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Sonisha S, Gaffoor FM, Gopakumar R, Girish CS, Mohan R, Anoop VN. Comparative Evaluation of Residual Antibacterial Substantivity of Chlorhexidine, MTAD and Chitosan Against Enterococcus Faecalis in Human Root Dentin - An In vitro Study. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2024; 16:S1400-S1403. [PMID: 38882860 PMCID: PMC11174313 DOI: 10.4103/jpbs.jpbs_693_23] [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: 08/18/2023] [Revised: 08/24/2023] [Accepted: 08/27/2023] [Indexed: 06/18/2024] Open
Abstract
Introduction Complex anatomy of the root canal system results in incomplete debridement with mechanical instrumentation, leaving some areas or root canal walls untouched. There comes the significance of endodontic irrigants with residual antibacterial substantivity which prolongs the post-antibiotic effect, thereby improving the success and predictability of endodontic treatment. Aim To comparatively evaluate the residual antibacterial substantivity of 2% chlorhexidine, Biopure MTAD and 2% chitosan against Enterococcus faecalis at intervals of 1, 14 and 28 days. Materials and Methods Seventy-five therapeutically extracted permanent single rooted mandibular premolars teeth were selected. Dentin blocks of 4 mm thickness were prepared and enlarged to 1.6 mm. The autoclaved blocks were inoculated with 24-hour colonies of pure cultures of E. faecalis for 14 days. After the contamination period, canals of each dentin block were irrigated with 5 ml of sterile saline and dried with sterile paper points. A total of 75 dentin blocks were randomly divided into five groups as follows: Group A (21 specimens): 2% chlorhexidine, Group B (21 specimens): Biopure MTAD, Group C (21 specimens): 2% chitosan, Group D (6 specimens): positive control (infected dentin tubes) and Group E (six specimens): negative control (sterile dentin tubes). Then, the lumens of dentin blocks were irrigated with the respective irrigants for 10 mins and were dried using sterile paper points. The specimens were then incubated at 37°C for 28 days to maintain humidity. At experimental intervals of 1, 14 and 28 days, dentin shavings were removed from the canals of respective groups by circumferential filing with sterile no. 35 Hedstrom files. The powdered dentin samples obtained with each dentin block were observed for colony forming units (CFUs) using a Digital Colony counter and were expressed as CFUs/mL. Result All the irrigants in the study showed a significant decrease in CFUs from day 1 to day 28 indicating that they have residual antibacterial substantivity against E. faecalis. Group B (Biopure MTAD) showed significantly least mean CFUs compared to Group A (2% CHX) and Group C (2% chitosan) against E. faecalis at B1(day 1), B2(day 14) and B3(day 28). Group A (2% CHX) showed significantly higher mean CFUs than Group C (2% chitosan) at A1(day 1). Group C (2% chitosan) showed significantly higher mean CFUs compared to Group A (2% CHX) at C2(day 14) and C3 (day 28). Conclusion MTAD showed statistically higher residual antibacterial substantivity against E. faecalis at experimental periods of 1, 14 and 28 days. The residual antibacterial effect of 2% chitosan was better compared to 2% CHX at day 1. The residual antimicrobial substantivity of 2% CHX was higher compared to 2% chitosan at intervals of 14 and 28 days.
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Affiliation(s)
- S Sonisha
- Department of Conservative Dentistry and Endodontics, Noorul Islam College of Dental Sciences, Thiruvananthapuram, Kerala, India
| | - Faisal Ma Gaffoor
- Department of Conservative Dentistry and Endodontics, Noorul Islam College of Dental Sciences, Thiruvananthapuram, Kerala, India
| | - Rethi Gopakumar
- Department of Conservative Dentistry and Endodontics, Noorul Islam College of Dental Sciences, Thiruvananthapuram, Kerala, India
| | - C Sabari Girish
- Department of Conservative Dentistry and Endodontics, Noorul Islam College of Dental Sciences, Thiruvananthapuram, Kerala, India
| | - Remya Mohan
- Department of Conservative Dentistry and Endodontics, Noorul Islam College of Dental Sciences, Thiruvananthapuram, Kerala, India
| | - V N Anoop
- Department of Conservative Dentistry and Endodontics, Noorul Islam College of Dental Sciences, Thiruvananthapuram, Kerala, India
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Rödig T, Westbomke V, Haupt F, Münster M, Baxter S. Effect of preparation size on the removal of accumulated hard-tissue debris from the mesial root canal system of mandibular molars using SWEEPS technology. Clin Oral Investig 2023; 27:2787-2796. [PMID: 36642725 PMCID: PMC10264281 DOI: 10.1007/s00784-023-04862-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 01/06/2023] [Indexed: 01/17/2023]
Abstract
OBJECTIVES This study assessed the influence of preparation size on the efficacy of shock wave-enhanced emission photoacoustic streaming (SWEEPS) and conventional irrigation (CI) on removal of accumulated hard tissue debris (AHTD) from isthmus-containing mandibular molars using micro-computed tomographic analysis. MATERIALS AND METHODS Sixty extracted mandibular molars with two mesial canals connected by an isthmus were selected. Canals were shaped with Mtwo instruments (VDW, Munich, Germany) up to sizes 25/.06, 40/.04 or 40/.06 (n = 20), and specimens were distributed into 2 final irrigation groups (n = 10): SWEEPS and CI. Roots were scanned at a resolution of 10.5 µm before and after preparation and final irrigation. Data sets were co-registered, and the percentage reduction of AHTD calculated for each specimen was statistically compared using analysis of variance with a of 5% significance level. RESULTS The preparation size did not significantly influence the percentage reduction of AHTD (p < 0.05), whereas the final irrigation technique had a significant effect on debris removal (p < 0.05). A significant reduction of AHTD was achieved after final irrigation in all groups (p < 0.05); however, SWEEPS was associated with a significantly greater percentage reduction of debris than CI (p < 0.05). None of the specimens presented a completely clean isthmus. CONCLUSIONS Removal of AHTD was not significantly affected by the preparation size. SWEEPS was associated with significantly less debris than CI. CLINICAL RELEVANCE SWEEPS performed significantly better than CI regarding the removal of AHTD from isthmus-containing mandibular molars irrespective of the preparation size.
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Affiliation(s)
- Tina Rödig
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany.
| | - Valerie Westbomke
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany
| | - Franziska Haupt
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany
| | - Marc Münster
- Endopur, Clinic for Endodontology, Frankfurt, Germany
| | - Steffi Baxter
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany
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Hoellwarth JS, Tetsworth K, Akhtar MA, Al Muderis M. Transcutaneous Osseointegration for Amputees: What Is It, How Did It Evolve, and What May Develop? CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2023. [DOI: 10.1007/s40141-023-00376-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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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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Kapralos V, Valen H, Koutroulis A, Camilleri J, Ørstavik D, Sunde PT. The dentine-sealer interface: modulation of antimicrobial effects by irrigation. Int Endod J 2022; 55:544-560. [PMID: 35080277 DOI: 10.1111/iej.13692] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 01/19/2022] [Accepted: 01/20/2022] [Indexed: 11/29/2022]
Abstract
AIM Assess whether sodium hypochlorite (NaOCl) or chlorhexidine (CHX) and two irrigation protocols may alter the antibacterial properties of dentine and three endodontic sealers using a novel ex vivo tooth model. METHODOLOGY Prior to antibacterial testing, the tooth model was validated by means of scanning electron microscopy (SEM) to evaluate the separation between dentine and sealer surfaces. Root blocks prepared from extracted human roots were pretreated with 17% EDTA + 0.9% saline and subsequently treated with 1% NaOCl (G1), 2% CHX (G2) or no irrigant (G3). Two irrigation protocols were further investigated, "1% NaOCl + 17% EDTA" (P1) and "1% NaOCl + 17% EDTA + 2% CHX" (P2). Following irrigation, the root blocks were either filled with AH Plus, BioRoot RCS and Pulp Canal Sealer (PCS), or left empty. All groups were incubated for 1, 7 and 28 days. Direct contact tests for planktonic E. faecalis and 48 hours E. faecalis biofilms were performed at the level of dentine and sealer surfaces. Statistical analysis was performed on the bacterial survival between irrigants (G1, G2 and G3) and between irrigation protocols (P1 and P2) (p<0.05). RESULTS The model was considered reproducible as SEM examination of dentine samples indicated consistent separation between dentine and sealer surfaces. Irrigation with CHX (G2) and irrigation protocol (P2) enhanced the antibacterial properties of dentine without sealer application as well as dentine in contact with all three sealers tested, especially against planktonic E. faecalis. G2 and P2 also improved the antibacterial effect of AH Plus surfaces for all three incubation times. No irrigation groups (G1, G2) or irrigation protocols (P1, P2) altered the antibacterial properties of BioRoot RCS surfaces against planktonic bacteria or biofilms. Only BioRoot RCS surfaces eliminated the planktonic E. faecalis in all irrigation groups (G1, G2, G3) and protocols (P1, P2) investigated while PCS surfaces eliminated E. faecalis in biofilms in all groups up to 7 days. CONCLUSIONS The tooth model was reproducible. CHX improved the antibacterial activity upon both sealer and dentine surfaces. Among sealers, BioRoot RCS was less affected by NaOCl and CHX, and exhibited high antibacterial properties regardless the irrigation applied.
