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Martinho FC, Corazza BJM, Khoury RD, Orozco EIF, Toia CC, Machado FP, Valera MC. Impact of N-acetylcysteine (NAC) and calcium hydroxide intracanal medications in primary endodontic infection: a randomized clinical trial. Clin Oral Investig 2023; 27:817-826. [PMID: 35723751 DOI: 10.1007/s00784-022-04585-9] [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: 04/05/2022] [Accepted: 06/10/2022] [Indexed: 02/03/2023]
Abstract
OBJECTIVES This RCT investigated the impact of N-acetylcysteine (NAC) and calcium hydroxide [Ca(OH)2] intracanal medications (ICMs) in primary endodontic infection with apical periodontitis (PEIAP). MATERIALS AND METHODS Thirty-six teeth with PEIAP were randomly divided into groups according to the ICM: NAC, Ca(OH)2 + saline solution (SSL), and Ca(OH)2 + 2% chlorhexidine-gel (2% CHX-gel) (all, n = 12). Root canal samples (RCSs) were collected before (s1) and after instrumentation (s2) and after 14 days of ICM (s3). Chemomechanical preparation (CMP) was performed with a Reciproc file and 2.5% NaOCl. Checkerboard DNA-DNA hybridization was used to assess 40 target bacteria species. RESULTS At s1, bacterial DNA was detected in 100% of RCSs (36/36). All 40 bacterial species were found in PEIAP. The mean number of species per RCS was 17.92 ± 13.18. The most frequent bacteria were S. mitis (65%), E. nodatum (63%), E. faecalis (63%), F. nucl sp vicentii (58%), T. forsythia (58%), and F. periodonticum (56%). CMP reduced the mean number of species per RCS to 6.8 ± 2.36 (p < 0.05). At s3, the intragroup analysis revealed a broader antimicrobial activity for Ca (OH)2 + 2% CHX-gel and NAC than Ca(OH)2 + SSL (p < 0.05). NAC eliminated 8/12 bacteria species resistant to both Ca (OH)2 ICMs, including P. micra, P. nigrescens, T. denticola, A. israelii, P. endodontalis, P. acnes, C. ochracea, and E. corrodens. CONCLUSIONS Ca (OH)2 + 2% chlorhexidine gel (2% CHX gel) showed a greater bacterial elimination over the number of bacterial species; however, NAC eliminated 8/12 bacteria species resistant to both Ca (OH)2 ICMs (RBR-3xbnnn). CLINICAL RELEVANCE The use of intracanal medication with a broad antimicrobial activity can optimize root canal disinfection. Ca(OH)2 + 2% CHX gel and NAC showed a broader antimicrobial activity than Ca(OH)2 + SSL against endodontic pathogens in primary root canal infection. TRIAL REGISTRATION Brazilian Registry of Clinical Trials (REBEC), No. RBR-3xbnnn.
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Affiliation(s)
- Frederico C Martinho
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, 650 West Baltimore Street, 6th floor, Suite 6253, Baltimore, MD, 21201, USA.
