 0.05). The sum of the mean counts of each bacterium represented almost 80% of the entire microbial community. Patients with pain had significantly more T. denticola, and those with edema showed a greater density of Streptococcus and P. nigrescens (p < 0.05). This study revealed that all 12 bacteria evaluated were found in all primary teeth with pulp necrosis. There was no predominance among the species studied; all species had a similar number of individuals.
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Affiliation(s)
- Samira Salomão Lemos
- Postgraduate Program in Dentistry, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil
| | - Dionéia Evangelista Cesar
- Department of Ecology and Molecular Biology of Microorganisms, Biological Sciences Institute, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil
| | - Stefânia Werneck ProcÓpio
- Postgraduate Program in Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Fernanda Campos Machado
- Department of Social and Child Dentistry, School of Dentistry, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil
| | - Luiz Claudio Ribeiro
- Department of Statistics, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil
| | - Rosangela Almeida Ribeiro
- Department of Social and Child Dentistry, School of Dentistry, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil
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Zargar N, Ashraf H, Marashi SMA, Sabeti M, Aziz A. Identification of microorganisms in irreversible pulpitis and primary endodontic infections with respect to clinical and radiographic findings. Clin Oral Investig 2020; 24:2099-2108. [PMID: 32377864 DOI: 10.1007/s00784-019-03075-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Accepted: 09/13/2019] [Indexed: 12/18/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate the composition of microbiota of irreversible pulpitis and primary endodontic infections with respect to clinical and radiographic findings by performing cultures and 16s rDNA sequencing in Iranian patients. MATERIAL AND METHODS In this prospective cross-sectional study, samples were collected from 41 root canals for 4 main groups of patients. Bacterial identification was performed by the polymerase chain reaction (PCR) and 16s rDNA sequencing of aerobic and anaerobic cultivable colonies taken from patients' culture plates. Additionally, the presence of 13 bacterial species and 3 nonbacterial species was also explored using PCR and species-specific primers. RESULTS Sixteen microbial species, 1 fungus (Candida albicans), and 1 virus (Herpes simplex virus) were discovered and isolated. Species with the highest prevalence were Dialister invisus (68.3%), Porphyromonas gingivalis (58.8%), Streptococcus salivarius (58.5%), and Treponema denticola (56.1%). Lysinibacillus fusiformis (19.1%) was detected in the root canals for the first time. Candida albicans was seen in 11 cases (26.8%). Herpes simplex virus (HSV) was seen in 4 patients (9.8%). CONCLUSIONS Our results suggest that Gram-negative anaerobic oral bacteria are the majority of the microbes in primary endodontic infections. Various combinations of bacterial species were related to different clinical and radiographic conditions. Lysinibacillus fusiformis was detected for the first time in primary endodontic infections. CLINICAL RELEVANCE The results of this investigation might help clinicians choose to identify suspected endodontic pathogens in the etiology of each form of pulpal and periradicular diseases to determine the best therapeutic measures.
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Affiliation(s)
- Nazanin Zargar
- Department of Endodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Daneshjoo Blv., Daneshgah Square, Chamran Highway, Tehran, 1983963113, Iran
| | - Hengameh Ashraf
- Department of Endodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Daneshjoo Blv., Daneshgah Square, Chamran Highway, Tehran, 1983963113, Iran
| | - S M Amin Marashi
- Medical Microbiology Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Mohammad Sabeti
- UCSF School of Dentistry, 707 Parnassus Ave. Room-D 3226, San Francisco, CA, 94143-0758, USA
| | - Alireza Aziz
- School of Dentistry, Shahid Beheshti University of Medical Sciences, Daneshjoo Blv., Evin Avenue, Chamran Highway, Tehran, 1983963113, Iran.
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Primary versus post-treatment apical periodontitis: microbial composition, lipopolysaccharides and lipoteichoic acid levels, signs and symptoms. Clin Oral Investig 2020; 24:3169-3179. [PMID: 31933111 DOI: 10.1007/s00784-019-03191-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 12/27/2019] [Indexed: 12/18/2022]
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18
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Weissman A, Goldberger T, Wigler R, Kfir A, Blau–Venezia N. Retrograde root canal retreatment with pre‐bent ultrasonic files. A retrospective outcome study. Int Endod J 2019; 52:1547-1555. [DOI: 10.1111/iej.13176] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 06/18/2019] [Indexed: 11/26/2022]
Affiliation(s)
- A. Weissman
- Department of Endodontology The Goldschleger School of Dental Medicine Tel Aviv University Tel Aviv Israel
| | - T. Goldberger
- Department of Endodontology The Goldschleger School of Dental Medicine Tel Aviv University Tel Aviv Israel
| | - R. Wigler
- Department of Endodontology The Goldschleger School of Dental Medicine Tel Aviv University Tel Aviv Israel
| | - A. Kfir
- Department of Endodontology The Goldschleger School of Dental Medicine Tel Aviv University Tel Aviv Israel
| | - N. Blau–Venezia
- Department of Endodontology The Goldschleger School of Dental Medicine Tel Aviv University Tel Aviv Israel
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Sabharwal S, Bhagat SK, Gami KS, Siddhartha A, Rai K, Ahluwalia Y. An In vivo Study to Compare Anti Microbial Activity of Triantibiotic Paste, 2% Chlorhexidine Gel, and Calcium Hydroxide on Microorganisms in the Root Canal of Immature Teeth. J Int Soc Prev Community Dent 2019; 9:263-268. [PMID: 31198699 PMCID: PMC6559045 DOI: 10.4103/jispcd.jispcd_400_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Accepted: 12/21/2018] [Indexed: 11/20/2022] Open
Abstract
Aims and Objectives: Intracanal medication plays an important role in disinfecting the root canal from various microorganisms. There are various intracanal medication frequently used by practitioners based on the efficacy of the same, therefore to compare antimicrobial activity of a triple antibiotic paste with chlorhexidine gel and calcium hydroxide against microorganisms in the root canal used as irrigating solution. Materials and Methods: The present study was conducted on 88 single rooted (central and lateral incisors), asymptomatic, nonvital, and necrotic teeth. Individuals included were between the ages of 12–15 years with no systemic complications. Overall, 88 teeth were divided randomly into four groups on the basis of treatment they were given, with each group having 22 teeth. Each group was assigned to one intervention group namely 2% chlorhexidine gel group, calcium hydroxide group, triantibiotic paste group, and the normal saline group. Triantibiotic paste was prepared from ciprofloxacin Hydrochloride 500 mg+ Metronidazole 400 mg+ Tetracycline 500 mg. Two samples were collected from individual tooth to assess the change in the extent of total colony forming units. Results: Mean log10 bacterial count among the triantibiotic paste was 5.222 preirrigation which was decreased to 0.653. Maximum percentage of log10 bacterial count was decreased among triantibiotic paste group of 87.20% while control group of normal saline has recorded a decrease of 54.65% in bacterial count. Among all the four groups, there was a decrease of 73.51% of bacterial count. Conclusion: From the above results, it was concluded that triantibiotic paste demonstrated the highest efficacy against bacterial pathogen when used as irrigating solution.