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Affiliation(s)
- V Kapralos
- Section of Endodontics, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Box 1109 Blindern, 0317, Oslo, Norway
| | - H Valen
- Nordic Institute of Dental Materials (NIOM), Sognsveien 70 A, 0855, Oslo, Norway
| | - A Koutroulis
- Section of Endodontics, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Box 1109 Blindern, 0317, Oslo, Norway
| | - J Camilleri
- School of Dentistry, Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, United Kingdom
| | - D Ørstavik
- Section of Endodontics, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Box 1109 Blindern, 0317, Oslo, Norway
| | - P T Sunde
- Section of Endodontics, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Box 1109 Blindern, 0317, Oslo, Norway
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Comparing the Antifungal Effect of Sodium Hypochlorite Gel versus Different Types of Root Canal Medicaments at Different Time Intervals Using the Agar Diffusion Test: An In Vitro Study. Int J Dent 2021; 2021:6550054. [PMID: 34938336 PMCID: PMC8687846 DOI: 10.1155/2021/6550054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 11/24/2021] [Indexed: 11/23/2022] Open
Abstract
Aims The purpose of this study was to compare the antifungal activity of sodium hypochlorite gel to those of four intracanal medicaments at various time intervals. Materials and Methods The agar well diffusion technique was utilized to test the antifungal activity of the following medicaments against Candida albinans (C. albicans): sodium hypochlorite gel, chlorhexidine gel, calcium hydroxide paste, Ledermix, and Diapex Plus. The inhibition zone related to each medicine was measured in millimeter after 24, 48, and 72 hours of incubation at 37°C. The data were analyzed using one-way ANOVA and Games–Howell tests, at a significance level of P < 0.05. Results Except for Ledermix and Diapex Plus, which had no antifungal action, all of the medicaments showed varied inhibitory zones for C. albicans. At all periods, the NaOCl gel had the most significant inhibition zones, followed by the CHX gel and calcium hydroxide. At all time intervals, the NaOCl gel demonstrated comparable antifungal efficacy. When compared to a 24-hour time interval, the CHX gel showed an increased antifungal activity at the 48-hour and 72-hour intervals. Calcium hydroxide, on the other hand, showed a decrease in its antifungal activity at the 72-hour interval. Conclusion The antifungal activity of sodium hypochlorite gel was the highest among the investigated medicaments. Chlorhexidine gel's antifungal activity improved over time, whereas calcium hydroxide's antifungal activity declined. Diapex Plus and Ledermix did not have any antifungal properties.
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Akram Z, Daood U, Aati S, Ngo H, Fawzy AS. Formulation of pH-sensitive chlorhexidine-loaded/mesoporous silica nanoparticles modified experimental dentin adhesive. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2021; 122:111894. [DOI: 10.1016/j.msec.2021.111894] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 01/11/2021] [Accepted: 01/18/2021] [Indexed: 12/19/2022]
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Carvalho NK, Barbosa AFA, Coelho BDP, Gonçalves LDS, Sassone LM, Silva EJNL. Antibacterial, biological, and physicochemical properties of root canal sealers containing chlorhexidine-hexametaphosphate nanoparticles. Dent Mater 2021; 37:863-874. [PMID: 33648745 DOI: 10.1016/j.dental.2021.02.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 01/27/2021] [Accepted: 02/12/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the influence of the incorporation of chlorhexidine-hexametaphosphate nanoparticles (CHX-HMP NPs) on antibacterial, cytotoxic and physicochemical properties of AH Plus (AH), MTA Fillapex (MTA) and Pulp Canal Sealer (PCS). METHODS The NPs were synthesized and characterized by Scanning Electron Microscopy (SEM), Dynamic Light Scattering (DLS), zeta potential, Atomic Force Microscopy (AFM) and Energy-Dispersive X-ray Spectroscopy (EDS). The incorporation was made by weight, 2% and 5% of NPs. The antimicrobial activity, cytotoxicity, flow, radiopacity, setting time, solubility and pH were evaluated. The statistical analysis was performed by two-way analysis of variance test and Tukey post hoc test (P < 0.05). RESULTS SEM analysis showed the tendency for CHX-HMP NPs to cluster, the effective mean diameter measured by DLS: 169.39 nm and the zeta potential: -10.18 mV. The NPs were individually measured by AFM: 22.99-52.75 nm. EDS analysis identified the presence of C, N, O, Na, P, Cl. After incorporation: The Direct Contact Test showed an increase in the antimicrobial action of AH, PCS and MTA; the sealers showed a decrease in flow and at 24 h of immersion also an increase in solubility, but did not affect the radiopacity of the samples; AH setting time increased and MTA did not reach setting under any of the conditions tested. All samples showed a decrease in pH value as the immersion time progressed. SIGNIFICANCE The incorporation of NPs can improve the antimicrobial performance of endodontic sealers without impairing other biological and physicochemical properties.
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Affiliation(s)
- Nancy Kudsy Carvalho
- Department of Endodontics, School of Dentistry, State University of Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil
| | - Ana Flávia Almeida Barbosa
- Department of Endodontics, School of Dentistry, State University of Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil
| | - Bárbara de Paula Coelho
- Department of Endodontics, School of Dentistry, State University of Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil
| | | | - Luciana Moura Sassone
- Department of Endodontics, School of Dentistry, State University of Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil
| | - Emmanuel João Nogueira Leal Silva
- Department of Endodontics, School of Dentistry, State University of Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil; Department of Endodontics, School of Dentistry, Grande Rio University (UNIGRANRIO), Rio de Janeiro, RJ, Brazil.
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Thakkar R, Kini S, Kamath S, Guleria V, Ballal V, Acharya S. Evaluation of Sealing Ability of Biodentine to Root-End Cavities Irrigated either with Maleic Acid or Irritrol Using Glucose Filtration Model. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2021. [DOI: 10.1590/pboci.2021.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Antibacterial Activity of Sodium Hypochlorite Gel versus Different Types of Root Canal Medicaments Using Agar Diffusion Test: An In Vitro Comparative Study. Int J Dent 2020; 2020:6483026. [PMID: 33354215 PMCID: PMC7737462 DOI: 10.1155/2020/6483026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 08/28/2020] [Accepted: 10/29/2020] [Indexed: 11/24/2022] Open
Abstract
Aim This study aimed to evaluate the antibacterial effect of sodium hypochlorite gel and four types of intracanal medicaments. Materials and Methods The agar diffusion method was used to evaluate the antibacterial effect of five medicaments (sodium hypochlorite gel (NaOCl), chlorhexidine gel (CHX), calcium hydroxide paste (CH), Ledermix, and Diapex plus) against Enterococcus faecalis (E. faecalis), Staphylococcus aureus (S. aureus), and Escherichia coli (E. coli). The zone of inhibition around each medicament was measured in millimeters, after 48 hours of incubation at 37°C. The antibacterial effects of medicaments against each microbial strain and the sensitivity of microorganisms towards each medicament were compared using the one-way ANOVA and Games–Howell post hoc tests. The level of significance was set to p < 0.05. Results All medicaments showed variable inhibition zones for all bacterial strains except Diapex Plus which showed no antibacterial activity. NaOCl gel exhibited the most significant inhibition zones for all bacterial strains followed by CHX gel, Ledermix, and CH. However, the effect of CHX and CH paste against S. aureus was statistically similar, while the effect of CH against E. faecalis was significantly higher than the Ledermix. Conclusion Sodium hypochlorite gel displayed the highest antibacterial activity among tested medicaments and can be recommended as a potent intracanal medicament. Chlorhexidine gel showed a significantly higher antibacterial effect when compared with Ledermix and calcium hydroxide. Calcium hydroxide demonstrated stronger antibacterial activity against E. faecalis than Ledermix. Diapex Plus exhibited no antibacterial effect.
