Antimicrobial effect of conventional root canal medicaments vs propolis against Enterococcus faecalis, Staphylococcus aureus and Candida albicans

Comparative evaluation of antimicrobial efficacy of various intracanal medicament in young permanent teeth: An in vivo study

INTRODUCTION

Bacteria and their byproducts are key contributors to the onset and perpetuation of pulpoperiapical pathosis. Intracanal medication is vital in achieving successful endodontic outcomes as it targets and eradicates remaining microorganisms following biomechanical preparation.

AIM AND OBJECTIVE

The aim of the study was to compare and evaluate the antimicrobial efficacy of calcium hydroxide (CH) paste, triple antibiotic paste (TAP), and probiotics (PBs) as intracanal medicament in 12-17-year-old children undergoing root canal treatment for the management of infected pulpal tissues in young permanent teeth.

MATERIALS AND METHODS

A total of 30 patients aged 12-17 years indicated for endodontic therapy in maxillary incisors and with no systemic complications were selected. They were randomly divided into three groups, i.e., Group I - CH group, Group II - TAP, and Group III - PB allocating 10 teeth in each group. After access opening, the first sample (S1) was collected by inserting a paper point into the root canal, the second sample (S2) was collected immediately after biomechanical preparation, and the third sample (S3) was collected after 7 days, i.e., postintracanal medication. Samples were sent for microbiological analysis to assess the microbial count, and statistical analysis was done for the obtained data.

RESULTS

The three intracanal medicaments were successful in reducing the microbial counts of Enterococcus faecalis in the infected root canals. However, according to the results of the study, the PB group demonstrated greater effectiveness against E. faecalis compared to the CH group and displayed similar antimicrobial efficacy as the TAP group.

CONCLUSION

PB exhibited antimicrobial efficacy comparable to TAP but greater than Ca (OH) 2 paste. Hence, PB can be utilized as an intracanal medicament in young permanent teeth.

Antibacterial biofilm efficacy of calcium hydroxide loaded on Gum Arabic nanocarrier: an in-vitro study

BACKGROUND

An innovative intracanal medication formulation was introduced in the current study to improve the calcium hydroxide (Ca(OH)2) therapeutic capability against resistant Enterococcus faecalis (E. faecalis) biofilm. This in-vitro study aimed to prepare, characterize, and evaluate the antibacterial efficiency of Ca(OH)2 loaded on Gum Arabic (GA) nanocarrier (Ca(OH)2-GA NPs) and to compare this efficiency with conventional Ca(OH)2, Ca(OH)2 nanoparticles (NPs), GA, and GA NPs.

MATERIALS AND METHODS

The prepared nanoparticle formulations for the tested medications were characterized using Transmission Electron Microscope (TEM) and Fourier-Transform Infrared Spectroscopy (FTIR). 141 human mandibular premolars were selected, and their root canals were prepared. Twenty-one roots were then sectioned into 42 tooth slices. All prepared root canals (n = 120) and teeth slices (n = 42) were divided into six groups according to the intracanal medication used. E. faecalis was inoculated in the samples for 21 days to form biofilms, and then the corresponding medications were applied for 7 days. After medication application, the residual E. faecalis bacteria were assessed using CFU, Q-PCR, and SEM. Additionally, the effect of Ca(OH)2-GA NPs on E. faecalis biofilm genes (agg, ace, and efaA) was investigated using RT-PCR. Data were statistically analyzed at a 0.05 level of significance.

RESULTS

The synthesis of NPs was confirmed using TEM. The results of the FTIR proved that the Ca(OH)2 was successfully encapsulated in the GA NPs. Ca(OH)2-GA NPs caused a significant reduction in the E. faecalis biofilm gene expression when compared to the control (p < 0.001). There were significant differences in the E. faecalis CFU mean count and CT mean values between the tested groups (p < 0.001) except between the Ca(OH)2 and GA CFU mean count. Ca(OH)2-GA NPs showed the least statistical E. faecalis mean count among other groups. SEM observation showed that E. faecalis biofilm was diminished in all treatment groups, especially in the Ca(OH)2-GA NPS group when compared to the control group.