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Affiliation(s)
- Sumit Sabharwal
- Department of Conservative Dentistry and Endodontics, Seema Dental College and Hospital, Rishikesh, Uttarakhand, India
| | - Shresth Kumar Bhagat
- Department of Conservative and Endodontic Dentistry, Sarjug Dental College and Hospital, Darbhanga, Bihar, India
| | - Kumar Shresth Gami
- Department of Conservative Dentistry and Endodontics, Sarjug Dental College and Hospital, Darbhanga, Bihar, India
| | - Abhishek Siddhartha
- Department of Conservative Dentistry and Endodontics, Sarjug Dental College and Hospital, Darbhanga, Bihar, India
| | - Kulwant Rai
- Department of Conservative Dentistry and Endodontics, Seema Dental College and Hospital, Rishikesh, Uttarakhand, India
| | - Yuvika Ahluwalia
- Department of Conservative Dentistry and Endodontics, Institute of Dental Sciences and Technologies, Ghaziabad, Uttar Pradesh, India
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20
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Prevalence of Candida Species in Endodontic Infections: Systematic Review and Meta-analysis. J Endod 2018; 44:1616-1625.e9. [PMID: 30241680 DOI: 10.1016/j.joen.2018.07.016] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 07/16/2018] [Accepted: 07/19/2018] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Candida in endodontic infections has been investigated in a large number of studies, but its role as an endodontic pathogen is still debatable. The aim of this study was to systematically review the literature on the prevalence of Candida species in root canal infections. METHODS Extensive literature research was performed in the most important electronic biomedical databases, and additional studies have been identified from references from relevant articles. Studies were critically appraised using a modified version of the Joanna Briggs Institute Critical Appraisal Checklist. RESULTS From 2225 unique records, 2118 were excluded on the basis of title and abstract. Of the remaining 107 studies, 50 were excluded after full-text review, and 57 were included for qualitative and quantitative analysis. The overall prevalence of Candida spp. in root canal infections was 8.20% (95% confidence interval, 5.56%-11.21%). Candida albicans was the most frequently isolated species. Significant heterogeneity among studies was observed (P < .001, I2 = 86.07%). Subgroup analyses revealed a higher prevalence of Candida spp. from African samples. All studies considered, a high or unclear risk of bias was prevalent regarding 6 out of the 8 items considered in the critical appraisal. CONCLUSIONS Candida spp. occurred in a small proportion of root canal infections. Further and better designed research is needed to investigate the real contribution of Candida spp. to the microbial ecology in infected root canals.
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Cardelle-Cobas A, Reis PJM, Costa E, Tavaria FK, Pintado ME. Chitosan impregnated gutta-percha points: antimicrobial in vitro evaluation and mechanical properties. INT J POLYM MATER PO 2018. [DOI: 10.1080/00914037.2018.1466134] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Alejandra Cardelle-Cobas
- Universidade Católica Portuguesa, Centro de Biotecnologia e Química Fina – Laboratório Associado, Escola Superior de Biotecnologia, Porto, Portugal
| | - Patrícia J. M. Reis
- Universidade Católica Portuguesa, Centro de Biotecnologia e Química Fina – Laboratório Associado, Escola Superior de Biotecnologia, Porto, Portugal
| | - Eduardo Costa
- Universidade Católica Portuguesa, Centro de Biotecnologia e Química Fina – Laboratório Associado, Escola Superior de Biotecnologia, Porto, Portugal
| | - Freni K. Tavaria
- Universidade Católica Portuguesa, Centro de Biotecnologia e Química Fina – Laboratório Associado, Escola Superior de Biotecnologia, Porto, Portugal
| | - Manuela E. Pintado
- Universidade Católica Portuguesa, Centro de Biotecnologia e Química Fina – Laboratório Associado, Escola Superior de Biotecnologia, Porto, Portugal
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22
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Brzezińska-Błaszczyk E, Pawłowska E, Płoszaj T, Witas H, Godzik U, Agier J. Presence of archaea and selected bacteria in infected root canal systems. Can J Microbiol 2018; 64:317-326. [DOI: 10.1139/cjm-2017-0531] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Infections of the root canal have polymicrobial etiology. The main group of microflora in the infected pulp is bacteria. There is limited data that archaea may be present in infected pulp tissue. The aim of this study was to check the prevalence of archaea in necrotic root canal samples obtained from patients with primary or post-treatment infection. The prevalence of selected bacteria species (Prevotella intermedia, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, Synergistes sp.) in necrotic samples was evaluated as well. Sixty-four samples from root canal were collected for DNA and RNA extraction. A PCR assay based on the 16S rRNA gene was used to determine the presence of archaea and selected bacteria. Of the 64 samples, 6 were analyzed by semiquantitative reverse transcription PCR to estimate expression profiles of 16S rRNA, and another 9 were selected for direct sequencing. Archaea were detected in 48.4% samples. Statistical analysis indicated a negative association in coexistence between archaea and Treponema denticola (P < 0.05; Pearson’s χ2 test). The main representative of the Archaea domain found in infected pulp tissue was Methanobrevibacter oralis. Archaea 16S rRNA gene expression was significantly lower than Synergistes sp., Porphyromonas gingivalis, and Tannerella forsythia (P < 0.05; Student’s t test). Thus, it can be hypothesized that archaea may participate in the endodontic microbial community.
