An in vitro study of the antimicrobial activity of some endodontic medicaments against Enteroccus faecalis biofilms

Facile green synthesis of non-genotoxic, non-hemolytic organometallic silver nanoparticles using extract of crushed, wasted, and spent Humulus lupulus (hops): Characterization, anti-bacterial, and anti-cancer studies

Since the last few decades, the green synthesis of metal nanoparticles was one of the most thrust areas due to its widespread application. The study proposed using wasted and unusable Humulus lupulus (Hops) extract to synthesize silver nanoparticles for biomedical application. The environment around us gives us many scopes to use the waste from environmental sources and turn it into something valuable. The spent Hops extract was used to synthesize silver nanoparticles (AgNP@HOPs), and the synthesized product exhibited an excellent therapeutic effect in terms of anti-bacterial and anti-cancer agents. The synthesis was optimized considering different factors like time and the concentration of AgNO₃. The silver nanoparticles were characterized in detail using different characterization techniques XRD, DLS, TEM, BET, XPS, Raman Spectroscopy, SEM, EDAX, AFM, which revealed the uniqueness of the silver nanoparticles. The average hydrodynamic size was found to be 92.42 ± 2.41 with a low polydispersity index. The presence of Ag-C and Ag-O bonds in the AgNP@HOPs indicated that it is composed of organo-silver and silver oxides. The nanoparticles were found to be spherical with an average size of 17.40 nm. The AgNPs were lethal to both E. coli and S. aureus with a MIC-50 of 201.881 μg/mL and 213.189 μg/mL, respectively. The AgNP@HOPs also exhibited an anti-cancer effect with an IC-50 of 147.175. The AgNP@HOPs exhibited less cytotoxicity and genotoxicity against normal cells and exhibited superior haemocompatibility (major criteria for drug selection). There are indeed various reports on the synthesis of silver nanoparticles, but this study proposes a green method for producing non-genotoxic, non-hemolytic organometallic silver nanoparticles using waste material with considerable therapeutic index from the environmental source with potential application in the medical industry. This work could be taken forward for in-vivo studies and for pre clinical studies.

Antimicrobial Effect of Calcium Hydroxide Combined with Electrolyzed Superoxidized Solution at Neutral pH on Enterococcus faecalis Growth

Objective

To evaluate the effect of the combination of calcium hydroxide (Ca(OH)₂) and a novel electrolyzed superoxidized solution at neutral pH, known as OxOral® on Enterococcus faecalis growth in root canals.

Methods

Sixty human teeth were used, from which root canals were infected and randomly divided into the following treatment groups: saline solution, saline solution plus Ca(OH)₂, OxOral®, and OxOral® plus Ca(OH)₂.

Results

A permanent reduction in bacterial growth was observed at days 1, 6, 12, and 18 after OxOral® plus Ca(OH)₂ treatment from 4.4 ± 0.074 log₁₀ CFU/mL to 0.0 ± 0.001 log₁₀ CFU/mL. In addition, alkaline conditions maintenance was observed from application time (pH = 12.2 ± 0.033) to 18 d posttreatment (pH = 12.6 ± 0.083).

Conclusion

The combination of OxOral® and Ca(OH)₂ provides an alkaline pH and inhibits E. faecalis growth into the root canals. Our study opens the possibility for further research on the use of OxOral® in endodontic therapy.

Evaluation of the diffusion of calcium hydroxide-based medicaments through the dentinal tubules and apical foramen: A mass spectrometry study

Aims:

This mass spectrometry study investigated the diffusion of hydroxyl and calcium ions from a calcium hydroxide intracanal medicament (Pulpdent^®) when used alone or mixed in equal parts with a steroid–antibiotic paste (Ledermix^®).

Materials and Methods:

The pH (using pH meter) and calcium ion concentration (using inductively coupled plasma-mass spectrometry) of the diffused medicaments were assessed using endodontically prepared human extracted teeth with either a sealed or a patent apex, at time intervals of 1, 3, 8, 24, and 168 h.

