Acidente de hipoclorito de sódio durante retratamento endodôntico / Sodium hypochlorite accident during endodontic retreatment / Accidente con hipoclorito de sodio durante retratamiento

O retratamento endodôntico é uma intervenção executada em um dente que já apresenta um tratamento realizado anteriormente que foi mal sucedido clínica e/ou radiograficamente. O objetivo deste trabalho foi o de relatar um caso de retratamento endodôntico na clínica de Atenção Básica III da Faculdade de Odontologia de Pernambuco devido ao desconforto estético do incisivo lateral superior que estava fraturado e necessitando de prótese fixa. Após anamnese, exames extra e intra-oral e exames radiográficos, constatou-se o canal do dente 12 havia sido tratado endodonticamente há aproximadamente quatro anos. A remoção da gutta percha contaminada foi realizada com as limas rotatórias EasyLogic RT® 25mm sequência 30.10 torque 4N e 900 RPM, 25.08 torque 4Ne 900 RPM. Após remoção da guta-percha, realizou-se o protocolo de irrigação com solução de hipoclorito de sódio a 2,5% (Biodinâmic). A odontometria foi realizada com localizador apical e confirmada por radiografia periapical e o repreparo do canal radicular confeccionado com a Lima EasyLogic 2® de número 35.06 e posterior irrigação com a solução de Labarraque. Nesse momento, o paciente relatou dor e após aspiração com sugador endodôntico, notou-se sangramento abundante, correspondendo ao extravasamento do hipoclorito de sódio (Enfizema por hipoclorito de sódio. O paciente foi medicado com Amoxacilina 875mg de 12 em 12 horas durante sete dias, Predisin 20mg ­ Corticóide - um comprimido pela manhã por 4 dias e Nimesulida 100mg de 12 em 12 horas durante 5 dias. Após 24 horas o paciente não relatou dor nem edema. Na segunda sessão, 10 dias após o acidente, a obturação foi realizada com cone único de guta-percha 35.06 HBassi (Easy, associado ao cimento Bio C Sealer Fillapex (Angelus®). Concluiu-se que a conduta terapêutica imediata instituída para este caso, foi efetiva para o controle da dor e prevenção de complicações adicionais após injeção acidental de hipoclorito de sódio.

Endodontic retreatment is an intervention performed on a tooth that already has a previously performed treatment that was clinically and/ or radiographically unsuccessful. The objective of this study was to report a case of endodontic retreatment at the Primary Care Clinic III of the Faculty of Dentistry of Pernambuco due to the aesthetic discomfort of the maxillary lateral incisor that was fractured and required a fixed prosthesis. After anamnesis, extra and intraoral exams and radiographic exams, it was found that the root canal of tooth 12 had been endodontically treated for approximately four years. Removal of contaminated gutta percha with those performed with EasyLogic RT® 25mm rotary files sequence 30.10 torque 4N and 900 RPM, 25.08 torque 4N and 900 RPM. After removing the gutta-percha, the irrigation protocol was performed with a 2.5% sodium hypochlorite solution (Biodynamic). Odontometry was performed with an apex locator and confirmed by periapical radiography and root canal re-preparation made with EasyLogic 2® File number 35.06 and subsequent irrigation with Labarraque's solution. At that moment, the patient reported pain and after aspiration with an endodontic sucker, there was profuse bleeding, corresponding to sodium hypochlorite extravasation (Sodium hypochlorite emphysema. The patient was medicated with Amoxicillin 875mg every 12 hours for seven days, Predisin 20mg - Corticosteroid - one tablet in the morning for 4 days and Nimesulide 100mg every 12 hours for 5 days. After 24 hours the patient did not report pain or swelling. In the second session, 10 days after the accident, the filling was performed with a single cone of gutta-percha 35.06 HBassi (Easy, associated with Bio C Sealer Fillapex cement (Angelus®). It was concluded that the immediate therapeutic approach instituted for this case was effective for pain control and prevention of complications. additional doses after accidental injection of sodium hypochlorite.

El retratamiento endodóntico es una intervención que se realiza sobre un diente que ya tiene un tratamiento realizado previamente que resultó clínica y/o radiográficamente fallido. El objetivo de este estudio fue relatar un caso de retratamiento endodóntico en la Clínica de Atención Básica III de la Facultad de Odontología de Pernambuco debido a la incomodidad estética del incisivo lateral maxilar que estaba fracturado y requirió prótesis fija. Después de anamnesis, exámenes extraorales, intraorales y exámenes radiográficos, se encontró que el conducto radicular del diente 12 había sido tratado endodónticamente durante aproximadamente cuatro años. Eliminación de gutapercha contaminada con las realizadas con limas rotatorias EasyLogic RT® 25mm secuencia 30.10 torque 4N y 900 RPM, 25.08 torque 4N y 900 RPM. Tras retirar la gutapercha, se realizó el protocolo de irrigación con una solución de hipoclorito de sodio al 2,5% (Biodynamic). Se realizó odontometría con localizador de ápices y se confirmó mediante radiografía periapical y repreparación del conducto radicular realizada con EasyLogic 2® File número 35.06 y posterior irrigación con solución de Labarraque. En ese momento el paciente refirió dolor y luego de aspiración con ventosa endodóntica presentó sangrado profuso, correspondiente a extravasación de hipoclorito de sodio (Enfisema por hipoclorito de sodio. El paciente fue medicado con Amoxicilina 875mg cada 12 horas por siete días. Predisin 20mg - Corticosteroide - una tableta por la mañana por 4 días y Nimesulida 100mg cada 12 horas por 5 días, luego de 24 horas el paciente no refirió dolor ni hinchazón, en la segunda sesión, 10 días después del accidente, se realizó el relleno con un solo cono de gutapercha 35.06 HBassi (Easy, asociado al cemento Bio C Sealer Fillapex (Angelus®). Se concluyó que el abordaje terapéutico inmediato instituido para este caso fue eficaz para el control del dolor y la prevención de complicaciones. dosis adicionales después de accidente inyección de hipoclorito de sodio.

Irrigants and irrigation activation systems in Endodontics

Abstract Root canal infections are typically polymicrobial and involve strong bacterial interactions. The goal of endodontic treatment is to remove infected content from the root canal system to allow the healing of a pre-existing periapical lesion or to prevent infection of the periradicular tissues. Instrumentation alone is not capable of touching all of the root canal walls. Therefore, the irrigation process is an essential step in the endodontic treatment. However, due to the complex anatomy of the root canal system, this cleaning is very challenging. Although syringe and needle irrigation associated with the use of chemical substances is still the most used method, it does not guarantee optimal cleaning of the root canals. As a result, not only alternative irrigating substances but also numerous activation systems - which are technologies that aim to optimize the action of irrigating substances, both chemically and physically - have been developed. This work aimed to review the characteristics of both classic and current alternatives of irrigating substances and irrigation activation systems.

