Evaluation of Antibacterial Efficiency of Different Root Canal Disinfection Techniques in Primary Teeth.

BACKGROUND: A successful primary root canal treatment depends on effective shaping and cleaning the root canal system and finally filling it with a hermetic sealer. Clinically, roots of primary teeth are difficult to shape and the irrigation/disinfection protocol has great importance on prognosis. OBJECTIVE: The present study evaluated the antibacterial efficiency of Endosafe (Orangedental GmbH & Co. KG), photo-activated disinfection (PAD; Orangedental GmbH & Co. KG), diode laser (Epic 10; Biolase, Inc.), ozone (O3, Ozonytron; Biozonix, München, Germany), and sodium hypochloride applications in primary root canals that were infected with Enterococcus faecalis after standard mechanical instrumentation. METHODS: The study was conducted on roots of 100 human primary molar teeth, which were extracted due to excessive caries. The roots were divided in 5 groups with 15 roots in each root disinfection protocol. In addition, 15 samples and 10 samples served as positive and negative controls, respectively. The Shapiro-Wilk test, the Kruskal-Wallis test and then by post hoc group comparisons with the Bonferroni-adjusted Mann-Whitney U test (unpaired observations) was used. RESULTS: Sodium hypochlorite (NaOCl) exhibited the highest antibacterial effect (0 colony-forming units per mL). Diode laser irradiation was statistically more effective than the ozone, PAD, and Endosafe groups (p < 0.001). Endosafe, PAD, and ozone groups showed similar antibacterial effect (p > 0.05). Although not statistically significant, the Endosafe was more effective in reducing the bacterial count when compared with ozone and PAD. CONCLUSIONS: The five tested irrigation systems were shown to be effective in disinfection of the E. faecalis-contaminated primary root canals and best results were obtained with 2.5% NaOCl and diode laser.

Dentin Topographic Features following Chemomechanical Caries Removal in Primary Teeth.

AIM: Study the topographic features of dentin after caries removal with a chemomechanical agent (Papacarie) compared with the conventional drilling method. STUDY DESIGN: The sample included 7 exfoliated and extracted primary teeth with carious dentin lesions, not reaching the pulp. Each tooth was sectioned longitudinally through the center of the carious lesions into two halves. The teeth were then divided into two groups according to the method of caries removal. Following caries removal, dentin topography and the cut section were examined using the scanning electron microscope. RESULTS: Papacarie produced an irregular, porous, rough and globular dentin appearance. The dentin surfaces were generally free of smear layer, visible bacteria and the dentinal tubules were opened. The dentin cut surfaces showed patent dentinal tubules with open orifices. The drilling method created a smooth and amorphous surface with a continuous smear layer occluding the dentinal tubules. Numerous bacteria were also observed. The cut dentin surfaces showed patent dentinal tubules with their orifices plugged with smear layer. CONCLUSIONS: Papacarie produced a rough and porous surface with partial or complete removal of the smear layer and opened dentinal tubules, while the drill produced a smooth surface with uniform smear layer occluding the dentinal tubules.

Bacterial penetration along different root canal fillings in the presence or absence of smear layer in primary teeth.

AIMS: To study the effect of the smear layer on the penetration of bacteria along different root canal fillings and to compare the sealing ability of new endodontic material Apexit plus as compared to Zinc Oxide Eugenol (ZOE) in primary teeth. STUDY DESIGN: A total of 60 human root segments were instrumented for endodontic treatment. Half of the sample size was irrigated with normal saline and in other half 3% NaOCl, 3% H2O2 and 17% EDTA was used alternatively as irrigant during instrumentation. The roots were rinsed thoroughly with distilled water and sterilized by autoclaving for 20 min at 121 +/- 2 degrees C. Roots with and without smear layer were obturated with Apexit plus, Zinc oxide eugenol. Following storage in humid conditions at 37 degrees C for 2 days, the specimens were mounted into a bacterial leakage test model for 180 days. RESULTS: At 180 days, there is statistically significant difference with a P value of < 0.05 among all groups except ZOE-smear and -nonsmear. In the presence of smear layer Apexit plus demonstrated more leakage. No leakage was observed in ZOE groups. ZOE demonstrated better sealing ability than Apexit plus. CONCLUSIONS: Removal of smear layer helps in better resistance to bacterial penetration along Apexit plus root canal fillings but no effect is seen along ZOE root canal fillings.

Propolis and commonly used intracanal irrigants: comparative evaluation of antimicrobial potential.

UNLABELLED: The objective of endodontic therapy is not just simple cleaning and filling of root canals, but successful treatment requires the establishment of a sufficient level of disinfection. AIM: To evaluate, in vivo, the antimicrobial and inflammatory/irritant potential of Propolis against mixed endodontic aerobic and anaerobic bacteria. METHOD: An in vivo randomized controlled trial was conducted in a group of 60 children aged 6-12 years presenting with an acute apical abscess of the maxillary primary molars. Fifteen children each were divided randomly into four groups where irrigation during pulpectomy was performed using either 2% chlorhexidine, 4% calcium hydroxide or 4% Dimethyl Sulfoxide (DMSO) extract of propolis with normal saline as the control irrigant. Microbiological samples were taken from the disto-buccal root canal before initiating the pulpectomy as well as after 3 days later and for mixed aerobic and anaerobic bacterial cultures. RESULTS: In all the four groups, a significant decrease in mean aerobic colony forming units (cfu) count was seen. Maximum change in anaerobic cfu count was seen with 2% chlorhexidine. CONCLUSIONS: Chlorhexidine proved to be superior antimicrobial agent against both endodontic aerobes and anaerobes. Calcium hydroxide was found to be least effective.

