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Khoury RD, de Carvalho LS, do Nascimento MFR, Alhussain F, Abu Hasna A. Endodontic irrigants from a comprehensive perspective. World J Clin Cases 2024; 12:4460-4468. [PMID: 39070803 PMCID: PMC11235474 DOI: 10.12998/wjcc.v12.i21.4460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 05/06/2024] [Accepted: 06/03/2024] [Indexed: 06/30/2024] Open
Abstract
This review article explores the fundamental principles of modern endodontics with a focus on root canal cleaning and shaping. It reviews commonly used endodontic irrigant, namely sodium hypochlorite (NaOCl), herbal extracts, chlorhexidine (CHX), and chelating agents, highlighting their properties, applications, and potential drawbacks. NaOCl, a key antimicrobial agent, demonstrates effectiveness against various microorganisms but poses challenges such as high cytotoxicity. Herbal extracts, gaining recognition in endodontics, present an alternative with potential advantages in preserving dentin integrity. CHX, known for its broad-spectrum antimicrobial activity, is discussed in both liquid and gel formulations, emphasizing its role in reducing smear layer formation and preserving hybrid layer durability. Chelating agents, specifically ethylenediaminetetraacetic acid and citric acid, play a vital role in removing the smear layer, enhancing dentin permeability, and facilitating the penetration of antimicrobial agents. The review article underscores the importance of careful application and consideration of each irrigant's properties to ensure safe and effective endodontic procedures. It serves as a valuable guide for clinicians in selecting appropriate irrigants based on specific treatment requirements.
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Affiliation(s)
- Rayana Duarte Khoury
- Department of Restorative Dentistry, Endodontics Division, Institute of Science and Technology, São Paulo State University, São José dos Campos 12245000, SP, Brazil
| | - Lara Steffany de Carvalho
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University, São José dos Campos 12245000, SP, Brazil
| | - Mauro Felipe Rios do Nascimento
- School of Dentistry, The National Institute of Higher Education and Postgraduate Studies Padre Gervásio-INAPÓS, Pouso Alegre 37550-121, MG, Brazil
| | - Fadi Alhussain
- School of Dentistry, Syrian Private University, Al Kiswah 877C+P2, Damascus, Syria
| | - Amjad Abu Hasna
- Department of Restorative Dentistry, Endodontics Division, Institute of Science and Technology, São Paulo State University, São José dos Campos 12245000, SP, Brazil
- School of Dentistry, Universidad Espíritu Santo, Samborondón 092301, Ecuador
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Domingues N, Ramos LDP, Pereira LM, do Rosário Estevam Dos Santos PB, Scorzoni L, Pereira TC, Abu Hasna A, Carvalho CAT, de Oliveira LD. Antimicrobial action of four herbal plants over mixed-species biofilms of Candida albicans with four different microorganisms. AUST ENDOD J 2023; 49:262-271. [PMID: 36057926 DOI: 10.1111/aej.12681] [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: 01/07/2022] [Revised: 07/18/2022] [Accepted: 08/17/2022] [Indexed: 11/02/2022]
Abstract
This study aimed to evaluate the antimicrobial effect of four herbal plants glycolic extracts over mixed-species biofilm composed of Candida albicans (C. albicans) and another pathogenic bacterium as alternative therapy to be investigated. Four plants extract of Pfaffia paniculata roots; Hamamelis virginiana leaf, Stryphnodendron barbatiman tree bark and Gymnema sylvestre stem and leaves were tested over multi-species biofilm of C. albicans (ATCC 18804) and Streptococcus mutans (ATCC 35688), Staphylococcus aureus (ATCC 6538), Enterococcus faecalis (ATCC 4083) or Pseudomonas aeruginosa (ATCC 15442) for 5 min and 24 h and colony forming units per millilitre was calculated. The data were analysed using Kruskal-Wallis with Dunn's test (p ≤ 0.05). All tested extracts showed antimicrobial action over the mixed-species biofilms after 24 h. Some extracts eliminated totally the biofilms. The glycolic extract of P. paniculata, H. virginiana, S. barbatiman and G. sylvestre are effective over mixed-species biofilms and may be indicated as endodontic irrigant or intracanal medication.