Resumo As infecções dos canais radiculares são tipicamente polimicrobianas e envolvem fortes interações bacterianas. O objetivo do tratamento endodôntico é remover o conteúdo infeccioso do sistema de canais radiculares, a fim de permitir a cicatrização de uma lesão periapical pré-existente ou prevenir a infecção dos tecidos perirradiculares. A instrumentação por si só não é capaz de tocar todas as paredes dos canais radiculares, desta forma a irrigação é uma etapa essencial no tratamento endodôntico. No entanto, devido à complexa anatomia do sistema de canais radiculares, essa limpeza é muito desafiadora. Embora a irrigação convencional com seringa e agulha, fazendo o uso de substâncias auxiliares seja o método mais utilizado, ela não garante a limpeza ideal dos canais radiculares. Como resultado, foram desenvolvidos inúmeros sistemas de ativação que visam otimizar a ação das substâncias irrigadoras, tanto química quanto fisicamente. O objetivo deste artigo foi revisar as características das substâncias irrigadoras (clássicas e alternativas) e dos sistemas de ativação destas substâncias.

Effect of sodium/calcium hypochlorite on adhesion and adaptation of fiber posts luted with a dual resin cement

Abstract This study aimed to evaluate the effect of different concentrations of sodium hypochlorite (NaOCl) and calcium hypochlorite [Ca(OCl)2] on the bond strength and adaptation of glass fiber posts luted with a dual-curing resin cement. Fifty decoronated premolars were sectioned 14 mm from the apex and endodontically treated. The root canal filling was partially removed. The specimens were divided into 5 groups (n=10) according to the irrigant for post space irrigation: 0.9% sodium chloride (NaCl), (control); 2.5% NaOCl; 5.25% NaOCl; 2.5% Ca(OCl)2; and 5.25% Ca(OCl)2. For each group, irrigation was performed with 5 ml of solution. Afterward, the posts were luted with a dual-curing resin cement. One slice from each third was obtained and submitted to the push-out test and failure modes analysis. An additional slice from the middle third was submitted to confocal images for analysis of adaptation failures (gaps). Two-way ANOVA, Tukey's post-hoc, Kruskal-Wallis with Bonferroni adjusted, and chi-square tests, analyzed data. The group treated with 5.25% NaOCl showed lower bond strength values and generated more cohesive failures compared to the control (p < 0.05). Bond strength decreased from coronal to apical in the post space (p < 0.001). The groups treated with NaOCl had the highest percentages of gaps compared to the control (p < 0.05). Regardless of concentration, Ca(OCl)2 did not influence the bond strength and the occurrence of gaps (P > 0.05). Ca(OCl)2 is a good option for irrigating the post space before luting a fiber post with a dual-curing resin cement.

Resumo Este estudo teve como objetivo avaliar o efeito de diferentes concentrações de hipoclorito de sódio (NaOCl) e hipoclorito de cálcio [Ca(OCl)2] na resistência de união e adaptação de pinos de fibra de vidro cimentados com um cimento resinoso dual. Cinquenta pré-molares tiveram suas coroas removidas, foram seccionados a 14 mm do ápice e tratados endodonticamente. A obturação do canal radicular foi parcialmente removida. Os espécimes foram divididos em 5 grupos (n=10) de acordo com o irrigante para irrigação do espaço do pino: cloreto de sódio 0.9% (NaCl), (controle); NaOCl 2.5%; NaOCl 5.25%; Ca(OCl)2 2.5%; e Ca(OCl)2 5.25%. Para cada grupo, a irrigação foi realizada com 5 ml da solução. Posteriormente, os pinos foram cimentados com um cimento resinoso dual. Uma fatia de cada terço foi obtida e submetida ao teste push-out e análise dos modos de falha. Um corte adicional do terço médio foi submetido a imagens confocais para análise de falhas de adaptação (gaps). Os dados foram analisados pelos testes ANOVA de duas vias, post-hoc de Tukey, Kruskal-Wallis com ajuste de Bonferroni e qui-quadrado. O grupo tratado com NaOCl 5.25% apresentou menores valores de resistência de união e gerou mais falhas coesivas em relação ao controle (p < 0.05). A resistência de união diminuiu de coronal para apical no espaço do pino (p < 0.001). Os grupos tratados com NaOCl apresentaram os maiores percentuais de gaps em relação ao controle (p < 0.05). Independentemente da concentração, o Ca(OCl)2 não influenciou a resistência de união e a ocorrência de gaps (P > 0.05). O Ca(OCl)2 é uma boa opção para irrigar o espaço do pino antes de cimentar um pino de fibra com um cimento resinoso dual.

Analysis of antimicrobial efficacy of sodium hypochlorite and ozonated water against biofilm in oval canals

Abstract This in vitro study compared the antimicrobial efficacy of 2.5% sodium hypochlorite (NaOCl) and 8 µg/mL ozonated water agitated by passive ultrasonic irrigation (PUI) or PUI combined with EndoActivator (EA) against mature multispecies biofilm. One hundred and five oval-shaped mandibular premolars were instrumented, sterilized, and inoculated with Enterococcus faecalis, Candida albicans, and Staphylococcus aureus, divided into: control group - saline; O3 group - ozonated water; O3 PUI group - ozonated water with PUI agitation; O3 PUI+EA group - ozonated water with PUI+EA agitation; NaOCl group - NaOCl; NaOCl PUI group - NaOCl with PUI agitation; and NaOCl PUI+EA group - NaOCl with PUI+EA agitation. Microbiological samples were collected before (S1) and after (S2) the disinfection procedures and the data were statistically analyzed using the Kruskal-Wallis test. In the culture method, there was significant disinfection in the O3 PUI+EA, NaOCl, NaOCl PUI, and NaOCl PUI+EA groups (p˂0.05). The combination of NaOCl with PUI+EA reduced microbial counts to zero (p˂0.05). In the qPCR method, there was a significant reduction in the total count of viable microorganisms in the O3 PUI, O3 PUI+EA, NaOCl, NaOCl PUI, and NaOCl PUI+EA groups (p˂0.05). It can be concluded that 2.5% NaOCl with and without agitation, as well as 8 µg/mL ozonated water with its action enhanced by the agitation techniques, were effective in root canal disinfection, and their antimicrobial efficacy is related to the microorganisms present in the biofilm.

