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Xie B, Liang C, Liu C, Wang X, Zhou H, Zhou J, Li K, Xu H, Su X, Luo Y, Zhang H, Liang D, Long A, Zhuo S, He X, Lin D, Chen Z, Chen W, Wang Y, Jiang X. Visual Antimicrobial Gold Nanocluster Hydrogel with Inflammation-Responsive and Time-Regulated Swelling/Degradation for Regenerative Endodontic Procedures. ACS NANO 2025; 19:11861-11877. [PMID: 40118781 DOI: 10.1021/acsnano.4c14202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/23/2025]
Abstract
Regenerative endodontic procedures (REPs) have become the primary therapy for immature permanent teeth. Double antibiotic (DA, ciprofloxacin, and metronidazole) is recommended as the intracanal medicament in REPs. However, it has several limitations, such as toxicity to stem cells, short-term antibacterial efficacy, and inability to be visualized radiographically. In this study, a method is induced to construct an antimicrobial gold nanocluster (Au NC) hydrogel loading DA (DA@Au NCs) via electrostatic interactions and disulfide bond generation for REPs. As exposed to interstitial fluid from root canal infection, DA@Au NCs can swell and fill the canal to thoroughly contact with bacteria in its biofilm. The increasing interstitial fluid and its internal protease can trigger the degradation of DA@Au NC hydrogel to release DA, and it has been found that the cross-linking time of hydrogel can regulate its degradation time because of the positive correlation between them. Au NC hydrogel has the characteristics of radiographical visualization to track the drug location and release dynamics. These properties can improve the antimicrobial efficiency, achieve long-term antibacterial effects, and reduce cells toxicity. Moreover, the hydrogel can also kill planktonic bacteria and biofilm, even penetrating dentin tubules. Attributed to the introduction of Au NCs, it also supports stem cell proliferation, migration, adhesion, and mineralization by regulating the expression of alkaline phosphatase (ALP). The in vivo experiments also verified that the multiple properties of DA@Au NC hydrogel offer a solution to address the problem of REPs.
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Affiliation(s)
- Beibei Xie
- Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, College & Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi 530021, China
- Conservative Dentistry & Endodontics Department, College & Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi 530021, China
| | - Chunyun Liang
- Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, College & Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi 530021, China
- Conservative Dentistry & Endodontics Department, College & Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi 530021, China
| | - Cong Liu
- Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, College & Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi 530021, China
- Conservative Dentistry & Endodontics Department, College & Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi 530021, China
| | - Xu Wang
- Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, College & Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi 530021, China
- Conservative Dentistry & Endodontics Department, College & Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi 530021, China
| | - Hailun Zhou
- Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, College & Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi 530021, China
- Conservative Dentistry & Endodontics Department, College & Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi 530021, China
| | - Jun Zhou
- Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, College & Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi 530021, China
- Conservative Dentistry & Endodontics Department, College & Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi 530021, China
| | - Kangjing Li
- Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, College & Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi 530021, China
- Conservative Dentistry & Endodontics Department, College & Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi 530021, China
| | - Huasheng Xu
- Stomatology Department, Affiliated Minzu Hospital of Guangxi Medical University, Guangxi, Nanning, Guangxi 530001, China
| | - Xiaoping Su
- Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, College & Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi 530021, China
- Experimental Research Department, College & Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi 530021, China
| | - Ying Luo
- Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, College & Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi 530021, China
- Experimental Research Department, College & Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi 530021, China
| | - Hao Zhang
- Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, College & Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi 530021, China
- Experimental Research Department, College & Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi 530021, China
| | - Dan Liang
- Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, College & Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi 530021, China
- Conservative Dentistry & Endodontics Department, College & Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi 530021, China
| | - Ao Long
- Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, College & Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi 530021, China
- Experimental Research Department, College & Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi 530021, China
| | - Shufang Zhuo
- Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, College & Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi 530021, China
- Experimental Research Department, College & Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi 530021, China
| | - Xuan He
- Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, College & Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi 530021, China
- Conservative Dentistry & Endodontics Department, College & Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi 530021, China
| | - Dan Lin
- Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, College & Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi 530021, China
- Experimental Research Department, College & Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi 530021, China
| | - Zhiyong Chen
- Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, College & Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi 530021, China
- Experimental Research Department, College & Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi 530021, China
| | - Wenxia Chen
- Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, College & Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi 530021, China
- Conservative Dentistry & Endodontics Department, College & Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi 530021, China
| | - Yaling Wang
- New Cornerstone Science Laboratory, CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety and CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology of China, Chinese Academy of Sciences, Beijing 100190, China
| | - Xinglu Jiang
- Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, College & Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi 530021, China
- Experimental Research Department, College & Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi 530021, China
- Clinical Laboratory Medicine Department, College & Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi 530021, China
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Tuamsomboon P, Charumanee S, Junmahasathien T, Louwakul P. Effect of Vehicles and Irrigation Solutions and Methods on Removal of Double Antibiotic Paste from Root Canals: Insights from High-performance Liquid Chromatography Analysis. J Endod 2024; 50:1307-1313. [PMID: 38851482 DOI: 10.1016/j.joen.2024.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Revised: 05/19/2024] [Accepted: 06/02/2024] [Indexed: 06/10/2024]
Abstract
INTRODUCTION In regenerative endodontics, eradicating antibiotic residues from root canals is imperative, given their detrimental effects on human apical papilla stem cells. Previous antibiotic removal studies lacked precision in identifying types and quantities of residual antibiotics. High-performance liquid chromatography (HPLC) enhances sensitivity and specificity, enabling accurate detection and quantification of residual drugs. Using HPLC analysis, this study explored the influence of vehicles and irrigation solutions and methods on double antibiotic paste (DAP) removal from root canals. METHODS Two DAP formulations, each containing 5 mg/mL ciprofloxacin and metronidazole, were created using distinct vehicles: macrogol and propylene glycol (MP) or hydroxypropyl methylcellulose (HPMC). Subsequently, 5 μL of DAP was applied to 200 simulated immature teeth with open apices (n = 100 per formulation) and cultured for 28 days at 37°C. Samples were then divided into 11 groups (n = 20 per group), and canals were irrigated with 17% ethylenediaminetetraacetic acid or 10% citric acid, employing a positive pressure syringe or passive ultrasonic irrigation. The irrigation solution and dentin sample from each tooth were evaluated via HPLC for ciprofloxacin and metronidazole quantification. RESULTS Citric acid exhibited significantly superior efficacy in antibiotic removal from root canals, with no observable effect of irrigation methods on drug removal. The HPMC-based DAP formulation significantly enhanced ciprofloxacin removal compared with MP-based DAP. CONCLUSIONS For antibiotic paste removal from root canals, citric acid is effective, and HPMC is a preferable vehicle over MP. Overall, HPLC is a valuable method for detecting, removing, and quantifying residual antibiotics in root canals.
