Antibacterial Efficacy of Synthetic and Natural-Derived Novel Endodontic Irrigant Solutions.

The aim of this study was to compare the efficacy of grape seed extract (GSE), calcium hypochlorite [Ca(ClO)2], and sodium hypochlorite (NaOCl) irrigant solutions with rotary or reciprocating instrumentation for disinfection of root canals inoculated with Enterococcus faecalis. The mesiobuccal root canals of mandibular molars were prepared and inoculated with Enterococcus faecalis for 21 days. The roots were then randomly divided into the following eight experimental groups (n=11) according to the instrumentation technique and disinfection protocol: ProTaper Next or Reciproc R25 with sodium chloride (control group), 6% NaOCl, 6% Ca(ClO)2, or 50% GSE used for irrigation during instrumentation. The antimicrobial activity was determined on the basis of a reduction in colony-forming units (CFUs) counted on bacterial samples collected before and after root canal instrumentation and expressed as a percentage of reduction. Data were evaluated by two-way ANOVA followed by Tukey HSD post-hoc tests (p<0.05). No significant differences were observed in bacterial reduction between the ProTaper Next and Reciproc R25 systems (p>0.05), regardless of the irrigant solution used. Furthermore, all active solutions (6% NaOCl, 50% GSE, and 6% Ca(ClO)2) showed similar potential to reduce bacterial counts (p>0.05) and were significantly more effective than sodium chloride (control) (p<0.05). The results suggest that the GSE and Ca(ClO)2 have potential clinical application as irrigant solutions in endodontic therapy since they present bactericidal efficacy against Enterococcus faecalis.

Antibacterial efficacy of synthetic and natural-derived novel endodontic irrigant solutions

Abstract The aim of this study was to compare the efficacy of grape seed extract (GSE), calcium hypochlorite [Ca(ClO)2], and sodium hypochlorite (NaOCl) irrigant solutions with rotary or reciprocating instrumentation for disinfection of root canals inoculated with Enterococcus faecalis. The mesiobuccal root canals of mandibular molars were prepared and inoculated with Enterococcus faecalis for 21 days. The roots were then randomly divided into the following eight experimental groups (n=11) according to the instrumentation technique and disinfection protocol: ProTaper Next or Reciproc R25 with sodium chloride (control group), 6% NaOCl, 6% Ca(ClO)2, or 50% GSE used for irrigation during instrumentation. The antimicrobial activity was determined on the basis of a reduction in colony-forming units (CFUs) counted on bacterial samples collected before and after root canal instrumentation and expressed as a percentage of reduction. Data were evaluated by two-way ANOVA followed by Tukey HSD post-hoc tests (p<0.05). No significant differences were observed in bacterial reduction between the ProTaper Next and Reciproc R25 systems (p>0.05), regardless of the irrigant solution used. Furthermore, all active solutions (6% NaOCl, 50% GSE, and 6% Ca(ClO)2) showed similar potential to reduce bacterial counts (p>0.05) and were significantly more effective than sodium chloride (control) (p<0.05). The results suggest that the GSE and Ca(ClO)2 have potential clinical application as irrigant solutions in endodontic therapy since they present bactericidal efficacy against Enterococcus faecalis.

Resumo O objetivo deste estudo foi comparar a eficácia do extrato de semente de uva (ESU), hipoclorito de cálcio [Ca(ClO)2] e hipoclorito de sódio (NaOCl) como soluções irrigadores quando utilizadas com instrumentos reciprocantes e rotatórios para desinfecção de canais radiculares infectados com Enterococcus faecalis. Raízes mesio-vestibulares de molares inferiores foram preparados e inoculados com E. faecalis por 21 dias. As raízes foram aleatoriamente divididas em 8 grupos (n=11) de acordo com a técnica de instrumentação e protocolo de irrigação: ProTaper Next ou Reciproc R25 associados com soro fisiológico (grupo controle), Ca(ClO)2 6%, NaOCl 6% ou ESU 50%. A atividade antimicrobiana foi determinada pela redução do número de Unidades Formadoras de Colonias (UFCs) coletadas antes e após a instrumentação e expressas em porcentagens de redução. Os dados foram analisados estatisticamente pelos testes ANOVA seguido pelo teste complementar de Tukey HSD (p<0,05). Não foi encontrado diferença estatisticamente significante na redução bacteriana entre os sistemas ProTaper Next e Reciproc R25 (p>0.05), independente da solução irrigadora usada. Além disso, todas as soluções ativas (NaOCl, ESU e Ca(ClO)2) mostraram similar potencial em reduzir a quantidade de bactérias (p>0.05) e foram significativamente mais efetivas que o soro fisiológico (p<0.05). Pode-se concluir que o ESU e o Ca(ClO)2 apresentam potencial para aplicação clínica como irrigantes endodônticos uma vez que apresentaram efetividade antimicrobiana contra o E. faecalis.