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Affiliation(s)
| | | | - Tomasz Płoszaj
- Department of Molecular Biology, Medical University of Lodz, Lodz, Poland
| | - Henryk Witas
- Department of Molecular Biology, Medical University of Lodz, Lodz, Poland
| | - Urszula Godzik
- Department of Experimental Immunology, Medical University of Lodz, Lodz, Poland
| | - Justyna Agier
- Department of Experimental Immunology, Medical University of Lodz, Lodz, Poland
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Dutta B, S Dhull K, Das D, Samir PV, K Verma R, Singh N. Evaluation of Antimicrobial Efficacy of various Intracanal Medicaments in Primary Teeth: An in vivo Study. Int J Clin Pediatr Dent 2017; 10:267-271. [PMID: 29104387 PMCID: PMC5661041 DOI: 10.5005/jp-journals-10005-1448] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Accepted: 02/28/2017] [Indexed: 11/23/2022] Open
Abstract
Introduction Bacteria and their products play a primary etiological role in the initiation and perpetuation of pulpoperiapical pathosis. Intracanal medication is important for endodontic success as it eliminates microorganisms that persist after chemomechanical preparation. Aim To compare antimicrobial efficacy of calcium hydroxide powder, triple antibiotic paste, calcium hydroxide with 2% chlorhexidine solution, and triple antibiotic paste with 2% chlorhexidine solution. Materials and methods A total of 48 nonvital primary teeth were included in this study. After access opening first microbiological sample (s1) was collected by using absorbent paper point introducing into canal. Second microbilogical sample (s2) was taken following chemomechanical preparation and the teeth were divided into four groups: Group I: calcium hydroxide (CH) powder with distilled water; group II: CH with 2% chlorhexidine solution; group III: triple antibiotic powder with distilled water; group IV: triple antibiotic paste with 2% chlorhexidine solution. Then the canals were filled with any one group of the medicament and cavity was temporarily sealed with zinc oxide eugenol. After 1 week, a postmedication sample (s3) was collected. Then the canal was filled with Metapex, restored with glass ionomer cement. Conclusion From the experiments carried out in this study, with the limitations, an inference can be drawn that a combination of antimicrobial agent used as intracanal medicament is definitely better than single agent like Ca(OH)2. How to cite this article Dutta B, Dhull KS, Das D, Samir PV, Verma RK, Singh N. Evaluation of Antimicrobial Efficacy of various Intracanal Medicaments in Primary Teeth: An in vivo Study. Int J Clin Pediatr Dent 2017;10(3):267-271.
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Affiliation(s)
- Brahmananda Dutta
- Professor and Head, Department of Pedodontiocs and Preventive Dentistry, Kalinga Institute of Dental Sciences, KIIT University, Bhubaneswar Odisha, India
| | - Kanika S Dhull
- Reader, Department of Pedodontiocs and Preventive Dentistry, Kalinga Institute of Dental Sciences, KIIT University, Bhubaneswar Odisha, India
| | - Debasmita Das
- Postgraduate Student, Department of Pedodontiocs and Preventive Dentistry, Kalinga Institute of Dental Sciences, KIIT University, Bhubaneswar Odisha, India
| | - P V Samir
- Senior Lecturer, Department of Pedodontiocs and Preventive Dentistry, Kalinga Institute of Dental Sciences, KIIT University, Bhubaneswar Odisha, India
| | - Rajnish K Verma
- Senior Lecturer, Department of Pedodontiocs and Preventive Dentistry, Kalinga Institute of Dental Sciences, KIIT University, Bhubaneswar Odisha, India
| | - Nipa Singh
- Senior Resident, Department of Microbiology, Kalinga Institute of Medical Sciences, KIIT University, Bhubaneswar Odisha, India
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Borzini L, Condò R, De Dominicis P, Casaglia A, Cerroni L. Root Canal Irrigation: Chemical Agents and Plant Extracts Against Enterococcus faecalis. Open Dent J 2016; 10:692-703. [PMID: 28217184 PMCID: PMC5299586 DOI: 10.2174/1874210601610010692] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Revised: 10/12/2016] [Accepted: 11/02/2016] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND There are various microorganisms related to intra and extra-radicular infections and many of these are involved in persistent infections. Bacterial elimination from the root canal is achieved by means of the mechanical action of instruments and irrigation as well as the antibacterial effects of the irrigating solutions. Enterococcus faecalis can frequently be isolated from root canals in cases of failed root canal treatments. Antimicrobial agents have often been developed and optimized for their activity against endodontic bacteria. An ideal root canal irrigant should be biocompatible, because of its close contact with the periodontal tissues during endodontic treatment. Sodium hypoclorite (NaOCl) is one of the most widely recommended and used endodontic irrigants but it is highly toxic to periapical tissues. OBJECTIVES To analyze the literature on the chemotherapeutic agent and plant extracts studied as root canal irrigants. In particularly, the study is focused on their effect on Enterococcus faecalis. METHOD Literature search was performed electronically in PubMed (PubMed Central, MEDLINE) for articles published in English from 1982 to April 2015. The searched keywords were "endodontic irrigants" and "Enterococcus faecalis" and "essential oil" and "plant extracts". RESULTS Many of the studied chemotherapeutic agents and plant extracts have shown promising results in vitro. CONCLUSION Some of the considered phytotherapic substances, could be a potential alternative to NaOCl for the biomechanical treatment of the endodontic space.