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Affiliation(s)
- Pornsupa Tuamsomboon
- Postgraduate Student in Endodontics, Faculty of Dentistry, Department of Restorative Dentistry and Periodontology, Chiang Mai University, Mueang, Chiang Mai, Thailand
| | - Suporn Charumanee
- Faculty of Pharmacy, Department of Pharmaceutical Sciences, Chiang Mai University, Mueang, Chiang Mai, Thailand
| | - Taepin Junmahasathien
- Faculty of Pharmacy, Department of Pharmaceutical Sciences, Chiang Mai University, Mueang, Chiang Mai, Thailand
| | - Phumisak Louwakul
- Faculty of Dentistry, Department of Restorative Dentistry and Periodontology, Chiang Mai University, Mueang, Chiang Mai, Thailand.
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Alazemi MJ, Badawi MF, Elbeltagy MG, Badr AE. Examining the Effects of Asiaticoside on Dental Pulp Stem Cell Viability and Proliferation: A Promising Approach to Root Canal Treatment. J Contemp Dent Pract 2024; 25:118-127. [PMID: 38514408 DOI: 10.5005/jp-journals-10024-3636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
AIM This study aims to evaluate the impact of asiaticoside (AC) on the viability and proliferation of dental pulp stem cells (DPSCs), considering the known negative effects of routinely used intracanal medicaments. This evaluation will be compared with the outcomes from using traditional intracanal medicaments, specifically triple antibiotic paste (TAP) and calcium hydroxide [Ca(OH)2]. MATERIALS AND METHODS The DPSCs were obtained from the third molars of an adult donor. The application of flow cytometry was employed to do a phenotypic analysis on DPSCs using CD90, CD73, CD105, CD34, CD14, and CD45 antibodies. The methylthiazol tetrazolium (MTT) assay was employed to assess cellular viability. The cells were treated with different concentrations of TAP and Ca(OH)2 (5, 2.5, 1, 0.5, and 0.25 mg/mL), along with AC (100, 50, 25, 12.5, and 6.25 µM). A cell proliferation rate was performed at 3, 5, and 7 days. RESULTS The characterization of DPSCs was conducted by flow cytometry analysis, which verified the presence of mesenchymal cell surface antigen molecules (CD105, CD73, and CD90) and demonstrated the absence of hematopoietic markers (CD34, CD45, and CD14). Cells treated with concentrations over 0.5 mg/mL of TAP and Ca(OH)2 showed a notable reduction in cell viability in comparison to the untreated cells (p < 0.05). Additionally, the cells treated with different concentrations of AC 12.5, 6.25, 25, and 50 µM did not differ significantly from the untreated cells (p > 0.05). Nevertheless, cells treated with concentrations of 100 µM showed a significant reduction in viability compared to the untreated cells (p < 0.05). After a period of 7 days, it was noted that cells exposed to three different concentrations of AC (50, 25, and 12.5 µM) had a notable rise in cell density in comparison to TAP and Ca(OH)2 (p < 0.05). Furthermore, cells that were exposed to a concentration of 12.5 µM exhibited the highest cell density. CONCLUSION The cellular viability of the AC-treated cells was superior to that of the TAP and Ca(OH)2-treated cells. Moreover, the AC with a concentration of 12.5 µM had the highest degree of proliferation. CLINICAL SIGNIFICANCE This study underscores the importance of evaluating alternative root canal medicaments and their effects on DPSCs' growth and vitality. The findings on AC, particularly its influence on the survival and proliferation of DPSCs, offer valuable insights for its probable use as an intracanal medication. This research contributes to the ongoing efforts to identify safer and more effective intracanal treatments, which are crucial for enhancing patient outcomes in endodontic procedures. How to cite this article: Alazemi MJ, Badawi MF, Elbeltagy MG, et al. Examining the Effects of Asiaticoside on Dental Pulp Stem Cell Viability and Proliferation: A Promising Approach to Root Canal Treatment. J Contemp Dent Pract 2024;25(2):118-127.
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Affiliation(s)
- Mohammad J Alazemi
- Department of Endodontics, Faculty of Dentistry, Mansoura University, Mansoura, Egypt, Orcid: https://orcid.org/0009-0005-5245-6514
| | - Manal F Badawi
- Department of Dental Biomaterials, Faculty of Dentistry, Mansoura University, Mansoura, Egypt, Orcid: https://orcid.org/0000-0001-9979-4354
| | - Mohamed G Elbeltagy
- Department of Stem Cells Research, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt., Orcid: https://orcid.org/0000-0003-3309-4480
| | - Amany E Badr
- Department of Endodontics, Faculty of Dentistry, Mansoura University, Mansoura, Egypt, Phone: +201200211211, e-mail: , Orcid: https://orcid.org/0000-0002-3811-149X
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Nasr El-Din S, Hassan R. The efficacy of various irrigation techniques on the removal of double antibiotic paste from simulated immature roots and the amount of apically extruded debris. BDJ Open 2024; 10:2. [PMID: 38182568 PMCID: PMC10770069 DOI: 10.1038/s41405-023-00183-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 12/11/2023] [Accepted: 12/12/2023] [Indexed: 01/07/2024] Open
Abstract
OBJECTIVE This study evaluated the effect of the XP-Endo Finisher (XPF), passive ultrasonic irrigation (PUI) and conventional irrigation using side-vented needle (SVN) on the amount of apically extruded debris and canal cleanliness following the removal of double antibiotic paste (DAP) from immature root canal models. MATERIAL AND METHODS Forty-eight extracted mandibular premolars were drilled using peeso drills to simulate immature apices. The canals were filled with DAP and were randomly assigned into 3 groups according to the DAP removal method: XPF, PUI, and SVN (n = 16). The amount of extruded debris was assessed with an analytical balance then roots were split longitudinally and imaged using stereomicroscope to evaluate the residual medicament. Data were statistically analyzed using Kruskal-Wallis and Dunn's test. Spearman's correlation coefficient was used to determine significant correlation between extruded debris and the residual DAP scores. RESULTS There was no significant difference between debris extrusion values for all groups (P value 0.237). For canal cleanliness, the amount of remaining DAP was significantly lower in the XPF and PUI compared to SVN (P value < 0.001). A non-significant positive (direct) correlation was found between the amounts of apically extruded debris and residual DAP scores (P value 0.087). CONCLUSION XPF and PUI were associated with better canal cleanliness during removal of DAP, no difference could be found between the three irrigation techniques regarding the debris extrusion.
