PLGA submicron particles containing chlorhexidine, calcium and phosphorus inhibit Enterococcus faecalis infection and improve the microhardness of dentin.

Enterococcus faecalis (E. faecalis), a Gram-positive facultative anaerobe, is reported to take responsibility for a large portion of refractory root canal infections and root canal re-infections of human teeth. Chlorhexidine is a strong bactericide against E. faecalis but cannot infiltrate into dentinal tubules. On the other hand, a common negative effect of root canal medicaments is the decrease of dentin microhardness. In this study, poly(D,L-lactic-co-glycolide) (PLGA) submicron particles were applied as delivery carriers to load and release the chlorhexidine as well as calcium and phosphorus. The release profiles, antibacterial ability against E. faecalis, infiltration ability into dentinal tubules, biocompatibility and effects on dentin microhardness of these particles were investigated. Results revealed that encapsulated chemicals could be released in a sustained manner from the particles. The particles also exhibited excellent biocompatibility on MC3T3-E1 cells and significant antimicrobial property against E. faecalis. On dentin slices, the particles could be driven into dentinal tubules by ultrasonic activiation and inhibit E. faecalis colonization. Besides, dentin slices medicated with the particles displayed an increase in microhardness. In conclusion, PLGA submicron particles carrying chlorhexidine, calcium and phosphorus could be developed into a new intra-canal disinfectant for dental treatments.

Critical Review on Eliminating Endodontic Dental Infections Using Herbal Products.

The main purpose of a root canal treatment is to eliminate the bacteria and their products from the pulp space. Chemomechanical preparation (chemical-refers to irrigating solutions, i.e., either synthetic chemicals or herbal solutions and mechanical-refers to instrumentation of a root canals with endodontic files) of a root canal system plays a major role in obtaining the rationale of root canal treatment. Various synthetic chemicals known as endodontic irrigants play a major role in disinfection, but also have undesirable properties like allergic potential, toxicity, unacceptable taste, etc. Today there is a major change in trend towards the use of natural herbal medicines as a part of dental treatment due to its easy availability, less toxicity, and cost effectiveness. This article aims to provide a comprehensive review of various herbal endodontic irrigants evaluated for their effectiveness in the disinfection of a root canal system. This literature review is conducted using electronic databases "PubMed," "Google Scholar," and "Scopus," and articles were limited to those in the English language and published between 1980 and 2014.

A Randomized Trial Using 3Mixtatin Compared to MTA in Primary Molars with Inflammatory Root Resorption: A Novel Endodontic Biomaterial.

OBJECTIVES: Novel methods for preserving primary teeth can help to maintain their developmental, esthetic, and functional capabilities. The aim of this study was to assess the success of the repair of bony defects, caused by pre-treatment perforations, with a mixture of three antibiotics combined with simvastatin (3Mixtatin) compared to MTA in hopeless primary molars. STUDY DESIGN: In this randomized clinical trial, 80 teeth from 65 healthy children aged 3-6 years with interradicular or periapical root resorption and/or perforation in primary molars were treated either with 3Mixtatin or MTA before conventional pulpectomy and restoration. The subjects were followed up clinically and radiographically for 4, 6, 12 and 24 months after pulp treatment to evaluate and compare the healing process. The data were compared using chi-square test at a significance level of 0.05. RESULTS: By the end of 24 months in 3Mixtatin group, 31 (96.8%) teeth revealed no clinical signs or symptoms with arrested resorption progress in radiographs. In MTA group, clinical signs and symptoms including pain, mobility and sinus tract were observed in 18 (48.6%) teeth with cessation of root/interradicular radiolucency in 7 (18.9%) teeth without bone repair. CONCLUSIONS: Radiographic and clinical healing occurred more successfully following 3Mixtatin treatment compared to treatment with MTA, it may lead to a paradigm shift in the pulpal treatment of primary teeth in the future.

Nigella sativa and its active constituent thymoquinone in oral health.

In this review, we summarized published reports that investigated the role of Nigella sativa (NS) and its active constituent, thymoquinone (TQ) in oral health and disease management. The literature studies were preliminary and scanty, but the results revealed that black seed plants have a potential therapeutic effect for oral and dental diseases. Such results are encouraging for the incorporation of these plants in dental therapeutics and hygiene products. However, further detailed preclinical and clinical studies at the cellular and molecular levels are required to investigate the mechanisms of action of NS and its constituents, particularly TQ.