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Affiliation(s)
- Nádia Domingues
- Department of Bioscience and Oral Diagnosis, Institute of Science and Technology, São Paulo State University - UNESP, São José dos Campos, Brazil
| | - Lucas de Paula Ramos
- Department of Bioscience and Oral Diagnosis, Institute of Science and Technology, São Paulo State University - UNESP, São José dos Campos, Brazil
| | - Larissa Marques Pereira
- Department of Bioscience and Oral Diagnosis, Institute of Science and Technology, São Paulo State University - UNESP, São José dos Campos, Brazil
| | - Pâmela Beatriz do Rosário Estevam Dos Santos
- Department of Bioscience and Oral Diagnosis, Institute of Science and Technology, São Paulo State University - UNESP, São José dos Campos, Brazil
- Universidade Paulista (UNIP), Health Sciences Institute, São José dos Campos, Brazil
| | - Liliana Scorzoni
- Department of Bioscience and Oral Diagnosis, Institute of Science and Technology, São Paulo State University - UNESP, São José dos Campos, Brazil
| | - Thaís Cristine Pereira
- Department of Bioscience and Oral Diagnosis, Institute of Science and Technology, São Paulo State University - UNESP, São José dos Campos, Brazil
| | - Amjad Abu Hasna
- Department of Restorative Dentistry, Endodontics Division, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos, SP, Brazil
| | - Cláudio Antonio Talge Carvalho
- Department of Restorative Dentistry, Endodontics Division, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos, SP, Brazil
| | - Luciane Dias de Oliveira
- Department of Bioscience and Oral Diagnosis, Institute of Science and Technology, São Paulo State University - UNESP, São José dos Campos, Brazil
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Maniscalco R, Mangano G, de Joannon AC, Vergassola M, Zucchi S, Mannello F, Ragni L. Effect of Sodium Hypochlorite 0.05% on MMP-9 Extracellular Release in Chronic Wounds. J Clin Med 2023; 12:jcm12093189. [PMID: 37176629 PMCID: PMC10179022 DOI: 10.3390/jcm12093189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 04/05/2023] [Accepted: 04/21/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND In chronic wounds, high concentrations of matrix metalloproteinases (MMPs) can cause excessive proteolysis and slow wound healing. Consequently, restoring a proper MMP balance can help reduce the risk of a chronic wound. An antiseptic solution containing 0.05% sodium hypochlorite (Amukine Med 0.05%, Angelini S.p.A.; hereafter termed NaClO solution) is available on the market. The NaClO solution was proven effective and safe in managing infected skin wounds. To further characterize its activity, this study evaluated the in vitro activity of the NaClO solution on the monocyte release of MMPs. METHODS Human monocytic THP-1 (ATCC® TIB-202™) cell lines were differentiated into macrophages and treated with different concentrations of NaClO (from 0.05% to 5 × 10-7%). In addition, the THP-1 cell line was stimulated with wound fluid (WF) from patients with active venous leg ulcers in the inflammatory phase. The effect of NaClO (0.025-0.0062%) was also evaluated on healthy human peripheral blood serum samples. The effects of treatments on the gelatinolytic activity of MMP-9 were evaluated by gelatin zymography. The effects on MMPs release were evaluated through the Pro™ Human MMP 9-plex Assay. An exploratory scratch wound healing assay was also performed. RESULTS The NaClO solution reduced the gelatinolytic activity of MMP-9 and its activated form. The downregulation of MMP-9 gelatinolytic activity was also observed in peripheral blood serum. The MMPs profile showed a reduction in MMP-1 release (p < 0.05) and a slight reduction of the release of MMP-9 and MMP-12 after the treatment with LPS and the NaClO solution. A slight improvement in wound healing was observed after macrophage activation and treatment with the NaClO solution. CONCLUSIONS The results obtained suggest a possible ability of the NaClO solution to modulate the proteolytic pathways in the wound microenvironment, further characterizing its activity and use in clinical practice during wound care.