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Affiliation(s)
| | - Reham Hassan
- Faculty of Dentistry, The Egyptian Russian University, Badr city, Egypt.
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Amer NA, Badawi MF, Elbeltagi MG, Badr AE. Effect of Boswellic Acid on Viability of Dental Pulp Stem Cells Compared to the Commonly Used Intracanal Medications: An In Vitro Study. J Contemp Dent Pract 2023; 24:957-966. [PMID: 38317393 DOI: 10.5005/jp-journals-10024-3609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
AIM This study was aimed at evaluating the effect of acetyl-11-keto-β-boswellic acid (AKBA) on dental pulp stem cells (DPSCs) viability and proliferation to be used as a potential root canal medicament. MATERIALS AND METHODS Dental pulp stem cells were isolated from human third molars. The phenotypic characterization of DPSCs was verified by flow cytometry analysis. The viability assay was performed using the methyl-thiazoltetrazolium (MTT) assay. Cells were treated with different concentration of triple antibiotic paste (TAP) and calcium hydroxide Ca(OH2) (5, 2.5, 1, 0.5, and 0.25 mg/mL), AKBA (10, 5, 1, 0.1, and 0.01 µM). All experiments were done in separate triplicate experiments. Results: Dental pulp stem cells were characterized by flow cytometry. Cells treated with Ca(OH)2 (1, 2.5, and 5 mg/mL) showed significantly reduced viability compared with the control cells (p < 0.05). Dental pulp stem cells treated with 1, 2.5, and 5 mg/mL TAP resulted in a significant decrease in viability (p < 0.05). Cells treated with AKBA in concentrations (1, 0.1, and 0.01 µM) demonstrated higher viability than the control group (p < 0.05), while AKBA in concentrations (5 and 10 µM) showed equal or decreased viability than the control group. (p > 0.05). Regarding cell density assay, AKBA showed significant increase in cell density after 5 and 7 days compared with cells medicated with TAP and Ca(OH)2 while TAP revealed marked reduction in cell density in all the tested intervals. CONCLUSION Acetyl-11-keto-β-boswellic acid in lower concentrations (0.01, 0.1, and 1 µM) demonstrated superior cell viability than TAP and Ca(OH)2, and it may possess the potential to be an intracanal medicament in regenerative endodontics. CLINICAL SIGNIFICANCE Studying the effect of different potential root canal medicaments and their capability to induce DPSCs proliferation might be of value. The influence of AKBA on the viability and proliferation of DPSCs tested in this study sheds light on its use as a potential intracanal medication especially in regenerative endodontics. How to cite this article: Amer NA, Badawi MF, Elbeltagi MG, et al. Effect of Boswellic Acid on Viability of Dental Pulp Stem Cells Compared to the Commonly Used Intracanal Medications: An In Vitro Study. J Contemp Dent Pract 2023;24(12):957-966.
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Affiliation(s)
- Nouran Ahmad Amer
- Department of Endodontics, Faculty of Dentistry, Mansoura University; Horus University, Egypt, Phone: +201068857871, e-mail: , Orcid: https://orcid.org/0000-0001-6818-8626
| | - Manal Farouk Badawi
- Dental Biomaterials, Faculty of Dentistry, Mansoura University, Egypt, Orcid: https://orcid.org/0000-0001-9979-4354
| | - Mohamed Gamal Elbeltagi
- Urology and Nephrology Center, Mansoura University, Mansoura, Egypt, Orcid: https://orcid.org/0000-0003-3309-4480
| | - Amany Elsaid Badr
- Department of Endodontics, Faculty of Dentistry, Mansoura University, Egypt, Orcid: https://orcid.org/0000-0002-3811-149X
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H.A Sabrah A, Hammad MM, Wahab FK, AlHadidi A, Salim NA, Alelaimat AF, Khatib I. A prospective case series in regenerative endodontics: The effective use of diluted antibiotic hydrogels in endodontic regeneration procedures. Saudi Dent J 2023; 35:854-860. [PMID: 38025603 PMCID: PMC10658392 DOI: 10.1016/j.sdentj.2023.06.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 06/14/2023] [Accepted: 06/17/2023] [Indexed: 12/01/2023] Open
Abstract
Objective to investigate the effectiveness of diluted antibiotic hydrogels in endodontic regeneration procedures. Materials and Methods One conventional treatment (calcium hydroxide) and two experimental treatments containing 1 mg/mL antibiotic in gel (MC-TAP and MC-DAP) were prepared for this study. The effect of these medicaments on the proliferation and differentiation potential of dental pulp stem cells (DPSCs) was examined before their clinical use, using WST and ALP assays. Twenty-two teeth diagnosed with necrotic immature roots were treated with calcium hydroxide, MC-TAP or MC-DAP using the endodontic regeneration protocol as described by the American Association of Endodontists (AAE). Teeth were examined after application of the medicament, at the time of regeneration and after 12-24 months. Results All treated teeth showed resolution of signs and symptoms shortly after treatment with the different medicaments. However, signs and symptoms returned a few months after initial treatment in clinical cases treated with MC-DAP. All successfully treated teeth examined after 12-24 months were free of signs and symptoms, but vitality was not achieved. Conclusion Low concentration antibiotic gel containing triple antibiotic paste (MC-TAP) can be successfully used for endodontic regeneration procedures.