Adjustable Strabismus Surgery under Topical Anesthesia: Alignment in Supine vs Seated Position.

PURPOSE: To compare ocular deviation in the operating room depending on whether the patient is in supine decubitus or seated after single-stage adjustable strabismus surgery under topical anesthesia. MATERIAL AND METHOD: We performed a prospective observational study of 30 patients with horizontal and/or vertical strabismus who underwent single stage adjustable strabismus surgery under topical anesthesia. Both distance and near deviation were evaluated before surgery, during surgery in both positions (seated and supine), and at 1 day, 1 month, and 3 months after surgery. A final horizontal deviation <10 pd and a vertical deviation <5 pd without diplopia was considered to be a good outcome (3 months after surgery). RESULTS: The mean age of the sample was 55 years and 76.7% were women. Most had esotropia (70%). The most frequently used surgical combination was the medial rectus and lateral rectus (36.7%). Surgical adjustment was necessary in 40% of cases. Mean preoperative deviation was 21.9 ± 12.63 pd (distance) and 20.66 ± 4.76 (near). Deviation with the patient supine was 8 ± 8.25 pd (distance) and 7.26 ± 5.81 (near). Deviation with the patient seated was 8.13 pd±8.38 (distance) and 8.5 ± 7.41 (near). There was no significant difference between the positions. Outcome was favorable in 70% of patients; this percentage increased to 83.33% at 1 day, 1 month, and 3 months after surgery. CONCLUSIONS: No statistically significant differences were found between ocular deviations in the seated or supine position in the operating room. Outcome was favorable in most cases 3 months after surgery. Intraoperative ocular deviation was not a predictor of outcome.

Effect of chemical and natural irrigant solutions on microhardness of root dentin­ an in vitro study

Aim: Modifications in the mechanical properties of dentin may reduce the fracture resistance of tooth, especially after endodontic treatment. The aim of present study was to evaluate the effect of the irrigation with different root canal irrigants on the microhardness of root dentin. Methods: The coronal portion of 60 single-rooted bovine incisors was sectioned and the pulpal tissue removed using endodontic K-files. The roots were cut transversely to obtain 2 fragments, which were embedded in acrylic resin and randomly distributed into six groups (n=20) according to the irrigation protocol: distilled water (DW) (control); 2% chlorhexidine solution (CHX); 6% sodium hypochlorite (NaOCl); 6% calcium hypochlorite (Ca[OCl]2); QMix; and 6.5% grape seed extract solution (GSE). The solutions were kept in contact with the root dentin specimens for 30 min. After that, irrigation with 5 mL of DW was performed. The Vickers microhardness was determined by performing three indentations in all specimens, using 300-g load and 20-second dwell time. The first indentation was made 1.000 µm from the root canal entrance, and two other indentations were made at a distance of 200 µm from each other. The microhardness value for each specimen was obtained as the average of the results for the three indentations. Data were statistically analyzed using one-way ANOVA with 5% significance level. Results: All the tested irrigant solutions maintained the same microhardness level of the root dentin when compared to the control group, with no statistically significant differences between them (p<0.05) Conclusion: The tested irrigant solutions did not present ability to modify the microhardness of root dentin

Effect of synthetic and natural-derived novel endodontic irrigant solutions on mechanical properties of human dentin.