CONCLUSIONS

Ca(OH)2 and GA nanoparticles demonstrate superior anti-E. faecalis activity when compared to their conventional counterparts. Ca(OH)2-GA NPs showed the best antibacterial efficacy in treating E. faecalis biofilm. The tested NP formulations could be considered as promising intracanal medications.

Treatment Outcomes of Pulpotomy with Propolis in Comparison with MTA in Human Primary Molars: A 24-month Follow-up Randomized Controlled Trial

Aim and objective

To evaluate the clinical efficacy of propolis as pulpotomy medicament in human primary molars.

Materials and methods

This randomized controlled trial is a two-arm, parallel group study with blinded outcome assessment. The study included a total of 60 primary molars that require pulpotomy treatment in 4- 8-year old children. Teeth were assigned to two groups randomly: Propolis (Test group); Mineral trioxide aggregate (MTA) (Control group). All the pulpotomized teeth were given stainless steel crowns and the teeth were evaluated clinically and radiographically at 6, 12, and 24 months to grade them as either success or failure. Chi-square test was employed to analyze the data.

Results

Success rates of pulpotomy with propolis and MTA were 80% and 93.1% respectively at 24 months of follow-up interval. Propolis has shown success rates of 90% and 80% at 6- and 12-month follow-up, while MTA has shown a consistent success rate of 93.1% at all the follow-up intervals. The difference in success rate between the groups at all the time intervals is statistically nonsignificant.

Conclusion

Propolis has demonstrated a clinically acceptable success rate comparable to MTA as pulpotomy medicament in primary teeth.

Clinical significance

Biocompatible materials with regenerative potential have drawn the momentum in vital pulp therapy. In this regard, MTA has been emerged as most successful material, but its high cost has limited its use. Hence, there is an absolute need of cost-effective pulpotomy material with regenerative potential. This study provides an evidence that propolis has clinically acceptable success rate as pulpotomy medicament. Considering its low cost and ready availability, it can be recommended as a cost-effective alternative for primary teeth pulpotomy.

How to cite this article

RojaRamya KS, Chandrasekhar R, Uloopi KS, et al. Treatment Outcomes of Pulpotomy with Propolis in Comparison with MTA in Human Primary Molars: A 24-month Follow-up Randomized Controlled Trial. Int J Clin Pediatr Dent 2022;15(S-1):S3-S7.

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

Aim

To compare the effectiveness of different intracanal medicaments against polymicrobial biofilm formed by Enterococcus faecalis, Staphylococcus aureus, and Candida albicans.

Materials and Methods

Eighty mature human roots with intraradicular polymicrobial biofilm were randomly assigned into four groups (n = 20). Intracanal medicaments 0.2% polyhexamethylene biguanide (PHMB), 2% chlorhexidine (CHX), and calcium hydroxide (CH) were applied into the root canals. Collected dentine samples were tested at 7^th, 15^th, and 30^th day for microbial growth, and the colony-forming units per ml (CFU/ml) were determined.

Results

The CFU/ml data were analyzed using unpaired t-test and one-way ANOVA-F comparison test. All medicaments resulted in a significant reduction (P < 0.05) in microbial growth at all time intervals compared to the control group. CHX and PHMB showed a similar reduction in CFU/ml at 7^th and 15^th day but significantly more than CH at all time intervals. At 30^th day, PHMB caused a significantly more reduction in CFU/ml than CHX.

Conclusions

All the three tested intracanal medicaments such as CH, CHX, and PHMB Gel were effective in reducing the microbial count. CH has a limited antimicrobial effect against the polymicrobial biofilm found inside the root canal. 2% CHX gel has a time-dependent antimicrobial effect. PHMB has a superior antimicrobial effect in comparison with CHX and CH.

The use of propolis in dentistry, oral health, and medicine: A review

BACKGROUND

Propolis is a resinous product that is collected from plants by bees to cover holes and crevices in their hives. Propolis has potent antibacterial, antiviral, anti-inflammatory, wound healing, and anticancer properties. Propolis has been used therapeutically by humans for centuries, including the treatment of dental caries and mouth infections.