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Affiliation(s)
- Alaa H.A Sabrah
- The University of Jordan, Department of Restorative dentistry, Amman 11942, Jordan
| | - Mohammad M. Hammad
- The University of Jordan, Department of Restorative dentistry, Amman 11942, Jordan
| | - Fouad K Wahab
- The University of Jordan, Department of Restorative dentistry, Amman 11942, Jordan
| | - Abeer AlHadidi
- The University of Jordan, Department of maxillofacial surgery, Amman 11942, Jordan
| | - Nesreen A Salim
- The University of Jordan, Department of Removable prosthodontics, Amman 11942, Jordan
| | | | - Ibrahim Khatib
- The University of Jordan, Department of Removable prosthodontics, Amman 11942, Jordan
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Rayos-Verdugo JY, Rivera-Chaparro F, Castro-Salazar GY, Ramírez-Álvarez M, Romero-Quintana JG, Loyola-Rodríguez JP, Zavala-Alonso NV, Avendaño-Félix M, Soto-Sainz JE, Silva-Benítez EDL. Propylene Glycol Potentiates the Inhibitory Action of CTZ Paste on Antibiotic-Resistant Enterococcus faecalis Isolated from the Root Canal: An In Vitro Study. Microorganisms 2023; 11:2208. [PMID: 37764052 PMCID: PMC10537855 DOI: 10.3390/microorganisms11092208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 08/25/2023] [Accepted: 08/29/2023] [Indexed: 09/29/2023] Open
Abstract
This study aimed to evaluate if the change of vehicle for CTZ (Chloramphenicol, Tetracycline, zinc oxide, and Eugenol) paste improves the inhibition of Enterococcus faecalis in vitro. The vehicles evaluated alone and mixed with CTZ were Eugenol, propylene glycol (PG), super-oxidized solution (SOS), grapefruit-seed extract (GSE), and 0.9% saline solution as a negative control. A clinical isolate of E. faecalis was morphologically and biochemically characterized, and its antimicrobial susceptibility was tested using 20 antimicrobial agents. Once characterized, the clinical isolate was cultivated to perform the Kirby-Bauer disc diffusion method with paper discs embedded with the different vehicles mixed or used alone, and incubated at 37 °C for 24 h. Data were analyzed using one-way ANOVA, and the means were compared using Tukey test with a significance level of p < 0.05. For vehicles used alone, GSE presented the greatest inhibition showing a statistically significant difference with the rest of the vehicles. When vehicles were mixed with the CTZ paste, PG showed a greater inhibition with a statistically significant difference from the rest of the vehicles. In conclusion, the vehicle used to mix the CTZ paste plays an important role in the inhibition of E. faecalis in vitro; therefore, we consider that this can be an important factor to achieve success in the use of this technique.
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Affiliation(s)
- Jesús Yareli Rayos-Verdugo
- Especialidad de Odontopediatría, Facultad de Odontología, Universidad Autónoma de Sinaloa, Culiacán 80040, Mexico;
| | - Fernando Rivera-Chaparro
- Laboratorio de Microbiología, Facultad de Ciencias Químico-Biológicas, Universidad Autónoma de Sinaloa, Culiacán 80040, Mexico; (F.R.-C.); (J.G.R.-Q.)
| | - Gloria Yolanda Castro-Salazar
- Especialidad de Endodoncia, Facultad de Odontología, Universidad Autónoma de Sinaloa, Culiacán 80040, Mexico; (G.Y.C.-S.); (M.R.-Á.); (M.A.-F.); (J.E.S.-S.)
| | - Maricela Ramírez-Álvarez
- Especialidad de Endodoncia, Facultad de Odontología, Universidad Autónoma de Sinaloa, Culiacán 80040, Mexico; (G.Y.C.-S.); (M.R.-Á.); (M.A.-F.); (J.E.S.-S.)
- Maestría en Rehabilitación Oral Avanzada, Facultad de Odontología, Universidad Autónoma de Sinaloa, Culiacán 80040, Mexico;
| | - José Geovanni Romero-Quintana
- Laboratorio de Microbiología, Facultad de Ciencias Químico-Biológicas, Universidad Autónoma de Sinaloa, Culiacán 80040, Mexico; (F.R.-C.); (J.G.R.-Q.)
| | - Juan Pablo Loyola-Rodríguez
- Maestría en Rehabilitación Oral Avanzada, Facultad de Odontología, Universidad Autónoma de Sinaloa, Culiacán 80040, Mexico;
- Maestría en Odontología Integral del Niño y el Adolescente, Facultad de Odontología, Universidad Autónoma de Sinaloa, Culiacán 80040, Mexico
| | - Norma Verónica Zavala-Alonso
- Maestría en Ciencias Odontológicas, Facultad de Estomatología, Universidad Autónoma de San Luis Potosí, San Luis Potosí 78210, Mexico;
| | - Mariana Avendaño-Félix
- Especialidad de Endodoncia, Facultad de Odontología, Universidad Autónoma de Sinaloa, Culiacán 80040, Mexico; (G.Y.C.-S.); (M.R.-Á.); (M.A.-F.); (J.E.S.-S.)
- Maestría en Rehabilitación Oral Avanzada, Facultad de Odontología, Universidad Autónoma de Sinaloa, Culiacán 80040, Mexico;
| | - Jesús Eduardo Soto-Sainz
- Especialidad de Endodoncia, Facultad de Odontología, Universidad Autónoma de Sinaloa, Culiacán 80040, Mexico; (G.Y.C.-S.); (M.R.-Á.); (M.A.-F.); (J.E.S.-S.)
