Evaluation of antimicrobial activity of thiolated methylated N-(4-N,N-dimethylaminobenzyl) chitosan as a new derivative of chitosan.

Despite chitosan, a natural cationic polysaccharide derived from chitin, being applied as an antimicrobial agent, many studies are being performed for enhancing its capability to fight against pathogens. The aim of this study was to investigate the antibacterial effect of thiolated methylated N-(4-N,N-dimethylaminobenzyl) chitosan (TTMAC) polymer and its nanoparticles as a novel derivation of chitosan. The polymer derivative was synthetized and characterized via 1 H NMR, Fourier transform infrared and the Elman test. The nanoparticles with different N/P ratios were prepared by the ionic gelation method and were characterized by dynamic light scattering and transmission electron microscopy. The cellular toxicity of polymer and nanoparticles at different concentrations were evaluated on human MCF-7 cell line. Antimicrobial assay was performed on Escherichia coli (ATCC 25922), Staphylococcus aureus (ATCC 25923) and Candida albicans (ATCC 10231) as Gram-negative, Gram-positive and yeast pathogens, respectively. The obtained results have shown the TTMAC polymer has a higher inhibition activity against microbial pathogens and also lower cellular toxicity in comparison with chitosan polymer. Furthermore, chitosan nanoparticles in comparison with TTMAC nanoparticles have lower size and highest zeta potential in different ratio and chitosan nanoparticles have more inhibitory effects against microbial pathogens. In conclusion, TTMAC derivative in polymeric form can be a promising tool against microbial pathogens.

Age-stratified transmission model of COVID-19 in Ontario with human mobility during pandemic's first wave.

In this work, we employ a data-fitted compartmental model to visualize the progression and behavioral response to COVID-19 that match provincial case data in Ontario, Canada from February to June of 2020. This is a "rear-view mirror" glance at how this region has responded to the 1st wave of the pandemic, when testing was sparse and NPI measures were the only remedy to stave off the pandemic. We use an SEIR-type model with age-stratified subpopulations and their corresponding contact rates and asymptomatic rates in order to incorporate heterogeneity in our population and to calibrate the time-dependent reduction of Ontario-specific contact rates to reflect intervention measures in the province throughout lockdown and various stages of social-distancing measures. Cellphone mobility data taken from Google, combining several mobility categories, allows us to investigate the effects of mobility reduction and other NPI measures on the evolution of the pandemic. Of interest here is our quantification of the effectiveness of Ontario's response to COVID-19 before and after provincial measures and our conclusion that the sharp decrease in mobility has had a pronounced effect in the first few weeks of the lockdown, while its effect is harder to infer once other NPI measures took hold.

Could high DNA stainability (HDS) be a valuable indicator of sperm nuclear integrity?

BACKGROUND: The Sperm Chromatin Structure Assay (SCSA®), in addition to identifying the DNA Fragmentation Index (DFI) also identifies High DNA satiability (HDS), supposed to reflect the nuclear compaction of spermatozoa. However, data on what exactly this parameter reveals, its relevance and usefulness are contradictory. In order to shed light on this situation, spermatozoa of a cohort (N = 397) of infertile men were subjected to the SCSA®, TUNEL (terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate-biotin nick end labeling) and CMA3 (Chromomycin A3) tests. In a smaller subcohort (N = 100), aniline blue (AB) and toluidine blue (TB) staining were performed in addition. The objective of this study was thus to answer the question of whether HDS is a relevant and reliable parameter to be taken into account? RESULTS: HDS does not appear to be a reliable indicator of nuclear immaturity because it shows a weak correlation with the CMA3, AB and TB stains. The low correlation of HDS with sperm DNA fragmentation (TUNEL and SCSA®) and DNA condensation (CMA3, AB and TB) tests suggests that these two parameters could be decoupled. Unlike DFI and TUNEL, HDS has not been shown to correlate with classic clinical situations of male infertility (asthenozoospermia, teratozoospermia or astheno-teratozoospermia). CONCLUSION: HDS correlates poorly with most tests that focus specifically on the level of maturity of the sperm nucleus. To our knowledge, this study is the first to compare SCSA®, TUNEL, AB, TB and CMA3 assays on identical samples. It shows the potency, consistency and limitations of each test and the care that must be taken in their interpretation.

