Effect of the Association of Nonsteroidal Anti-inflammatory and Antibiotic Drugs on Antibiofilm Activity and pH of Calcium Hydroxide Pastes.

INTRODUCTION: The objective of the present study was to evaluate the in vitro antibiofilm activity and pH of calcium hydroxide associated with different nonsteroidal anti-inflammatory drugs (NSAIDs). METHODS: The groups analyzed were as follows: group 1, calcium hydroxide paste with propylene glycol; group 2, calcium hydroxide paste with propylene glycol + 5% diclofenac sodium; group 3, calcium hydroxide paste with propylene glycol + 5% ibuprofen; group 4, calcium hydroxide paste with propylene glycol + 5% ciprofloxacin; and group 6, positive control (without medication). For analysis of the pH, the pastes were inserted into tubes and immersed in flasks containing ultrapure water. At the time intervals of 3, 24, 72, and 168 hours, the pH was measured with a calibrated pH meter. For microbial analysis, biofilm was induced in 30 bovine dentin blocks for 21 days. Subsequently, the pastes were placed on the blocks with biofilm for 7 days. Afterward, the pastes were removed by irrigation with sterile water, and the specimens were analyzed with a laser scanning confocal microscope with the 50 µL Live/Dead BacLight Bacterial Viability solution L7012 Kit (Molecular Probes, Inc, Eugene, OR). Data were subjected to statistical analysis at a significance level of 5%. RESULTS: The highest pH values were found for calcium hydroxide associated with ciprofloxacin in all periods analyzed. With the exception of pure calcium hydroxide paste, the other groups showed statistically significant differences (P < .05) in comparison with the positive control. CONCLUSIONS: The association of NSAIDs or antibiotic did not interfere with the pH of calcium hydroxide paste and increased the antimicrobial action of calcium hydroxide paste against Enterococcus faecalis biofilm formation.

Effects of the association of antifungal drugs on the antimicrobial action of endodontic sealers.

This in vitro study aimed to determine the susceptibility of oral specimens and ATCC lineages of Candida albicans for five endodontic sealers, which were pure and associated with two antifungal drugs, and to analyze their effect on the physical properties. For this purpose, 30 lineages of C. albicans, collected from the oral cavity of patients assisted at the endodontics clinic of the Universidade Sagrado Coração, were analyzed. Yeasts susceptibility to the sealers was tested by diffusion on agar plates. Physical properties were evaluated according to the ADA specification no. 57. The pure versions of the Sealer 26, AH Plus, Endofill, Fillapex, and Sealapex demonstrated antifungal activity, with Endofill presenting the greatest inhibition zones. All cements, except for Endofill, had their antifungal actions enhanced by addition of ketoconazole and fluconazole (p < 0.05), and the AH Plus presented the best antifungal activity. The addition of antifungal drugs did not interfere with the setting time and flowability of the sealers. It was concluded that the addition of antifungals to endodontic sealers enhanced the antimicrobial action of most cements tested without altering their physical properties.

Atividade antibacteriana de cimentos endodônticos puros e acrescidos de antibióticos contra duas linhagens ATCC de Enterococcus faecalis / Antibacterial activity of pure endodontic sealers and antibiotic-loaded sealers against two ATCC strains of Enterococcus faecalis

Introdução: canais radiculares necrosados e não tratados se caracterizam pela presença de uma microbiota mista e polimicrobiana.O E. faecalis demonstra alta resistência a medicamentos usados durante o tratamento endodôntico, sendo um dos poucos microrganismos que tem demonstrado in vitro resistir ao efeito antibacteriano do hidróxido de cálcio. Além disso, é a espécie bacteriana mais frequentemente isolada, com prevalência variando entre 29% e 77% nos canais radiculares de dentes com insucesso endodôntico. Objetivo: avaliar a atividade antibacteriana dos cimentos endodônticos MTA Fillapex, Sealapex, Sealer 26 e Endofill puros e acrescidos de amoxicilina e ciprofloxacina frente a duas linhagens ATCC de Enterococcus faecalis (ATCC 29212 e ATCC 4083). Método: os testes foram realizados pela técnica de difusão radial dos cimentos aplicados diretamente no ágar, impregnados em discos de papel aplicados sobre o ágar e pelo teste de contato direto. Para a análise estatística utilizaram-se os testes de ANOVA e Tukey com nível de significância de 5%. Resultados e Discussão: os resultados mostraram que pela técnica da difusão radial, considerando os cimentos puros, o Sealapex foi o único que apresentou halo de inibição frente às duas linhagens. Já, quando da associação da amoxicilina e ciprofloxacina o MTA Fillapex demonstrou os melhores halos de inibição para as duas linhagens. Todos os cimentos tiveram a ação potencializada pela adição dos antibióticos (p<0,05). Pela técnica de difusão dos cimentos impregnados em discos de papel, o cimento Sealapex puro fresco revelou atividade antimicrobiana e também em todas as variáveis de tempo. Quando acrescidos os antibióticos, todos os cimentos tiveram a ação antimicrobiana potencializada pelas drogas, em todas as variáveis de tempo. Este mesmo resultado foi observado na técnica do contato direto dos cimentos com ambas as linhagens. Conclusão: a atividade antibacteriana, frente ao E. faecalis, dos cimentos MTA Fillapex, Endofill, Sealer e Sealapex acrescidos os antibióticos amoxicilina e ciprofloxacina, é potencializada mesmo após um longo período da presa dos cimentos.