- Maestría en Rehabilitación Oral Avanzada, Facultad de Odontología, Universidad Autónoma de Sinaloa, Culiacán 80040, Mexico;
| | - Erika de Lourdes Silva-Benítez
- Especialidad de Endodoncia, Facultad de Odontología, Universidad Autónoma de Sinaloa, Culiacán 80040, Mexico; (G.Y.C.-S.); (M.R.-Á.); (M.A.-F.); (J.E.S.-S.)
- Maestría en Rehabilitación Oral Avanzada, Facultad de Odontología, Universidad Autónoma de Sinaloa, Culiacán 80040, Mexico;
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Wassel M, Radwan M, Elghazawy R. Direct and residual antimicrobial effect of 2% chlorhexidine gel, double antibiotic paste and chitosan- chlorhexidine nanoparticles as intracanal medicaments against Enterococcus faecalis and Candida albicans in primary molars: an in-vitro study. BMC Oral Health 2023; 23:296. [PMID: 37542254 PMCID: PMC10401786 DOI: 10.1186/s12903-023-02862-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 03/06/2023] [Indexed: 08/06/2023] Open
Abstract
BACKGROUND Thorough disinfection of root canals in primary molars may be complicated by the complex root canal morphology. This in-vitro study aimed to compare direct and residual antimicrobial effect of 2% chlorhexidine (CHX) gel, 500 mg/ml double antibiotic paste (DAP) and chitosan-chlorhexidine nanoparticles (CS-CHX NPs) as intracanal medicaments against Enterococcus faecalis (E. faecalis) and Candida albicans (C. albicans) in primary molars. METHODS Mesial roots of 63 mandibular second primary molars were infected with E. faecalis and C. albicans. Teeth were divided into 9 groups: Ia: (CS-CHX NPs), IIa: (CHX), IIIa: (DAP), IVa: chitosan nanoparticles (CSNPs) in which medicaments were placed for 3 days, groups Ib: (CS-CHX NPs), IIb: CHX, IIIb: (DAP), IVb: (CSNPs) in which medicaments were placed for 7 days, and Group V (control): teeth were infected, irrigated with saline, and sampled 3- and 7-days post-infection. Microbiological samples were obtained after infection, 3, and 7 days after medicament placement and 7 days after medicament removal for both time points. One-way ANOVA, Tukey's post hoc test and paired t-test were used at p < 0.05. RESULTS CS-CHX NPs had the highest anticandidal effect which was comparable to CHX and significantly higher than other medicaments (p < 0.001) at both time points. CS-CHX NPs had the highest effect against E. faecalis which was comparable to DAP and significantly higher than other medicaments (p < 0.001) at 3 days. All medicaments showed similar effect against E. faecalis after 7 days. The 7-days placement significantly increased the antimicrobial effect against both micro-organisms in all groups, except CS-CHX NPs which showed an insignificant increase. CS-CHX NPs showed the highest residual effect against both micro-organisms that increased with 7-days placement. CONCLUSION CSNPs and CHX combination showed a synergistic effect against both micro-organisms. CS-CHX NPs displayed a higher effect at a shorter period compared to other medicaments, yet its residual effect was higher with 7-days placement.
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Affiliation(s)
- Mariem Wassel
- Pediatric Dentistry and Dental Public Health Department, Faculty of Dentistry, Ain Shams University Cairo, Organization of African Unity St.-Abbasia-Cairo, 11566 Cairo, Egypt
| | - Mohamed Radwan
- Pediatric Dentistry and Dental Public Health Department, Faculty of Dentistry, Ain Shams University Cairo, Organization of African Unity St.-Abbasia-Cairo, 11566 Cairo, Egypt
| | - Reham Elghazawy
- Pediatric Dentistry and Dental Public Health Department, Faculty of Dentistry, Ain Shams University Cairo, Organization of African Unity St.-Abbasia-Cairo, 11566 Cairo, Egypt
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9
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Eldessoky AE, Khalefa MM, Abu-Seida AM. Regenerative endodontic therapy in mature teeth with necrotic pulp and apical periodontitis using two disinfection protocols. BMC Oral Health 2023; 23:163. [PMID: 36949460 PMCID: PMC10031861 DOI: 10.1186/s12903-023-02863-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 03/06/2023] [Indexed: 03/24/2023] Open
Abstract
OBJECTIVE This study compared the effect of diode laser (DL) 980 nm and double antibiotic paste (DAP) on response of mature teeth with necrotic pulp and apical periodontitis to regenerative endodontic therapy in a dog model. METHODS Pulp necrosis and periapical pathosis were induced in 40 mature double rooted premolars in four 2-year-old mongrel dogs. These teeth were randomly divided according to disinfection protocol into four equal groups (10 teeth each/20 roots), group I: DAP; group II: DL980 nm; group III: positive control (without treatment) and group IV: negative control (untouched teeth). These groups were further subdivided into 2 subgroups (5 teeth each/10 roots) according to evaluation period, subgroup (A): one month and subgroup (B): three months. Revascularization techniques were performed using bleeding induction and application of platelet rich fibrin (PRF). The coronal cavities were sealed with mineral trioxide aggregate (MTA) and glass ionomer cement. The inflammatory response, vital tissue in-growth, new hard tissue formation and bone resorption were assessed. Statistical analysis was done utilizing ANOVA, Tukey's post hoc and paired t tests. RESULTS In both subgroups, there were no significant differences between DAP and DL980 in terms of inflammatory cell count, vital tissue in-growth, new hard tissue formation and bone resorption (P ≤ 0.05). CONCLUSION Diode laser 980 nm can alternate DAP as a disinfection method of the root canal during RET for mature necrotic teeth, therefore it may accelerate regenerative endodontic therapy for both the patient and dentist and allows for RET in a single appointment.