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Punathil S, Moyin S, Bhat SS, Hedge S, Pai A, James J. Comparison of Antibacterial Effect of Calcium Hydroxide Combined With Chlorhexidine and Povidone-Iodine Against Enterococcus faecalis in Dentinal Tubules of Human Incisors: An In Vitro Comparative Study. J Pharm Bioallied Sci 2020; 12:S448-S452. [PMID: 33149504 PMCID: PMC7595516 DOI: 10.4103/jpbs.jpbs_134_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 03/06/2020] [Indexed: 11/17/2022] Open
Abstract
Background and Objectives: It has been found that the microorganism behind the failure of root-filled teeth is Enterococcus faecalis, which shows resistance to most of the intra-canal medicaments. Therefore, the purpose of this study was to evaluate the antibacterial efficacy of three intra-canal medications—calcium hydroxide with saline, combinations of calcium hydroxide with 2% chlorhexidine (CHX), and calcium hydroxide with 5% povidone-iodine—against E. faecalis in dentinal tubules of human incisors. Materials and Methods: Forty permanent maxillary central incisors were made into standardized segments and infected with E. faecalis. They were treated with a paste made of calcium hydroxide and 2% CHX, calcium hydroxide and 5% povidone-iodine, and calcium hydroxide and saline for 1 week. Dentinal shavings collected from the canal were suspended in thioglycollate broth solution and spread on brain heart infusion agar. Colony-forming units (CFUs) were enumerated and the CFU per milligram of dentin was calculated. The pH of the medicaments used was measured with the help of pH meter. Results: The results showed that the paste made from calcium hydroxide and 2% CHX was significantly more effective than that made from calcium hydroxide and povidone-iodine, and calcium hydroxide and saline. The addition of CHX or povidone-iodine did not affect the alkalinity of calcium hydroxide. Conclusion: This study concludes that Ca(OH)2 + 2% CHX are effective against E. faecalis. Combinations of calcium hydroxide and 5% povidone-iodine showed better antibacterial effect than calcium hydroxide and saline. Ca(OH)2 + saline was ineffective against E. faecalis.
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Affiliation(s)
- Sameer Punathil
- Department of Pediatric and Preventive Dentistry, Sree Anjaneya Institute of Dental Sciences, Calicut, Kerala, India
| | - Shabna Moyin
- Department of Conservative Dentistry and Endodontics, Sree Anjaneya Institute of Dental Sciences, Calicut, Kerala, India
| | - Sham S Bhat
- Department of Pediatric and Preventive Dentistry, Yenepoya Dental College, Mangalore, Karnataka, India
| | - Sundeep Hedge
- Department of Pediatric and Preventive Dentistry, Yenepoya Dental College, Mangalore, Karnataka, India
| | - Archana Pai
- Department of Pediatric and Preventive Dentistry, Sree Anjaneya Institute of Dental Sciences, Calicut, Kerala, India
| | - Jeswin James
- Department of Pediatric and Preventive Dentistry, Sree Anjaneya Institute of Dental Sciences, Calicut, Kerala, India
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Sharaf NF, Alshareef WA. The Comparative Evaluation of the Post-Antimicrobial Effect of MTAD ® and 2% Chlorhexidine against Enterococcus faecalis of Permanent Teeth with Necrotic Pulp. Open Access Maced J Med Sci 2019; 7:3270-3275. [PMID: 31949529 PMCID: PMC6953941 DOI: 10.3889/oamjms.2019.570] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 09/09/2019] [Accepted: 09/10/2019] [Indexed: 12/02/2022] Open
Abstract
AIM: Enterococcus faecalis is one of the most resistant bacteria in necrotic teeth. That’s why the goal of this study was to determine the post-antibiotic effect of MTAD®& 2% Chlorhexidine® as root canal irrigating solution on clinical isolates of E. faecalis from infected root canals of permanent teeth, using the spectrophotometric technique. MATERIAL AND METHODS: The antibacterial efficacy of Chloramphenicol 30 mcg, Nitrofurantoin 300 mcg, Vancomycin 5 mcg, Amoxicillin/clavulanic acid 30 mcg and Ofloxacin 5 mcg against E. faecalis was compared using the Disc diffusion method. Patients were selected for this study with permanent necrotic teeth. The sterile paper point was inserted inside the infected root canal and left for 60 seconds; to obtain the microbiological sample. Postantibiotic effect of MTAD® and 2% Chlorohexidine® on E. faecalis was compared. The absorbance of bacterial growth was examined for both irrigating solutions during the first 10 hours with an hour interval, and then tested at 48, 72, 96 up to 240 hours. RESULTS: The results showed that during the first 10 hours, MTAD® showed immediate antibacterial effect and maintained its higher antibacterial activity than 2% chlorohexidine®. After 48, 72, 96 and 240 hours, both MTAD® and 2% chlorohexidine® showed the same prolonged action of post-antibiotic effect against E. faecalis with a non-significant difference. According to Antibiotic sensitivity, the results revealed MTAD® is the most effective antimicrobial drug, showing the highest zone of inhibition, followed by 2% Chlorhexidine and Nitrofurantoin 300 mcg which showed the same inhibitory activity CONCLUSION: From the current study, it can be concluded that MTAD® has a strong bactericidal effect against E. faecalis and showed the highest zone of inhibition.
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Affiliation(s)
- Nehal F Sharaf
- Researcher of Endodontics, National Research Centre, Egypt. Orcid number 0000-0001-6505-2854
| | - Walaa A Alshareef
- Lecturer of Microbiology and immunology, 6OU, Egypt. Orcid number 0000-0003-3487-9044
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Anna H, Barnabás P, Zsolt L, Romána Z. Tracking of the degradation process of chlorhexidine digluconate and ethylenediaminetetraacetic acid in the presence of hyper-pure chlorine dioxide in endodontic disinfection. J Pharm Biomed Anal 2019; 164:360-364. [DOI: 10.1016/j.jpba.2018.11.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 10/29/2018] [Accepted: 11/01/2018] [Indexed: 11/25/2022]
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Prada I, Micó-Muñoz P, Giner-Lluesma T, Micó-Martínez P, Muwaquet-Rodríguez S, Albero-Monteagudo A. Update of the therapeutic planning of irrigation and intracanal medication in root canal treatment. A literature review. J Clin Exp Dent 2019; 11:e185-e193. [PMID: 30805124 PMCID: PMC6383907 DOI: 10.4317/jced.55560] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 01/21/2019] [Indexed: 11/30/2022] Open
Abstract
Background The success of endodontic treatment derives from the complete elimination of microorganisms capable of causing an intraradicular or extraradicular infection. To achieve a more effective eradication of these microorganisms, endodontic instrumentation must always be implemented with abundant irrigation, which has to achieve chemical, mechanical and biological effects. The irrigators most used today are NaOCl, CHX and EDTA, released into the ducts through different techniques such as syringe, manual agitation, positive or negative apical pressure, sonic or ultrasonic activation, PIPS and PDT. The objective of this review is to update the different irrigating solutions and intracanal disinfection drugs, as well as to establish an irrigation protocol in the endodontic treatment. Material and Methods Systematic search of scientific articles in the databases PubMed, Medline and Google Scholar, with the following keywords Endodontic, Infection, Failure, Irrigation, Retreatment and Irrigation protocol. The exclusion criteria were “case report” articles and articles with a publication date prior to 2000. Results 48 articles that met the inclusion criteria were analyzed. Comparing the different articles it can be seen that the NaOCl is the “gold standard” in terms of immediate antimicrobial efficacy, followed by the CHX that has a long-term antibacterial effect. As an intra-conductive drug it is advisable to use the combination of Ca(OH)2 with CPMC. Conclusions The most adequate irrigation protocol consists of using 2.5% NaOCl activated with ultrasound followed by a final wash with 7% MA or 0.2% CTR combined with 2% CHX. Key words:Endodontic failure, endodontic infection, enterococcus faecalis, endodontic retreatment, irrigation, sodium hipoclorite, irrigation protocol.
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Affiliation(s)
- Ilaria Prada
- Licensed Dentist at Universidad Europea de Valencia, España
| | - Pedro Micó-Muñoz
- Endodontic and restorative dentistry Titular Professor, Universidad Europea de Valencia, España
| | - Teresa Giner-Lluesma
- Endodontic and restorative dentistry Associate Professor, Universidad Europea de Valencia, España
| | - Pablo Micó-Martínez
- Licensed Dentist at Universidad Europea de Valencia. Periodontology and Osteointegration Master at Universidad de Valencia, España
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15
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Gomes BPFDA, Herrera DR. Etiologic role of root canal infection in apical periodontitis and its relationship with clinical symptomatology. Braz Oral Res 2018; 32:e69. [PMID: 30365610 DOI: 10.1590/1807-3107bor-2018.vol32.0069] [Citation(s) in RCA: 78] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 06/12/2018] [Indexed: 12/16/2022] Open
Abstract
Evidence shows the polymicrobial etiology of endodontic infections, in which bacteria and their products are the main agents for the development, progression, and dissemination of apical periodontitis. Microbial factors in necrotic root canals (e.g., endotoxin) may spread into apical tissue, evoking and supporting a chronic inflammatory load. Thus, apical periodontitis is the result of the complex interplay between microbial factors and host defense against invasion of periradicular tissues. This review of the literature aims to discuss the complex network between endodontic infectious content and host immune response in apical periodontitis. A better understanding of the relationship of microbial factors with clinical symptomatology is important to establish appropriate therapeutic procedures for a more predictable outcome of endodontic treatment.
