1
|
Salah HM, Hashem AAR, Mustafa T, Soliman AH, Khallaf M, Haddadeen H. The impact of root end filling material type and the application of bone graft on healing of periapical tissues after endodontic microsurgery (a clinical randomized controlled trial). Sci Rep 2024; 14:25378. [PMID: 39455597 DOI: 10.1038/s41598-024-66033-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 06/26/2024] [Indexed: 10/28/2024] Open
Abstract
To evaluate the effect of combining different bioactive root-end filling materials with composite bone graft (xenogeneic mixed with autogenous bone fragments) on the healing process of periapical tissues after endodontic micro-surgery procedure. In this triple-blinded clinical trial, 56 patients were divided into 2 main groups (28 each) according to the root-end filling material and 2 subgroups according to the presence or absence of the composite bone graft material. Group I: MTA root-end filling (n = 28) in which there are Sub-group A: without bone graft (n = 14) and Sub-group B: with composite bone graft (n = 14). Group II: TotalFill root-end filling (n = 28) in which there are Sub-group A: without bone graft (n = 14) and Sub-group B: with composite bone graft (n = 14). Healthy patients whose ages range from 20 to 50 years with small-to-medium size radiolucency in CBCT related to single-rooted maxillary teeth were included in this study. Patients were assigned a number starting from 1 to 56 and were randomly allocated to four test groups (2 main groups and 2 sub-groups) following simple randomization procedure guidelines described by IBM SPSS V23 (IBM USA) statistical analysis software. This trial was triple-blind where the patient, the outcome assessors, and the main operator were blinded to the applied intervention. Every patient was evaluated clinically and by CBCT at two main observation periods: presurgical and 12-month post-operative. They were also examined and evaluated clinically and radiographically through periapical x-rays after one week, three, and six months. Statistical analysis was performed with IBM SPSS Statistics for Windows Version 23.0. Armonk, NY: IBM Corp. Of the 56 patients enrolled in the study, 49 patients were available for the final analysis. All groups showed no statistically significant differences with regard to healing or success rates at the 12-month follow-up mark. No adverse effects were encountered. Results showed that high success rates were achieved using MTA and TotalFill in the healing of periapical lesions after endodontic surgery. The addition of bone graft in small-to-medium size lesions did not affect the success rate of endodontic surgeries.
Collapse
Affiliation(s)
- Hesham Mohamed Salah
- Endodontic Department, Faculty of Dentistry, Future University in Egypt, New Cairo City, Egypt.
- Ain Shams University, Cairo, Egypt.
| | | | | | - Amgad Hassan Soliman
- Endodontic Department, Faculty of Dentistry, Future University in Egypt, New Cairo City, Egypt
| | - Mustafa Khallaf
- Cleveland Dental Institute, Cleveland, OH, USA
- Faculty of Dentistry, Cairo - Boys, Al Azhar University, Cairo, Egypt
| | - Haseeb Haddadeen
- College of Arts and Sciences & College of Medicine, The Ohio State University, Columbus, USA
| |
Collapse
|
2
|
Yu KW, Hamdan MH, Sidow SJ. Ectopic Dental Canal: A Case Report Highlighting a Unique Bifid Mandibular Canal Variant. J Endod 2024:S0099-2399(24)00522-3. [PMID: 39342989 DOI: 10.1016/j.joen.2024.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2024] [Revised: 09/20/2024] [Accepted: 09/22/2024] [Indexed: 10/01/2024]
Abstract
Bifid mandibular canals are common anatomical findings with variations based on direction and location of branching, which carry significant clinical implications for endodontic and surgical dental procedures. This case report describes a previously unreported ectopic dental canal that branches off the superior border of the mandibular canal, enters the apex of a mandibular second molar, traverses through the root, anastomoses with the root canal system, and subsequently exits through the lingual aspect of the root. The anastomosis of this ectopic dental canal with the mesial lingual canal led to significant bleeding during rotary instrumentation. This unique anatomical variation demonstrates the importance of a thorough cone-beam computed tomography analysis to identify critical structures prior to undertaking dental procedures involving the root apices of mandibular posterior teeth and adjacent areas.
Collapse
Affiliation(s)
- Kevin W Yu
- Department of Surgical and Diagnostic Sciences, Marquette University School of Dentistry, Milwaukee, Wisconsin, USA.
| | - Manal H Hamdan
- Department of Surgical and Diagnostic Sciences, Marquette University School of Dentistry, Milwaukee, Wisconsin, USA
| | - Stephanie J Sidow
- Department of Surgical and Diagnostic Sciences, Marquette University School of Dentistry, Milwaukee, Wisconsin, USA
| |
Collapse
|
3
|
Khudhur HA, Bakr DK, Hamasaeed NH, Saleem SS, Mahdi SF, Tawfiq HF. Unveiling SmearOFF Efficacy in Smear Layer Removal through Ultrasonic Activation Examined by Scanning Electron Microscopy. Int J Biomater 2024; 2024:8188413. [PMID: 39410934 PMCID: PMC11479784 DOI: 10.1155/2024/8188413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 04/01/2024] [Accepted: 09/10/2024] [Indexed: 10/19/2024] Open
Abstract
A layer of smear that coats the walls of root canals is produced by root canal instrumentation, which could be unfavorable to endodontic therapy. The endodontic irrigant SmearOFF is designed to effectively remove both the smear layer and bacteria concurrently. The objective of this study was to evaluate and compare the efficacy of SmearOFF and 17% EDTA in removing the smear layer across the coronal, middle, and apical thirds of root canals. Sixty-four single-canal mandibular premolar roots were chosen. Two irrigant protocols were separated into two sets of thirty-two teeth, respectively, Group 1 (6% NaOCL/SmearOFF) and Group 2 (6% NaOCl/17% EDTA.) Until X2, the ProtaperNext rotary system (Dentsply, Maillefer, Switzerland), with a COXO C-SMART Endomotor (Foshan COXO Medical instrument Co., Ltd., China) was utilized for the shaping of all teeth, the equipment settings were tuned to 300 revolutions per minute (rpm) and a torque of 3 Newton-centimeters (Ncm). Before applying the final irrigants, an initial irrigation with 6% sodium hypochlorite (NaOCl) was performed using a 27-G side-vented needle. An ultrasonic gadget, EndoUltra, was utilized to activate the irrigation. After that, the determination of how well the proposed solutions worked on the prepared teeth was conducted by scanning electron microscopy. The mean smear layer scores were lower in all three regions (coronal, middle, and apical) using 17% EDTA in comparison with the samples treated with SmearOFF. Despite that, there were no significant differences between G1, 6% NaOCL/SmearOFF and G2, 6% NaOCL/17% EDTA in smear layer removal according to Kruskal-Wallis tests and Mann-Whitney U-tests (p < 0.05). Considering the findings of this investigation, both 17% EDTA and SmearOFF serve as chelating agents, demonstrating the capability to effectively remove the smear layer. This process is facilitated with the assistance of passive ultrasonic irrigation at intervals of every third of the root canal.
Collapse
|
4
|
Shafiei F, Tavangar MS. Pre-Sealing of Endodontic Access Cavities for the Preservation of Anterior Teeth Fracture Resistance. Clin Exp Dent Res 2024; 10:e936. [PMID: 39016080 PMCID: PMC11252827 DOI: 10.1002/cre2.936] [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: 11/25/2023] [Revised: 06/25/2024] [Accepted: 06/26/2024] [Indexed: 07/18/2024] Open
Abstract
OBJECTIVE Sodium hypochlorite solution (NaOCl) is an effective canal irrigant but interferes with the mechanical features of dentin and the bonding capability of adhesives when restoring endodontically treated teeth. This study evaluated whether access cavity resin sealing before using canal irrigant would augment the resistance of endodontically treated anterior teeth against fracture. METHODS Sixty maxillary incisors underwent endodontic treatment in five groups (n = 12). Irrigation with 5.25% NaOCl and 17% ethylenediaminetetraacetic acid (EDTA) was performed in all groups except for Group 5. After root canal obturation, in Group 1, the access cavity was kept unrestored. In Group 2, immediate restoration after obturation was achieved. For Group 3, delayed restoration after 1 week was provided. In Group 4 (pre-sealed), before canal irrigation, the dentin surface of access cavities was sealed using self-adhesive composite resin (Vertise Flow) and then restored after obturation. In Group 5, which was saline irrigated, immediate restoration was performed. After storage and thermal cycling for 5000 cycles at 5°C-55°C with a dwell time of 15 s and a transfer time of 5 s, teeth were statically loaded by a universal testing machine until a fracture occurred. Data were collected as the fracture resistance (FR) and analyzed using the one-way analysis of variance and Tukey's tests. RESULTS FR significantly differed between all groups (p < 0.001). The lowest FR was recorded in the unrestored group (284 ± 86 N), which was not statistically different from the immediately restored group (p = 0.065). The pre-sealed group exhibited the highest FR value (810 ± 127 N, p ≤ 0.02 vs. other groups). The FR of the saline-irrigated and delayed restored groups was almost similar (p = 0.13). CONCLUSIONS NaOCl/EDTA irrigation resulted in an adverse effect on FR. Delayed restoration could reduce this adverse effect. Access cavity pre-sealing with flowable composites led to a higher FR than conventional methods and may be considered an effective step during treatment procedures.
Collapse
Affiliation(s)
- Fereshteh Shafiei
- Department of Operative Dentistry, School of Dentistry, Oral and Dental Disease Research CenterShiraz University of Medical SciencesShirazIran
| | - Maryam S. Tavangar
- Department of Operative Dentistry, School of Dentistry, Oral and Dental Disease Research CenterShiraz University of Medical SciencesShirazIran
| |
Collapse
|
5
|
Usta SN, Keskin C. Color stability and solubility of Biodentine and NeoPutty in contact with different irrigation solutions. Restor Dent Endod 2024; 49:e25. [PMID: 39247647 PMCID: PMC11377880 DOI: 10.5395/rde.2024.49.e25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Revised: 05/29/2024] [Accepted: 06/13/2024] [Indexed: 09/10/2024] Open
Abstract
Objectives This study aimed to evaluate the color stability and solubility of Biodentine and NeoPutty in contact with different irrigation solutions. Materials and Methods Biodentine and NeoPutty were set in cylindrical molds with 7 mm diameter and 1.5 mm high and immersed in distilled water, 17% ethylenediaminetetraacetic acid (EDTA), 2% chlorhexidine (CHX), 9% 1-hydroxyethylidene 1,1-diphosphonate (HEDP), and 5% sodium hypochlorite (NaOCl) solutions for 24 hours. The color change was measured with a spectrophotometer. The solubility values were calculated as the mass loss was expressed as a percentage of the original mass using an analytical balance with 10-4 g accuracy. Data were analyzed with Kruskal-Wallis followed by Mann-Whitney U tests, and 2-way analysis of variance test followed by Bonferroni corrections for pairwise comparisons for solubility and color stability with a 5% significance threshold, respectively. Results Biodentine exhibited higher color changes compared to the NeoPutty contact with all solutions except distilled water (p < 0.05). Both hydraulic cements (HCs) showed higher discoloration values immersion in CHX followed by NaOCl. No statistically significant difference was found between Biodentine and NeoPutty regardless of irrigation solution in terms of solubility (p > 0.05). Solubility values were lower in the distilled water group compared to EDTA and CHX (p < 0.05). Conclusions Tested HCs showed solubility and color changes at various rates. NeoPutty could be an appropriate material in aesthetic areas. The usage of HEDP as an irrigant solution can be considered suitable for various endodontic treatments due to its relatively lower solubility and discoloration values.
Collapse
Affiliation(s)
- Sıla Nur Usta
- Department of Endodontics, Gulhane Faculty of Dentistry, University of Health Sciences, Ankara, Turkey
| | - Cangül Keskin
- Department of Endodontics, Faculty of Dentistry, University of Ondokuz Mayıs, Samsun, Turkey
| |
Collapse
|
6
|
Amend S, Stork S, Lücker S, Seipp A, Gärtner U, Frankenberger R, Krämer N. Influence of different pre-treatments on the resin infiltration depth into enamel of teeth affected by molar-incisor hypomineralization (MIH). Dent Mater 2024; 40:1015-1024. [PMID: 38744567 DOI: 10.1016/j.dental.2024.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Revised: 05/01/2024] [Accepted: 05/03/2024] [Indexed: 05/16/2024]
Abstract
OBJECTIVES This in vitro pilot study aimed to evaluate whether different pre-treatments (demineralization, deproteinization, (chemo-)mechanical reduction of the surface layer) influence the penetration depth of a resin infiltrant into MIH-affected enamel compared to initial carious lesions. METHODS Thirty extracted human permanent molars with non-cavitated initial carious lesions (n = 5) or MIH (n = 25) were chosen and randomly assigned to six experimental groups: IC: initial caries; M: MIH; MN: MIH, 5.25% sodium hypochlorite; MM: MIH, microabrasion; MA: MIH, air abrasion; MAN: MIH, air abrasion and 5.25% sodium hypochlorite. A modified indirect dual fluorescence staining method was adopted to assess the penetration depth (PD) of the resin infiltrant and the lesion depth (LD) by confocal laser scanning microscopy (CLSM). Exemplarily, scanning electron microscopic (SEM) images were captured. The relationship between group assignment and penetration/lesion depth was estimated using a linear mixed model incorporating the tooth as random effect (two observations/tooth). The significance level was set at p < 0.05. RESULTS For MIH-affected molars, the mean PD (in µm; median, [minimum-maximum]) were M (178.2 [32.5-748.9]), MN (275.6 [105.3-1131.0]), MM (48.7 [0.0-334.4]), MA (287.7 [239.4-491.7]), and MAN (245.4 [76.1-313.5]). Despite the observed differences in PD between the groups, these could not be statistically verified (Bonferroni, p = 0.322). The percentage penetration was significantly higher for IC than for MIH groups (Bonferroni, p < 0.05). SIGNIFICANCE Compared to IC, resin infiltration into MIH-affected enamel ist more variable. Different pre-treatments influence the resin penetration into developmentally hypomineralized enamel to a fluctuating level.
Collapse
Affiliation(s)
- Stefanie Amend
- Department of Pediatric Dentistry, Medical Center for Dentistry, University Medical Center Giessen and Marburg (Campus Giessen), Justus-Liebig-University Giessen, Schlangenzahl 14, 35392 Giessen, Germany.
| | - Stephan Stork
- Department of Pediatric Dentistry, Medical Center for Dentistry, University Medical Center Giessen and Marburg (Campus Giessen), Justus-Liebig-University Giessen, Schlangenzahl 14, 35392 Giessen, Germany.
| | - Susanne Lücker
- Department of Pediatric Dentistry, Medical Center for Dentistry, University Medical Center Giessen and Marburg (Campus Giessen), Justus-Liebig-University Giessen, Schlangenzahl 14, 35392 Giessen, Germany.
| | - Anika Seipp
- Institute of Anatomy and Cell Biology, Justus-Liebig-University Giessen, Aulweg 123, 35392 Giessen, Germany.
| | - Ulrich Gärtner
- Institute of Anatomy and Cell Biology, Justus-Liebig-University Giessen, Aulweg 123, 35392 Giessen, Germany.
| | - Roland Frankenberger
- Department of Operative Dentistry, Endodontics and Pediatric Dentistry, Medical Center for Dentistry, University Medical Center Giessen and Marburg (Campus Marburg), Philipps-University Marburg, Georg-Voigt-Str. 3, 35039 Marburg, Germany.
| | - Norbert Krämer
- Department of Pediatric Dentistry, Medical Center for Dentistry, University Medical Center Giessen and Marburg (Campus Giessen), Justus-Liebig-University Giessen, Schlangenzahl 14, 35392 Giessen, Germany.
| |
Collapse
|
7
|
Gobbo LB, de Araújo LP, Vieira WDA, de-Jesus-Soares A, de Almeida JFA, Ferraz CCR. Impact of passive ultrasonic irrigation on the outcome of non-surgical root canal treatment: a systematic review and meta-analysis of randomized clinical trials. Evid Based Dent 2024:10.1038/s41432-024-01033-3. [PMID: 38951661 DOI: 10.1038/s41432-024-01033-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 06/18/2024] [Indexed: 07/03/2024]
Abstract
OBJECTIVE This systematic review aimed to assess the impact of Passive Ultrasonic Irrigation on the periapical healing rate of primary root canal treatment compared to conventional syringe irrigation. METHODS Registered a priori in the PROSPERO database, this review was conducted by two independent reviewers who performed an electronic search up to December 2023. The search included databases such as MEDLINE (PubMed), Scopus, Web of Science, Embase, LILACS, and the Cochrane Library, as well as grey literature. We included randomized clinical trials (RCTs) that focused on patients undergoing primary root canal treatments. The study compared intervention groups using PUI with control groups that did not use activation techniques. Periapical healing was assessed over follow-up periods of at least six months, utilizing either periapical radiographs or cone-beam computed tomography. To synthesize the findings, a meta-analysis and trial sequence analysis were conducted, employing the Relative Risk as the measure of effect, with a 95% confidence interval. The GRADE approach was utilized to assess the certainty of the evidence. RESULTS The meta-analysis incorporated three RCTs, involving 474 patients (501 teeth). The analysis revealed that PUI led to a higher rate of periapical healing compared to CSI (Relative Risk: 1.10; 95% Confidence Interval: 1.01-1.21, I² = 0%), with moderate certainty of evidence. CONCLUSIONS Despite the limited number of high-quality RCTs, the findings showed a positive impact of PUI on periapical healing rates in primary root canal treatments, in comparison to CSI. REGISTER CRD42021290894.