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Affiliation(s)
- Aalaa E Eldessoky
- Department of Endodontics, Faculty of Dental Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Mohammed M Khalefa
- Department of Endodontics, Faculty of Dental Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Ashraf M Abu-Seida
- Department of Surgery, Anesthesiology & Radiology, Faculty of Veterinary Medicine, Cairo University, PO: 12211, Giza, Egypt.
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10
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Velázquez-Moreno S, González-Amaro AM, Aragón-Piña A, López-López LI, Sánchez-Sánchez R, Pérez-Díaz MA, Oliva Rodríguez R, Lorenzo-Leal AC, González-Ortega O, Martinez-Gutierrez F, Bach H. Use of a Cellulase from Trichoderma reesei as an Adjuvant for Enterococcus faecalis Biofilm Disruption in Combination with Antibiotics as an Alternative Treatment in Secondary Endodontic Infection. Pharmaceutics 2023; 15:pharmaceutics15031010. [PMID: 36986869 PMCID: PMC10059093 DOI: 10.3390/pharmaceutics15031010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 03/12/2023] [Accepted: 03/16/2023] [Indexed: 03/30/2023] Open
Abstract
Apical periodontitis is an inflammation leading to the injury and destruction of periradicular tissues. It is a sequence of events that starts from root canal infection, endodontic treatment, caries, or other dental interventions. Enterococcus faecalis is a ubiquitous oral pathogen that is challenging to eradicate because of biofilm formation during tooth infection. This study evaluated a hydrolase (CEL) from the fungus Trichoderma reesei combined with amoxicillin/clavulanic acid as a treatment against a clinical E. faecalis strain. Electron microscopy was used to visualize the structure modification of the extracellular polymeric substances. Biofilms were developed on human dental apices using standardized bioreactors to evaluate the antibiofilm activity of the treatment. Calcein and ethidium homodimer assays were used to evaluate the cytotoxic activity in human fibroblasts. In contrast, the human-derived monocytic cell line (THP-1) was used to evaluate the immunological response of CEL. In addition, the secretion of the pro-inflammatory cytokines IL-6 and TNF-α and the anti-inflammatory cytokine IL-10 were measured by ELISA. The results demonstrated that CEL did not induce the secretion of IL-6 and TNF-α when compared with lipopolysaccharide used as a positive control. Furthermore, the treatment combining CEL with amoxicillin/clavulanic acid showed excellent antibiofilm activity, with a 91.4% reduction in CFU on apical biofilms and a 97.6% reduction in the microcolonies. The results of this study could be used to develop a treatment to help eradicate persistent E. faecalis in apical periodontitis.
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Affiliation(s)
- Selene Velázquez-Moreno
- Microbiology Laboratory, School of Chemical Sciences, Autonomous University of San Luis Potosí, San Luis Potosí 78300, Mexico
| | - Ana Maria González-Amaro
- Endodontics Postgraduate Program, School of Dentistry, Autonomous University of San Luis Potosí, San Luis Potosí 78300, Mexico
| | - Antonio Aragón-Piña
- Electronic Microscopy Laboratory, Institute of Metallurgy, Autonomous University of San Luis Potosí, San Luis Potosí 78300, Mexico
| | - Lluvia Itzel López-López
- Institute of Desert Zones, Autonomous University of San Luis Potosí, San Luis Potosí 78300, Mexico
| | | | - Mario Alberto Pérez-Díaz
- National Institute of Rehabilitation, Mexico City 14389, Mexico
- Biomembranes Laboratory, National School of Biological Sciences, National Polytechnic Institute, Mexico City 07738, Mexico
| | - Ricardo Oliva Rodríguez
- Endodontics Postgraduate Program, School of Dentistry, Autonomous University of San Luis Potosí, San Luis Potosí 78300, Mexico
| | - Ana C Lorenzo-Leal
- Division of Infectious Diseases, Department of Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Omar González-Ortega
- Bioseparations Laboratory, School of Chemical Sciences, Autonomous University of San Luis Potosí, San Luis Potosí 78300, Mexico
- Center for Research in Health Sciences and Biomedicine, Autonomous University of San Luis Potosí, San Luis Potosí 78300, Mexico
| | - Fidel Martinez-Gutierrez
- Microbiology Laboratory, School of Chemical Sciences, Autonomous University of San Luis Potosí, San Luis Potosí 78300, Mexico
- Center for Research in Health Sciences and Biomedicine, Autonomous University of San Luis Potosí, San Luis Potosí 78300, Mexico
- Laboratorio de Antimicrobianos Biopelículas y Microbiota, Facultad de Ciencias Químicas, Autonomous University of San Luis Potosí, San Luis Potosí 78210, Mexico
| | - Horacio Bach
- Division of Infectious Diseases, Department of Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
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11
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Eskandari F, Abbaszadegan A, Gholami A, Ghahramani Y. The antimicrobial efficacy of graphene oxide, double antibiotic paste, and their combination against Enterococcus faecalis in the root canal treatment. BMC Oral Health 2023; 23:20. [PMID: 36639767 PMCID: PMC9840282 DOI: 10.1186/s12903-023-02718-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Accepted: 01/04/2023] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Inter-appointment medication of the root canals with appropriate intracanal medicaments has been advocated to improve root canal disinfection. Graphene oxide (GO) has shown promising antimicrobial activity against a wide range of microorganisms, besides the capability of carrying antibiotics. The current study aimed to compare the antibacterial activity of double antibiotic paste (DAP) and GO per se and in combination (GO-DAP) against Enterococcus faecalis (E. faecalis). METHODS A total of 108 extracted human mandibular premolars were contaminated with three-week-old E. faecalis and subjected to a primary microbial assessment. The samples were categorized into 15 groups concerning the intracanal medicament (DAP, GO, GO-DAP, and control) and contact time (1, 7, and 14 days). Then, the root canals were medicated, incubated, and resubjected to a secondary antimicrobial evaluation. The colony-forming units (CFU) were counted to calculate the antimicrobial efficacy. The data were analyzed via the Kruskal-Wallis test (α = 0.05). RESULTS GO-DAP was the only medicament that completely eradicated E. faecalis in 1 day. The percentage reduction of CFU/ml in the GO-DAP and DAP groups was higher than that in the GO group at all allocated contact times. Furthermore, a significant decrease of the CFU/ml was seen in the GO and DAP groups after 7 and 14 days of being medicated (P < 0.05). CONCLUSION Since GO-DAP improved root canal disinfection, this novel material can be introduced as a promising intracanal medicament against E. faecalis even in the short run.