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Affiliation(s)
| | - Daniel Rodrigo Herrera
- Universidade Estadual de Campinas -Unicamp, Piracicaba Dental School, Department of Restorative Dentistry, Piracicaba, SP, Brazil
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16
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Yan H, Wang S, Han L, Peng W, Yi L, Guo R, Liu S, Yang H, Huang C. Chlorhexidine-encapsulated mesoporous silica-modified dentin adhesive. J Dent 2018; 78:83-90. [PMID: 30153498 DOI: 10.1016/j.jdent.2018.08.012] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 08/10/2018] [Accepted: 08/23/2018] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVES This work aims to explore the feasibility of chlorhexidine-encapsulated mesoporous silica (CHX@pMSN) as a modifier of a commercial dental adhesive via the evaluation of physicochemical properties and antibacterial capabilities of adhesive-dentin interface. METHODS Therapeutic adhesives were developed in the present study by incorporating CHX@pMSN into a commercial adhesive at four mass fractions (0, 1, 5 and 10 wt.%). The antibacterial capability on Streptococcus mutans (S. mutans) biofilm, conversion degree, adhesive morphology, microtensile bond strength (MTBS) and nanoleakage expression were evaluated comprehensively. RESULTS MTT and CLSM evaluation showed that CHX@pMSN-doped adhesive inhibits S. mutans biofilm growth, while CHX is released from the modified adhesive continuously. The incorporation of CHX@pMSN did not affect immediate bond strength at the concentration of 1% and 5% (P > 0.05). Moreover, these bonds were mainly preserved in 5% CHX@pMSN group after one month of collagenase ageing. Meanwhile, CHX@pMSN-doped adhesive groups exhibited similar nanoleakage distribution compared with the control. CONCLUSION This study showed that the 5% CHX@pMSN-modified adhesive achieved balance amongst unaffected immediate bonding strength, well-preserved bonds against collagenase ageing and effective inhibition of S. mutans biofilm growth. CLINICAL SIGNIFICANCE CHX@pMSN-modified dentin adhesive can potentially extend the service life of adhesive restoration in clinic.
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Affiliation(s)
- Huiyi Yan
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory for Oral Biomedical Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Shilei Wang
- Key Laboratory of Analytical Chemistry for Biology and Medicine (Ministry of Education), College of Chemistry and Molecular Sciences, Wuhan University, Wuhan, China
| | - Lin Han
- CR&WISCO General Hospital, Wuhan, China
| | - Wenan Peng
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory for Oral Biomedical Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Luyao Yi
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory for Oral Biomedical Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Rui Guo
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory for Oral Biomedical Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Siying Liu
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory for Oral Biomedical Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Hongye Yang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory for Oral Biomedical Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, China.
| | - Cui Huang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory for Oral Biomedical Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, China.
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17
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Neelakantan P, Herrera DR, Pecorari VGA, Gomes BPFA. Endotoxin levels after chemomechanical preparation of root canals with sodium hypochlorite or chlorhexidine: a systematic review of clinical trials and meta-analysis. Int Endod J 2018; 52:19-27. [DOI: 10.1111/iej.12963] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 06/06/2018] [Indexed: 11/28/2022]
Affiliation(s)
- P. Neelakantan
- Faculty of Dentistry; The University of Hong Kong; Hong Kong
| | - D. R. Herrera
- Department of Restorative Dentistry; Endodontics Division; Piracicaba Dental School; State University of Campinas-UNICAMP; Piracicaba SP Brazil
| | - V. G. A. Pecorari
- Dental Research Division; School of Dentistry; Paulista University; São Paulo SP Brazil
| | - B. P. F. A. Gomes
- Department of Restorative Dentistry; Endodontics Division; Piracicaba Dental School; State University of Campinas-UNICAMP; Piracicaba SP Brazil
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18
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Bighetti Trevisan RL, Scatolin RS, Castro Raucci LMSD, Raucci Neto W, Froner IC. Effects of EDTA gel and chlorhexidine gel on root dentin permeability. Microsc Res Tech 2017; 81:191-197. [PMID: 29083081 DOI: 10.1002/jemt.22963] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 09/30/2017] [Accepted: 10/17/2017] [Indexed: 12/13/2022]
Abstract
The aim of this study was to evaluate the effect of 24% ethylenediaminetetraacetic acid (EDTA) gel and 2% chlorhexidine gel (CHX) in dentin permeability and smear layer removal from root canals instrumented with NiTi rotary system using histochemical staining and scanning electron microscopy (SEM) analysis. Overall, 43 premolars were classified into two experimental groups, EDTA (n = 20) and CHX (n = 20), and a negative control (NC) (n = 3). All specimens were instrumented and the irrigant solutions were used after each file change. The EDTA group received a final rinse with 5-ml 1% NaOCl followed by a 5-ml 0.9% saline solution; the CHX group received a final rinse with 10-ml 0.9% saline solution; and the negative control group received a final rinse with only 0.9% saline solution. Fifteen teeth from each group were prepared for histochemical staining and evaluation of dentin permeability using the image-scanning software Axion Vision (v.4.8.2). Five remaining teeth were prepared for analysis using SEM for morphological analysis. The study found that 24% EDTA gel increased the permeability of dentin in all thirds evaluated and also demonstrated an increased cleaning ability, with dentinal walls free of smear layer and open dentinal tubules, as compared to 2% CHX gel. It was concluded that EDTA was efficient in cleaning the dentinal tubules and increased dentin permeability.
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Affiliation(s)
- Rayana Longo Bighetti Trevisan
- School of Dentistry of Ribeirão Preto, Department of Restorative Dentistry, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Renata Siqueira Scatolin
- School of Dentistry of Ribeirão Preto, Department of Restorative Dentistry, University of São Paulo, Ribeirão Preto, SP, Brazil
| | | | - Walter Raucci Neto
- School of Dentistry, Department of Dentistry, University of Ribeirão Preto, Ribeirão Preto, São Paulo, Brazil
| | - Izabel Cristina Froner
- School of Dentistry of Ribeirão Preto, Department of Restorative Dentistry, University of São Paulo, Ribeirão Preto, SP, Brazil
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19
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Cha HS, Shin DH. Antibacterial capacity of cavity disinfectants against Streptococcus mutans and their effects on shear bond strength of a self-etch adhesive. Dent Mater J 2017; 35:147-52. [PMID: 26830836 DOI: 10.4012/dmj.2015-175] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
We evaluated the antibacterial properties of three disinfectants [2% chlorhexidine (CHX), 6% sodium hypochlorite (NaOCl), and 0.01% urushiol)] against Streptococcus mutans and their effects on bond strength of Scotchbond(TM) Universal. The reduction in bacterial growth was evaluated by the colony counting method. Total 105 specimens were assigned to seven groups, according to surface pretreatment: control group (C) without pretreatment; chlorhexidine gluconate with rinse (CR) or without rinse (CD); NaOCl with rinse (NR) or without rinse (ND); and urushiol with rinse (UR) or without rinse (UD). The shear bond test was performed at a cross-head speed of 0.5 mm/min. None of the disinfected specimens had viable microbes after a 30 min incubation. The control group exhibited the strongest bond; however, no significant difference was detected with the disinfectant-treated groups, except weak bonding with ND group. These findings suggest that all disinfectants tested had strong antibacterial capacity and may better be rinsed away.
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Affiliation(s)
- Han-Sol Cha
- Department of Conservative Dentistry, Graduate School, DanKook University
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20
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Alyas SM, Fischer BI, Ehrlich Y, Spolnik K, Gregory RL, Yassen GH. Direct and indirect antibacterial effects of various concentrations of triple antibiotic pastes loaded in a methylcellulose system. J Oral Sci 2016; 58:575-582. [PMID: 28025443 DOI: 10.2334/josnusd.16-0384] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
We investigated the direct and indirect (residual) antibacterial effects of various concentrations of triple antibiotic paste (TAP) loaded into a methylcellulose system. Enterococcus faecalis (E. faecalis) was grown on sterilized dentin blocks (n = 60) and treated with clinically used TAP (1,000 mg/mL), low concentrations of methylcellulose-based TAP (100, 10, and 1 mg/mL), placebo paste, or 1.5% NaOCl (n = 10). The pastes were then removed, and biofilm disruption assays were performed. Additional dentin blocks (n = 120) were pretreated with the same experimental groups (n = 20). The pastes were rinsed off, and the samples were immersed independently in phosphate-buffered saline for 2 and 4 weeks (n = 10). E.faecalis was then grown on the dentin blocks, and biofilm disruption assays were performed. Fisher's Exact and Wilcoxon rank sum tests were used for statistical analyses. With regard to direct antibacterial effects, all treatment groups demonstrated complete eradication of biofilms in comparison to placebo paste, while 10 mg/mL of TAP or higher provided substantial residual antibacterial effects. However, dentin treated with 1 mg/mL of TAP or 1.5% NaOCl did not provide substantial residual antibacterial effects. Dentin pretreated with 10 mg/mL of TAP or higher exhibited extended residual antibacterial effects and can thus be used during endodontic regeneration.(J Oral Sci 58, 575-582, 2016).