Endodontic treatment of primary teeth using a combination of antibacterial drugs.

AIM: To evaluate the clinical outcome of 'Lesion Sterilization and Tissue Repair' (LSTR) therapy for endodontic treatment of primary teeth. METHODOLOGY: A mixture of metronidazole, ciprofloxacin, and minocycline (3Mix) in ointment (macrogol mixed with propylene glycol: MP) or in a root canal sealer was used to disinfect infected root canals of 56 patients aged 4-18 years. Out of a total of 87 primary teeth, 81 cases had physiologic root resorption. A total of 54 radiolucent periradicular lesions were present. The root canals were not prepared before or after disinfection. 3Mix medicament (3Mix-MP/3Mix-sealer) was placed at orifices of root canals or on the bottom of pulp chambers, and then sealed with glass-ionomer cement and further reinforced by a composite resin inlay prepared using a direct method and cemented with resin. RESULTS: In all cases, clinical symptoms such as gingival swelling (52 cases), sinus tracts (22 cases), induced dull pain (3 cases), spontaneous dull pain (26 cases), and pain on biting (46 cases) disappeared after treatment, although in four cases clinical signs and symptoms were finally resolved only after retreatment using the same procedures. Thus, gingival abscesses and fistulae, if present, disappeared after a few days. Successor permanent teeth erupted without any disorders, or were found radiographically to be normal and in the process of eruption. All the cases were evaluated as successful. The mean function time of the primary teeth was 680 days (range: 68-2390 days), except for one case in which the successor permanent tooth was congenitally missing. CONCLUSION: Primary teeth with periradicular lesions with or without physiologic root resorption were treated successfully by the LSTR endodontic therapy.

Antimicrobial efficacy of chloroxylenol and chlorhexidine in the treatment of infected root canals.

PURPOSE: To investigate the antimicrobial efficacy of a chlorhexidine gluconate (2.0%) and of an ethanolic chloroxylenol solution (10%) as a temporary root canal dressing against selected test microorganisms (Staphylococcus aureus, Streptococcus faecium, Escherichia coli, Candida albicans). MATERIALS AND METHODS: Extracted single-rooted human teeth were instrumented up to size 40. After removal of the smear layer suspensions of the test microorganisms were inserted into the root canals. After incubation for 48 hrs each suspension of the test organisms was removed and the root canals were filled with one of the two different disinfectants. The teeth were then incubated for 48 hrs. Twelve teeth and three controls were used for each of the four test organisms and each of the two regimens. After incubation, each root canal was instrumented and the removed canal wall dentin was examined microbiologically. RESULTS: With a contact time of 48 hrs between the two disinfectants and the four bacterial suspensions the medications led to a total killing of microorganisms in 82% of a total of 96 contaminated teeth. In the dentin layer situated 50 microm from the root canal, both medications achieved bacterial killing in a range from 99.9% to 99.99%, depending on the test organism. There were no significant differences (P> 0.1) between the relative antimicrobial activity of the two root canal dressings.

[Endodontic treatment of gangrenous teeth--literature review]. / A gangrénás fogak endodontial kezelése (lrodalmi összefoglaló).

This overview was put together to update the endodontic knowledge of the general practitioners. Several treatment methods sometimes with contradicting principles are applied in Hungary using a wide range of endodontic medicines. The aim of the paper was not only to clarify the basic therapeutic principles but also to provide practical information about the relevant endodontic products for the everyday use.

[Analgesic effect of Pilostigma reticulatum (nguiguis)]. / Etude de l'activite analgesique du pilostigma reticulatum (nguiguis).

Mankind has always given himself means to fight pain by using at first, means offered to him by his environment particularly the plants. African pharmacopoeia is rich of thousand of plants. It changes in term of its ecosystem and its vegetation. Decocted leaves of pilostigma reticulatum (nguiguis in ouolof) are used in western Africa, because of its analgesic properties in case of "borom bop" literally meaning headache associated to odontalgias and mumps. In our study we used lyophilisate obtained from dry leaves of the plant which has been used for experimentation while the decocted dry leaves have been used for clinical application. So, it appeared that leaves of pilostigma reticulatum are almost atoxic when administrated by oral tract (DL50 = 17 g/kg) according to GLEASON classification which recognizes as atoxic every substance having a DL50 higher to 15 g of lyophilisate by kilogram of corporal weight. Elsewhere the study of the peripheric analgesic activity (according to the acetic acid test) has shown a very significant peripheric analgesia since the dose of 750 mg/kg which climbs with it. The clinical survey carried out at the dental community center of Pikine Icotaf based on the usual method of the utilization of the decocted (as mouth rinse) has shown that, this plant procures pain sedation in 97% of the patients having undergone dental avulsion and in 78% of the cases of desmondontal syndromes. This inaugural report must be continued in order to certify the pharmacologic or toxic effects of that plant and define clinical doses from experimental doses we have cleared.