| | - Bruna J M Corazza
- Department of Restorative Dentistry, Endodontic Division, Institute of Science and Technology, São Paulo State University - UNESP, São José dos Campos, São Paulo, Brazil
| | - Rayana D Khoury
- Department of Restorative Dentistry, Endodontic Division, Institute of Science and Technology, São Paulo State University - UNESP, São José dos Campos, São Paulo, Brazil
| | - Esteban I F Orozco
- Department of Restorative Dentistry, Endodontic Division, Institute of Science and Technology, São Paulo State University - UNESP, São José dos Campos, São Paulo, Brazil
| | - Cassia C Toia
- Department of Restorative Dentistry, Endodontic Division, Institute of Science and Technology, São Paulo State University - UNESP, São José dos Campos, São Paulo, Brazil
| | - Felipe P Machado
- Department of Restorative Dentistry, Endodontic Division, Institute of Science and Technology, São Paulo State University - UNESP, São José dos Campos, São Paulo, Brazil
| | - Marcia C Valera
- Department of Restorative Dentistry, Endodontic Division, Institute of Science and Technology, São Paulo State University - UNESP, São José dos Campos, São Paulo, Brazil
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Nasrabadi N, Naseri M, Khosraviani F, Nematollahi Z. A Successful Non-surgical Management of a Type II Dens Invaginatus with Antimicrobial Photodynamic Therapy: A Case Report. IRANIAN ENDODONTIC JOURNAL 2023; 18:59-62. [PMID: 36751410 PMCID: PMC9900150 DOI: 10.22037/iej.v18i1.38789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 11/24/2022] [Accepted: 12/03/2022] [Indexed: 02/09/2023]
Abstract
Endodontic therapy of dens invaginatus (DI) anomalies is challenging due to difficult access, inadequate cleaning and shaping, and incomplete disinfection of its complicated root canal system. The present case report describes the treatment of tooth #10 with tooth discomfort, intermittent pus discharge, and localized swelling. Sinus tract, mobility, and probing grade 1 were observed. The tooth was tender on palpation and percussion with negative responses to pulp sensibility tests. Radiographic assessments revealed an atypical structure of pulpal anatomy, probably dens invaginatus, associated with a large periapical lesion and severe root curvature. Cone-beam computed tomography confirmed the presence of DI type II. Finally, the diagnosis of pulp necrosis with chronic apical abscess of tooth #10 was made. Combining antimicrobial photodynamic therapy as an adjunctive treatment with different irrigation techniques were effective in nonsurgical endodontic management of the complicated DI type II in a maxillary lateral incisor with a large periradicular lesion and severe root curvature. Six-month and one-year recall radiographic images revealed asymptomatic tooth and progressive osseous healing.
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Affiliation(s)
- Navid Nasrabadi
- Department of Endodontics, School of Dentistry, Birjand University of Medical Sciences, Birjand, Iran;
| | - Mandana Naseri
- Department of Endodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran;
| | - Farshad Khosraviani
- University of California Los Angeles, School of Dentistry, Los Angeles, USA; ,Corresponding author: Farshad Khosraviani, 714 Tiverton Drive, Los Angeles, CA, 90024. E-mail:
| | - Zahra Nematollahi
- Dental Research Center, Research Institute of Dental Science, Shahid Beheshti University of Medical Science, Tehran, Iran, and Crani -Maxillofacial Research Center, Azad University, Dental Branch, Tehran, Iran
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Oliveira Tavares SJ, Pintor AVB, Caetano SK, dos Santos NCA, Pistoia BM, de Carvalho Camilo MR, Scelza P, Scelza MFZ. Is There a Relationship between Laser Therapy and Root Canal Cracks Formation? A Systematic Review. IRANIAN ENDODONTIC JOURNAL 2023; 18:2-14. [PMID: 36751412 PMCID: PMC9900151 DOI: 10.22037/iej.v18i1.39754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 11/23/2022] [Accepted: 12/26/2022] [Indexed: 02/09/2023]
Abstract
Introduction Crack formation has become an important issue for endodontists, as it can be decisive for the long-term prognosis of the endodontically treated tooth. Since the applicability of laser in endodontics has become frequent, this systematic review aimed to evaluate the association between laser therapy and the formation of cracks in the dentinal structure of the root canal. Materials and Methods A search was performed in PubMed, Scopus, Web of Science, and Virtual Health Library, as well as in the gray literature, on September 24, 2021. Studies that evaluated the formation of cracks in human root dentin due to different types of lasers were included. The risk of bias was assessed following the modified version of the Consolidated Standards of Reporting Trials (CONSORT) checklist tool. A meta-analysis was performed to evaluate (i) the total number of crack incidences; (ii) complete crack formation; (iii) incomplete crack formation; (iv) intra-dentinal crack formation between ultrasonic tips and laser use. The mean difference was calculated with a 95% confidence interval in a fixed-effect model, the heterogeneity was tested using the I2 index with level of significance of 5%. Results Of the 22 studies included in this review, 15 have shown that lasers can form cracks in root dentin, including those that performed baseline assessment of samples. The meta-analysis confirmed no difference in crack formation between ultrasonic tips and laser devices. Conclusions Laser therapy has been gaining prominence in endodontics and that irradiation can form and propagate cracks in the dentinal structure of the root canal assessed by in vitro studies. This is a critical concern for endodontists as it affects the strength and longevity of the tooth. Future research is encouraged to seek the standardization of good methodological practices and achieve establishing parameters to minimize harmful effects of laser on dentin.