Introduction: necrotic root canals and untreated are characterized by the presence of a mixed and polymicrobial flora. E. faecalis show high resistance to drugs used during endodontic treatment, one of the few microorganisms which have shown in vitro to resist the antibacterial effect of calcium hydroxide. Furthermore, it is the bacterial species most often isolated, with a prevalence ranging between 29% and 77%, in root canals of teeth with endodontic failure. Objective: the aim of this study was to evaluate the antibacterial activity of the sealers MTA Fillapex, Sealapex, Sealer 26 and Endofill, pure and loaded with amoxicillin and ciprofloxacin against two ATCC strains of Enterococcus faecalis (ATCC 29212 and ATCC 4083). Method: the tests were conducted by means of radial diffusion technique of the cement applied in to the agar, impregnated paper discs applied on the agar and by the direct contact test. For the statistical analysis, the ANOVA and the Tukey?s test were used at a 5% significance level. Results and Discussion: results showed that, through the technique of radial diffusion, regarding the pure cements, the Sealapex was the only one that showed inhibition halo for the two strains. However, considering the association of amoxicillin and ciprofloxacin Fillapex, the MTA showed better inhibition zones for the two strains. All cements had their actions enhanced by with addition of antibiotics (p <0.05). Through the technique of diffusion of cements impregnated in paper discs, the Sealapex pure fresh cement revealed an antimicrobial activity and also in all the variables of time. When loaded with antibiotics, all cements had the antimicrobial action potentiated by drugs in all variables of time. The same result was observed in the technique of direct contact of cement with both strains. Conclusionn: the antibacterial activity against the E. faecalis, of the cements MTA Fillapex, Endofill, Sealer and Sealapex loaded with the antibiotics amoxicillin and ciprofloxacin, is enhanced even after a long period of use of cements.

Avaliação da atividade antibacteriana do hidróxido de cálcio associado a diferentes veículos em blocos de dentina contaminados por Enterococcus faecalis / Evaluation of the antibacterial activity of calcium hydroxide associated different vehicles in dentin blocks contaminated with Enterococcus faecalis

Introdução: A infecção endodôntica ocasionada por Enterococcus faecalis é um problema sério no tratamento de dentes comprometidos. É de preocupação do cirurgião dentista um completo saneamento do sistema de canais radiculares pela aplicação de medicação antisséptica entre sessões. Dentre estas medicações, a pasta de hidróxido de cálcio tem sido associada a diferentes veículos para potencializar sua ação. Objetivos: Diante disto, este estudo objetivou avaliar e comparar a eficiência da atividade antimicrobiana in vitro de diferentes pastas de hidróxido de cálcio frente ao E. faecalis. Material e Métodos: Os testes foram executados em 49 blocos de dentina infectados com E. faecalis e tratados com pastas de hidróxido de cálcio em diferentes veículos por uma semana. A eficiência das pastas foi avaliada pela microscopia confocal de varredura a laser. Para comparação entre as pastas foi empregado o teste de Kruskal-Wallis e pelo teste de Dunn para comparações individuais com nível de significância estabelecido em 5%. Resultados: A aplicação das diferentes pastas proporcionou uma significativa alteração na proporção de bactérias viáveis e não viáveis encontradas no biovolume celular total dos blocos de dentina. Conclusão: A pasta que revelou melhor desempenho antimicrobiano foi aquela cujo veículo foi água destilada. A pasta de hidróxido de cálcio associada ao extrato propilenoglicólico de guaçatonga não apresentou desempenho antimicrobiano sobre células de E. faecalis. (AU)