Resumo Este estudo in vitro comparou a desinfecção do hipoclorito de sódio 2,5% (NaOCl) e da água ozonizada 8 µg/mL agitados pela irrigação ultrassônica passiva (PUI) e por associação da PUI com EndoActivator (EA) na redução de biofilme misto maduro. Cento e cinco pré-molares inferiores ovalados foram instrumentados, esterilizados e inoculados com Enterococcus faecalis, Candida albicans e Staphylococcus aureus, divididos em: Grupo controle: soro; Grupo O3: água ozonizada; Grupo O3 PUI: água ozonizada agitada por PUI; Grupo O3 PUI + EA: água ozonizada agitada por PUI e EA: Grupo NaOCl: hipoclorito de sódio; Grupo NaOCl PUI: hipoclorito de sódio agitado por PUI; Grupo NaOCl PUI + EA: hipoclorito de sódio agitado por PUI e EA. Amostras microbiológicas foram coletadas antes (S1) e após (S2) os procedimentos de desinfecção e os dados foram analisados estatisticamente pelo teste de Kruskal-Wallis. No método de cultura, houve desinfecção significativa nos grupos O3 PUI + EA, NaOCl, NaOCl PUI e NaOCl PUI + EA (p˂0.05), sendo que no grupo NaOCl PUI + EA não houve crescimento de microrganismo (p˂0.05). No método de qPCR, nas contagens dos microrganismos antes e após os protocolos de desinfecção, houve redução microbiana nos grupos O3 PUI, O3 PUI + EA, NaOCl, NaOCl PUI, NaOCl PUI + EA (p˂0.05). Concluiu-se que o NaOCl 2,5% com e sem agitação foi eficiente, assim como a água ozonizada 8 µg/mL potencializada pelos métodos de agitação na desinfecção e que a mesma está relacionada com os microrganismos presentes no biofilme.

Irrigation protocols effects on radicular dentin: Cleaning, disinfection and remaining ultrastructure / Efecto del protocolo de irrigación en la dentina radicular: limpieza, desinfección y ultraestructura remanente

A successful endodontic treatment requires a combination of satisfactory mechanical instrumentation, adequate irrigation protocols, and three-dimensional obturation of the canal system. Irrigation is considered the most critical procedure to ensure cleaning and disinfection. To date, a large variety of irrigants has been proposed. However, sodium hypochlorite (NaOCl) remains the gold standard. In order to achieve complete cleaning and disinfection, final irrigation with EDTA and ultrasonic devices has been used as an ideal protocol. Most endodontic research focuses on the cleaning and antibacterial properties of the irrigant solutions. Recent evidence demonstrated that the irrigation protocols cause erosion, affecting the radicular dentin ultrastructure. This article aims to describe the clinical features of the present knowledge concerning the effect of irrigation protocols on radicular dentin.

Un tratamiento de endodoncia exitoso requiere de una satisfactoria instrumentación mecánica, protocolos de irrigación adecuados y obturación tridimensional del sistema de conductos radiculares. La irrigación se considera el procedimiento más crítico para garantizar la limpieza y desinfección. Hasta la fecha, se ha propuesto una gran variedad de irrigantes. Sin embargo, el hipoclorito de sodio (NaOCl) sigue siendo el estándar de oro. Para lograr una limpieza y desinfección completa, se ha utilizado como protocolo ideal la irrigación final con EDTA y dispositivos ultrasónicos. La mayor parte de la investigación en endodoncia se enfoca en las propiedades antibacterianas y de limpieza de las soluciones de irrigación. Reciente evidencia demostró que los protocolos de irrigación provocan erosión, afectando la ultraestructura de la dentina radicular. Este artículo tiene como objetivo describir algunas consideraciones clínicas del conocimiento actual sobre el efecto de los protocolos de irrigación en la dentina radicular.

Efficacy of Chlorine Dioxide as an Endodontic Irrigant for Pulp Dissolution in vitro

Determine the efficacy of 5 % chlorine dioxide as an endodontic irrigant for pulp dissolution. Thirty five samples of human dental pulp were obtained, previously weighed and immersed in three solutions= 5 % ClO 2, 5.25 % NaOCl and saline (control group), for 10 minutes at 32 ºC; they were dried and reweighed. Then the weight loss was compared to the original weight and analyzed statistically. 5.25 % NaOCl and 5 % ClO 2 dissolved the dental pulp samples more effectively than saline (p> 0.001). No statistically significant difference was found between the tissue dissolving proper ties of 5.25 % NaOCl and 5 % ClO2 (p=0.893). 5 % ClO2 is effective in dissolving human dental pulp tissue.

El objetivo de este estudio fue determinar la eficacia del dióxido de cloro al 5 % como irrigante endodóntico para la disolución pulpar. Se obtuvieron 35 muestras de pulpa dental humana, se pesaron previamente y se sumergieron en tres soluciones= 5 % ClO2, 5.25 % NaOCl y suero fisiológico (grupo control), durante 10 minutos a 32ºC; se secaron y se pesaron de nuevo. Luego se comparó la pérdida de peso del peso original y se analizó estadísticamente. NaOCl al 5.25 % y ClO2 al 5 % disolvieron las muestras de pulpa dental con más eficacia que el suero fisiológico (p> 0.001). No se encontró diferencias estadísticamente significativas entre las propiedades de disolución de tejido de NaOCl al 5.25 % y ClO2 al 5 % (p=0.893) ClO2 al 5 % es eficaz para disolver tejido de pulpa dental humana.

Antibacterial Effect of Hypochlorous Acid on Bacteria Associated with the Formation of Periodontal Biofilms: An in vitro Pilot Study

ABSTRACT Objective: To evaluate the antibacterial effect of electrolytically generated hypochlorous acid on Streptococcus gordonii, Fusobacterium nucleatum, and Porphyromonas gingivalis. Material and Methods: In this in vitro experiment, the effect of hypochlorous acid (HOCl) on the strains S. gordonii, F. nucleatum, and P. gingivalis was evaluated using 4% sodium hypochlorite, 0.12% chlorhexidine, and distilled water as controls. The four groups were placed on each plate, and each group was replicated five times. The agar diffusion method by zones measurement was used. The data were processed with SPSS using the Kruskal-Wallis test and multiple comparison tests. Results: Hypochlorous acid showed an average inhibition halo of 9.28 mm on S. gordonii. As expected with distilled water, no zone of inhibition was noted for any of the bacteria, nor were zones of inhibition observed with HOCl for F. nucleatum and P. gingivalis. Conclusion: Hypochlorous acid showed antimicrobial properties against only S. gordonii and was less effective than 4% sodium hypochlorite and 0.12% chlorhexidine, although no significant differences were found between the latter.

