In vitro physicochemical characterization of five root canal sealers and their influence on an ex vivo oral multi-species biofilm community.

AIM: To evaluate the physicochemical properties of five root canal sealers and assess their effect on an ex vivo dental plaque-derived polymicrobial community. METHODOLOGY: Dental plaque-derived microbial communities were exposed to the sealers (AH Plus [AHP], GuttaFlow Bioseal [GFB], Endoseal MTA [ESM], Bio-C sealer [BCS] and BioRoot RCS [BRR]) for 3, 6 and 18 h. The sealers' effect on the biofilm biomass and metabolic activity was quantified using crystal violet (CV) staining and MTT assay, respectively. Biofilm community composition and morphology were assessed by denaturing gradient gel electrophoresis (DGGE), 16S rRNA sequencing and scanning electron microscopy. The ISO6876:2012 specifications were followed to determine the setting time, radiopacity, flowability and solubility. Obturated acrylic teeth were used to assess the sealers' effect on pH. Surface chemical characterization was performed using SEM with coupled energy-dispersive spectroscopy. Data normality was assessed using the Shapiro-Wilk test. One-way anova and Tukey's tests were used to analyze data from setting time, radiopacity, flowability and solubility. Two-way anova and Dunnett's tests were used for the data analysis from CV, MTT and pH. 16S rRNA sequencing data were analyzed for alpha (Shannon index and Chao analysis) and beta diversity (Bray-Curtis dissimilarities). Differences in community composition were evaluated by analysis of similarity (p < .05). RESULTS: The sealers significantly influenced microbial community composition and morphology. All sealers complied with ISO6876:2012 requirements for setting time, radiopacity and flowability. Although only AHP effectively reduced the biofilm biomass, all sealers, except BRR, reduced biofilm metabolic activity. CONCLUSION: Despite adequate physical properties, none of the sealers tested prevented biofilm growth. Significant changes in community composition were observed. If observed in vivo, these changes could affect intracanal microbial survival, pathogenicity and treatment outcomes.

Optical Coherence Tomography Angiography of Asymptomatic Neovascularization in Intermediate Age-Related Macular Degeneration.

PURPOSE: To determine whether angiography with swept-source (SS) optical coherence tomography (OCT) identifies subclinical type 1 neovascularization in asymptomatic eyes with intermediate age-related macular degeneration (iAMD). DESIGN: Prospective, observational, consecutive case series. PARTICIPANTS: Patients with asymptomatic iAMD in one eye and neovascular age-related macular degeneration (AMD) in their fellow eye. METHODS: The patients underwent SS OCT angiography (OCTA), fluorescein angiography (FA), and indocyanine green angiography (ICGA), and the images from these 3 angiographic techniques were compared. MAIN OUTCOME MEASURES: Identification of subclinical type 1 neovascularization with SS OCTA in asymptomatic eyes with iAMD. RESULTS: Eleven consecutive patients with iAMD in one eye and neovascular AMD in their fellow eye were imaged with FA, ICGA, and SS OCTA between August 2014 and September 2015. Clinical examination of the 11 eyes revealed drusen and pigmentary abnormalities in the central macula and no evidence of macular fluid on routine OCT imaging. Ten of the 11 eyes had no evidence of leakage on FA and 1 eye had questionable fluorescein leakage. Indocyanine green angiography revealed the presence of central macular plaques in 3 of the 11 asymptomatic eyes with iAMD, and SS OCTA revealed unambiguous type 1 neovascularization corresponding to the plaques in all 3 eyes. Optical coherence tomography angiography did not identify neovascularization in the remaining 8 eyes. CONCLUSIONS: Swept-source OCTA identified type 1 neovascularization corresponding to ICGA plaques in asymptomatic eyes with iAMD. The ability of OCTA to provide noninvasive, fast, detailed, depth-resolved identification of nonexudative neovascular lesions in eyes with iAMD suggests the need for a new classification system that distinguishes between neovascular and nonneovascular iAMD.