Introduction: The endodontic infection caused by Enterococcus faecalis is a serious problem in the treatment of compromised teeth. It is a concern to the dental surgeon a complete sanitation of the root canal system by applying antiseptic medication between sessions. Among these medications, the calcium hydroxide paste has been linked to different vehicles to enhance its action. Objectives: Thus, this study aimed to evaluate and compare the efficiency of in vitro antimicrobial activity of different pastes of calcium hydroxide against E. faecalis. Material and Methods: Tests were performed in 49 blocks dentin infected with E. faecalis and treated with calcium hydroxide pastes in different vehicles for a week. The efficiency of the pastes was evaluated by confocal laser scanning. The Kruskal-Wallis test was used to compare the pastes and the Dunn test was used for individual comparisons with a significance level set at 5%. Results: The application of different pastes provided a significan change in the proportion of viable and non-viable bacteria found in the total cell biovolume of the blocks of dentin. Conclusion: The paste that revealed the best antimicrobial performance was the one whose vehicle was distilled water. The calcium hydroxide paste associated with the extract of guaçatonga in propylene glycol showed no antimicrobial performance on cells of E. faecalis. (AU)

Effects of the association of antifungal drugs on the antimicrobial action of endodontic sealers

This in vitro study aimed to determine the susceptibility of oral specimens and ATCC lineages of Candida albicans for five endodontic sealers, which were pure and associated with two antifungal drugs, and to analyze their effect on the physical properties. For this purpose, 30 lineages of C. albicans, collected from the oral cavity of patients assisted at the endodontics clinic of the Universidade Sagrado Coração, were analyzed. Yeasts susceptibility to the sealers was tested by diffusion on agar plates. Physical properties were evaluated according to the ADA specification no. 57. The pure versions of the Sealer 26, AH Plus, Endofill, Fillapex, and Sealapex demonstrated antifungal activity, with Endofill presenting the greatest inhibition zones. All cements, except for Endofill, had their antifungal actions enhanced by addition of ketoconazole and fluconazole (p < 0.05), and the AH Plus presented the best antifungal activity. The addition of antifungal drugs did not interfere with the setting time and flowability of the sealers. It was concluded that the addition of antifungals to endodontic sealers enhanced the antimicrobial action of most cements tested without altering their physical properties.

Avaliação das atividades antimicrobiana e biológica do cimento portland associado ao AH PLUS em diferentes proporções / Evaluation of antimicrobial and biological activities of Portland cement associated of AH Plus sealer in different proportions

A endodontia vem sofrendo um processo de evolução muito grande nos últimos anos. Apesar dessa grande evolução técnico-científica, infelizmente o tratamento endodôntico convencional ainda não possibilita a obtenção do sucesso total. Objetivo: O objetivo do presente estudo foi avaliar a atividade antimicrobiana e a resposta do tecido subcutâneo de ratos frente à implantação do cimento Portland associado ao AH Plus em diferentes proporções. Metodologia: Para a avaliação da resposta biológica, foram utilizados 42 ratos (Rattus Norvegicus), que foram divididos em 14 animais para cada período experimental. Para se avaliar a atividade antimicrobiana, foi utilizada a técnica de difusão radial em placas de ágar Mueller-Hinton. Foram utilizadas 30 linhagens de campo e 1 ATCC (29212) de Enterococcus faecalis. Os materiais foram proporcionados em massa e os poços preenchidos com os cimentos através de seringas tipo Luer-Look. Com os dados em mãos, os mesmos foram submetidos à análise estatística, empregando-se o teste Kruskal-Wallis para comparação global e o teste de Miller para as comparações individuais com nível de significância de 5 por cento. Resultados: Quanto à resposta biológica, todos os grupos apresentaram bom comportamento. Em relação a atividade antimicrobiana, os grupos 4, 5 e 6 apresentaram atividade, tanto em 24, quanto em 48 horas, com diferença estatisticamente significante com relação aos outros grupos. Conclusão: Conclui-se que a associação do AH Plus ao cimento Portland apresenta boa resposta tecidual e atividade antimicrobiana, principalmente nos grupo com maior quantidade de cimento AH Plus...