CONTEXTE: Le test SCSA® (Sperm Chromatin Structure Assay), en plus d'identifier l'indice de fragmentation de l'ADN (DFI = DNA fragmentation Index), identifie également la susceptibilté à la coloration à l'acridine orange de l'ADN (HDS: High DNA Stainability), censée refléter la compaction nucléaire des spermatozoïdes. Cependant, les données sur ce que révèle exactement ce paramètre, sa pertinence et son utilité sont contradictoires. Afin de faire la lumière sur cette situation, les spermatozoïdes d'une cohorte (N = 397) d'hommes stériles ont été soumis aux tests SCSA®, TUNEL et CMA3. Dans une sous-cohorte plus petite (N = 100), la coloration au bleu d'aniline (AB) et au bleu de toluidine (TB) a été effectuée en plus. L'objectif de cette étude était donc de répondre à la question de savoir si le HDS est. un paramètre pertinent et fiable à prendre en compte? RÉSULTATS: Le HDS ne semble pas être un indicateur fiable de l'intégrité nucléaire car il montre une faible corrélation avec les tests CMA3, AB et TB. La faible corrélation du HDS avec les tests de fragmentation de l'ADN du sperme (TUNEL et SCSA®) et de condensation de l'ADN (CMA3, AB et TB) suggère que ces deux paramètres pourraient être découplés. Contrairement au DFI et au TUNEL, il n'a pas été démontré que le HDS est. corrélé avec les situations cliniques classiques de l'infertilité masculine (asthénozoospermie, tératozoospermie ou asthéno-tératozoospermie). CONCLUSION: Le HDS présente une faible corrélation avec la plupart des tests qui se concentrent spécifiquement sur le niveau de maturité du noyau du sperme. À notre connaissance, cette étude est. la première à comparer les tests SCSA®, TUNEL, AB, TB et CMA3 sur des échantillons identiques. Elle montre la puissance, la cohérence et les limites de chaque test et le soin qui doit être apporté à leur interprétation.

Effects of short-term feeding of different sources of fatty acids in pre-mating diets on reproductive performance and blood metabolites of fat-tailed Iranian Afshari ewes.

The effects of dietary omega-3 and omega-6 fatty acids (FAs) in pre-mating diets on reproductive performances and metabolic status of ewes have not been well investigated. Therefore, this study investigated the effect of supplementing different source of FAs on different aspects of reproductive performance of fat-tailed Iranian Afshari ewes. Thirty-two cycling, multiparous Afshari ewes were divided into four groups and fed one of the isocaloric and isonitrogenous diets supplemented with Sunflower oil (SFO), Fish oil (FO), calcium salt of palm oil (CaPO) and/or an equal mixture of SFO + FO (SFOFO). One day after the start of the flushing, the estrous cycles of all ewes were synchronized using 12-day CIDRs. After detecting signs of estrous, all ewes were mated with rams for 2 days. The examination of ovarian follicles was done by a transrectal ultrasonography. After counting all visible follicles, they were classified into 3 classes based on their diameters: small (≤3 mm), medium (3-4 mm) and large (≥4 mm). The results showed that fat sources had no impact on dry matter intake (DMI) and body condition score (BCS) of animals (P > 0.05). Plasma glucose, total cholesterol, and albumin concentrations also were not significantly affected by supplemental fat sources (P > 0.05). Plasma insulin levels were higher at the end of the flushing (on the day of CIDR removal) and the day of mating for ewes on CaPO diet (P < 0.05). Plasma estradiol-17ß concentration was greater on the day of mating for ewes fed FO (P < 0.05). Progesterone levels in pregnant ewes fed FO were higher 30 d after mating (11.02 ng/mL; P < 0.05). Dietary treatments had no significant effect on number of small, medium and total follicles as well as the average size of small and medium follicles at the end of the flushing and the day of mating. The number of medium follicles on the day of oestrus (mating) were significantly higher for the ewes fed FO or SFO diets (P < 0.05). Likewise, the mean number and size of large follicles at the end of flushing and the day of oestrus were higher in ewes on FO diet (P < 0.05). Lambing rate and twinning rate increased (P < 0.05) in ewes fed FO or SFO, respectively. In conclusion, supplementation of n-3 PUFA rich FA especially FO in pre-mating diets showed beneficial effects on some indices of reproductive performance of Afshari ewes including lambing and twining rate due to higher number of medium sized follicles and size of the ovulatory (large) follicles at the day of oestrus and increased plasma progesterone levels in pregnant ewes.

