Corrigendum to "Sustained-Release Fillers for Dentin Disinfection: An Ex Vivo Study".

[This corrects the article DOI: 10.1155/2019/2348146.].

Potential Combinatory Effect of Cannabidiol and Triclosan Incorporated into Sustained Release Delivery System against Oral Candidiasis.

Candida albicans is a common fungal pathogen. Biofilm formation on various surfaces is an important determinant of C. albicans pathogenicity. Our previous results demonstrated the high potential of cannabidiol (CBD) to affect C. albicans biofilms. Based on these data, we investigated the possibility of incorporating CBD and/or triclosan (an antimicrobial agent that is widely utilized in dentistry) in a sustained-release varnish (SRV) (SRV-CBD, SRV-triclosan) to increase their pharmaceutical potential against C. albicans biofilm, as well as that of the mixture of the agents into SRV (SRV-CBD/triclosan). The study was conducted in a plastic model, on agar, and in an ex vivo tooth model. Our results demonstrated strong antibiofilm activity of SRV-CBD and SRV-triclosan against C. albicans in all tested models. Both formulations were able to inhibit biofilm formation and to remove mature fungal biofilm. In addition, SRV-CBD and SRV-triclosan altered C. albicans morphology. Finally, we observed a dramatic enhancement of antibiofilm activity when combined SRV-CBD/triclosan was applied. In conclusion, we propose that incorporation of CBD or triclosan into SRV is an effective strategy to fight fungal biofilms. Importantly, the data demonstrate that our CBD/triclosan varnish is safe, and is not cytotoxic for normal mammalian cells. Furthermore, we propose that CBD and triclosan being in mixture in SRV exhibit complementary antibiofilm activity, and thus can be explored for further development as a potential treatment against fungal infections.

Sustained-Release Fillers for Dentin Disinfection: An Ex Vivo Study.

Enterococcus faecalis is the most commonly recovered species from failed root canal treatments. In this study, we tested the capability of a novel intracanal sustained-release filler (SRF) containing cetylpyridinium chloride (CPC) to disinfect dentinal tubules of segmented human tooth specimens. Human dental root specimens were infected with E. faecalis V583 for 3 weeks in a static environment. The tested intracanal medicaments were SRF-CPC and calcium hydroxide (CH). Each medicament was introduced into the canal of the dental specimen and incubated for 7 days. The bacteriological samples were taken by shaving the dentine surrounding the root canal with dental burs ranging in size from ISO 014-020. The obtained dentine powder was collected in test tubes containing phosphate-buffered saline, sonicated, and plated on agar plates. Colony-forming units were counted after 48 h of incubation. Random specimens were also examined under confocal laser scanning microscopy and scanning electron microscopy. A statistical difference was found in the bacterial counts obtained from all layers of infected dentin between the control and the SRF-CPC groups. CH reduced bacterial viability significantly only in the first layer of the infected dentin, up to 150 µm into the dentinal tubules. CLSM images showed that SRF-CPC killed most bacteria throughout the infected dentin up to 700 µm of penetration. SEM images demonstrated the adhesion ability of SRF-CPC to the dentinal wall. In conclusion, SRF-CPC is a potential intracanal medicament for disinfecting dentinal tubules.

Dental treatment in the era of new anti-thrombotic agents.

BACKGROUND: In recent years, there have been dramatic changes in anti-thrombotic treatment as a result of new anti-thrombotic agents, as well as changes in the indications for their use. As a consequence, dentists are encountering larger numbers of patients who are undergoing anti-thrombotic treatment and who have increased risk for bleeding. The current paper aims to review the literature regarding up-to-date anti-thrombotic treatment and provide information regarding their implications on dentistry. METHODS: An online search was performed of the literature published between 2000 and 2016. Articles dealing with evidence-based clinical guidelines for anti-thrombotic treatments, as well as literature reporting the use of anti-thrombotic medications were included. The manuscripts were screened according to their relevance to dentistry as well as their treatment protocol guidelines. RESULTS: In total, 5,539 publications were identified: 56 of 554 evidence-based clinical guidelines were found that dealt with treatment protocols with anti-thrombotic agents; and 132 of 5,539 articles describe direct anti-thrombotic medications. CLINICAL IMPLICATIONS: Dental treatment includes a risk for bleeding. As a result of the increasing number of patients taking new-generation anti-thrombotic drugs, dentists must be up to date regarding the implications of such drugs on dental treatment as well as the practical means to achieve haemostasis.

Er:YAG Laser Irradiation Induces Behavioral Changes in V. harveyi.

OBJECTIVE: Laser technologies have many different applications in medical, agricultural, and industrial fields. Studies have shown several effects of laser energy on different bacterial species, in a wide variety of settings. Recent reports have found that one of the unique features of bacteria is their ability to communicate among themselves (quorum sensing). We sought to investigate whether low-energy laser irradiation affects bacterial behavior, which is regulated by quorum sensing. METHODS: Laser irradiations were performed using Er:YAG laser (2940 nm wavelength) at output powers of 0.5, 1.5, 2.5, and 4 W on wild-type Vibrio harveyi. Bioluminescence, motility, and biofilm forming capability were assessed on the bacteria after irradiation. RESULTS: After irradiation of bacteria, positive dose/output power dependencies were found in the bioluminescence omitted from tested experimental groups. Motility of colonies on semi-solid media was inhibited as irradiation output power was increased. However, after irradiation, biomass analysis of biofilm samples showed negligible differences between the irradiated samples and controls. CONCLUSIONS: Results indicate the impact of low-energy laser irradiation on bacterial behavior such as quorum sensing and motility, without affecting bacterial growth patterns.