Research progress on root canal irrigation disinfection drugs / 口腔疾病防治

@#Endodontic infection control is crucial to successful root canal treatment. Irrigation is the key step in endodontic procedures, and the application of root canal irrigation and disinfection medications play an important role. How to enhance antibacterial effects and functions in removing tissues while maintaining biocompatibility is a hot topic in endodontics. Currently, insights to address this issue can be split into two categories: one, the modification or combination of conventional endodontic irrigation solutions, and two, the development of novel endodontic irrigation solutions with new technologies and materials, for instance, nanomaterials and natural exacts. However, conventional endodontic irrigation solutions, such as sodium hypochlorite and chlorhexidine, are still the first choice in clinical practice. Most novel endodontic irrigation solutions remain at the pre-clinical laboratory stage. Clinical research and relevant data are required to determine whether various methods can improve endodontic irrigation. From basic research to clinical application is the direction for advancing to the next stage. The present article focuses on research progress on endodontic irrigation, especially concerning its antibacterial mechanism, characteristics and efficacy, to provide a reference for future clinical translation.

Calcium hydroxide diffusion after agitation of endodontic irrigants: an ex vivo study

Aim: To compare the influence of two methods of agitation of endodontics irrigants, by diffusion of calcium hydroxide [Ca(OH)2] through the dentinal tubules, measuring the pH of the medium where they were kept. Methods: Twenty mandibular incisors were prepared using a WaveOne Gold Large file, in a reciprocating movement, and then divided into (n = 10): gutta-percha cone (GPC) or Easy Clean system (ECS) agitation of 1% sodium hypochlorite and 17% ethylenediaminetetraacetic acid. The specimens were filled with Ca(OH)2 paste, placed in flasks with 4 mL of deionized water, and stored in an incubator. The pH was read using a digital pH meter immediately after storage (T0), after 7 (T1), 14 (T2), 21 (T3), and 35 (T4) days. Results: Statistical difference between groups was observed regardless of the day pH was measured (p < 0.01). From T2 on, ECS presented higher pH values in comparison with GPC, with significant difference (p < 0.01). Conclusion: Agitation of endodontic irrigants with ECS enhances the Ca(OH)2 diffusion, providing higher pH values, from the 14th day on, when compared with GPC

Effect of two methods of irrigant agitation on the temperature and cleanliness of sodium hypochlorite associated or not with a chelator: irrigant agitation and influence in temperature

Aim: This study investigated the influence in vitro of different sodium hypochlorite (NaOCl) agitation protocols associated or not with DualRinse (HEDP) on the temperature of the solution. Methods: Forty-eight premolars were instrumented and their apical third sealed to allow a closed irrigation system. The teeth remained immersed in a basin of warm water (37°C). The teeth were divided into the groups: G1 (NaOCl+Passive Ultrasonic Irrigation (PUI)), G2 (NaOCl/HEDP + PUI), G3 (NaOCl + EasyClean (EC)) and G4 (NaOCl/HEDP + EC). The canals were filled with the respective solutions and after 180 seconds the first temperature measurement was taken (T0). Then, the solutions were agitated, following the different protocols, for 60 seconds and a new measurement was performed (T60). The temperature was measured using a digital thermometer for type "K" sensors that was inserted into the middle third of the teeth. At the end of the measurements, the teeth were sectioned and prepared for scanning electron microscopy. The dentinal wall of middle third was graded according to the amount of debris and smear layer remaining on the walls. The results were analyzed using ANOVA test and Tukey's multiple comparisons (p<0.05). Results: G1 and G2 had an average increase in temperature of 1.1°C and 1.65°C, respectively (p>0.05). EasyClean caused a decrease in the temperature of the solutions in both groups, without a significant statistical difference with T0 (p>0.05). Regarding cleaning, it was only possible to observe clean dentinal tubules in the groups with the chelator. PUI discretely increased the temperature of the solution, regardless of the solution. The opposite effect was observed after activation with EasyClean. Conclusion: The association of NaOCl with a chelating agent promoted the cleaning of the dentinal tubules

Evaluation of the Efficacy of Different Intracanal Medicaments againstCandida albicans and Enterococcus faecalis - An In-Vitro Study

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

Influence of chlorhexidine 2% and sodium hypochlorite 5. 25% on micro-tensile bond strength of Universal adhesive system (G-Premio Bond)

Aim One of the reasons for the failure of adhesion in composite restorations and secondary caries may be the chemical irrigants used during the endodontic treatment. NaOCl is widely used for the biomechanical preparation of root canals due to its antimicrobial properties and capacity to dissolve organic material. In addition, another very effective decontamination solution is chlorhexidine 2%. There are few studies about the effect of root canal irrigation solutions on bond strength of universal adhesives therefore, in this study we have investigated the influence of CHX 2% and NaOCl 5.25% on micro-tensile bond strength of G-Premio Bond. Methods Twenty-four human teeth were randomly allocated to the following groups: G1, immersion in saline solution 0.9% for 30 minutes (control); G2, immersion in CHX 2% for 30 minutes; G3, immersion in NaOCl 5.25% for 30 minutes. After restoration, the dentin/resin interface was tested by micro-tensile bond strength. The surfaces morphology was analyzed by Scanning Electron Microscopy. Data were analyzed by ANOVA followed by Tukey test in SPSS software Version 24. Results There was a statistically significant difference between G3 and G1 (P < 0.05). There were no statistically significant differences among G1 and G2, G2 and G3. Conclusion Root canal irrigation with NaOCl 5.25% significantly reduced the micro-tensile bond strength in the G-Premio Bond at self-etch mode, but the use of CHX did not make a significant difference.