Using intron splicing trick for preferential gene expression in transduced cells: an approach for suicide gene therapy.

Suicide gene therapy is one of the most innovative approaches in which a potential toxic gene is delivered to the targeted cancer cell by different target delivery methods. We constructed a transfer vector to express green fluorescent protein (GFP) in transduced cells but not in packaging cells. We placed gfp under the control of the cytomegalovirus (CMV) promoter, which is positioned between the two long-terminal repeats in reverse direction. The intron-2 sequence of the human beta globin gene with two poly-A signals and several stop codons on the antisense strand was placed on the leading strand between the CMV promoter and gfp. For lentiviral production, the HEK293T and line were co-transfected with the PMD2G, psPAX2 and pLentiGFP-Ins2 plasmids. The HEK293T and line were transduced with this virus. PCR was performed for evaluation of intron splicing in transduced cells. The GFP expression was seen in 65% of the cells transduced. The PCR amplification of the genomic DNA of transduced cells confirmed the splicing of intron 2. The strategy is significant to accomplish our goal for preserving the packaging cells from the toxic gene expression during viral assembly and the resultant reduction in viral titration. Also it serves to address several other issues in the gene therapy.

Determining the minimum inhibitory concentration of Tetraclean against Candida albicans.

The purpose of the present study was to determine the minimum inhibitory concentrations of Tetraclean, chlorhexidine, hydrogen peroxide, and sodium hypochlorite against Candida albicans.Amphotericin B was used as positive control and RPMI plus 1 ml Candida suspension was used as negative control. Serial dilution method was used to determine MIC of the irrigants. Findings showed that all positive controls demonstrated complete inhibition of C. albicans at concentration of 0.78 microg mL(-1). On the other hand, all negative controls were positive for fungal growth which confirms the methodology of the study. Findings showed that the MIC of CHX was significantly lesser than other tested irrigants (p < 0.05). The MICs of other groups in an ascending order were as follows: Tetraclean, NaOCl, and H2O2. However, the difference betweenTetraclean and NaOCI was not significant (p > 0.05). It can be concluded that MIC of CHX was significantly lower than other irrigations solutions which confirms its strong antifungal activity.

The incidence of cleft lip and palate in a Kurd population: a prospective study.

AIM: To assess the incidence of cleft lip and palate and factors associated with them in the hospital births of Iran's Kurdistan province in 2010. METHODS: Researcher-completed questionnaires captured data on gender, mother's age during pregnancy, parents' occupation, father's birthplace, family background, consanguinity, systemic diseases, mother's disease during pregnancy, drugs abuse, smoking, alcohol drinking, radiography and mother's radiotherapy during pregnancy. RESULTS: Of 26,537 newborns, 29 (19 male and 10 females) were affected by various types of cleft lip and palate. Of newborns with cleft lip and palate: 38% had other abnormalities, consanguinity was reported in about 31% of cases and 28% of mothers used prescribed drugs during pregnancy while no mothers used cigarettes or alcohol. There was no report of radiotherapy or radiography. CONCLUSIONS: The incidence rate of oral clefts was 1.09 in the 1,000 live births.

Rip3 knockdown rescues photoreceptor cell death in blind pde6c zebrafish.