Evaluation of the effectiveness of sodium hypochlorite used with three irrigation methods in the elimination of Enterococcus faecalis from the root canal, in vitro.

The effectiveness of 4.0% sodium hypochlorite (NaOCl) used with three irrigation methods in the elimination of Enterococcus faecalis from the root canal was tested in vitro. Root canals contaminated with E. faecalis were treated as follows: (i) irrigation with 2 mL of NaOCl solution and agitation with hand files; (ii) irrigation with 2 mL of NaOCl solution and ultrasonic agitation; (iii) irrigation with NaOCl alternated with hydrogen peroxide. Contaminated canals irrigated with sterile saline solution served as the control. Paper points used to sample bacteria from the root canals were transferred to tubes containing 5 mL of brain heart infusion (BHI) broth. Tubes were incubated and the appearance of broth turbidity was indicative of bacteria remaining in the root canal. There were no statistically significant differences between the experimental groups. However, NaOCl applied by the three methods tested, was significantly more effective than the saline solution (control group) in disinfecting the root canal.

[Histological study on repairing experimental pulp chamber floor perforations with yunnan bai-yao in dog].

UNLABELLED: Yunnan Baiyao (YNBY), amalgam, hydroxylapatite and calcium hydroxide were used separately in repairing the experimental pulp chamber floor perforation (PCFP) of dog teeth. The animals were killed at the time of 1, 4, 8 and 12 weeks after experiment. The experimental teeth with periapical tissue were removed and observed their histological changes by optical microscope. The effects that different materials in repairing the tissue of PCFP were observed. Twenty teeth were taken from every dog, each group contained four teeth, the others were used for control group. RESULTS: In initial period (1st, 4th week) inflammatory infiltration was present in PCFP of every group, but the group with YNBY was milder. Pyogenic foci were present in the hydroxylapatite and calcium hydroxide groups. In late stage of experiment (8th and 12th week) inflammatory reactions of each group were alleviated except control group. Epithelial metaplasia and cicatritation were found in the vicinity of perforated area. Dentin cementum and alveolar bone were absorbed in majority of experimental group. It was also observed in the group with YNBY. But in late stage similar cementum formation and alveolar bone neogenesis were found in the perforated area around the repairing materials. It revealed that hemostasis, Promoting Blood Circulation to Remove Stasis and antiphlogistic actions were advantageous to the inflammation, control and repair course of the PCFP. The article discussed that YNBY might promote the repairing of cementum and alveolar bone of perforated area.

Disinfection by endodontic irrigants and dressings of experimentally infected dentinal tubules.

The effect of endodontic irrigants and dressings was tested on bacteria in bovine dentin specimens experimentally infected with Enterococcus faecalis, Streptococcus sanguis, Escherichia coli, or Pseudomonas aeruginosa. Standardized, cylindrical dentin test pieces were prepared and cleaned by ultrasonic treatment with EDTA and sodium hypochlorite. The specimens were infected with the test organism for periods up to 14 days, and the degree of infection into the tubules was monitored using Brown & Brenn stain, scanning electron microscopy, and culturing of dentin dust from sequential bur samples starting from the pulpal side. E. faecalis rapidly infected the whole length of the tubules; S. sanguis required up to 2 weeks for complete infection; E. coli only penetrated to some 600 microns, even after prolonged incubation periods. P. aeruginosa infected dentin quickly, but apparently in very low numbers. E. faecalis persisted for at least 10 d after withdrawal of nutrient support, whereas the other 3 organisms died within 4 to 48 h. Endodontic medicaments were applied to infected specimen for comparison of antibacterial potency. Camphorated p-monochlorophenol was generally more efficient than Calasept, and of the irrigants tested, iodine potassium iodide appeared more potent than sodium hypochlorite or chlorhexidine. The presence of a smear layer delayed, but did not eliminate, the effect of the medicaments.