Comparação da propriedade antimicrobiana da clorexidina e do hipoclorito de sódio como irrigantes endodônticos: revisão integrativa / Comparison between the antimicrobial properties of chlorhexidine and sodium hypochlorite as endodontic irrigants: an integrative review / Comparación de la propiedad antimicrobiana de la clorhexidina y el hipoclorito de sodio como irrigantes endodónticos: revisión integradora

Introdução:Durante o tratamento endodôntico, devido às complexidades anatômicas dos canais radiculares, a ação mecânica dos instrumentos não é suficiente para a completa desinfecção dos condutos. Dessa forma, se faz necessário o uso de soluções irrigadoras que possampotencializar a desinfecção do sistema de canais radiculares. Objetivo:Realizar uma revisão integrativa da literatura para comparar as propriedades antimicrobianas da clorexidina com o hipoclorito de sódio.Metodologia:A busca na literatura foi realizada no período de setembro de 2019 a agosto de 2021, nas seguintes bases de dados: PUBMED/MEDLINE, LILACS e SCIELO. Utilizando os descritores: clorexidina, hipoclorito de sódio, irrigante do canal radicular e limpeza. Utilizou-se como critérios de busca, trabalhos experimentais laboratoriais in vitro, publicados entre os anos de 2017 e 2021.Resultados:Foram encontrados 165 artigos, dos quais 15 foram selecionados ao final do processo. 8 trabalhos não encontraram diferença estatisticamente significativa entre a clorexidina e o hipoclorito,5 artigos apresentaram resultados superiores dohipoclorito de sódioem 2 a clorexidina foi superior. Conclusões:Após análise da literatura, observamos semelhança entre a ação antimicrobiana do hipoclorito de sódioe da clorexidina, e podemos concluir que ambas apresentam boa ação antimicrobiana, justificando seu uso clinicamente (AU).

Introduction:During endodontic treatment, due to the anatomical complexities of the root canals, the mechanical action of the instruments is not sufficient for the complete disinfection of the canals. Thus, it is necessary to use irrigating solutions that can makethe disinfection of the root canal system.Objective:Conduct an integrative literature review to compare the antimicrobial properties of chlorhexidine with sodium hypochlorite.Methodology:The literature search was carried out from September 2019 to August 2021, in the following databases: PUBMED/MEDLINE, LILACS and SCIELO. Using the descriptors: chlorhexidine, sodium hypochlorite, root canal irrigant and cleaning. As search criteria, in vitro laboratory experimental works published between 2017 and 2021 were used.Results:A total of 165 articles were found, of which 15 were selected at the end of the process. 8 studies did not find a statistically significant difference between chlorhexidine and hypochlorite, 5 articles showed superior results for NaOCl and in 2 chlorhexidine was superior.Conclusions:After analyzing the literature, we observed a similarity between the antimicrobial action of sodium hypochlorite and chlorhexidine, and we can conclude that both have good antimicrobial action, justifying their clinical use (AU).

Introducción:Durante el tratamiento endodóntico, debido a las complexidades anatómicas de los conductos radiculares, la acción mecánica de los instrumentos no es suficiente para la desinfección completa de los conductos. Por lo tanto, es necesario utilizar soluciones de irrigación que puedan mejorar la desinfección del sistema de conductos radiculares.Objetivo: Realice una revisión integradora de la literatura para comparar las propiedades antimicrobianas de la clorhexidina con el hipoclorito de sodio.Metodología: La búsqueda bibliográfica se realizó desde septiembre de 2019 hasta agosto de 2021, en las siguientes bases de datos: PUBMED/MEDLINE, LILACS y SCIELO. Usando los descriptores: chlorhexidine, sodium hypochlorite, root canal irrigant and cleaning. Como criterio de búsqueda se utilizaron trabajos experimentales de laboratorio in vitro publicados entre 2017 y 2021.Resultados: Se encontraron un total de 165 artículos, de los cuales 15 fueron seleccionados al final del proceso. 8 estudios no encontraron diferencia estadísticamente significativa entre clorhexidinae hipoclorito, 5 artículos mostraron resultados superiores para NaOCl y en 2 la clorhexidina fue superior.Conclusiones: Después de analizar la literatura, observamos una similitud entre la acción antimicrobiana del hipoclorito de sodio y la clorhexidina,y podemos concluir que ambos tienen una buena acción antimicrobiana, lo que justifica su uso clínico (AU).

In vitro assessment of interaction between lidocaine hydrochloride and irrigating solutions on root canal dentin: a scanning electron microscope study / Evaluación in vitro de la interacción entre el clorhidrato de lidocaína y las soluciones de irrigación en la dentina del conducto radicular: un estudio con microscopio electrónico de barrid

Aim: To investigate the precipitate formed from the interaction between 2% lidocaine hydrochloride with adrenaline (LA) with 2.5% sodium hypochlorite (NaOCl) and 0.2% chitosan nanoparticles on root canal dentin, using scanning electron microscopy (SEM). Material and Methods: Sixty mandibular premolars were decoronated, and the root length standardised. The specimens were randomly distributed into the following groups: Group 1 (control): 2% LA mixed with sterile water without root canal instrumentation, Group 2: 2% LA with 2.5% NaOCl in water without root canal instrumentation, and Group 3: 2% LA with 0.2% chitosan nanoparticles in water without root canal instrumentation. Teeth specimens were split and subjected to SEM analysis at cervical, middle, and apical root thirds. On observing precipitate formation in Group 2, 10 premolars were decoronated and treated with 2% LA and 2.5% NaOCl and subjected to root canal instrumentation. Results: Group 1 and Group 3 showed patent dentinal tubules and no precipitate formation. Group 2 showed precipitate blocking dentinal tubules in all the three sections, and the precipitate could not be removed completely after cleaning and shaping. Conclusion: NaOCl forms an insoluble precipitate on interaction with local anaesthetic solution that cannot be removed after chemo-mechanical preparation. Chitosan nanoparticles do not form any such precipitate and show patent dentinal tubules. Hence, chitosan can be used as a flushing irrigant.

Objetivo: Investigar el precipitado formado a partir de la interacción entre el clorhidrato de lidocaína al 2% con adrenalina (LA), el hipoclorito de sodio al 2,5% (NaOCl) y nanopartículas de quitosano al 0,2% en la dentina del conducto radicular, mediante microscopía electrónica de barrido (SEM). Material y Métodos: Se decoraron 60 premolares mandibulares y se estandarizó la longitud de la raíz. Los especímenes se distribuyeron aleatoriamente en los siguientes grupos: Grupo 1 (control): 2% la que fue mezclado con agua estéril sin instrumentación del conducto radicular, Grupo 2: 2% LA con 2,5% de NaOCl sin instrumentación del conducto radicular y Grupo 3: 2 % LA con 0,2% de nanopartículas de quitosano sin instrumentación del conducto radicular. Las muestras de dientes se dividieron y se sometieron a análisis SEM en los tercios radiculares cervical, medio y apical. Al observar la formación de precipitado en el Grupo 2, 10 premolares fueron decorados y tratados con LA al 2% y NaOCl al 2,5% y sometidos a instrumentación de conductos radiculares. Resultado: El Grupo 1 y el Grupo 3 mostraron túbulos dentinarios permeables y sin formación de precipitados. El grupo 2 mostró precipitado que bloqueaba los túbulos dentinarios en las tres secciones, y el precipitado no se pudo eliminar por completo después de limpieza y conformación. Conclusión: el NaOCl forma un precipitado insoluble al interactuar con la solución anestésica local que no se puede eliminar después de la preparación quimiomecánica. Las nanopartículas de quitosano no forman ningún precipitado de este tipo y muestran túbulos dentinarios permeables. Por lo tanto, el quitosano se puede utilizar como irrigante para el lavado.

