Photoinactivation Effects of Curcumin, Nano-curcumin, and Erythrosine on Planktonic and Biofilm Cultures of Streptococcus mutans.

Introduction: This in vitro study was conducted to assess the phototoxic effects of curcumin, nano-curcumin, and erythrosine on the viability of Streptococcus mutans (S. mutans) in suspension and biofilm forms. Methods: Various concentrations of curcumin (1.5 g/L, 3 g/L), nano-curcumin (3 g/L), and erythrosine (100 µM/L, 250 µM/L) were examined for their impact on planktonic and biofilm cultures of S. mutans, either individually or in conjunction with light irradiation (photodynamic therapy or PDT). A blue light-emitting diode (LED) with a central wavelength of 450 nm served as the light source. The results were compared to 0.12% chlorhexidine digluconate (CHX) as the positive control, and a solution containing neither a photosensitizer (PS) nor a light source as the negative control group. The dependent variable was the number of viable microorganisms per experiment (CFU/mL). Results: Antimicrobial PDT caused a significant reduction in the viability of S. mutans in both planktonic and biofilm forms, compared to the negative control group (P<0.05). The highest cell killing was observed in PDT groups with curcumin 3 g/L or erythrosine 250 µmol/L, although the difference with PDT groups using curcumin 1.5 g/L or erythrosine 100 µmol/L was not significant (P>0.05). Antimicrobial treatments were more effective against planktonic S. mutans than the biofilm form. Conclusion: PDT with either curcumin 1.5 g/L or erythrosine 100 µmol/L may be suggested as an alternative to CHX to inactivate the bacteria in dental plaque or deep cavities. Nano-curcumin, at the selected concentration, exhibited lower efficacy in killing S. mutans compared to Curcumin or erythrosine.

Antimicrobial photodynamic therapy against Lactobacillus casei using curcumin, nano-curcumin, or erythrosine and a dental LED curing device.

This study aimed to investigate the photodynamic effects of curcumin, nanomicelle curcumin, and erythrosine on Lactobacillus casei (L. casei). Various concentrations of curcumin (1.5 g/L, 3 g/L), nano-curcumin (3 g/L), and erythrosine (100 µM/L, 250 µM/L) were tested either alone or combined with light irradiation (PDT effect) against L. casei in planktonic and biofilm cultures. The light was emitted from a light-emitting diode (LED) with a central wavelength of 450 nm. A 0.12% chlorhexidine digluconate (CHX) solution served as the positive control, and a solution containing neither photosensitizer nor light was the negative control group. The number of viable microorganisms was determined using serial dilution. There was a significant difference in the viability of L. casei in both planktonic and biofilm forms (P < 0.05). In the planktonic culture, the antibacterial effects of CHX and PDT groups with curcumin 3 g/L and erythrosine 250 µM/L were significantly greater than the other groups (P < 0.05). For L. casei biofilms, the greatest toxic effects were observed in CHX and PDT groups with curcumin 3 g/L, erythrosine 250 µmol/L, erythrosine 100 µmol/L, and nanomicelle curcumin 3 g/L, with a significant difference to other groups (P < 0.05). The antibacterial effects of all photosensitizers (except erythrosine 250 µmol/L at planktonic culture) enhanced significantly when combined with light irradiation (P < 0.05). PDT with curcumin 3 g/L or erythrosine 250 µmol/L produced comparable results to CHX against L. casei at both planktonic and biofilm cultures. Alternatively, PDT with erythrosine 100 µmol/L or nanomicelle curcumin 3 g/L could be suggested to kill L. casei biofilms.

Distal guide as a substitute for distal shoe space maintainer: a case series study.

Early loss of the primary second molar (DSM) before the eruption of the permanent first molar (PFM) may result in its mesial drift during the eruption. Traditionally, a distal shoe space maintainer is used in this situation to control the path of eruption and preserve the space. However, considering its disadvantages, an alternative appliance needs to be developed for guiding the unerupted PFM. The purpose of this article is to represent an innovative design for preserving space after the early loss of the DSM, describe the fabrication process, and present some data on the successful results of using the appliance in five cases.

Management of oral mucositis in pediatric patients receiving cancer therapy: A systematic review and meta-analysis.

