ABSTRACT
INTRODUCTION: This randomized clinical study compared the antibacterial effectiveness of treatment protocols using either a triple antibiotic solution (1 mg/mL) or calcium hydroxide/chlorhexidine paste as interappointment medication in infected canals of teeth with primary apical periodontitis. METHODS: The root canals of single-rooted teeth with apical periodontitis were prepared by using a reciprocating single-instrument technique with 2.5% sodium hypochlorite irrigation and then medicated for 1 week with either a triple antibiotic solution (minocycline, metronidazole, and ciprofloxacin) at 1 mg/mL (n = 24) or a calcium hydroxide paste in 2% chlorhexidine gluconate (n = 23). Samples were taken from the canal at the baseline (S1), after chemomechanical preparation (S2), and after intracanal medication (S3). DNA extracts from clinical samples were evaluated for total bacterial reduction using a 16S ribosomal RNA gene-based quantitative polymerase chain reaction assay. RESULTS: All S1 samples were positive for the presence of bacteria, and counts were substantially reduced after treatment procedures (P < .01). Bacterial levels in S2 and S3 samples did not significantly differ between groups (P > .05). S2 to S3 reduction was 97% in the antibiotic group and 39% in the calcium hydroxide/chlorhexidine group; only the former reached statistical significance (P < .01). There were significantly more quantitative polymerase chain reaction-negative S3 samples in the antibiotic group than in the calcium hydroxide group (P < .05). CONCLUSIONS: Interappointment medication with a triple antibiotic solution at the concentration of 1 mg/mL significantly improved root canal disinfection, and its effects were at least comparable with the calcium hydroxide/chlorhexidine paste. Effectiveness and easy delivery of the antibiotic solution make it an appropriate medicament as part of a disinfecting protocol for conventional nonsurgical endodontic treatment and possibly regenerative endodontic procedures.
Subject(s)
Anti-Bacterial Agents/administration & dosage , Bacterial Infections/microbiology , Bacterial Infections/prevention & control , Calcium Hydroxide/administration & dosage , Chlorhexidine/administration & dosage , Ciprofloxacin/administration & dosage , Dental Disinfectants/administration & dosage , Metronidazole/administration & dosage , Minocycline/administration & dosage , Periapical Periodontitis/microbiology , Periapical Periodontitis/surgery , Root Canal Irrigants/administration & dosage , Root Canal Preparation/methods , Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Ointments , Solutions , Young AdultABSTRACT
INTRODUCTION: This study investigated the association of CD14 -260C>T and TLR4 +896A>G gene polymorphisms with post-treatment apical periodontitis in Brazilian individuals. METHODS: The study population consisted of 41 patients with post-treatment apical periodontitis and 42 individuals with root canal-treated teeth exhibiting healed/healing periradicular tissues (controls). All teeth had apical periodontitis lesions at the time of treatment, which was completed at least 1 year previously. Saliva was collected from the participants; DNA was extracted and used for CD14 and TLR4 genotyping using the polymerase chain reaction-restriction fragment length polymorphism approach and a real-time polymerase chain reaction TaqMan assay (Applied Biosystems, Foster City, CA), respectively. RESULTS: No specific genotype or allele of the CD14 and TLR4 genes or any combination thereof was positively associated with post-treatment apical periodontitis (P > .05). CONCLUSIONS: Data from the present study suggest that polymorphisms in the CD14 and TLR4 genes do not influence the response to endodontic treatment of teeth with apical periodontitis.
Subject(s)
Lipopolysaccharide Receptors/genetics , Periapical Periodontitis/therapy , Polymorphism, Genetic/genetics , Toll-Like Receptor 4/genetics , Adenine , Adult , Cytosine , Female , Gene Frequency/genetics , Genotype , Guanine , Homozygote , Humans , Male , Periapical Periodontitis/genetics , Polymerase Chain Reaction/methods , Polymorphism, Restriction Fragment Length/genetics , Polymorphism, Single Nucleotide/genetics , Radiography, Bitewing/methods , Real-Time Polymerase Chain Reaction/methods , Root Canal Therapy/methods , Saliva/chemistry , Smoking , Thymine , Wound Healing/geneticsABSTRACT
INTRODUCTION: Polymorphisms of genes encoding leukocyte surface receptors for the constant region of immunoglobulin G (FcγR) might influence the host response to infection and consequently affect the outcome of the endodontic treatment. This study investigated the association of FcγRIIIa gene (FcγRIIIA) polymorphism with post-treatment apical periodontitis in Brazilian subjects. METHODS: The study population consisted of 26 patients with post-treatment apical periodontitis and 43 subjects with root canal-treated teeth exhibiting healthy/healing periradicular tissues (controls). All teeth had apical periodontitis lesions at the time of treatment, which was completed at least 1 year previously. Saliva was collected from the participants; DNA was extracted and used for FcγRIIIA genotyping. RESULTS: No significant associations were found between any specific genotype of FcγRIIIA (P = .63) or allele (P = .76) and post-treatment apical periodontitis. Overall, the most prevalent allele in the study population was FcγRIIIA-F158 (68.8%). The genotype V/F was the most common among the population, occurring in 50.7% of the subjects. CONCLUSIONS: Data from the present study suggest that polymorphism in the FcγRIIIa does not influence the patient's response to endodontic treatment of teeth with apical periodontitis.
Subject(s)
Dental Restoration Failure , Periapical Periodontitis/genetics , Periapical Periodontitis/immunology , Receptors, IgG/genetics , Treatment Failure , Adult , Alleles , Brazil , Case-Control Studies , Chi-Square Distribution , Chronic Disease , Female , Gene Frequency , Genetic Predisposition to Disease , Genotype , Humans , Male , Multiplex Polymerase Chain Reaction , Periapical Periodontitis/therapy , Polymorphism, Genetic , Root Canal Therapy , Saliva/chemistryABSTRACT
OBJECTIVE: Herpesvirus infection can cause immunosuppression and then act as a modifier of apical periodontitis, influencing the disease severity and response to treatment. The purpose of this study was to investigate if herpesvirus infection, as inferred by salivary carriage, may influence the endodontic treatment outcome. STUDY DESIGN: The study population included 72 patients who had root canals treated more than 1 year previously because of necrotic pulps and apical periodontitis. At the follow-up examination, 27 of these patients presented with posttreatment apical periodontitis (failure) and 45 individuals exhibited healed/healing periradicular tissues (success). Saliva was collected from these individuals, DNA was extracted, subjected to multiple displacement amplification, and screened by polymerase chain reaction (PCR) assays for the presence of 6 herpesviruses: herpes simplex virus types 1 and 2 (HSV-1/2), Epstein-Barr virus (EBV), human cytomegalovirus (HCMV), human herpesvirus-6 (HHV-6), and human herpesvirus-8 (HHV-8). RESULTS: Except for HSV-1/2, all other herpesviruses were detected in saliva from both healed/healing and diseased groups. HHV-8 was the most frequent herpesvirus found in saliva (84% in success, 89% in failure), followed by HCMV (22% in success, 30% in failure), EBV (16% in success, 18.5% in failure) and HHV-6 (7% in success, 15% in failure). No significant association of herpesvirus carriage in saliva with poor treatment outcome was discernible in the population studied (P > .05). CONCLUSIONS: Data from the present study suggest that herpesvirus infection may not influence the outcome of endodontic treatment. Further longitudinal studies are warranted to confirm these findings.