Evaluating bacterial resistance to antimicrobials in isolated bacteria from food contact surfaces / Evaluación de la resistencia bacteriana a los antimicrobianos en bactérias aisladas de superficies en contacto con alimentos / Avaliação da resistência bacteriana a antimicrobianos em bactérias isoladas de superfícies em contacto com alimentos

ABSTRACT Bacteria isolated from food contact surfaces, can transfer resistance factors when exposed to pressure exerted by inappropriate use of antimicrobial agents. This study aimed to evaluate bacterial resistance against antibiotics and disinfectants commonly used (NaOCl and CH3COOH) in bacteria isolated from food contact surfaces. Additionally, using PCR, the presence of tetracycline resistance genes was evaluated. Results showed that 47% of the isolates exhibit resistance against more than one antibiotic, being Tetracycline the antibiotic that most isolates were resistant to (35.3%). A PCR analysis found that the tet M gene is the most frequent of the genes tested. Likewise, it was evidenced that although NaOCl is effective as a surface disinfectant, Aerococcus urinae and Kocuria kristinae isolates could resist up to 10 min of exposure. Likewise, all isolates were resistant to CH3COOH, demonstrating the low inhibitory capacity of this disinfectant. Finally, the observed correlation between resistance to antibiotics and resistance to disinfectants is confirmed. An important factor that should be studied since the generalized use of disinfectants can increase the spectrum of antibiotic resistance.

RESUMEN Bacterias aisladas de superficies en contacto con alimentos pueden transferir factores de resistencia cuando se exponen a presiones ejercidas por el uso inadecuado de agentes antimicrobianos. En este estudio se evaluó la resistencia bacteriana frente a antibióticos y desinfectantes de uso común (NaOCl y CH3COOH) en bacterias aisladas de superficies en contacto con alimentos. Adicionalmente, mediante la PCR se evaluó la presencia de genes de resistencia a la Tetraciclina. Los resultados mostraron que el 47% de los aislados presentaron resistencia a más de un antibiótico, siendo la Tetraciclina al que la mayoría de los aislamientos fueron resistentes (35,3%). El análisis de PCR encontró que el gen tet M fue el más frecuente. Además, se evidenció que, si bien el NaOCl es efectivo como desinfectante de superficies, Aerococcus urinae y Kocuria kristinae pudieron resistir hasta 10 minutos de exposición. Igualmente, todos los aislados fueron resistentes a CH3COOH, demostrando la baja capacidad inhibitoria de este desinfectante. Finalmente, se confirma una correlación entre la resistencia a antibióticos y desinfectantes. Un factor importante que conviene estudiar ya que el uso generalizado de desinfectantes podría incrementar el espectro de resistencia a los antibióticos.

RESUMO Bactérias isoladas de superfícies em contacto com alimentos podem transferir factores de resistência quando expostas a tensões exercidas pela utilização inadequada de agentes antimicrobianos. Neste estudo, foi avaliada a resistência bacteriana aos antibióticos e desinfectantes comummente utilizados (NaOCl e CH3COOOH) em bactérias isoladas de superfícies em contacto com alimentos. Além disso, a presença de genes de resistência à tetraciclina foi avaliada por PCR. Os resultados mostraram que 47% dos isolados mostraram resistência a mais do que um antibiótico, sendo a Tetraciclina a que a maioria dos isolados era resistente (35,3%). A análise PCR constatou que o gene tet M era o mais frequente. Além disso, era evidente que, embora NaOCl seja eficaz como desinfectante de superficie, Aerococcus urinae e Kocuria kristinae foram capazes de resistir até l0 minutos de exposição. Da mesma forma, todos os isolados eram resistentes ao CH3COOH, demonstrando a baixa capacidade inibitória deste desinfectante. Finalmente, é confirmada uma correlação entre a resistência aos antibióticos e a resistência aos desinfectantes. Este é um factor importante que deve ser estudado uma vez que a utilização generalizada de desinfectantes poderia aumentar o espectro da resistência aos antibióticos.

Physicochemical properties and penetration into dentinal tubules of calcium hypochlorite with surfactants

Abstract The aim was to assess the physicochemical properties and the penetration into dentinal tubules of calcium hypochlorite solution [Ca(OCl)2], with or without surfactants. The surfactants benzalkonium chloride, cetrimide, Tween 80 and Triton X-100 were mixed at different concentrations with sodium hypochlorite solution (NaOCl), Ca(OCl)2 and distilled water (control). Once the critical micellar concentration (CMC) of the surfactants in Ca(OCl)2 and NaOCl was determined, pH, free chlorine, surface tension and free calcium ions were evaluated. The penetration into dentinal tubules of NaOCl and Ca(OCl)2, with or without benzalkonium chloride and Triton X-100 [surfactants that promoted the lowest surface tension of Ca(OCl)2], was assessed using human premolars stained with crystal violet. The statistical tests were one-way ANOVA and Tukey's post-test, Kruskal-Wallis and Dunn's post-test, two-way ANOVA and Bonferroni's post-test, and t-test; depending on the assay. The addition of surfactants reduced the surface tension of NaOCl and Ca(OCl)2, and did not alter the pH or the free available chlorine of either solution. The addition of all surfactants increased the availability of free calcium ions in Ca(OCl)2, especially benzalkonium chloride. Ca(OCl)2 exhibited lower penetration into dentinal tubules than NaOCl, and the addition of surfactants did not improve the penetration of Ca(OCl)2, but did increase the penetration of NaOCl. It can be concluded that the addition of surfactants to Ca(OCl)2 did not increase the penetration into dentinal tubules, but it did promote lower surface tension, without changing the pH or free available chlorine values, and higher availability of free calcium ions in Ca(OCl)2.