BACKGROUND: One of the most common complications of cancer chemotherapy is oral mucositis (OM). OM affects more than 75% of patients undergoing chemotherapy and represents a significant burden to patients and caregivers. We performed a systematic review and meta-analysis of published studies to investigate the effects of agents and techniques in reducing OM. PROCEDURE: This systematic review investigated, critically appraised, and rated the evidence on agents used to manage OM in children undergoing cancer therapy. A comprehensive search of the relevant literature was performed from January 2006 to December 2017. MEDLINE, Scopus, the Cochrane Database of Systematic Reviews, EMBASE, and the Web of Science were searched. Nine eligible studies were identified. Using random-effects models, standardized mean difference was estimated between treated and control groups across all studies. The Cochran test and the I2 index were performed for heterogeneity between studies. The significance level was set at P = 0.05. RESULTS: Palifermin reduced the incidence (OR = 4.131, P = 0.000), duration (St diff mean = 0.803, P = 0.000), and severity (St diff mean = 0.637, P = 0.000) of OM in pediatric cancer patients significantly. However, the laser did not show significant efficacy in decreasing the incidence rate of OM (OR = 2.870, P = 0.364). CONCLUSION: This review provided a comprehensive examination of available options for children who have OM. The results support the possibility of a positive effect of palifermin on reducing OM in children receiving cancer therapy.

Antimicrobial photodynamic therapy of Lactobacillus acidophilus by indocyanine green and 810-nm diode laser.

This study investigated the efficacy of photodynamic therapy (PDT) using EmunDo as a photosensitizer against Lactobacillus acidophilus. A gallium aluminum arsenide diode laser was used in this experiment (810 nm, CW). Standard suspensions of Lactobacillus acidophilus were divided into six groups by treatment: 1) EmunDo, 2) diode laser (100 mW, 90 s), 3) diode laser (300 mW, 30 s); 4) EmunDo + diode laser (100 mW, 90 s), 5) EmunDo + diode laser (300 mW, 30 s), 6) control (no treatment). Bacterial suspensions from each group were subcultured onto the surface of MRS agar plates immediately and 24 h after treatment, and the viable microorganisms of Lactobacillus acidophilus were counted. The data were analyzed by ANOVA and student's t-test at p < 0.05. There was a significant between-group difference in the number of Lactobacillus acidophilus colonies in cell cultures obtained at 24 h after treatment (p < 0.001). The viable counts were significantly lower in EmunDo and both PDT groups, as compared to the other groups (p < 0.05). In the control and laser-irradiated groups, the number of colonies increased significantly at 24 h compared to the immediately after treatment (p < 0.05), whereas in both PDT groups, the number of colonies showed a significant reduction after 24 h of therapy (p < 0.05). Under the conditions used in this study, L. acidophilus colonies were susceptible to PDT after sensitization with EmunDo and exposure to diode laser. These findings imply that PDT is capable to reduce cariogenic bacteria, potentially leading to more conservative cavity preparation.

The effect of toothbrushing and flossing sequence on interdental plaque reduction and fluoride retention: A randomized controlled clinical trial.

BACKGROUND: Mechanical plaque control methods such as brushing and flossing are highly recommended to remove dental plaque. The aim of this study is to evaluate the efficacy of the sequence of brushing and flossing on reducing interdental plaque and increasing fluoride retention in that area. METHODS: This randomized controlled crossover trial was conducted on 25 dental students. After prophylaxis, they were asked to discontinue all forms of oral hygiene for 48 hours. The study was performed in two phases with two-week washout intervals. In one phase, they first brushed, then flossed (sequence 1: brush-floss group). In the other phase they initially used dental floss then brushed (sequence 2: floss-brush group). At each phase, dental plaque (using the Rustogi Modified Navy Plaque Index) and fluoride concentrations (using a fluoride ion specific electrode) were measured before and after flossing and brushing, and the dental plaque reduction and fluoride increase were compared between the two groups using the mixed model test. A significance level of 5% was selected. RESULTS: In the floss-brush group interdental and whole plaque was reduced significantly more than the brush-floss group (p = 0.001, p = 0.009 respectively). However, marginal plaque did not show any statistically significant difference between the two groups (p = 0.2). Fluoride concentrations in interdental plaque were significantly higher in the floss-brush group than the other group (p = 0.027). CONCLUSION: The results showed that flossing followed by brushing is preferred to brushing then flossing in order to reduce interdental plaque and increase fluoride concentration in interdental plaque.