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Affiliation(s)
- Rosanna Maniscalco
- Unit of Clinical Biochemistry, Section of Biochemistry and Biotechnology, Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Giorgina Mangano
- Scientific Consultant, ToxHub S.r.l. Albano Laziale, 00073 Rome, Italy
| | | | - Matteo Vergassola
- Global R&D Angelini Pharma S.p.A, Via Vecchia del Pinocchio, 22, 60131 Ancona, Italy
| | - Sara Zucchi
- Global R&D Angelini Pharma S.p.A, Via Vecchia del Pinocchio, 22, 60131 Ancona, Italy
| | - Ferdinando Mannello
- Unit of Clinical Biochemistry, Section of Biochemistry and Biotechnology, Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Lorella Ragni
- Global R&D Angelini Pharma S.p.A, Via Vecchia del Pinocchio, 22, 60131 Ancona, Italy
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Dos Santos Liberato SF, da Cruz Vegian MR, Abu Hasna A, de Alvarenga JA, Dos Santos JG, Tini ÍRP, Amêndola I, Junqueira JC, de Oliveira LD. Antibiofilm action of Persea americana glycolic extract over Acinetobacter baumannii and absence of toxicity in Galleria mellonella. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2022; 19:905-911. [PMID: 34265885 DOI: 10.1515/jcim-2021-0051] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 07/05/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES This study aimed to evaluate the antibiofilm activity and toxicity of the glycolic extract of Persea americana "P. americana" over multidrug-resistant strains of Acinetobacter baumannii "A. baumannii" as alternative therapy to be investigated. METHODS A bacterial inoculum of each bacterial strain (4a, 5a, 9a, 12a, ATCC 19606) of A. baumannii was prepared and adjusted by the spectrophotometer. The microdilution broth method was performed to determine the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC). P. americana glycolic extracts were obtained of the tree stalk and leaves. The biofilm viability was tested by MTT assay after 5 min exposure. The toxicity of the extracts was tested by invertebrate model Galleria mellonella. The data were analyzed by ANOVA, Tukey test and log-rank method (α=0.05). RESULTS The extract showed an inhibitory and bactericidal action over all the tested strains with the lowest MIC value observed for the reference strain (3.12 mg/mL). The extract did not demonstrate toxicity in any of the tested concentrations (12.5, 25 and 50 mg/mL) in Galleria mellonella larvae, with a survival percentage above 80% after 168 h. CONCLUSIONS The glycolic extract of P. americana has microbicidal and antibiofilm activity on multidrug-resistant clinical strains of A. baumannii and showed low toxicity for the invertebrate model G. mellonella.
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Affiliation(s)
| | - Mariana Raquel da Cruz Vegian
- Department of Bioscience and Oral Diagnosis, Institute of Science and Technology, São Paulo State University - UNESP, São Paulo, Brazil
| | - Amjad Abu Hasna
- Department of Restorative Dentistry, Endodontics division, Institute of Science and Technology, São Paulo State University - UNESP, São Paulo, Brazil
| | - Janaína Araújo de Alvarenga
- Department of Bioscience and Oral Diagnosis, Institute of Science and Technology, São Paulo State University - UNESP, São Paulo, Brazil
| | - Juliana Guimarães Dos Santos
- Department of Bioscience and Oral Diagnosis, Institute of Science and Technology, São Paulo State University - UNESP, São Paulo, Brazil
| | - Ítalo Rigotti Pereira Tini
- Department of Bioscience and Oral Diagnosis, Institute of Science and Technology, São Paulo State University - UNESP, São Paulo, Brazil
| | - Isabela Amêndola
- Department of Bioscience and Oral Diagnosis, Institute of Science and Technology, São Paulo State University - UNESP, São Paulo, Brazil
| | - Juliana Campos Junqueira
- Department of Bioscience and Oral Diagnosis, Institute of Science and Technology, São Paulo State University - UNESP, São Paulo, Brazil
| | - Luciane Dias de Oliveira
- Department of Bioscience and Oral Diagnosis, Institute of Science and Technology, São Paulo State University - UNESP, São Paulo, Brazil
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de Sá Assis MA, de Paula Ramos L, Abu Hasna A, de Queiroz TS, Pereira TC, Nagai de Lima PM, Berretta AA, Marcucci MC, Talge Carvalho CA, de Oliveira LD. Antimicrobial and Antibiofilm Effect of Brazilian Green Propolis Aqueous Extract against Dental Anaerobic Bacteria. Molecules 2022; 27:molecules27238128. [PMID: 36500223 PMCID: PMC9740127 DOI: 10.3390/molecules27238128] [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: 10/20/2022] [Revised: 11/11/2022] [Accepted: 11/15/2022] [Indexed: 11/25/2022] Open
Abstract
Green propolis may represent a promising therapeutic alternative against dental anaerobic pathogens because of its antimicrobial action. This study aimed to evaluate the antimicrobial and antibiofilm actions of Brazilian green propolis aqueous extract (BGP-AqExt) against dental anaerobic bacteria. The minimum inhibitory concentration (MIC) and minimum microbicide concentration (MMC) of the extract were determined against the standard strains (ATCC) of Fusobacterium nucleatum, Parvimonas micra, Prevotella intermedia, Porphyromonas gingivalis and Porphyromonas endodontalis. BGP-AqExt was chemically characterized by high-performance liquid chromatography with diode-array detection (HPLC-DAD) analysis. Antibiofilm action was measured by MTT and crystal violet tests. The data were statistically analyzed by ANOVA and Tukey (5%) tests. The extract had antimicrobial action against all tested anaerobic bacteria, with an MIC value of 55 mg/mL for all bacteria, an MMC of 27.5 mg/mL for F. nucleatum and P. micra and 55 mg/mL for P. intermedia. Chemically, BGP-AqExt is composed of quercetin, gallic acid, caffeic and p-coumaric acid, drupani, kaempferol and Artepillin C. Significant reductions in biomass and metabolic action of biofilms were found after BGP-AqExt application. Therefore, BGP-AqExt has an antimicrobial and antibiofilm effect against dental anaerobic bacteria.
