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Lee ES, de Josselin de Jong E, Kim E, Kim BI. Real-time optical detection of endodontic infection using bacterial autofluorescence. J Dent 2023; 136:104600. [PMID: 37392816 DOI: 10.1016/j.jdent.2023.104600] [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: 05/12/2023] [Revised: 06/21/2023] [Accepted: 06/23/2023] [Indexed: 07/03/2023] Open
Abstract
OBJECTIVES For successful root canal treatment (RCT), it is essential to objectively assess the presence and activity of bacteria in the root canal system. However, current methods rely on subjective observations of root canal exudates. This study aimed to confirm whether real-time optical detection using bacterial autofluorescence can evaluate endodontic infection status by assessing the red fluorescence (RF) detected from root canal exudates. METHODS During RCT, endodontic paper points were used to collect root canal exudates scored using conventional organoleptic tests to assess the severity of root canal infections. RF on the paper points was assessed using quantitative light-induced fluorescence (QLF) technology. RF intensity and area from the paper points were quantified, and their correlations with infection severity were assessed using their organoleptic scores. The oral microbiome composition of RF samples was compared with non-red fluorescent (non-RF) samples. RESULTS The RF detection rate was nil and >98% in the non-infectious and severe groups. The RF intensity and area significantly increased with infection severity (p<0.001) and showed strong correlations with organoleptic scores (r=0.72, 0.82, respectively). The diagnostic accuracy for detecting root canal infection using RF intensity was good to excellent (AUC = 0.81-0.95) and increased with infection severity. The microbial diversity of the RF samples was significantly lower than that of the non-RF samples. Gram-negative anaerobic bacteria such as Prevotella and Porphyromonas were more predominant in RF samples. CONCLUSIONS Optical detection using bacterial autofluorescence can objectively evaluate endodontic infection status in real-time by assessing the RF of endodontic root canal exudates. CLINICAL SIGNIFICANCE This real-time optical technology can be utilised to detect endodontic bacterial infection without conventional incubation, allowing clinicians to determine the endpoint of chemomechanical debridement and increase the positive outcomes of RCTs.
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Affiliation(s)
- Eun-Song Lee
- Department of Preventive Dentistry & Public Oral Health, BK21 FOUR Project, Yonsei University College of Dentistry, Seoul, Korea
| | - Elbert de Josselin de Jong
- Department of Preventive Dentistry & Public Oral Health, BK21 FOUR Project, Yonsei University College of Dentistry, Seoul, Korea; Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam, Amsterdam, The Netherlands; Inspektor Research Systems BV, Amsterdam, The Netherlands
| | - Euiseong Kim
- Microscope Center, Department of Conservative Dentistry and Oral Science Research Center, Yonsei University College of Dentistry, Seoul, Korea; Department of Electrical & Electronic Engineering, Yonsei University College of Engineering, Seoul, Korea
| | - Baek-Il Kim
- Department of Preventive Dentistry & Public Oral Health, BK21 FOUR Project, Yonsei University College of Dentistry, Seoul, Korea.
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Weber MT, Alkhafaji Y, Pioch A, Trips E, Basche S, Dannemann M, Kilistoff A, Hannig C, Sterzenbach T. Quantification of Bacterial DNA from Infected Human Root Canals Using qPCR and DAPI after Disinfection with Established and Novel Irrigation Protocols. MATERIALS 2022; 15:ma15051911. [PMID: 35269141 PMCID: PMC8912041 DOI: 10.3390/ma15051911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 02/23/2022] [Accepted: 02/25/2022] [Indexed: 02/05/2023]
Abstract
The removal of bacterial infections within the root canal system is still a challenge. Therefore, the cleansing effect of established and new irrigation-protocols (IP) containing silver diamine fluoride (SDF) 3.8% on the whole root canal system was analyzed using quantitative PCR (qPCR) and 4′,6-diamidino-phenylindole-(DAPI)-staining. Extracted human premolars were instrumented up to F2 (ProTaper Gold) under NaCl 0.9% irrigation and incubated with Enterococcus faecalis for 42 days. Subsequently, different ultrasonically agitated IP were applied to the roots: control (no irrigation), 1. NaOCl 3%, EDTA 20%, CHX 2%, 2. NaOCl 3%, EDTA 20%, 3. NaOCl 3%, EDTA 20%, SDF 3.8%, 4. SDF 3.8%, and 5. NaCl 0.9%. One half of the root was investigated fluorescent-microscopically with DAPI. The other half was grinded in a cryogenic mill and the bacterial DNA was quantified with qPCR. The qPCR results showed a statistically significant reduction of bacteria after the application of IP 1, 2, and 3 compared to the control group. While IP 4 lead to a bacterial reduction which was not significant, IP 5 showed no reduction. These data corresponded with DAPI staining. With qPCR a new molecular-biological method for the investigation of the complete root canal system was implemented. The novel IP 3 had an equally good cleansing effect as the already established IP.
