ABSTRACT
The internal topography of the root canal is complex, especially for the permanent molar's mesial root. In response to such issues, improved irrigation techniques have been created, which use laser pulses to agitate fluids and improve microbial deposit removal. Objective: To assess the effectiveness of the Er,Cr:YSGG laser with a wavelength of 2,780 nm via photon-induced photoacoustic streaming (PIPS) protocol which agitated of 2% chlorohexidine (CHX) in removing mature Enterococcus faecalis (E. faecalis) biofilm in root canal systems of lower molars. Material and Methods: The mesial roots of lower first and second molars were separated and inoculated with E. faecalis bacterial suspension for 30 days. The roots were irrigated with CHX, some of them were agitated with a passive ultrasonic device (PUI), while the other roots were agitated by an Er,Cr:YSGG laser in PIPS at 60 µs/pulse, 5 Hz, (0.25, 0.5, 0.75, and 1) W. An atomic force microscope (AFM) was used as a new method to get the results in the isthmus area; the obtained results from each group were compared with each other. Results: Based on the AFM and SEM analyses, laser and ultrasonic activation groups showed higher antimicrobial efficacy than the conventional syringe irrigation group (P<0.05). Conclusion: Based on the investigation's findings, the activation of 2% CHX solution by Er,Cr:YSGG laser in PIPS and PUI offers better mature bacterial biofilm removal in the mesial root of lower human molars than the same irrigant with the SI technique (AU)
A topografia interna do canal radicular é complexa, especialmente para a raiz mesial do molar permanente. Em resposta a esses problemas, foram criadas técnicas aprimoradas de irrigação, que utilizam pulsos de laser para agitar fluidos e melhorar a remoção de depósitos microbianos. Objetivo: Avaliar a eficácia do laser Er,Cr:YSGG com comprimento de onda de 2.780 nm via protocolo de streaming fotoacústico induzido por fótons (PIPS) que agitou clorohexidina a 2% (CHX) na remoção de Enterococcus faecalis maduro (E. faecalis) biofilme em sistemas de canais radiculares de molares inferiores. Material e Métodos: As raízes mesiais de 28 primeiros e segundos molares inferiores foram separadas e inoculadas com suspensão bacteriana de E. faecalis por 30 dias. As raízes foram irrigadas com CHX, sendo algumas delas agitadas com aparelho ultrassônico passivo (PUI), enquanto as demais raízes foram agitadas com laser Er,Cr:YSGG em PIPS a 60 µs/pulso, 5 Hz (0,25, 0,5, 0,75 e 1) W. Um microscópio de força atômica (AFM) foi utilizado como um novo método para obter os resultados na área do istmo; os resultados obtidos de cada grupo foram comparados entre si. Resultados: Com base nas análises de AFM e SEM, os grupos de ativação por laser e ultrassom apresentaram maior eficácia antimicrobiana do que o grupo de irrigação com seringa convencional (P<0.05). Conclusão: Com base nos achados da investigação, a ativação da solução de CHX a 2% pelo laser Er,Cr:YSGG em PIPS a (60 µs/pulso, 5 Hz, 0,75 W) oferece melhor remoção de biofilme (AU)
Subject(s)
Enterococcus faecalis , Dental PlaqueABSTRACT
To evaluate whether the WaveOne Gold and Reciproc single file instrumentation systems, are effective in reducing the microbial load of a mixed biofilm and the cleaning of apical third compared to the Twisted File Adaptive system (multiple- file system). Seventy mesial roots of the first and second molars were included and randomly divided into three experimental groups (n=20, n=10 controls). Biofilms were formed inside canals over 31 days. After instrumentation with the unique file systems, WaveOne Gold and Reciproc and the multiple file system Twisted File Adaptive, using 2.25% sodium hypochlorite as an irrigant in all cases, a count of colony forming units was performed using serial dilutions, cleaning of the apical third was evaluated using scanning electron microscopy. Comparisons amongst groups were made by using parametric and non-parametric statistics, according to a normal or non-normal data distribution, respectively. No significant differences in the reduction of the microbial load after employing a single-file system in comparison to the multiple-file system were found; in addition, the cleaning of the apical third was similar for the three different instrumentation systems. The single-file system is equal in effectiveness compared with the multiple-file system in reducing the microbial load.
Evaluar si los sistemas de instrumentación de lima única, como WaveOne Gold y Reciproc son efectivos para reducir la carga microbiana de un biofilm mixto y la limpieza del tercio apical, comparado con los sistemas de limas múltiples, como Twisted File Adaptive. Setenta raíces mesiales de primeros y segundos molares fueron incluidos y divididos de forma aleatoria en tres grupos experimentales (n=20, n=10 controles). El biofilm fue formado en el interior de los conductos durante 31 días. Después se instrumentó con los sistemas de lima única (WaveOne Gold y Reciproc) y el sistema de limas múltiples Twisted File Adaptive, usando hipoclorito de sodio al 2.5% en todos los casos. El conteo de unidades formadoras de colonias se realizó usando diluciones seriales, la limpieza del tercio apical se evaluó empleando el microscopio electrónico de barrido. La comparación entre grupos se realizó con pruebas paramétricas y no paramétricas, de acuerdo con la distribución normal y no normal de los datos, respectivamente. No hubo una diferencia significativa en la reducción de la carga microbiana después de emplear los sistemas de lima única en comparación a los de limas múltiples, además, la limpieza del tercio apical fue similar en los 3 diferentes sistemas de instrumentación. Los sistemas de lima única son igual de efectivos para reducir la carga microbiana comparados con los sistemas de limas múltiples.
ABSTRACT
Introduction: Intracanal medication with antibiotics is used to ensure the success of treatments. However, no studies evaluating the efficacy of triantibiotic paste after several hours of preparation have been reported. Objective: To evaluate the antimicrobial activity of the triantibiotic paste against Enterococcus faecalis, according to the time of application and storage of the components used for its preparation. Methods: An experimental in vitro study was carried out in the microbiology laboratory of Universidad Nacional Mayor de San Marcos. The sample consisted of three colonies of Enterococcus faecalis, formed in bile-esculin agar. On three specific days (0, 14 and 28), the antimicrobial activity of the conventional (ciprofloxacin/metronidazole/minocycline) and modified (cefaclor/metronidazole/minocycline) paste was evaluated, measuring (mm) the inhibition zones. The freshly obtained components were used to prepare the paste on day 0, and the stored components (powdered antibiotics kept in amber glass bottles at room temperature) were used on days 14 and 28. Two interventions were performed on each specific day (morning and afternoon). Freshly prepared pastes were used in the morning (immediate application), while pastes stored for 6 hours (delayed application) were used in the afternoon. Results: On day 0, it was found that the modified triantibiotic paste of immediate application had higher antimicrobial activity than the one of delayed application (p = 0.046). On day 28, the conventional triantibiotic paste for immediate application showed higher antimicrobial activity than that for delayed application (p = 0.049). Pasta prepared with fresh components (day 0) had higher antimicrobial activity than pasta prepared with components stored for 14 and 28 days. Conclusions: The application time of the triantibiotic paste and the storage times of the components could influence the antimicrobial activity for the eradication of Enterococcus faecalis.
