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Background Carbapenem-resistant Acinetobacter baumannii (CRAB) are difficult to eradicate from the environment and are virtually immune to all antibiotics. Consequently, CRAB may culminate in severe outbreaks and fatal infections among people attending hospitals and nursing homes. Salvadora persica has been used as an herbal remedy and chewing sticks for dental cleansing. Evaluating S. persica's efficacy against CRAB may provide an alternative approach to treating CRAB infections in healthcare environments, considering its traditional application in dental hygiene. Employing S. persica as an herbal remedy could be a part of a more sustainable approach to control CRAB infections. Aim To investigate the phytochemical composition of S. persica and evaluate its antimicrobial properties. Materials and methods The roots were extracted by Soxhlet apparatus using n-hexane, chloroform, and methanol. Each extract was analyzed using gas chromatography-mass spectrometry (GCMS) and characterized using WN908.L and National Institute of Standards and Technology (NIST) libraries. The antimicrobial activity of each extract against CRAB was evaluated using a broth microdilution assay to determine the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC). Results The GCMS analysis of different solvent extracts of S. persica roots showed the presence of various phytochemical compounds such as steroids, phenolic compounds, fatty acids, alcohols, terpenoids, and vitamin E. Both chloroform and hexane extracts showed the most effective antimicrobial activity with a MIC value of 3.13 mg/mL and an MBC value of 12.50 mg/mL, respectively. Benzoic acid was the major phytochemical compound identified from S. persica extract. N-hexane, chloroform, and methanol extracts exhibited maximum antimicrobial activity due to the presence of active compounds in them. Conclusion Chloroform and hexane extracts showed the most potent antibacterial activities against CRAB.
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The main goal of root canal treatment is to eliminate the infection in the complex root canal system for the long-term preservation of a functional tooth. Proper debridement of the root canal system, especially in the apical portion, is essential for successful root canal treatment. The complexity of the canal anatomy in the apical region plays a crucial role in reducing the microbial load. Therefore, clinicians must have a thorough knowledge of the anatomy of the root canal system and its variations, especially in the apical portion. Root canal configurations in cross-section have been classified as round, oval, long oval, flattened, or irregularly shaped. Treating oval, long oval, flattened, or irregularly shaped canals is challenging and should be approached differently than a circular canal. Recognizing the root canal shape and apical anatomy determines the different strategies to be used in cleaning, shaping, and obturation to achieve the best result of root canal treatment. The recent development of the instrumentation system improves the treatment outcome for clinicians and patients. This review aimed to discuss the definition, prevalence, and instrumentation for cleaning and shaping in the apical area with the complexity of root canal systems. Therefore, with the aid of this review, we can better understand the variations in the anatomy of the root canal, especially at the apical portion.
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AIM: To compare the effect of different tapers of the K3XF file system on the fracture resistance of endodontically treated mandibular premolars obturated with a three-dimensional (3-D) obturation system. METHODOLOGY: For the study, 80 freshly extracted human mandibular premolars with single well-developed roots without any curvatures were taken and the tooth roots were wrapped in a single layer of aluminum foil, and they were placed vertically in a plastic mold filled with self-curing acrylic resin. The access was opened, and working lengths were determined. The canals were instrumented keeping an apical size of #30 by different taper rotary files: Group 1: un-instrumented (control group), Group 2: 30/.04, Group 3: 30/.06, Group 4: 30/.08 K3XF file system, and teeth were obturated using a 3-D obturation system, and access cavities were filled using composite. Both experimental and control groups were subjected to fracture load using a conical steel tip (0.5mm) attached to a universal testing machine to record force applied in newton until root fracture. RESULTS: Root canal instrumented groups showed lower fracture resistance than the uninstrumented group. CONCLUSION: Hence it could be concluded that endodontic instrumentation with increased taper rotary instruments caused a decrease in fracture resistance of the teeth, and biomechanical preparation of root canal system with rotary or reciprocating instruments caused a significant decrease in fracture resistance of endodontically treated teeth (ETT), thereby decreasing their prognosis and long-term survival.
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Calcium silicate-based cements (CSCs) are widely used in various endodontic treatments to promote wound healing and hard tissue formation. Chitosan-based accelerated Portland cement (APC-CT) is a promising and affordable material for endodontic use. This study investigated the effect of APC-CT on apoptosis, cell attachment, dentinogenic/osteogenic differentiation and mineralization activity of stem cells from human exfoliated deciduous teeth (SHED). APC-CT was prepared with various concentrations of chitosan (CT) solution (0%, 0.625%, 1.25% and 2.5% (w/v)). Cell attachment was determined by direct contact analysis using field emission scanning electron microscopy (FESEM); while the material extracts were used for the analyses of apoptosis by flow cytometry, dentinogenic/osteogenic marker expression by real-time PCR and mineralization activity by Alizarin Red and Von Kossa staining. The cells effectively attached to the surfaces of APC and APC-CT, acquiring flattened elongated and rounded-shape morphology. Treatment of SHED with APC and APC-CT extracts showed no apoptotic effect. APC-CT induced upregulation of DSPP, MEPE, DMP-1, OPN, OCN, OPG and RANKL expression levels in SHED after 14 days, whereas RUNX2, ALP and COL1A1 expression levels were downregulated. Mineralization assays showed a progressive increase in the formation of calcium deposits in cells with material containing higher CT concentration and with incubation time. In conclusion, APC-CT is nontoxic and promotes dentinogenic/osteogenic differentiation and mineralization activity of SHED, indicating its regenerative potential as a promising substitute for the commercially available CSCs to induce dentin/bone regeneration.