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Affiliation(s)
- Letizia Borzini
- Department of Clinical Science and Translational Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Roberta Condò
- Department of Clinical Science and Translational Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Paolo De Dominicis
- Department of Clinical Science and Translational Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Adriano Casaglia
- Department of Clinical Science and Translational Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Loredana Cerroni
- Department of Clinical Science and Translational Medicine, University of Rome "Tor Vergata", Rome, Italy
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Accuracy of commercial kits and published primer pairs for the detection of periodontopathogens. Clin Oral Investig 2016; 20:2515-2528. [PMID: 27020914 PMCID: PMC5119851 DOI: 10.1007/s00784-016-1748-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Accepted: 02/10/2016] [Indexed: 01/26/2023]
Abstract
OBJECTIVES Despite the input of microbiome research, a group of 20 bacteria continues to be the focus of periodontal diagnostics and therapy. The aim of this study was to compare three commercial kits and laboratory-developed primer pairs for effectiveness in detecting such periodontopathogens. MATERIALS AND METHODS Fourteen bacterial mock communities, consisting of 16 randomly assembled bacterial strains, were used as reference standard for testing kits and primers. Extracted DNA from mock communities was analyzed by PCR in-house with specific primers and forwarded for analysis to the manufacturer's laboratory of each of the following kits: ParoCheck®Kit 20, micro-IDent®plus11, and Carpegen® Perio Diagnostik. RESULTS The kits accurately detected Fusobacterium nucleatum, Prevotella intermedia/Prevotella nigrescens, Parvimonas micra, Aggregatibacter actinomycetemcomitans, Campylobacter rectus/showae, Streptococcus mitis, Streptococcus mutans, and Veillonella parvula. The in-house primers for F.nucleatum were highly specific to subtypes of the respective periopathogen. Other primers repeatedly detected oral pathogens not present in the mock communities, indicating reduced specificity. CONCLUSIONS The commercial kits used in this study are reliable tools to support periodontal diagnostics. Whereas the detection profile of the kits is fixed at a general specificity level, the design of primers can be adjusted to differentiate between highly specific strains. In-house primers are more error-prone. Bacterial mock communities can be established as a reference standard for any similar testing. CLINICAL RELEVANCE The tested kits render good results with selected bacterial species. Primers appear to be less useful for routine clinical diagnostics and of limited applicability in research. Basic information about the periodontopathogens identified in this study supports clinical decision-making.
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Pinheiro ET, Candeiro GT, Teixeira SR, Shin RC, Prado LC, Gavini G, Mayer MP. RNA-based Assay Demonstrated Enterococcus faecalis Metabolic Activity after Chemomechanical Procedures. J Endod 2015; 41:1441-4. [DOI: 10.1016/j.joen.2015.04.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Revised: 03/22/2015] [Accepted: 04/28/2015] [Indexed: 10/23/2022]
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Aguiar AS, Guerreiro-Tanomaru JM, Faria G, Leonardo RT, Tanomaru-Filho M. Antimicrobial Activity and pH of Calcium Hydroxide and Zinc Oxide Nanoparticles Intracanal Medication and Association with Chlorhexidine. J Contemp Dent Pract 2015; 16:624-629. [PMID: 26423497 DOI: 10.5005/jp-journals-10024-1732] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
AIM To evaluate pH and antibacterial activity of pastes with calcium hydroxide [Ca(OH)2] and zinc oxide (ZnO) microparticles (micro) or nanoparticles (nano) and association with 0.4% chlorhexidine against Enterococcus faecalis. MATERIALS AND METHODS The following pastes were analyzed: Ca(OH)2/ZnO micro, (2) Ca(OH)2/ZnO nano, (3) Ca(OH)2/ ZnO micro + 0.4% chlorhexidine, (4) Ca(OH)2/ZnO nano + 0.4% chlorhexidine. Antibacterial activity against E. faecalis was evaluated by agar diffusion test. The direct contact test on planktonic cells of E. faecalis was performed for 30 and 60 seconds. Root canals from bovine teeth were filled with the pastes and pH was evaluated after 1, 7, 14, 21, 30 and 60 days. The data obtained were submitted to the statistical tests analysis of variance (ANOVA) and Tukey or Kruskal-Wallis and Dunn test, with a 5% significance level. RESULTS Calcium hydroxide and zinc oxide nano, and the pastes with 0.4% chlorhexidine were more effective in agar diffusion test. In the direct contact test, the pastes with chlorhexidine showed the highest effect after 30 seconds. All pastes eliminated E. faecalis after 60 seconds. All pastes promoted an increase in pH. The highest increase in pH was observed with nanoparticle medications after 1 and 7 days (p < 0.05). After this period, the pastes presented similar pH increase. CONCLUSION It was concluded that calcium hydroxide and zinc oxide nanoparticles promoted greater initial alkalinization. The antimicrobial activity of the pastes against E. faecalis is favored by the association with chlorhexidine. CLINICAL SIGNIFICANCE Although nanoparticles of calcium hydroxide and zinc oxide promoted antibacterial effect, the activity against E. faecalis is favored by association with chlorhexidine.