Introducción: La medicación intracanal con antibióticos se utiliza para asegurar el éxito de los tratamientos. Sin embargo, no se han reportado estudios que evalúen la eficacia de la pasta triantibiótica después de varias horas de preparación. Objetivo: Evaluar la actividad antimicrobiana de la pasta triantibiótica frente al Enterococcus faecalis, según el tiempo de aplicación y de almacenamiento de los componentes utilizados para su preparación. Métodos: Estudio experimental in vitro, realizado en el laboratorio de microbiología de la Universidad Nacional Mayor de San Marcos. La muestra consistió en tres colonias de Enterococcus faecalis, formadas en agar bilis-esculina. En tres días específicos (0, 14 y 28) se evaluó la actividad antimicrobiana de la pasta convencional (ciprofloxacina/metronidazol/minociclina) y modificada (cefaclor/metronidazol/minociclina), midiendo las zonas de inhibición (mm). Los componentes recién obtenidos se utilizaron para preparar la pasta el día 0, y los componentes almacenados (antibióticos pulverizados conservados en frascos de vidrio color ámbar a temperatura ambiente) se utilizaron los días 14 y 28. Se realizaron dos intervenciones en cada día específico (mañana y tarde). Las pastas recién preparadas se utilizaron por la mañana (aplicación inmediata), mientras que por la tarde se utilizaron las pastas almacenadas durante 6 horas (aplicación tardía). Resultados: El día 0, se encontró que la pasta triantibiótica modificada de aplicación inmediata presentó una actividad antimicrobiana superior a la de aplicación tardía (p = 0,046). El día 28, la pasta triantibiótica convencional de aplicación inmediata presentó una actividad antimicrobiana superior a la de aplicación tardía (p = 0,049). La pasta preparada con componentes recién obtenidos (día 0) tuvo una mayor actividad antimicrobiana que la pasta preparada con componentes almacenados durante 14 y 28 días. Conclusiones: El tiempo de aplicación de la pasta triantibiótica y los tiempos de almacenamiento de los componentes podrían influir en la actividad antimicrobiana para la erradicación de Enterococcus faecalis.
ABSTRACT
Endodontic treatment consists of decontamination of the root canal using irrigants like Sodium Hypochlorite (NaOCl). However, some microorganisms resist conventional therapies, causing relapse and secondary infections. Substances with microbicidal power and potential to become new irrigants need to be studied. Thus, the objective of the present study was to evaluate the antimicrobial potential of Psidium guajava L. (guava tree) extract against clinical and standard (ATCC) strains of Enterococcus faecalis and Candida albicans. For this purpose, the extract was produced from the raw material (leaves and shoots) diluted in the hydroethanolic vehicle (EtOH: H2O / 50:50) for subsequent microbiological analysis. The Minimum Inhibitory Concentration (MIC) and Minimum Microbicidal Concentration (MMC) of the plant extract were tested, according to the Clinical and laboratory standards institute (CLSI) guidelines, on four strains: E. faecalis (ATCC and clinic) and C. albicans (ATCC and clinic). The extract of P. guajava did not produce antifungal action on C. albicans, however, it showed microbicidal potential against strains of E. faecalis, showing MIC of 0.20%. This concentration was lower than the MIC of NaOCl which was 0.31%, a solution that is commonly used in dental clinics. In conclusion, the hydroethanolic extract of P. guajava presents bactericidal action against E. faecalis, being a natural product with potential for future studies regarding the development of new endodontic irrigants.
O tratamento endodôntico consiste na descontaminação do canal radicular com emprego de soluções irrigadoras, como por exemplo, o Hipoclorito de Sódio (NaOCl). Contudo, alguns microrganismos resistem as terapias convencionais, causando recidiva e infecções secundárias. Substâncias com poder microbicida e potencial para se tornarem novas soluções irrigadoras precisam ser estudadas. Assim, o objetivo do presente estudo foi avaliar o potencial antimicrobiano do extrato de Psidium guajava L. (goiabeira) contra cepas clínicas e padrão (ATCC) de Enterococcus faecalis e Candida albicans. Para tanto, o extrato foi produzido a partir da matéria bruta (folhas e brotos) diluído no veículo hidroetanólico (EtOH: H2O / 50:50) para posterior análise microbiológica. Foram testadas a Concentração Inibitória Mínima (CIM) e Concentração Microbicida Miníma (CMM) do extrato vegetal, de acordo com as normas da Clinical and laboratory standards institute (CLSI), sobre quatro cepas: E. faecalis (ATCC e clínica) e C. albicans (ATCC e clínica). O extrato de P. guajava não produziu ação antifúngica sobre C. albicans, contudo, apresentou potencial microbicida contra cepas de E. faecalis, exibindo CIM de 0,20%. Esta concentração foi menor que a CIM do NaOCl que foi de 0,31%, uma solução que é comumente utilizada nas clínicas odontológicas. Em conclusão, o extrato hidroetanólico de P. guajava apresenta ação bactericida contra E. faecalis, sendo um produto natural com potencial para futuros estudos quanto ao desenvolvimento de novos irrigantes endodônticos.
El tratamiento endotónico consiste en la descontaminación del canal raíz con el uso de soluciones de irrigación, como el Hipoclorito de Sodio (NaOCl). Sin embargo, algunos microorganismos se resisten a las terapias convencionales, causando recaídas e infecciones secundarias. Es necesario estudiar las sustancias con poder de microbicida y el potencial para convertirse en nuevas soluciones de riego. Por lo tanto, el objetivo de este estudio fue evaluar el potencial antimicrobiano del extracto de Psidium guajava L. (guava) frente a cepas clínicas y estándar (ATCC) de Enterococcus faecalis y Candida albicans. Con este fin, el extracto se produjo a partir de la materia prima (hojas y brotes) diluida en el vehículo hidroetanólico (EtOH: H2O / 50:50) para análisis microbiológicos posteriores. La Concentración Mínima Inhibidora (CMI) y la Concentración de Microbicidas Minima (CCM) del extracto vegetal se probaron de acuerdo con el Clinical and laboratory standards institute (CLSI) en cuatro cepas: E. faecalis (ATCC y clínico) y C. albicans (ATCC y clínico). El extracto de P. guajava no produjo acción antifúngica sobre C. albicans, sin embargo mostró potencial microbicida frente a cepas de E. faecalis, presentando CIM 0,20%. Esta concentración fue menor que la CMI de NaOCl, que fue del 0,31%, una solución comúnmente utilizada en clínicas dentales. En conclusión, el extracto hidroetanólico de P. guajava muestra una acción bactericida frente a E. faecalis, siendo un producto natural con potencial para futuros estudios sobre el desarrollo de nuevos irrigantes endotónicos.