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Affiliation(s)
- Marie-Theres Weber
- Clinic of Operative and Pediatric Dentistry, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Germany; (Y.A.); (A.P.); (S.B.); (C.H.); (T.S.)
- Correspondence: ; Tel.: +49-351-458-7456
| | - Yousef Alkhafaji
- Clinic of Operative and Pediatric Dentistry, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Germany; (Y.A.); (A.P.); (S.B.); (C.H.); (T.S.)
| | - Anne Pioch
- Clinic of Operative and Pediatric Dentistry, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Germany; (Y.A.); (A.P.); (S.B.); (C.H.); (T.S.)
| | - Evelyn Trips
- Coordination Center for Clinical Studies Dresden, Medical Faculty Carl Gustav Carus, Technical University Dresden, Fetscherstraße 74, 01309 Dresden, Germany;
| | - Sabine Basche
- Clinic of Operative and Pediatric Dentistry, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Germany; (Y.A.); (A.P.); (S.B.); (C.H.); (T.S.)
| | - Martin Dannemann
- Faculty of Automotive Engineering, Institute of Energy and Transport Engineering, Westsächsische Hochschule Zwickau, Scheffelstraße 39, 08012 Zwickau, Germany;
| | - Alan Kilistoff
- Faculty of Medicine & Dentistry, University of Alberta, 11405 87th Ave NW, Edmonton, AB T6G 1C9, Canada;
| | - Christian Hannig
- Clinic of Operative and Pediatric Dentistry, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Germany; (Y.A.); (A.P.); (S.B.); (C.H.); (T.S.)
| | - Torsten Sterzenbach
- Clinic of Operative and Pediatric Dentistry, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Germany; (Y.A.); (A.P.); (S.B.); (C.H.); (T.S.)
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3
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Siqueira JF, Rôças IN. Present status and future directions - microbiology of endodontic infections. Int Endod J 2021; 55 Suppl 3:512-530. [PMID: 34958494 DOI: 10.1111/iej.13677] [Citation(s) in RCA: 85] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 12/22/2021] [Accepted: 12/26/2021] [Indexed: 11/29/2022]
Abstract
Apical periodontitis has a microbial aetiology and is one of the most common inflammatory diseases that affect humans. Fungi, archaea and viruses have been found in association with apical periodontitis, but bacteria are by far the most prevalent and dominant microorganisms in endodontic infections. Bacterial infection of the root canal system only occurs when the pulp is necrotic or was removed for previous treatment. In some specific cases, including acute and chronic abscesses, the bacterial infection may reach the periradicular tissues. Intracanal bacteria are usually observed as sessile multispecies communities (biofilms) attached to the dentinal root canal walls. Infection in the main root canal lumen can spread to other areas of the root canal system. Although more than 500 bacterial species have been detected in endodontic infections, a selected group of 20 to 30 species are most frequently detected and may be considered as the core microbiome. There is a high interindividual variability in the endodontic microbiome in terms of species composition and relative abundance. Obligate anaerobic species are more abundant in the intraradicular bacterial communities of teeth with primary apical periodontitis, while both anaerobes and facultatives dominate the communities in post-treatment apical periodontitis. Bacterial interactions play an essential role in determining the overall virulence of the community, which has been regarded as the unit of pathogenicity of apical periodontitis. This article reviews the microbiologic aspects of endodontic infections and provides perspectives for future research and directions in the field.