Achromatopsia is a progressive autosomal recessive retinal disease characterized by early loss of cone photoreceptors and later rod photoreceptor loss. In most cases, mutations have been identified in CNGA3, CNGB3, GNAT2, PDE6C or PDE6H genes. Owing to this genetic heterogeneity, mutation-independent therapeutic schemes aimed at preventing cone cell death are very attractive treatment strategies. In pde6c(w59) mutant zebrafish, cone photoreceptors expressed high levels of receptor-interacting protein kinase 1 (RIP1) and receptor-interacting protein kinase 3 (RIP3) kinases, key regulators of necroptotic cell death. In contrast, rod photoreceptor cells were alternatively immunopositive for caspase-3 indicating activation of caspase-dependent apoptosis in these cells. Morpholino gene knockdown of rip3 in pde6c(w59) embryos rescued the dying cone photoreceptors by inhibiting the formation of reactive oxygen species and by inhibiting second-order neuron remodelling in the inner retina. In rip3 morphant larvae, visual function was restored in the cones by upregulation of the rod phosphodiesterase genes (pde6a and pde6b), compensating for the lack of cone pde6c suggesting that cones are able to adapt to their local environment. Furthermore, we demonstrated through pharmacological inhibition of RIP1 and RIP3 activity that cone cell death was also delayed. Collectively, these results demonstrate that the underlying mechanism of cone cell death in the pde6c(w59) mutant retina is through necroptosis, whereas rod photoreceptor bystander death occurs through a caspase-dependent mechanism. This suggests that targeting the RIP kinase signalling pathway could be an effective therapeutic intervention in retinal degeneration patients. As bystander cell death is an important feature of many retinal diseases, combinatorial approaches targeting different cell death pathways may evolve as an important general principle in treatment.

Dislocation of the zygomatic bone into the nasal cavity.

A 25-year-old patient sustained a traumatric dislocation of the right zygomatic bone into the nasal cavity. After ten days the bone was taken out of the nose and fixed in its presumed original place. After the operation, the facial contour was desirable and orbital functions were also normal.

The effect of ascorbic Acid on the substantivity of tetraclean in sodium hypochlorite-treated bovine dentin.

OBJECTIVE: The purpose of this study was to assess the in vitro effect of ascorbic acid on the antibacterial substantivity of Tetraclean in bovine root dentin pretreated with sodium hypochlorite (NaOCl). MATERIALS AND METHODS: Eighty dentin tubes prepared from bovine incisor teeth were infected with Enterococcus faecalis for 14 days. The specimens were divided into five groups as follows: Tetraclean; 5.25% NaOCl/Tetraclean; 5.25% NaOCl/ascorbic acid/Tetraclean; infected dentin tubes (positive control); and sterile dentin tubes (negative control). At experimental times of 0, 7, 14, 21 and 28 days, dentin chips were removed from the canals by sequential sterile low-speed round burs with increasing diameters of 025, 027, 029, 031 and 033 ISO sizes, respectively. After culturing, the number of colony-forming units (CFU) was counted. RESULTS: In all experimental groups, the number of CFU was minimum in the first cultures and the results obtained were significantly different at any time period (p < 0.05). The Tetraclean group showed the most effective antibacterial action at all five experimental periods (p < 0.05). NaOCl/Tetraclean group showed the least antibacterial activity at all time periods. The NaOCl/ascorbic acid/Tetraclean group showed similar antibacterial substantivity to the Tetraclean group at all time periods (p> 0.05). CONCLUSION: Ascorbic acid prevents the decrease of residual antibacterial activity of Tetraclean in dentin samples pretreated with NaOCl.

Comparison of the surface tension of 5.25% sodium hypochlorite solution with three new sodium hypochlorite-based endodontic irrigants.