Comparison of positive-pressure, passive ultrasonic, and laser-activated irrigations on smear-layer removal from the root canal surface.

OBJECTIVE: The purpose of this study was to compare the efficacy of three irrigation techniques for smear-layer removal with 17% EDTA. BACKGROUND DATA: Cleaning and shaping the root canal system during endodontic treatment produces a smear layer and hard tissue debris. Three irrigation techniques were tested for solution infiltration of this layer: positive-pressure irrigation, passive ultrasonic irrigation, and laser-activated irrigation. MATERIALS AND METHODS: Sixty extracted teeth were divided into six equal groups; 17% EDTA was used for 60 sec irrigation of five of the groups. The groups were as follows: Group 1, treated only with ProTaper™ F3 Ni-Ti files; Group 2, positive-pressure irrigation, with a syringe; Group 3, passive ultrasonic irrigation, inserted 1 mm short of the working length; Group 4, passive ultrasonic irrigation, inserted in the upper coronal third of the root; Group 5, Er:YAG laser-activated irrigation, inserted 1 mm short of the working length; and Group 6, Er:YAG laser-activated irrigation, inserted in the upper coronal third of the root. RESULTS: Scanning electron microscopy showed that the smear layer is removed most efficiently using laser-activated irrigation at low energy with 17% EDTA, inserted either at the working length or only in the coronal upper third of the root. Amounts of Ca, P, and O were not significantly different on all treated dentin surfaces. CONCLUSIONS: Smear-layer removal was most effective when the root canals were irrigated using Er:YAG laser at low energy with 17% EDTA solution. Interestingly, removal of the smear layer along the entire canal was similar when the laser was inserted in the upper coronal third and at 1 mm short of the working length of the root canal. This effect was not observed with the ultrasonic and positive-pressure techniques.

Effect of Er:YAG laser-activated irrigation solution on Enterococcus Faecalis biofilm in an ex-vivo root canal model.

UNLABELLED: Abstract Objective: The purpose of this study was to evaluate mineral content and surface morphology of root canals coated with Enterococcus faecalis biofilm after treatment with several endodontic irrigation solutions, with and without Er:YAG laser-activated irrigation (LAI). BACKGROUND DATA: LAI has been introduced as a powerful method for root canal irrigation resulting in smear-layer removal from the root canal wall. METHODS: Distal and palatal roots from 60 freshly extracted human molars were used in this study. The coronal of each tooth was removed. Roots were split longitudinally and placed in an ultrasonic bath to remove the smear layer, creating conditions for the formation of E. faecalis biofilm. After incubation, the two halves were reassembled in impression material to simulate clinical conditions. Specimens were divided into two main groups: roots rinsed with irrigation solutions and roots subjected to laser irradiation combined with irrigation solutions. Solutions tested were 2% chlorhexidine and 17% ethylenediaminetetraacetic acid (EDTA) and saline. RESULTS: Surface morphology: 17% EDTA irrigant solution combined with Er:YAG laser showed the best results for removing bacteria from the root canal walls. Chemical analysis: all samples treated with combined laser irradiation and irrigation solution had low surface levels of Ca compared with samples treated with irrigation alone. The Ca/P ratio was highest in the laser-EDTA group. Overall, mineral changes caused by laser with irrigation solutions were minimal, and statistically nonsignificant. CONCLUSIONS: In vitro irrigation solutions, combined with Er:YAG laser irradiation, were effective in removing E. faecalis biofilm from root canal walls. Irrigation solutions without laser irradiation were less effective, leaving a layer of biofilm on the dentin surface.

Synergistic effect of Er:YAG laser irradiation in combination with chlorhexidine on the viability of Enterococcus faecalis: an in vitro study.

OBJECTIVE: This study aimed to examine the potential synergistic effect of laser and chlorhexidine (CHX) applications on the growth of Enterococcus faecalis. BACKGROUND DATA: CHX has been recommended for root canal irrigation because of its antibacterial properties. Er:YAG 2.94??m laser irradiation was shown to be beneficial in disinfecting infected root canals. Producing minimal side effects is the goal of any clinical procedure. One means of achieving this is via a synergistic effect caused by simultaneously introducing two applications with reduced dosages, with no compromise on their biological effect. METHODS: Bacterial suspensions of E. faecalis supplemented with 0.01?0.0001% v/v CHX solutions were lased at energy levels between 300 and 500?mJ. Bacterial growth was continuously monitored for 18?h using a GENios apparatus. RESULTS: Laser irradiation between 350 and 500?mJ delayed initiation of bacterial growth for 6?h. A concentration of 0.0001% CHX did not delay bacteria growth. However, a combination of 0.0001% CHX and laser irradiation had a synergistic effect on bacterial growth. A maximal inhibition period of bacterial growth was observed at energy levels of 500?mJ with 0.0001% CHX. CONCLUSIONS: Laser combined with CHX has a synergistic effect in killing E. faecalis. A combined regimen of a low concentration of CHX with laser irradiation was found to be a potential means of inhibiting bacterial growth.

Lasers in endodontics.

With the rapid development of laser technology, new lasers with a wide range of characteristics are now available and being used in various fields of dentistry. In the past two decades, much experience and knowledge has been gained. This article provides an overview of the current and possible future clinical applications of lasers in endodontics, including their use in alleviating dentinal hypersensitivity, modification of the dentin structure, pulp diagnosis, pulp capping and pulpotomy, cleaning and shaping of the root canal system, and endodontic surgery. Endodontic procedures for which conventional treatments cannot provide comparable results or are less effective are emphasized.