Antibacterial and Solubility Analysis of Experimental Phytotherapeutic Paste for Endodontic Treatment of Primary Teeth

Lesion sterilization and tissue repair with chloramphenicol, tetracyline, zinc oxide/eugenol paste versus conventional pulpectomy: A 36-month randomized controlled trial

BACKGROUND

Endodontic treatment of primary molars represents one of the challenges in pediatric dentistry. There is a lack of consensus in the literature about the endodontic techniques and filling paste for primary teeth with pulp necrosis.

AIM

To compare the effectiveness of the LSTR technique (lesion sterilization and tissue repair) with CTZ paste (chloramphenicol, tetracycline, zinc oxide and eugenol) and pulpectomy with ZOE paste (zinc oxide and eugenol) in the treatment of primary molars with pulp necrosis.

DESIGN

Eighty-eight primary molars with pulp necrosis from 70 children between the ages of 3 and 8 years were included. The teeth were randomized to the LSTR with CTZ paste group or pulpectomy with ZOE paste group. Clinical and radiographic evaluations were performed at 18, 24, 30 and 36 months.

RESULTS

At 36 months, clinical success was 86.4% in LSTR with CTZ paste and 90.9% in pulpectomy with ZOE paste (p = .45). Radiographic success was 43.2% in both groups (p = 1.00). The overall success was 40.9% in LSTR with CTZ paste and 43.2% in pulpectomy with ZOE paste (p = 1.00).

CONCLUSION

After 36 months of evaluation, the effectiveness of the LSTR technique with CTZ paste and pulpectomy with ZOE paste was similar for the treatment of primary molars with pulp necrosis.

Development and In Vitro Validation of Antibacterial Paints Containing Chloroxylenol and Terpineol

The establishment of self-disinfecting surfaces is an important method to avoid surface contamination. Recently, paints with antimicrobial properties have been developed to be applied on different surfaces, avoiding contamination with pathogens. In this work, self-disinfecting paints containing Chloroxylenol (CLX), Terpineol (TRP), and a mixture of both substances were developed. The goal was to evaluate and validate these paints using international standards for eventual commercialization and application in scenarios where surface contamination represents a problem. The paints were challenged with five different bacteria, Gram-positive and Gram-negative, before and after a scrub resistance test, where the long-term efficacy of the paints was evaluated. The antibacterial activity assessment was performed following ISO 22196 and JIS Z2801. In general, the paints showed very promising results, demonstrating their antibacterial activity, before and after scrub resistance test. The paint incorporating the mixture of CLX and TRP (CLX+TRP) stood out by revealing consistent results of antibacterial activity both before and after the scrub resistance test for most of the tested bacteria. The cytotoxicity of the developed paints was assessed in vitro by performing tests by direct contact with a human skin cell line, HaCaT, and testes on extracts with HaCaT and a pulmonary cell line, A549. The methodologies for cytotoxicity assessment were developed based in ISO 10993. For genotoxicity assessment, alkaline comet assay was conducted on both cell lines. The cytotoxicity assessment revealed promising results with the paints, demonstrating values of cellular viability above 70% and values of lactate dehydrogenase (LDH) leakage below 30%. The genotoxic assessment also revealed acceptable values of primary DNA damage for the developed antibacterial paints. In general, the selected methodologies presented good potential to be applied in the validation of both efficacy and safety of the antimicrobial paints, aiming to be applied in real scenarios.

Antimicrobial effects of different concentrations of simvastatin versus triple antibiotic paste on Enterococcus faecalis biofilms at different stages of development

Background. This study assessed the antimicrobial effects of different concentrations of simvastatin versus triple antibiotic paste (TAP) on Enterococcus faecalis biofilms at different stages of development. Methods. In this in vitro study, 70 human single-rooted mature premolars were decoronated, instrumented, and autoclave-sterilized. Next, an E. faecalis suspension was prepared and inoculated into the canals to obtain 4- and 6-week biofilms. After ensuring biofilm formation, the samples in each group were randomly assigned to 5 subgroups (n=12): 1 mg/mL TAP, 10 mg/ mL TAP, 1 mg/mL simvastatin, 10 mg/mL simvastatin, and positive control (phosphate-buffered saline solution). The medicaments were applied in the canals, and the teeth were incubated for one week. Dentin samples were collected by a rotary file, cultured, and the number of E. faecalis colonies was counted. The Kruskal-Wallis, Mann-Whitney U, and Wilcoxon tests were used for data analysis (α=0.05). Results. There were significant differences in colony counts between the two concentrations of TAP and the control group against both 4- and 6-week biofilms (P<0.05). The antibacterial effect of 10 mg/mL TAP and simvastatin was stronger than that of 1 mg/mL concentration against the 4- and 6-week E. faecalis biofilms (P<0.05). Furthermore, 10 mg/mL TAP and simvastatin were more effective against the 4-week biofilms than the 6-week biofilms (P<0.05). Conclusion. According to the present results and since biofilms may remain viable in the root canal system for weeks to months, applying 10 mg/mL TAP and simvastatin might be more effective.