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Affiliation(s)
- José F Siqueira
- Department of Dental Research, Faculty of Dentistry, Iguaçu University (UNIG), Nova Iguaçu, RJ, and Department of Endodontics and Molecular Microbiology Laboratory, Faculty of Dentistry, Grande Rio University, Rio de Janeiro, RJ, Brazil
| | - Isabela N Rôças
- Department of Dental Research, Faculty of Dentistry, Iguaçu University (UNIG), Nova Iguaçu, RJ, and Department of Endodontics and Molecular Microbiology Laboratory, Faculty of Dentistry, Grande Rio University, Rio de Janeiro, RJ, Brazil
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4
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Tsai AC, George R, Walsh LJ. Evaluation of the effect of various endodontic irrigants and medicaments on dentine fluorescence. Photodiagnosis Photodyn Ther 2021; 37:102651. [PMID: 34838696 DOI: 10.1016/j.pdpdt.2021.102651] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 09/30/2021] [Accepted: 11/22/2021] [Indexed: 12/18/2022]
Abstract
This study examined the effect of various root canal irrigants and medicaments on dentin fluorescence elicited by 655 nm visible red laser light. To replicate clinical use, irrigants were applied onto dentin samples for 2 min, while medicaments were applied for 2 weeks. Fluorescence values tracked from baseline across the following to 24 h, starting 5 min after exposure. Sodium hypochlorite, hydrogen peroxide, and articaine local anaesthetic (4% articaine with 1:1000,000 adrenaline) all significantly quenched fluorescence (p < 0.0001), which then returned to baseline levels after 20 min. Conversely, elevated fluorescence readings were recorded after 3% mepivacaine (p < 0.05), 0.2% chlorhexidine (p < 0.01) and chloroform (p <0.05). A 2 week application of Ledermix™ paste containing 3% demeclocycline caused an irreversible increase in fluorescence (p < 0.0001). Other tested endodontic materials (15% EDTA, eucalyptus oil, calcium hydroxide, Odontopaste™ clindamycin paste, and distilled water) had no impact on dentine fluorescence. The influences of endodontic materials on dentin fluorescence need to considered when using fluorescence endpoints to guide the progress of root canal treatment.
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Affiliation(s)
- Andy C Tsai
- School of Dentistry, University of Queensland, Herston, QLD, Australia
| | - Roy George
- School of Medcine and Dentistry, Griffith University, Southport, Queensland, Australia.
| | - Laurence J Walsh
- School of Dentistry, University of Queensland, Herston, QLD, Australia.
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Zehnder M, Belibasakis GN. A critical analysis of research methods to study clinical molecular biomarkers in Endodontic research. Int Endod J 2021; 55 Suppl 1:37-45. [PMID: 34655496 PMCID: PMC9298367 DOI: 10.1111/iej.13647] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 10/14/2021] [Indexed: 12/22/2022]
Abstract
The authors of this narrative review aimed to address various experimental methods and make recommendations for how research should move forward in the context of studying biomarkers in clinical Endodontic research. The approach adopted is exemplified using two prominent clinical problems, namely (a) the ‘reversible’ versus ‘irreversible’ pulpitis conundrum and (b) persistent idiopathic dentoalveolar pain (PIDAP). Pulpitis under deep caries or dentinal cracks is understood from a histological perspective, but clinical assessment tools to indicate irreversibly inflamed aspects of the dental pulp are elusive. PIDAP, on the other hand, is a diagnosis of exclusion; its pathophysiology is complex and not understood sufficiently to avoid unnecessary dental treatments. This review addresses how diagnostic biomarkers could further our understanding of those and other clinical problems, and how issues can be tackled from a methodological point of view. Hence, different methodological approaches to identify suitable diagnostic biomarker(s) or use known biomarkers are presented. The importance of asking a relevant research question, collecting the most suitable fluid and using the ideal collection vehicle for the research question under investigation is discussed based on the defined clinical problems.