Endodontics has been suffering a long evolution process in recent years. Despite this great technical and scientific developments, unfortunately the conventional endodontic treatment hasn't allows obtaining the total success. Objective: the objective of the present study was to evaluate the antimicrobial activity and the response of the subcutaneous tissue against deployment of associated Portland cement to AH Plus sealer in different proportions. Methodology: for evaluation of biological response, 42 rats were used (Rattus Norvegicus), which were divided into 14 animals for each experimental period. To evaluate antimicrobial activity, was used the technique of radial diffusion in Mueller-Hinton agar plates. 30 strains were used and 1 ATCC (29212) of Enterococcus faecalis. The materials were provided by weight and pits filled with the cements through syringes Luer-type Look. With data, they were subjected to statistical analysis, using the Kruskal-Wallis test for global comparison and the Miller test for individual comparisons with a significance level of 5. Results: as for biological response, all groups showed good behavior. In relation to antimicrobial activity, groups 4, 5 and 6 showed activity in both. 24, 48 hours, with statistically significant difference with respect to other groups. Conclusion: It is concluded that the Association of AH Plus to Portland cement and tissue response presents good antimicrobial activity, mainly in the group with the highest amount of cement AH Plus...

Atividade antibacteriana in vitro de pastas de hidróxido de cálcio associadas à bioprodutos frente a linhagens gram positivas e gram negativas / Antibacterial activity in vitro of calcium hydroxide paste associated to bioproducts against on Gram-positive and Gram-negative strains

Introdução: o hidróxido de cálcio Ca(OH)2 em endodontia, tem sido utilizado em pulpotomias, tratamento de perfurações radiculares, como componente de cimentos obturadores e como medicação intracanal, sendo que quando utilizado nesta última situação, é associado a um veículo com a finalidade de se obter a consistência de pasta. Assim, diferentes veículos têm sido propostos para associação ao Ca(OH)2. A atividade antimicrobiana do Ca(OH)2 está relacionada a liberação de íons hidroxila. Apesar de sua ampla utilização, esta substância não tem demonstrado eficácia sobre algumas cepas de micro-organismos in vivo. Objetivo: o propósito da presente pesquisa foi avaliar a atividade antibacteriana in vitro de várias pastas de Ca(OH)2 associadas com bioprodutos contra linhagens ATCC de Enterococcus. faecalis, Staphylococcus aureus, Streptococcus pyogenes, Pseudomonas aeruginosa e Escherichia coli. Métodos: os testes de susceptibilidade bacteriana frente às pastas, aos bioprodutos na forma de extratos e aos géis foram realizados pelo método da difusão, sobre ágar Mueller-Hinton. Os dados foram submetidos a análise estatística, empregando-se o teste Kruskal-Wallis com nível de significância de 5 por cento. Resultados e Discussão: a clorexidina, tanto a 1 por cento como a 2 por cento, mostrou grande atividade antibacteriana pura, na forma de gel e associada como veículo ao Ca(OH)2, estatisticamente significante (p<0,05). Todas as pastas de Ca(OH)2 revelaram efetividade contra todos os micro-organismos testados com exceção da pasta cujo veículo foi o óleo de alho. Frente ao St. pyogenes, somente as pastas de clorexidina 1 por cento e 2 por cento revelaram efetividade. As pastas de Ca(OH)2 cujos veículos puros revelaram atividade antibacteriana, não foram potencializadas para atividade antibacteriana.

Introduction: calcium hydroxide Ca(OH)2 is a highly alkaline white powder that has been used in Endodontics in pulpotomies, treatment of root perforations, as component of sealers and intracanal medication; when used for the latter purpose, it is associated with a vehicle to achieve a paste consistency. Thus, different vehicles have been proposed for association with Ca(OH)2. The antimicrobial activity of Ca(OH)2 is related to the release of hydroxyl ions. Despite its wide utilization, this substance has not been demonstrated to be effective against some microorganism stains in vivo. Objective: this study evaluated the in vitro antibacterial activity of several Ca (OH)2 pastes associated with bioproducts against ATCC strains of E. faecalis, Staphylococcus aureus, Streptococcus pyogenes, Pseudomonas aeruginosa and Escherichia coli. Methods: thebacterial susceptibility test to the pastes of bioproducts in extract andgel was analyzed by the paste diffusion method on Mueller-Hinton agar. Data were statistically analyzed by the Kruskal-Wallis test at a significance level of 5 per cent. Results and Discussion: chlorhexidine, both at 1 per cent and 2 per cent, presented wide antibacterial activity both pure, in gel and associated as vehicle to Ca(OH)2, with statistical significance (p<0.05). All Ca(OH)2 pastes were effective against all microorganisms tested, except for the paste with garlic oil as vehicle. Concerning the St. pyogenes, only 1 per cent and 2 per cent chlorhexidine pastes were effective. The Ca(OH)2 pastes whose pure vehicles presented antibacterial activity were not strengthened for the antibacterial activity.