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Affiliation(s)
- Sarmad M Alyas
- Department of Endodontics, Indiana University School of Dentistry
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21
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Fan W, Li Y, Sun Q, Ma T, Fan B. Calcium-silicate mesoporous nanoparticles loaded with chlorhexidine for both anti- Enterococcus faecalis and mineralization properties. J Nanobiotechnology 2016; 14:72. [PMID: 27769275 PMCID: PMC5073856 DOI: 10.1186/s12951-016-0224-7] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2016] [Accepted: 10/12/2016] [Indexed: 11/21/2022] Open
Abstract
Background In infected periapical tissues, Enterococcus faecalis is one of the most common dominant bacteria. Chlorhexidine has been proved to show strong antibacterial ability against E. faecalis but is ineffective in promoting mineralization for tissues around root apex. Mesoporous calcium-silicate nanoparticles are newly synthesized biomaterials with excellent ability to promote mineralization and carry-release bioactive molecules in a controlled manner. In this study, mesoporous calcium-silicate nanoparticles were functionalized with chlorhexidine and their releasing profile, antibacterial ability, effect on cell proliferation and in vitro mineralization property were evaluated. Results The chlorhexidine was successfully incorporated into mesoporous calcium-silicate nanoparticles by a mixing-coupling method. The new material could release chlorhexidine as well as Ca2+ and SiO32− in a sustained manner with an alkaline pH value under different conditions. The antimicrobial ability against planktonic E. faecalis was dramatically improved after chlorhexidine incorporation. The nanoparticles with chlorhexidine showed no negative effect on cell proliferation with low concentrations. On dentin slices, the new synthesized material demonstrated a similar inhibitory effect on E. faecalis as the chlorhexidine. After being immersed in SBF for 9 days, numerous apatite crystals could be observed on surfaces of the material tablets. Conclusions Mesoporous calcium-silicate nanoparticles loaded with chlorhexidine exhibited release of ions and chlorhexidine, low cytotoxicity, excellent antibacterial ability and in vitro mineralization. This material could be developed into a new effective intra-canal medication in dentistry or a new bone defect filling material for infected bone defects.
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Affiliation(s)
- Wei Fan
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, 237 Luoyu Road, Wuhan, 430079, People's Republic of China
| | - Yanyun Li
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, 237 Luoyu Road, Wuhan, 430079, People's Republic of China
| | - Qing Sun
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, 237 Luoyu Road, Wuhan, 430079, People's Republic of China
| | - Tengjiao Ma
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, 237 Luoyu Road, Wuhan, 430079, People's Republic of China
| | - Bing Fan
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, 237 Luoyu Road, Wuhan, 430079, People's Republic of China.
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22
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Mohammadi Z, Jafarzadeh H, Shalavi S. Antimicrobial efficacy of chlorhexidine as a root canal irrigant: a literature review. J Oral Sci 2016; 56:99-103. [PMID: 24930745 DOI: 10.2334/josnusd.56.99] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Use of an appropriate root canal irrigant is essential during endodontic treatment, due to the complex and unpredictable anatomy of the root canal system and limitations in the mechanical instrumentation techniques used to obtain a clean, bacteria-free canal. Several irrigants, such as sodium hypochlorite, chlorhexidine, hydrogen peroxide, and normal saline, have been proposed as canal system irrigants in endodontic treatment. The widely used endodontic irrigant chlorhexidine is a positively charged lipophilic/hydrophobic molecule that interacts with phospholipids and lipopolysaccharides on the bacterial cell membrane. In endodontics, its mode of antibacterial activity is determined by its concentration (0.2% or 2%). This article reviews findings from available endodontic studies on the antibacterial, antifungal, and antibiofilm activities of chlorhexidine.
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Affiliation(s)
- Zahed Mohammadi
- Iranian Center for Endodontic Research, Shahid Beheshti University of Medical Sciences
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23
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Mohd Daud N, Saeful Bahri IF, Nik Malek NAN, Hermawan H, Saidin S. Immobilization of antibacterial chlorhexidine on stainless steel using crosslinking polydopamine film: Towards infection resistant medical devices. Colloids Surf B Biointerfaces 2016; 145:130-139. [PMID: 27153117 DOI: 10.1016/j.colsurfb.2016.04.046] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Revised: 04/21/2016] [Accepted: 04/26/2016] [Indexed: 01/29/2023]
Abstract
Chlorhexidine (CHX) is known for its high antibacterial substantivity and is suitable for use to bio-inert medical devices due to its long-term antibacterial efficacy. However, CHX molecules require a crosslinking film to be stably immobilized on bio-inert metal surfaces. Therefore, polydopamine (PDA) was utilized in this study to immobilize CHX on the surface of 316L type stainless steel (SS316L). The SS316L disks were pre-treated, modified with PDA film and immobilized with different concentrations of CHX (10mM-50mM). The disks were then subjected to various surface characterization analyses (ATR-FTIR, XPS, ToF-SIMS, SEM and contact angle measurement) and tested for their cytocompatibility with human skin fibroblast (HSF) cells and antibacterial activity against Escherichia coli and Staphylococcus aureus. The results demonstrated the formation of a thin PDA film on the SS316L surface, which acted as a crosslinking medium between the metal and CHX. CHX was immobilized via a reduction process that covalently linked the CHX molecules with the functional group of PDA. The immobilization of CHX increased the hydrophobicity of the disk surfaces. Despite this property, a low concentration of CHX optimized the viability of HSF cells without disrupting the morphology of adherent cells. The immobilized disks also demonstrated high antibacterial efficacy against both bacteria, even at a low concentration of CHX. This study demonstrates a strong beneficial effect of the crosslinked PDA film in immobilizing CHX on bio-inert metal, and these materials are applicable in medical devices. Specifically, the coating will restrain bacterial proliferation without suffocating nearby tissues.
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Affiliation(s)
- Nurizzati Mohd Daud
- Biomedical Science Laboratory, Faculty of Biosciences and Medical Engineering, Universiti Teknologi Malaysia, 81310 Johor Bahru, Johor, Malaysia
| | - Ihda Fithriyana Saeful Bahri
- Biomedical Science Laboratory, Faculty of Biosciences and Medical Engineering, Universiti Teknologi Malaysia, 81310 Johor Bahru, Johor, Malaysia
| | - Nik Ahmad Nizam Nik Malek
- Department of Biotechnology and Medical Engineering, Faculty of Biosciences and Medical Engineering, Universiti Teknologi Malaysia, 81310 Johor Bahru, Johor, Malaysia
| | - Hendra Hermawan
- Department of Mining, Metallurgical and Materials Engineering & CHU de Québec Research Center, Laval University, Quebec City, G1V 0A6, Canada
| | - Syafiqah Saidin
- Biomedical Science Laboratory, Faculty of Biosciences and Medical Engineering, Universiti Teknologi Malaysia, 81310 Johor Bahru, Johor, Malaysia; Department of Biotechnology and Medical Engineering, Faculty of Biosciences and Medical Engineering, Universiti Teknologi Malaysia, 81310 Johor Bahru, Johor, Malaysia.
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24
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HERRERA DR, DURAND-RAMIREZ JE, FALCÃO A, SILVA EJLND, SANTOS EBD, GOMES BPFDA. Antimicrobial activity and substantivity of Uncaria tomentosa in infected root canal dentin. Braz Oral Res 2016; 30:e61. [DOI: 10.1590/1807-3107bor-2016.vol30.0061] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Accepted: 01/11/2016] [Indexed: 11/22/2022] Open
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25
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Chitosan based nanoparticles functionalized with peptidomimetic derivatives for oral drug delivery. N Biotechnol 2016; 33:23-31. [DOI: 10.1016/j.nbt.2015.07.005] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Revised: 07/27/2015] [Accepted: 07/28/2015] [Indexed: 01/08/2023]
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26
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Liu Y, Guo L, Li Y, Guo X, Wang B, Wu L. In vitro comparison of antimicrobial effectiveness of QMix and other final irrigants in human root canals. Sci Rep 2015; 5:17823. [PMID: 26631907 PMCID: PMC4668572 DOI: 10.1038/srep17823] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Accepted: 11/06/2015] [Indexed: 11/14/2022] Open
Abstract
Final root canal irrigation stands as an effective strategy for eliminating the dentin infection. This study aimed to investigate and compare the antibacterial efficacy of QMix and other four final irrigation regimens in reducing Enterococcus faecalis within human root canals. Single-canal human teeth contaminated with E. faecalis for 4 weeks were prepared chemomechanically with sodium hypochlorite (NaOCl). Then, the teeth were randomly assigned into six groups according to the final irrigation protocols: (1) EDTA/NaOCl, 17% EDTA followed by 5.25% NaOCl; (2) EDTA/chlorhexidine (CHX), 17% EDTA followed by 2% CHX; (3) EDTA/cetrimide (CTR), 17% EDTA followed by 2% CTR; (4) MTAD; (5) QMix; and (6) control, 0.9% saline. Bacterial samples collected before instrumentation and after final irrigation were cultured and the colony-forming units (CFUs) were counted. The CFUs in the QMix, EDTA/CHX, and EDTA/CTR groups were significantly lower than those in the EDTA/NaOCl group. No significant differences were observed between the QMix, EDTA/CHX, and EDTA/CTR groups. MTAD showed weaker ability than QMix and EDTA/CHX to eliminate E. faecalis, but it caused a greater reduction in CFU than EDTA/NaOCl. Hence, the antimicrobial activity of QMix was comparable to that of EDTA/CHX and EDTA/CTR and more effective than that of EDTA/NaOCl against intracanal E. faecalis.