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Affiliation(s)
- Alana Souza Aguiar
- Department of Restorative Dentistry, Araraquara Dental School, Sao Paulo, Brazil
| | | | - Gisele Faria
- Department of Restorative Dentistry, Araraquara Dental School, Sao Paulo, Brazil
| | | | - Mario Tanomaru-Filho
- Professor, Department of Restorative Dentistry, Araraquara Dental School, Sao Paulo, Brazil, Brazil, Phone: 551633016390, e-mail:
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Barros J, Dias A, Rodrigues MA, Pina-Vaz C, Lopes MA, Pina-Vaz I. Antibiofilm and Antimicrobial Activity of Polyethylenimine: An Interesting Compound for Endodontic Treatment. J Contemp Dent Pract 2015; 16:427-32. [PMID: 26323443 DOI: 10.5005/jp-journals-10024-1701] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIM Bacteria levels of necrotic teeth are greatly reduced after endodontic treatment procedures but the presence of persisting microorganisms leads to continuous efforts to develop materials with antimicrobial properties. The purpose of the study was to determine the antimicrobial activity of polyethylenimine (PEI) against common bacteria and yeasts, regarding planktonic cells and biofilm, and to clarify its antimicrobial mechanism of action through flow cytometry. MATERIALS AND METHODS The antibiofilm and antimicrobial effect of PEI was determined against Enterococcus faecalis, Staphylococcus aureus, Escherichia coli and Candida albicans strains using reference protocols. The effect of PEI was evaluated regarding adhesion, biofilm formation and biofilm disaggregation. In order to understand PEI cellular effects flow cytometric analysis was performed with different fluorescent markers. RESULTS It was verified that minimal inhibitory concentrations (MIC) values and minimal lethal concentrations (MLC) obtained for PEI were similar and ranged between 50 and 400 mg/l, proving the microbicidal and fungicidal activity of this compound. Antibiofilm activity was also proved for all the microorganisms. Severe lesion of the membrane and cell depolarization was demonstrated. CONCLUSION Polyethylenimine showed antimicrobial and antibiofilm activity against microorganisms often associated with apical periodontitis. CLINICAL SIGNIFICANCE Theoretically, prolonging the antibacterial effects of materials used in endodontics may be interesting to help prevent reinfection and possibly to affect residual bacteria that survived the treatment procedures.
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Affiliation(s)
- Joana Barros
- Professor, Department of Endodontics, Faculty of Dental Medicine University of Porto, Porto, Portugal, Phone: +351 220 901 100, e-mail:
| | - Ana Dias
- Department of Microbiology, Faculty of Medicine, University of Porto, Porto; Cardiovascular Research and Development Unit, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Miguel A Rodrigues
- Department of Metallurgical and Materials Engineering Faculty of Engineering, University of Porto, Porto; Centre for Mechanical Engineering of the University of Coimbra Portugal
| | - Cidália Pina-Vaz
- Department of Microbiology, Faculty of Medicine, University of Porto, Porto; Cardiovascular Research and Development Unit, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Maria A Lopes
- Department of Metallurgical and Materials Engineering Faculty of Engineering, University of Porto, Porto; Centre for Mechanical Engineering of the University of Coimbra Portugal
| | - Irene Pina-Vaz
- Department of Endodontics, Faculty of Dental Medicine University of Porto, Porto, Portugal
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Microbiological Profile Resistant to Different Intracanal Medications in Primary Endodontic Infections. J Endod 2015; 41:824-30. [DOI: 10.1016/j.joen.2015.01.031] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Revised: 01/26/2015] [Accepted: 01/29/2015] [Indexed: 11/17/2022]
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Prevalence of Treponema Species Detected in Endodontic Infections: Systematic Review and Meta-regression Analysis. J Endod 2015; 41:579-87. [DOI: 10.1016/j.joen.2015.01.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Revised: 11/25/2014] [Accepted: 01/17/2015] [Indexed: 11/20/2022]
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Qi Z, Cao H, Jiang H, Zhao J, Tang Z. Combinations of bacterial species associated with symptomatic endodontic infections in a Chinese population. Int Endod J 2015; 49:17-25. [PMID: 25565631 DOI: 10.1111/iej.12428] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Accepted: 01/03/2015] [Indexed: 11/27/2022]
Abstract
AIM To use microarrays to detect 11 selected bacteria in infected root canals, revealing bacterial combinations that are associated with clinical symptoms and signs of primary endodontic infections in a Chinese population. METHODOLOGY DNA was extracted from 90 samples collected from the root canals of teeth with primary endodontic infections in a Chinese population, and the 16S rRNA gene was amplified by polymerase chain reaction (PCR). The PCR products were hybridized to microarrays containing specific oligonucleotide probes targeting 11 species, and the arrays were screened with a confocal laser scanner. Pearson's chi-squared test and cluster analysis were performed to investigate the associations between the bacterial combinations and clinical symptoms and signs using SAS 8.02. RESULTS Seventy-seven samples (86%) yielded at least one of the 11 target species. Parvimonas micra (56%), Porphyromonas endodontalis (51%), Tannerella forsythia (48%), Prevotella intermedia (44%) and Porphyromonas gingivalis (37%) were the most prevalent taxa and were often concomitant. The following positive associations were found between the bacterial combinations and clinical features: P. endodontalis and T. forsythia with abscess; P. gingivalis and P. micra with sinus tract; P. gingivalis and P. endodontalis or P. micra and P. endodontalis with abscess and sinus tract; and the combination of P. endodontalis, P. micra, T. forsythia and P. gingivalis with sinus tract (P < 0.05). CONCLUSIONS Various combinations of P. micra, P. endodontalis, T. forsythia and P. gingivalis may contribute to abscesses or sinus tracts of endodontic origin with bacterial synergism in a Chinese population.