Resumo O objetivo foi avaliar as propriedades físico-químicas e a penetrabilidade nos túbulos dentinários da solução de hipoclorito de cálcio [Ca(OCl)2], com ou sem surfactantes. Os surfactantes cloreto de benzalcônio, cetrimida, Tween 80 e Triton X-100 foram misturados em diferentes concentrações com a solução de hipoclorito de sódio (NaOCl), Ca(OCl)2 e água destilada (controle). Uma vez determinada a concentração micelar crítica (CMC) dos surfactantes em Ca(OCl)2 e NaOCl, foram avaliados o pH, cloro livre, tensão superficial e íons de cálcio livre. A penetrabilidade nos túbulos dentinários de NaOCl e Ca(OCl)2, com ou sem cloreto de benzalcônio e Triton X-100 [surfactantes que promoveram a menor tensão superficial de [Ca(OCl)2] foi avaliada utilizando pré-molares humanos corados com cristal violeta. Os testes estatísticos foram ANOVA de uma via e pós-teste de Tukey, Kruskal-Wallis e pós-teste de Dunn, ANOVA de duas vias e pós-teste de Bonferroni, e teste t; dependendo do ensaio. A adição de surfactantes reduziu a tensão superficial do NaOCl e Ca(OCl)2, e não alterou o pH ou cloro livre das soluções. A adição de todos os surfactantes aumentou a disponibilidade de íons de cálcio livre de Ca(OCl)2, principalmente o cloreto de benzalcônio. Ca(OCl)2 apresentou menor penetrabilidade nos túbulos dentinários do que NaOCl, e a adição de surfactantes não aumentou a penetrabilidade de Ca(OCl)2, mas aumentou a penetrabilidade de NaOCl. Pode-se concluir que a adição de surfactantes no Ca(OCl)2 não aumentou a penetrabilidade nos túbulos dentinários, mas promoveu menor tensão superficial, sem alterar os valores de pH ou cloro livre, e maior disponibilidade de íons de cálcio livre em Ca(OCl)2.

Pretratamiento de la dentina como estrategia de mejora de la adhesión: una revisión de la literatura / Pretreatment of dentine as a strategy to improve adhesion: a literature review

RESUMEN El tratamiento de la dentina como paso previo al procedimiento de adhesión tiene como propósito mejorar las condiciones del sustrato mejorando la fuerza de unión entre la superficie dentaria y el material de restauración, promoviendo mayor longevidad y estabilidad de la restauración. El objetivo del estudio fue realizar una revisión de la literatura que describe las propiedades de diferentes agentes acondicionantes de la dentina. Se realizó una revisión de la literatura incluyendo trabajos publicados entre el 2014 a 2020, de bases de datos médicas como PubMeb, SciELO y ScienceDirect; en idioma inglés, español y portugués. Se seleccionaron un total de 20 artículos que cumplían los criterios de inclusión. Se ha identificado en la literatura el uso de diversos agentes pre tratamiento de la dentina, principalmente agentes químicos como el hipoclorito de sodio, clorhexidina, el ácido etilenodiaminatetraacético (EDTA), las nanopartículas metálicas y las técnicas mecánicas como la abrasión por aire con óxido de aluminio y bicarbonato de sodio.

ABSTRACT Dentin treatment as a prior step to the adhesion procedure is intended to improve the substrate condition by improving the bonding strength between the tooth surfaces and the restorative material, promoting greater longevity and stability of the restoration. The objective of the study was to carry out a review of the literature that describes the properties of different conditioning agents of dentin. A review of the literature was carried out, including works published between 2014 and 2020, from medical databases such as PubMeb, SciELO and ScienceDirect; in English, Spanish and Portuguese. A total of 20 articles that met the inclusion criteria were selected. The use of various dentin pre-treatment agents has been identified in the literature, mainly chemical agents such as sodium hypochlorite, chlorhexidine, ethylenediaminetetraacetic acid (EDTA), metallic nanoparticles and mechanical techniques such as air abrasion. with aluminum oxide and baking soda.

Effects of different concentrations of sodium hypochlorite on dentine adhesion and the recovery application of sodium erythorbate / 中南大学学报(医学版)

OBJECTIVES@#Root canal therapy is the most effective and common method for pulpitis and periapical periodontitis. During the root canal preparation, chemical irrigation plays a key role. However, sodium hypochlorite (NaOCl), the widely used irrigation fluid, may impact the bonding strength between dentin and restorative material meanwhile sterilization and dissolving. Therefore, it's important to explore the influence of NaOCl on the adhesion between dentin and restoration materials to ensure clinical efficacy. This study aims to explore the effect of NaOCl on dentine adhesion and evaluate the effect of dentine adhesion induced by sodium erythorbate (ERY), and to provide clinical guidance on dentin bonding after root canal therapy.@*METHODS@#Seventy freshly complete extracted human third molars aged 18-33 years old, without caries and restorations were selected. A diamond saw was used under running water to achieve dentine fragments which were divided into 10 groups with 14 fragments in each group: 2 control [deionized water (DW)±10% ERY] and 8 experimental groups (0.5%, 1%, 2.5%, and 5.25% NaOCl±10% ERY). The dentine specimens in the control group (treated with DW) and the experimental groups (treated with 0.5% NaOCl, 1% NaOCl, 2.5% NaOCl, and 5.25% NaOCl) were immersed for 20 min using corresponding solutions which were renewed every 5 min. The other 5 groups were immersed in 10% ERY for 5 min after an initial washing with DW for 1 min. Then, we selected 4 dentine fragments from all 14 fragments in each group and the numbers and diameters of opening dentinal tubules were observed under scanning electron microscope (SEM). The other 10 dentine fragments from each group were used to make adhesive samples by using self-etch adhesive wand composite resin. All the above adhesive samples were sectioned perpendicular to the bonded interface into 20 slabs with a cross-sectional area of 1 mm×1 mm using a diamond saw under the cooling water, and then the morphology of 10 slabs in each group's bonding interface was observed from aspects of formation of resin tags, depth of tags in dentin, and formation of hybrid layer under SEM. The other 10 slabs of each group's microtensile bond strength and failure modes were also analyzed.@*RESULTS@#Among the 0.5% NaOCl, 1% NaOCl, 2.5% NaOCl, and 5.25% NaOCl groups, the number and diameter of patent dentinal tubules gradually increased with the rise of concentration of NaOCl solution (all P<0.05). Among the DW, 0.5% NaOCl, 1% NaOCl, 2.5% NaOCl, and 5.25% NaOCl groups, the number and diameter of patent dentinal tubules increased after using ERY, but without significant difference (all P>0.05). Among the DW, 0.5% NaOCl, 1% NaOCl, and 2.5% NaOCl groups, the scores of formation of resin tags under SEM gradually increased with the increase of concentration of NaOCl solution, while the score in the 5.25% NaOCl group decreased significantly compared with the score of the 2.5% NaOCl group (P<0.05). There was no significant difference between using 10% ERY groups and without using 10% ERY groups (all P>0.05). The scores of length of the tags under SEM in the 5.25% NaOCl group was significantly higher than the scores of DW, 0.5% NaOCl, and 1% NaOCl groups (all P<0.05), and it was also higher than the score of the 2.5% NaOCl group, but without significant difference (P>0.05). There was no significant difference between using 10% ERY groups and without using 10% ERY groups (P>0.05). The scores of formation of hybrid layer under SEM in the 2.5% NaOCl and 5.25% NaOCl groups significantly decreased compared with the score of the DW group (all P<0.05). There were significant differences between the 2.5% NaOCl±10% ERY groups and between the 5.25% NaOCl±10% ERY groups (all P<0.05). Microtensile bond strength was greater in the 0.5% NaOCl, 1% NaOCl, and 2.5% NaOCl groups, but lower in the 5.25% NaOCl group than that in the DW group (all P<0.05). There were significant differences between the 2.5% NaOCl±10% ERY groups and between the 5.25% NaOCl±10% ERY groups (all P<0.05). The incidence of type "Adhesive" of failure modes in the 5.25% NaOCl group was significantly higher than that in other groups (all P<0.05), while the incidence of type "Adhesive" in the 5.25% NaOCl+10% ERY group was lower than that in the 5.25% NaOCl group (P<0.05).@*CONCLUSIONS@#The bonding strength to dentine increases with the increase of NaOCl concentration when the concentration lower than 2.5%; whereas it is decreased at a higher concentration (such as 5.25%). 10% ERY has a definite recovery effect on attenuated bonding strength to 5.25% NaOCl-treated dentine.

