Application of a chairside anaerobic culture test for endodontic treatment

Microbial identification from traumatized immature permanent teeth with periapical lesions using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry

BACKGROUND

This study aims at identifying the microbiota in traumatized immature permanent teeth with periapical lesions using Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS).

METHODS

The study included 16 immature maxillary central incisors with periapical lesions in 13 patients. Field decontamination and negative control samples were performed before and after access cavity preparation. Root canal samples were taken using sterile stainless-steel hand files following field decontamination. In-office inoculation and pure sub-cultures were performed. Bacterial isolates were prepared for MALDI-TOF MS (Bruker, Billerica, MA USA) analysis using the formic acid extraction method. A comparison of the prevalence of isolated microorganisms was done using a one-sample chi-square test. Comparisons between identified microbial species with the, cone beam computed tomography periapical index (CBCT PAI) scores and lesion volume were also conducted. The Chi-square test was applied to investigate the association between the categorical variables .

RESULTS

Out of the forty isolates recovered from the 16 traumatized teeth included in the present study with the mean patients' age of 10.93 ± 1.77, 37 isolates were reliably identified by MALDI-TOF MS. Twelve teeth (62.5%) were polymicrobial. The recovered bacteria belonged to five phyla, 15 genera and 25 species. Firmicutes were the predominant phylum (P < 0.001) over Bacteroidetes, Proteobacteria, Actinobacteria and Fusobacteria. Gram positive bacteria were significantly more prevalent than Gram negative (p = 0.03). Facultative anaerobes were the most prevalent (P < 0.001) compared to the obligate anaerobes and the obligate aerobes. The latter were the least prevalent. Statistically, significant differences existed in the comparison between CBCT PAI scores according to bacterial gram staining.

CONCLUSION

Traumatized immature permanent teeth with periapical lesions showed a significant predominance of Gram-positive facultative anaerobes. MALDI-TOF MS provided accurate identification of numerous viable endodontic microbes.

Combined endodontic and periodontal management of a class 3 invasive cervical resorption in a mandibular first molar

Dental radiography and cone-beam computed tomography revealed the left mandibular first molar in a 68-year-old female patient with Heithersay Class 3 invasive cervical resorption (ICR). The inhibition of ICR progression and environmental improvement in and around the affected tooth through combined endodontic and periodontal treatments led to a favorable clinical outcome.

In vivo antimicrobial efficacy of 6% Morinda citrifolia, Azadirachta indica, and 3% sodium hypochlorite as root canal irrigants

Objective:

To evaluate and compare the antimicrobial efficacy of 6% Morinda citrifolia, Azadirachta indica, and 3% sodium hypochlorite (NaOCl) as root canal irrigants.

Materials and Methods:

Thirty nonvital maxillary anteriors were randomly assigned to one of the three groups corresponding to the irrigant to be tested; 6% Morinda citrifolia juice (MCJ) (n = 10), A. indica (n = 10) and 3% NaOCl (n = 10). After the root canal access opening a root canal culture sample was taken with two paper points and cultured under aerobic and anaerobic conditions. Cleaning and shaping were completed with irrigation by 10 mL of respective irrigants and 5 mL of final rinse. The patients were recalled after 3 days and canals were rinsed again with 5 mL of the test irrigants. This was followed by obtaining a posttreatment root canal culture sample and culturing and analyzed by counting the colony forming units (CFUs).

Results:

Six percentage MCJ, A. indica, and 3% NaOCl showed a significant reduction (P < 0.05) in the mean CFU counts for aerobic and anaerobic bacteria between baseline and 3 days.

Conclusion:

There was no difference in the antimicrobial efficacy of 6% M. citrifolia, A. indica, and 3% NaOCl as root canal irrigants.