HIGHLIGHT

This review article attempts to analyze the potential use of propolis in general dentistry and oral health management.

CONCLUSION

Propolis is potentially useful in dentistry and oral health management based on available in vitro, in vivo, and ex vivo studies, as well as human clinical trials.

In vivo evaluation of zinc oxide-propolis mixture as root canal filling material in the primary molars: A 24-month follow-up randomized controlled trial

BACKGROUND

Pulpectomy is a routine practice in children with pulpal and periapical infections, the success of which depends on the elimination of bacteria from the root canals. Propolis, a natural product with proven antibacterial and anti-inflammatory properties when mixed with zinc oxide powder as root canal filling material, it could provide good success in endodontic therapy of primary teeth.

AIM

The aim was to evaluate and compare the clinical effectiveness of zinc oxide-propolis mixture with zinc oxide eugenol (ZOE) as root canal filling material in nonvital primary molars.

SETTINGS AND DESIGN

This was a 2-arm, parallel group randomized controlled trial with blinded outcome assessment.

MATERIALS AND METHODS

Forty primary molars from children aged 4-8 years requiring pulpectomy treatment were randomly allocated into two groups according to the obturating material used: zinc oxide-propolis mixture (test group) and ZOE (control group). All the pulpectomy treated teeth were finally restored with stainless steel crowns, and the children were recalled at 6, 12, and 24 months for postoperative clinical and radiographic evaluation.

STATISTICAL ANALYSIS

Chi-square test was used to analyze the data.

RESULTS

The overall success rate of pulpectomy with zinc oxide-propolis mixture and ZOE was found to be 95% and 70%, respectively, and the difference was statistically significant (P = 0.037). Zinc oxide-propolis mixture has shown a success rate of 100% at 6 months and 95% at 12 and 24 months follow-up, whereas ZOE has shown 80% success rate at 6 and 12 months, and it declined to 70% at 24-month follow-up.

CONCLUSION

Zinc oxide-propolis mixture demonstrated good clinical and radiographic success at the end of 24 months, and hence, it can be considered as an alternate root canal filling material in the primary teeth.

Detection, treatment and prevention of endodontic biofilm infections: what's new in 2020?

Endodontic disease, a biofilm infection of the root canal space, is a significant cause of dental morbidity worldwide. Endodontic treatment, or root canal treatment, as it is commonly known is founded on the ability to eradicate microbial biofilm infection and prevent re-infection of the highly complex root canal space. Despite many "advances" in clinical endodontics we have seen little improvement in outcomes. The aim of this critical review paper is to provide a contemporary view of endodontic microbiology and biofilm polymicrobiality, provide an understanding of the host response, and how together these impact upon clinical treatment. Ultimately, it is intended to provide insight into novel opportunities and strategies for the future diagnostics, treatment, and prevention of endodontic disease.

Propolis Affects Pseudomonas aeruginosa Growth, Biofilm Formation, eDNA Release and Phenazine Production: Potential Involvement of Polyphenols

Pseudomonas aeruginosa (P. aeruginosa) is an opportunistic pathogen responsible for a wide range of clinical conditions, from mild infections to life-threatening nosocomial biofilm-associated diseases, which are particularly severe in susceptible individuals. The aim of this in vitro study was to assess the effects of an Albanian propolis on several virulence-related factors of P. aeruginosa, such as growth ability, biofilm formation, extracellular DNA (eDNA) release and phenazine production. To this end, propolis was processed using three different solvents and the extracted polyphenolic compounds were identified by means of high performance liquid chromatography coupled to electrospray ionization mass spectrometry (HPLC-ESI-MS) analysis. As assessed by a bioluminescence-based assay, among the three propolis extracts, the ethanol (EtOH) extract was the most effective in inhibiting both microbial growth and biofilm formation, followed by propylene glycol (PG) and polyethylene glycol 400 (PEG 400) propolis extracts. Furthermore, Pseudomonas exposure to propolis EtOH extract caused a decrease in eDNA release and phenazine production. Finally, caffeic acid phenethyl ester (CAPE) and quercetin decreased upon propolis EtOH extract exposure to bacteria. Overall, our data add new insights on the anti-microbial properties of a natural compound, such as propolis against P. aeruginosa. The potential implications of these findings will be discussed.