Collapse
Affiliation(s)
- Leandro Bueno Gobbo
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, SP, Brazil
| | | | - Walbert de Andrade Vieira
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, SP, Brazil
| | - Adriana de-Jesus-Soares
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, SP, Brazil
| | - José Flávio Affonso de Almeida
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, SP, Brazil
| | - Caio Cezar Randi Ferraz
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, SP, Brazil
| |
Collapse
|
8
|
Abat VH, Bayrak GD, Gündoğar M. Assessment of apical extrusion in regenerative endodontics: a comparative study of different irrigation methods using three-dimensional immature tooth models. Odontology 2024:10.1007/s10266-024-00961-x. [PMID: 38913232 DOI: 10.1007/s10266-024-00961-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2024] [Accepted: 06/04/2024] [Indexed: 06/25/2024]
Abstract
To investigate the apical extrusion of sodium hypochlorite in immature permanent teeth caused by conventional syringe irrigation (CSI), EDDY, XP-endo Finisher file (XP-F), and a new laser irrigation activation system [shock-wave-enhanced-emission-photo-acoustic-streaming (SWEEPS)]. Three-dimensionally printed forty-nine teeth with immature central incisor morphology were randomly assigned to seven experimental groups, based on the irrigation activation methods and insertion depths (1 mm and 2 mm short of the working length) as follows: CSI-1, CSI-2, EDDY-1, EDDY-2, XP-1, XP-2, and SWEEPS. Prior to the irrigation activation process, samples were placed in metacresol mixed agar gel in Eppendorf tubes. To evaluate NaOCI extrusion into the gel, each sample was digitally photographed, and the area of apical extrusion was analyzed using ImageJ software. To examine potential significant differences between the continuous variables, the Mann-Whitney U test and Kruskal-Wallis H test, were applied (P = .05). The SWEEPS resulted in a greater amount of apical extrusion compared to the CSI method, regardless of the insertion depth (P < 0.001). The SWEEPS resulted in greater apical extrusion scores compared to EDDY-2 (P < 0.001). The EDDY-1 resulted in greater amount of apical extrusion scores compared to EDDY-2 (P < 0.001). This study, the first to show the effect of the novel SWEEPS technology on NaOCI extrusion, found that irrigation activation can cause different levels of apical extrusion depending on the method and distance from the working length. It is crucial to consider the potential occurrence of apical extrusion when applying activation methods to immature teeth.
Collapse
Affiliation(s)
- Vahide Hazal Abat
- Department of Endodontics, Faculty of Dentistry, Uskudar University, Istanbul, Turkey.
| | - Gökçen Deniz Bayrak
- Department of Pediatric Dentistry, Faculty of Dentistry, Yeditepe University, Istanbul, Turkey
| | - Mustafa Gündoğar
- Department of Endodontics, Faculty of Dentistry, Medipol University, Istanbul, Turkey
| |
Collapse
|
9
|
Parkar A, Banga KS, Pawar AM, Luke AM. Extrusion of Sodium Hypochlorite in Oval-Shaped Canals: A Comparative Study of the Potential of Four Final Agitation Approaches Employing Agarose-Embedded Mandibular First Premolars. J Clin Med 2024; 13:2748. [PMID: 38792290 PMCID: PMC11121930 DOI: 10.3390/jcm13102748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 04/26/2024] [Accepted: 05/02/2024] [Indexed: 05/26/2024] Open
Abstract
Background: The aim of this investigation was to assess the apical extrusion potential of sodium hypochlorite (NaOCl) in agarose-embedded mandibular first premolars employing four final agitation procedures. Methods: Based on CBCT confirmation of single oval-shaped canals, one hundred extracted mandibular first premolars were chosen. Using 5.25% NaOCl, the teeth were prepared using the XP Endo Shaper and divided into experimental and control groups. The following were the experimental groups: Group 1 comprised the XP-Endo Finisher, Group 2 the Ultrasonic Activation, Group 3 the Gentle File Finisher Brush, and Group 4 the 27-gauge side-vented needle. To test extrusion, the teeth were placed in a 0.2% agarose gel that contained the pH-sensitive dye m-cresol purple, allowing pixel quantification via ImageJ software (version 1.54i). Results: The XP Endo Finisher featured the most pixels, depicting higher apical extrusion (p < 0.01), followed by the side-vented needle, Gentle File Finisher Brush, and PUI, while the Control Group endured no extrusion. Conclusions: The effective irrigation method for root canal therapy is critical, especially in situations of open apices, resorption, or perforation. According to in vitro experiments, the XP-Endo Finisher has the maximum sodium hypochlorite extrusion, which is determined by parameters such as apical preparation size and irrigation system.
Collapse
Affiliation(s)
- Aalisha Parkar
- Department of Conservative Dentistry and Endodontics, Nair Hospital Dental College, Mumbai 400008, India; (A.P.); (K.S.B.)
| | - Kulvinder Singh Banga
- Department of Conservative Dentistry and Endodontics, Nair Hospital Dental College, Mumbai 400008, India; (A.P.); (K.S.B.)
| | - Ajinkya M. Pawar
- Department of Conservative Dentistry and Endodontics, Nair Hospital Dental College, Mumbai 400008, India; (A.P.); (K.S.B.)
| | - Alexander Maniangat Luke
- Department of Clinical Sciences, College of Dentistry, Ajman University, Al-Jruf, Ajman P.O. Box 346, United Arab Emirates;
- Centre of Medical and Bio-Allied Health Science Research (CMBHSR), Ajman University, Al-Jruf, Ajman P.O. Box 346, United Arab Emirates
| |
Collapse
|
10
|
Savaris JM, Isoton JC, Fluck BF, Tedesco M, Bortoluzzi EA, da Fonseca Roberti Garcia L, da Silveira Teixeira C. Comparative Analysis of AH Plus Bond Strength to Root Canal Dentin and Adhesive Interface Quality after Calcium Hydroxide Removal using Different Irrigation Protocols. J Endod 2024; 50:659-666. [PMID: 38431198 DOI: 10.1016/j.joen.2024.02.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 02/23/2024] [Accepted: 02/23/2024] [Indexed: 03/05/2024]
Abstract
INTRODUCTION To evaluate the push-out bond strength (POBS) of AH Plus sealer to root dentin and the adhesive interface quality after calcium hydroxide (Ca(OH)2) intracanal dressing removal with different final irrigation protocols. METHOD After root canal instrumentation and irrigation, 40 root canals were filled with Ca(OH)2 and sealed. After 14 days, the specimens were randomly distributed according to the irrigation protocols for Ca(OH)2 removal (n = 10): GH2O (control) - distilled water; GNaOCl - 1% NaOCl; GEDTA - 17% EDTA; GEDTA + NaOCl - 17% EDTA + 1% NaOCl. The root canals were filled with AH Plus sealer and gutta-percha. After 7 days, the roots were sectioned into dentin slices and submitted to POBS test and analysis of the adhesive interface under scanning electron microscope. The POBS data were statistically evaluated (analysis of variance and Tukey test). The Kruskal-Wallis and Mann-Whitney tests were used to analyze the adhesive interface (α = 0.05). RESULTS GH2O, GNaOCl, and GEDTA + NaOCl had similar POBS values, with higher values on the apical third, in comparison with other thirds (P < .05). A homogeneous and free-of-gaps adhesive interface was observed for GH2O, GNaOCl, and GEDTA + NaOCl, with difference between GH2O and GEDTA (P < .05). GH2O and GEDTA + NaOCl presented higher sealer tags formation (P < .05). CONCLUSION The final rinse with EDTA for Ca(OH)2 dressing removal had a negative effect on the POBS of the filling material to root dentin. The use of EDTA followed by NaOCl had results similar to the distilled water, providing uniform and free-of-gaps adhesive interface, and a higher number of sealer tags.
Collapse
Affiliation(s)
- Julia Menezes Savaris
- Postgraduate Program in Dentistry, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Jakson Carlos Isoton
- Postgraduate Program in Dentistry, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Bruna Fiorine Fluck
- Postgraduate Program in Dentistry, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Maybell Tedesco
- Postgraduate Program in Dentistry, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Eduardo Antunes Bortoluzzi
- Division of Endodontics, Department of Diagnosis and Oral Health, University of Louisville, Louisville, Kentucky
| | | | | |
Collapse
|
11
|
Sharma A, Naorem N, Srivastava B, Gupta N, Konsam B, Haider K. Comparative Evaluation of Antifungal Efficacy of 3% Sodium Hypochlorite, 2% Chlorhexidine Gluconate, Ozonated Water, Alum Water, and Normal Saline Solutions against Endodontopathogenic Microorganism, Candida Albicans: A Microbiological In Vitro Study. Int J Clin Pediatr Dent 2024; 17:S17-S24. [PMID: 39185258 PMCID: PMC11343986 DOI: 10.5005/jp-journals-10005-2754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/27/2024] Open
Abstract
Aims and objective To compare and evaluate the antifungal efficacy of 3% sodium hypochlorite (NaOCl), 2% chlorhexidine (CHX) gluconate, 4 mg/mL ozonated water, and 2M alum water against Candida albicans (C. albicans). Materials and methods A total of 35 patients were selected from those attending the outpatient department of Pedodontics and Preventive Dentistry at Santosh Dental College and Hospitals, Ghaziabad. Their salivary samples were taken and cultured on a Sabouraud's dextrose agar (SDA) plate. The antifungal efficacy of 3% NaOCl, 2% CHX gluconate, 4 mg/mL concentration of ozonated water, and 2M alum water was assessed against clinical strains of C. albicans with the help of agar well diffusion method. The microbial isolates were inoculated into 10 mL of sterile peptone water and incubated at 37°C for 8 hours. The cultures were swabbed on the surface of sterile Mueller-Hinton agar plates using a sterile cotton swab. Five wells of 6 mm diameter were punched in each Petri dish. Around 100 µL of each test solution was poured into the designated wells. Further, the plates were incubated in an upright position at 37°C for 24 hours. The antifungal activity of the test solutions was determined by measuring the diameter of the inhibition zone in mm produced against the Candida isolates, and means were calculated. Results It was observed that all test solutions used in this study were inhibitory against C. albicans but with a variation in the size of inhibitory zones. According to the means of the diameter of inhibitory zones for all test solutions, the 3% NaOCl represented the statistically significant largest average zones of inhibition against C. albicans, followed by 2% CHX when compared with the other two test solutions alum water and ozonated water. Ozonated water produced the smallest mean inhibitory zone. How to cite this article Sharma A, Naorem N, Srivastava B, et al. Comparative Evaluation of Antifungal Efficacy of 3% Sodium Hypochlorite, 2% Chlorhexidine Gluconate, Ozonated Water, Alum Water, and Normal Saline Solutions against Endodontopathogenic Microorganism, Candida Albicans: A Microbiological In Vitro Study. Int J Clin Pediatr Dent 2024;17(S-1):S17-S24.
Collapse
Affiliation(s)
- Anumedha Sharma
- Department of Dental, ESIC Model Hospital, Guwahati, Assam, India
| | - Nena Naorem
- Department of Paediatrics and Preventive Dentistry, Dental College, Jawaharlal Nehru Institute of Medical Sciences, Imphal, Manipur, India
| | - Binita Srivastava
- Department of Pediatric Dentistry, Santosh Dental College and Hospital, Ghaziabad, Uttar Pradesh, India
| | - Nidhi Gupta
- Department of Pediatric Dentistry, Santosh Dental College and Hospital, Ghaziabad, Uttar Pradesh, India
| | - Bidya Konsam
- Department of Periodontology, Dental College, Jawaharlal Nehru Institute of Medical Sciences, Imphal, Manipur, India
| | - Khushtar Haider
- Department of Dentistry, Government Medical College, Datia, Madhya Pradesh, India
| |
Collapse
|
12
|
Irani D, Jungbauer G, Sculean A, Eick S. Effect of sodium hypochlorite gel on bacteria associated with periodontal disease. Clin Oral Investig 2024; 28:190. [PMID: 38430333 PMCID: PMC10908609 DOI: 10.1007/s00784-023-05446-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 12/17/2023] [Indexed: 03/03/2024]
Abstract
OBJECTIVES An adjunct in non-surgical periodontal therapy might be sodium hypochlorite (NaOCl)-based agents. The purpose of the present in vitro study was to get deeper knowledge on the influence of different parameters as time after mixing, pH, and chemical composition of an amino acid 0.475% NaOCl (AA-NaOCl) gel consisting of two components on its anti-biofilm activity. MATERIALS AND METHODS Six-species biofilms were cultured for 5 days, before AA-NaOCl gel was applied. In the different series, the influence of the time after mixing of the two components before application, of the concentration of NaOCl in the gel mixture, of the pH of the gel mixture, and of an exchange of the amino acid component by hyaluronic acid (HA), was analyzed. RESULTS Mixing time point experiments showed that the AA-NaOCl gel is capable of statistically significantly reducing colony-forming unit (cfu) counts up to 30 min after mixing, but only up to 20 min after mixing the reduction was more than 2 log10 cfu. The pH experiments indicate that a reduced pH results in a reduced activity of the NaOCl formulation. NaOCl concentrations in the formulation in the range from 0.475 to 0.2% provide adequate activity on biofilms. A HA/NaOCl gel was equally active against the biofilm as the AA-NaOCl gel. CONCLUSION Mixing of the components should be made in a timeframe of 20 min before applications. An optimization of the composition of the NaOCl formulation might be possible and should be a topic in further in vitro studies. CLINICAL RELEVANCE The AA-NaOCl gel formulation can be mixed up to 20 min before application. Further, the study indicates that the composition of the NaOCl gel formulation can be optimized.
Collapse
Affiliation(s)
- Delia Irani
- School of Dentistry, Department of Periodontology, University of Bern, Freiburgstrasse 7, CH-3010, Bern, Switzerland
| | - Gert Jungbauer
- School of Dentistry, Department of Periodontology, University of Bern, Freiburgstrasse 7, CH-3010, Bern, Switzerland
| | - Anton Sculean
- School of Dentistry, Department of Periodontology, University of Bern, Freiburgstrasse 7, CH-3010, Bern, Switzerland
| | - Sigrun Eick
- School of Dentistry, Department of Periodontology, University of Bern, Freiburgstrasse 7, CH-3010, Bern, Switzerland.
| |
Collapse
|
13
|
Tsai CF, Chung JJ, Ding SJ, Chen CC. In vitro cytotoxicity and antibacterial activity of hypochlorous acid antimicrobial agent. J Dent Sci 2024; 19:345-356. [PMID: 38303880 PMCID: PMC10829635 DOI: 10.1016/j.jds.2023.07.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 07/03/2023] [Indexed: 02/03/2024] Open
Abstract
Background/purpose Bacteria-associated oral diseases such as dental caries and periodontitis are widespread epidemics that cause oral pain and loss of function. The purpose of this study was to evaluate the in vitro cytotoxicity and antibacterial activity of different concentrations of hypochlorous acid (HOCl). Materials and methods Five different concentrations (100, 200, 300, 400, and 500 ppm) of HOCl were evaluated for their antimicrobial efficacy against Gram-negative (A. actinomycetcmcomitans and P. gingivalis) and Gram-positive bacteria (S. mutans and S. sanguinis) after treatment for 1 and 10 min. Sodium hypochlorite (NaOCl) and chlorhexidine (CHX) were used as positive controls. In addition, HOCl was examined for L929 cytotoxicity and RAW 264.7 growth. Results The bacteriostatic ratio of NaOCl was comparable to that of CHX and significantly (P < 0.05) higher than that of all HOCl solutions. Higher HOCl concentration had significantly (P < 0.05) higher antibacterial effect, and the bacteriostatic ratio of 10 min treatment was slightly higher than that of 1 min treatment. CHX and NaOCl seeded into L929 cells resulted in low cell viability with only 30-39%, much significantly (P < 0.05) lower than all HOCl groups (greater than 80%). All HOCl solutions met the recommendations of ISO 10993-5 and showed no cytotoxicity, although there was a concentration-dependent decrease in cell viability. All antimicrobial agents showed the same trend of response to RAW 264.7 as L929. Conclusion Within the limit of this study, 400 ppm HOCl disinfectant may be a potential antimicrobial candidate for mouthwash, endodontic irrigants, and periodontitis treatment.
