ABSTRACT
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.
Subject(s)
Biofilms , Cetrimonium Compounds/chemistry , Therapeutic Irrigation , Animals , Cattle , Cetrimonium , Microscopy, ConfocalABSTRACT
La cirugía endodóntica con obturación simultánea de los conductos radiculares consiste en la eliminación de los factores etiológicos locales concomitante con la instrumentación y obturación del sistema de conductos radiculares. Esta técnica está indicada cuando no existe la posibilidad de obturación por los métodos convencionales. Algunos inconvenientes pueden dificultar los procedimientos clínicos operatorios, tales como la interpretación radiográfica del caso en cuestión. La radiografía periapical no debe ser usada como principal recurso de diagnóstico debido a sus desventajas, tales como la distorsión y superposición sobre otras estructuras anatómicas. El objetivo de este relato de caso clínico es mostrar la limitación del examen radiográfico en el plan de tratamiento quirúrgico, donde la perforación radicular no era visible en la imagen radiográfica, así como el cono de gutapercha no está relacionado con la real localización clínica.
The apical surgery with simultaneous root filling consists in the elimination of the local etiologic factors concomitant with the shaping and obturation of the root canal system. This technique is indicated when there is no possibility of obturating the root canal by conventional methods. Some adverse factors may difficult the clinical procedures, such as the radiographic interpretation. Periapical radiographs must not be used as the main diagnostic resource due to their inherent disadvantages, such as distortion and superimposition with other anatomical structures. The aim of this clinical case report is to show the limitations of radiographic examination in an apical surgery in which a root perforation was not visible in the radiographic image, as well as the gutta-percha was not related to its real clinical location.
Subject(s)
Humans , Adult , Female , Dental Pulp Cavity/injuries , Root Canal Obturation , Surgery, Oral , Oral Surgical Procedures , Radiography, Dental, DigitalABSTRACT
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.
Subject(s)
Anti-Bacterial Agents/pharmacology , Root Canal Filling Materials/pharmacology , Acrylic Resins/chemistry , Acrylic Resins/pharmacology , Aluminum Compounds/chemistry , Aluminum Compounds/pharmacology , Animals , Bacterial Load/drug effects , Biofilms/drug effects , Bismuth/chemistry , Bismuth/pharmacology , Calcium Compounds/chemistry , Calcium Compounds/pharmacology , Calcium Hydroxide/chemistry , Calcium Hydroxide/pharmacology , Cattle , Dentin/microbiology , Drug Combinations , Enterococcus faecalis/drug effects , Enterococcus faecalis/physiology , Epoxy Resins/chemistry , Epoxy Resins/pharmacology , Hydrogen-Ion Concentration , Materials Testing , Oxides/chemistry , Oxides/pharmacology , Root Canal Filling Materials/chemistry , Salicylates/chemistry , Salicylates/pharmacology , Silicates/chemistry , Silicates/pharmacology , Solubility , Time Factors , Water/chemistryABSTRACT
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.
Subject(s)
Anti-Infective Agents/pharmacology , Enterococcus faecalis/drug effects , Root Canal Irrigants/pharmacology , Analysis of Variance , Citric Acid/pharmacology , Colony Count, Microbial , Doxycycline/pharmacology , Edetic Acid/pharmacology , Humans , Polysorbates/pharmacology , Sodium Hypochlorite/pharmacology , Statistics, NonparametricABSTRACT
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.