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Affiliation(s)
- Matthias Zehnder
- Clinic of Conservative and Preventive Dentistry, University of Zürich Center of Dental Medicine, Zürich, Switzerland
| | - Georgios N Belibasakis
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
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6
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Sterzenbach T, Pioch A, Dannemann M, Hannig C, Weber MT. Quantification of Bacterial Colonization in Dental Hard Tissues Using Optimized Molecular Biological Methods. Front Genet 2021; 11:599137. [PMID: 33391351 PMCID: PMC7775318 DOI: 10.3389/fgene.2020.599137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 12/01/2020] [Indexed: 11/25/2022] Open
Abstract
Bacterial infections of root canals and the surrounding dental hard tissue are still a challenge due to biofilm formation as well as the complex root canal anatomy. However, current methods for analyzing biofilm formation, bacterial colonization of root canals and dental hard tissue [e.g., scanning electron microscopy, confocal laser scanning microscopy (CLSM) or determination of colony forming units (CFU)] are time-consuming and only offer a selective qualitative or semi-quantitative analysis. The aim of the present study is the establishment of optimized molecular biological methods for DNA-isolation and quantification of bacterial colonization via quantitative PCR (qPCR) from dental hard tissue. Root canals of human premolars were colonized with Enterococcus faecalis. For isolation of DNA, teeth were then grinded with a cryo mill. Since the hard tissues dentin and especially enamel belong to the hardest materials in the human organism, the isolation of bacterial DNA from root dentin is very challenging. Therefore, treatment steps for the isolation of DNA from grinded teeth were systematically analyzed to allow improved recovery of bacterial DNA from dental hard tissues. Starting with the disintegration of the peptidoglycan-layer of bacterial cells, different lysozyme solutions were tested for efficacy. Furthermore, incubation times and concentrations of chelating agents such as EDTA were optimized. These solutions are crucial for the disintegration of teeth and hence improve the accessibility of bacterial DNA. The final step was the determination of prior bacterial colonization of each root canal as determined by qPCR and comparing the results to alternative methods such as CFU. As a result of this study, optimized procedures for bacterial DNA-isolation from teeth were established, which result in an increased recovery rate of bacterial DNA. This method allows a non-selective and straightforward procedure to quantify bacterial colonization from dental hard tissue. It can be easily adapted for other study types such as microbiome studies and for comparable tissues like bones.
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Affiliation(s)
- Torsten Sterzenbach
- Clinic of Operative and Pediatric Dentistry, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Anne Pioch
- Clinic of Operative and Pediatric Dentistry, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Martin Dannemann
- Institute of Lightweight Engineering and Polymer Technology (ILK), Technische Universität Dresden, Dresden, Germany
| | - Christian Hannig
- Clinic of Operative and Pediatric Dentistry, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Marie-Theres Weber
- Clinic of Operative and Pediatric Dentistry, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
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7
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Walsh DJ, Livinghouse T, Durling GM, Arnold AD, Brasier W, Berry L, Goeres DM, Stewart PS. Novel phenolic antimicrobials enhanced activity of iminodiacetate prodrugs against biofilm and planktonic bacteria. Chem Biol Drug Des 2021; 97:134-147. [PMID: 32844569 PMCID: PMC7821224 DOI: 10.1111/cbdd.13768] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 07/09/2020] [Accepted: 07/19/2020] [Indexed: 12/23/2022]
Abstract
Prodrugs are pharmacologically attenuated derivatives of drugs that undergo bioconversion into the active compound once reaching the targeted site, thereby maximizing their efficiency. This strategy has been implemented in pharmaceuticals to overcome obstacles related to absorption, distribution, and metabolism, as well as with intracellular dyes to ensure concentration within cells. In this study, we provide the first examples of a prodrug strategy that can be applied to simple phenolic antimicrobials to increase their potency against mature biofilms. The addition of (acetoxy)methyl iminodiacetate groups increases the otherwise modest potency of simple phenols. Biofilm-forming bacteria exhibit a heightened tolerance toward antimicrobial agents, thereby accentuating the need for new antibiotics as well as those, which incorporate novel delivery strategies to enhance activity toward biofilms.