Nematode-Associated Bacteria: Production of Antimicrobial Agent as a Presumptive Nominee for Curing Endodontic Infections Caused by Enterococcus faecalis

Xenorhabdus and/or Photorhabdus bacteria produce antibacterial metabolites to protect insect cadavers against food competitors allowing them to survive in nature with their nematode host. The effects of culture supernatant produced by Xenorhabdus and Photorhabdus spp. were investigated against the multidrug-resistant dental root canal pathogen Enterococcus faecalis. The efficacy of seven different cell-free supernatants of Xenorhabdus and Photorhabdus species against E. faecalis was assessed with overlay bioassay and serial dilution techniques. Additionally, time-dependent inactivation of supernatant was evaluated. Among the seven different bacterial species, X. cabanillasii produced the strongest antibacterial effects. Loss of bioactivity in a phosphopantetheinyl transferase-deficient mutant of X. cabanillasii indicated that this activity is likely based on non-ribosomal peptide synthetases (NRPSs) or polyketide synthases (PKSs). Subsequent in silico analysis revealed multiple possible biosynthetic gene clusters (BGCs) in the genome of X. cabanillasii including a BGC homologous to that of zeamine/fabclavine biosynthesis. Fabclavines are NRPS-derived hexapeptides, which are connected by PKS-derived malonate units to an unusual polyamine, also PKS-derived. Due to the known broad-spectrum bioactivity of the fabclavines, we generated a promoter exchange mutant in front of the fabclavine-like BGC. This leads to over-expression by induction or a knock-out by non-induction which resulted in a bioactive and non-bioactive mutant. Furthermore, MS and MS² experiments confirmed that X. cabanillasii produces the same derivatives as X. budapestensis. The medicament potential of 10-fold concentrated supernatant of induced fcl promoter exchanged X. cabanillasii was also assessed in dental root canals. Calcium hydroxide paste, or chlorhexidine gel, or fabclavine-rich supernatant was applied to root canals. Fabclavine-rich supernatant exhibited the highest inactivation efficacy of ≥3 log₁₀ steps CFU reduction, followed by calcium hydroxide paste (≤2 log₁₀ step). The mean percentage of E. faecalis-free dental root canals after treatment was 63.6, 45.5, and 18.2% for fabclavine, calcium hydroxide, and chlorhexidine, respectively. Fabclavine in liquid form or preferably as a paste or gel formulation is a promising alternative intracanal medicament.

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.

Propolis: A natural biomaterial for dental and oral healthcare

The field of health has always emphasised on the use of natural products for curing diseases. There are varieties of natural products (such as silk, herbal tea, chitosan) used today in the biomedical application in treating a large array of systemic diseases. The natural product "Propolis" is a non-toxic resinous material having beneficial properties such as antimicrobial, anticancer, antifungal, antiviral and anti-inflammatory; hence gain the attention of researchers for its potential for bio-dental applications. The study aims to explore the properties and chemistry of propolis concerning biomedical and dental applications. In addition, status and scope of propolis for current and potential future in bio-dental applications have been discussed. This review gives an insight to the reader about the possible use of propolis in modern-day dentistry.

In vitro comparison of antibacterial properties of bioceramic-based sealer, resin-based sealer and zinc oxide eugenol based sealer and two mineral trioxide aggregates

Objective:

Our goal of the study was to evaluate the antibacterial properties of endodontic sealers against the E. faecalis.

Materials and Methods:

Six millimeters wells were made for each material in all the preinoculated petri plates. Then, the petri plates were incubated for 24 h. The zones of inhibition appeared were measured, and the measurements were put to statistical analysis.