This study aimed to evaluate the effects of different synthetic and natural-derived root canal irrigants (6% sodium hypochlorite [NaOCl], 6% calcium hypochlorite [Ca(OCl)2] and 6.5% grape seed extract [GSE]) on dentin mechanical properties (flexural strength, ultimate tensile strength [UTS] and fracture resistance). Rectangular-shaped beams and hourglass-shaped sections obtained from mid-coronal and root dentin were treated with 6% NaOCl, 6% Ca(OCl)2 or 6.5% GSE for 30 min. The irrigant solutions were replaced every 5 min. Then, the dentin specimens were rinsed with distilled water (DW) followed by incubation with 17% EDTA for 1 min, and thoroughly rinsed with DW again. Specimens from the control group were tested without prior irrigation. After treatment with the irrigants, dentin beams were used to assess the flexural strength (n = 10) while UTS was evaluated using the root dentin hourglass-shaped sections (n = 10). Similarly, roots with 1 mm of dentinal wall thickness were obtained from human teeth and treated with the same irrigant solutions (n = 10). A compressive loading was applied to the coronal surfaces of roots until fracture. The values of each mechanical test were statistically analyzed individually by one-way ANOVA followed by Tukey HSD test (P < 0.05). NaOCl significantly reduced the mechanical properties of dentin in all mechanical tests (P < 0.05) and no statistical difference was found among Ca(OCl)2, GSE and control group (P > 0.05). It can be concluded that Ca(OCl)2 and GSE may be alternative irrigant solutions, since they do not negatively affect the dentin mechanical properties.

Bond Strength between Fiber Posts and Root Dentin Treated with Natural Cross-linkers.

INTRODUCTION: The aim of this study was to investigate the effects of a proanthocyanidin-rich extract (grape seed extract [GSE]) on the bond strength and stability of the adhesion of fiber posts to the root dentine using 2 adhesive systems: a total-etch and a self-etch adhesive system. METHODS: Single-rooted human teeth were randomly divided into 6 groups: G1 (control), untreated + total-etch adhesive Adper Scotchbond Multi-Purpose (3M ESPE, St Paul, MN); G2, 6.5% GSE for 5 minutes + SB; G3, 10% GSE for 5 minutes + SB; and G4 to G6 groups were similar to previous ones; however, the self-etch adhesive system Clearfil SE Bond (Kuraray, Kurashiki, Japan) was used. Fiber posts were cemented with RelyX ARC (3M ESPE), and the specimens were immediately tested for push out or stored for 12 months. The bond strength means were analyzed by analysis of variance and Games-Howell post hoc tests (α = 0.05). Additionally, matrix metalloproteinase inhibition by 0.65%, 0.065%, and 0.0065% GSE was examined with gelatin zymography. RESULTS: The use of GSE did not affect immediate bond strength to dentin and contributed to preserve the bond strength after 12 months (P < .05) for both adhesives. The bond strength of SB was significantly higher than Clearfil SE Bond (P < .05). Gelatin zymography showed reduced matrix metalloproteinase activity when recombinant enzymes were incubated with both 0.65% and 0.065% GSE, with complete inhibition at the highest concentration. CONCLUSIONS: The pretreatment with GSE can be used as a natural alternative to improve bond strength stability of dentin-adhesive interfaces in root canals.

A galloylated dimeric proanthocyanidin from grape seed exhibits dentin biomodification potential.

Grape seeds are a rich source of polyphenols, especially proanthocyanidins (PACs), and are also known for the presence of galloylated oligomeric PACs (OPACs). The present study focuses on the phytochemical methodology for grape seed (O)PACs and their potential role as dentin biomodifiers to be used in restorative and reparative dentistry. A new method using centrifugal partition chromatography (CPC) was developed for the preparative separation of the grape seed (O)PACs. Orthogonal phytochemical profiling of the resulting CPC fractions was performed using C18 and diol HPLC, normal phase HPTLC, and IT-TOF MS analysis. A galloylated procyanidin dimer (1) was isolated from a CPC fraction in order to evaluate its potential to enhance dentin bio-mechanical properties. Moreover, it helped to evaluate the impact of the galloyl moiety on the observed bioactivity. Structure elucidation was performed using ESI-MS, 1D and 2D NMR analyses. For the first time, (1)H iterative full spin analysis (HiFSA) was performed on this type of molecule, enabling a detailed proton chemical shift and coupling constant assignment. The CPC fractions as well as 1 showed promising results in the dentin stiffness bioassay and indicate that they may be used as dental intervention biomaterial.