Microhardness of composite resin cured through different primary tooth thicknesses with different light intensities and curing times: In vitro study.

OBJECTIVE: The aim of this study was to evaluate the effect of increased exposure time and light intensity on microhardness of cured composite through different thicknesses of tooth structure in primary teeth. MATERIALS AND METHODS: One hundred and seventy cylindrical resin composite specimens were prepared. All specimens were divided into 17 experimental and control groups. "Light-emitting diode" light curing unit (LCU) applied directly or through 1, 2, and 3 mm thicknesses tooth slices for experimental groups. The irradiation protocols were 25 and 50 s at 650 mW/cm(2) and 15 and 30 s at 1100 mW/cm(2). The "quartz-tungsten-halogen" LCU (400 mW/cm(2)) for 40 s was used in control group. Microhardness was measured by the Vickers hardness test. RESULTS: Indirectly cured specimens and those cured through a 1 mm thick tooth structure, an increase in intensity caused hardness drop. In the specimens cured through 2 and 3 mm thick tooth structures, increased intensity and/or exposure time did not show any appropriate changes on microhardness. CONCLUSION: Irradiation through a 1.0 mm thick tooth slice resulted in reduced microhardness although it was still within the clinically acceptable level. The hardness values of the specimens cured through 2 or 3 mm thick tooth slices fell below the clinically acceptable level even after doubling the exposure time and/or light intensity.

Clinical evaluation of fiber-reinforced composite crowns in pulp-treated primary molars: 12-month results.

OBJECTIVE: The aim of this study was to evaluate the clinical performance of tooth-colored fiber-reinforced composite (FRC) crowns in pulp-treated second primary mandibular teeth. MATERIALS AND METHODS: This split-mouth randomized, clinical trial performed on 67 children between 3 and 6 years with two primary mandibular second molars requiring pulp treatment. After pulp therapy, the teeth were randomly assigned to stainless steel crown (SSC) or FRC crown groups. Modified United States Public Health Service criteria were used to evaluate marginal integrity, marginal discoloration, and secondary caries in FRC crowns at intervals of 3, 6, and 12 months. Retention rate and gingival health were also compared between the two groups. The data were analyzed using Friedman, Cochran, and McNemar's tests at a significance level of 0.05. RESULTS: Intact marginal integrity in FRC crowns at 3, 6, and 12 months were 93.2%, 94.8%, and 94.2%, respectively. Marginal discoloration and secondary caries were not found at any of the FRC crowns. The retention rates of the FRC crowns were 100%, 98.3%, and 89.7% at 3, 6 and 12 months, respectively, whereas all the SSCs were found to be present and intact after 12 months (P = 0.016). There was no statistically significant difference between the two groups in gingival health. CONCLUSION: According to the results of this study, it seems that when esthetics is a concern, in cooperative patients with good oral hygiene, FRC crowns can be considered as a valuable procedure.

Effects of sealant, viscosity, and bonding agents on microleakage of fissure sealants: An in vitro study.

OBJECTIVE: The aim of this study was to evaluate the effects of enamel or dentin bonding agent (DBA) and sealant viscosity on sealant microleakage. MATERIALS AND METHODS: Sixty extracted human premolars were randomly divided into two equal groups (based on sealant viscosity) and each group was divided into three subgroups of 10 teeth. Group 1 (low viscosity sealant, Seal-Rite, Pulpdent, USA with 7.7% filler): Prophylaxis, enameloplasty, etching of occlusal surfaces with 38% of phosphoric acid gel, rinsing and drying, followed by (1) enamel bonding agent (EBA) (Margin Bond, Coltène/Whaledent AG) or (2) DBA (Excite, Ivoclar Vivadent AG, Liechtenstein) or (3) no bonding (NB) prior to sealant application. In Group 2, similar procedures were performed except for applying a high viscosity sealant (Seal-Rite, Pulpdent, The USA with 34.4% filler). Specimens were thermocycled and then immersed in a 0.5% basic fuchsine solution for 24 h next, buccolingual slices of samples were scored under a stereomicroscope. The Kruskal-Wallis and Mann-Whitney U-tests were used for data analysis. RESULTS: There was no significant difference between DBA, EBA, and NB subgroups in the microleakage scores in both groups. Low viscosity sealant had a lower microleakage than the high viscosity sealant in both DBA (P = 0.002) and NB (P = 0.041) subgroups. CONCLUSION: The results indicated that the use of low viscosity sealant reduced the microleakage of pit and fissure sealants. However, the use of a bonding agent before sealant placement didn't affect the microleakage.