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INTRODUCTION: While there are many root morphology classification systems with their own distinct advantages, there are many shortcomings that come along with each system. OBJECTIVES: The aim of this review was to compare the various root and root canal morphology classifications, their advantages, limitations, and clinical and research implications. Data Sources and Selection. An extensive literature search was conducted on PubMed and Scopus to identify the published data on root and root canal classification systems published until 1 May 2020 using keywords, root canal classification system, classification systems for root canals, and root morphology. The related literature was reviewed and then summarized. Data Synthesis. Several studies have analysed and detailed root and root canal classifications and further added new subsystems, works of Weine et al. (1969) and Vertucci et al. (1974). Besides, Sert and Bayirli (2004) added supplementary types to Vertucci's classification system. A new classification was most recently introduced by Ahmed et al. (2017) involving the use of codes for tooth numbering, number of roots, and canal configuration. CONCLUSIONS: Weine et al. classified only single-rooted teeth, without considering multirooted teeth and complex configurations. Vertucci's classification included complex configurations, with Sert and Bayirli adding further complex supplemental types. Ahmed et al.'s classification simplifies classifying root and canal morphology while overcoming the limitations of several previous classification systems making it beneficial for implementation in dental schools.
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This study aimed to investigate the effects of nanohydroxyapatite-silica-glass ionomer cement (nanoHA-silica-GIC) on the differentiation of dental pulp stem cells (DPSCs) into odontogenic lineage. DPSCs were cultured in complete Minimum Essential Medium Eagle-Alpha Modification (α-MEM) with or without nanoHA-silica-GIC extract and conventional glass ionomer cement (cGIC) extract. Odontogenic differentiation of DPSCs was evaluated by real-time reverse transcription polymerase chain reaction (rRT-PCR) for odontogenic markers: dentin sialophosphoprotein (DSPP), dentin matrix protein 1 (DMP1), osteocalcin (OCN), osteopontin (OPN), alkaline phosphatase (ALP), collagen type I (COL1A1), and runt-related transcription factor 2 (RUNX2) on day 1, 7, 10, 14, and 21, which were normalized to the house keeping gene glyceraldehyde-3-phosphate dehydrogenase (GAPDH). Untreated DPSCs were used as a control throughout the study. The expressions of DSPP and DMP1 were higher on days 7 and 10, that of OCN on day 10, those of OPN and ALP on day 14, and that of RUNX2 on day 1; COL1A1 exhibited a time-dependent increase from day 7 to day 14. Despite the above time-dependent variations, the expressions were comparable at a concentration of 6.25 mg/mL between the nanoHA-silica-GIC and cGIC groups. This offers empirical support that nanoHA-silica-GIC plays a role in the odontogenic differentiation of DPSCs.
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An untreated root canal infection usually stimulates the development of a radicular cyst. Nonsurgical root canal procedures and periapical surgery followed by placement of bone substitute will promote the healing process of the bony defect.
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BACKGROUND: Despite their lower strength, glass ionomer cements (GICs) are widely used as restorative materials because of their anti-cariogenic properties, direct adhesion to tooth structure and good biocompatibility. Recently, the addition of nano-hydroxyapatite (nano-HA)-silica to conventional GIC (cGIC) has been shown to improve the strength of cGIC. However, the biocompatibility and cell attachment properties of this material are unknown. AIMS: This study aims to evaluate and compare the cytotoxicity and cell attachment properties of cGIC and nano-HA-silica-GIC on dental pulp stem cells (DPSCs). METHODS AND MATERIALS: Material extracts of nano-HA-silica-GIC and cGIC were prepared into seven serial dilutions and applied to 96 well plates seeded with DPSCs. After 72 h, the cell viability was determined using MTT assay. The DPSCs cell attachment properties were examined under scanning electron microscope (SEM) after 24 and 72 h. Kruskal-Wallis test was used to analyse the data for MTT assay (P < 0.05). SEM images of cell attachment properties were also described. RESULTS: Nano-HA-silica-GIC and cGIC was shown to be slight to non-cytotoxic at all concentrations, except 200 mg/ml. Moderate cytotoxicity has been observed at 200 mg/ml concentration where nano-HA-silica-GIC and cGIC revealed cell viability values of 44.38 and 42.15%, respectively. Nano-HA-silica-GIC demonstrated better cell viability values than cGIC at all concentrations except for 6.25 and 12.5 mg/ml. Nevertheless, the results were not statistically significant (P > 0.05). SEM examination revealed the increasing numbers of DPSCs attached to both groups with prominent filopodia, especially after 72 h. CONCLUSIONS: Nano-HA-silica-GIC exhibited good biocompatibility which is comparable to cGIC and favoured the attachment of DPSCs.