ABSTRACT
As infecções do trato urinário causadas por bactérias resistentes aos antimicrobiano são o terceiro tipo de infecção mais comum em humanos, descritas em todo o mundo. Trata-se de estudo de série temporal realizado a partir de registros de urocultura positiva, no período de 1º de janeiro de 2011 a 31 de dezembro de 2019, na região metropolitana do município de Goiânia, Centro-Oeste do Brasil, em pessoas de todas as idades e sexos, com objetivo de avaliar a prevalência as infeções urinárias, o padrão de resistência aos antimicrobianos e a tendência do crescimento da resistência em Enterococcus faecalis. A análise descritiva e o teste Qui-quadrado de Pearson foram utilizados para avaliar o crescimento da prevalência da resistência aos antimicrobianos e a análise de correlação pelo método de Poisson foi usada para avaliar a tendência do crescimento da resistência bacteriana. De 22.034 registros de uroculturas positivas, 646 (2,9%) eram E. faecalis. Os achados demonstraram que as infeções urinárias são mais prevalentes em mulheres com idade superior a 19 anos. A prevalência da resistência foi elevada para as fluoroquinolonas e significante crescimento da resistência para Gentamicina (p=0,02%) e diminuição para Ampicilina (p<0,001) e Tobramicina (p<0,001). A tendência de crescimento positiva foi significante para a Gentamicina e negativa para Ampicilina e Tobramicina. Os achados demonstram que é necessária a criação de programas de vigilância que objetivam monitorar o crescimento do padrão de resistência nas ITUs comunitárias, levando em consideração o local de estudo.
Urinary tract infections caused by antibiotic-resistant bacteria are the third most common type of infection in humans described worldwide. This is a time series study carried out from positive urine culture records, from January 1, 2011, to December 31, 2019, in the metropolitan region of the municipality of Goiania, Midwest Brazil, in people of all ages and sexes. The aim was to assess the prevalence of urinary tract infections, the pattern of resistance to antibiotics, and the trend of increasing resistance in Enterococcus faecalis. Descriptive analysis and Pearson's chi-square test were used to assess the growth in the prevalence of antibiotic resistance, and a correlation analysis by the Poisson method was used to assess the trend in the growth of bacterial resistance. Of 22,034 positive urine cultures, 646 (2.9%) were of E. faecalis. The findings showed that urinary tract infections are more prevalent in women aged over 19 years old. The prevalence of resistance was high for the fluoroquinolone drugs and a significant increase in resistance against Gentamicin (p=0.02%) and a decrease toward Ampicillin (p<0.001) and Tobramycin (p<0.001). The increasing trend was significant for Gentamicin and negative for Ampicillin and Tobramycin. The findings demonstrate that it is necessary to create surveillance programs that aim to monitor the growth of the resistance patterns in public UTIs, while considering the study site.
ABSTRACT
Objective:To construct a recombinant vaccine of Schistosoma japonicum (Sj) mediated by Enterococcus faecalis (Efs, rEfs-Sj26GST vaccine), and to study the expression of Sj26GST-GST fusion protein in the recombinant vaccine. Methods:The recombinant plasmid pGEX-Sj26GST was transformed into the susceptible strain Efs ATCC47077 by electroporation to construct rEfs-Sj26GST vaccine, and the plasmid was extracted for PCR identification. After induction of expression with isopropyl-beta-D-thiogalactopyranoside (IPTG), the products were analyzed and identified by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and Western blot.Results:After PCR identification, a 676 bp fragment was amplified, which was consistent with the length of Sj26GST amplification fragment. SDS-PAGE analysis showed that the relative molecular mass was 52 × 10 3, which was consistent with the band of Sj26GST-GST fusion protein. Western blot results showed that the Sj26GST-GST fusion protein expressed by rEfs-Sj26GST vaccine could be specifically recognized by the serum of Sj infected patients. Conclusion:The rEfs-Sj26GST vaccine is successfully constructed, and the Sj26GST-GST fusion protein expressed by recombinant vaccine can be specifically recognized by the serum of Sj infected patients.
ABSTRACT
Objective@#o explore the antibacterial effect of combined use of photon-induced photoacoustic streaming (PIPS) and silver nanoparticles (AgNPs) on Enterococcus faecalis biofilm in root canals.@*Methods@#A total of 36 isolated teeth with single root canal were collected to establish an experimental root canal model of Enterococcus faecalis infection. Samples were randomly divided into six groups and 0.9% NaCl, 2% NaClO, 0.1% AgNPs solutions were used with conventional needle irrigation (CNI) or PIPS for root canals. Colony count method was used to measure the number of Enterococcus faecalis biofilm in root canals before and after treatment, and the percentage of colony count reduction was calculated.@*Results@#The inhibitory effect of Enterococcus faecalis biofilm in all experimental groups was stronger than that in the control group (P<0.05). The decrease amplitude of 0.9% NaCl, 2% NaClO, 0.1% AgNPs assisted with PIPS was greater than that of 0.9% NaCl, 2% NaClO, 0.1% AgNPs assisted with CNI (P<0.05). The decrease in the 0.1% AgNPs assisted with PIPS group was significantly greater than that in the 2% NaClO assisted with PIPS group (P<0.05).@*Conclusion@#PIPS-assisted AgNPs solution washing can significantly improve the effect of clearing Enterococcus faecalis biofilm in root canals.
ABSTRACT
Alcoholic liver disease (ALD) is one of the most common chronic liver diseases worldwide and includes the different stages of steatosis, steatohepatitis, fibrosis, and liver cirrhosis. Enterococcus faecalis is a common bacterium for nosocomial infection and has a significant impact on the prognosis of patients with alcoholic hepatitis. This review mainly introduces the pathogenesis of ALD and the pathogenic mechanism of E. faecalis , summarizes the research advances in E. faecalis in ALD, and briefly describes the detection and treatment methods for E. faecalis infection in clinical practice. Since there is an extremely high mortality rate in ALD patients with lytic E. faecalis infection, an in-depth understanding of E. faecalis has become an important issue nowadays.