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Affiliation(s)
| | - Andréa Vaz Braga Pintor
- Department of Pediatric Dentistry and Orthodontics, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil;
| | | | | | - Bruna Muniz Pistoia
- Faculty of Dentistry, Universidade Federal Fluminense, Niterói, RJ, Brazil;
| | | | - Pantaleo Scelza
- Geriatric Dentistry Department, Faculty of Dentistry, Universidade Federal Fluminense, Niterói, RJ, Brazil;
| | - Miriam Fatima Zaccaro Scelza
- Department of Endodontics, Laboratory of Experimental Culture Cell (LECCel), Faculty of Dentistry, Universidade Federal Fluminense, Niterói, RJ, Brazil,Corresponding author: Miriam Zaccaro Scelza, Department of Endodontics, Universidade Federal Fluminense, Niterói, RJ, Brazil. 30 Mario Santos Braga Street, Centro, Niteroi, RJ 24020-140, Brazil. E-mail:
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Marques Meccatti V, de Souza Moura L, Guerra Pinto J, Ferreira-Strixino J, Abu Hasna A, Alves Figueiredo-Godoi LM, Campos Junqueira J, Marcucci MC, de Paula Ramos L, Carvalho CAT, Pucci CR, de Oliveira LD. Curcuma longa L. Extract and Photodynamic Therapy are Effective against Candida spp. and Do Not Show Toxicity In Vivo. Int J Dent 2022; 2022:5837864. [PMID: 35815117 PMCID: PMC9270141 DOI: 10.1155/2022/5837864] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 05/30/2022] [Accepted: 06/15/2022] [Indexed: 12/18/2022] Open
Abstract
Radiotherapy induces a higher level of Candida spp. colonization, resulting in oral candidiasis. This study aimed to evaluate the phototransformation potential of the glycolic extract of Curcuma longa (C. longa); the antifungal activity of C. longa, curcumin, and antifungal photodynamic therapy (aPDT) with blue light-emitting diodes "LED" on Candida albicans and Candida tropicalis in vitro; and the toxicity of C. longa and curcumin in Galleria mellonella model. In order to confirm the light absorption capacity of the C. longa extract, its phototransformation potential was evaluated. The antifungal effect of C. longa, curcumin, and aPDT was evaluated over Candida spp. Finally, the toxicity of C. longa and curcumin was evaluated on the Galleria mellonella model. The data were analyzed using the GraphPad Prism 5.0 software considering α = 5%. It was found that C. longa, curcumin, and aPDT using blue LED have an antifungal effect over C. albicans and C. tropicalis. The extract of C. longa 100 mg/mL and curcumin 200 μg/mL do not show toxicity on Galleria mellonella model.
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Affiliation(s)
- Vanessa Marques Meccatti
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (ICT-UNESP), São José dos Campos, São Paulo, Brazil
| | - Larissa de Souza Moura
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (ICT-UNESP), São José dos Campos, São Paulo, Brazil
| | - Juliana Guerra Pinto
- Photobiology Applied to Health (PHOTOBIOS)—University of Vale do Paraiba, Research and Development Institute. Av. Shishima Hifumi, 2911—São José dos Campos, São Paulo, Brazil
| | - Juliana Ferreira-Strixino
- Photobiology Applied to Health (PHOTOBIOS)—University of Vale do Paraiba, Research and Development Institute. Av. Shishima Hifumi, 2911—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 (ICT-UNESP), São José dos Campos, São Paulo, Brazil
| | - Lívia Mara Alves Figueiredo-Godoi
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (ICT-UNESP), São José dos Campos, São Paulo, Brazil
| | - Juliana Campos Junqueira
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (ICT-UNESP), São José dos Campos, São Paulo, 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, São Paulo, 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, São Paulo, Brazil
| | - Claudio Antonio Talge Carvalho
- Department of Restorative Dentistry, Endodontics Division, Institute of Science and Technology, São Paulo State University (ICT-UNESP), São José dos Campos, São Paulo, Brazil
| | - Cesar Rogério Pucci
- Department of Restorative Dentistry, Institute of Science and Technology, São Paulo State University (ICT-UNESP), São José dos Campos, São Paulo, 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, São Paulo, Brazil
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