Results:

EndoSequence BC Sealer, MM-mineral trioxide aggregate (MTA), and ProRoot MTA showed maximum means of diameter of zones of inhibition, whereas MM-seal and Endoseal did not show any zones of inhibition.

Conclusion:

EndoSequence BC Sealer was found to be a better endodontic sealer as compared to resin-based and zinc oxide-eugenol-based sealer.

Antibacterial effect of calcium hydroxide combined with chlorhexidine on Enterococcus faecalis: a systematic review and meta-analysis

Objective

Enterococcus faecalis (E. faecalis) is the most frequently isolated strain in failed endodontic therapy cases since it is resistant to calcium hydroxide (CH). Whether a combination of CH and chlorhexidine (CHX) is more effective than CH alone against E. faecalis is a matter of controversy. Thus, the aim of this study was to conduct a systematic review and meta-analysis of the literature.

Material and Methods

A comprehensive search in PubMed, EMbase, EBSCOhost, The Cochrane Library, SciELO, and BBO databases, Clinical trials registers, Open Grey, and conference proceedings from the earliest available date to February 1, 2013 was carried out and the relevant articles were identified by two independent reviewers. Backward and forward search was performed and then inclusion and exclusion criteria were applied. The included studies were divided into "comparisons" according to the depth of sampling and dressing period of each medicament. Meta-analysis was performed using Stata software 10.0. The level of significance was set at 0.05.

Results

Eighty-five studies were retrieved from databases and backward/forward searches. Fortyfive studies were considered as relevant (5 in vivo, 18 in vitro, 18 ex vivo, and 4 review articles). Nine studies were included for meta-analysis. Inter-observer agreement (Cohen kappa) was 0.93. The included studies were divided into 21 comparisons for meta-analysis. Chi-square test showed the comparisons were heterogeneous (p<0.001). Random effect model demonstrated no significant difference between CH/CHX mixture and CH alone in their effect on E. faecalis (p=0.115).

Conclusions

According to the evidence available now, mixing CH with CHX does not significantly increase the antimicrobial activity of CH against E. faecalis. It appears that mixing CH with CHX does not improve its ex vivo antibacterial property as an intracanal medicament against E. faecalis. Further in vivo studies are necessary to confirm and correlate the findings of this study with the clinical outcomes.

Antimicrobial Activity and pH of Calcium Hydroxide and Zinc Oxide Nanoparticles Intracanal Medication and Association with Chlorhexidine

AIM

To evaluate pH and antibacterial activity of pastes with calcium hydroxide [Ca(OH)2] and zinc oxide (ZnO) microparticles (micro) or nanoparticles (nano) and association with 0.4% chlorhexidine against Enterococcus faecalis.

MATERIALS AND METHODS

The following pastes were analyzed: Ca(OH)2/ZnO micro, (2) Ca(OH)2/ZnO nano, (3) Ca(OH)2/ ZnO micro + 0.4% chlorhexidine, (4) Ca(OH)2/ZnO nano + 0.4% chlorhexidine. Antibacterial activity against E. faecalis was evaluated by agar diffusion test. The direct contact test on planktonic cells of E. faecalis was performed for 30 and 60 seconds. Root canals from bovine teeth were filled with the pastes and pH was evaluated after 1, 7, 14, 21, 30 and 60 days. The data obtained were submitted to the statistical tests analysis of variance (ANOVA) and Tukey or Kruskal-Wallis and Dunn test, with a 5% significance level.

RESULTS

Calcium hydroxide and zinc oxide nano, and the pastes with 0.4% chlorhexidine were more effective in agar diffusion test. In the direct contact test, the pastes with chlorhexidine showed the highest effect after 30 seconds. All pastes eliminated E. faecalis after 60 seconds. All pastes promoted an increase in pH. The highest increase in pH was observed with nanoparticle medications after 1 and 7 days (p < 0.05). After this period, the pastes presented similar pH increase.

CONCLUSION

It was concluded that calcium hydroxide and zinc oxide nanoparticles promoted greater initial alkalinization. The antimicrobial activity of the pastes against E. faecalis is favored by the association with chlorhexidine.