ABSTRACT
OBJECTIVE@#To construct a model of Enterococcus faecalis (E. faecalis) infection in dentinal tubules by gradient centrifugation and to evaluate the antibacterial effect of low-temperature plasma on E. faecalis in dentinal tubules.@*METHODS@#Standard dentin blocks of 4 mm×4 mm×2 mm size were prepared from single root canal isolated teeth without caries, placed in the E. faecalis bacterial solution, centrifuged in gradient and incubated for 24 h to establish the model of dentinal tubule infection with E. faecalis. The twenty dentin blocks of were divided into five groups, low-temperature plasma jet treatment for 0, 5 and 10 min, calcium hydroxide paste sealing for 7 d and 2% chlorhexidine gel sealing for 7 d. Scanning electron microscopy and confocal laser scanning microscope were used to assess the infection in the dentinal tubules and the antibacterial effect of low-temperature plasma.@*RESULTS@#The results of scanning electron microscopy and confocal laser scanning microscopy showed that after 24 h of incubation by gradient centrifugation, E. faecalis could fully enter the dentinal tubules to a depth of more than 600μm indicating that this method was time-saving and efficient and could successfully construct a model of E. faecalis infection in dentinal tubules. Low-temperature plasma could enter the dentinal tubules and play a role, the structure of E. faecalis was still intact after 5 min of low-temperature plasma treatment, with no obvious damage, and after 10 min of low-temperature plasma treatment, the surface morphology of E. faecalis was crumpled and deformed, the cell wall was seriously collapsed, and the normal physiological morphology was damaged indicating that the majority of E. faecalis was killed in the dentinal tubules. The antibacterial effect of low-temperature plasma treatment for 10 min exceeded that of the calcium hydroxide paste sealing for 7 d and the 2% chlorhexidine gel sealing for 7 d. These two chemicals had difficulty entering deep into the dentinal tubules, and therefore only had a few of antibacterial effect on the bacterial biofilm on the root canal wall, and there was also no significant damage to the E. faecalis bacterial structure.@*CONCLUSION@#Gradient centrifugation could establish the model of E. faecalis dentin infection successfully. Low-temperature plasma treatment for 10 min could kill E. faecalis in dentinal tubules effectively, which is superior to the calcium hydroxide paste sealing for 7 d and the 2% chlorhexidine gel sealing for 7 d.
Subject(s)
Chlorhexidine/pharmacology , Calcium Hydroxide/pharmacology , Enterococcus faecalis/physiology , Temperature , Dentin , Biofilms , Anti-Bacterial Agents/pharmacology , Root Canal Irrigants/pharmacology , Dental Pulp CavityABSTRACT
Abstract The aim of this study was to evaluate the prevalence of Enterococcus species in the mouth of adults with periodontal health and periodontitis. A systematic search was made in databases in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The search for articles was conducted in Medline/PubMed, Latin American and Caribbean Health Sciences Literature Database (LILACS), Cochrane Library, Scopus, Embase, Web of Science databases and in the System of Information on Grey Literature in Europe (SINGLE) and included articles published in English up to April 25th, 2021. Observational studies in humans with and without periodontitis were evaluated to identify the prevalence of Enterococcus species. Articles that met the inclusion criteria were analyzed and classified to determine the quality rating in good, fair, and poor. A new detailed checklist for quality assessment was developed based on the information required for applicable data extraction in reviews. The study design, sample size, demographic data, periodontal clinical parameters, microbial analysis method, biological sample, prevalence of Enterococcus spp., and correlations with periodontal clinical parameters were assessed. After screening and full-text reading, 8 articles met the inclusion criteria. All selected studies showed a significantly higher prevalence of Enterococcus spp. in patients with periodontitis compared with periodontally healthy patients. Thus, the present systematic review suggests that the prevalence of Enterococcus faecalis in the mouth of periodontitis individuals is higher than that of periodontally healthy individuals.
ABSTRACT
Apesar da confiabilidade, as falhas mecânicas e biológicas das reabilitações protéticas sobre implantes ainda são persistentes. A capacidade altamente adaptativa das bactérias e sua colonização na superfície dos implantes e componentes protéticos ainda hoje é um sério problema clínico, causando mucosite e peri-implantite. O objetivo do trabalho foi avaliar o efeito antimicrobiano do fino filmes de carbono tipo diamante (DLC) dopado com nanopartículas de prata, depositado nos parafusos protéticos. Os filmes de DLC e DLC-Ag foram depositados pelo processo conhecido como PECVD (Plasma Enhanced Chemical Vapour Deposition). A caracterização do material foi realizada em discos da liga Ti6Al4V pelas análises scratch test, espectroscopia de espalhamento Raman, perfilometria mecânica, goniometria e espectroscopia de energia dispersiva (EDS). A atividade antimicrobiana foi avaliada utilizando uma cepa padrão de Enterococcus faecalis (ATCC 29212). Para avaliar a efetividade dos filmes depositados, foram realizados ensaios nos discos e nos parafusos (isolados e no modelo implante/pilar). Foram utilizados implantes hexágono externo de plataforma regular 4,1 mm com os respectivos pilares. Para todas as análises, as amostras foram divididas em 3 grupos de acordo com o tipo de tratamento: Grupo controle (sem tratamento); Grupo DLC, amostras revestidas com filme de DLC, Grupo DLC-Ag, amostras revestidas com filme de DLC com prata. As amostras foram analisadas por MEV. Também foi avaliada a citotoxicidade dos filmes frente a células de fibroblastos (3T3) através do ensaio de MTT. A caracterização dos filmes por espectroscopia de espalhamento raman e EDS, apresentaram resultados característicos ao DLC e DLC-Ag, como uma distribuição homogênea de carbono, prata e silício. As análises de scratch test, perfilometria mecânica e goniometria, apresentaram filmes com características hidrofóbicas, sendo DLC-Ag o grupo de maior rugosidade e coeficiente de atrito. Os dados obtidos foram analisados estatisticamente com auxílio do programa GraphPad Prism versão 9.0 (GraphPad Software Inc., San Diego, CA, USA) e realizado os testes ANOVA e de Tukey para comparações entre os grupos (discos), e os testes Kruskal-Wallis e post-hoc de Dunn (parafusos). O nível de significância para todos os testes foi estabelecido em 5%. Os resultados demonstraram que a deposição do filme de DLC e DLC-Ag apresentaram redução de maneira significativa (p<0,05) na contagem de UFC/ml nos discos e parafusos isolados. Porém a dopagem com prata não trouxe um resultado superior ao filme DLC e ambos os materiais se apresentaram como não citotóxico. Concluímos que o revestimento com DLC e DLC-Ag é um material promissor, com efeito antimicrobiano, porém com limitação de aplicação (AU)