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Affiliation(s)
- Ying Liu
- Department of Endodontics, School of Stomatology, Tianjin Medical University, Tianjin, China
| | - Lili Guo
- Department of Stomatology, The First Affiliated Hospital of Henan University of TCM, Henan, China
| | - Yuqin Li
- Department of Stomatology, Affiliated Hospital of Guiyang Medical College, Guizhou, China
| | - Xiangjun Guo
- Department of Endodontics, School of Stomatology, Tianjin Medical University, Tianjin, China
| | - Bin Wang
- Department of Endodontics, School of Stomatology, Tianjin Medical University, Tianjin, China
| | - Ligeng Wu
- Department of Endodontics, School of Stomatology, Tianjin Medical University, Tianjin, China
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Mittal S, Soni H, Sharma DK, Mittal K, Pathania V, Sharma S. Comparative evaluation of the antibacterial and physical properties of conventional glass ionomer cement containing chlorhexidine and antibiotics. J Int Soc Prev Community Dent 2015; 5:268-75. [PMID: 26310885 PMCID: PMC4547440 DOI: 10.4103/2231-0762.161754] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Objective: To evaluate the antimicrobial efficacy and compressive strength of conventional glass ionomer cement (GIC) containing chlorhexidine and antibiotics at varying concentrations. Materials and Methods: Chlorhexidine diacetate and antibiotics (ciprofloxacin, metronidazole, and minocycline) were incorporated into GIC Fuji IX at 1.5% and 3% w/w ratio to form the experimental groups. The experimental GIC specimens were placed on brain heart infusion agar plates inoculated with Streptococcus mutans, and the area of inhibition was measured after 48 h. The 24-h compressive strength of the set specimens was evaluated using a Universal Testing Machine. Results: The control group demonstrated no zone of inhibition. All experimental groups showed inhibition against S. mutans (P < 0.05), with larger zones of inhibition found in the higher concentration groups. Compressive strength at the end of 24 h decreased in the experimental groups as compared to the control group (P < 0.05), but no difference was found between the experimental groups (P > 0.05). Conclusion: The present study demonstrated that experimental GICs containing chlorhexidine diacetate and antibiotics were effective in inhibiting S. mutans, and incorporation of 1.5% ABX was optimal to give the appropriate antibacterial and physical properties.
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Affiliation(s)
- Sudhir Mittal
- Department of Pedodontics, Himachal Dental College, Sunder Nagar, Himachal Pradesh, India
| | - Heena Soni
- Department of Pedodontics, Himachal Dental College, Sunder Nagar, Himachal Pradesh, India
| | - Devender Kumar Sharma
- Department of Microbiology, Himachal Dental College, Sunder Nagar, Himachal Pradesh, India
| | - Kavita Mittal
- Department of Pedodontics, Guru Nanak Dev Dental College and Research Institute, Sunam, Punjab, India
| | - Vasundhara Pathania
- Department of Pedodontics, Himachal Dental College, Sunder Nagar, Himachal Pradesh, India
| | - Samridhi Sharma
- Department of Pedodontics, Himachal Dental College, Sunder Nagar, Himachal Pradesh, India
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28
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Ma J, Tong Z, Ling J, Liu H, Wei X. The effects of sodium hypochlorite and chlorhexidine irrigants on the antibacterial activities of alkaline media against Enterococcus faecalis. Arch Oral Biol 2015; 60:1075-81. [DOI: 10.1016/j.archoralbio.2015.04.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2015] [Revised: 04/16/2015] [Accepted: 04/19/2015] [Indexed: 10/23/2022]
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Böttcher DE, Sehnem NT, Montagner F, Fatturi Parolo CC, Grecca FS. Evaluation of the Effect of Enterococcus faecalis Biofilm on the 2% Chlorhexidine Substantivity: An In Vitro Study. J Endod 2015; 41:1364-70. [PMID: 26025346 DOI: 10.1016/j.joen.2015.04.016] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2014] [Revised: 04/21/2015] [Accepted: 04/22/2015] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The aim of this study was to correlate the bacterial viability and the presence of 2% chlorhexidine (CHX) solution on dentin by means of confocal laser scanning microscopy and high-performance liquid chromatography for 48 hours, 7 days, and 30 days. METHODS One hundred twenty-three extracted human teeth were used. Samples were divided into 4 groups according to the solution (CHX or saline) and the presence of Enterococus faecalis biofilm. Samples were kept in contact with 5 mL of the solution for 5 minutes. Each group was divided into 3 subgroups according to the evaluation period (n = 10). Statistical analysis was performed by using the Kruskal-Wallis test, the Mann-Whitney U test (P < .05), and the Spearman rank correlation coefficient (P < .01). RESULTS There was a negative correlation between the percentage of live cells and the amount of remaining CHX (P = .000). CHX significantly reduced the percentage of viable cells compared with saline after 48 hours (P = .007). Differences were maintained in the 7-day evaluation period (P = .001). After 30 days, the CHX group presented an increase of viable cells, thereby becoming similar to saline (P = .623). Simultaneously, the remaining CHX was significantly reduced in the 30-day specimens (P = .000). CONCLUSIONS The results of this study indicate that 2% CHX solution was detected for 48 hours and 7 days with a low percentage of viable cells. The presence of microorganisms on human dentin did not affect 2% CHX maintenance.
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Affiliation(s)
- Daiana Elisabeth Böttcher
- Department of Conservative Dentistry, School of Dentistry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil.
| | - Nicole T Sehnem
- Biotechnology and Biochemical Engineering Laboratory (BiotecLab), School of Food Engineering, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Francisco Montagner
- Department of Conservative Dentistry, School of Dentistry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Clarissa Cavalcanti Fatturi Parolo
- Social and Preventive Dentistry Department, School of Dentistry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Fabiana Soares Grecca
- Department of Conservative Dentistry, School of Dentistry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
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Khademi AA, Saleh M, Khabiri M, Jahadi S. Stability of antibacterial activity of Chlorhexidine and Doxycycline in bovine root dentine. J Res Pharm Pract 2014; 3:19-22. [PMID: 24991631 PMCID: PMC4078646 DOI: 10.4103/2279-042x.132705] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE The aim of this study was to compare the substantivity of chlorhexidine (CHX) and doxycycline bond to the dentin in diffusion disk method. METHODS A total of 92 dentin disks were prepared from Bovine's teeth root. After removing cementum and standardizing disks in weight and outer diameter, they were irrigated with sodium hypochlorite 2.5%, ethylenediaminetetraacetic acid 17% and sterile saline and sterilled in autoclave. Then, the first group (n = 36) were irrigated with chlrohexine 2% and the second group (n = 36) with doxycycline 100 mg/mL, each for a period of 10 min. The third group (n = 20) was considered as the control group. Samples were divided into four subgroups, which after 1 day, 3, 6, and 12 weeks were incubated in plates containing Muller Hinton agar broth and Enterococcus faecalis for a period of 48 h at 37°C temperature; then the diameter of the zone of inhibition was measured. The antimicrobial effect of irrigating solutions without binding to the dentin was also studied using the plate well method. One-way and univariate variance tests as well as Post-hoc Tukey were used for data analyses. FINDINGS The diameter of the zone of inhibition of doxycycline group was significantly more than the CHX group from the beginning to the 3(rd) week (P < 0.005). After 3(rd) week, mean diameter in doxycycline group declined as compared with the CHX group up to 12(th) week (P < 0.005). The difference between means in two groups was not significant in the 3(rd) week (P = 0.87). CONCLUSION The results of this study show that CHX and doxycycline show antibacterial activity for 12 weeks; although after 3(rd) week, the substantivity of CHX was significantly greater than doxycycline. Both of these irrigants can be used in other pharmacological and medical fields whenever a long-lasting antibacterial action is needed.