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Affiliation(s)
- Z Qi
- Department of Endodontics, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - H Cao
- Shanghai Institute of Microsystem and Information Technology, Chinese Academy of Sciences, State Key Lab of Transducer Technology, Shanghai, China
| | - H Jiang
- Shanghai Institute of Microsystem and Information Technology, Chinese Academy of Sciences, State Key Lab of Transducer Technology, Shanghai, China
| | - J Zhao
- Shanghai Institute of Microsystem and Information Technology, Chinese Academy of Sciences, State Key Lab of Transducer Technology, Shanghai, China
| | - Z Tang
- Department of Endodontics, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China
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Bacterial Biofilms and Endodontic Disease: Histobacteriological and Molecular Exploration. SPRINGER SERIES ON BIOFILMS 2015. [DOI: 10.1007/978-3-662-47415-0_5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Microbial Diversity in Persistent Root Canal Infections Investigated by Checkerboard DNA-DNA Hybridization. J Endod 2014; 40:899-906. [DOI: 10.1016/j.joen.2014.02.010] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2013] [Revised: 02/05/2014] [Accepted: 02/11/2014] [Indexed: 11/23/2022]
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Siqueira JF, Rôças IN. Present status and future directions in endodontic microbiology. ACTA ACUST UNITED AC 2014. [DOI: 10.1111/etp.12060] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Xu P, Gunsolley J. Application of metagenomics in understanding oral health and disease. Virulence 2014; 5:424-32. [PMID: 24642489 DOI: 10.4161/viru.28532] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Oral diseases including periodontal disease and caries are some of the most prevalent infectious diseases in humans. Different microbial species cohabitate and form a polymicrobial biofilm called dental plaque in the oral cavity. Metagenomics using next generation sequencing technologies has produced bacterial profiles and genomic profiles to study the relationships between microbial diversity, genetic variation, and oral diseases. Several oral metagenomic studies have examined the oral microbiome of periodontal disease and caries. Gene annotations in these studies support the association of specific genes or metabolic pathways with oral health and with specific diseases. The roles of pathogenic species and functions of specific genes in oral disease development have been recognized by metagenomic analysis. A model is proposed in which three levels of interactions occur in the oral microbiome that determines oral health or disease.
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Affiliation(s)
- Ping Xu
- VCU Philips Institute; Virginia Commonwealth University; Richmond, VA USA; Center for the Study of Biological Complexity; Virginia Commonwealth University; Richmond, VA USA; Department of Microbiology and Immunology; Virginia Commonwealth University; Richmond, VA USA
| | - John Gunsolley
- Periodontics Department; Virginia Commonwealth University; Richmond, VA USA
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Teles AM, Manso MC, Loureiro S, Silva R, Madeira IGC, Pina C, Cabeda JM. Effectiveness of two intracanal dressings in adult Portuguese patients: a qPCR and anaerobic culture assessment. Int Endod J 2013; 47:32-40. [PMID: 23647356 DOI: 10.1111/iej.12122] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Accepted: 04/03/2013] [Indexed: 12/20/2022]
Abstract
AIM To quantify bacterial equivalents before and after chemomechanical preparation using 3% sodium hypochlorite (NaOCl) and intracanal dressing with calcium hydroxide paste (Ca(OH)2 ) or 2% Chlorhexidine digluconate gel (CHX) in necrotic pulps associated or not with apical periodontitis and to further compare this quantification with counts of anaerobic microorganisms. METHODOLOGY Prospective clinical trial in 69 single-rooted adult teeth (strict inclusion criteria); CHX group: 34; Ca(OH)2 group: 35. Bacteria samples were taken at baseline (S1), after chemomechanical preparation (S2) and after 14 days of intracanal dressing (S3). Bacterial equivalents were assessed by broad-range real-time polymerase chain reaction (qPCR), and live viable bacteria measured with conventional anaerobic culture (CFU/mL). Descriptive/inferential analysis was performed with spss vs. 20.0 (α = 0.05) using the Kruskal-Wallis, Mann-Whitney and chi-squared tests and Spearman's correlation coefficients. RESULTS Both groups showed a significant decrease between S1 and S2 (Mann-Whitney U-test; P < 0.001) both in qPCR and in culture. In the Ca(OH)2 -group, no variation was observed between S2 and S3 by qPCR and culture. In contrast, the CHX group showed a significant increase from S2 to S3 by both techniques. The two groups were only significantly different in S3 (Mann-Whitney U-test; P ≤ 0.001), with a worse performance in the CHX group. Again, these results were congruent by both approaches. Data from both approaches correlate reasonably (rS < 0.5). CONCLUSIONS Infected root canals contained a high bacterial load, and the chemomechanical root canal preparation reduced bacterial equivalents by 99.1% and anaerobic counts by 98.5%. Intracanal dressings were not efficient at reducing bacterial load, but the 14-day intracanal dressing with Ca(OH)2 performed significantly better than CHX, particularly in cases with apical periodontitis.
