Colloidal chitosan-silver nanoparticles-fluoride nanocomposite as an antibacterial mouthwash against salivary Streptococcus mutans in orthodontic patients (a randomized clinical trial).

OBJECTIVES: This study aimed to synthesize and characterize colloidal chitosan-silver nanoparticles-fluoride nanocomposite (CCAgNPF) and evaluate its efficacy compared to chlorhexidine on salivary Streptococcus mutans in orthodontic patients. MATERIALS AND METHODS: AgNPs stabilized with chitosan were synthesized by chemical reduction of AgNO3. The nanoparticles were characterized with SEM, FTIR, DLS and ICP-OES. The MIC and MBC against S. mutans and IC50 concentration of CCAgNPF were obtained for antibacterial and cytotoxicity evaluations, respectively. For the clinical study, a total of 45 orthodontic patients were divided into three groups of 15 and used the following mouthwashes twice a day for 1 month: CCAgNPF, chlorhexidine 0.2% and the combination of these mouthwashes. The colony count of salivary S. mutans was evaluated before and after using the mouthwashes. The data were analyzed using One-way ANOVA and Tukey's test. RESULTS: Stabilized AgNPs were spherical with a diameter of 25.3 ± 3.3 nm. The MIC, MBC and IC50 of CCAgNPF were 4.42, 8.85 and 18.89 µg/ml. All mouthwashes reduced the salivary S. mutans of the orthodontic patients, however, no significant difference was found between the efficacy of CCAgNPF and chlorhexidine (P-value > 0.05). The best results were achieved by the combination of CCAgNPF and chlorhexidine mouthwashes (P-value < 0.05). CONCLUSION: The CCAgNPF and its combination with chlorhexidine present potent bactericidal, biocompatible and effective anti-carious mouthwashes for orthodontic patients. CLINICAL RELEVANCE: This study proved CCAgNPF as an antibacterial mouthwash with lower cytotoxicity and side effects for patients undergoing orthodontic treatments to maintain oral hygiene and reduce salivary S. mutans.

Antimicrobial effect of grape seed extract as a potential intracanal medicament combined with Nd:YAG laser.

This study evaluated the antimicrobial efficacy of grape seed extract medicament combined with Nd:YAG laser, against Enterococcus faecalis, Staphylococcus aureus and Candida albicans biofilms. Root canals infected with 4-week-old biofilms were divided into five groups (n = 11): calcium hydroxide, 6.5% GSE, Nd:YAG laser (1064 nm, 1.5 w, 15 Hz and 100 mj) and 6.5% GSE followed by Nd:YAG laser and normal saline (control). Dentin chips were collected using Gates-Glidden and cultured to obtain colony-forming units. Statistical analysis was performed using Kruskal-Wallis and Mann-Whitney U test. GSE showed higher antibacterial activity against all species investigated compared to Ca(OH)2 . However, the lowest microbial count was obtained using a combination of GSE and Nd:YAG laser (p < 0.001). No significant difference in the susceptibility of tested pathogens to each of the protocols was observed (p > 0.05). Application of Nd:YAG laser following GSE medicament is efficient against endodontic biofilms; also, GSE can be considered as an alternative to Ca(OH)2 dressing.

Portland Cement: An Overview as a Root Repair Material.

Portland cement (PC) is used in challenging endodontic situations in which preserving the health and functionality of pulp tissue is of considerable importance. PC forms the main component of mineral trioxide aggregate (MTA) and demonstrates similar desirable properties as an orthograde or retrograde filling material. PC is able to protect pulp against bacterial infiltration, induce reparative dentinogenesis, and form dentin bridge during the pulp healing process. The biocompatibility, bioactivity, and physical properties of PC have been investigated in vitro and in animal models, as well as in some limited clinical trials. This paper reviews Portland cement's structure and its characteristics and reaction in various environments and eventually accentuates the present concerns with this material. This bioactive endodontic cement has shown promising success rates compared to MTA; however, considerable modifications are required in order to improve its characteristics and expand its application scope as a root repair material. Hence, the extensive chemical modifications incorporated into PC composition to facilitate preparation and handling procedures are discussed. It is still important to further address the applicability, reliability, and cost-effectiveness of PC before transferring into day-to-day clinical practice.

Chitosan biomaterials application in dentistry.

Chitosan is a natural biopolymer derived from deacetylation of chitin and it has been investigated with interdisciplinary approaches for multitude applications. Chitosan biomaterials possess unique properties such as biocompatibility, biodegradability, non-toxicity, muco-adhesion and a wide range of antibacterial and antifungal activity. Additionally, chitosan is the only cationic polysaccharide in nature and can be chemically modified to derivatives, based on the aim of function and application. The distinctive properties of chitosan and its derivatives have aroused interest in pharmaceutical industries and biomedical fields worldwide. This review discusses the crucial role of chitosan in production of bio-dental materials and accentuates its current profitable utilizations in oral drug delivery system, bone tissue engineering for treatment of periodontitis and dentin-pulp regeneration. Chemical modifications and incorporation of diverse bioactive molecules in order to improve the mechanical and biological characteristics of chitosan have also been discussed.

Effects of Orthodontic Adhesives on Dental Enamel Color Alteration Using Chemically Cured and Light-Cured Composites.

OBJECTIVES: The purpose of this investigation was to evaluate the color alteration of dental enamel following the use of light-cured and chemically cured composites for bonding of metal brackets. MATERIALS AND METHODS: Sixty extracted human premolars divided into five groups (n=12) were included in this study. Metal brackets were bonded using chemically cured (System 1+ and Unite) and light-cured (Transbond XT and Grengloo) composites. The control group remained untreated. After 72 hours of immersion in a staining solution and 24 hours of photoaging, the brackets were debonded, and adhesive remnants were cleaned using a 12-blade tungsten carbide bur and polished with Sof-Lex discs. The color was assessed at the baseline and after cleaning procedures in accordance with the CIE L*a*b (lightness, red/green, blue/yellow) color system. Statistical analyses were performed using paired sample t-test and one-way analysis of variance (ANOVA). RESULTS: The L*, a*, and b* parameters showed a significant increase in all adhesive groups (P<0.001). The experimental groups showed significant color changes (P<0.05), and the mean ΔE ranged from 2.46 to 3.15 units. No significant difference was found between the ΔE of the adhesive groups (P>0.05). CONCLUSION: The enamel color change is influenced by bonding and debonding procedures. Chemically cured and light-cured composites have similar effects on dental enamel color alterations.