Despite the reliability, the mechanical and biological failures in rehabilitating implantsupported dental are still persistent. Mucositis and peri-implantitis are still severe clinical problems due to the high adaptive capacity of bacteria that colonize the surface of implants and prosthetic components. The present study aimed to evaluate, in vitro, the antimicrobial action of thin films of diamond-like carbon (DLC) doped with silver nanoparticles, deposited on prosthetic screws. The deposition of the films was performed by PECVD (Plasma Enhanced Chemical Vapor Deposition). The characterizations were performed of both deposited samples and control (Ti6Al4V) by scratch test analysis, raman scattering spectroscopy, mechanical profilometry, goniometry, and energy dispersive spectroscopy (EDS). The antimicrobial was evaluated activity against Enterococcus faecalis (ATCC 29212). To evaluate the effectiveness of the deposited films, tests were performed on disks and screws (isolated and on the implant/abutment model) Using 30 regular platforms with 4.1 mm external hexagon implants with the respective abutments, distributed into 3 groups according to the type of prosthetic screw treatment (n=10): Group control screw (no treatment); Group screw coated with DLC film, Group screw coated with DLC film doped with silver nanoparticles (Ag-DLC). The samples were also analyzed by SEM The cytotoxicity of the films against (3T3) fibroblast cells was also assessed using the MTT assay. The caracterization was performed from raman spectroscopy and EDS, showed results which are characteristics of DLC and Ag-DLC films, such as a homogeneous distribution of carbon, silver and silicon. The scratch test, mechanical profilometry and goniometry analyzes showed films with hydrophobic characteristics, with Ag-DLC being the group with the higher coefficient of friction values and roughness Data were statistically analyzed using GraphPad Prism version 9.0 (GraphPad Software Inc., San Diego, CA, USA). ANOVA and Tukey tests were performed, followed by comparisons between groups (disks) and Kruskal-Walis and post-hoc Dunn (screw) tests The significance level for all tests was set at 5%. The results demonstrated that the deposition of the DLC and Ag-DLC film showed a significant reduction (p<0.05) in the CFU/ml count compared to the contro, disks and isolated screwl. However, silver doping did not enhance the DLC films; both materials were non-cytotoxic. It concludes that titanium alloys coated with DLC and Ag-DLC are promising materials with antibacterial properties to prevent peri-implantitis (AU)
Subject(s)
Dental Implants , Enterococcus faecalisABSTRACT
Aim: This study aims to evaluate the antimicrobial efficacy of certain intracanal medicaments against Candida albicans and Enterococcus faecalis. Methods: Freshly extracted 120 single rooted mandibular premolars were selected for the study. Teeth were decoronated and cleaning and shaping was done up to F3 universal protaper system and were divided mainly into two groups: Candida albicans (C. albicans) (n = 60) and Enterococcus faecalis (E. faecalis) (n = 60). The medicaments include: G1: chlorhexidine + calcium hydroxide, G2: sodium hypochlorite + calcium hydroxide, G3: 2% chlorhexidine gel, G4: octenisept, G5: 0.1% octenisept solution + calcium hydroxide, and G6: physiologic saline (n = 5). Teeth were contaminated with Enterococcus faecalis and Candida albicans which were cultured, respectively, in brain heart infusion and Sabouraud’s dextrose agar for 21 days followed by intracanal medication and colony forming units were counted on the second and seventh day. Statistical analysis was done using Analysis of Variance (ANOVA) and Tukey’s post hoc test. Results: Against C. albicans, CHX + CH, 2% CHX gel, 0.1% octenidine (OCT) gel and OCT + CH showed statistically significant differences on the 2 nd and 7 th day. But against Enterococcus faecalis, only 0.1% OCT gel and 2% CHX gel showed statistically significant differences on the 2 nd and 7 th day. Among all the groups, 0.1% OCT gel and 2% CHX gel showed predominant antimicrobial efficacy. Conclusion: From the limitations of the current study, all the medicaments showed antimicrobial effect against Candida albic
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Abstract This study evaluated the effect of photodynamic therapy (PDT) on infected root canals. Twenty-one human teeth were selected, and 18 were infected by E. faecalis for 60 days. The antimicrobial strategies tested were: G1. Root canal preparation (RCP) using Niquel-Titanium (NiTi) rotary instruments, 2.5% NaOCl, and final irrigation with 17% EDTA, followed by PDT with methylene blue photosensitizer and laser diode low power; G2. RCP using stainless steel files and the same irrigation and PDT protocols as G1; G3. Same RCP protocol as G1 without PDT; G4. Only irrigation with 2.5% NaOCl; G5. Same PDT protocol as G1 without RCP; G6. Negative control; G7. Positive control. Samples for microbiological tests were collected initially (S1), after RCP (S2), and after PDT (S3). Subsequently, the roots were sectioned and prepared for Scanning Electron Microscopy (SEM) analysis. Bacterial growth was analyzed according to the turbidity of the culture medium, followed by spectrophotometric optical density (nm). The effect of PDT on the dentinal structure was evaluated at magnifications 1,600X and 5,000X and described qualitatively. The Wilcoxon test was used for the comparisons from the same specimens, and the Mann-Whitney test was used to compare groups ((=5%). Bacteria were found in all experimental groups' microbiological samples (S1, S2 and S3). The optical density of culture media was lower in S2 than in S1 of G1, 2, 3, and 4 (p> 0.05). After PDT (S3) in G1 and 2, there was an additional reduction in optical density of the culture medium, respectively (p>0.05). In Group 5, the analysis of culture media at S2 revealed an increase in optical density compared to S1(p>0.05). In SEM images of G1, 2, and 5, dentin with melting and recrystallization areas were evidenced. After preparation of the root canal with the rotary system or manually associated with 2.5% NaOCl, PDT was not able to completely eliminate E. faecalis present in the root canal.
Resumo Este estudo avaliou o efeito da terapia fotodinâmica (PDT) em canais radiculares infectados com E. faecalis. Vinte e um dentes humanos extraídos foram selecionados, e 18 foram infectados por E. faecalis por 60 dias. As estratégias antimicrobianas testadas foram: G1. Preparo do canal radicular (PCR) com instrumentos rotatórios de NiTi, NaOCl 2,5% e irrigação final com EDTA 17%, seguido de PDT com fotossensibilizador azul de metileno e laser diodo de baixa potência; G2. PCR usando limas de aço inoxidável e os mesmos protocolos de irrigação e PDT do G1; G3. Protocolo de PCR similar que G1 sem PDT; G4. Somente irrigação com NaOCl 2,5%; G5. Protocolo similar ao G1, sem PCR; G6. Controle negativo; G7. Controle positivo. Amostras para exames microbiológicos foram coletadas inicialmente (S1), após PCR (S2) e após PDT (S3). Na sequência, as raízes foram seccionadas e preparadas para análise em microscopia eletrônica de varredura (MEV). O crescimento bacteriano foi analisado de acordo com a turbidez do meio de cultura seguida pela densidade óptica espectrofotométrica (nm). O efeito da PDT na estrutura dentinária foi avaliado em aumentos de 1.600X e 5.000X, e descrito qualitativamente. O teste de Wilcoxon foi utilizado para as comparações dos mesmos espécimes e o teste de Mann-Whitney para as comparações entre os grupos ((=5%). Bactérias foram encontradas em todos os grupos experimentais, e em todas as coletas microbiológicas (S1, S2 e S3). A densidade óptica dos meios de cultura foi menor em S2 do que em S1 de G1, 2, 3 e 4 (p>0,05). Após a PDT (S3) em G1 e 2, houve redução adicional na densidade óptica do meio de cultura de 90,0% e 92,0%, respectivamente (p>0,05). No Grupo 5, a análise dos meios de cultura em S2 revelou um aumento de 3,2% na densidade óptica em comparação com S1(p>0,05). Nas imagens de MEV do G1, 2 e 5 foram evidenciadas dentina com áreas de fusão e recristalização. O PDT utilizado após preparo do canal radicular com sistema rotatório ou manual, associado ao NaOCl 2,5%, não foi capaz de eliminar completamente o E. faecalis em biofilme maduro presente no canal radicular.