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Affiliation(s)
- Maria Angélica de Sá Assis
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (ICT-UNESP), São José dos Campos 12245-000, Brazil
| | - Lucas de Paula Ramos
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (ICT-UNESP), São José dos Campos 12245-000, Brazil
| | - Amjad Abu Hasna
- Department of Restorative Dentistry, Endodontics Division, Institute of Science and Technology, São Paulo State University (ICT-UNESP), São José dos Campos 12245-000, Brazil
- Correspondence:
| | - Talita Suelen de Queiroz
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (ICT-UNESP), São José dos Campos 12245-000, Brazil
| | - Thaís Cristine Pereira
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (ICT-UNESP), São José dos Campos 12245-000, Brazil
| | - Patrícia Michelle Nagai de Lima
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (ICT-UNESP), São José dos Campos 12245-000, Brazil
| | - Andresa Aparecida Berretta
- Research and Development Laboratory, Apis Flora Industrial e Comercial Ltda., Rua Triunfo, 945, Ribeirão Preto 14020-670, Brazil
| | - Maria Cristina Marcucci
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (ICT-UNESP), São José dos Campos 12245-000, Brazil
| | - Cláudio Antonio Talge Carvalho
- Department of Restorative Dentistry, Endodontics Division, Institute of Science and Technology, São Paulo State University (ICT-UNESP), São José dos Campos 12245-000, Brazil
| | - Luciane Dias de Oliveira
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (ICT-UNESP), São José dos Campos 12245-000, Brazil
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de Oliveira LD, de Oliveira FE, Hatje BA, Valera MC, Carvalho CAT, Hasna AA. Detoxification of LTA by intracanal medication: analysis by macrophages proinflammatory cytokines production. Braz Dent J 2022; 33:36-43. [PMID: 36477963 PMCID: PMC9733371 DOI: 10.1590/0103-6440202205195] [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: 09/01/2022] [Accepted: 10/17/2022] [Indexed: 12/12/2022] Open
Abstract
The aim of this study was to evaluate in vitro the effect of calcium hydroxide [Ca(OH)2], 2% chlorhexidine gel (CHX) on macrophages (RAW 264.7) to produce pro-inflammatory cytokines and nitric oxide after pretreatment with lipoteichoic acid (LTA) of Enterococcus faecalis. Forty-eight human single-rooted teeth were instrumented with R25.08 (RECIPROC) and sterilized by gamma irradiation. LTA was inoculated in the root canal of each specimen for 96 hours. Specimens were instrumented with 40.06 and 50.05 (RECIPROC) and medicated with: I) Pyrogen-free saline solution (SS); II) 2% CHX gel; III) Ca(OH)2 + SS; or IV) Ca(OH)2 + CHX for 14 days. Three samples (S) were performed of the root canal of each specimen at: S1) immediately after instrumentation; S2) after Ethylenediaminetetraacetic acid (EDTA); S3) after intracanal medication removal. Subsequent quantification of cytokines (IL-1β, TNF-α, MIP-1α, IP-10, G-CSF and IL-6) by immunosorbent assay (ELISA) and nitric oxide by the Griess method was carried-out. Data were submitted to a normality test and then analyzed with one-way ANOVA and Tukey test with a significance level of 5% using GraphPad Prism 6. Ca(OH)2 + SS and Ca(OH)2 + CHX presented lower levels of TNF-α, TNF-α, IL-6, G-CSF and nitric oxide. Ca(OH)2 + SS was the most effective in reducing MIP-1α. CHX was effective in reducing IL-6 and G-CSF. Therefore, the combined intracanal medication of calcium hydroxide and chlorhexidine is effective in reducing the cytokines TNF-α, IL-1β, IL-6, G-CSF and nitric oxide.