Collapse
Affiliation(s)
- Cheng-Feng Tsai
- Institute of Oral Science, Chung Shan Medical University, Taichung, Taiwan
| | - Jia-Jia Chung
- Institute of Oral Science, Chung Shan Medical University, Taichung, Taiwan
| | - Shinn-Jyh Ding
- Institute of Oral Science, Chung Shan Medical University, Taichung, Taiwan
- Department of Stomatology, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Chun-Cheng Chen
- Department of Stomatology, Chung Shan Medical University Hospital, Taichung, Taiwan
- School of Dentistry, Chung Shan Medical University, Taichung, Taiwan
| |
Collapse
|
14
|
Pai ARV. Injection of sodium hypochlorite into soft tissues of the oral cavity: A literature review with clinical preventive recommendations. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101581. [PMID: 37544507 DOI: 10.1016/j.jormas.2023.101581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 07/30/2023] [Indexed: 08/08/2023]
Abstract
Injection of sodium hypochlorite (NaOCl) solution instead of local anaesthetic (LA) solution is an iatrogenic error with serious consequences including medico-legal implications. Such cases have been reported despite recommended precautionary measures. The purpose of this article is to review the literature on such cases and present clinical preventive recommendations. Electronic search was conducted in PubMed/Medline, Google Scholar, Cochrane, Scopus, Lilacs, ScienceDirect, and Crossref databases for articles reporting accidental or mistaken or inadvertent injection of NaOCl instead of LA during dental or endodontic treatment. Articles reporting NaOCl accident due to extrusion or injection of NaOCl beyond root confines were excluded. A total of 11 articles were found and reviewed. Data pertaining to the patient, injected NaOCl, cause, clinical manifestations, management, hospitalization, healing and recovery, and long-term or residual effects were extracted, compiled, and analysed for interpretation and discussion. Injection of NaOCl instead of LA into the soft tissues leads to varying clinical manifestations with unpredictable extent, outcome, and recovery period. The onus lies with the clinician to prevent it. Therefore, a clinician must take all the precautionary measures and confirm the identity of LA and NaOCl solutions before delivering them. The presented clinical recommendations assist clinicians to prevent it, including its potential medico-legal consequences. However, in case of such an unfortunate event, it is crucial to immediately identify and quickly manage it to limit the tissue damage or complications.
Collapse
Affiliation(s)
- A R Vivekananda Pai
- Department of Conservative Dentistry and Endodontics, Faculty of Dentistry, Manipal University College Malaysia (MUCM), Jalan Batu Hampar, Bukit Baru, Melaka 75150, Malaysia.
| |
Collapse
|
15
|
Lee MJ, Kim MA, Min KS. Combined effect of electrical energy and graphene oxide on Enterococcus faecalis biofilms. Dent Mater J 2023; 42:844-850. [PMID: 37914231 DOI: 10.4012/dmj.2023-087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2023]
Abstract
This study aimed to investigate the effects of electrical energy and its synergistic activity with graphene oxide (GO) in Enterococcus faecalis (E. faecalis) biofilms. The viability of E. faecalis biofilms was analyzed by colony-forming units, crystal violet staining, and confocal laser scanning microscopy. The morphologies of the biofilms and the bacterial organelles were observed by scanning electron microscopy and transmission emission microscopy (TEM), respectively. Application of electrical energy combined with 0.2% sodium hypochlorite (NaOCl) on E. faecalis in biofilms significantly decreased the bacterial viability and biofilm biomass compared to the 0.2% NaOCl-only-treated group. Furthermore, additional application of GO showed similar antibacterial effects to 0.5% NaOCl. Notably, TEM observation revealed that the bacteria treated with electric energy and GO showed damaged cell membranes. The results suggest that combination of electrical energy and GO enhances antibacterial activity of NaOCl and has the potential to be applied to root canal irrigation protocols.
Collapse
Affiliation(s)
- Myung-Jin Lee
- Department of Conservative Dentistry, School of Dentistry, Seoul National University
| | - Mi-Ah Kim
- Department of Conservative Dentistry, School of Dentistry and Institute of Oral Bioscience, Jeonbuk National University
| | - Kyung-San Min
- Department of Conservative Dentistry, School of Dentistry and Institute of Oral Bioscience, Jeonbuk National University
- Research Institute of Clinical Medicine of Jeonbuk National University
- Biomedical Research Institute of Jeonbuk National University Hospital
| |
Collapse
|
16
|
Shahi Ardakani A, Afrasiabi S, Sarraf P, Benedicenti S, Solimei L, Chiniforush N. In Vitro Assessment of SWEEPS and Antimicrobial Photodynamic Therapy Alone or in Combination for Eradicating Enterococcus faecalis Biofilm in Root Canals. Pharmaceutics 2023; 15:2628. [PMID: 38004605 PMCID: PMC10674832 DOI: 10.3390/pharmaceutics15112628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 11/12/2023] [Accepted: 11/14/2023] [Indexed: 11/26/2023] Open
Abstract
OBJECTIVES This study investigates the efficacy of antimicrobial photodynamic therapy (aPDT) using riboflavin and a blue diode laser (BDL), combined with shock wave-enhanced emission photoacoustic streaming (SWEEPS), against Enterococcus faecalis. MATERIALS AND METHODS A total of 48 extracted single-rooted human teeth were used. The root canals were instrumented, sealed at their apices, had the smear layer removed, and then underwent autoclave sterilization. Subsequently, each canal was inoculated with E. faecalis bacterial suspension and allowed to incubate for ten days. After confirming the presence of biofilms through scanning electron microscopy (SEM) in three teeth, the remaining teeth were randomly allocated into nine groups, each containing five teeth: control, 5.25% sodium hypochlorite (NaOCl), BDL, SWEEPS + normal saline, SWEEPS + NaOCl, riboflavin, riboflavin + SWEEPS, riboflavin + BDL, and riboflavin + BDL + SWEEPS. After the treatment, the numbers of colony-forming units (CFUs)/mL were calculated. The data were analysed using one-way ANOVA followed by Tukey's test for comparisons. RESULTS All groups, with the exception of the BDL group, exhibited a significant reduction in E. faecalis CFU/mL when compared to the control group (p < 0.001). The difference in CFU/mL value between riboflavin + BDL + SWEEPS and riboflavin + SWEEPS was significant (p = 0.029), whereas there was no significant difference between riboflavin + BDL + SWEEPS and riboflavin + BDL (p = 0.397). Moreover, there was no statistically significant difference between the riboflavin + SWEEPS group and the riboflavin + BDL group (p = 0.893). CONCLUSIONS The results demonstrated that combining the SWEEPS technique with riboflavin as a photosensitizer activated by BDL in aPDT effectively reduced the presence of E. faecalis in root canals.
Collapse
Affiliation(s)
- Ali Shahi Ardakani
- Laser Research Center of Dentistry, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran 1441987566, Iran;
| | - Shima Afrasiabi
- Laser Research Center of Dentistry, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran 1441987566, Iran;
| | - Pegah Sarraf
- Department of Endodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran 1441987566, Iran;
| | - Stefano Benedicenti
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, 16132 Genoa, Italy; (S.B.); (L.S.)
| | - Luca Solimei
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, 16132 Genoa, Italy; (S.B.); (L.S.)
| | - Nasim Chiniforush
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, 16132 Genoa, Italy; (S.B.); (L.S.)
| |
Collapse
|
17
|
Pascale C, Geaman J, Mendoza C, Gao F, Kaminski A, Cuevas-Nunez M, Darvishan B, Mitchell JC, Carrilho MR, Sigar I. In vitro assessment of antimicrobial potential of low molecular weight chitosan and its ability to mechanically reinforce and control endogenous proteolytic activity of dentine. Int Endod J 2023; 56:1337-1349. [PMID: 37584496 DOI: 10.1111/iej.13962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 07/25/2023] [Accepted: 07/28/2023] [Indexed: 08/17/2023]
Abstract
AIMS Chitosan-based biomaterials exhibit several properties of biological interest for endodontic treatment. Herein, a low molecular weight chitosan (CH) solution was tested for its antimicrobial activity against Enterococcus faecalis (E. faecalis) and effects on dentine structure. METHODOLOGY The root canal of 27 extracted uniradicular teeth were biomechanically prepared, inoculated with a suspension of E. faecalis and randomly assigned to be irrigated with either 5.25% sodium hypochlorite (NaClO), 0.2% CH or sterile ultrapure water (W). Bacteriologic samples were collected from root canals and quantified for of E. faecalis colony-forming units (CFUs). The effectiveness of CH over E. faecalis biofilms was further measured using the MBEC Assay®. Additionally, dentine beams and dentine powder were obtained, respectively, from crowns and roots of 20 extracted third molars. Dentine samples were treated or not with 17% EDTA and immersed in either CH or W for 1 min. The effects of CH on dentine structure were evaluated by assessment of the modulus of elasticity, endogenous proteolytic activity and biochemical modifications. RESULTS The number of E. faecalis CFUs was significantly lower for samples irrigated with CH and NaClO. No significant differences were found between CH and NaClO treatments. Higher modulus of elasticity and lower proteolytic activity were reported for dentine CH-treated specimens. Chemical interaction between CH and dentine was observed for samples treated or not with EDTA. CONCLUSIONS Present findings suggest that CH could be used as an irrigant during root canal treatment with the triple benefit of reducing bacterial activity, mechanically reinforcing dentine and inhibiting dentine proteolytic activity.
Collapse
Affiliation(s)
- Christina Pascale
- College of Dental Medicine Illinois, Midwestern University, Downers Grove, Illinois, USA
| | - Jay Geaman
- College of Dental Medicine Illinois, Midwestern University, Downers Grove, Illinois, USA
| | - Christine Mendoza
- College of Dental Medicine Illinois, Midwestern University, Downers Grove, Illinois, USA
| | - Feng Gao
- College of Dental Medicine Illinois, Midwestern University, Downers Grove, Illinois, USA
| | - Amber Kaminski
- College of Graduate Studies, Midwestern University, Downers Grove, Illinois, USA
| | - Maria Cuevas-Nunez
- College of Dental Medicine Illinois, Midwestern University, Downers Grove, Illinois, USA
| | - Behnam Darvishan
- College of Dental Medicine Illinois, Midwestern University, Downers Grove, Illinois, USA
| | - John C Mitchell
- College of Dental Medicine Illinois, Midwestern University, Downers Grove, Illinois, USA
- College of Dental Medicine Arizona, Midwestern University, Downers Grove, Illinois, USA
| | - Marcela R Carrilho
- College of Dental Medicine Illinois, Midwestern University, Downers Grove, Illinois, USA
| | - Ira Sigar
- College of Graduate Studies, Midwestern University, Downers Grove, Illinois, USA
| |
Collapse
|
18
|
Chandraseharan P, Sockalingam SNM, Shafiei Z, Zakaria ASI, Mahyuddin A, Rahman MA. The Efficacy of Apple Cider Vinegar at Different pH Values as an Antimicrobial Agent: An In Vitro Study. J Contemp Dent Pract 2023; 24:779-786. [PMID: 38152911 DOI: 10.5005/jp-journals-10024-3581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2023]
Abstract
AIMS AND BACKGROUND This study evaluates the antimicrobial activities of commercially available 5% apple cider vinegar (ACV) against Enterococcus faecalis, Streptococcus mutans, and Lactobacillus casei. Materials and methods: Minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) were conducted using the broth microdilution method. Sodium hypochlorite (NaOCl) of 5.25% was used as a positive control, and comparisons were also made with acetic acid (AA) as the main ingredient in ACV. The three test bacteria treated with the most effective ACV dilution were visualized under a transmission electron microscope (TEM) for structural changes. RESULTS Minimal inhibitory concentration was determined at 0.625% of the concentration of ACV against S. mutans and E. faecalis and 1.25% of the concentration of ACV against L. casei with two-fold serial dilutions. A concentration of 5 × 10-1% with 10-fold serial dilutions was found to be the MIC value for all three bacteria. No significant differences were found when compared with the positive control (NaOCl) (p = 0.182, p = 0.171, and p = 0.234), respectively, for two-fold serial dilutions and (p = 1.000, p = 0.658, and p = 0.110), respectively for 10-fold serial dilutions. MBC was observed to be 5% ACV for both E. faecalis and S. mutans. However, positive microbial growth was observed on the agar plate when cultured with L. casei. An independent sample t-test showed no significant differences (p > 0.05) in the antimicrobial activities between 5% ACV and 5% pure AA. TEM revealed cell wall and cytoplasmic membrane disruptions on all three bacteria at MIC value. CONCLUSION Apple cider vinegar has antimicrobial activities against Enterococcus faecalis, Streptococcus mutans, and Lactobacillus casei at their respective MIC values. CLINICAL SIGNIFICANCE Apple cider vinegar can be an alternative antimicrobial dental pulp disinfectant to sodium hypochlorite. Apple cider vinegar can be used safely, especially in children's dental pulp therapy and deep caries management, when adequate tooth isolation is not readily achievable. Thus, adverse reactions commonly associated with other frequently used chemical disinfectants can be avoided.
Collapse
Affiliation(s)
- Prasanna Chandraseharan
- Department of Family Oral Health, Faculty of Dentistry, The National University of Malaysia (UKM), Jalan Raja Muda Abdul Aziz, Kuala Lumpur, Malaysia, https://orcid.org/0000-0002-1387-5848
| | - S Nagarajan Mp Sockalingam
- Department of Family Oral Health, Faculty of Dentistry, The National University of Malaysia (UKM), Jalan Raja Muda Abdul Aziz, Kuala Lumpur, Malaysia, Phone: +60166606493, e-mail: , https://orcid.org/0000-0002-7976-5115
| | - Zaleha Shafiei
- Department of Craniofacial Diagnostics and Biosciences, Faculty of Dentistry, The National University of Malaysia (UKM), Jalan Raja Muda Abdul Aziz, Kuala Lumpur, Malaysia, https://orcid.org/0000-0002-7703-9785
| | - Ahmad Shuhud Irfani Zakaria
- Department of Family Oral Health, Faculty of Dentistry, The National University of Malaysia (UKM), Jalan Raja Muda Abdul Aziz, Kuala Lumpur, Malaysia, https://orcid.org/0000-0003-3715-9181
| | - Alida Mahyuddin
- Department of Family Oral Health, Faculty of Dentistry, The National University of Malaysia (UKM), Jalan Raja Muda Abdul Aziz, Kuala Lumpur, Malaysia, https://orcid.org/0000-0003-3720-8617
| | - Mariati Abdul Rahman
- Department of Craniofacial Diagnostics and Biosciences, Faculty of Dentistry, The National University of Malaysia (UKM), Jalan Raja Muda Abdul Aziz, Kuala Lumpur, Malaysia, https://orcid.org/0000-0002-6856-8511
| |
Collapse
|
19
|
Rai S, Sundaramoorthy N, Mahalaxmi S, Purushothaman PV. Bioburden assessment of necrotic teeth disinfected with sodium hypochlorite, diode laser, and photodynamic therapy using flow cytometry-a randomized double-blinded clinical trial. Lasers Med Sci 2023; 38:216. [PMID: 37735303 DOI: 10.1007/s10103-023-03877-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 09/06/2023] [Indexed: 09/23/2023]
Abstract
This study aimed to comparatively evaluate the disinfecting potential of sodium hypochlorite, diode laser, and photodynamic therapy in non-vital teeth with or without periapical rarefaction. Forty-five patients with the diagnosis of pulp necrosis with apical rarefaction were randomly assigned to three groups (n = 15) based on the disinfection protocol. Access cavities were prepared and pre-instrumentation microbial samples were taken using a paper point. Working length determination followed by cleaning and shaping with rotary files was performed. The canals were lubricated with ethylenediaminetetraacetic acid (EDTA) during instrumentation and finally rinsed with copious amounts of saline. Canals in group 1 were irrigated with 5 mL of 5.25% NaOCl, those in group 2 received irradiation with 808-nm diode laser (30 s, 7W), and those in group 3 were soaked with methylene blue photosensitizer (5 min) before irradiation with 660-nm diode laser (3 min). Post-disinfection microbial samples were collected using a paper point. Pre- and post-disinfection live bacterial counts were analyzed using a flow cytometer. The data were statistically analyzed using one-way ANOVA and Student's t-test. Comparison of pre-instrumentation mean live bacterial count showed no significant difference between the groups (p > 0.05). The mean live bacterial count post-disinfection was 41.07%, 46.99%, and 34.45% in groups 1-3 respectively. A significant reduction in the bacterial count was seen following disinfection in all the groups (p < 0.05). It can be concluded that both diode laser and photodynamic therapy were equally effective as 5.25% NaOCl in reducing the bioburden in root canals. TRIAL REGISTRATION: CTRI/2018/03/012667.