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Introducción: Las infecciones recurrentes en el sistema de conductos radiculares son atribuidas principalmente a la presencia de especies como Enterococcus faecalis, lo que hace necesario el estudio de sustancias alternativas al hipoclorito de sodio que puedan ser empleadas como irrigantes de los conductos y mejorar la tasa de éxito de tratamiento. Objetivo: Identificar la composición química del aceite esencial de Origanum vulgare L. (orégano) y evaluar su actividad antibacateriana frente a E. Faecalis ATCC 29212. Métodos: Se diseñó un estudio experimental in vitro. El Origanum vulgare L. se recolectó en la provincia de Tarata, Tacna, Perú. El aceite esencial se obtuvo por método de arrastre de vapor y una muestra fue sometida a cromatografía de gases acoplada a espectrometría de masas en un equipo cromatográfico QP2010 (Ultra Shimazu) equipado con una columna DB-5 MS para identificar sus constituyentes. La actividad antibacteriana del aceite esencial se evaluó a través del método de difusión de disco en agar cerebro-corazón con concentraciones desde 2,261 a 27,132 mg/µL. El cálculo de las repeticiones se realizó con el programa EPi infoTM. Adicionalmente, se identificó la concentración mínima inhibitoria y la concentración mínima bactericida del aceite esencial. Se realizó el análisis descriptivo de los datos y se aplicó la prueba ANOVA de un factor para comparar los valores medios de los halos de inhibición de las distintas concentraciones. Se adoptó un nivel de significancia de p < 0,05. Resultados: Se identificaron 20 constituyentes, siendo los principales compuestos alpha.-pinene (24,44 por ciento) y 1,6-Ocatien-3-ol,3,7,7dimethyl (12,52 por ciento). E. Faecalis fue muy sensible (++) y extremadamente sensible (+++) a concentraciones mayores a 15,827 mg/µL del aceite esencial de Origanum vulgare L. Todas las concentraciones inhibieron el crecimiento bacteriano, mientras que las concentraciones mayores de 14,018 mg/µL fueron bactericidas. Conclusiones: Los principales constituyentes del aceite esencial de Origanum vulgare L. fueron .alpha.-Pinene y Cis-.beta.-Terpineol. Además, se demostró un importante efecto antibacteriano frente a Enterococcus faecalis ATCC 29212(AU)
Introduction: Recurrent infections in the root canal system are mainly attributed to the presence of species such as Enterococcus faecalis. It is therefore necessary to study substances other than sodium hypochlorite which may be used as irrigants for the canals, thus improving the success rate of the treatment. Objective: Identify the chemical composition of essential oil from Origanum vulgare L. (oregano) and evaluate its antibacterial activity against E. faecalis ATCC 29212. Methods: An in vitro experimental study was conducted. Origanum vulgare L. was collected from the province of Tarata, Tacna, Peru. The essential oil was obtained by steam entrainment, and a sample was subjected to gas chromatography / mass spectrometry in a QP2010 chromatograph (Ultra Shimadzu) equipped with a DB-5 MS column to identify its constituents. Antibacterial activity of the essential oil was evaluated by the brain heart agar disk diffusion method at concentrations ranging from 2 261 to 27 132 mg/µl. The software EPi InfoTM was used to estimate the repetitions. Additionally, identification was performed of the minimum inhibitory concentration and the minimum bactericidal concentration of the essential oil. The data were subjected to descriptive analysis and one-factor ANOVA was performed to compare the mean values of inhibition haloes at the different concentrations. A significance level of p < 0.05 was established. Results: Twenty constituents were identified. The main compounds were .alpha.-pinene (24.44 percent) and 1,6-Ocatien-3-ol,3,7,7dimethyl (12.52 percent). E. Faecalis was very sensitive (++) and extremely sensitive (+++) to concentrations above 15 827 mg/µl of the essential oil of Origanum vulgare L. All the concentrations inhibited bacterial growth, and concentrations above 14 018 mg/µl were bactericidal. Conclusions: The main constituents of the essential oil of Origanum vulgare L. were .alpha.-pinene and cis-.beta.-terpineol. Additionally, the essential oil was shown to display considerable antibacterial activity against Enterococcus faecalis ATCC 29212(AU)
Subject(s)
Humans , Oils, Volatile , Enterococcus faecalis , Anti-Bacterial Agents , Sodium Hypochlorite , Software , Microbial Sensitivity Tests , Analysis of VarianceABSTRACT
RESUMEN: El objetivo del estudio experimental in vitro fue evaluar la eficacia antimicrobiana del cemento Portland (CP) comparado con el Mineral Trióxido Agregado (MTA) frente a cepas de Enterococcus faecalis (E. faecalis) y Candida albicans (C. albicans) a las 24, 48 y 72 horas después del sembrado. Para ello se utilizó la técnica de difusión en agar. La capa base fue realizada con el Agar Müller-Hinton en el que se hicieron agujeros de 6 mm de diámetro a fin de contener los cementos de estudio y medir posteriormente la zona de inhibición microbiana alrededor de los materiales mediante un calibrador vernier digital. Se utilizó la prueba T de Student para comparar la diferencia entre el CP y MTA y el análisis de ANOVA para evaluar las diferencias entre los tres tiempos de estudio. Los resultados mostraron que tanto frente a E. faecalis y C. albicans el CP tuvo un mayor halo de inhibición que el MTA, siendo estas diferencias estadísticamente significativas (p0.05). Asimismo, la C. albicans presentó valores mayores de inhibición que el E. faecalis en los dos cementos estudiados. Se concluyó que el CP tuvo mayor eficacia antimicrobiana que el MTA independientemente del tiempo evaluado.
ABSTRACT: The aim of the experimental in vitro study was to evaluate the antimicrobial efficacy of Portland cement (CP) compared with Mineral Trioxide Aggregate (MTA) against Enterococcus faecalis (E. faecalis) and Candida albicans (C. albicans) strains at 24, 48 and 72 hours after sowing. For this, the agar diffusion technique was used. The base layer was made with Müller-Hinton Agar in which 6 mm diameter holes were made in order to contain the study cements and subsequently measure the zone of microbial inhibition around the materials using a digital vernier caliper. The Student's t test was used to compare the difference between CP and MTA and the ANOVA analysis to evaluate the differences between the three study times. The results showed that both against E. faecalis and C. albicans, CP had a greater inhibition than MTA, these differences being statistically significant (p 0.05). Likewise, C. albicans presented higher inhibition values than E. faecalis in the two cements studied. It was concluded that CP had greater antimicrobial efficacy than MTA regardless of the time evaluated.