Localized idiopathic root resorption in the primary dentition: Review of the literature and a case report.

Idiopathic root resorption (IRR) is an infrequent condition that is usually found as an accidental finding on radiography. A significant number of cases of IRR in permanent dentition have been presented but are rarely reported in primary dentition. The aim of this case report is to present a case of localized IRR in a 7-year-old boy. The patient was referred because of increased mobility of the left mandibular primary second molar. On radiographic evaluation, severe root resorption of that tooth, and mild root resorption of the right mandibular primary second molar were evident; the patient was caries-free. The left affected tooth was lost, and after placing a band and loop space maintainer, the patient was followed for 18 months. A patient with an abnormal pattern of root resorption, especially in the primary dentition, should alert the clinician to rule out the known important local and systemic factors. The exact causes of and treatments for IRR continue to be discovered.

In vitro investigation of heat transfer phenomenon in human immature teeth.

Background and aims. Heat generated within tooth during clinical dentistry can cause thermally induced damage to hard and soft components of the tooth (enamel, dentin and pulp). Geometrical characteristics of immature teeth are different from those of mature teeth. The purpose of this experimental and theoretical study was to investigate thermal changes in immature permanent teeth during the use of LED light-curing units (LCU). Materials and methods. This study was performed on the second mandibular premolars. This experimental investiga-tion was carried out for recording temperature variations of different sites of tooth and two dimensional finite element models were used for heat transfer phenomenon in immature teeth. Sensitivity analysis and local tests were included in the model validation phase. Results. Overall, thermal stimulation for 30 seconds with a low-intensity LED LCU increased the temperature from 28°C to 38°C in IIT (intact immature tooth) and PIT (cavity-prepared immature tooth). When a high-intensity LED LCU was used, tooth temperature increased from 28°C to 48°C. The results of the experimental tests and mathematical modeling illustrated that using LED LCU on immature teeth did not have any detrimental effect on the pulp temperature. Conclusion. Using LED LCU in immature teeth had no effect on pulp temperature in this study. Sensitivity analysis showed that variations of heat conductivity might affect heat transfer in immature teeth; therefore, further studies are required to determine thermal conductivity of immature teeth.

Sodium hypochlorite vs formocresol as pulpotomy medicaments in primary molars: 1-year follow-up.

PURPOSE: The study evaluated the effects of 3 percent sodium hypochlorite (NaOCl) and formocresol (FC) as pulp dressing agents in pulpotomized primary molars. METHODS: One hundred children between three and six years each with at least one primary mandibular second molar requiring pulpotomy were randomly allocated to two groups (of 50 each). All the teeth received stainless steel crown after conventional pulpotomy procedure with either NaOCI (applied for 15 second) or FC (applied for one minute). Clinical and radiographic signs/symptoms were blindly recorded at zero, six. and 12 months. The differences were statistically analyzed using the Fisher's exact test. RESULTS: At six months, 100 percent clinical success was found with both NaOCl, and FC. Radiographic success rates for NaOCl were 98 percent and 92 percent at 6- and 12-month recalls respectively. FC group showed 94 percent and 93 percent radiographic success rates at the same periods respectively. There was no statistically significant difference between the groups. CONCLUSION: NaOCl can be suggested as a pulpotomy agent for primary teeth pulpotomies. However further clinical studies with long-term follow-ups are needed to test the efficacy of NaOCl as a pulpotomy medicament in primary teeth.