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Affiliation(s)
- Abbas Ali Khademi
- Department of Endodontics, Torabinejad Dental Research Center, Iranian Academy of Medical Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Marjan Saleh
- Department of Endodontics, Islamic Azad University of Khorasgan, Isfahan, Iran
| | - Masoud Khabiri
- Department of Endodontics, Islamic Azad University of Khorasgan, Isfahan, Iran
| | - Sanaz Jahadi
- Department of Endodontics, Dental Implant Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Photodynamic killing of Enterococcus faecalis in dentinal tubules using mTHPC incorporated in liposomes and invasomes. Clin Oral Investig 2014; 19:373-84. [DOI: 10.1007/s00784-014-1271-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Accepted: 06/09/2014] [Indexed: 10/25/2022]
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Raheja J, Tewari S, Tewari S, Duhan J. Evaluation of efficacy of chlorhexidine intracanal medicament on the periodontal healing of concomitant endodontic-periodontal lesions without communication: an interventional study. J Periodontol 2014; 85:1019-26. [PMID: 24835418 DOI: 10.1902/jop.2014.130430] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Treatment of concomitant endodontic-periodontal lesions remains a challenge in clinical practice and requires effective endodontic and regenerative periodontal therapy. Among other factors, cross seeding and recolonization of flora may affect the outcome of periodontal therapy. Intracanal medicaments have been shown to exert antimicrobial activity on the external root surface, and local delivery of antimicrobials has been suggested to be a complementary approach in the management of periodontitis. Therefore, the objective of this study is to determine the influence of chlorhexidine (CHX) intracanal medicament on the clinical outcomes of therapy. METHODS Thirty-one patients were divided into two treatment groups: 1) open flap debridement (OFD) in endodontically treated teeth (control); and 2) OFD in endodontically treated teeth with CHX placed in the coronal space (test). The clinical variables evaluated were probing depth (PD), clinical attachment level (CAL), and percentage of sites with PD ≥5 mm. Reevaluation was performed at 3 and 6 months post-surgery. RESULTS Both treatments resulted in improvement in all the clinical variables evaluated. Postoperative measurements from test and control groups showed reductions in mean PD of 2.22 ± 1.27 and 0.91 ± 0.81 mm, mean CAL gains of 2.16 ± 1.12 and 0.60 ± 0.93 mm, and 43.33% ± 31.37% and 17.71% ± 14.23% reduction in sites with PD ≥5 mm. Significantly more PD reduction, CAL gain, and percentage reduction in sites with PD ≥5 mm were observed in the test group at 6 months (P <0.05). CONCLUSION CHX may be used as an effective intracanal medicament for promoting periodontal healing in concomitant endodontic-periodontal lesions.
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Affiliation(s)
- Jyoti Raheja
- Department of Conservative Dentistry & Endodontics, Post Graduate Institute of Dental Sciences, Rohtak, Haryana, India
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Tavares WLF, de Brito LCN, Henriques LCF, Oliveira RR, Maciel KF, Vieira LQ, Sobrinho APR. The impact of chlorhexidine-based endodontic treatment on periapical cytokine expression in teeth. J Endod 2013; 39:889-92. [PMID: 23791257 DOI: 10.1016/j.joen.2013.02.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2012] [Revised: 02/01/2013] [Accepted: 02/15/2013] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Root canal treatment typically involves cleaning and shaping procedures followed by treatment with antibacterial endodontic dressing between appointments and, ultimately, 3-dimensional,hermetic filling. Chlorhexidine (CHX) is effective as an irrigation solution and is used as an endodontic dressing. The aim of this study was to examine the influence of CHX on periapical cytokine expression. METHODS Expression levels of the cytokines interferon γ, tumor necrosis factor α, interleukin (IL)-1β, IL-17A, IL-10, and the chemokine monocyte chemoattractant protein-1 (CCL2/MCP-1) were assayed by real-time polymerase chain reaction immediately after root canal cleaning and 15 days later. RESULTS Messenger RNA expression of IL-1β, interferon γ, IL-10, and CCL2/MCP-1 was increased on day 15 in teeth without endodontic dressing. No statistical change was observed in the messenger RNA expression of cytokines when comparing sampling times for teeth that received endodontic dressing. CONCLUSIONS The results show that CHX application between appointments prevented the increase of both proinflammatory and immunoregulatory cytokines 15 days after the dental procedure.
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Gomes BP, Vianna ME, Zaia AA, Almeida JFA, Souza-Filho FJ, Ferraz CCR. Chlorhexidine in Endodontics. Braz Dent J 2013; 24:89-102. [DOI: 10.1590/0103-6440201302188] [Citation(s) in RCA: 135] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2013] [Accepted: 04/02/2013] [Indexed: 11/21/2022] Open
Abstract
Chemical auxiliary substances (CAS) are essential for a successful disinfection and cleanness of the root canals, being used during the instrumentation and if necessary, as antimicrobial intracanal medicaments. Different CAS have been proposed and used, among which sodium hypochlorite (NaOCl), chlorhexidine (CHX), 17% EDTA, citric acid, MTAD and 37% phosphoric acid solution. CHX has been used in Endodontics as an irrigating substance or intracanal medicament, as it possesses a wide range of antimicrobial activity, substantivity (residual antimicrobial activity), lower cytotoxicity than NaOCl whilst demonstrating efficient clinical performance, lubricating properties, rheological action (present in the gel presentation, keeping the debris in suspension); it inhibits metalloproteinase, is chemically stable, does not stain cloths, it is odorless, water soluble, among other properties. CHX has been recommended as an alternative to NaOCl, especially in cases of open apex, root resorption, foramen enlargement and root perforation, due to its biocompatibility, or in cases of allergy related to bleaching solutions. The aim of this paper is to review CHX's general use in the medical field and in dentistry; its chemical structure, presentation form and storage; mechanism of action; antimicrobial activity including substantivity, effects on biofilms and endotoxins, effects on coronal and apical microbial microleakage; tissue dissolution ability; interaction with endodontic irrigants; effects on dentin bonding, metalloproteinases and collagen fibrils; its use as intracanal medicament and diffusion into the dentinal tubules; its use as disinfectant agent of obturation cones; other uses in the endodontic therapy; and possible adverse effects, cytotoxicity and genotoxicity.
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Mohammadi Z, Giardino L, Palazzi F, Shalavi S, Farahani MF. Substantivity of three concentrations of tetraclean in bovine root dentin. Chonnam Med J 2012; 48:155-8. [PMID: 23323220 PMCID: PMC3539095 DOI: 10.4068/cmj.2012.48.3.155] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2012] [Revised: 08/25/2012] [Accepted: 09/09/2012] [Indexed: 11/08/2022] Open
Abstract
In the present study, the residual antibacterial activity, or substantivity, of three concentrations of Tetraclean (Ogna Laboratori Farmaceutici, Muggiò, Italy) was assessed in bovine root dentin in vitro. One hundred ten dentin tubes prepared from bovine incisor teeth were infected in vitro for 14 days with Enterococcus faecalis. Thereafter, the specimens were divided into five groups as follows: 100% Tetraclean, 10% Tetraclean, 1% Tetraclean, sterile dentin tubes (negative control), and infected dentin tubes (positive control). Dentin chips were collected with round burs into tryptic soy broth and, after culturing, the number of colony-forming units (CFU) was counted. The number of CFU was minimal in the first cultures in all experimental groups, and the results obtained were significantly different in the different groups at all time periods (p<0.05). At all five experimental periods, the 100% Tetraclean group showed the most effective antibacterial action (p<0.05). In each group, the number of CFU increased significantly with time (p<0.05). There was a direct relationship between the concentration of Tetraclean and its substantivity. In conclusion, under the conditions of the study presented here, the substantivity of 100% Tetraclean was significantly higher than that of lower concentrations.
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Affiliation(s)
- Z Mohammadi
- Department of Endodontics, Hamedan University of Medical Sciences, Hamedan, Iran & Iranian Center for Endodontic Research (ICER), Tehran, Iran
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Baca P, Junco P, Arias-Moliz MT, Castillo F, Rodríguez-Archilla A, Ferrer-Luque CM. Antimicrobial substantivity over time of chlorhexidine and cetrimide. J Endod 2012; 38:927-30. [PMID: 22703655 DOI: 10.1016/j.joen.2012.04.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2012] [Revised: 03/28/2012] [Accepted: 04/10/2012] [Indexed: 11/17/2022]
Abstract
INTRODUCTION To reach an adequate control of dentin infection and to promote success in endodontic therapy, antimicrobial irrigating solutions with confirmed substantivity are recommended. The aim of the present study was to evaluate the antimicrobial substantivity against Enterococcus faecalis of a dentin-volumetric unit exposed for 1 minute to chlorhexidine (CHX) and cetrimide (CTR). METHODS Standardized coronal dentin blocks of human molars, with and without collagen, were treated for 1 minute with 0.2% and 2% CHX and 0.2% CTR. Afterwards, they were exposed to E. faecalis suspension to determine the antimicrobial substantivity over a period of 60 days. Results were analyzed by means of Kaplan-Meier survival analysis (P < .05). RESULTS A direct relationship was seen between CHX concentration and survival time, and the most statistically significant results were obtained in specimens with collagen. CTR showed intermediate survival values close to those of 2% CHX. CONCLUSIONS The present study shows that 2% CHX used for 1 minute provides the longest substantivity followed by 0.2% CTR when applied to a dentin-volumetric model.