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Abstract Bacteria are related do different oral diseases, such as dental caries and periodontal disease. Therefore, the control or/and eradication of microorganisms and their by-products is primordial for the success of their treatment. An alternative for decrease bacterial load is the use of plant extracts used in popular medicine. The cytotoxicity and antimicrobial action of extracts of Cariniana rubra Gardiner ex Miers, Senna martiniana, Anadenanthera colubrina (Vell.) Brenan and Spiranthera odoratissima St. Hil. against strains of Streptococcus mutans, Enterococcus faecalis, Staphylococcus aureus, Escherichia coli, Aggregatibacter actinomyces- tencomitans and Candida albicans were investigated. Cytotoxicity was assessed at concentrations of 1, 10, 40, 80, 100 and 1000 μg/mL by means of the MTT test and compared to a control group with untreated cells. Those with acceptable cytotoxicity had the antimicrobial action measured by the XTT test. As a positive control, sodium hypochlorite was used. Cariniana rubra Gardiner ex Miers had the highest citototoxicity results while Spiranthera odoratissima St. Hil. had the best results, but all extracts showed acceptable cytotoxicity at different concentrations. The plant extracts showed higher activity against A. actinomycetencomitans: Anadenanthera columbrina (Vell.) Brenan (80.52%) at 40 μg/mL, Spiranthera odoratissima St. Hil (78.48%) in 1 μg/mL, Senna martiniana (73.28%) in the concentration of 40 μg/mL and Cariniana rubra Gardiner ex Miers (70.50%) in 10 μg/mL. All extracts analyzed showed acceptable cytotoxicity at different concentrations and were promising for inhibition of the pathogenic microorganisms studied.
Resumo Bactérias estão relacionadas a diferentes doenças bucais, como a cárie dentária e a doença periodontal. Assim, o controle e/ou erradicação de microrganismos e seus subprodutos é primordial para o sucesso dos tratamentos. Uma alternativa para diminuir a carga bacteriana é a utilização de extratos vegetais utilizados na medicina popular. A citotoxicidade e ação antimicrobiana de extratos de Cariniana rubra Gardinerex Miers, Senna martiniana H.S. Irwin & Barneby, Anadenanthera colubrina (Vell.) Brenan e Spiranthera odoratissima St. Hil. contra cepas de Streptococcus mutans, Enterococcusfaecalis, Staphylococcus aureus, Escherichia coli, Agartibacter actinomycetencomitans e Candida albicans foram investigados. A citotoxicidade foi avaliada nas concentrações de 1, 10, 40, 80, 100 e 1000 μg/mL por meio do teste MTT. Aqueles com citotoxicidade aceitável tiveram a ação antimicrobiana medida pelo teste XTT. Cariniana rubra Gardinerex Miers apresentou os maiores resultados de citototoxicidade, enquanto Spiranthera odoratissima St. Hil. obteve os melhores resultados, mas todos os extratos apresentaram citotoxicidade aceitável em diferentes concentrações. Os extratos vegetais apresentaram maior atividade contra A. actinomycetencomitans: Anadenanthera columbrina (Vell.) Brenan (80,52%) a 40 μg/mL, Spiranthera odoratissima St. Hil (78,48%) em 1 μg/mL, Senna martiniana H.S. Irwin & Barneby (73,28%) na concentração de 40 μg/mL e Cariniana rubra Gardinerex Miers (70,50%) em 10 μg/mL. Todos os extratos analisados apresentaram citotoxicidade aceitável em diferentes concentrações e foram promissores na inibição dos microrganismos patogênicos estudados.
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Objective@#To investigate the clearance effect of photodynamic therapy (PDT) with an oxygen-releasing photosensitizer methylene blue (MB) formula on Enterococcus faecalis in the root canal.@*Methods @# Groups were divided into the MB group and oxygen release MB group. Samples in the MB group were mixed with 50 μmol/L MB solution, and samples in the oxygen release MB group were mixed with 50 μmol/L MB in oxygen release emulsion. N-acetyl-L-tryptophan amide (NATA) and 1,3-diphenylisobenzofuran (DPBF) were used to detect the oxidative activity and singlet oxygen generation of different formulas of MB (MB group, oxygen-releasing MB group), and the oxygen-releasing capacity of the oxygen-releasing photosensitizer formula was analyzed. The single root canal anterior teeth were collected, and the Enterococcus faecalis root canal infection model of isolated teeth was constructed. The distribution of Enterococcus faecalis in the root canal was observed by scanning electron microscopy. The isolated teeth with Enterococcus faecalis root canal infection were divided into three groups: the conventional root canal therapy group, MB-PDT therapy group, and oxygen-releasing MB-PDT therapy group, with 10 teeth in each group. Bacterial samples in the root canals of each group were obtained, the number of colonies was analyzed(CFU/mL) after 24 h of in vitro culture, and the clearance rate of Enterococcus faecalis in the root canal by photodynamic therapy was evaluated. The remaining isolated teeth with Enterococcus faecalis root canal infection were divided into 3 groups, with 5 samples in each group. Bacterial samples at a depth of 1 000 μm in the dentin tubules of the upper root, middle root and lower root segment were obtained and cultured in vitro for 24 h for calculations. The number of colonies (CFU/mL) was analyzed, and the clearance rate of Enterococcus faecalis in the dentin tubules of different segments of the root canals in each group was analyzed. @*Results @#The oxidation activity and singlet oxygen generation capacity in the oxygen-releasing MB group were stronger than those in the MB group. Scanning electron microscope detection showed that Enterococcus faecalis was distributed in dentinal tubules, indicating that the model of root canal infection in vitro was successfully constructed. The clearance rate of Enterococcus faecalis in the oxygen-releasing MB-PDT therapy group was higher than that in the conventional therapy group and the MB-PDT therapy group (P<0.05). Oxygen-releasing PDT significantly improved the bactericidal effect in the lower dentinal tubules, and the clearance rate of Enterococcus faecalis was better than in the other two groups (P<0.05).@*Conclusion@#Photodynamic therapy with the oxygen-releasing photosensitizer MB can achieve a better root canal bactericidal effect and can significantly improve the clearance effect of Enterococcus faecalis in the deep dentin of the lower root segment.