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Affiliation(s)
- Danica J. Walsh
- Chemistry and BiochemistryMontana State UniversityBozemanMTUSA
- Center for Biofilm EngineeringMontana State UniversityBozemanMTUSA
| | - Tom Livinghouse
- Chemistry and BiochemistryMontana State UniversityBozemanMTUSA
| | - Greg M. Durling
- Chemistry and BiochemistryMontana State UniversityBozemanMTUSA
| | - Adrienne D. Arnold
- Center for Biofilm EngineeringMontana State UniversityBozemanMTUSA
- Microbiology and ImmunologyMontana State UniversityBozemanMTUSA
| | - Whitney Brasier
- Center for Biofilm EngineeringMontana State UniversityBozemanMTUSA
| | - Luke Berry
- Chemistry and BiochemistryMontana State UniversityBozemanMTUSA
| | - Darla M. Goeres
- Center for Biofilm EngineeringMontana State UniversityBozemanMTUSA
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8
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Knight A, Blewitt I, Al-Nuaimi N, Watson T, Herzog D, Festy F, Patel S, Foschi F, Koller G, Mannocci F. Rapid Chairside Microbial Detection Predicts Endodontic Treatment Outcome. J Clin Med 2020; 9:jcm9072086. [PMID: 32635158 PMCID: PMC7408726 DOI: 10.3390/jcm9072086] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 06/30/2020] [Indexed: 01/03/2023] Open
Abstract
Background. The aim of this longitudinal, one-year cohort study was to explore the hypothesis that fluorescence sampling of the root canal space prior to obturation could predict the outcome of root canal treatment (RCT). Methods. Sixty-five teeth underwent primary RCT and were followed up clinically and radiographically. The outcome was determined radiographically with periapical radiographs (PR) and cone beam computed tomography (CBCT) scans. Results. Success at 12 months was predictable based on the fluorescence score. When the fluorescence score (defined as the percentage of signal over total signal including background) was lower than 67, there was a 4.5 times (Odds ratio (OR) = 0.028; 95% confidence interval (CI): 0.003, 0.291, p = 0.001) greater chance of success (90% overall). When the readings were above this threshold, the success rate was 20%. Conclusion. A chairside sampling method is able to predict the outcome of RCT, through the use of paper point sampling and fluorescence staining. This has reduced the prevalence of persistent infections by guiding the optimum time for obturation. ClinicalTrials.gov trial NCT03660163.
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Affiliation(s)
- Alan Knight
- Department of Endodontics, Faculty of Dentistry, Oral and Craniofacial Sciences, Floor 22 Tower Wing, Guy’s Dental Hospital, London SE1 9RT, UK; (A.K.); (I.B.); (N.A.-N.); (T.W.); (D.H.); (F.F.); (S.P.); (F.F.); (G.K.)
| | - Ian Blewitt
- Department of Endodontics, Faculty of Dentistry, Oral and Craniofacial Sciences, Floor 22 Tower Wing, Guy’s Dental Hospital, London SE1 9RT, UK; (A.K.); (I.B.); (N.A.-N.); (T.W.); (D.H.); (F.F.); (S.P.); (F.F.); (G.K.)
| | - Nassr Al-Nuaimi
- Department of Endodontics, Faculty of Dentistry, Oral and Craniofacial Sciences, Floor 22 Tower Wing, Guy’s Dental Hospital, London SE1 9RT, UK; (A.K.); (I.B.); (N.A.-N.); (T.W.); (D.H.); (F.F.); (S.P.); (F.F.); (G.K.)
- Department of Conservative Dentistry, College of Dentistry, University of Baghdad, Baghdad 10001, Iraq
| | - Tim Watson
- Department of Endodontics, Faculty of Dentistry, Oral and Craniofacial Sciences, Floor 22 Tower Wing, Guy’s Dental Hospital, London SE1 9RT, UK; (A.K.); (I.B.); (N.A.-N.); (T.W.); (D.H.); (F.F.); (S.P.); (F.F.); (G.K.)
| | - Dylan Herzog
- Department of Endodontics, Faculty of Dentistry, Oral and Craniofacial Sciences, Floor 22 Tower Wing, Guy’s Dental Hospital, London SE1 9RT, UK; (A.K.); (I.B.); (N.A.-N.); (T.W.); (D.H.); (F.F.); (S.P.); (F.F.); (G.K.)
| | - Frederic Festy
- Department of Endodontics, Faculty of Dentistry, Oral and Craniofacial Sciences, Floor 22 Tower Wing, Guy’s Dental Hospital, London SE1 9RT, UK; (A.K.); (I.B.); (N.A.-N.); (T.W.); (D.H.); (F.F.); (S.P.); (F.F.); (G.K.)
| | - Shanon Patel
- Department of Endodontics, Faculty of Dentistry, Oral and Craniofacial Sciences, Floor 22 Tower Wing, Guy’s Dental Hospital, London SE1 9RT, UK; (A.K.); (I.B.); (N.A.-N.); (T.W.); (D.H.); (F.F.); (S.P.); (F.F.); (G.K.)
- Specialist practice, London W1G 8SB, UK
| | - Federico Foschi
- Department of Endodontics, Faculty of Dentistry, Oral and Craniofacial Sciences, Floor 22 Tower Wing, Guy’s Dental Hospital, London SE1 9RT, UK; (A.K.); (I.B.); (N.A.-N.); (T.W.); (D.H.); (F.F.); (S.P.); (F.F.); (G.K.)