Statistical Analysis:

A one-way ANOVA was used to explore differences between and within groups, with Tukey–Kramer/Games–Howell posttests.

Results:

In both situations tested, Pulpdent^® showed greater release of both calcium and hydroxyl ions than when mixed in equal parts with Ledermix^®. Greater initial release of both ions occurred in roots with a patent apex, but by 1 week there was no significant difference between the two. If a 50:50 combination of Pulpdent^® paste and Ledermix^® paste is used, there is a lower release of calcium ions and hydroxyl ions than using Pulpdent^® paste alone.

Conclusion:

With both Pulpdent^® paste alone and Pulpdent^® paste mixed equally with Ledermix^® paste, the major pathway for movement of hydroxyl ions and calcium ions is diffusion through the dentine of the root, with the apex playing only a minor role.

Novel Approaches to Detect and Treat Biofilms within the Root Canals of Teeth: A Review

Biofilms located within the root canals of teeth are a unique and pressing concern in dentistry and in medical microbiology. These multispecies biofilms, which include fungi as well as bacteria, form in a protected site with low shear stress and low oxygen tension. Systemic antibiotics are of limited value because of the lack of blood flow of the site, and issues with innate and acquired resistance. Physical disruption using hand or rotary powered instruments does not reach all locations in the root canal system where biofilms are present. Alternative strategies including agitated irrigation fluids, continuous chelation, materials with highly alkaline pH, and antimicrobial nanoparticles are being explored to meet the challenge. Detection and quantification of biofilms using fluorescence-based optical methods could provide an indication of successful biofilm removal and an endpoint for physical and chemical treatments.

Aspects of Solvent Chemistry for Calcium Hydroxide Medicaments

Calcium hydroxide pastes have been used in endodontics since 1947. Most current calcium hydroxide endodontic pastes use water as the vehicle, which limits the dissolution of calcium hydroxide that can be achieved and, thereby, the maximum pH that can be achieved within the root canal system. Using polyethylene glycol as a solvent, rather than water, can achieve an increase in hydroxyl ions release compared to water or saline. By adopting non-aqueous solvents such as the polyethylene glycols (PEG), greater dissolution and faster hydroxyl ion release can be achieved, leading to enhanced antimicrobial actions, and other improvements in performance and biocompatibility.

Antimicrobial Activity of Calcium Hydroxide and Betamethasone on Enterococcus faecalis; An in vitro Assessment

INTRODUCTION

Calcium hydroxide (CH) is one of the most common intracanal medications. Corticosteroids (CS) are used in endodontics because of their anti-inflammatory activity. This study aimed to evaluate the antimicrobial effect of CH+betamethasone and CH+saline against Enterococcus faecalis (E. faecalis) using agar diffusion test and measuring the microbial zone of inhibition (ZOI).

METHODS AND MATERIALS

Four plates containing Mueller-Hinton broth and E. faecalis culture media, were prepared. In each plate, 5 holes (5×3 mm) were created and a creamy mixture of CH+betamethasone was inserted into the holes (10 holes for each material). Two holes with ampicillin disks and two empty holes were used as negative and positive controls, respectively. Plates were incubated for 24 h and then the diameter of microbial ZOI was measured. The pH of each mixture was measured by pH meter. Data were analyzed using the Mann-Whitney U test.

RESULTS

The mean diameter of ZOI for CH+betamethasone and CH+saline was 3.4 and 3 mm, respectively. The difference was not significant (P=0.143). The pH was 12.5 for CH+saline and 12.3 CH+betamethasone, respectively.

CONCLUSION

The mixture of CH+betamethasone had good antimicrobial effects against E. faecalis. Further studies are needed to confirm the value of this mixture in clinical settings.

Clonal diversity in biofilm formation by Enterococcus faecalis in response to environmental stress associated with endodontic irrigants and medicaments

AIM

To determine whether clonal diversity within E. faecalis affects biofilm formation when exposed to antimicrobial compounds found in endodontic medicaments and irrigants.