AIM: To investigate the surface tension characteristics of 5.25% sodium hypochlorite and three recently introduced sodium hypochlorite solutions, which had been modified to reduce their surface tension: Chlor-Xtra, Hypoclean A and Hypoclean B. METHODOLOGY: Freshly produced MilliQ water was used as a reference liquid. All measurements of surface tension were taken by the Wilhelmy plate technique, using a Cahn DCA-322 Dynamic Contact Angle Analyzer at the temperature of 22 °C. A glow-discharge cleaned glass slide was immersed in 5 mL of the test liquid in a beaker cleaned with hot chromic acid, rinsed with MilliQ water and finally air plasma-cleaned in a glow-discharge reactor. The force on the glass slide was recorded continuously by the instrument software as the beaker was raised and withdrawn at the constant speed of 40 micron/s, until at least 1 cm of the glass slide was immersed. The typical accuracy was 0.5 mJ m(-2). For each sample, fifteen measurements were taken, and mean values were calculated. A Kruskal-Wallis anova analysis, followed by Mann-Whitney's U rank sum test for pair-wise comparisons, was used to compare surface tension values. Statistical significance was set at α = 0.05. RESULTS: MilliQ water (72.13 mJ m(-2)) and 5.25% sodium hypochlorite (48.90 mJ m(-2) ) had the highest surface tension values (P < 0.01) compared to Chlor-Xtra (33.14 mJ m(-2)), Hypoclean B (30.00 mJ m(-2) ) and Hypoclean A (29.13 mJ m(-2)). Hypoclean A had the lowest surface tension (P < 0.01). CONCLUSIONS: The new 5.25% sodium hypochlorite solutions modified with surfactants, Hypoclean A and Hypoclean B, had surface tension values that were significantly lower (P < 0.01) than Chlor-Xtra and 5.25% NaOCl. Because of their low surface tension and increased contact with dentinal walls, these new irrigants have the potential to penetrate more readily into uninstrumented areas of root canal system as well as allow a more rapid exchange with fresh solution, enabling greater antimicrobial effectiveness and enhanced pulp tissue dissolution ability.

Antimicrobial activity of calcium hydroxide in endodontics: a review.

The purpose of endodontic therapy is to preserve the patient's natural teeth without compromising the patient's local or systemic health. Calcium hydroxide has been included in several materials and antimicrobial formulations that are used in several treatment modalities in endodontics, such as inter-appointment intracanal medicaments. The purpose of this article was to review the antimicrobial properties of calcium hydroxide in endodontics. Calcium hydroxide has a high pH (approximately 12.5-12.8) and is classified chemically as a strong base. The lethal effects of calcium hydroxide on bacterial cells are probably due to protein denaturation and damage to DNA and cytoplasmic membranes. Calcium hydroxide has a wide range of antimicrobial activity against common endodontic pathogens but is less effective against Enterococcus faecalis and Candida albicans. Calcium hydroxide is also a valuable anti-endotoxin agent. However, its effect on microbial biofilms is controversial.

Substantivity of three concentrations of tetraclean in bovine root dentin.

In the present study, the residual antibacterial activity, or substantivity, of three concentrations of Tetraclean (Ogna Laboratori Farmaceutici, Muggiò, Italy) was assessed in bovine root dentin in vitro. One hundred ten dentin tubes prepared from bovine incisor teeth were infected in vitro for 14 days with Enterococcus faecalis. Thereafter, the specimens were divided into five groups as follows: 100% Tetraclean, 10% Tetraclean, 1% Tetraclean, sterile dentin tubes (negative control), and infected dentin tubes (positive control). Dentin chips were collected with round burs into tryptic soy broth and, after culturing, the number of colony-forming units (CFU) was counted. The number of CFU was minimal in the first cultures in all experimental groups, and the results obtained were significantly different in the different groups at all time periods (p<0.05). At all five experimental periods, the 100% Tetraclean group showed the most effective antibacterial action (p<0.05). In each group, the number of CFU increased significantly with time (p<0.05). There was a direct relationship between the concentration of Tetraclean and its substantivity. In conclusion, under the conditions of the study presented here, the substantivity of 100% Tetraclean was significantly higher than that of lower concentrations.

In vivo transfection study of chitosan-DNA-FAP-B nanoparticles as a new non viral vector for gene delivery to the lung.