- Department of Therapeutic Dentistry, I. M. Sechenov First Moscow State Medical University, 119146 Moscow, Russia
| | - Garrit Koller
- Department of Endodontics, Faculty of Dentistry, Oral and Craniofacial Sciences, Floor 22 Tower Wing, Guy’s Dental Hospital, London SE1 9RT, UK; (A.K.); (I.B.); (N.A.-N.); (T.W.); (D.H.); (F.F.); (S.P.); (F.F.); (G.K.)
| | - Francesco Mannocci
- Department of Endodontics, Faculty of Dentistry, Oral and Craniofacial Sciences, Floor 22 Tower Wing, Guy’s Dental Hospital, London SE1 9RT, UK; (A.K.); (I.B.); (N.A.-N.); (T.W.); (D.H.); (F.F.); (S.P.); (F.F.); (G.K.)
- Correspondence: ; Tel.: +44(0)-2071-881-573
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9
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Abusrewil S, Alshanta OA, Albashaireh K, Alqahtani S, Nile CJ, Scott JA, McLean W. Detection, treatment and prevention of endodontic biofilm infections: what's new in 2020? Crit Rev Microbiol 2020; 46:194-212. [PMID: 32233822 DOI: 10.1080/1040841x.2020.1739622] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Endodontic disease, a biofilm infection of the root canal space, is a significant cause of dental morbidity worldwide. Endodontic treatment, or root canal treatment, as it is commonly known is founded on the ability to eradicate microbial biofilm infection and prevent re-infection of the highly complex root canal space. Despite many "advances" in clinical endodontics we have seen little improvement in outcomes. The aim of this critical review paper is to provide a contemporary view of endodontic microbiology and biofilm polymicrobiality, provide an understanding of the host response, and how together these impact upon clinical treatment. Ultimately, it is intended to provide insight into novel opportunities and strategies for the future diagnostics, treatment, and prevention of endodontic disease.
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Affiliation(s)
- Sumaya Abusrewil
- Glasgow Dental School, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Om Alkhir Alshanta
- Glasgow Dental School, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Khawlah Albashaireh
- Glasgow Dental School, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Saeed Alqahtani
- Glasgow Dental School, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Christopher J Nile
- School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - James Alun Scott
- Glasgow Dental School, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - William McLean
- Glasgow Dental School, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
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10
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Novel Approaches to Detect and Treat Biofilms within the Root Canals of Teeth: A Review. Antibiotics (Basel) 2020; 9:antibiotics9030129. [PMID: 32244927 PMCID: PMC7148501 DOI: 10.3390/antibiotics9030129] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 03/11/2020] [Accepted: 03/19/2020] [Indexed: 01/31/2023] Open
Abstract
Biofilms located within the root canals of teeth are a unique and pressing concern in dentistry and in medical microbiology. These multispecies biofilms, which include fungi as well as bacteria, form in a protected site with low shear stress and low oxygen tension. Systemic antibiotics are of limited value because of the lack of blood flow of the site, and issues with innate and acquired resistance. Physical disruption using hand or rotary powered instruments does not reach all locations in the root canal system where biofilms are present. Alternative strategies including agitated irrigation fluids, continuous chelation, materials with highly alkaline pH, and antimicrobial nanoparticles are being explored to meet the challenge. Detection and quantification of biofilms using fluorescence-based optical methods could provide an indication of successful biofilm removal and an endpoint for physical and chemical treatments.
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11
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Kang SM, de Josselin de Jong E, Higham SM, Hope CK, Kim BI. Fluorescence fingerprints of oral bacteria. JOURNAL OF BIOPHOTONICS 2020; 13:e201900190. [PMID: 31654475 DOI: 10.1002/jbio.201900190] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 09/30/2019] [Accepted: 10/02/2019] [Indexed: 06/10/2023]
Abstract
The rapid detection and identification of microorganisms is one of the most important factors in many cases of ill health. The purpose of this study was to determine the fluorescence characteristics of seven oral bacteria using emission spectra with the aim of distinguishing between the bacteria, and to compare fluorescence imaging methods for the direct assessment of oral bacteria. Fluorescence images of each bacterium were obtained under a 405-nm light source using a two-filter system. The emissions of all samples were measured with a fluorescence spectrometer. The complete fluorescence data set collected for each sample employed a three-dimensional data cube. The differences in the autofluorescence characteristics of the seven oral bacteria were determined by principal components analysis (PCA). The fluorescence images of the oral bacteria varied with the genus and the filter system. The three-dimensional excitation-emission matrix fluorescence spectra exhibited distinctive fluorescence features associated with intracellular fluorophores. The seven bacteria could be clearly differentiated on the PCA score plot. The findings of this study indicate that oral bacteria can be identified based on their autofluorescence characteristics. Fluorescence spectroscopy coupled with PCA can be used to detect and classify oral bacteria.
