Comparison of Different Irrigants in the Removal of Endotoxins and Cultivable Microorganisms from Infected Root Canals.
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ABSTRACT:
SUBMITTER: Valera MC
PROVIDER: S-EPMC4546762 | biostudies-other | 2015
REPOSITORIES: biostudies-other
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Project description:Ultraviolet C (UVC) light emitting diode (LED) can kill the endodontic pathogen Enterococcus faecalis and has the potential to kill other oral microorganisms associated with endodontic infections. This same bacteriocidal device shows great promise in the stimulation of periapical healing and pain reduction resulting from inflammation in root canals. Previously, we found that 255 nm UVC LED killed E. faecalis and induced the production of cellular biomarkers in HEPM cells and gingival fibroblasts (Morio et al., 2019). Here, we extend those findings and hypothesize that UVC LED at other wavelengths and power levels kill microorganisms associated with root canal infections. Units emitting UVC LED at 265 nm (12 mW), 265 nm (22.5 mW), and 280 nm (8 mW) wavelenths were assembled and the energy levels of their emissions were measured. The energy doses in millijoules (mJ) were calculated from the power readings of the meter (µW) × time of exposure (seconds). Ex vivo models of root canals were prepared in extracted, instrumented, single canal human premolars. Five cultures of microorganisms were treated with 265 nm (12 mW), 265 nm (22.5 mW), or 280 nm (8 mW) UVC LED on discs in laboratory assays and 4 cultures of microorganisms were treated with 265 nm (22.5 mW) UVC LED in root canals of extracted, instrumented teeth. After UVC LED treatment, all microorganisms were cultivated on microbiological media. Colony forming units (CFU) of viable microorganisms treated with UVC LED were counted and compared with those of viable microorganisms not treated with UVC LED as controls. Tukey's Honestly Significant Difference was used to determine statistical significances (0.05). Units emitting UVC LED at 265 nm (12 mW), 265 nm (22.5 mW), and 280 nm (8 mW) killed Candida albicans, Staphylococcus aureus, methicillin-resistant S. aureus (MRSA), E. faecalis, and Streptococcus sanguinis after 30-90 seconds of exposure in laboratory assays (p < 0.05). Microbial killing differed among treatment times, UVC LED wavelengths, power levels of each unit, and specific microorganism. The unit emitting UVC LED at 265 nm (22.5 mW) killed C. albicans, S. aureus, MRSA, and E. faecalis in 30 s in root canals of extracted, instrumented teeth (p < 0.05). This dataset can be reused to assess the ability of other wavelengths and power levels to kill microorganisms as well as improve procedures for treating endodontic infections and inflammation in root canals.
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Project description:Background. The aim of this study was to evaluate the effectiveness of different concentrations of sodium hypochlorite (NaOCl) solution in reducing bacterial growth in Enterococcus faecalis biofilms in root canals. Methods. The root canals of maxillary central incisors of 104 subjects underwent chemomechanical debridement. In order to remove the smear layer, 5.25% sodium hypochlorite solution was used for 3 minutes in the root canals. Then, the samples were immersed in 1 mL of 17% EDTA for 3 minutes. Finally, the root canals were irrigated with phosphate-buffered saline (PBS) solution. After removing the smear layer, the samples were sterilized. Then E. faecalis biofilms formed within the root canals at 4-, 6-, and 10-week intervals were evaluated. Each group was divided into 4 subgroups in terms of the antibacterial treatment: group 1: 1% NaOCl solution; group 2: 2.5% NaOCl solution; group 3: 5.25% NaOCl solution; and group 4: PBS solution. After preparation of root canal filings, the counts of live bacteria were calculated through the classic method of counting, i.e. colony forming units (CFU), followed by the analysis of data. Results. In groups 2 and 3, there was no bacterial growth due to complete removal of E. faecalis biofilms (P<0001), while the bacterial counts in group 1 at 4-, 6- and 10-week intervals decreased compared to the control group. Conclusion. The bacterial cells in mature and old biofilms have higher resistance to 1% NaOCl solution compared to the young biofilms. However, the 2.5% and 5.25% NaOCl solutions caused complete inhibition of the growth of E. faecalis biofilm in all the stages of development.
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Project description:Antibiotic resistance is an ever-growing problem faced by all major sectors of health care, including dentistry. Recurrent infections related to multidrug-resistant bacteria such as methicillin-resistant Staphylococcus aureus, carbapenem-resistant Enterobacteriaceae, and vancomycin-resistant enterococci (VRE) in hospitals are untreatable and question the effectiveness of notable drugs. Two major reasons for these recurrent infections are acquired antibiotic resistance genes and biofilm formation. None of the traditionally known effective techniques have been able to efficiently resolve these issues. Hence, development of a highly effective antibacterial practice has become inevitable. One example of a hard-to-eradicate pathogen in dentistry is Enterococcus faecalis, which is one of the most common threats observed in recurrent root canal treatment failures, of which the most problematic to treat are its biofilm-forming VRE strains. An effective response against such infections could be the use of bacteriophages (phages). Phage therapy was found to be highly effective against biofilm and multidrug-resistant bacteria and has other advantages like ease of isolation and possibilities for genetic manipulations. The potential of phage therapy in dentistry, in particular against E. faecalis biofilms in root canals, is almost unexplored. Here we review the efforts to develop phage therapy against biofilms. We also focus on the phages isolated against E. faecalis and discuss the possibility of using phages against E. faecalis biofilm in root canals.