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Affiliation(s)
- Luciane Dias de Oliveira
- Department of Bioscience and Oral Diagnosis, Institute of Science and Technology, São Paulo State University - UNESP, São José dos Campos, São Paulo, Brazil
| | - Felipe Eduardo de Oliveira
- Department of Bioscience and Oral Diagnosis, Institute of Science and Technology, São Paulo State University - UNESP, São José dos Campos, São Paulo, Brazil
| | - Bárbara Araujo Hatje
- Department of Bioscience and Oral Diagnosis, Institute of Science and Technology, São Paulo State University - UNESP, São José dos Campos, São Paulo, Brazil
| | - Marcia Carneiro Valera
- Department of Restorative Dentistry, Endodontics division, Institute of Science and Technology, São Paulo State University - UNESP, São José dos Campos, São Paulo, Brazil.
| | - Cláudio Antonio Talge Carvalho
- Department of Restorative Dentistry, Endodontics division, Institute of Science and Technology, São Paulo State University - UNESP, São José dos Campos, São Paulo, Brazil.
| | - Amjad Abu Hasna
- Department of Restorative Dentistry, Endodontics division, Institute of Science and Technology, São Paulo State University - UNESP, São José dos Campos, São Paulo, Brazil.
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Matrix Metalloproteinases in Dental and Periodontal Tissues and Their Current Inhibitors: Developmental, Degradational and Pathological Aspects. Int J Mol Sci 2022; 23:ijms23168929. [PMID: 36012195 PMCID: PMC9409155 DOI: 10.3390/ijms23168929] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 08/02/2022] [Accepted: 08/09/2022] [Indexed: 12/14/2022] Open
Abstract
Objectives: This review article aims to describe some of the roles of Matrix metalloproteinases (MMPs) in enamel, dentine, dental caries, hybrid layer degradation, pulp and periodontal tissues, throwing light on their current inhibitors. The article addresses the potential of MMPs to serve as biomarkers with diagnostic and therapeutic value. Design: The sections of this review discuss MMPs’ involvement in developmental, remodeling, degradational and turnover aspects of dental and periodontal tissues as well as their signals in the pathogenesis, progress of different lesions and wound healing of these tissues. The literature was searched for original research articles, review articles and theses. The literature search was conducted in PubMed and MEDLINE for articles published in the last 20 years. Results: 119 published papers, two textbooks and two doctoral theses were selected for preparing the current review. Conclusions: MMPs are significant proteases, of evident contribution in dental and periapical tissue development, health and disease processes, with promising potential for use as diagnostic and prognostic disease biomarkers. Continuing understanding of their role in pathogenesis and progress of different dental, periapical and periodontal lesions, as well as in dentine-pulp wound healing could be a keystone to future diagnostic and therapeutic regimens.
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Antimicrobial Action, Genotoxicity, and Morphological Analysis of Three Calcium Silicate-Based Cements. BIOMED RESEARCH INTERNATIONAL 2022; 2022:2155226. [PMID: 35592523 PMCID: PMC9113872 DOI: 10.1155/2022/2155226] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 03/08/2022] [Accepted: 04/19/2022] [Indexed: 12/31/2022]
Abstract
This study is aimed at evaluating five mineral oxides (5MO), mineral trioxide aggregate repair high plasticity (MTA HP), and mineral trioxide aggregate (MTA) in relation to the antimicrobial action over Porphyromonas gingivalis, Porphyromonas endodontalis, Parvimonas micra, Fusobacterium nucleatum, and Prevotella intermedia; the genotoxicity over mouse macrophage (RAW 264.7) and osteoblast (Mg-63) cultures; and the morphological analysis using scanning electron microscopy (SEM) analysis (50 k and ×100 k). Sodium hypochlorite (NaOCl), calcium hydroxide, and saline solution were used as control groups in the different analysis. All data were submitted to a normality test and then analyzed with one-way ANOVA, Tukey, and Kruskal-Wallis and Dunn tests, considering α ≤ 0.05 significance level. It was found that over P. gingivalis and P. endodontalis, there was no a significant difference between the calcium silicate-based cements (CSC) and the control group of saline solution, and only 5MO was similar to the NaOCl group. However, over P. micra, all groups were effective and showed a statistically significant difference compared to the saline solution group. Conversely, none of the groups were effective over F. nucleatum and P. intermedia, except of the NaOCl group. There was a significant difference between 5MO and MTA groups in comparison with NaOCl and MTA HP over osteoblasts and macrophages after 24 hours. SEM images showed small irregular particles interspersed with some elongated needle-like particles and small irregular particles with some larger particles as well as elongated particles. It was concluded that 5MO, MTA, and MTA HP have effective antimicrobial action over P. micra. However, only 5MO is effective over P. gingivalis and P. endodontalis. Besides, 5MO and MTA are not genotoxic over mouse macrophage (RAW 264.7) and osteoblast (Mg-63) cultures.