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Affiliation(s)
- A M Teles
- Health Sciences Faculty, Fernando Pessoa University, Oporto, Portugal; Abel Salazar Institute for the Biomedical Sciences, Oporto University, Oporto, Portugal
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Fedorowicz Z, Nasser M, Sequeira-Byron P, de Souza RF, Carter B, Heft M. Irrigants for non-surgical root canal treatment in mature permanent teeth. Cochrane Database Syst Rev 2012:CD008948. [PMID: 22972129 DOI: 10.1002/14651858.cd008948.pub2] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND Root canal treatment is carried out on teeth in which irreversible pulpitis has led to necrosis of the dental pulp. As a treatment option it is an alternative to dental extraction. Mechanical preparation and irrigation with antiseptic or antibacterial solutions destroys bacteria and cleans the infected root canal. Irrigants should be effective in deactivating bacteria in the entire root canal space without causing any adverse tissue reactions. Sodium hypochlorite (NaOCl) and chlorhexidine are commonly used but there is uncertainty as to which solution, concentration or combination is the most effective. OBJECTIVES To assess the effects of irrigants used in the non-surgical root canal treatment of mature permanent teeth. SEARCH METHODS We searched the Cochrane Oral Health Group's Trials Register (to 5 July 2012), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2012, Issue 4), MEDLINE via Ovid (1950 to 5 July 2012), EMBASE via Ovid (1980 to 5 July 2012), LILACS via BIREME (1980 to 5 July 2012). There were no restrictions regarding language or date of publication. SELECTION CRITERIA Randomised controlled trials in single or multi-rooted permanent teeth with pulpal or periapical pathology or both, which require root canal treatment. Irrigants either against each other or against inactive irrigant or placebo. Combinations of irrigants were allowed and if used in conjunction with EDTA (ethylenediaminetetra-acetic acid) or similar chelating agents. DATA COLLECTION AND ANALYSIS Two review authors independently assessed risk of bias of included trials and extracted data. MAIN RESULTS We included 11 trials involving 851 participants with 879 teeth which had undergone root canal treatment and involved the use of irrigants. Two trials were assessed as being at low risk of bias, with six unclear and three high. Four trials compared sodium hypochlorite versus chlorhexidine, however, no primary outcomes and only one secondary outcome, bacterial growth cultures, was reported for two of these trials (20% and 50% of teeth in the control group had positive bacterial culture). The meta-analysis indicated no strong evidence of a difference in the existence of bacterial growth between the interventions (risk ratio 0.73; 95% confidence interval 0.34 to 1.56; P = 0.41). The seven remaining trials each compared different interventions and only two of these trials included useable data on the primary outcomes of swelling and pain. One trial compared sodium hypochlorite 5.25% alone versus sodium hypochlorite 5.25% combined with hydrogen peroxide 3%, and versus normal saline and reported pain at 3 to 14 days after the procedure. There was no evidence of a difference in pain between the three groups. The other trial compared sodium hypochlorite 5% versus sodium hypochlorite with 'proteolytic enzyme', and there was no evidence of a difference in swelling between the groups. Two further trials reported bacterial growth, and three trials failed to report any data which could be used in the review. None of the included trials reported any data on adverse effects nor radiological changes in periapical radiolucency. AUTHORS' CONCLUSIONS Although root canal irrigants such as sodium hypochlorite and chlorhexidine appear to be effective at reducing bacterial cultures when compared to saline, most of the studies included in this review failed to adequately report these clinically important and potentially patient-relevant outcomes. There is currently insufficient reliable evidence showing the superiority of any one individual irrigant. The strength and reliability of the supporting evidence was variable and clinicians should be aware that changes in bacterial counts or pain in the early postoperative period may not be accurate indicators of long-term success. Future trials should report both clinician-relevant and patient-preferred outcomes at clearly defined perioperative, as well as long-term, time points.
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Affiliation(s)
- Zbys Fedorowicz
- UKCC(Bahrain Branch),Head of ResearchCollege ofMedicine, AMA InternationalUniversity of Bahrain, Awali, Bahrain
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Characterization of microbiota of root canal-treated teeth with posttreatment disease. J Clin Microbiol 2012; 50:1721-4. [PMID: 22403423 DOI: 10.1128/jcm.00531-12] [Citation(s) in RCA: 92] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
This study evaluated the microbiota of root canals undergoing retreatment. The most prevalent taxa detected by checkerboard included Propionibacterium species, Fusobacterium nucleatum, streptococci, and Pseudoramibacter alactolyticus. Quantitative real-time PCR detected Enterococcus faecalis and streptococci in 38% and 41% of the cases, comprising 9.76% and 65.78% of the total bacterial counts, respectively. The findings call into question the status of E. faecalis as the main pathogen and suggest that other species can be candidate pathogens associated with persistent/secondary endodontic infections.
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Gondim JO, Avaca-Crusca JS, Valentini SR, Zanelli CF, Spolidorio DMP, Giro EMA. Effect of a calcium hydroxide/chlorhexidine paste as intracanal dressing in human primary teeth with necrotic pulp against Porphyromonas gingivalis and Enterococcus faecalis. Int J Paediatr Dent 2012; 22:116-24. [PMID: 21883559 DOI: 10.1111/j.1365-263x.2011.01174.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Intracanal medication is important for endodontic treatment success as it eliminates microorganisms that persist after biomechanical preparation. Aim. To evaluate the effect of two intracanal medications against Porphyromonas gingivalis and Enterococcus faecalis in the root canals of human primary teeth with necrotic pulp with and without furcal/periapical lesion, using quantitative real-time polymerase chain reaction (qRT-PCR). DESIGN Thirty-two teeth with necrotic pulp were used. Twelve teeth did not present lesion, and 20 teeth presented radiographically visible furca/periapical lesion. Microbiological samples were collected after coronal access and biomechanical preparation. The teeth were medicated with calcium hydroxide pastes prepared with either polyethylene glycol or chlorhexidine. After 30days, the medication was removed and a third collection was performed. Microbiological samples were processed using qRT-PCR. Data were analysed by Wilcoxon and Mann-Whitney tests (α=0.05). RESULTS There was no significant difference in the microbiota present in the primary teeth with and without furcal/periapical lesion. Biomechanical preparation was effective in reducing the number of microorganisms (P<0.05). The intracanal medications had similar antibacterial activity. CONCLUSION The association of chlorhexidine with calcium hydroxide did not increase the antibacterial activity of the intracanal medication in the treatment of primary teeth with necrotic pulp with and without furcal/periapical lesion.
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Affiliation(s)
- Juliana O Gondim
- Department of Orthodontics and Pediatric Dentistry, Araraquara Dental School, UNESP - Universidade Estadual Paulista, Araraquara, SP, Brazil.