Gene therapy targeted at the respiratory epithelium holds therapeutic potential for diseases such as cystic fibrosis and lung cancer. We recently reported that Chitosan-DNA-FAP-B nanoparticles are good candidates for targeted gene delivery to fibronectin molecules (FAP-B receptors) of lung epithelial cell membrane. In this study Chitosan-DNA-FAP-B nanoparticles were nebulized to mice using air jet nebulizer. The effect of nebulization on size, zeta potential and DNA binding ability of nanoparticles were studied. The level of gene expression in the mice lungs was evaluated. Nebulization did not affect the physicochemical properties of nanoparticles. Aerosol delivery of Chitosan-DNA-FAP-B nanoparticles resulted in 16-fold increase of gene expression in the mice lungs compared with Chitosan-DNA nanoparticles. This study suggested that Chitosan-FAP-B nanoparticle can be a promising carrier for targeted gene delivery to the lung.

Properties and applications of calcium hydroxide in endodontics and dental traumatology.

Calcium hydroxide has been included within several materials and antimicrobial formulations that are used in a number of treatment modalities in endodontics. These include, inter-appointment intracanal medicaments, pulp-capping agents and root canal sealers. Calcium hydroxide formulations are also used during treatment of root perforations, root fractures and root resorption and have a role in dental traumatology, for example, following tooth avulsion and luxation injuries. The purpose of this paper is to review the properties and clinical applications of calcium hydroxide in endodontics and dental traumatology including its antibacterial activity, antifungal activity, effect on bacterial biofilms, the synergism between calcium hydroxide and other agents, its effects on the properties of dentine, the diffusion of hydroxyl ions through dentine and its toxicity. Pure calcium hydroxide paste has a high pH (approximately 12.5-12.8) and is classified chemically as a strong base. Its main actions are achieved through the ionic dissociation of Ca(2+) and OH(-) ions and their effect on vital tissues, the induction of hard-tissue deposition and the antibacterial properties. The lethal effects of calcium hydroxide on bacterial cells are probably due to protein denaturation and damage to DNA and cytoplasmic membranes. It has a wide range of antimicrobial activity against common endodontic pathogens but is less effective against Enterococcus faecalis and Candida albicans. Calcium hydroxide is also an effective anti-endotoxin agent. However, its effect on microbial biofilms is controversial.

Laser application in tooth bleaching: an update review.

Since the development of laser, a variety of potential applications for lasers in endodontics such as pulp diagnosis, disinfection of the root canal system, canal shaping, obturation of the root canal, apicoectomy, treatment of dentin hypersensitivity, and tooth bleaching have been proposed. The aim of this paper was to review the benefits and drawbacks of laser tooth bleaching.

Preparation and evaluation of chitosan-DNA-FAP-B nanoparticles as a novel non-viral vector for gene delivery to the lung epithelial cells.

Gene delivery using cationic polymers such as chitosan shows good biocompatibility, but reveals low transfection efficiency. Fibronectin Attachment Protein of Mycobacterium bovis (FAP-B) which is responsible for the attachment of many Mycobacteria on the Fibronectin molecule of epithelial cell membrane can be considered as a new targeting ligand and can improve transfection rates in epithelial cells. In this study, chitosan-DNA nanoparticles were prepared using coacervation process. The effect of stirring speed and charge ratio (N/P) on the size and zeta potential of nanoparticles were evaluated. FAP-B ligand was added to nanoparticles at the specific condition to form chitosan-DNA-FAP-B nanoparticles via electrostatic attraction. Transfection efficiency of the final nanoparticles was investigated in A549 (alveolar epithelial cells). Cell viability was investigated using MTT assay. The optimum speed of stirring which was yielded the smallest chitosan-DNA nanoparticles with a narrow distribution (227±43 nm), was 500 rpm with the corresponding N/P ratio of 20. Chitosan-DNA-FAP-B nanoparticles presented the size of 279±27 nm with transfection efficiency about 10-fold higher than chitosan-DNA nanoparticles and resulted in 97.3% cell viability compared to 71.7% using Turbofect controls. Chitosan-DNA-FAP-B nanoparticles showed good transfection efficiency without cell toxicity. They have small particle size around 279 nm which make them a promising candidate as a novel non-viral gene vector for gene delivery to lung epithelial cells.

Association of pulp stones with coronary artery stenosis.