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Affiliation(s)
- Pilar Baca
- Department of Preventive Dentistry, School of Dentistry, University of Granada, Granada, Spain.
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Lewinstein I, Zenziper E, Block J, Kfir A. Incorporation of chlorhexidine diacetate in provisional cements: antimicrobial activity againstStreptococcus mutansand the effect on tensile strengthin vitro. Int Endod J 2012; 45:1010-7. [DOI: 10.1111/j.1365-2591.2012.02063.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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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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Calcium Hydroxide Mixed With Camphoric p-Monochlorophenol or Chlorhexidine in Delayed Tooth Replantation. J Craniofac Surg 2011; 22:2097-101. [DOI: 10.1097/scs.0b013e3182326de4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Kandaswamy D, Venkateshbabu N. Root canal irrigants. J Conserv Dent 2011; 13:256-64. [PMID: 21217955 PMCID: PMC3010032 DOI: 10.4103/0972-0707.73378] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2010] [Revised: 09/13/2010] [Accepted: 09/14/2010] [Indexed: 12/02/2022] Open
Abstract
Successful root canal therapy relies on the combination of proper instrumentation, irrigation, and obturation of the root canal. Of these three essential steps of root canal therapy, irrigation of the root canal is the most important determinant in the healing of the periapical tissues. The primary endodontic treatment goal must thus be to optimize root canal disinfection and to prevent reinfection. In this review of the literature, various irrigants and the interactions between irrigants are discussed. We performed a Medline search for English-language papers published untill July 2010. The keywords used were ‘root canal irrigants’ and ‘endodontic irrigants.’ The reference lists of each article were manually checked for additional articles of relevance.
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Affiliation(s)
- Deivanayagam Kandaswamy
- Journal of Conservative Dentistry Editor (2005-2007), Department of Conservative dentistry and Endodontics, Faculty of Dental Sciences, Sri Ramachandra University, Porur - 116, Chennai, Tamil Nadu, India
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Huth KC, Quirling M, Lenzke S, Paschos E, Kamereck K, Brand K, Hickel R, Ilie N. Effectiveness of ozone against periodontal pathogenic microorganisms. Eur J Oral Sci 2011; 119:204-10. [DOI: 10.1111/j.1600-0722.2011.00825.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Mohammadi Z, Giardino L, Palazzi F. Evaluation of the antifungal activity of four solutions used as a final rinsein vitro. AUST ENDOD J 2010; 39:31-4. [DOI: 10.1111/j.1747-4477.2010.00278.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Mohammadi Z, Giardino L, Mombeinipour A. Antibacterial substantivity of a new antibiotic-based endodontic irrigation solution. AUST ENDOD J 2010; 38:26-30. [DOI: 10.1111/j.1747-4477.2010.00263.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Hiraishi N, Yiu C, King N, Tay F. Effect of chlorhexidine incorporation into a self-etching primer on dentine bond strength of a luting cement. J Dent 2010; 38:496-502. [DOI: 10.1016/j.jdent.2010.03.005] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2009] [Revised: 01/25/2010] [Accepted: 03/10/2010] [Indexed: 11/26/2022] Open
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Mohammadi Z, Abbott PV. Antimicrobial substantivity of root canal irrigants and medicaments: a review. AUST ENDOD J 2010; 35:131-9. [PMID: 19961451 DOI: 10.1111/j.1747-4477.2009.00164.x] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Disinfection of the root canal system is one of the primary aims of root canal treatment. This can be achieved through the use of various antimicrobial agents in the form of irrigants and medicaments. These agents are only used for relatively short periods of time ranging from minutes (for irrigants) up to days or several weeks (for medicaments) and therefore their long-term antimicrobial effects rely on whether or not the particular agent has any properties of substantivity. If irrigants and medicaments had effective long-term residual antimicrobial activity that could prevent re-infection of the root canal system, then the long-term outcomes of endodontic treatment might be improved. Only a small number of studies have investigated the short-term substantivity of commonly used antimicrobial agents and the results show substantivity of chlorhexidine lasts for up to 12 weeks and tetracycline for up to 4 weeks. However, it is not known whether the substantivity of these agents will last for longer periods of time as this has not been investigated.
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Affiliation(s)
- Zahed Mohammadi
- Shahid Sadoughi Dental School, Department of Endodontics, Imam Avenue, Fazaye Sabz Cross Road, Yazd, Iran.
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Effect of Hydrogen Peroxide on the Antibacterial Substantivity of Chlorhexidine. Int J Dent 2010; 2010:946384. [PMID: 21318180 PMCID: PMC3034917 DOI: 10.1155/2010/946384] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2010] [Revised: 10/07/2010] [Accepted: 11/04/2010] [Indexed: 11/30/2022] Open
Abstract
The purpose of this in vitro study was to assess the effect of hydrogen peroxide on the antibacterial substantivity of chlorhexidine (CHX). Seventy-five dentine tubes prepared from human maxillary central and lateral incisor teeth were used. After contamination with Enterococcus faecalis for 14 days, the specimens were divided into five groups as follows: CHX, H2O2, CHX + H2O2, infected dentine tubes (positive control), and sterile dentine tubes (negative control). Dentine chips were collected with round burs into tryptic soy broth, and after culturing, the number of colony-forming units (CFU) was counted. The number of CFU was minimum in the first cultures in all experimental groups, and the results obtained were significantly different from each other at any time period (P < .05). At the first culture, the number of CFU in the CHX + H2O2 group was lower than other two groups. At the other experimental periods, the CHX group showed the most effective antibacterial action (P < .05). Hydrogen peroxide group showed the worst result at all periods. In each group, the number of CFU increased significantly by time lapse (P < .05). In conclusion, H2O2 had no additive effect on the residual antibacterial activity of CHX.
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Rasimick BJ, Shah RP, Musikant BL, Deutsch AS. Bacterial colonisation of root canal dentine previously treated with endodontic irrigants. AUST ENDOD J 2009; 36:70-3. [DOI: 10.1111/j.1747-4477.2009.00193.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Mohammadi Z, Abbott PV. On the local applications of antibiotics and antibiotic-based agents in endodontics and dental traumatology. Int Endod J 2009; 42:555-67. [PMID: 19467048 DOI: 10.1111/j.1365-2591.2009.01564.x] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Z Mohammadi
- Department of Endodontics, School of Dentistry, Hamedan University of Medical Sciences, Hamedan, Iran.
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Huth KC, Quirling M, Maier S, Kamereck K, Alkhayer M, Paschos E, Welsch U, Miethke T, Brand K, Hickel R. Effectiveness of ozone against endodontopathogenic microorganisms in a root canal biofilm model. Int Endod J 2009; 42:3-13. [PMID: 19125975 DOI: 10.1111/j.1365-2591.2008.01460.x] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM To assess the antimicrobial efficacy of aqueous (1.25-20 microg mL(-1)) and gaseous ozone (1-53 g m(-3)) as an alternative antiseptic against endodontic pathogens in suspension and a biofilm model. METHODOLOGY Enterococcus faecalis, Candida albicans, Peptostreptococcus micros and Pseudomonas aeruginosa were grown in planctonic culture or in mono-species biofilms in root canals for 3 weeks. Cultures were exposed to ozone, sodium hypochlorite (NaOCl; 5.25%, 2.25%), chlorhexidine digluconate (CHX; 2%), hydrogen peroxide (H(2)O(2); 3%) and phosphate buffered saline (control) for 1 min and the remaining colony forming units counted. Ozone gas was applied to the biofilms in two experimental settings, resembling canal areas either difficult (setting 1) or easy (setting 2) to reach. Time-course experiments up to 10 min were included. To compare the tested samples, data were analysed by one-way anova. RESULTS Concentrations of gaseous ozone down to 1 g m(-3) almost and aqueous ozone down to 5 microg mL(-1) completely eliminated the suspended microorganisms as did NaOCl and CHX. Hydrogen peroxide and lower aqueous ozone concentrations were less effective. Aqueous and gaseous ozone were dose- and strain-dependently effective against the biofilm microorganisms. Total elimination was achieved by high-concentrated ozone gas (setting 2) and by NaOCl after 1 min or a lower gas concentration (4 g m(-3)) after at least 2.5 min. High-concentrated aqueous ozone (20 microg mL(-1)) and CHX almost completely eliminated the biofilm cells, whilst H(2)O(2) was less effective. CONCLUSION High-concentrated gaseous and aqueous ozone was dose-, strain- and time-dependently effective against the tested microorganisms in suspension and the biofilm test model.
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Affiliation(s)
- K C Huth
- Department of Restorative Dentistry & Periodontology, Ludwig-Maximilians University, Munich, Germany.
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Affiliation(s)
- Z Mohammadi
- Department of Endodontics, School of Dentistry, Hamedan University of Medical Sciences, Hamedan, Iran.
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