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Effect of Passive Ultrasonic Irrigation over Organic Tissue of Simulated Internal Root Resorption. Int J Dent 2021; 2021:3130813. [PMID: 34745262 PMCID: PMC8570868 DOI: 10.1155/2021/3130813] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 09/13/2021] [Accepted: 10/15/2021] [Indexed: 01/17/2023] Open
Abstract
This study aimed to evaluate the efficacy of passive ultrasonic irrigation (PUI) on dissolving the organic tissue inside simulated internal root resorption (IRR) using sodium hypochlorite (NaOCl) or chlorhexidine (CHX). A total of 40 human lower premolars were collected based on dimensional and morphological similarities. The roots were embedded in cylinders (3 cm diameter; 2.5 cm height) of self-cured acrylic resin, and then an IRR was simulated. The specimens were divided into 4 groups (n = 10) according to irrigation protocols: group 1: CHX + PUI; group 2: CHX; group 3: NaOCl + PUI; group 4: NaOCl. The total irrigation time was 150 s at a flow rate of 5 mL/min. A tissue mass of porcine palatine mucosa was used to simulate the organic tissue, it was weighed before and after the irrigation using an analytic balance, and the difference between both readings was calculated and transferred to percentage values. Data were submitted to statistical analysis using two-way ANOVA (factors: irrigant type and with/without PUI) and Tukey's test for multiple comparisons among the experimental groups (α = 0.05). There was a significant difference in both factors (irrigant: p=0.04; PUI: p ≤ 0.001). The groups that used PUI were more effective in dissolving the organic tissue of the IRR simulation than the groups without PUI. PUI is more effective than the syringe and needle irrigation in organic tissue dissolution.
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Al-Nahlawi T, Ala Rachi M, Abu Hasna A. Endodontic Perforation Closure by Five Mineral Oxides Silicate-Based Cement with/without Collagen Sponge Matrix. Int J Dent 2021; 2021:4683689. [PMID: 34539787 PMCID: PMC8443381 DOI: 10.1155/2021/4683689] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Accepted: 08/26/2021] [Indexed: 02/07/2023] Open
Abstract
Endodontic perforations are common accidents that occasionally happen as a result of misuse or difficult anatomy of some teeth; it may lead to teeth loss unless a good management is provided. Bioceramic (silicate-based) cements like mineral trioxide aggregate have a big role in management of such accidents. This case report aimed to evaluate the ability of five mineral oxides cement "5MO" in sealing two root canal perforations (furcation and postdrill perforations) and inducing clinical and radiographic healing in the periodontal tissues with/without the use of collagen sponge matrix. A 58-year-old healthy female was referred to our dental office complaining of severe pain in the upper left premolars' region. Periapical radiographic examination revealed unsatisfactory root canal treatment of the teeth #24 and #25 with a furcation perforation and a postdrill perforation, respectively. Cone-beam computed tomography "CBCT" scans confirmed the findings of the periapical radiography and revealed the presence of radiolucent lesions surrounding the apex of both teeth #24 and #25. The treatment plan was a nonsurgical root canal retreatment by endodontic access through the full-ceramic crowns. After three years of follow-up, CBCT scans revealed a complete healing and bone formation on both premolars. This case report indicates the use of 5MO cement for endodontic perforations management.