Collapse
Affiliation(s)
- Sadhana Rai
- Department of Conservative Dentistry and Endodontics, SRM Institute of Science and Technology, SRM Dental College, Bharathi Salai, Ramapuram, Chennai, 600089, India
| | - Nagarathinam Sundaramoorthy
- Department of Conservative Dentistry and Endodontics, SRM Institute of Science and Technology, SRM Dental College, Bharathi Salai, Ramapuram, Chennai, 600089, India
| | - Sekar Mahalaxmi
- Department of Conservative Dentistry and Endodontics, SRM Institute of Science and Technology, SRM Dental College, Bharathi Salai, Ramapuram, Chennai, 600089, India.
| | | |
Collapse
|
20
|
Lakshmaiah D, Irudayaraj N, Ambeth N, Ramachandran A, Sakthi N, Kumar N. Comparative Evaluation of Microhardness, Smear Layer Removal Efficacy and Depth of Penetration Using Punica granatum, Emblica officinalis and Sodium Hypochlorite As Endodontic Irrigants: An In Vitro Study. Cureus 2023; 15:e44760. [PMID: 37809222 PMCID: PMC10556994 DOI: 10.7759/cureus.44760] [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] [Accepted: 09/06/2023] [Indexed: 10/10/2023] Open
Abstract
Introduction Root canal morphology tends to be complicated by nature and dealing with this intricacy can be challenging because it makes it difficult to completely disinfect the root canal space. The success of root canal therapy is also determined by the biomechanical preparation of the canal with the application of instruments and irrigating solutions. Due to the fact that the root dentin surface continues to interact with the irrigating solution during preparation, it's critical to evaluate the mechanical characteristics and smear layer removal. Though sodium hypochlorite (NaOCl) is the most commonly used irrigant due to its tissue-dissolving abilities, it has certain drawbacks which include the inability to remove the smear layer and also affects the mechanical properties of root dentin. To overcome these limitations, a variety of herbal substitutes like Punica granatum and Emblica officinalis which possess anti-bacterial and anti-fungal properties can be used as endodontic irrigants. Several studies on the anti-bacterial properties of natural irrigants of pomegranate and amla were reported. However, the mechanical properties and smear layer removal of Punica granatum and Emblica officinalis have not been explored in the field of endodontics. Aim The main aim of this in vitro study is to compare and evaluate microhardness, smear layer removal efficacy and depth of penetration of herbal and conventional irrigants. Materials and methods Thirty-six palatal roots of maxillary molars were decoronated and instrumented up to F3. These roots were sectioned longitudinally and divided into three test groups: Group 1: 12.5% Punica granatum; Group 2: 6.25% Emblica officinalis; control: Group 3: 2.5% NaOCl. All specimens were irrigated with 5ml of each irrigant for 5 minutes. Microhardness of root dentin was measured using a Vickers diamond intender, smear layer removal using a scanning electron microscope (SEM) and depth of penetration using a stereomicroscope. The data was analyzed using one-way ANOVA and the inter-group comparison using Tukey's post hoc test. Results Statistical analysis was done using one-way analysis of variance (ANOVA) and Tukey's post hoc test using SPSS software version 17.0 (SPSS Inc., Chicago ). The highest microhardness was seen in Group 1 (cervical: 53.8375 ± 1.35956, middle: 53.9875 ± 1.01761, apical: 53.6875 ± 1.63133) while Group 2 (cervical: 43.2750 ± 1.73596, middle: 43.3125 ± 1.17648, apical: 43.8000 ± 1.32665) and Group 3 (cervical: 42.7250 ± 2.93391, middle: 41.9625 ± 1.66985, apical: 42.0250 ± 2.21085) showed significant reduction in root dentin hardness. Regarding smear layer removal Group 1 (1.3750 ± 0.51755), and Group 2 (1.2500 ± 0.46291) reveals greater smear removal in the middle third of the root dentin compared with Group 3 (2.3750 ± 0.51755), which showed the least smear layer removal. A greater depth of penetration was seen in Group 1 (0.5488 ± 0.05222) and Group 2 (0.5263 ± 0.05181) than in Group 3 (0.3087 ± 0.05743). Conclusion The present study reveals that the least reduction of microhardness was seen in Punica granatum followed by Emblica officinalis and NaOCl. The smear layer removal efficacy and depth of penetration were greater in Punica granatum and Emblica officinalis than in NaOCl. It was concluded that as these herbal irrigants are biocompatible agents, they can be considered for future use in root canal treatment.
Collapse
Affiliation(s)
- Deepika Lakshmaiah
- Department of Conservative Dentistry and Endodontics, Chettinad Dental College and Research Institute, Chennai, IND
| | - Nancy Irudayaraj
- Department of Conservative Dentistry and Endodontics, Chettinad Dental College and Research Institute, Chennai, IND
| | - Nivetha Ambeth
- Department of Conservative Dentistry and Endodontics, Chettinad Dental College and Research Institute, Chennai, IND
| | - Anupama Ramachandran
- Department of Conservative Dentistry and Endodontics, Chettinad Dental College and Research Institute, Chennai, IND
| | - Nikesh Sakthi
- Department of Conservative Dentistry and Endodontics, Chettinad Dental College and Research Institute, Chennai, IND
| | - Nirmal Kumar
- Department of Conservative Dentistry and Endodontics, Ragas Dental College and Hospital, Chennai, IND
| |
Collapse
|
21
|
Gandhi M, Lakade L, Davalbhakta R, Patel A, Chaudhary S, Jajoo S. Scanning electron microscope analysis to evaluate the effect of pretreatment with ozone and sodium hypochlorite on pits and fissures of primary teeth. J Indian Soc Pedod Prev Dent 2023; 41:258-264. [PMID: 37861642 DOI: 10.4103/jisppd.jisppd_352_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2023] Open
Abstract
Introduction The cornerstone of preventative therapy is made up of pit and fissure sealants and fluorides. Resin sealants have been shown to help reduce fissure decay in both primary and permanent teeth. Etching of primary molars is not effective due to prismless enamel, higher organic content, and diversity in fissure shape. Methods of pretreatment of pits and fissures have been hypothesized to promote microporosities in etched enamel and hence sealant adherence. Examining the etching pattern and surface roughness of the enamel surface can be used to gauge these. Objective This study aimed to evaluate the effect of pretreatment with ozone gas and 5.25% sodium hypochlorite solution on pits and fissures of primary teeth to check for the etching pattern and surface roughness. Materials and Methods Thirty noncarious primary molars were sectioned to retain the crowns, and randomly divided into three groups, sodium hypochlorite, ozone gas, and control. Each sample was pretreated with the agent, washed, followed by etching with 37% phosphoric acid. Samples were sectioned and subjected to scanning electron microscope analysis to evaluate the etching pattern and surface roughness. Results Comparison of the etching pattern in three groups showed a statistically insignificant difference (P=0.364). Surface roughness was highest in the hypochlorite group followed by ozone and control which showed a statistically significant difference (P = 0.001). The surface area between the three groups showed a statistically insignificant difference. Conclusion Sodium hypochlorite is a better pretreatment agent compared to ozone gas and acid etching alone. However, as all results were not statistically significant further research must be carried out to prove the effectiveness of these agents.
Collapse
Affiliation(s)
- Mehek Gandhi
- Department of Pediatric and Preventive Dentistry, Bharati Vidyapeeth Dental College and Hospital, Pune, Maharashtra, India
| | - Laxmi Lakade
- Department of Pediatric and Preventive Dentistry, Bharati Vidyapeeth Dental College and Hospital, Pune, Maharashtra, India
| | - Rucha Davalbhakta
- Department of Pediatric and Preventive Dentistry, Bharati Vidyapeeth Dental College and Hospital, Pune, Maharashtra, India
| | - Alok Patel
- Department of Pediatric and Preventive Dentistry, Bharati Vidyapeeth Dental College and Hospital, Pune, Maharashtra, India
| | - Shweta Chaudhary
- Department of Pediatric and Preventive Dentistry, Bharati Vidyapeeth Dental College and Hospital, Pune, Maharashtra, India
| | - Shweta Jajoo
- Department of Pediatric and Preventive Dentistry, Bharati Vidyapeeth Dental College and Hospital, Pune, Maharashtra, India
| |
Collapse
|
22
|
Parhar M, Bansal P. Development of a High Penetration Safe Irrigant from Withania somnifera. Int J Appl Basic Med Res 2023; 13:149-152. [PMID: 38023598 PMCID: PMC10666837 DOI: 10.4103/ijabmr.ijabmr_89_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 07/24/2023] [Accepted: 07/28/2023] [Indexed: 12/01/2023] Open
Abstract
Background Herbal medicine is regaining a strong position in health care by virtue of better safety and minimal toxicity as compared to conventional chemotherapies. It is making a place in dental care in the form of various toothpastes, lotions, and mouthwashes. It has been analyzed that very few discrete herbal irrigants have an action comparable to that of sodium hypochlorite. No data about any study on penetration depth and penetration area for herbal-based irrigants used in root canal treatment are available. Aim The aim of this study was to assess the efficacy of Withania somnifera extracts by assessing its penetration depth and area inside dentinal tubules using a confocal laser scanning microscope. Materials and Methods Freshly extracted 25 maxillary central incisors were divided into three groups: Group 1: W. somnifera; Group 2: sodium hypochlorite; and Group 3: distilled water. Results W. somnifera showed better results with respect to penetration depth and area inside the dentinal tubules thansodium hypochlorite. Conclusion From the study, it can be concluded that W. somnifera extract-based irrigant may be used as an alternative to sodium hypochlorite-based irrigant. It also shows that more herbal drugs need such types of screening and incorporation in dental practice to reduce the potential side effects of the conventional drugs used in daily practice.
Collapse
Affiliation(s)
- Manreet Parhar
- Department of Conservative Dentistry and Endodontics, Sri Guru Ram Das Institute of Dental Sciences and Research, Amritsar, Punjab, India
| | - Parveen Bansal
- Department of Herbal Drug Technology, University Centre of Excellence in Research, Baba Farid University of Health Sciences, Faridkot, Punjab, India
| |
Collapse
|
23
|
Navayath M, Ramesh SR, Kalaiselvam R, Ashok R, Rajendran MR, Balaji L. Evaluation of Nanomagnesium Oxide in Combination with Garlic Extract as an Endodontic Irrigant: An In Vitro Study. J Contemp Dent Pract 2023; 24:459-466. [PMID: 37622623 DOI: 10.5005/jp-journals-10024-3530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/26/2023]
Abstract
AIM The aim of this in vitro study was to evaluate the effectiveness of the combination of garlic extract in combination with magnesium oxide (MgO) for use as an endodontic irrigant at various contact times. MATERIALS AND METHODS All 48 teeth were divided into 6 groups according to irrigation used after inoculation with Enterococcus faecalis and incubation. The control groups consisted of saline and sodium hypochlorite (NaOCl) used as irrigants and the test groups employed garlic extract combined with nano-magnesium oxide (nano-MgO) used as irrigant with two contact times, namely, 2 and 5 minutes, and garlic extract and nano-MgO used solely for 5 minutes each. Colony-forming units (CFUs) were counted after plating and incubation. RESULTS In NaOCl, and in both combination groups, there was a significant reduction in CFU counts. The saline group showed no decrease. Statistical analysis showed no difference in efficacy between NaOCl and the two combination groups. There was a statistical difference between the combination group and garlic/nano-MgO alone at both 2 and 5 minutes. CONCLUSIONS Under the conditions of this study, a novel irrigant, a combination of nanoparticles of MgO and garlic extract was as effective as NaOCl against E. faecalis in an in vitro model at two tested contact times. CLINICAL SIGNIFICANCE Combination of MgO nanoparticles and garlic extract achieves disinfection comparable to gold standard NaOCl without harmful caustic effects of hypochlorite.
Collapse
Affiliation(s)
- Malikka Navayath
- Department of Conservative Dentistry and Endodontics, Sri Ramachandra Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Seshan Rakkesh Ramesh
- Department of Conservative Dentistry and Endodontics, Sri Ramachandra Dental College and Hospital, Chennai, Tamil Nadu, India, Phone: +91 9952841991, e-mail:
| | - Rajeswari Kalaiselvam
- Department of Conservative Dentistry and Endodontics, Sri Ramachandra Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Rupa Ashok
- Department of Conservative Dentistry and Endodontics, Sri Ramachandra Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Mathan Rajan Rajendran
- Department of Conservative Dentistry and Endodontics, Sri Ramachandra Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Lakshmi Balaji
- Department of Conservative Dentistry and Endodontics, Sri Ramachandra Dental College and Hospital, Chennai, Tamil Nadu, India
| |
Collapse
|
24
|
Kotecha N, Shah NC, Doshi RJ, Kishan KV, Luke AM, Shetty KP, Mustafa M, Pawar AM. Microbiological Effectiveness of Sodium Hypochlorite Gel and Aqueous Solution When Implemented for Root Canal Disinfection in Multirooted Teeth: A Randomized Clinical Study. J Funct Biomater 2023; 14:jfb14050240. [PMID: 37233350 DOI: 10.3390/jfb14050240] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 04/07/2023] [Accepted: 04/20/2023] [Indexed: 05/27/2023] Open
Abstract
The aim of endodontic therapy is to use various antimicrobial medications for proper cleaning and shaping to create an environment free of microorganisms by eradicating as many as possible from the root canal space. Even although it is a gold standard irrigant, sodium hypochlorite (NaOCl) is known for its cytotoxic effects on vital periapical tissues, making its higher concentrations inappropriate for use in conditions such as wide, underdeveloped, or damaged apices and in cases of perforations. Consequently, if it is ascertained that a gel form of sodium hypochlorite has equivalent antibacterial activity to the aqueous solution form, it could be employed in such situations. The aim of this study was the microbiologic evaluation of 5.25% sodium hypochlorite gel and aqueous solution as root canal disinfectants in multirooted teeth with primary endodontic lesions. Following ethical approval and CTRI registration, 42 patients who gave their consent and had multirooted teeth with pulpal necrosis and asymptomatic apical periodontitis were considered for the study. Following the opening of the access, pre-endodontic build up in case of class-II cavities and working length determination, a pre-operative sample (S1), which was regarded as the pre-operative microbial load of that canal, was acquired from the largest canal using a sterile paper point while maintaining strict isolation and disinfection. The computer randomization approach was used to divide the teeth into two groups at random just before beginning of chemo-mechanical preparation: Group A (n = 21)-canal disinfection with 5.25% sodium hypochlorite gel; Group B (n = 21)-canal disinfection with 5.25% sodium hypochlorite aqueous solution. Following the canal disinfection, a post-operative (S2) sample which was regarded as the postoperative microbial load of that canal was collected from the same canal using a sterile paper point. The Colony-Forming Units (CFUs) for the S1 and S2 samples were determined after 48 h aerobic incubation on Brain Heart Infusion (BHI) agar plates. The patients and the microbiologist were blinded throughout the procedure. Using SPSS 20.0 software (USA), the Shapiro-Wilk test and the Lilliefors Significance Correction were used for normality, followed by the Mann-Whitney U test which was used to compare the CFU difference (×105) between the two groups. A p value of <0.05 was perceived as statistically significant. The mean colony-forming units count difference between the 5.25% sodium hypochlorite gel and aqueous solution groups did not differ in a manner that was statistically significant (p = 0.744). In multirooted teeth with primary endodontic lesions, the 5.25% sodium hypochlorite gel and the aqueous solution demonstrated comparable antimicrobial effectiveness when implemented as root canal disinfectants.