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Affiliation(s)
- Si-Mook Kang
- Department of Preventive Dentistry and Public Oral Health, BK21 PLUS Project, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Elbert de Josselin de Jong
- Department of Preventive Dentistry and Public Oral Health, BK21 PLUS Project, Yonsei University College of Dentistry, Seoul, Republic of Korea
- Department of Health Services Research, University of Liverpool, Liverpool, UK
- Inspektor Research Systems BV, Amsterdam, the Netherlands
| | - Susan M Higham
- Department of Health Services Research, University of Liverpool, Liverpool, UK
| | - Christopher K Hope
- Department of Health Services Research, University of Liverpool, Liverpool, UK
| | - Baek-Il Kim
- Department of Preventive Dentistry and Public Oral Health, BK21 PLUS Project, Yonsei University College of Dentistry, Seoul, Republic of Korea
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Kumar AG, Joseph B, Nandagopal S, Sankarganesh P, Jagdish SK. Experimental Human Root Canal Irrigant NaOCl Against Enterococcus Faecalis and 3T3, and Determination of Cytotoxicity Effect. ACTA ACUST UNITED AC 2019. [DOI: 10.13005/bpj/1723] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
The main aim of endodontic treatment is disinfection of root canal and to prevent chances of reinfection. The most commonly isolated species due to oral infections is Enterococcus faecalis. For nonsurgical endodontic procedures Sodium hypochlorite (NaOCl) has been the irrigant of choice. The mechanism by which endodontic irrigants induce cytotoxicity is still unclear. However, many studies clearly indicated that rapid expression of the reactive oxygen species (ROS) leads to free radicals formation which results in cytotoxicity and cell death. Hence this study was done to determine the viability of cells and oxidative stress mediated by NaOCl, an endodontic irrigant. The irrigants were tested for their effect against fibroblast isolated from human primary buccal mucosa and against 3T3 Cell line. Antibacterial activity was performed against Enterococcus faecalis. Cytotoxicity was determined by MTT. To determine the oxidative stress, total intracellular glutathione, superoxide radical scavenging activity, and catalase assays were performed. The MIC (Minimal Inhibitory Concentration) for the irrigants against Enterococcus faecalis was found to be 10 µl. 10 µl of NaOCl plain 5.2% produced the same effect as that of 10 μl of NaOCl plain 3%. The higher concentration of the irrigants decreased viability of the cells during dye exclusion assay. Enzyme based study showed there is a decrease in enzyme dehydrogenase when treat with irrigants. Glutathione, SOD level was increased gradually on 3T3 cells. But CAT level was increased when the irrigants concentration less. The results of this study indicated that endodontic irrigants were potentially controlling the Enterococcus faecalis and non-toxic/reduced viability of 3T3 cells by MTT which could be due to the oxidative stress and loss of cellular integrity probably due to the liberation of ROS evidenced by the alteration of antioxidant enzymes Glutathione, SOD and CAT.
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Affiliation(s)
- A. Ganesh Kumar
- Department of Microbiology, Hindustan College of Arts and Science, Padur, Chennai - 603 103, Tamil Nadu, India
| | - Baby Joseph
- Centre for Research and Consultancy, Hindustan Institute of Technology and Science, Padur, Chennai - 603103 Tamil Nadu, India
| | - S. Nandagopal
- Department of Botany, Department of Botany, Government Arts College, Hosur - 635 001, Tamil Nadu, India
| | - P. Sankarganesh
- Centre for Research and Consultancy, Hindustan Institute of Technology and Science, Padur, Chennai - 603103 Tamil Nadu, India
| | - S. K. Jagdish
- Department of Prosthodontics, Chettinad Dental College, Kelambakkam - 603 103, Tamil Nadu, India
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