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Affiliation(s)
- Talal Al-Nahlawi
- Operative Dentistry and Endodontics Department, Syrian Private University (S.P.U), Damascus, Syria
| | - Maisour Ala Rachi
- Operative Dentistry and Endodontics Department, Syrian Private University (S.P.U), Damascus, Syria
| | - Amjad Abu Hasna
- Department of Restorative Dentistry, Endodontics Division, Institute of Science and Technology, Sa˜o Paulo State University – UNESP, Sa˜o José Dos Campos, São Paulo, Brazil
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Paula-Silva FWG, Arnez MFM, de Campos Chaves Lamarque G, Petille R, Ribeiro-Santos FR, de Sena MF, Nelson-Filho P, da Silva LAB. Osteoclast formation, inflammation, and matrix metalloproteinase-9 are downregulated in bone repair following root canal treatment in dogs teeth. Clin Oral Investig 2021; 25:4699-4707. [PMID: 33449195 DOI: 10.1007/s00784-021-03784-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 01/06/2021] [Indexed: 01/26/2023]
Abstract
OBJECTIVES The aim of this study was to investigate the inflammatory infiltrate, osteoclast formation, and expression of MMP-9 during the healing phase following root canal treatment in teeth with apical periodontitis. MATERIALS AND METHODS Apical periodontitis was induced in dogs teeth, and root canal treatment was performed in a single visit or using calcium hydroxide as intracanal medication. One hundred and eighty days following treatment the presence of inflammation was examined, and the tissues were stained to detect osteoclasts by means of a tartrate resistant alkaline phosphatase (TRAP) assay. Synthesis of MMP-9 was detected using Western blotting and immunohistochemistry. RESULTS Teeth with apical periodontitis that had root canal therapy performed in a single visit presented a higher synthesis of MMP-9 compared with root canal treatment using calcium hydroxide. Treatment with calcium hydroxide resulted in a reduced amount of inflammatory cells and MMP-9 positive cells. Osteoclast formation, the number of MMP-9 positive osteoclasts and cementocytes, was reduced following root canal treatment, regardless of the root canal treatment protocol used. CONCLUSION Root canal treatment reduced the amount of inflammatory cells and osteoclasts in periapical area. The use of calcium hydroxide as intracanal medication resulted in a lower synthesis of MMP-9, though the number of osteoclasts and MMP-9 positive osteoclasts were similar between the groups. CLINICAL RELEVANCE Periapical bone repair following root canal treatment is impacted by therapy performed either in single visit or using calcium hydroxide dressing measured by inflammatory cell recruitment, osteoclast formation, and MMP-9 synthesis.
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Affiliation(s)
| | - Maya Fernanda Manfrin Arnez
- Department of Pediatric Clinics, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | | | - Renato Petille
- Department of Pediatric Clinics, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Fernanda Regina Ribeiro-Santos
- Department of Pediatric Clinics, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
- Universidade de Pernambuco, Arco Verde, PE, Brazil
| | - Marina Fernandes de Sena
- Department of Pediatric Clinics, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Paulo Nelson-Filho
- Department of Pediatric Clinics, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Léa Assed Bezerra da Silva
- Department of Pediatric Clinics, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
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Abu Hasna A, Pereira Santos D, Gavlik de Oliveira TR, Pinto ABA, Pucci CR, Lage-Marques JL. Apicoectomy of Perforated Root Canal Using Bioceramic Cement and Photodynamic Therapy. Int J Dent 2020; 2020:6677588. [PMID: 33376491 PMCID: PMC7746471 DOI: 10.1155/2020/6677588] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 11/22/2020] [Accepted: 12/02/2020] [Indexed: 12/26/2022] Open
Abstract
Root perforation is a common endodontic accident. Its management depends mainly on root canal disinfection and sealing the perforation area by preventing any communication with the periodontium to prevent recontamination. A patient was referred to treat root perforation due to a previous treatment of tooth #22. The diagnosis was symptomatic periapical periodontitis, and the treatment plan was to retreat the root canal of #22 and make a surgical intervention (apicoectomy) associated with antimicrobial photodynamic therapy as a complementary technique. Five mineral oxides (5MO) cement was used as a root-end filling material. The procedures were performed in two sessions and controlled in two visits (after 30 days and 12 months). A bone neoformation was observed at the periapical area of tooth #22. 5MO bioceramic cement was effective in inducing the repair of the periapical lesion and had the ability to seal the exposed periapical area of the tooth. Its success depended mainly on root canal and surgical site disinfection.