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Abstract Objective: To assess the effects of different peracetic acid (PAA) formulations on smear layer (SL) removal, dentine erosion, cytotoxicity, and antibiofilm activity. Methodology: SL removal and dentine erosion were assessed using 90 premolars, distributed into six groups, according to final irrigation: PAA formulations (1% Sigma, 1% Bacterend OX, 1% Arposept, and 0.09-0.15% Anioxyde), 17% ethylenediaminetetraacetic acid (EDTA), and water (control). Cytotoxicity was assessed by methyl-thiazol-tetrazolium (MTT) and neutral red assays. Antibacterial and antibiofilm effectiveness was evaluated against Enterococcus faecalis. For cytotoxicity and antibiofilm activity assessment, the 2.5% NaOCl was also included. Results: EDTA, Sigma, and Bacterend OX removed more SL than Arposept, Anioxyde, and water (p<0.05). EDTA caused more severe dentine erosion than Sigma and Bacterend OX (p<0.05). Sigma and Bacterend OX had higher cytotoxicity than the other solutions (p<0.05). NaOCl, Bacterend OX, Sigma, and Anioxyde significantly reduced E. faecalis colony-forming units (CFU) (p<0.05). The 2.5% NaOCl solution promoted greater biofilm biomass reduction (p<0.05) than the other solutions. All PAA formulations promoted greater biomass reduction than 17% EDTA (p<0.05). Conclusions: Although Sigma and Bacterend OX had higher cytotoxicity, they had a SL removal capability similar to that of EDTA, were as effective as NaOCl against E. faecalis biofilm, and promoted less dentine erosion than EDTA. Arposept and Anioxyde failed to remove the SL, had lower cytotoxicity, and showed less bacterial activity than NaOCl.
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Abstract Infective endocarditis (IE) is a rare but severe disease, due to an infection of the endocardial surface of the heart. The annual incidence ranging from 3 to 7 per 100 000 person-years, with an overall mortality rates of 25%. Staphylococci and Streptococci accounted for approximately 80% of IE cases. Enterococci are the third leading cause accounted for approximately 5-18% of all cases and are increasingly linked to health-care contact. The increasing number of cardiovascular electronic devices, prosthetic valves implants along with frequent invasive diagnostic or therapeutic procedures performed in elderly, may also contribute to the rise of IE in this population. Blood cultures and echocardiographic findings are the cornerstone of the IE diagnosis, confirmed or rejected according to modified Duke criteria. Other imaging modalities as Cardiac Computed Tomography, Cardiac Magnetic Resonance Imaging and 18Ffluorodeoxyglucose Positron Emission Tomography - Computed Tomography (18FDG-PET/CT) can determine a more correct diagnosis and identify many of the endocarditis-related complications. Here, we describe a patient with aortic prosthetic valve and Enterococcus faecalis (EF) IE. Cerebral and spinal MRI and 18FDG-PET/CT, performed during the hospitalization, showed multi-organ silent periferic embolization. Furthermore, the cultural examination of the valvular surgical specimen revealed a methicillin-sensitive Staphylococcus aureus suggestive for polymicrobial endocarditis. Some Authors demonstrated a possible false-positive valve culture due to a postoperative contamination. Since contaminated cultures usually yield microorganisms compatible with endocarditis, such as coagulase-negative Staphylococci, viridans group Streptococcus species, may be difficult for the physician not to treat the patient. This case represents need for high level of suspicion to diagnose IE. Multimodality assessment improves the diagnosis and allows the detection of the complications. Moreover, a multidisciplinary team and specialized centers determine a better patients outcome.
Resumen La endocarditis infecciosa (EI) es una enfermedad poco frecuente pero severa, dada por una infección del endocardio. La incidencia anual oscila entre 3 y 7 por cada 100 000 personas-año, con una tasa de mortalidad general del 25%. Los estafilococos y los estreptococos representaron aproximadamente un 80% de los casos de EI. Los enterococos son la tercera causa, aportando aproximadamente 5% a 18% de todos los casos, y se vinculan cada vez más al contacto con la atención médica. El número creciente de dispositivos electrónicos cardiovasculares e implantes de válvulas protésicas, junto con los frecuentes procedimientos invasivos diagnósticos o terapéuticos en las personas ancianas, también podrían contribuir al incremento de EI en esta población. Los hemocultivos y los hallazgos ecocardiográficos son la piedra angular del diagnóstico de EI, confirmado o rechazado de acuerdo con los criterios modificados de Duke. Otras modalidades de imagenología tales como la Tomografía Computarizada Cardíaca (TCC), la Resonancia Magnética Cardíaca (RMC) y la Tomografía por Emisión de Positrones - Tomografía Computarizada con 18F-fluorodeoxiglucosa (18F-FDG PET/TC) pueden determinar un diagnóstico más preciso e identificar muchas de las complicaciones asociadas a la endocarditis. Aquí describimos un paciente con una válvula aórtica protésica y EI por EF. Una RM del cerebro y la columna vertebral y una 18F-FDG PET/TC practicadas durante la hospitalización evidenciaron embolia periférica multiorgánica silenciosa. Además, el examen por cultivo de la muestra quirúrgica valvular reveló Staphylococcus aureus sensible a la meticilina (SASM), sugestivo de endocarditis polimicrobiana. Algunos autores demostraron un posible falso positivo del cultivo valvular dado por contaminación postoperatoria. Ya que los cultivos contaminados generalmente producen microorganismos compatibles con la endocarditis, tales como estafilococos coagulasa negativos y estreptococos del grupo viridans, le puede resultar difícil al médico no tratar al paciente. Este caso representa la necesidad de tener un alto nivel de sospecha para diagnosticar la EI. La valoración multimodal mejora el diagnóstico y permite detectar complicaciones. Además, un equipo multidisciplinario y los centros especializados determinan un mejor desenlace para el paciente.
Subject(s)
Humans , Endocarditis , Intracranial Embolism , Electrons , CoinfectionABSTRACT
El objetivo de este estudio es conocer la efectividad del gel de clorhexidina y pasta de hidróxido de calcio con clorhexidina como medicamento intracanal en la eliminación del Enterococcus faecalis (E. faecalis). Se realizó una revisión bibliográfica mediante una búsqueda exhaustiva en diferentes bases de datos como: PubMed, ScienceDirect, SciELO, Springer, Google Scholar. Se seleccionaron mediante los criterios de inclusión y exclusión 37 artículos publicados en el periodo 2003-2020, los cuales fueron enfocados especialmente en E. faecalis y medicación intracanal. Teniendo como resultados que la clorhexidina en mayor porcentaje resultó ser el medicamento intracanal más eficaz en un tiempo promedio de 7 días, seguida de la combinación de hidróxido de calcio más clorhexidina que actuó de igual manera eliminando el E. faecalis de los canales radiculares, mientras que el hidróxido de calcio no presentó actividad antimicrobiana frente al E. faecalis.
The aim of this study was to know the effectiveness of chlorhexidine gel and calcium hydroxide paste with chlorhexidine as intracanal medicaments in Enterococcus faecalis(E. faecalis) elimination. A bibliographic review was done through an exhaustive search in different databases such as: PubMed, ScienceDirect, Scielo, Springer, Google Scholar. Using inclusion and exclusion criteria, 37 articles published in the period 2003-2020 were selected, which were especially focused on E. faecalis and intracanal medication. The analysis showed that chlorhexidine in a higher percentage was the most effective intracanal medication in an average time of 7 days, followed by the combination of calcium hydroxide plus chlorhexidine that acted in the same way eliminating E. faecalisfrom the root canals, while calcium hydroxide did not show any antimicrobial activity against E. faecalis.