METHODOLOGY

Five human isolates of E. faecalis were compared; biofilms were grown in microtitre trays in the presence of sodium hypochlorite, calcium hydroxide, chlorhexidine, tetracycline or clindamycin. Biofilms were quantified by staining with crystal violet and optical density determined with a microplate reader. Slime production (an amorphous extracellular matrix comprising polysaccharides, glycoproteins and glycolipids loosely attached to the cell surface) was determined qualitatively by growth on Congo red agar plates. Linear mixed models were used to examine whether medicaments affected biofilm growth of the isolates in the presence of the medicaments or irrigants.

RESULTS

Overall, different endodontic antimicrobials significantly altered biofilm growth in E. faecalis isolates. Two E. faecalis isolates significantly (P < 0.0001) increased biofilm formation in the presence of tetracycline and one in the presence of NaOCl (P = 0.018). Qualitatively, slime production also varied between isolates and correlated with biofilm production.

CONCLUSIONS

When subjected to sub-minimum inhibitory concentration (MIC) levels of antimicrobial compounds found in endodontic medicaments, E. faecalis isolates demonstrated significant clonal variation in their capacity to form biofilms. Interestingly, there was a correlation between slime production and the ability of isolates to form a biofilm in the presence of antimicrobials. The results indicate that isolates of E. faecalis that form biofilms in response to endodontic medicaments may be more likely to survive endodontic treatment.

Antibacterial activity of calcium hydroxide combined with chitosan solutions and the outcomes on the bond strength of RealSeal sealer to radicular dentin

The purpose of this study was to investigate the antibacterial activity of calcium hydroxide [Ca(OH)₂] combined with chitosan solutions against Enterococcus faecalis-infected root canal dentin and the effect of this new intracanal medicament on the bond strength of RealSeal sealer to radicular dentin. An experimental intracanal medicament was prepared by mixing different concentrations of chitosan solution (25%, 50%, and 100%, W/V) to Ca(OH)₂ powder. Antibacterial activity was evaluated and the total numbers of colony forming units were determined. Bonding ability of RealSeal sealer to radicular dentin was evaluated using push-out bond strength test. Data were analyzed using one-way analysis of variance (ANOVA) and Tukey's multiple comparison tests. We found that Ca(OH)₂ combined with different concentrations of chitosan solutions showed better antibacterial activity than Ca(OH)₂ mixed with saline, without significantly affecting the bond strength of RealSeal sealer to radicular dentin (P > 0.05). The findings suggest that Ca(OH)₂ combined with chitosan is a promising intracanal medicament and may be effective in endodontic therapy.

In vitro study of the inactivation by dentine of some endodontic medicaments and their bases

BACKGROUND

The aim of this study was to investigate the antimicrobial effect of endodontic medicaments and their bases in the presence of dentine powder.

METHODS

The medicaments tested were Ledermix paste, Pulpdent paste, a 50:50 combination of the Pulpdent:Ledermix and their bases. The test organism was Enterococcus faecalis ATCC 29212. The presence or absence of dentine was examined as well as the effect of autoclaving dentine. Serial dilutions of samples at 1 hour, 1 day and 3 days were used for colony counting. The effects of dentine powder on pH for saturated Ca(OH)2 solution and Pulpdent paste at 1 hour and 24 hours were also measured.

RESULTS

Pulpdent and the 50:50 combination of Pulpdent:Ledermix completely inhibited the growth of E. faecalis from 1 hour onwards, and these results were not affected by the presence/absence of dentine powder, pre-incubation period, timing of autoclaving, or exposure time. Saturated solutions of Ca(OH)2 are prone to inactivation by dentine powder unlike Pulpdent paste. Ledermix paste took 3 days to exert a significant effect on the growth of E. faecalis.

CONCLUSIONS

In this laboratory study, both Pulpdent and the 50:50 mixture of Pulpdent with Ledermix were effective medicaments against E. faecalis in the presence of dentine powder.