BACKGROUND: Dental pulp stones are discrete calcifications in the pulp chamber which are often seen in deciduous and permanent teeth. It has been hypothesised that atherosclerosis can be associated with their development. OBJECTIVE: To determine whether a higher prevalence of dental pulp stones is correlated with coronary artery stenosis. CLINICAL SETTING: Sixty-one patients aged 20-55 years referred to Afshar Heart Center for invasive coronary angiography were invited to undergo panoramic dental radiography. The panoramic radiographs were independently examined for the presence of pulp stones. RESULTS: Pulp stones were present in 82% (31/38) of patients with at least one clinically significant coronary artery stenosis and in 48% (11/23) of patients with normal coronary angiography. They were present in 13% of the teeth in the former group and in 5% of the teeth in the latter. The findings show a statistically significant association between coronary artery stenosis and presence of pulp stones (odds ratio 4.83, 95% confidence interval 1.5-15.4). CONCLUSION: Coronary artery stenosis and dental pulp calcification are significantly associated. Dental radiography has the potential to be used as a rapid screening method for the early detection of coronary artery stenosis.

On the local applications of antibiotics and antibiotic-based agents in endodontics and dental traumatology.

Antibiotics are a valuable adjunctive to the armamentarium available to health professionals for the management of bacterial infections. During endodontic treatment and when managing trauma to the teeth, antibiotics may be applied systemically (orally and/or parenterally) or locally (i.e. intra-dentally via irrigants and medicaments). Due to the potential risk of adverse effects following systemic application, and the ineffectiveness of systemic antibiotics in necrotic pulpless teeth and the periradicular tissues, the local application of antibiotics may be a more effective mode for delivery in endodontics. The aim of this article was to review the history, rationale and applications of antibiotic-containing irrigants and medicaments in endodontics and dental traumatology. The search was performed from 1981 to 2008 and was limited to English-language papers. The keywords searched on Medline were 'Antibiotics AND endodontics', 'Antibiotics AND root canal irrigation', 'Antibiotics AND intra-canal medicament', 'Antibiotics AND Dental trauma' and 'Antibiotics AND root resorption'. The reference section of each article was manually searched to find other suitable sources of information. It seems that local routes of antibiotic administration are a more effective mode than systemic applications. Various antibiotics have been tested in numerous studies and each has some advantages. Tetracyclines are a group of bacteriostatic antibiotics with antibacterial substantivity for up to 12 weeks. They are typically used in conjunction with corticosteroids and these combinations have anti-inflammatory, anti-bacterial and anti-resorptive properties, all of which help to reduce the periapical inflammatory reaction including clastic-cell mediated resorption. Tetracyclines have also been used as part of irrigating solutions but the substantivity is only for 4 weeks. Clindamycin and a combination of three antibiotics (metronidazole, ciprofloxacin and minocycline) have also been reported to be effective at reducing bacterial numbers in the root canal systems of infected teeth.

The properties and applications of chlorhexidine in endodontics.

Microorganisms and their by-products are considered to be the major cause of pulp and periradicular pathosis. Hence, a major objective in root canal treatment is to disinfect the entire root canal system, which requires that all contents of the root canal system be eliminated as possible sources of infection. This goal may be accomplished using mechanical instrumentation and chemical irrigation, in conjunction with medication of the root canal system between treatment sessions. To reduce or eliminate bacteria, various irrigation solutions have been advocated. Chlorhexidine is a cationic molecule, which can be used during treatment. It has a wide range of antimicrobial activity. Its cationic structure provides a unique property named substantivity. The purpose of this paper is to review the structure and mechanism of action of CHX, its antibacterial and antifungal activity, its effect on biofilm, its substantivity (residual antibacterial activity), its tissue solvent ability, its interaction with calcium hydroxide and sodium hypochlorite, its anticollagenolytic activity, its effect on coronal and apical leakage of bacteria, its toxicity and allergenicity and the modulating effect of dentine and root canal components on its antimicrobial activity. A Medline search was performed from 1981 to the end of March 2008 and was limited to English-language papers. The keywords searched on Medline were 'chlorhexidine AND endodontics', 'chlorhexidine AND root canal therapy', 'chlorhexidine AND substantivity' and 'chlorhexidine AND toxicity'. The reference lists of each article were manually checked for additional articles of relevance.