Endodontic cement penetration after removal of calcium hydroxide dressing using XP-endo finisher

Abstract: We aimed to evaluate the penetration of endodontic cement following the removal of calcium hydroxide (Ca(OH)2) dressing using the XP-endo Finisher in association with different irrigating solutions. Sixty premolars were instrumented and applied with a Ca(OH)2 dressing. To remove Ca(OH)2, the teeth were divided into six groups, each with a different volume of sodium hypochlorite (NaOCl) and ethylenediaminetetraacetic acid (EDTA), as well as solution stirring time with XP-endo Finisher (0, 30, and 60 sec). Root canals were filled using the lateral condensation technique. Fluorescein dye was added to the cement for microscopic laser scanning analysis. In the generated images, linear measurements were taken in micrometers, and their averages were calculated. To analyze the perimeter penetration ratio of the cement, the total perimeter of the canal and the segment of the total perimeter of the canal where the endodontic cement penetrated into the dentinal tubules were measured in micrometers. We found that using an XP-endo Finisher in irrigation was more effective than using a needle and syringe during the extension and penetration of endodontic cement. Shaking with XP-endo Finisher with 17% EDTA increased the extent and perimeter of the penetration of the endodontic cement into the dentinal tubules. However, using the XP-endo Finisher with EDTA only was more efficient than using the instrument interchangeably in NaOCl and EDTA. Although XP-endo Finisher contributes to the removal of Ca(OH)2, none of the protocols or instruments used removed all Ca(OH)2 from the root system.

Cytotoxicity and antibacterial activity of bleached turmeric hydro-alcoholic extract versus sodium hypochlorite as an endodontic irrigant: in vitro study / Citotoxicidade e atividade antibacteriana do extrato hidroalcoólico de cúrcuma branqueado versus hipoclorito de sódio como irrigante endodôntico: estudo in vitro

Objetivo: Avaliar a citotoxicidade e o efeito antibacteriano do extrato hidroalcoólico de cúrcuma branqueado comparado ao hipoclorito de sódio como irrigante endodôntico. Material e Métodos: A citotoxicidade foi avaliada em fibroblastos de pele humana usando o ensaio MTT. Os irrigantes foram testados em intervalos de tempo de 1, 5 e 15 minutos. Após o tempo de contato, a solução de MTT foi adicionada e as placas de poços foram incubadas. Após o período de incubação, a densidade óptica foi lida e correlacionada com a porcentagem de viabilidade celular. A eficiência antibacteriana foi avaliada usando o teste de contato direto. Cada irrigante endodôntico foi adicionado à suspensão fresca de Enterococcus faecalis e ao meio de infusão cérebro-coração e então incubados por 48 horas. Após o período de incubação, as leituras de densidade óptica foram obtidas e lidas por leitor de ELISA a 620 nm. Resultados: Os resultados do teste de citotoxicidade revelaram que o extrato de cúrcuma branqueado apresentou porcentagem de viabilidade celular significativamente maior do que o hipoclorito de sódio (NaOCl) em todos os intervalos de tempo (p<0,001). No entanto, no grupo de intervenção, a porcentagem de viabilidade celular diminuiu significativamente ao longo do tempo. Os resultados do teste antibacteriano mostraram inibição bacteriana por ambos os grupos com diferença não significativa entre os dois grupos testados (p<0,05). Conclusão:O extrato hidroalcoólico de cúrcuma branqueado pode representar uma alternativa fitoterápica irrigante endodôntico para evitar os efeitos tóxicos indesejáveis do NaOCl devido à sua menor citotoxicidade e efeito antibacteriano proeminente contra Enterococcus faecalis (AU)

Objective: To evaluate the cytotoxicity and antibacterial effect of bleached turmeric hydro-alcoholic extract compared to sodium hypochlorite as an endodontic irrigant. Material and Methods: Cytotoxicity was evaluated on human skin fibroblasts using MTT assay. The irrigants were tested at 1, 5- and 15-minutes time intervals. After contact time, MTT solution was added and well plates were incubated. After the incubation period, optical density was read and correlated with cell viability percent. Antibacterial efficiency was evaluated using direct contact test. Each endodontic irrigant was added to fresh Enterococcus faecalis suspension and brain heart infusion media then incubated for 48 hours. After incubation period, optical density readings were obtained and read by ELISA reader at 620 nm. Results:Results of cytotoxicity test revealed that bleached turmeric extract had significant higher cell viability percent than Sodium hypochlorite (NaOCl) at all time intervals (p<0.001). However, in the intervention group, cell viability percent significantly decreased over time. Results of antibacterial test showed bacterial inhibition by both groups with non-significant difference between the two tested groups (p<0.05). Conclusion: Bleached turmeric hydro-alcoholic extract can represent an herbal alternative endodontic irrigant to avoid the undesirable toxic effects of NaOCl due to its less cytotoxicity and prominent antibacterial effect against Enterococcus faecalis. (AU)