Collapse
Affiliation(s)
- Niral Kotecha
- Department of Conservative Dentistry and Endodontics, K M Shah Dental College and Hospital Sumandeep Vidyapeeth, Pipariya, Waghodia, Vadodara 391760, Gujarat, India
| | - Nimisha Chinmay Shah
- Department of Conservative Dentistry and Endodontics, K M Shah Dental College and Hospital Sumandeep Vidyapeeth, Pipariya, Waghodia, Vadodara 391760, Gujarat, India
| | - Rohan Jiteshkumar Doshi
- Department of Conservative Dentistry and Endodontics, K M Shah Dental College and Hospital Sumandeep Vidyapeeth, Pipariya, Waghodia, Vadodara 391760, Gujarat, India
| | - Karkala Venkappa Kishan
- Department of Conservative Dentistry and Endodontics, K M Shah Dental College and Hospital Sumandeep Vidyapeeth, Pipariya, Waghodia, Vadodara 391760, Gujarat, India
| | - Alexander Maniangat Luke
- Department of Clinical Science, College of Dentistry, Ajman University, Al-Jurf, Ajman 346, United Arab Emirates
- Center of Medical and Bio-allied Health Sciences Research, Ajman University, Al-Jurf, Ajman 346, United Arab Emirates
| | - Krishna Prasad Shetty
- Department of Clinical Science, College of Dentistry, Ajman University, Al-Jurf, Ajman 346, United Arab Emirates
- Center of Medical and Bio-allied Health Sciences Research, Ajman University, Al-Jurf, Ajman 346, United Arab Emirates
| | - Mohammed Mustafa
- Department of Conservative Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, P.O. Box 173, Al-Kharj 11942, Saudi Arabia
- Centre for Transdisciplinary Research, Department of Conservative Dentistry and Endodontics, Saveetha Dental College, Saveetha University, Chennai 600077, Tamil Nadu, India
| | - Ajinkya M Pawar
- Department of Conservative Dentistry and Endodontics, Nair Hospital Dental College, Mumbai 400008, Maharashtra, India
| |
Collapse
|
25
|
Briggs EA, Toner R, Kilgariff JK. Evidence-based Standard Operating Procedures FoR the Prevention and Management of Sodium Hypochlorite Accidents in Dentistry. Prim Dent J 2023; 12:97-109. [PMID: 36916617 DOI: 10.1177/20501684231155784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/15/2023]
Abstract
This article aims to reduce harm and improve patient safety in dentistry by providing evidence-based guidance on the prevention, recognition, management, and reporting of sodium hypochlorite injuries occurring in the course of endodontic dental treatment. In contrast to previous publications all types of sodium hypochlorite harm and near-harm events in the dental setting are considered, to offer the reader an all-encompassing clinical guide for reference.
Collapse
|
26
|
Zharkova MS, Komlev AS, Filatenkova TA, Sukhareva MS, Vladimirova EV, Trulioff AS, Orlov DS, Dmitriev AV, Afinogenova AG, Spiridonova AA, Shamova OV. Combined Use of Antimicrobial Peptides with Antiseptics against Multidrug-Resistant Bacteria: Pros and Cons. Pharmaceutics 2023; 15:291. [PMID: 36678918 PMCID: PMC9863607 DOI: 10.3390/pharmaceutics15010291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 01/09/2023] [Accepted: 01/12/2023] [Indexed: 01/18/2023] Open
Abstract
Antimicrobial peptides (AMPs) are acknowledged as a promising template for designing new antimicrobials. At the same time, existing toxicity issues and limitations in their pharmacokinetics make topical application one of the less complicated routes to put AMPs-based therapeutics into actual medical practice. Antiseptics are one of the common components for topical treatment potent against antibiotic-resistant pathogens but often with toxicity limitations of their own. Thus, the interaction of AMPs and antiseptics is an interesting topic that is also less explored than combined action of AMPs and antibiotics. Herein, we analyzed antibacterial, antibiofilm, and cytotoxic activity of combinations of both membranolytic and non-membranolytic AMPs with a number of antiseptic agents. Fractional concentration indices were used as a measure of possible effective concentration reduction achievable due to combined application. Cases of both synergistic and antagonistic interaction with certain antiseptics and surfactants were identified, and trends in the occurrence of these types of interaction were discussed. The data may be of use for AMP-based drug development and suggest that the topic requires further attention for successfully integrating AMPs-based products in the context of complex treatment. AMP/antiseptic combinations show promise for creating topical formulations with improved activity, lowered toxicity, and, presumably, decreased chances of inducing bacterial resistance. However, careful assessment is required to avoid AMP neutralization by certain antiseptic classes in either complex drug design or AMP application alongside other therapeutics/care products.
Collapse
Affiliation(s)
- Maria S. Zharkova
- Institute of Experimental Medicine, WCRC “Center for Personalized Medicine”, 12 Academic Pavlov Street, St. Petersburg 197022, Russia
| | - Aleksey S. Komlev
- Institute of Experimental Medicine, WCRC “Center for Personalized Medicine”, 12 Academic Pavlov Street, St. Petersburg 197022, Russia
| | - Tatiana A. Filatenkova
- Institute of Experimental Medicine, WCRC “Center for Personalized Medicine”, 12 Academic Pavlov Street, St. Petersburg 197022, Russia
| | - Maria S. Sukhareva
- Institute of Experimental Medicine, WCRC “Center for Personalized Medicine”, 12 Academic Pavlov Street, St. Petersburg 197022, Russia
| | - Elizaveta V. Vladimirova
- Institute of Experimental Medicine, WCRC “Center for Personalized Medicine”, 12 Academic Pavlov Street, St. Petersburg 197022, Russia
| | - Andrey S. Trulioff
- Institute of Experimental Medicine, WCRC “Center for Personalized Medicine”, 12 Academic Pavlov Street, St. Petersburg 197022, Russia
| | - Dmitriy S. Orlov
- Institute of Experimental Medicine, WCRC “Center for Personalized Medicine”, 12 Academic Pavlov Street, St. Petersburg 197022, Russia
| | - Alexander V. Dmitriev
- Institute of Experimental Medicine, WCRC “Center for Personalized Medicine”, 12 Academic Pavlov Street, St. Petersburg 197022, Russia
| | - Anna G. Afinogenova
- St. Petersburg Pasteur Institute, 14 Mira Street, St. Petersburg 197101, Russia
| | - Anna A. Spiridonova
- Department of Clinical Microbiology, Pavlov First Saint Petersburg State Medical University, 6/8 Lev Tolstoy Street, St. Petersburg 197022, Russia
| | - Olga V. Shamova
- Institute of Experimental Medicine, WCRC “Center for Personalized Medicine”, 12 Academic Pavlov Street, St. Petersburg 197022, Russia
- Department of Biochemistry, Saint Petersburg State University, 7/9 Universitetskaya Embankment, St. Petersburg 199034, Russia
| |
Collapse
|
27
|
Behbehani JM, Irshad M, Shreaz S, Karched M. Anticandidal Activity of Capsaicin and Its Effect on Ergosterol Biosynthesis and Membrane Integrity of Candida albicans. Int J Mol Sci 2023; 24:ijms24021046. [PMID: 36674560 PMCID: PMC9860720 DOI: 10.3390/ijms24021046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 11/22/2022] [Accepted: 12/05/2022] [Indexed: 01/06/2023] Open
Abstract
Oral candidiasis is an infection of the oral cavity commonly caused by Candida albicans. Endodontic treatment failure has also been found to be persistent from C. albicans in the root canal system. Despite the availability of antifungal drugs, the management of Candida oral infection is difficult as it exhibits resistance to a different class of antifungal drugs. Therefore, it is necessary to discover new antifungal compounds to cure fungal infections. This study aimed to examine the antifungal susceptibility of Capsaicin, an active compound of chili pepper. The susceptibility of Capsaicin and Fluconazole was tested against the Candida species by the CLSI (M27-A3) method. The effect of Capsaicin on the fungal cell wall was examined by the ergosterol inhibitory assay and observed by the scanning electron micrograph. The MIC range of Capsaicin against Candida isolates from oral (n = 30), endodontic (n = 8), and ATCC strains (n = 2) was 12.5−50 µg/mL. The MIC range of Fluconazole (128- 4 µg/mL) significantly decreased (2- to 4-fold) after the combination with Capsaicin (MIC/4) (p < 0.05). Capsaicin (at MIC) significantly reduced the mature biofilm of C. albicans by 70 to 89% (p < 0.01). The ergosterol content of the cell wall decreased significantly with the increase in the Capsaicin dose (p < 0.01). Capsaicin showed high sensitivity against the hyphae formation and demonstrated a more than 71% reduction in mature biofilm. A fluorescence microscopy revealed the membrane disruption of Capsaicin-treated C. albicans cells, whereas a micrograph of electron microscopy showed the distorted cells’ shape, ruptured cell walls, and shrinkage of cells after the release of intracellular content. The results conclude that Capsaicin had a potential antifungal activity that inhibits the ergosterol biosynthesis in the cell wall, and therefore, the cells’ structure and integrity were disrupted. More importantly, Capsaicin synergistically enhanced the Fluconazole antifungal activity, and the synergistic effect might be helpful in the prevention of Fluconazole resistance development and reduced drug-dosing.
Collapse
Affiliation(s)
- Jawad M. Behbehani
- Department of Restorative Sciences, Faculty of Dentistry, Kuwait University, Kuwait City 13060, Kuwait
| | - Mohammad Irshad
- Department of Bioclinical Sciences, Faculty of Dentistry, Kuwait University, Kuwait City 13060, Kuwait
- Dasman Diabetes Institute, Dasman 15462, Kuwait
| | - Sheikh Shreaz
- Department of Bioclinical Sciences, Faculty of Dentistry, Kuwait University, Kuwait City 13060, Kuwait
| | - Maribasappa Karched
- Department of Bioclinical Sciences, Faculty of Dentistry, Kuwait University, Kuwait City 13060, Kuwait
- Correspondence: ; Fax: +965-25326049
| |
Collapse
|
28
|
Alharbi AM, Alharbi TM, Alqahtani MS, Elfasakhany FM, Afifi IK, Rajeh MT, Fattouh M, Kenawi LMM. A Comparative Evaluation of Antibacterial Efficacy of Moringa oleifera Leaf Extract, Octenidine Dihydrochloride, and Sodium Hypochlorite as Intracanal Irrigants against Enterococcus faecalis: An In Vitro Study. Int J Dent 2023; 2023:7690497. [PMID: 36960331 PMCID: PMC10030228 DOI: 10.1155/2023/7690497] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 02/20/2023] [Accepted: 02/21/2023] [Indexed: 03/17/2023] Open
Abstract
Objectives The aim of this study is to investigate and compare the microbial efficacy of Moringa oleifera leaf extract, octenidine dihydrochloride (OCT), NaOCl, and their combinations as intracanal irrigants against Enterococcus faecalis. Materials and Methods Sixty single-rooted mandibular premolars were decoronated followed by root canal preparation. Each root specimen was autoclaved, inoculated with E. faecalis, and incubated at 37°C for 48 hr. Then, the specimens were divided into six groups based on the irrigation solution used: 2.5% NaOCl (Group 1), 0.1% OCT (Group 2), M. oleifera leaves extract (Group 3), a combination of M. oleifera extract and 1.25% NaOCl (Group 4), a combination of M. oleifera extract and OCT (Group 5) and normal saline (Group 6). Microbial samples were taken from each root canal before (S1) and after (S2) irrigation and the bacterial viability was assessed using colony-forming units (CFU) on bile esculin agar plates. Results Comparing the number of CFU/ml before and after irrigation showed a significant reduction (P < 0.001) in all studied groups. Comparison between the CFU/ml after irrigation by NaOCl and each of the combination groups showed a significant difference. Conclusion M. oleifera leaves extract and 0.1% OCT solutions have antibacterial effect against E. faecalis comparable to 2.5% NaOCl and might be used as root canal irrigants. The combination groups showed better antimicrobial activities than individual irrigants. However, further studies are required to investigate the biocompatibility and possible toxic effects of the tested irrigants.
Collapse
Affiliation(s)
- Afrah M. Alharbi
- 1Bachelor of Dental Medicine and Surgery, Faculty of Dental Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Tahani M. Alharbi
- 1Bachelor of Dental Medicine and Surgery, Faculty of Dental Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Mashael S. Alqahtani
- 2Department of Basic and Clinical Oral Sciences, Faculty of Dental Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Fathy M. Elfasakhany
- 2Department of Basic and Clinical Oral Sciences, Faculty of Dental Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
- 3Department of Medical Biochemistry, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Ibtesam K. Afifi
- 2Department of Basic and Clinical Oral Sciences, Faculty of Dental Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
- 4Department of Medical Microbiology and Immunology, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Mona T. Rajeh
- 5Department of Dental Public Health, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mohamed Fattouh
- 6Department of Fixed Prosthodontics, Faculty of Dentistry, Cairo University, Cairo, Egypt
- 7Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Laila Mohamed Mohamed Kenawi
- 8Department of Endodontics, Faculty of Dentistry, Cairo University, Cairo, Egypt
- 9Department of Restorative Dentistry, Faculty of Dental Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| |
Collapse
|
29
|
Chauhan N, Kumar G, Goswami M, Johar S, Sharma A. Antimicrobial efficacy of sodium hypochlorite, saline, and Er, Cr:YSGG laser-assisted disinfection in root canal treatment of primary molars: An in vivo study. J Indian Soc Pedod Prev Dent 2023; 41:70-75. [PMID: 37282415 DOI: 10.4103/jisppd.jisppd_98_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/08/2023] Open
Abstract
Aim The aim of the study was to compare the antimicrobial efficacy of sodium hypochlorite (NaOCl), Saline, and Er, Cr:YSGG laser-assisted disinfection through microbiological analysis in root canal treatment of primary molars. Materials and Methods Forty-five primary teeth were selected for this study as per the inclusion and exclusion criteria in the age group of 4-8 years and then randomly allocated to Three Groups A, B, and C. In Group A, during root canal treatment, irrigation was done using NaOCl, in Group B, laser-assisted disinfection was done using Er, Cr:YSGG laser, and in Group C, saline was used as an irrigating agent. This was followed by obtaining pre- and postirrigation samples from the canals for microbiological investigation in all the groups. Data analysis was performed using Statistical Package for the Social Science-21 (SPSS-21). Results NaOCl was more effective against aerobic bacteria while Er, Cr:YSGG laser was more effective against anaerobic bacteria when used for disinfection in root canal treatment. There was a significant difference among the three groups (P > 0.05). Conclusion The study showed that NaOCl and Er, Cr:YSGG laser have antimicrobial effects when used for disinfection in root canal treatment of primary teeth. Moreover, the study also shows that Er, Cr:YSGG laser may be used as a valuable tool for laser-assisted disinfection in root canal treatment of primary teeth.
Collapse
Affiliation(s)
- Neha Chauhan
- Department of Pediatric and Preventive Dentistry, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Gyanendra Kumar
- Department of Pediatric and Preventive Dentistry, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Mridula Goswami
- Department of Pediatric and Preventive Dentistry, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Smriti Johar
- Department of Pediatric and Preventive Dentistry, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Abha Sharma
- Department of Microbiology, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, New Delhi, India
| |
Collapse
|
30
|
Shabbir J, Khurshid Z, Zafar MS, Farooqui WA, Imran E, Najeeb S, Bencharit S. Antimicrobial Efficacy of Silver Diamine Fluoride against Enterococcus faecalis: A Systematic Review of In Vitro Studies. BIOMED RESEARCH INTERNATIONAL 2022; 2022:6544292. [PMID: 36567909 PMCID: PMC9788898 DOI: 10.1155/2022/6544292] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 09/20/2022] [Accepted: 10/11/2022] [Indexed: 12/23/2022]
Abstract
Introduction/Objectives. Enterococcus faecalis has been implicated in infections of treated root canals. Current irrigants and intracanal medicaments cannot eliminate E. faecalis completely from the root canal. Silver diamine fluoride (SDF) prevents caries by promoting remineralization and exerting an antibacterial effect. Studies suggest that SDF may possess antibacterial properties against E. faecalis. The purpose of this review is to systematically and critically analyze the literature, focusing on the use of SDF as an intracanal medicament or irrigant, when compared to other antibacterial agents. Data/Sources. The focused question was "Is the antibacterial effect of SDF against E. faecalis better than other intracanal medicaments and irrigants?" Using the keywords ((silver diamine fluoride) AND (Enterococcus faecalis)) AND ((sodium hypochlorite) OR (NaOCl) OR (chlorhexidine) OR (calcium hydroxide) OR (Ca(OH)2)), an electronic search was conducted on the following databases: PubMed/MEDLINE, ISI Web of Science, Scopus, EMBASE, and Google Scholar. The clinical trial registers ClinicalTrials.gov and CONTROL were also searched using the same keywords. General characteristics and outcomes were extracted, and quality of the studies was assessed using the Preferred Reporting Items for Laboratory studies in Endodontology (PRILE) guidelines. Study Selection. Six articles (five in vitro studies and one ex vivo study) were included in this systematic review. In the majority of the studies, SDF had equal or better antibacterial efficacy against E. faecalis compared to calcium hydroxide, sodium hypochlorite, and chlorhexidine. However, the majority of the studies did not fulfill several items in the PRILE criteria and had numerous sources of bias. Conclusions. Within the limitations of the systematic review and the studies reviewed, SDF may be effective against E. faecalis and therefore could be used as an intracanal medicament and/or irrigant to prevent reinfections of the root canals and improve the outcomes of endodontic treatment. However, animal and clinical studies should be carried out to determine the efficacy of SDF in endodontics. Trial Registration. The protocol for this review was registered on PROSPERO. Registration number: CRD42021224741.