CLINICAL SIGNIFICANCE

Although nanoparticles of calcium hydroxide and zinc oxide promoted antibacterial effect, the activity against E. faecalis is favored by association with chlorhexidine.

Bactericidal effects of various irrigation solutions against staphylococcus aureus in human root canal

Purpose:

The aim of the present study was to evaluate and to compare the antibacterial effects of various irrigation solutions against Staphylococcus aureus (S. aureus) in human root canals.

Materials and Methods:

120 single-root mandibular premolar teeth were selected. The teeth were prepared and sterilized. S. aureus was incubated in the root canals and kept at 37°C for 24h. The infected root canals were divided into one positive (saline) and one negative (sodium hypochlorite) control, and four experimental groups [Ethylene-diaminetetra-aceticacid, Chlorhexidine Gluconate, Super-oxidized water(SPO), Aqueous ozone] (n=20). Flow rate of irrigation was applied with 5 mL/min flow rate for 3 min to ensure standardization among all study groups. Following the irrigation, paper points were placed in the root canals and then transferred in sterile eppendorf. Remaining bacteria were counted on blood agar plates and the data were analyzed using one-way ANOVA and Tukey’s test.

Results:

Although there were statistically significant differences among SPO and other experimental groups (p<0.05), there was no statistically significant difference between SPO and NaOCl (p>0.05).

Conclusion:

Super-oxidized water may be recommended as an alternative irrigation solution instead of NaOCl against S. aureus in root canals.

Antimicrobial activity of root canal irrigants associated with cetrimide against biofilm and planktonic Enterococcus faecalis

AIM

To evaluate the antibacterial activity of sodium hypochlorite (NaOCl) and chlorhexidine (CHX) alone or associated with cetrimide (CTR), and QMiX against biofilm and planktonic Enterococcus faecalis (E. faecalis) [American type culture collection (ATCC) 29212].

MATERIALS AND METHODS

The solutions 2.5% NaOCl, 2.5% NaOCl + 0.2% CTR, 2% CHX, 2% CHX + 0.2% CTR, 0.2% CTR, and QMiX were evaluated. E. faecalis biofilms were induced for 14 days on bovine dentin blocks. The irrigants were evaluated after contact with E. faecalis suspension and biofilm for 1 and 3 minutes. After that, serial decimal dilutions were made and plated on tryptic soy agar (TSA) medium. Plates were incubated for 24 hours at 37°C and the colony-forming unit (CFU) 1 ml was determined. Data were subjected to ANOVA and Tukey's tests at 5% significance.

RESULTS

All microorganisms were eliminated by direct contact of the irrigants with planktonic cells. Only NaOCl and NaOCl + CTR were able to completely eliminate the microorganisms by direct contact with E. faecalis biofilm. CHX presented effectiveness similar to CHX + CTR CTR, and QMiX after 1 minute of contact and similar to NaOCl and NaOCl + CTR after 3 minutes (p > 0.05), but was unable to completely eliminate the microorganisms. CTR and QMiX did not differ from each other.

CONCLUSION

CTR addition to CHX and NaOCl solutions did not improve the antimicrobial activity against biofilm. All evaluated irrigants and associations presented activity against planktonic E. faecalis. Only NaOCl and NaOCl + CTR eliminated biofilm after 1 and 3 minutes of direct contact.

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.

Does propolis help to maintain oral health?

Propolis, known also as bee glue, is a wax-cum-resin substance which is created out of a mix of buds from some trees with the substance secreted from bee's glands. Its diverse chemical content is responsible for its many precious salubrious properties. It was used in medicine already in ancient Egypt. Its multiple applications during the centuries have been studied and described in details. The purpose of this study is to present the possible use of propolis in treatment of various diseases of oral cavity in their dental aspect. The paper presents properties and possible applications of bee glue depending on dental specialities. An overview of publications which appeared during the recent years will allow the reader to follow all the possibilities to apply propolis in contemporary dentistry.