Subject(s)
Anti-Bacterial Agents/pharmacology , Calcium Hydroxide/pharmacology , Dental Pulp Cavity/microbiology , Enterococcus faecalis/drug effects , Root Canal Irrigants/pharmacology , Anti-Infective Agents, Local/pharmacology , Bacterial Load/drug effects , Camphor/pharmacology , Chlorhexidine/analogs & derivatives , Chlorhexidine/pharmacology , Chlorophenols/pharmacology , Drug Combinations , Humans , Materials Testing , Microbial Viability/drug effects , Root Canal Filling Materials/pharmacology , Root Canal Preparation/methods , Time FactorsABSTRACT
AIM: To evaluate bacterial leakage after filling root canals with several endodontic sealers, including MTA-based materials. METHODOLOGY: One hundred and thirty single-rooted extracted human teeth were randomly divided into experimental groups (n = 15) and two control groups (n = 5). Six root canal sealers were namely: AH Plus (AHP), Sealer 26 (S26), Epiphany SE (ESE), Sealapex (SEL), Active GP (AGP), Endofill (EDF), and two MTA-based sealers were namely: Endo CPM Sealer (CPM) and MTA-based sealer (MTAS, MTA Sealer). Teeth in the control groups were either filled with no sealer or made completely impermeable. Root canals were prepared and filled with either gutta-percha and one of the sealers or with Resilon and Epiphany SE. Teeth were sterilized by ethylene oxide prior to the bacterial leakage experiments using Enterococcus faecalis. Leakage was evaluated every 24 h for 16 weeks. Data were analysed by the Kaplan-Meier, Kruskal-Wallis and Dunn tests at 5% significance. RESULTS: Control groups had either immediate leakage or no leakage. During 120 days, significantly more leaking samples were detected for AGP, CPM and MTAS (P < 0.05). The best sealing ability was observed for AH Plus and Sealapex (P < 0.05). CONCLUSIONS: All sealers evaluated allowed bacterial leakage. The MTA-based sealers had the most leakage.
Subject(s)
Dental Leakage/prevention & control , Root Canal Filling Materials , Dental Leakage/microbiology , Enterococcus faecalis , Humans , Kaplan-Meier Estimate , Materials Testing , Root Canal Filling Materials/chemistry , Statistics, NonparametricABSTRACT
La elección de un aparato bucal apropiado para lograr los mejores resultados en el tratamiento de la apnea obstructiva del sueño es importante. El objetivo de este estudio fue evaluar el efecto de un aparato bucal específico, el PMPositioner, para el tratamiento del ronquido y la apnea obstructiva del sueño leve, a través de polisomnografía y la Escala de Epworth del sueño, después de seis meses de uso del mencionado aparato. Se incluyeron en el estudio 17 pacientes divididos en dos grupos: un grupo de roncadores (n=7) y otro grupo (n=10) con apnea obstructiva leve. Los resultados fueron significativos para el segundo grupo, revelando una disminución en el índice de apnea-hipoapnea de 7,4 +- 5,0 a 3,0 +- 2,5 (p<0.05), aumento del sueño REM de 16,0+-4,0 a 19+-6,0 y una mejora de la somnolencia en la Escala Epworth de 12,5+-5,4 a 7,4+-2,4. Se constató una disminución en los ronquidos y los síntomas subjetivos. PMPositioner, fue efectivo en el tratamiento de los ronquidos y la apnea obstructiva leve, la reducción de la somnolencia y de otros síntomas.
The choice of an adequate oral appliance is very important in the treatment of obstructive sleep apnea. The present study evaluated the effect of PMPositioner for the treatment of snoring and mild obstructive sleep apneathrough polysomnography and Epworth Sleep Scale prior to treatment and after six months. Seventeen patients, divided into 2 groups, snoring (n=7) and 10 with mild obstructive sleep apnea were enrolled. The results were significant for obstructive sleep apnea group reveling a decrease in the apnea/hypopnea index from 7.4±5.0 to 3.0±2.5 (p<0.05), anincrease in oxigen saturation from 88.0±6.0 to 90.0±2.8 (p<0.05), an increase in REM sleep from 16.0±6.0 to 19±4.0 and a sleepiness improved in from 12.5±5.4 to 7.4±2.4. Furthermore, it was noticed an improvement in snoring and subjective symptoms. The PM Positioner is efficient in the treatment of snoring and mild obstructive sleep apnea and in reduction of sleepness and others symptoms.