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Affiliation(s)
- Fateme Eskandari
- School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Abbas Abbaszadegan
- Department of Endodontics, School of Dentistry, Shiraz University of Medical Sciences, Ghasrdasht Street, Shiraz, 71956-15878, Iran
| | - Ahmad Gholami
- Biotechnology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Pharmaceutical Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Pharmaceutical Biotechnology, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Yasamin Ghahramani
- Department of Endodontics, School of Dentistry, Shiraz University of Medical Sciences, Ghasrdasht Street, Shiraz, 71956-15878, Iran.
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12
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Ruiz-Linares M, Monroy-Rojas JF, Solana C, Baca P, Aguado B, Soriano-Lerma A, Arias-Moliz MT, Ferrer-Luque CM. Antimicrobial potential of new diclofenac hydrogels for disinfection in regenerative endodontics: An in vitro and ex vivo study. Int Endod J 2023; 56:103-117. [PMID: 36169591 DOI: 10.1111/iej.13840] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 09/07/2022] [Accepted: 09/22/2022] [Indexed: 12/13/2022]
Abstract
AIM There is a need to explore new alternatives for root canal disinfection in regenerative endodontics, since the current strategies are far from ideal. Currently, the potential use of diclofenac (DC) is being investigated for controlling root canal infections. The objective was to evaluate the antimicrobial efficacy of novel DC-based hydrogels (DCHs) against polymicrobial biofilms grown in radicular dentine and root canals and to compare results with triantibiotic (TAH) and diantibiotic (DAH) hydrogels, and calcium hydroxide (Ca[OH]2 ). METHODOLOGY The in vitro antimicrobial activity of intracanal medicaments was evaluated against 3-week-old polymicrobial root canal biofilms grown on human radicular dentine. Dentine samples were obtained and randomly divided into the study groups (n = 4/group): (1) 1 mg/ml TAH; (2) 1 mg/ml DAH; (3) 5% diclofenac (DCH); (4) 2.5% DCH; (5) 1.25% DCH; (6) 1 mg/ml DAH + 5% DCH; (7) Ca(OH)2 paste; (8) positive control. The microbial viability, in terms of percentage of intact cell membranes, was assessed after 7 days by confocal scanning laser microscopy (CSLM). The ex vivo efficacy of intracanal medications was evaluated in root canals infected with a polymicrobial suspension. Intracanal microbiological samples at baseline (S1) and 7 days post-treatment (S2) were taken; microbial quantification and cell viability were assessed by quantitative polymerase chain reaction (qPCR) and flow cytometry (FC). The mean Log10 of bacterial DNA copies in root canal samples before (S1) and the Log10 reduction of DNA copies S1-S2 in qPCR were recorded. The absolute value of total cells stained, and the percentage reduction of intact membrane cells after treatment (S1-S2), were analysed by FC. Global comparison was done using the Kruskal-Wallis test, whilst the Mann-Whitney U test was used for pair-by-pair comparison. RESULTS Confocal scanning laser microscopy analysis indicated that the greatest effectiveness was obtained with 5% DCH, showing significant differences with respect to the other groups (p < .001). In root canals, the highest Log10 DNA reduction S1-S2 was obtained with 5% DCH and TAH, with no differences between them. The results of FC showed that only 5% DCH proved significantly superior to the other treatments. CONCLUSIONS Sodium DC hydrogels demonstrate antimicrobial efficacy against endodontic biofilms.
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Affiliation(s)
- Matilde Ruiz-Linares
- Department of Stomatology, School of Dentistry, University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Javier F Monroy-Rojas
- Department of Stomatology, School of Dentistry, University of Granada, Granada, Spain
| | - Carmen Solana
- Department of Stomatology, School of Dentistry, University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Pilar Baca
- Department of Stomatology, School of Dentistry, University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Beatriz Aguado
- Department of Stomatology, School of Dentistry, University of Granada, Granada, Spain
| | - Ana Soriano-Lerma
- Department of Physiology, Faculty of Pharmacy, Institute of Nutrition and Food Technology "José Mataix", University of Granada, Granada, Spain.,GENYO, Centre for Genomics and Oncological Research, Pfizer/University of Granada/Andalusian Regional Government, PTS Granada, Granada, Spain
| | - María Teresa Arias-Moliz
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.,Department of Microbiology, School of Dentistry, University of Granada, Granada, Spain
| | - Carmen María Ferrer-Luque
- Department of Stomatology, School of Dentistry, University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
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13
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Elgamal SG, El-Shafei JM, Azzazy HMES, Dwedar RA, El-Khodary SA. Evaluation of the Antimicrobial Effect of Pre-Synthesized Novel Antibiotic Electrospun Nanofibers as an Intracanal Delivery Strategy for Regenerative Endodontics: A Randomized Clinical Trial. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.9750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
AIM: The aim of this study is to evaluate the antimicrobial effect of pre-synthesized novel antibiotic loaded electrospun nanofibers and compare it with conventional triple antibiotic paste when used in patients with immature necrotic teeth.
METHODS: Antibiotic loaded nanofibers were fabricated by electrospinning. Thirty-four patients with immature necrotic teeth were included in the study. In the first visit, access cavity preparation was performed to obtain the first bacteriological sample (S1). The canals were thoroughly irrigated using sodium hypochlorite 1.5% and a second sampling was performed (S2). Patients were randomly divided into two groups according to the intracanal medicament used: Modified triple antibiotic paste (MTAP) loaded electrospun nanofibers or MTAP paste. At the second appointment, the third samples (S3) were taken. The intracanal bacterial count was determined using the spread plate culture technique. Scanning electron microscopy (SEM) was used to examine the morphology of the fabricated MTAP loaded electrospun nanofibers.