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Ito Y, Sato T, Yamaki K, Mayanagi G, Hashimoto K, Shimauchi H, Takahashi N. Microflora profiling of infected root canal before and after treatment using culture-independent methods. J Microbiol 2012; 50:58-62. [PMID: 22367938 DOI: 10.1007/s12275-012-0459-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2010] [Accepted: 10/12/2011] [Indexed: 11/26/2022]
Abstract
This study aimed to profile the microflora in infected root canals before and after root canal treatment using culture-independent methods. Six infected root canals in single-rooted teeth with periapical lesions from five subjects were included. Quantification of total bacteria was performed by real-time PCR with primers targeting 16S rRNA genes. PCR products with universal 16S rRNA gene primers were cloned and partially sequenced, and bacterial identification at the species level was performed by comparative analysis with the GenBank database. The concentration of extracted DNA before treatment was higher than that after root canal treatment, although the difference was not statistically significant. Sequence analysis revealed that oral bacteria such as Fusobacterium, Streptococcus, Olsenella, and Pseudoramibacter detected in cases before root canal treatment disappeared after treatment. These results suggest that the root canal microflora are distinct before and after root canal treatment, and that treatment changes the microflora in both quantity and quality.
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Affiliation(s)
- Yasuhiro Ito
- Division of Periodontology and Endodontology, Tohoku University Graduate School of Dentistry, Sendai, 980-8575, Japan
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Didilescu AC, Rusu D, Anghel A, Nica L, Iliescu A, Greabu M, Bancescu G, Stratul SI. Investigation of six selected bacterial species in endo-periodontal lesions. Int Endod J 2011; 45:282-93. [DOI: 10.1111/j.1365-2591.2011.01974.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Baumotte K, Bombana AC, Cai S. Microbiologic endodontic status of young traumatized tooth. Dent Traumatol 2011; 27:438-41. [DOI: 10.1111/j.1600-9657.2010.00903.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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ZEHNDER MATTHIAS, PAQUÉ FRANK. Disinfection of the root canal system during root canal re-treatment. ACTA ACUST UNITED AC 2011. [DOI: 10.1111/j.1601-1546.2011.00254.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Tavares WLF, Neves de Brito LC, Teles RP, Massara MLA, Ribeiro Sobrinho AP, Haffajee AD, Socransky SS, Teles FR. Microbiota of deciduous endodontic infections analysed by MDA and Checkerboard DNA-DNA hybridization. Int Endod J 2011; 44:225-35. [PMID: 21083570 PMCID: PMC3177302 DOI: 10.1111/j.1365-2591.2010.01805.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
AIMS To evaluate the microbiota of endodontic infections in deciduous teeth by Checkerboard DNA-DNA hybridization after uniform amplification of DNA in samples by multiple displacement amplification (MDA). METHODOLOGY Forty samples from the root canal system of deciduous teeth exhibiting pulp necrosis with or without radiographically detectable periradicular/interradicular bone resorption were collected and 32 were analysed, with three individuals contributing two samples; these were MDA-amplified and analysed by Checkerboard DNA-DNA hybridization for levels of 83 bacterial taxa. Two outcome measures were used: the percentage of teeth colonized by each species and the mean proportion of each bacterial taxon present across all samples. RESULTS The mean amount of DNA in the samples prior to amplification was 5.2 (±4.7) ng and 6.1 (±2.3) μg after MDA. The mean number of species detected per sample was 19 (±4) (range: 3-66) to the nearest whole number. The most prevalent taxa were Prevotella intermedia (96.9%), Neisseria mucosa (65.6%), Prevotella nigrescens (56.2%) and Tannerella forsythia (56.2%). Aggregatibacter (Haemophilus) aphrophilus and Helicobacter pylori were not detected. P. intermedia (10%), Prevotella tannerae (7%) and Prevotella nigrescens (4.3%) presented the highest mean proportions of the target species averaged across the positive samples. CONCLUSION Root canals of infected deciduous teeth had a diverse bacterial population. Prevotella sp. were commonly found with P. intermedia, Prevotella tannerae and Prevotella nigrescens amongst the most prominent species detected.
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Affiliation(s)
- W L F Tavares
- Federal University of Minas Gerais School of Dentistry, Belo Horizonte, Minas Gerais, Brazil
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Siqueira JF, Rôças IN. Distinctive features of the microbiota associated with different forms of apical periodontitis. J Oral Microbiol 2009; 1. [PMID: 21523208 PMCID: PMC3077003 DOI: 10.3402/jom.v1i0.2009] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2009] [Revised: 07/08/2009] [Accepted: 07/09/2009] [Indexed: 12/17/2022] Open
Abstract
Microorganisms infecting the dental root canal system play an unequivocal role as causative agents of apical periodontitis. Although fungi, archaea, and viruses have been found in association with some forms of apical periodontitis, bacteria are the main microbial etiologic agents of this disease. Bacteria colonizing the root canal are usually organized in communities similar to biofilm structures. Culture and molecular biology technologies have demonstrated that the endodontic bacterial communities vary in species richness and abundance depending on the different types of infection and different forms of apical periodontitis. This review paper highlights the distinctive features of the endodontic microbiota associated with diverse clinical conditions.
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Affiliation(s)
- José F Siqueira
- Department of Endodontics and Molecular Microbiology Laboratory, School of Dentistry, Estácio de Sá University, Rio de Janeiro, RJ, Brazil
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Community as the unit of pathogenicity: An emerging concept as to the microbial pathogenesis of apical periodontitis. ACTA ACUST UNITED AC 2009; 107:870-8. [DOI: 10.1016/j.tripleo.2009.01.044] [Citation(s) in RCA: 102] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2008] [Revised: 01/21/2009] [Accepted: 01/25/2009] [Indexed: 11/19/2022]
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Ricucci D, Siqueira JF, Bate AL, Pitt Ford TR. Histologic Investigation of Root Canal–treated Teeth with Apical Periodontitis: A Retrospective Study from Twenty-four Patients. J Endod 2009; 35:493-502. [DOI: 10.1016/j.joen.2008.12.014] [Citation(s) in RCA: 170] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2008] [Revised: 12/23/2008] [Accepted: 12/28/2008] [Indexed: 10/20/2022]
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