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Project description:BackgroundXP-Endo Finisher (XPF) and passive ultrasonic irrigation (PUI) are commonly used in intracanal medicament removal. The effectiveness of these two techniques needs to be compared, and evidence-based research should be conducted.MethodsA comprehensive literature search was conducted in PubMed, Web of Science, Embase, Cochrane Library, and Google Scholar up to December 20th, 2020. The outcomes of the included trials were pooled into the Cochrane Collaboration's Review Manager 5.3 software. Cochrane's risk-of-bias tool 2.0 was applied to assess the risk of bias.ResultsNine articles were included in this systematic review and processed for data extraction, and eight studies were identified for meta-analysis. In general, the use of PUI showed better medicament removal effectiveness than XPF (odds ratio [OR]: 3.09; 95% confidence interval [CI], 1.96-4.86; P < 0.001). PUI was also significantly more efficient than XPF in the apical third (OR: 3.42; 95% CI, 1.32-8.84; P = 0.01). For trials using sodium hypochlorite (NaOCl) alone, PUI was also significantly more effective than XPF on intracanal medicaments removal (OR: 5.23; 95% CI, 2.79-9.82; P < 0.001). However, there was no significant difference between PUI and XPF when NaOCl and ethylenediaminetetraacetic acid (EDTA) were used in combination (OR: 1.51; 95% CI, 0.74-3.09; P = 0.26). In addition, for studies whose intracanal medicament periods were two weeks, the effectiveness of PUI was statistically better than the XPF (OR: 7.73; 95% CI, 3.71-16.07; P < 0.001). Nevertheless, for trials whose intracanal medicament time was one week or over two weeks, no differences between the XPF and PUI were found (OR: 1.54; 95% CI, 0.74-3.22; P = 0.25) (OR: 1.42; 95% CI, 0.44-4.61; P = 0.56).ConclusionsThe meta-analysis is the first study to quantitatively compare the effectiveness of XPF and PUI techniques on intracanal medicaments removal. With rigorous eligibility criteria, the study only included high-quality randomised controlled trials. The study indicated that PUI might be superior over XPF techniques for removing intracanal medicaments from artificial standardized grooves and cavities in the root canal system. The anatomical areas, irrigation protocol, and intracanal medicaments time may influence the cleaning efficacy.
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Project description:The aim was to compare the efficacy of the passive ultrasonic irrigation PUI and the Xp-endo Finisher (FKG-Dentaire, La-Chaux-de-Fonds, Switzerland) in removing the calcium hydroxide paste from root canals and from the apical third.Sixty-eight root canals of single-rooted teeth were shaped using the BT-Race files (FKG-Dentaire, La-Chaux-de-Fonds, Switzerland). Ca(OH)2 was placed in all samples except for the negative control group (n=4). Remaining teeth were randomly divided into three groups: G1-Xp (n=30), G2-PUI (n=30) and the positive control group (n=4). Removal procedure consisted of three repeated one-minute-cycles. Samples were split longitudinally, photos of halves were taken at X6.4 magnification and were analyzed using the ImageJ-Software (The National Institutes of Health NIH, Bethesda, Maryland, USA) to calculate the percentage of surfaces with residual Ca(OH)2; the results were compared using the Wilcoxon-Mann Whitney test. Photos of the apical thirds were taken at X16 and X40 magnifications and were scored by two examiners from (0) to (4). Scores of the apical third were compared using the Fisher test.The Xp-endo Finisher removed completely the Ca(OH)2 dressing from four teeth (13.33%) whereas the PUI in one tooth (3.33%). The mean values of the remaining Ca(OH)2 were (2.1%, 3.6%) respectively and the difference was not significant (p= 0.195). Both examiners found the Xp-endo Finisher more efficient in the apical third and the difference was significant; p= (0.025, 0.047) respectively.The Xp-endo Finisher showed a superiority over the PUI in removing the Ca(OH)2 from the apical third after 3 minutes of activation. Key words:Calcium hydroxide removal, Passive ultrasonic irrigation, Xp-endo Finisher.
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Project description:Final root canal irrigation stands as an effective strategy for eliminating the dentin infection. This study aimed to investigate and compare the antibacterial efficacy of QMix and other four final irrigation regimens in reducing Enterococcus faecalis within human root canals. Single-canal human teeth contaminated with E. faecalis for 4 weeks were prepared chemomechanically with sodium hypochlorite (NaOCl). Then, the teeth were randomly assigned into six groups according to the final irrigation protocols: (1) EDTA/NaOCl, 17% EDTA followed by 5.25% NaOCl; (2) EDTA/chlorhexidine (CHX), 17% EDTA followed by 2% CHX; (3) EDTA/cetrimide (CTR), 17% EDTA followed by 2% CTR; (4) MTAD; (5) QMix; and (6) control, 0.9% saline. Bacterial samples collected before instrumentation and after final irrigation were cultured and the colony-forming units (CFUs) were counted. The CFUs in the QMix, EDTA/CHX, and EDTA/CTR groups were significantly lower than those in the EDTA/NaOCl group. No significant differences were observed between the QMix, EDTA/CHX, and EDTA/CTR groups. MTAD showed weaker ability than QMix and EDTA/CHX to eliminate E. faecalis, but it caused a greater reduction in CFU than EDTA/NaOCl. Hence, the antimicrobial activity of QMix was comparable to that of EDTA/CHX and EDTA/CTR and more effective than that of EDTA/NaOCl against intracanal E. faecalis.
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