Collapse
Affiliation(s)
- Juzer Shabbir
- Department of Operative Dentistry and Endodontics, Baqai Medical University, Karachi, Pakistan
| | - Zohaib Khurshid
- Department of Prosthodontics and Dental Implantology, College of Dentistry, King Faisal University, Al Ahsa, Saudi Arabia
- Center of Excellence for Regenerative Dentistry, Department of Anatomy, Faculty of Dentistry, Chulalongkorn University, Bangkok 10330, Thailand
| | - Muhammad Sohail Zafar
- Department of Restorative Dentistry, College of Dentistry, Taibah University, Al Madinah, Al Munawwarah 41311, Saudi Arabia
- Department of Dental Materials, Islamic International Dental College, Riphah International University, Islamabad 44000, Pakistan
| | | | - Eisha Imran
- Department of Dental Materials, Islamabad Medical and Dental College (IMDC), Islamabad, Pakistan
| | - Shariq Najeeb
- Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
- Evidentia Dental Reseach, Calgary, Alberta, Canada
| | - Sompop Bencharit
- Department of Oral and Molecular Craniofacial Biology, Philips Institute for Oral Health Research, School of Dentistry, Virginia Commonwealth University, Richmond, VA 23298, USA
- Department of Biomedical Engineering, College of Engineering, Virginia Commonwealth University, Richmond, VA 23220, USA
- Department of Oral Rehabilitation, The James B. Edwards College of Dental Medicine, Medical University of South Carolina, Charleston, SC 29425, USA
| |
Collapse
|
31
|
Muacevic A, Adler JR, Madkaikar M, Devi RKS, Gada A, Bapat S. Assessment of the Influence of Various Concentrations of Sodium Hypochlorite on Stem Cell Derived From Human Exfoliated Deciduous Teeth (SHED) Proliferation and Differentiation. Cureus 2022; 14:e33024. [PMID: 36726895 PMCID: PMC9886376 DOI: 10.7759/cureus.33024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 12/27/2022] [Indexed: 12/29/2022] Open
Abstract
Objectives Previous research has established that sodium hypochlorite (NaOCl) has a detrimental effect on dental stem cell viability and maturation. However, a review of the literature revealed no study evaluating the response of NaOCl to the survival of stem cells derived from human exfoliated deciduous teeth (SHEDs). Hence, the aim of the present trial was to assess the influence of various dilutions of NaOCl on SHED proliferation and differentiation. Materials and Methods The 5.25% NaOCl solutions at concentrations of 0.5, 0.1, 0.025, 0.0125, and 0.005 mg/ml were used to assess the response to SHED proliferation and differentiation through methyl tetrazolium (MTT) assay, alkaline phosphatase (ALP) assay, and reverse transcription polymerase chain reaction gene expression analysis at various time point intervals. Results MTT assay showed that the viability of SHEDs decreased with an increase in the concentration of NaOCl and an increase in incubation time. The ALP activity decreased with an increase in the concentration of NaOCl up to 14 days of incubation. However, the ALP activity of all the test specimens further decreased after 14 days of incubation. The gene expression levels of osteocalcin, dentin sialophosphoprotein, and STRO-1 were statistically significant when compared to the control after one, three, and seven days of incubation. Conclusion Different doses of NaOCl other than 0.5 mg/ml revealed encouraging outcomes in terms of proliferation, long-term ALP functioning, and odontogenic differentiation potential when cultivated in SHEDs.
Collapse
|
32
|
Boschi G, Piccinelli G, Bonfanti C, Salgarello SA. Ex-vivo study about antimicrobial effectiveness of phytic acid against Enterococcus faecalis into root canals. Minerva Dent Oral Sci 2022; 71:299-307. [PMID: 36760199 DOI: 10.23736/s2724-6329.22.04614-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
BACKGROUND Endodontic failure is due to the persistence of microorganisms, especially Enterococcus faecalis, which have become resistant to disinfection measures. Sodium hypochlorite has been traditionally used, whereas phytic acid, a natural irrigant, needs to be further investigated. METHODS This ex-vivo study compared the antibacterial effectiveness of 0.9% saline solution, 5% sodium hypochlorite and 5% phytic acid against Enterococcus faecalis ATCC 29212 into the apical root canal third of 96 single-rooted extracted teeth, after 1-minute push-and-pull irrigation - a basic irrigation technique. Survived microorganisms were evaluated both through a traditional colony-forming-unit count and introducing the viability PCR, which precisely detects only DNA from intact cells: dead and damaged cells were excluded thanks to a propidium monoazide dye. RESULTS The culture methods showed that 5% sodium hypochlorite (median: 0 CFU/mL) has a significant greater antibacterial effectiveness (P<0.001) compared both to 0.9% saline solution (median: 4.76 CFU/mL) and 5% phytic acid (median: 0.25 CFU/mL). However, 5% phytic acid proved to be significantly more effective (P<0.001) than 0.9% saline solution. The viability PCR did not reveal a significant difference between 5% sodium hypochlorite (median: 4.12×104 survived bacteria) and 0.9% saline solution (median: 8.45×104 survived bacteria). Five percent phytic acid (median: 0.83×104 survived bacteria) was significantly more effective than both 0.9% saline solution (P<0.001) and 5% sodium hypochlorite (P<0.001). CONCLUSIONS The findings suggest that 5% phytic acid works against root canal bacteria even with a basic irrigation technique and viability PCR seems to lead to more reliable and sensitive data rather than the culture methods.
Collapse
Affiliation(s)
- Giulia Boschi
- School of Dentistry, Department of Medical and Surgery Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy -
| | - Giorgio Piccinelli
- Institute of Microbiology, Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Carlo Bonfanti
- Institute of Microbiology, Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Stefano A Salgarello
- School of Dentistry, Department of Medical and Surgery Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| |
Collapse
|
33
|
Kermeoglu F, Abduljalil M. Impacts of NaOCl and Irritrol irrigation solutions with/without autoclave sterilisation on the cyclic fatigue resistance of different nickel-titanium files. AUST ENDOD J 2022; 48:392-399. [PMID: 34617638 DOI: 10.1111/aej.12580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 08/22/2021] [Accepted: 09/26/2021] [Indexed: 12/14/2022]
Abstract
This research aimed to examine the impact of NaOCl and Irritrol solutions with/without autoclave sterilisation on the cyclic fatigue resistance of ProTaper, WaveOne Gold and Reciproc NiTi files. Seventy files in every group were separated into seven subgroups (n = 10) according to irrigation solutions and sterilisation procedures. The mean and standard deviations of the time to fracture was calculated for each group, and the data statistical analysis was performed (P ≤ 0.05). Significantly higher cyclic fatigue resistance was found in Reciproc files than the other types of files. The differences between the control and other subgroups were found to be statistically insignificant (P > 0.05), except for subgroups 5 and 7 (P ≤ 0.05). Immersing NiTi files in NaOCl or Irritrol with sterilisation for three times considerably reduced the cyclic fatigue resistance of these files. Reciproc files exhibited the highest cyclic fatigue resistance in comparison with ProTaper and WaveOne Gold files.
Collapse
Affiliation(s)
- Fatma Kermeoglu
- Department of Endodontics, Faculty of Dentistry, Near East University, Mersin10, Turkey
| | - Mohamad Abduljalil
- Department of Endodontics, Faculty of Dentistry, Near East University, Mersin10, Turkey
| |
Collapse
|
34
|
Govindarajan J, Hemasathya BA, Reddy BN, Nathan S, Sankar S, Subramani SK. Comparative Assessment of Novel Collagen Cross-linking Agents on Push-out Bond Strength of Two Different Sealers: An In Vitro Study. J Contemp Dent Pract 2022; 23:1122-1127. [PMID: 37073935 DOI: 10.5005/jp-journals-10024-3439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2023]
Abstract
AIM To assess the push-out bond strength and tubular penetration of resin-based and bioceramic sealers after employing two collagen cross-linking agents, namely, cashew nut shell liquid (CNSL) and epigallocatechin-3-gallate (EGCG) on sodium hypochlorite treated root canal dentin. MATERIALS AND METHODS Fifty human permanent mandibular premolars selected were decoronated at CEJ, this was followed by cleaning and shaping protocols, root canals were enlarged up to 20 sizes with 6% taper and were randomly divided into the following 5 groups with 10 samples each based on the cross-linking agent and the sealer: • Group I: Irrigation with saline (control). • Group II: Irrigation with cashew nut shell liquid followed by bioceramic sealer obturation. • Group III: Irrigation with cashew nut shell liquid followed by resin-based sealer obturation. • Group IV: Irrigation with EGCG followed by bioceramic sealer obturation. • Group V: Irrigation with EGCG followed by resin-based sealer obturation. Five specimens in each group were evaluated for push-out bond strength with the universal testing machine while the remaining five specimens in each group were evaluated for depth of sealer penetration by a scanning electron microscope (SEM). The data was recorded, tabulated, and statistically analyzed. RESULTS The push-out bond strength was found to be maximum in the apical region in all the five groups followed by the middle third and coronal region. The maximum push-out bond strength was seen in group II followed by groups III and IV, and least in group V. The mean depth of tubular penetration of sealers was found to be effective in the coronal portion followed by the middle third while the apical third region showed the least depth penetration of sealers into the tubules. The maximum penetration of sealers was revealed in group V followed by groups III and IV, and least in group II. CONCLUSION Within the limitations of this study, it can be concluded that push-out bond strength was found to the maximum in specimens irrigated with cashew nut shell liquid and obturated with bioceramic sealer. The maximum push-out bond strength was seen in the apical third of all root canals followed by the middle and coronal region. The scanning microscopic analysis revealed maximum mean tubular penetration in the coronal portion followed by the middle third and apical third. A greater penetration was seen in specimens irrigated with EGCG and obturated with hybrid sealer. CLINICAL SIGNIFICANCE Selection of sealers plays a pivotal role in the success of endodontic therapy. Leakage-related issues can compromise the bond strength enhancing the bond strength can be achieved through the addition of cross-linking agents.
Collapse
Affiliation(s)
- Jayanthi Govindarajan
- Department of Conservative Dentistry and Endodontics, Vivekanandha Dental College for Women, Elayampalyam, Tamil Nadu, India
| | - Bahavathi Ananthan Hemasathya
- Department of Conservative Dentistry and Endodontics, Adhiparsakthi Dental College and Hospital, Melmaruvathur, Tamil Nadu, India
| | - Bharath Naga Reddy
- Department of Conservative Dentistry and Endodontics, Adhiparsakthi Dental College and Hospital, Melmaruvathur, Tamil Nadu, India, Phone: +91 9444792260, e-mail:
| | - Senthil Nathan
- Department of Conservative Dentistry and Endodontics, Adhiparsakthi Dental College and Hospital, Melmaruvathur, Tamil Nadu, India
| | - Sriram Sankar
- Department of Conservative Dentistry and Endodontics, Adhiparsakthi Dental College and Hospital, Melmaruvathur, Tamil Nadu, India
| | | |
Collapse
|
35
|
Muacevic A, Adler JR, AL-Ostwani AEO, Abdo A, Kayed K. The Effect of a Novel Silver-Citrate Root Canal Irrigation Solution (BioAkt), Ethylenediamine Tetraacetic Acid (EDTA), and Citric Acid on the Microhardness of Root Canal Dentin: A Comparative In Vitro Study. Cureus 2022; 14:e31255. [PMID: 36505159 PMCID: PMC9731556 DOI: 10.7759/cureus.31255] [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] [Accepted: 11/08/2022] [Indexed: 11/11/2022] Open
Abstract
Background and objective The use of a chelating agent as an adjunct to disinfectant irrigation is very necessary to remove the smear layer formed during root canal treatment. However, the decalcifying solutions have a negative impact on dentin microhardness, which might affect the result of endodontic therapy. The aim of this study is to evaluate the effect of 17% ethylenediamine tetraacetic acid (EDTA), a novel silver-citrate root canal irrigation solution (BioAkt), 10% citric acid, and 40% citric acid on the microhardness of root canal dentin. Materials and methods Forty-five single-root teeth were distributed equally into five groups A, B, C, D, and E treated with distilled water as a control, 17% EDTA, BioAkt, 10% citric acid, and 40% citric acid, respectively. The dentin microhardness was measured before and after the experiment, and the collected data were analyzed using paired sample T-test, One-way ANOVA test, and least significant difference (LSD) test (multiple comparisons), (P < 0.05). Result The results showed that the averages of dentin microhardness values before the experiment were 62.83 kg/mm², 65.34 kg/mm², 64.79 kg/mm², 62.95 kg/mm², and 56.47 kg/mm² for groups A, B, C, D, and E, respectively, while the averages after the experiment were 62.60 kg/mm², 54.92 kg/mm², 54.50 kg/mm², 51.31 kg/mm², and 49.37kg/mm² accordingly. Statistical analysis revealed that 17% EDTA, BioAkt, 10% citric acid, and 40% citric acid decreased the dentin microhardness significantly comparing with the negative control group, without statistical differences among them. Conclusion The chelating agents 17% EDTA, BioAkt, 10% citric acid, and 40% citric acid declined the microhardness of root canal dentin similarly, which might have possible effects on endodontic treatment and the properties of root canal filling materials as well.
Collapse
|
36
|
Saikaew P, Sattabanasuk V, Harnirattisai C, Chowdhury AFMA, Carvalho R, Sano H. Role of the smear layer in adhesive dentistry and the clinical applications to improve bonding performance. JAPANESE DENTAL SCIENCE REVIEW 2022; 58:59-66. [PMID: 35140823 PMCID: PMC8814382 DOI: 10.1016/j.jdsr.2021.12.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 12/08/2021] [Accepted: 12/12/2021] [Indexed: 11/23/2022] Open
Abstract
Currently, dental adhesives can be divided into two systems; a smear layer-removal approach with etch-and-rinse adhesives or a smear layer-modified approach with self-etching adhesives. After phosphoric acid etching, the smear layer is completely removed. More attention is, however, required when using self-etching adhesives. The smear layer is partially demineralized by the weak acidic monomer and subsequently incorporated into the hybrid layer. Therefore, the characteristics of the smear layer play an important role on the bonding performance of self-etching adhesives. Such characteristics, for instance, smear layer thickness and smear layer density, are influenced by many factors, e.g., instruments used for dentin surface preparation, cutting speed, and the abrasive particle size of the cutting instruments. This review discusses the contributing factors that affect the smear layer characteristics, and the influence of the smear layer on the bonding performance of dental adhesives. Also, the application techniques regarding how to improve the bonding performance of self-etching adhesives - the smear layer removal by using chemical agents, or the modification of the adhesive application procedures - are provided.
