In vitro antimicrobial activity of different gutta-percha points and calcium hydroxide pastes

Antimicrobial Efficacy of Two Different Calcium Hydroxide Endodontic Dressings on the Eradication of Enterococcus faecalis in Single-Rooted Canals: An In Vitro Study

INTRODUCTION

Bacterial pulp infections are considered the most common cause of endodontic treatment failure. Enterococcus faecalis was isolated from most cases of failure of endodontic treatment. Therefore, using the appropriate intra-canal dressing is essential for successful treatment. The improved formula used in calcium hydroxide PLUS points ensures more calcium hydroxide is released over a longer period and more space to release calcium hydration. This in vitro research aimed to evaluate the differences in the efficacy between Ca(OH)₂ paste and PLUS points as an endodontic dressing in eradicating E. faecalis growth inside infected single-rooted canals.

MATERIALS AND METHODS

Thirty mandibular first premolars with single canals were extracted for orthodontic reasons and were prepared after cutting their crowns to standardize the length of the roots to 17 mm, root preparation, and isolating E. faecalis. The infected sample root canals were contaminated with the prepared bacterial suspension, and the sample was incubated in the incubator under air conditions at 37°C for seven days, counting the bacteria colonies. Then, the bacterial units were counted before applying the drug, applying Ca(OH)₂ paste in the first group and Ca(OH)₂ PLUS points in the second group. The bacterial units were counted, and the number of bacteria was compared between the two substances applied to the samples, measuring the intracanal dressings' effectiveness. Wilcoxon signed-rank tests were used to detect significant differences.  Results: The results showed a statistically significant difference in the bacterial count of E. faecalis before and after applying the dressing of Ca(OH)₂ paste from a mean of 11.89 to a mean of 3.18 (p=0.003) and no statistical difference in applying Ca(OH)₂ PLUS points from mean 11.98 to mean 10.50 (p>0.05).

CONCLUSION

Within the limits of the current in vitro study, the Ca(OH)₂ paste cones were more effective than Ca(OH)₂ PLUS points in eradicating E. faecalis growth inside the infected single-rooted canals.

Oroactive dental biomaterials and their use in endodontic therapy

Dental biomaterials have revolutionized modern therapies. Untreated dental caries remains the major etiological factor for endodontic treatment, and together with a decreasing rate of tooth loss escalates the importance of continuously improving the materials used for endodontic therapies. Endodontic biomaterials are used for vital pulp therapies, irrigation, intracanal medicaments, obturation and regenerative procedures. These materials offer several functions including: antimicrobial activity, mechanical reinforcement, aesthetics, and therapeutic effects. Vital pulp therapies have seen an improvement in clinical results with an incremental approach to build on the strengths of past materials such as calcium hydroxide and calcium silicates. While sodium hypochlorite remains the gold standard for canal irrigation, numerous nanoparticle formulations have been developed to promote sustained antimicrobial action. Gutta-percha based bulk fillers remain the most common materials for root filling. However, while multiple studies focus on the development of novel formulations containing drugs, glass derivatives or ionic-, polymeric-, or drug- loaded nanoparticles, a lack of reliable and long-term clinical evidence obligates further study as experienced clinicians prefer to use what has worked for decades. This review delves in to the biochemistry of the materials to scrutinize their shortcomings, and where opportunity lies to further enhance their efficacy in endodontic practice. © 2019 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 108B:201-212, 2020.

In vitro evaluation of antimicrobial activity of different Gutta-percha points and calcium hydroxide pastes

Purpose:

To evaluate the antimicrobial activity of different compositions of Gutta-percha points and calcium hydroxide (Ca(OH)₂) pastes, used in endodontic therapy.

Materials and Methods:

The evaluated material consisted of Gutta-percha points containing Ca(OH)₂, Gutta-percha points containing chlorhexidine (Chx), conventional Gutta-percha points and Ca(OH)₂ pastes. Antimicrobial properties of Chx and CaOH paste are compared with CaOH points. Antimicrobial tests included three species of microorganisms: Escherichia coli (ATCC 25923), Staphylococcus aureus (ATCC 25922) Pseudomonas aeruginosa (ATCC BAA-427), the agar disc diffusion method was employed. The plates were kept at room temperature for 2 h for prediffusion and then incubated at 37°C for 24 h. Zones of inhibition were measured.

Results and Conclusion:

All microbial species used in the study were inhibited by the Gutta-percha points containing Chx and by the Ca(OH)₂ pastes, no antimicrobial activity was observed for the other groups (conventional Gutta-percha and Ca(OH)₂ group).

Antimicrobial effect of calcium hydroxide as an intracanal medicament in root canal treatment: a literature review - Part I. In vitro studies

The goal of endodontic treatment is the prevention and control of pulpal and periradicular infections. Calcium hydroxide (Ca(OH)2) has been widely used in endodontics as an intracanal medicament to eliminate the remaining microorganisms after chemomechanical preparation. The purpose of this article is to review the antimicrobial properties of Ca(OH)2 as an intracanal medicament in root canal treatment. The first part of this review details the characteristics of Ca(OH)2 and summarizes the results of in vitro studies related to its antimicrobial effect. The antimicrobial effect of Ca(OH)2 results from the release of hydroxyl ions when it comes into contact with aqueous fluids. Ca(OH)2 has a wide range of antimicrobial effects against common endodontic pathogens, but is less effective against Enterococcus faecalis and Candida albicans. The addition of vehicles or other agents might contribute to the antimicrobial effect of Ca(OH)2.

Case Report: retained gutta-percha as a cause for persistent maxillary sinusitis and pain

Dental sources of infection can produce acute and chronic maxillary sinusitis. In some cases, the source of the infection may be related to the presence of endodontic materials in the oral cavity. In this article, we report a case of retained gutta-percha in the maxillary sinus resulting in chronic sinusitis.

Effectiveness of different chemical agents for disinfection of gutta-percha cones

This aim of this study was to evaluate and compare the efficacy of different chemical methods to disinfect gutta-percha cones (GP). Eighty-six size 80 GP cones were used. The cones were contaminated by immersion in saliva and Enterococcus faecalis. Four chemical agents were used: 1% sodium hypochlorite (G1), 2% chlorhexidine gluconate (G2), 10% povidone iodine (G3) and 0.9% saline solution (G4). GP cones were immersed in the solutions for periods of 1 and 10 min. After the disinfection procedure, the cones were incubated in blood heart infusion and the presence of bacterial growth was analysed by turbidity of the medium. In G4, bacterial growth was observed in all specimens; G3 showed growth after immersion for 1 min when contaminated with E. faecalis; G1 showed diverse results after the immersion for 1 min. Meanwhile, G1 and G3 after 10 min, and G2 at both times evaluated did not show bacterial growth. The immersion of GP cones in 2% chlorhexidine gluconate for 1 min was an effective method for GP disinfection, while 10% povidone iodine and 1% sodium hypochlorite needed 10 min of immersion to disinfect the GP.