Effectiveness of polyhexamethylene biguanide, chlorhexidine, and calcium hydroxide intracanal medicament against intraradicular mature polymicrobial biofilm: A microbiological study

Eradication of mature biofilm from the isthmus region using Er, Cr: YSGG Laser as an activator of 2% chlorhexidine gluconate

Background

Challenges in the root canal system, such as isthmus, may limit the action of endodontic equipment and irrigation solutions, so using laser agitation is recommended to upgrade the removal of microbial biofilm. The objective of this study is to assess the effectiveness of the laser in photon-induced photoacoustic streaming protocol agitation of 2% chlorohexidine gluconate in removing mature biofilm in complex root canal systems.

Material and Methods

Seventy-five mesial roots of the lower first and second molars were separated and cultivated with Enterococcus faecalis bacteria for 30 days (except for the negative control group samples). The samples were divided into four groups (n=15), one group acted as a positive control, other groups were irrigated with 2% chlorohexidine gluconate, some of them were agitated with a passive ultrasonic device, while the other samples were agitated by an Erbium, chromium-doped yttrium, scandium, gallium, and garnet laser in photon-induced photoacoustic streaming protocol. An atomic force microscope was used as a new method to get the results in the isthmus area; A scanning electron microscope was also used in the study to examine the samples before and after the treatment. Statistical Package for Social Sciences software was used to collect and analyze data, and two-way ANOVA was used to compare the means of the test groups.

Results

According to the atomic force microscope and scanning electron microscope analyses, Erbium laser and passive ultrasonic activation groups showed higher antimicrobial efficacy than the syringe irrigation group (p<0.05).

Conclusions

According to the study's results, the agitation of chlorohexidine gluconate fluid by Erbium laser in photon-induced photoacoustic streaming at 0.75 W offers better Enterococcus faecalis biofilm removal in the difficult-to-reach areas of lower first and second molars. Key words:Atomic force microscope, 2% chlorhexidine gluconate, Enterococcus faecalis, Erbium, chromium-doped yttrium, scandium, gallium, garnet laser, passive ultrasonic.

Comparative evaluation of calcium ion release, pH change, and dentinal tubule penetration of four different formulations of calcium hydroxide-based intracanal medicaments - An in vitro study

Aim

The aim of the study was to evaluate and compare the release of calcium ion, pH change, and dentinal penetration depth of four different formulations of calcium hydroxide-based intracanal medicaments.

Materials and Methods

Eighty mandibular single-rooted premolar teeth were divided into four groups (n = 20): Group 1 - calcium hydroxide (CH) + distilled water (DW), Group 2 - nanocalcium hydroxide + DW, Group 3 - calcium hydroxide + chitosan, and Group 4 - calcium hydroxide + 2% chlorhexidine gluconate. Biomechanical preparation was done till the F2 rotary ProTaper system and intracanal medicaments were placed. Calcium ions and pH were assessed at 24 h, 7 days, 15 days, and 30 days using an ultraviolet spectrophotometer and pH meter, respectively. The evaluation of tubule penetration was scanned under a field emission scanning electron microscope.

Results

A significant difference was seen in calcium ion release and pH change among the four groups at 24 h, 7 days, 15 days, and 30 days as well as depth of dentinal penetration.

Conclusion

Calcium hydroxide mixed with 2% chlorhexidine gel showed alkaline pH and the highest calcium ion release as well as significant dentinal tubule penetration among all the four groups under observation. Both combinations can enhance antimicrobial effectiveness as intracanal medicaments. Further clinical study should be carried out to optimize its use as an alternative treatment modality.

Critical analysis of the reporting quality of animal studies within Endodontics using the Preferred Reporting Items for Animal Studies in Endodontics (PRIASE) 2021 quality standard checklist

AIM

To critically evaluate the reporting quality of a random sample of animal studies within the field of endodontics against the Preferred Reporting Items for Animal Studies in Endodontics (PRIASE) 2021 checklist and to investigate the association between the quality of reporting and several characteristics of the selected studies.

METHODOLOGY

Fifty animal studies related to endodontics were randomly selected from the PubMed database with publication dates from January 2017 to December 2021. For each study, a score of '1' was given when the item of the PRIASE 2021 checklist was fully reported, whereas a score of '0' was given when an item was not reported; when the item was inadequately or partially reported, a score of '0.5' was given. Based on the overall scores allocated to each manuscript, they were allocated into three categories of reporting quality: low, moderate and high. Associations between study characteristics and reporting quality scores were also analysed. Descriptive statistics and Fisher's exact tests were used to describe the data and determine associations. The probability value of .05 was selected as the level of statistical significance.

RESULTS

Based on the overall scores, four (8%) and 46 (92%) of the animal studies evaluated were categorized as 'High' and 'Moderate' reporting quality, respectively. A number of items were adequately reported in all studies related to background (Item 4a), relevance of methods/results (7a) and interpretation of images (11e), whereas only one item related to changes in protocol (6d) was not reported in any. No associations were confirmed between reporting quality scores and number of authors, origin of the corresponding author, journal of publication (endodontic specialty vs. non- specialty), impact factor or year of publication.

CONCLUSIONS

Animal studies published in the specialty of endodontics were mostly of 'moderate' quality in terms of the quality of reporting. Adherence to the PRIASE 2021 guidelines will enhance the reporting of animal studies in the expectation that all future publications will be high quality.

Irrigation in Endodontics: Polyhexanide Is a Promising Antibacterial Polymer in Root Canal Treatment

Background:chronic apical periodontitis is a common pathology in dentistry, especially in endodontics. It is necessary to systematize data concerning commonly used irrigation solutions. The development of new protocols for endodontic treatment is a very promising direction. The use of a polyhexanide-based antiseptic can positively affect the results of endodontic treatment. Methods: the review was carried out involving the search for English language research and meta-analyses in the Google Scholar and PubMed databases. Results: the number of literary sources that were identified during the literature review is 180. After excluding publications that did not match the search criteria, the total number of articles included in the systematic review was determined to be 68. Conclusions: polyhexanide is a promising solution for infected root canal irrigation. The antibacterial activity of this substance is suitable for the elimination of pathogens responsible for the appearance of apical periodontitis.