Collapse
Affiliation(s)
- Pipop Saikaew
- Department of Operative Dentistry and Endodontics, Faculty of Dentistry, Mahidol University, 6 Yothi Road, Ratchathewi, Bangkok 10400, Thailand
| | - Vanthana Sattabanasuk
- Department of Operative Dentistry and Endodontics, Faculty of Dentistry, Mahidol University, 6 Yothi Road, Ratchathewi, Bangkok 10400, Thailand
| | - Choltacha Harnirattisai
- Department of Operative Dentistry and Endodontics, Faculty of Dentistry, Mahidol University, 6 Yothi Road, Ratchathewi, Bangkok 10400, Thailand
| | - Abu Faem Mohammad Almas Chowdhury
- Department of Conservative Dentistry and Endodontics, Sapporo Dental College and Hospital, Plot 24, Sector 8, Dhaka 1230, Bangladesh
| | - Ricardo Carvalho
- Department of Oral Biological and Medical Sciences, Division of Biomaterials, Faculty of Dentistry, University of British Columbia, 2199 Wesbrook Mall, Vancouver, BC V6T 1Z3, Canada
| | - Hidehiko Sano
- Department of Restorative Dentistry, Faculty of Dentistry, Hokkaido University Graduate School of Dental Medicine, Japan
| |
Collapse
|
37
|
Cîmpean SI, Pop-Ciutrila IS, Matei SR, Colosi IA, Costache C, Nicula GZ, Badea IC, Colceriu Burtea L. Effectiveness of Different Final Irrigation Procedures on Enterococcus faecalis Infected Root Canals: An In Vitro Evaluation. MATERIALS (BASEL, SWITZERLAND) 2022; 15:ma15196688. [PMID: 36234029 PMCID: PMC9571448 DOI: 10.3390/ma15196688] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 09/20/2022] [Accepted: 09/22/2022] [Indexed: 06/01/2023]
Abstract
This study aimed to evaluate the antibacterial effect of three final irrigation protocols and to compare their ability to remove the smear layer and debris from the root canal. Methods: Sixty-three single-rooted human teeth were inoculated with Enterococcus faecalis for 14 days. The teeth were divided into a positive control group (N = 3) and three treatment groups (N = 20) as follows: final irrigation with saline solution (control group), irrigation with 5.25% NaOCl ultrasonically activated with EndoUltra (EU), standard needle irrigation with Qmix 2in1 (Qx) and irrigation with 5.25% NaOCl activated using SiroLaser Blue (SB). The bacterial load was evaluated by analyzing the colony-forming units (CFU/mL). Selected specimens were split longitudinally and examined using scanning electron microscopy in order to determine the presence of a smear layer and debris. Statistical analyses were performed using one-way ANOVA and the Kruskal−Wallis rank-sum test. Results: Activation of NaOCl with EndoUltra or SiroLaser Blue was superior at reducing intracanal bacteria relative to standard needle irrigation with Qmix 2in1 solution (p < 0.05). Even though SiroLaser Blue showed the best results for removing the smear layer and debris, no significant differences were detected between the groups (p > 0.05). Conclusions: Final irrigation with 5.25% NaOCl ultrasonically activated using EndoUltra or SiroLaser Blue demonstrated a higher efficacy in bacterial reduction than standard needle irrigation with Qmix 2in1.
Collapse
Affiliation(s)
- Sanda Ileana Cîmpean
- Department of Conservative Dentistry and Endodontics, Iuliu Hatieganu University of Medicine and Pharmacy, 33 Motilor Street, 400001 Cluj-Napoca, Romania
| | - Ioana-Sofia Pop-Ciutrila
- Department of Conservative Dentistry and Endodontics, Iuliu Hatieganu University of Medicine and Pharmacy, 33 Motilor Street, 400001 Cluj-Napoca, Romania
| | - Sebastian-Roberto Matei
- Department of Conservative Dentistry and Endodontics, Iuliu Hatieganu University of Medicine and Pharmacy, 33 Motilor Street, 400001 Cluj-Napoca, Romania
| | - Ioana Alina Colosi
- Department of Molecular Sciences, Discipline of Microbiology, Iuliu Hatieganu University of Medicine and Pharmacy, 6 Louis Pasteur Street, 400349 Cluj-Napoca, Romania
| | - Carmen Costache
- Department of Molecular Sciences, Discipline of Microbiology, Iuliu Hatieganu University of Medicine and Pharmacy, 6 Louis Pasteur Street, 400349 Cluj-Napoca, Romania
| | - Gheorghe Zsolt Nicula
- Department of Molecular Sciences, Discipline of Cell and Molecular Biology, Iuliu Hatieganu University of Medicine and Pharmacy, 6 Louis Pasteur Street, 400349 Cluj-Napoca, Romania
| | - Iulia Clara Badea
- Department of Prevention in Dentistry, Iuliu Hatieganu University of Medicine and Pharmacy, 31 Avram Iancu Street, 400083 Cluj-Napoca, Romania
| | - Loredana Colceriu Burtea
- Department of Conservative Dentistry and Endodontics, Iuliu Hatieganu University of Medicine and Pharmacy, 33 Motilor Street, 400001 Cluj-Napoca, Romania
| |
Collapse
|
38
|
Rajamanickam K, Teja KV, Ramesh S, AbuMelha AS, Alkahtany MF, Almadi KH, Bahammam SA, Janani K, Choudhari S, Jose J, Srivastava KC, Shrivastava D, Patil S. Comparative Study Assessing the Canal Cleanliness Using Automated Device and Conventional Syringe Needle for Root Canal Irrigation-An Ex-Vivo Study. MATERIALS (BASEL, SWITZERLAND) 2022; 15:6184. [PMID: 36143496 PMCID: PMC9504894 DOI: 10.3390/ma15186184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 09/02/2022] [Accepted: 09/04/2022] [Indexed: 06/16/2023]
Abstract
The success of endodontic treatment relies on both apical and coronal sealing. To achieve a good three-dimensional seal, the removal of the smear layer becomes mandatory. This study aims to assess the difference in debris accumulation and smear layer formation while using automated root canal irrigation and conventional syringe needle irrigation. Single-rooted human mandibular premolar teeth (n = 30) which were indicated for orthodontic extractions were selected. An endodontic access cavity was prepared, and a glide path was created. Based on the irrigation protocol decided upon for the study, the teeth were randomly allocated into three study groups, namely Group 1, where the manual syringe needle irrigation method was adopted; Group 2, in which automated root canal irrigation was undertaken; and Group 3, in which teeth remained un-instrumented as it was considered the Control group. The teeth were decoronated at the cement-enamel junction (CEJ) and were subjected for scanning electron microscopy (SEM) examination. Debris and smear layers were viewed in 1000× magnification and scored. A statistically significant (p < 0.05) lower mean debris and smear layer score (p < 0.05) was observed in both study groups when compared with the control group. However, no significant difference (p > 0.05) in the debris and smear layer was observed between the manual syringe needle irrigation and automated irrigation, although automated irrigation devices can be a potential alternative. The present study concluded that the efficacy of smear layer removal remained the same with both automated irrigation and manual syringe irrigation.
Collapse
Affiliation(s)
- Keerthika Rajamanickam
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai 600077, Tamil Nadu, India
| | - Kavalipurapu Venkata Teja
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai 600077, Tamil Nadu, India
| | - Sindhu Ramesh
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai 600077, Tamil Nadu, India
| | - Abdulaziz S. AbuMelha
- Restorative Dental Science Department, College of Dentistry, King Khalid University, Abha 62529, Saudi Arabia
| | - Mazen F. Alkahtany
- Department of RDS, Division of Endodontics, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia
| | - Khalid H. Almadi
- Department of RDS, Division of Endodontics, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia
| | - Sarah Ahmed Bahammam
- Department of Pediatric Dentistry and Orthodontics, College of Dentistry, Taibah University, P.O. Box 344, Medina 42353, Saudi Arabia
| | - Krishnamachari Janani
- Department of Conservative Dentistry and Endodontics, SRM Dental College, SRM Institute of Science & Technology, Chennai 600089, Tamil Nadu, India
| | - Sahil Choudhari
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai 600077, Tamil Nadu, India
| | - Jerry Jose
- Private Practice, Aluva, Ernakulam District, Kochi 683106, Kerala, India
| | - Kumar Chandan Srivastava
- Department of Oral & Maxillofacial Surgery & Diagnostic Sciences, College of Dentistry, Jouf University, Sakaka 72388, Saudi Arabia
| | - Deepti Shrivastava
- Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka 72388, Saudi Arabia
| | - Shankargouda Patil
- Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia
- Centre of Molecular Medicine and Diagnostics (COMManD), Saveetha Dental College & Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai 600077, Tamil Nadu, India
| |
Collapse
|
39
|
Scelza MZ, Iorio NLPP, Scelza P, Póvoa HCC, Adeodato CSR, Souza ACN, Batista AC, Tavares S, Alves G. Cytocompatibility and antimicrobial activity of a novel endodontic irrigant combining citric acid and chlorhexidine. J Dent 2022; 125:104278. [PMID: 36058346 DOI: 10.1016/j.jdent.2022.104278] [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: 04/18/2022] [Revised: 08/19/2022] [Accepted: 09/01/2022] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVES This study aimed to evaluate the antibacterial ability and cytocompatibility of a new irrigant solution for endodontic treatment composed of 10% citric acid (CA) and 1% chlorhexidine (CHX). METHODS Thirty-five extracted single-canal human teeth were selected and de-crowned. Canal systems (n = 7/group) were infected with Enterococcus faecalis for 4 weeks and subject to irrigation with 1% CHX; 10% CA; irrigating solution 10% CA associated with 1% CHX (CACHX); 2.5% NaOCl or sterile water (control). Microbiological samples were collected immediately and 18 h after irrigation (enriched samples). The canals were filled with culture medium post irrigation to verify the bacterial presence/absence qualitatively and quantitatively through colony counting (log10 CFU/mL). A multiparametric assay was performed after exposure of human periodontal ligament fibroblasts (HPdLF) to the test solutions. The Kruskal-Wallis test with Dunn´s post-test and Fisher's exact test were employed at the 95% confidence level to compare differences among groups. RESULTS All tested solutions were cytocompatible with human periodontal ligament fibroblasts. No difference was observed on antibacterial activity between 1% CHX, 10% CA, CACHX and 2.5% NaOCl (p > 0.05). Eighteen hours after irrigation, CACHX samples were the only that did not present E. faecalis in the root canal system. CONCLUSIONS The demonstrated good in vitro biocompatibility and elimination of E. faecalis suggest a potential use of 10% CA associated with 1% CHX as a solution for microbiological control during endodontic treatment. CLINICAL RELEVANCE Irrigants play an essential role during endodontic therapy. This irrigating solution, based on the association of 10% citric acid with 1% chlorhexidine, seems viable for clinical procedures.
Collapse
Affiliation(s)
- Miriam Zaccaro Scelza
- Endodontics Department and Laboratory of Experimental Culture Cell (LECCel), Faculty of Dentistry, Federal Fluminense University (UFF), Niteroi, RJ, Brazil.
| | - Natalia L P P Iorio
- Department of Basic Sciences, Federal Fluminense University (UFF), Nova Friburgo, Rio de Janeiro, Brazil
| | - Pantaleo Scelza
- Geriatric Dentistry Department, Faculty of Dentistry of Federal Fluminense University (UFF), Niteroi, RJ, Brazil
| | - Helvécio C C Póvoa
- Department of Basic Sciences, Federal Fluminense University (UFF), Nova Friburgo, Rio de Janeiro, Brazil
| | - Caroline S R Adeodato
- Post-graduation Program in Dentistry of Federal Fluminense University (UFF), Niteroi, RJ, Brazil
| | - Ana Carolina N Souza
- Department of Basic Sciences, Federal Fluminense University (UFF), Nova Friburgo, Rio de Janeiro, Brazil
| | - Ana Carolina Batista
- Clinical Research Unit of the Antonio Pedro Hospital, Fluminense Federal University, Niteroi, RJ, Brazil
| | - Sandro Tavares
- Post-graduation Program in Dentistry of Federal Fluminense University (UFF), Niteroi, RJ, Brazil
| | - Gutemberg Alves
- Clinical Research Unit of the Antonio Pedro Hospital, Fluminense Federal University, Niteroi, RJ, Brazil; Cell and Molecular Biology Department, Institute of Biology, Fluminense Federal University, Niteroi, Brazil
| |
Collapse
|
40
|
Keskin NB, Bozkurt DA, İnce Yusufoğlu S. Evaluation of dentinal tubule penetration of Irritrol and chlorhexidine irrigating solutions activated using EDDY and photon-initiated photoacoustic streaming. Photodiagnosis Photodyn Ther 2022; 39:102925. [PMID: 35623543 DOI: 10.1016/j.pdpdt.2022.102925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 04/20/2022] [Accepted: 05/20/2022] [Indexed: 11/24/2022]
Abstract
The aim of the study was to compare the penetration depth and percentage of Irritrol and chlorhexidine (CHX) solutions into dentinal tubules using conventional needle irrigation (CI), EDDY, and photon-induced photoacoustic streaming (PIPS). Sixty oval shaped mandibular premolar teeth were divided into two main groups according to the irrigating solutions as follows; Irritrol and CHX, which were later randomly divided into three subgroups according to the activation technique; CI, EDDY and PIPS (n = 10). Following the irrigation activation procedures, all roots were horizontally sectioned at 3 (apical), 8 (middle), and 13 (coronal) mm from the root apex and then examined with confocal laser scanning microscope (CLSM). Penetration depth (µm) and penetration percentage (%) as determined from the images were analyzed using LSM Image Browser software (Zeiss) and Image J analysis software (V. 1.44p; National Institutes of Health, Bethesda, MD), respectively. Data were statistically analyzed using Kruskal-Wallis and Mann-Whitney U tests were performed for multiple comparisons. In both Irritrol and CHX groups, the PIPS activation system demonstrated the highest values for irrigant penetration depth and penetration percentage compared with the other activation methods. Activation of the CHX and Irritrol the final irrigating solutions with PIPS activation technique improved the penetration depth and percentage solutions into the dentinal tubules.
Collapse
Affiliation(s)
- Neslihan Büşra Keskin
- Department of Endodontics, Faculty of Dentistry, Yıldırım Beyazıt University, Ankara, Turkey.
| | - Durmuş Alperen Bozkurt
- Department of Endodontics, Faculty of Dentistry, Necmettin Erbakan University, Konya, Turkey
| | - Selen İnce Yusufoğlu
- Department of Endodontics, Faculty of Dentistry, Yıldırım Beyazıt University, Ankara, Turkey
| |
Collapse
|
41
|
Mathew T, BM S, GV P, Jose J. Comparative Evaluation of the Antibacterial Efficacy of Chlorhexidine and 810 nm Diode Laser in the Disinfection of Root Canals Contaminated With Enterococcus faecalis: An In Vitro Study. Cureus 2022; 14:e28596. [PMID: 36185833 PMCID: PMC9521298 DOI: 10.7759/cureus.28596] [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] [Accepted: 08/30/2022] [Indexed: 12/02/2022] Open
Abstract
Introduction: This study compared the antibacterial efficacy of three different root canal irrigants, sodium hypochlorite, chlorhexidine and 810 nm diode laser and diode laser in combination with chlorhexidine in root canals contaminated with Enterococcus faecalis. Methods: Fifty extracted mandibular first premolars were decoronated at the cementoenamel junction and cut at the apical end; biomechanical preparation was done, autoclaved and contaminated with Enterococcus faecalis. The specimens were divided into five groups containing 10 teeth each: group I: saline (negative control), group II: 2.5% sodium hypochlorite, group III: 2% chlorhexidine gluconate solution, group IV: diode laser, and group V: diode laser in combination with 2% chlorhexidine. Disinfection was carried out, after which dentinal shavings were collected from the specimens of each group. Antimicrobial efficacy was tested by counting the colony-forming units of viable Enterococcus faecalis on the agar plates. One-way ANOVA and Scheffe’s post hoc test were done to analyse the results. Results: Diode laser with chlorhexidine group showed minimum colony-forming units followed by the diode laser group. The post hoc test showed a statistically significant difference between saline, 2.5% sodium hypochlorite and 2% chlorhexidine groups (P = 0.001) and a non-significant difference between diode laser and diode laser with chlorhexidine group (P = 0.997). Conclusions: Diode laser can be used as a root canal disinfectant alone or in combination with chlorhexidine.
Collapse
|
42
|
Wagih M, Hassanien E, Nagy M. Sealing Ability and Adaptability of Nano Mineral Trioxide Aggregate as a Root-End Filling Material. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.10080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Aim: Comparison between Nano MTA & MTA as a root-end filling materials regarding adaptability and sealing ability.
Materials and Methods: Forty extracted human maxillary incisors with straight roots were used. After root canals preparation and obturation, the apical 3 mm of each root was resected perpendicular to the long axis of the tooth. Root end cavities were prepared to a depth of 3mm parallel to the long axis of the tooth. The teeth were randomly divided into two main equal groups of 20 samples each according to the root-end filling material used either MTA or Nano MTA. Ten samples from each group were sectioned longitudinally into two equal halves to measure the sealing ability and another ten samples from each group were sectioned transversally to obtain 1 mm thick section to measure the adaptability of both materials. All samples were photographed under the SEM at three different magnifications (×1000). The gap thickness between the root end filling material and the retro cavity dentine walls were measured at seven selected points at the material-dentine interface in micrometers (µm).