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Affiliation(s)
- Amjad Abu Hasna
- Department of Restorative Dentistry, Endodontics Division, Institute of Science and Technology, Sa˜o Paulo State University—UNESP, Sa˜o José Dos Campos, SP, Brazil
| | | | | | - Alana Barbosa Alves Pinto
- Department of Dental Materials and Prosthodontics, Institute of Science and Technology, Sa˜o Paulo State University—UNESP, Sa˜o José Dos Campos, SP, Brazil
| | - César Rogerio Pucci
- Department of Restorative Dentistry, Institute of Science and Technology, Sa˜o Paulo State University—UNESP, Sa˜o José Dos Campos, SP, Brazil
| | - José Luiz Lage-Marques
- Department of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
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Abu Hasna A, Pereira Da Silva L, Pelegrini FC, Ferreira CLR, de Oliveira LD, Carvalho CAT. Effect of sodium hypochlorite solution and gel with/without passive ultrasonic irrigation on Enterococcus faecalis, Escherichia coli and their endotoxins. F1000Res 2020; 9:642. [PMID: 33149896 PMCID: PMC7573735 DOI: 10.12688/f1000research.24721.1] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/18/2020] [Indexed: 01/15/2023] Open
Abstract
Background: Sodium hypochlorite (NaOCl) is the most commonly used irrigant in endodontics
. The purpose of this study was to evaluate the effect of NaOCl solution (2.5%) and gel (3%) with/without passive ultrasonic irrigation (PUI) on
Enterococcus faecalis, Escherichia coli, and their endotoxins, lipopolysaccharide (LPS) and lipoteichoic acid (LTA). Methods: 40 human lower premolars were contaminated with
E. coli (ATCC 25922) for 28 days and
E. faecalis (ATCC 29212) for 21 days. Specimens were randomly divided into four groups: (1) 2.5% NaOCl irrigating the canals without PUI activation; (2) 2.5% NaOCl with PUI; (3) 3% NaOCl gel irrigating the canals without PUI; and (4) 3% NaOCl gel with PUI. 40 mL of irrigant was used for each group. PUI activation was carried out using E1-Irrisonic stainless-steel tip at 10% frequency. After treatment, all specimens were filled with 3mL of 17% ethylenediaminetetraacetic acid (EDTA) for 3min and then washed with nonpyrogenic saline solution. Three samples were collected from the canals: S1, at baseline to confirm biofilm formation; S2 after treatment; and S3 after EDTA. Samples were assessed for
E. coli and
E. faecalis colony forming units, and LPS and LTA were assessed using chromogenic kinetic LAL assay and ELISA, respectively. Data were analyzed by Kruskal-Wallis, Friedmann and Dunn tests with α≤0.05. Results: All groups were effective in reducing the microbial load of
E. coli and
E. faecalis after treatment without a significant difference among the groups. NaOCl and NaOCl gel groups had no significant difference in reducing LPS and LTA. Statistically increased reduction was seen for NaOCL + PUI and NaOCl gel + PUI compared for groups without PUI. Conclusions: NaOCl gel has the same antimicrobial action of NaOCl solution and can partially detoxify endotoxins. PUI improves NaOCl (gel or solution) action over
E. faecalis and
E. coli and their endotoxins.
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Affiliation(s)
- Amjad Abu Hasna
- Department of Restorative Dentistry, Endodontic Division., São Paulo State University (UNESP), Institute of Science and Technology, São José dos Campos, São Paulo, 12245000, Brazil
| | - Laiana Pereira Da Silva
- Department of Restorative Dentistry, Endodontic Division., São Paulo State University (UNESP), Institute of Science and Technology, São José dos Campos, São Paulo, 12245000, Brazil
| | - Fernanda Carvalho Pelegrini
- Department of Restorative Dentistry, Endodontic Division., São Paulo State University (UNESP), Institute of Science and Technology, São José dos Campos, São Paulo, 12245000, Brazil
| | - Cláudia Luísa Ribeiro Ferreira
- Department of Restorative Dentistry, Endodontic Division., São Paulo State University (UNESP), Institute of Science and Technology, São José dos Campos, São Paulo, 12245000, Brazil
| | - Luciane Dias de Oliveira
- Department of Biosciences and Oral Diagnosis, São Paulo State University (UNESP), Institute of Science and Technology, São José dos Campos, São Paulo, 12245000, Brazil
| | - Cláudio Antonio Talge Carvalho
- Department of Restorative Dentistry, Endodontic Division., São Paulo State University (UNESP), Institute of Science and Technology, São José dos Campos, São Paulo, 12245000, Brazil
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