Comparative evaluation of antimicrobial efficacy of various root canal filling materials along with aloevera used in primary teeth: a microbiological study.

AIM: this study was conducted to evaluate the antimicrobial effectiveness of 6 root canal filling materials and a negative control agent against 18 strains of bacteria isolated from infected root canals of primary molar teeth using agar diffusion assay. MATERIALS: Aloevera with sterile water Zinc oxide and Eugenol, Zinc oxide-Eugenol with aloevera, Calcium hydroxide and sterile water, Calcium hydroxide with sterile water and aloevera, Calcium hydroxide and Iodoform (Metapex) and Vaseline (Control). MIC and MBC of aloevera was calculated. RESULTS: All materials except Vaseline showed varied antimicrobial activity against the test bacterias. The zones of inhibition were ranked into 4 inhibition categories based on the proportional distribution of the data. All the 18 bacterial isolates were classified under 2 groups based on Gram positive and Gram negative aerobes. Statistical analysis was carried out to compare the antimicrobial effectiveness between materials tested with each of the bacterial groupings. CONCLUSION: Aloevera + Sterile Water was found to have superior antimicrobial activity against most of the microorganisms followed by ZOE + Aloevera, calcium hydroxide + Aloevera, ZOE, calcium hydroxide, Metapex in the descending order and Vaseline showed no inhibition.

Atividade anticariogênica de extratos e compostos químicos do café / Anticariogenic activity of coffee extracts and coffee chemical compounds

Avaliou-se a atividade anticariogênica de extratos e compostos químicos docafé, através de dois estudos laboratoriais. No primeiro, foram testados grãos integrais e descafeinados das espécies Coffea arabica e Coffea canephora, emdiferentes graus de torrefação (6, 7, 8, 13 e 15 minutos), totalizando 36extratos. Os extratos e 6 constituintes químicos presentes em ambas asespécies (ácido clorogênico – 5-CQA; ácido caféico, trigonelina, cafeína, ácidonicotínico e ácido ferúlico) foram submetidos a ensaios de susceptibilidade microbiológica. Assim, pode-se identificar a concentração mínima destas substâncias necessária para inibição do crescimento (CMI) de Streptococcus mutans (SM). Em acréscimo, avaliou-se a capacidade dos extratos e compostos de inibir a formação do biofilme de cepas de SM e/ou reduzí-lo. Todos os extratos de café foram caracterizados quimicamente através de cromatografia líquida de alta eficiência e medições do pH. Os extratos integrais com tempo de torrefação entre 6 e 8 minutos (torra clara à média clara), assim como os descafeinados com tempo de torra de 6 e 7 minutos, apresentaram o mesmo valor de CMI (5 mg/mL). Trigonelina, 5-CQA e ácido caféico demonstraram uma CMI de 0,8 mg/mL. O extrato de C. canephora com 6 minutos de torra e de qualidade superior dos grãos obteve os melhores resultados na inibição da formação do biofilme de SM (39,6%) e reduziu em 6,6% o biofilme já formado, sendo, por isso, selecionado para o segundo estudo. Experimentos foram realizados a fim de identificar a atividade antibacteriana do extrato selecionado diante do SM e do Streptococcus sobrinus (SS). A viabilidade das células planctônicas de SM e SS frente a diferentes concentrações do extrato foi analisada através de testes de suscetibilidade para verificar: a CMI, a concentração mínima bactericida (CBM) e a curva de morte das bactérias. O efeito do extrato sobre a desmineralização dentária foi investigado após a sua aplicação sobre o biofilme misto...

Photodynamic therapy in endodontic treatment of deciduous teeth.

The purpose of this study was to evaluate photodynamic therapy in deciduous teeth with necrotic pulp by means of fully quantifying viable bacteria, before and after instrumentation and after the use of photodynamic therapy. Radicular canal cultures were conducted (n = 10): the first one was performed right after access and location of the radicular canal; the second was performed after the conclusion of chemical-mechanical instrumentation, and the last one after photodynamic therapy. The photodynamic therapy was performed with 4 J/cm energy low-intensity diode together with toluidine blue. The results (log(10)) were submitted to a descriptive analysis and Wilcoxon test. The percentage of reduction was submitted to the Mann-Whitney test. The instrumentation resulted in a reduction of 82.59% of viable bacteria, and, after photodynamic therapy, the microbial reduction observed was 98.37% (P = 0.0126). Photodynamic therapy is recommended as adjunct therapy for microbial reduction in deciduous teeth with necrotic pulp.