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Therapeutic Potential of Gramicidin S in the Treatment of Root Canal Infections.

ABSTRACT: An intrinsic clindamycin-resistant Enterococcus faecalis, the most common single species present in teeth after failed root canal therapy, often possesses acquired tetracycline resistance. In these cases, root canal infections are commonly treated with Ledermix(®) paste, which contains demeclocycline, or the new alternative endodontic paste Odontopaste, which contains clindamycin; however, these treatments are often ineffective. We studied the killing activity of the cyclic antimicrobial peptide gramicidin S (GS) against planktonic and biofilm cells of tetracycline-resistant clinical isolates of E. faecalis. The high therapeutic potential of GS for the topical treatment of problematic teeth is based on the rapid bactericidal effect toward the biofilm-forming, tetracycline-resistant E. faecalis. GS reduces the cell number of planktonic cells within 20-40 min at a concentration of 40-80 ?g/mL. It kills the cells of pre-grown biofilms at concentrations of 100-200 ?g/mL, such that no re-growth is possible. The translocation of the peptide into the cell interior and its complexation with intracellular nucleotides, including the alarmon ppGpp, can explain its anti-biofilm effect. The successful treatment of persistently infected root canals of two volunteers confirms the high effectiveness of GS. The broad GS activity towards resistant, biofilm-forming E. faecalis suggests its applications for approval in root canal medication.

SUBMITTER: Berditsch M

PROVIDER: S-EPMC5039509 | biostudies-literature | 2016 Sep

REPOSITORIES: biostudies-literature

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Therapeutic Potential of Gramicidin S in the Treatment of Root Canal Infections.

Berditsch Marina M Lux Hannah H Babii Oleg O Afonin Sergii S Ulrich Anne S AS

Pharmaceuticals (Basel, Switzerland) 20160907 3

An intrinsic clindamycin-resistant Enterococcus faecalis, the most common single species present in teeth after failed root canal therapy, often possesses acquired tetracycline resistance. In these cases, root canal infections are commonly treated with Ledermix(®) paste, which contains demeclocycline, or the new alternative endodontic paste Odontopaste, which contains clindamycin; however, these treatments are often ineffective. We studied the killing activity of the cyclic antimicrobial peptide ...[more]

PMID: 27618065

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Project description:Few studies have examined the longevity of endodontically treated teeth in nonacademic clinical settings where most of the population receives its care. This study aimed to quantify the longevity of teeth treated endodontically in general dentistry practices and test the hypothesis that longevity significantly differed by the patient's age, gender, dental insurance, geographic region, and placement of a crown and/or other restoration soon after root canal treatment (RCT). This retrospective study used deidentified data of patients who underwent RCT of permanent teeth through October 2015 in 99 general dentistry practices in the National Dental Practice-Based Research Network (Network). The data set included 46,702 patients and 71,283 RCT permanent teeth. The Kaplan-Meier (product limit) estimator was performed to estimate survival rate after the first RCT performed on a specific tooth. The Cox proportional hazards model was done to account for patient- and tooth-specific covariates. The overall median survival time was 11.1 y; 26% of RCT teeth survived beyond 20 y. Tooth type, presence of dental insurance any time during dental care, placement of crown and/or receiving a filling soon after RCT, and Network region were significant predictors of survival time (P < 0.0001). Gender and age were not statistically significant predictors in univariable analysis, but in multivariable analyses, gender was significant after accounting for other variables. This study of Network practices geographically distributed across the United States observed shorter longevity of endodontically treated permanent teeth than in previous community-based studies. Also, having a crown placed following an RCT was associated with 5.3 y longer median survival time. Teeth that received a filling soon after the RCT before the crown was placed had a median survival time of 20.1 y compared to RCT teeth with only a crown (11.4 y), only a filling (11.2 y), or no filling and no crown (6.5 y).

Project description:BackgroundThe prevalence of root filled teeth (RFT) worldwide will inform about the amount of clinical activity of dentists dedicated to treat endodontic disease.ObjectivesTo carry out a systematic review with meta-analysis answering the following question: What is the prevalence of RFT around the world? The percentage of people with at least one RFT was also investigated.MethodsA systematic review including population-based studies using the following databases: PubMed, EMBASE and Scielo. Studies related to prevalence of RFT were included. The outcome of interest of the study was the prevalence of RFT. The meta-analyses were calculated with the Open Meta Analyst software to determine the global prevalence of RFT. Subgroups analyses were performed comparing geographical distribution, radiographic method and year of the study (classified in 20th or 21th century). The prevalence of people with at least one RFT was also analysed.ResultsSeventy-four population-based studies fulfilled the inclusion criteria. Twenty-eight, forty-four and two studies reported high, moderate and low risk of bias, respectively. No obvious publication bias was observed. Prevalence of RFT was estimated with 1 201 255 teeth and 32 162 patients. The calculated worldwide prevalence of RFT was 8.2% (95% CI = 7.3%-9.1%; p < .001). The global prevalence of people with at least one RFT was 55.7% (95% CI = 49.6%-61.8%; p < .001). In 20th century, the prevalence of RFT was 10.2% (95% CI = 7.9%-12.5%; p < .001), whereas in the 21st century the overall calculated prevalence of RFT was 7.5% (95% CI = 6.5%-8.6%; p < .001). Brazilian people (12%) and the European population (9.3%) showed the highest prevalence of RFT. In Europe, 59.6% (95% CI = 52.4%-66.8%) of people has at least one RFT.ConclusionsThis review showed that root canal treatment is a very common therapy throughout the world. More than half of the studied population have at least one RFT. A limitation of the present study is that most of the studies did not consider random sampling for population selection.RegistrationPROSPERO Systematic review registration number: (CRD42022329053).

Dataset Information

Therapeutic Potential of Gramicidin S in the Treatment of Root Canal Infections.

Publications

Therapeutic Potential of Gramicidin S in the Treatment of Root Canal Infections.

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