Results: Nano MTA and MTA showed no statistically significant difference in the gap thickness between dentin-material interface in both longitudinal and transverse sections. Regarding the sealing ability, the mean value in MTA was (3.27±0.77), while the mean in Nano-MTA was (3.15±0.71). Regarding the adaptability, the mean value in MTA was (2.46±0.60), while the mean in Nano-MTA was (2.05±0.712). Both materials showed good sealing ability and good adaptation to the dentinal wall.
Conclusion: Nano MTA revealed good sealing ability and adaptability comparable to MTA when used as a retrograde filling material.
Collapse
|
43
|
Takenaka S, Sotozono M, Ohkura N, Noiri Y. Evidence on the Use of Mouthwash for the Control of Supragingival Biofilm and Its Potential Adverse Effects. Antibiotics (Basel) 2022; 11:727. [PMID: 35740134 PMCID: PMC9219991 DOI: 10.3390/antibiotics11060727] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 05/19/2022] [Accepted: 05/26/2022] [Indexed: 12/14/2022] Open
Abstract
Antimicrobial mouthwash improves supragingival biofilm control when used in conjunction with mechanical removal as part of an oral hygiene routine. Mouthwash is intended to suppress bacterial adhesion during biofilm formation processes and is not aimed at mature biofilms. The most common evidence-based effects of mouthwash on the subgingival biofilm include the inhibition of biofilm accumulation and its anti-gingivitis property, followed by its cariostatic activities. There has been no significant change in the strength of the evidence over the last decade. A strategy for biofilm control that relies on the elimination of bacteria may cause a variety of side effects. The exposure of mature oral biofilms to mouthwash is associated with several possible adverse reactions, such as the emergence of resistant strains, the effects of the residual structure, enhanced pathogenicity following retarded penetration, and ecological changes to the microbiota. These concerns require further elucidation. This review aims to reconfirm the intended effects of mouthwash on oral biofilm control by summarizing systematic reviews from the last decade and to discuss the limitations of mouthwash and potential adverse reactions to its use. In the future, the strategy for oral biofilm control may shift to reducing the biofilm by detaching it or modulating its quality, rather than eliminating it, to preserve the benefits of the normal resident oral microflora.
Collapse
Affiliation(s)
- Shoji Takenaka
- Division of Cariology, Operative Dentistry and Endodontics, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8514, Japan; (M.S.); (N.O.); (Y.N.)
| | | | | | | |
Collapse
|
44
|
Provoost C, Rocca GT, Thibault A, Machtou P, Bouilllaguet S. Influence of Needle Design and Irrigant Flow Rate on the Removal of Enterococcus faecalis Biofilms In Vitro. Dent J (Basel) 2022; 10:dj10040059. [PMID: 35448053 PMCID: PMC9030241 DOI: 10.3390/dj10040059] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 03/24/2022] [Accepted: 03/30/2022] [Indexed: 01/27/2023] Open
Abstract
This study aimed to evaluate the influence of needle design and irrigant flow rate on the removal of Enterococcus faecalis mature biofilms during sodium hypochlorite irrigation. Forty-eight single-rooted human teeth were instrumented (ProTaper F3), autoclaved and inoculated with Enterococcus faecalis to establish a two-week-old biofilm. E. faecalis biofilms were treated with Sodium hypochlorite that was injected in the root canals using three types of needles (NaviTip, ProRinse, IrriFlex). For the IrriFlex needle, one, two, or four bars of pressure was applied to the irrigating solution to increase flow rates. Bacteria were labeled with the LIVE/DEAD BacLight Bacterial Viability kit, and viability was assessed by flow cytometry (FCM). Results were statistically analyzed using one-way ANOVA and Tukey multiple comparison intervals (α = 0.05). Bacterial viability was significantly reduced after sodium hypochlorite passive irrigation but the number of viable bacteria retrieved from root canal specimens irrigated with the Pro-Rinse needle was significantly higher compared to NaviTip and IrriFlex needles (p < 0.05). When the irrigant flow rate was increased, the viability of bacterial biofilms was significantly reduced compared to passive irrigation using the IrriFlex needle (p < 0.05). Applying higher flow rates during irrigation using the IrriFlex needle did not further reduce bacterial viability.
Collapse
|
45
|
Hojabri N, Kunzelmann KH. Adhesion and whitening efficacy of P11-4 self-assembling peptide and HAP suspension after using NaOCl as a pre-treatment agent. BMC Oral Health 2022; 22:59. [PMID: 35246089 PMCID: PMC8895591 DOI: 10.1186/s12903-022-02080-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Accepted: 02/08/2022] [Indexed: 12/03/2022] Open
Abstract
Background This study evaluated the adhesion and whitening efficacy of a mixture of hydroxyapatite and P11-4 self-assembling peptide (HAP-peptide) on bovine enamel after pre-treatment with low-concentrated sodium hypochlorite (NaOCl). Methods Fifty-two caries-free bovine incisors were selected. 50 teeth were randomly allocated to five groups (n = 10). The first group was treated with a mixture of 6.25 wt% HAP and 5 ml P11-4 peptide, using NaOCl 3% as pre-treatment. Second, third and fourth groups were treated with 6.25 wt% HAP, 5 ml P11-4 peptide, and NaOCl 3%, respectively. In the fifth group, only water was applied (control group). The color of samples was measured using a spectrophotometer (USB4000-VIS-NIR-ES, Ostfildern, Germany). To evaluate color changes, ΔE values were statistically analyzed. Finally, adherence of HAP particles on two enamel surfaces with and without pre-treatment with NaOCl was analyzed with SEM. Results It was observed that the ΔE of the HAP-peptide suspension after pre-treatment with NaOCl was significantly stronger than the control group. In contrast, the overall color changes of separate applications of HAP, peptide, and NaOCl did not differ notably from the control group. SEM observations confirmed that pre-treatment with NaOCl resulted in a more pronounced coverage of HAP on the enamel surface. Conclusions Pre-treatment with a low-concentrated NaOCl enhanced the adherence of the HAP layer on the enamel surface, resulting in a stronger whitening effect. Trial registration The peptide-HAP suspension is effective in improving tooth whiteness.
Collapse
Affiliation(s)
- Niloofar Hojabri
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-University Munich, Goethestr. 70, 80336, Munich, Germany
| | - Karl-Heinz Kunzelmann
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-University Munich, Goethestr. 70, 80336, Munich, Germany.
| |
Collapse
|
46
|
Zhou C, Yuan Z, Xu H, Wu L, Xie C, Liu J. Regenerative Endodontic Procedures in Immature Permanent Teeth With Dental Trauma: Current Approaches and Challenges. FRONTIERS IN DENTAL MEDICINE 2022. [DOI: 10.3389/fdmed.2021.767226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
After dental trauma to immature permanent teeth (IPT), there can be pulpitis, necrotic, and periapical periodontitis, which will halt further root development. Traditional endodontic root canal treatments and apexification cannot revitalize the necrotic pulp to revitalize the tooth to promote further root development. As a consequence, IPT with thin dentinal walls can be prone to fracture and if a fracture occurs, the patient will likely suffer the loss of the tooth. In an attempt to save IPT, there has been a growing interest among dentists to use regenerative endodontic procedures (REPs) to revitalize a replace dental pulp to continue root development and strengthen the dentinal walls to help prevent a subsequent loss of the tooth. However, the effectiveness of REPs and the precise methods to successfully accomplish REPs are controversial. Therefore, the objective of this review is to compare the different approaches to REPs in case reports by highlighting their advantages and limitations.
Collapse
|
47
|
Morozova Y, Voborná I, Žižka R, Bogdanová K, Večeřová R, Rejman D, Kolář M, Do Pham DD, Holík P, Moštěk R, Rosa M, Pospíšilová L. Ex Vivo Effect of Novel Lipophosphonoxins on Root Canal Biofilm Produced by Enterococcus faecalis: Pilot Study. Life (Basel) 2022; 12:life12010129. [PMID: 35054522 PMCID: PMC8781533 DOI: 10.3390/life12010129] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 01/09/2022] [Accepted: 01/12/2022] [Indexed: 11/24/2022] Open
Abstract
(1) Background: The root canal system has complex anatomical and histological features that make it impossible to completely remove all bacteria by mechanical means only; they must be supplemented with disinfectant irrigation. Current disinfectants are unable to eliminate certain microorganisms that persist in the root canal, resulting in treatment failure. At the Institute of Organic Chemistry and Biochemistry, Prague, novel substances with the bactericidal effect, termed lipophosphonoxins (LPPOs), have been discovered. The aim of this pilot study was to investigate the ex vivo effects of second- and third-generation LPPOs on Enterococcus faecalis and compare them with 5% sodium hypochlorite (NaOCl), 0.12% chlorhexidine digluconate, and 17% ethylenediaminetetraacetic acid (EDTA). (2) Methods: The root canal’s dentin was used as a carrier for biofilm formation in the extracted human mature mandibular premolars. The samples were filled with cultivation broth and 0.25% glucose with tested solutions. In control samples, only fresh cultivation broth (negative control) and cultivation broth with bacterial suspension (growth control) were used. Each sample was inoculated with E. faecalis CCM4224 except for the negative control, and cultivation was performed. To determine the number of planktonic cells, the sample content was inoculated on blood agar. To evaluate biofilm formation inhibition, samples were placed in tubes with BHI. (3) Results: LPPOs exhibited a reduction in biofilm growth and bacteria comparable to NaOCl, and they were superior to other tested disinfectants. (4) Conclusions: The study results suggest the effect of lipophosphonoxins on E. faecalis CCM 4224 reduces planktonic bacterial cells and inhibits formation of biofilm in root canal samples.
Collapse
Affiliation(s)
- Yuliya Morozova
- Institute of Dentistry and Oral Sciences, Faculty of Medicine and Dentistry, Palacký University, Palackého 12, 772 00 Olomouc, Czech Republic; (R.Ž.); (P.H.); (R.M.); (M.R.); (L.P.)
- Correspondence: (Y.M.); (I.V.)
| | - Iva Voborná
- Institute of Dentistry and Oral Sciences, Faculty of Medicine and Dentistry, Palacký University, Palackého 12, 772 00 Olomouc, Czech Republic; (R.Ž.); (P.H.); (R.M.); (M.R.); (L.P.)
- Correspondence: (Y.M.); (I.V.)
| | - Radovan Žižka
- Institute of Dentistry and Oral Sciences, Faculty of Medicine and Dentistry, Palacký University, Palackého 12, 772 00 Olomouc, Czech Republic; (R.Ž.); (P.H.); (R.M.); (M.R.); (L.P.)
| | - Kateřina Bogdanová
- Department of Microbiology, Faculty of Medicine and Dentistry, Palacký University, Hněvotínská 3, 775 15 Olomouc, Czech Republic; (K.B.); (R.V.); (M.K.)
| | - Renata Večeřová
- Department of Microbiology, Faculty of Medicine and Dentistry, Palacký University, Hněvotínská 3, 775 15 Olomouc, Czech Republic; (K.B.); (R.V.); (M.K.)
| | - Dominik Rejman
- Institute of Organic Chemistry and Biochemistry, Czech Academy of Sciences, Fleming Square 542/2, 160 00 Prague, Czech Republic; (D.R.); (D.D.D.P.)
| | - Milan Kolář
- Department of Microbiology, Faculty of Medicine and Dentistry, Palacký University, Hněvotínská 3, 775 15 Olomouc, Czech Republic; (K.B.); (R.V.); (M.K.)
| | - Duy Dinh Do Pham
- Institute of Organic Chemistry and Biochemistry, Czech Academy of Sciences, Fleming Square 542/2, 160 00 Prague, Czech Republic; (D.R.); (D.D.D.P.)
| | - Pavel Holík
- Institute of Dentistry and Oral Sciences, Faculty of Medicine and Dentistry, Palacký University, Palackého 12, 772 00 Olomouc, Czech Republic; (R.Ž.); (P.H.); (R.M.); (M.R.); (L.P.)
| | - Roman Moštěk
- Institute of Dentistry and Oral Sciences, Faculty of Medicine and Dentistry, Palacký University, Palackého 12, 772 00 Olomouc, Czech Republic; (R.Ž.); (P.H.); (R.M.); (M.R.); (L.P.)
| | - Matej Rosa
- Institute of Dentistry and Oral Sciences, Faculty of Medicine and Dentistry, Palacký University, Palackého 12, 772 00 Olomouc, Czech Republic; (R.Ž.); (P.H.); (R.M.); (M.R.); (L.P.)
| | - Lenka Pospíšilová
- Institute of Dentistry and Oral Sciences, Faculty of Medicine and Dentistry, Palacký University, Palackého 12, 772 00 Olomouc, Czech Republic; (R.Ž.); (P.H.); (R.M.); (M.R.); (L.P.)
| |
Collapse
|
48
|
Farhad A, Saatchi M, Bagherieh S. Effect of citric acid versus ethylenediaminetetraacetic acid on radiographic root development in regenerative endodontic treatment: An animal study. J Endod 2022; 48:535-541. [PMID: 35026229 DOI: 10.1016/j.joen.2022.01.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 12/26/2021] [Accepted: 01/03/2022] [Indexed: 01/15/2023]
Abstract
INTRODUCTION Regenerative endodontic treatment was introduced aiming to reinforce the root and enable further root development. In the process of dentin mineralization, bioactive molecules are entrapped in the dentin matrix, which can be later released by rinsing the dentin with chelating agents. This study aimed to compare the effects of citric acid and ethylenediaminetetraacetic acid (EDTA) on radiographic root development in regenerative endodontic treatment in an animal model. METHODS Premolars of three beagle dogs were used in this study. The teeth at one side of the jaw were irrigated with EDTA according to the regeneration protocol of the American Association of Endodontists (AAE). The teeth in the other quadrant were irrigated with citric acid in the second treatment session. Follow-up radiographs were obtained at six months, and the primary and final data were analyzed in SPSS using the Analysis of covariance (ANCOVA). RESULTS There was no significant difference between the two irrigating solutions regarding the increase in root length (P=0.668); however, EDTA showed significantly superior efficacy in increasing the root dentin thickness compared with citric acid (P=0.022). CONCLUSIONS Within the limitations of this study, the use of citric acid versus EDTA was not superior on radiographic root development in regenerative endodontic treatment.
Collapse
Affiliation(s)
- Alireza Farhad
- Department of Endodontics, Dental Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Masoud Saatchi
- Department of Endodontics, Dental Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shervin Bagherieh
- Department of Endodontics, Dental Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran.
| |
Collapse
|
49
|
Kaushik G, Mittal R, Tandan M. Antimicrobial efficacy of commercially available ozonated olive oil and sodium hypochlorite with and without ultrasonic activation in primary endodontic infections: A randomized clinical trial. ENDODONTOLOGY 2022. [DOI: 10.4103/endo.endo_57_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
50
|
Abidin T, Susilo D, Gani B. The effectiveness of nano-chitosan high molecular 0.2% as irrigant agent against Enterococcus faecalis with passive ultrasonic irrigant. J Conserv Dent 2022; 25:37-41. [PMID: 35722074 PMCID: PMC9200192 DOI: 10.4103/jcd.jcd_437_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 12/10/2021] [Accepted: 12/21/2021] [Indexed: 11/06/2022] Open
Abstract
Context: Enterococcus faecalis is the microorganism most frequently associated with failure of endodontic treatment. Chitosan is an irrigant in dentistry has the properties of biocompatibility, biodegradability, bioadhesion, and not toxic to human cells. Several studies have suggested the use of ultrasonics to enhancing the action of irrigants. Aims: The aim of the study was to investigate the bacterial growth and surface roughness of the root canal surface after irrigation and agitation with passive ultrasonic irrigant. Subjects and Methods: Experimental research with randomized block design obtained a sample size for each group of 9 samples with a total number of 27 teeth divided into three treatment groups. Statistical analysis used was one-way analysis of variance. Results: The irrigation material for nano-chitosan high molecular 0.2% with passive ultrasonic irrigation (PUI) activation was shown to cause lysis on surface of bacterial cell walls. There was no significant difference between the roughness values in all treatment groups. Conclusions: The irrigation of root canal treatment with 0.2% high molecular nano-chitosan with the addition of PUI activation had significant antibacterial activities against E. faecalis.
Collapse
|