Antibiofilm activity of irrigating solutions associated with cetrimide. Confocal laser scanning microscopy.

AIM: To evaluate the antibiofilm activity of sodium hypochlorite (NaOCl) and chlorhexidine (CHX) solutions associated with cetrimide (CTR), and QMiX using confocal laser scanning microscopy. METHODOLOGY: Enterococcus faecalis (ATCC- 29212) biofilms were induced on bovine dentine blocks for 14 days. The dentine blocks containing biofilm were immersed for 1 min in the following solutions: 2.5% NaOCl; 2.5% NaOCl + 0.2% CTR; 2% CHX; 2% CHX + 0.2% CTR; 0.2% CTR; QMiX. After contact with the solutions, the dentine blocks were stained with Live/Dead(®) BacLight for analysis of the remaining biofilm using confocal laser scanning microscope. Images were evaluated using the BioImage_L software to determine the total biovolume (µm(3) ), the green biovolume (live cells) (µm(3) ) and the percentage of substrate coverage (%). The data were subjected to nonparametric statistical test using Kruskal-Wallis and Dunn's tests at 5% significance level. RESULTS: After exposure to irrigants, the total biovolume observed for CHX, CHX+CTR, CTR, QMiX was similar to distilled water (P > 0.05). NaOCl and NaOCl+CTR had the lowest total and green biovolume. The CTR and QMiX had intermediate green biovolume, with greater antibacterial activity than CHX and CHX+CTR (P < 0.05). The NaOCl and NaOCl+CTR solutions were associated with microorganism removal and substrate cleaning ability. CONCLUSIONS: NaOCl and NaOCl+CTR solutions were effective on microorganism viability and were able to eliminate biofilm. The addition of cetrimide did not influence antibacterial activity.

Antibiofilm activity, pH and solubility of endodontic sealers.

AIM: To evaluate antibiofilm activity against Enterococcus faecalis, pH and solubility of AH Plus, Sealer 26, Epiphany SE, Sealapex, Activ GP, MTA Fillapex (MTA-F) and an experimental MTA-based Sealer (MTA-S). METHODOLOGY: Sealer samples were manipulated and stored for 2 or 7 days. Prepared sealers were evaluated by a modified direct contact test (DCT) for 5 h, 10 h or 15 h with biofilm previously induced on bovine dentine for 14 days. In the control group, the biofilm was not exposed to the sealers. The number of colony-forming units (CFU mL(-1) ) in the remaining biofilm was determined. Sealer solubility was assessed by the percentage of mass loss after 15 h of immersion in distilled water. Sealer pH was measured at 5 h, 10 h and 15 h. Statistical analysis was performed using Kruskal-Wallis and Dunn or anova and Tamhane's T2 tests, at 5% significance. RESULTS: At 2 days post-manipulation, the DCT showed that Sealapex and MTA-F were associated with a reduction in the number of bacteria in all 3 contact periods evaluated, compared with the control group (P < 0.05). At 7 days, Sealapex had the greatest antibiofilm action at 10 h and 15 h. Sealapex had the highest pH values 2 and 7 days post-manipulation. Regarding the solubility, at 2 days the highest values were observed for MTA-F, MTA-S, Sealapex and Activ GP (P < 0.05). At 7 days, MTA-S and MTA-F had greater solubility than the other materials (P < 0.05). AH Plus had the lowest solubility for both post-manipulation periods (P < 0.05). CONCLUSION: Sealapex and MTA-F were associated with a reduction in the number of bacteria in biofilms and had greater solubility. The high solubility and pH may be related to the antibacterial activity of these materials.

Antibacterial effectiveness of several irrigating solutions and the Endox Plus system - an ex vivo study.

AIM: To compare the ex vivo antibacterial effectiveness of the Endox Plus system and sodium hypochlorite (NaOCl) in combination with BioPure MTAD (Tulsa Dental, Tulsa, OK, USA) or with EDTA in Enterococcus faecalis-contaminated root canals. METHODOLOGY: After initial preparation, the root canals of 70 single-rooted human teeth were inoculated with E. faecalis (ATCC 29212) and incubated for 21 days. Specimens were divided into five groups: Endox Plus/saline; 2.5% NaOCl/MTAD; 2.5% NaOCl/EDTA; saline (positive control); negative control (root canals not prepared, nor irrigated). Samples were collected using paper points. Microbiological analysis evaluated the number of CFUs. Data were analysed by anova and Tukey tests at 0.05 significance. RESULTS: All specimens had bacterial growth after the incubation period, with similar CFU per mL counts (P > 0.05). After chemo-mechanical preparation, the number of bacteria in all groups reduced, except for the negative control. No significant differences were observed between 2.5% NaOCl/MTAD and 2.5% NaOCl/EDTA, but these groups had lower CFU counts than the other groups (P < 0.05). In the final samples, an increase in the bacterial counts was observed for Endox Plus/saline, 2.5% NaOCl/MTAD, 2.5% NaOCl/EDTA and saline (P < 0.05) with no significant differences between these groups. CONCLUSIONS: This ex vivo study revealed that the Endox Plus system was associated with a reduced antibacterial effectiveness compared with conventional irrigation using 2.5% NaOCl/MTAD and 2.5% NaOCl/EDTA. All irrigation procedures allowed recovery of bacteria 7 days after treatment, demonstrating persistence of contamination within the root canal system.

Effectiveness of calcium hydroxide-based intracanal medicaments against Enterococcus faecalis.

AIM: To evaluate the antimicrobial efficacy of calcium hydroxide-based intracanal medicaments against Enterococcus faecalis. METHODOLOGY: One hundred and six single-rooted human teeth were inoculated with E. faecalis (ATCC 29212) and incubated in an microaerophilic environment for 21 days. Teeth were divided according to the medicaments and period: G1 - Calen (7 days); G2 - Calen (14 days); G3 - Calen/camphorated paramonochlorophenol (CMCP) (7 days); G4 - Calen/CMCP (14 days); G5 - Calen/0.4% chlorhexidine (CHX) (7 days); G6 - Calen/0.4% CHX (14 days); G7 - Calen/1% CHX (7 days); G8 - Calen/1% CHX (14 days); G9 - chemo-mechanical preparation with no medication and G10 - no chemo-mechanical preparation and no medication. Microbial samples were harvested immediately after removal of the intracanal dressing and 7 days later. Data were subjected to anova (P < 0.05). RESULTS: All medicaments were associated with a reduction in E. faecalis after removal of the dressing (post-medication harvest). However, all specimens were associated with an increase in CFU mL(-1) values after 7 days (final harvest). Calen/CMCP and Calen/CHX had the lowest CFU mL(-1) values (P < 0.05). CONCLUSION: In this laboratory study using extracted teeth all calcium hydroxide-based medicaments were able to significantly reduce the CFU mL(-1) values of E. faecalis in the root canal system.