RESULTS: Both MTAP nanofibers and MTAP paste resulted in significant reduction of bacterial count after the irrigation step. MTAP nanofibers resulted in significantly higher percent reduction of bacterial count (p < 0.05).
CONCLUSIONS: It was concluded that electrospinning technology can be used to fabricate antibiotic containing nanofibers which can results in enhanced disinfection in regenerative endodontic procedures.
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14
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Efficacy of Ciprofloxacin, Metronidazole and Minocycline in Ordered Mesoporous Silica against Enterococcus faecalis for Dental Pulp Revascularization: An In-Vitro Study. MATERIALS 2022; 15:ma15062266. [PMID: 35329718 PMCID: PMC8953332 DOI: 10.3390/ma15062266] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 03/13/2022] [Accepted: 03/14/2022] [Indexed: 11/16/2022]
Abstract
Pulp revascularization of teeth with necrotic pulp has become an alternative treatment in cases with immature apex. Microbial control is essential to achieve a successful outcome and continued root development. Enterococcus faecalis (E. faecalis) is the most frequently isolated bacterial species in root canals of endodontically failed teeth. Our main goal was to compare the in-vitro antimicrobial efficacy of different antibiotic formulations delivered by ordered mesoporous silica (OMS) against E. faecalis. To determine antibiotic susceptibility, we tested OMS and triple antibiotic paste (TAP; ciprofloxacin:metronidazole:minocycline) with different reagents in different concentrations, using the Kirby−Bauer disk diffusion method. OMS and metronidazole showed no antibacterial activity against E. faecalis. Mixtures of OMS and antibiotics in proportions of 2:2:14 and 4:1:7 (mg/L of ciprofloxacin:metronidazole:minocycline, respectively) showed the lowest antibacterial activity. The antibacterial activity of the combined solutions of ciprofloxacin and metronidazole was significantly higher (p < 0.005). Combinations in different concentrations of minocycline, ciprofloxacin, and metronidazole in OMS have shown activity against E. faecalis, although the combined use of ciprofloxacin and metronidazole has shown the most effective results. This study demonstrates the efficacy of intracanal antibiotic combination paste activity against E. faecalis, avoiding the use of minocycline, whose undesirable effect of teeth staining is a common problem for patients and professionals in dental clinic.
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15
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Rahimi S, Ghasemi N, Davoudi P, Taleb I, Farajollahi M, Rahimi Darehchi N, Kazeminejad E. Antimicrobial effects of different concentrations of simvastatin versus triple antibiotic paste on Enterococcus faecalis biofilms at different stages of development. J Dent Res Dent Clin Dent Prospects 2022; 16:153-158. [PMID: 36704189 PMCID: PMC9871176 DOI: 10.34172/joddd.2022.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 09/09/2022] [Indexed: 01/20/2023] Open
Abstract
Background. This study assessed the antimicrobial effects of different concentrations of simvastatin versus triple antibiotic paste (TAP) on Enterococcus faecalis biofilms at different stages of development. Methods. In this in vitro study, 70 human single-rooted mature premolars were decoronated, instrumented, and autoclave-sterilized. Next, an E. faecalis suspension was prepared and inoculated into the canals to obtain 4- and 6-week biofilms. After ensuring biofilm formation, the samples in each group were randomly assigned to 5 subgroups (n=12): 1 mg/mL TAP, 10 mg/ mL TAP, 1 mg/mL simvastatin, 10 mg/mL simvastatin, and positive control (phosphate-buffered saline solution). The medicaments were applied in the canals, and the teeth were incubated for one week. Dentin samples were collected by a rotary file, cultured, and the number of E. faecalis colonies was counted. The Kruskal-Wallis, Mann-Whitney U, and Wilcoxon tests were used for data analysis (α=0.05). Results. There were significant differences in colony counts between the two concentrations of TAP and the control group against both 4- and 6-week biofilms (P<0.05). The antibacterial effect of 10 mg/mL TAP and simvastatin was stronger than that of 1 mg/mL concentration against the 4- and 6-week E. faecalis biofilms (P<0.05). Furthermore, 10 mg/mL TAP and simvastatin were more effective against the 4-week biofilms than the 6-week biofilms (P<0.05). Conclusion. According to the present results and since biofilms may remain viable in the root canal system for weeks to months, applying 10 mg/mL TAP and simvastatin might be more effective.
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Affiliation(s)
- Saeed Rahimi
- Dental and Periodontal Research Center, Department of Endodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Negin Ghasemi
- Department of Endodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Paria Davoudi
- Department of Endodontics, Faculty of Dentistry, Shahid Beheshti Medical University, Tehran, Iran
| | | | - Mehran Farajollahi
- Department of Endodontics, Faculty of Dentistry, Shahid Beheshti Medical University, Tehran, Iran,Corresponding author: Mehran Farajollahi,
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Zan R, Topcuoglu HS, Hubbezoglu I, Gorler O, Altunbas D, Ayhan M. Effect of different irrigation activation methods on non-infected dentinal tubule penetration of medicaments: A CLSM study. Niger J Clin Pract 2022; 25:895-902. [DOI: 10.4103/njcp.njcp_1932_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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17
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Abu Zeid ST, Alamoudi RA, Alothmani OS, Mokeem Saleh AA, Siddiqui AY. A Prospective Study of Long-Term Regenerative Endodontics Outcomes of Necrotic Immature Permanent Teeth: An 8-Year Follow-Up. Healthcare (Basel) 2021; 9:healthcare9121670. [PMID: 34946396 PMCID: PMC8701996 DOI: 10.3390/healthcare9121670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 11/21/2021] [Accepted: 11/23/2021] [Indexed: 11/16/2022] Open
Abstract
For the management of necrotic immature teeth, regenerative endodontics offers the advantage of further root lengthening, thickening of dentin wall, and apical closure. This prospective study aimed to evaluate the long-term outcome of regenerative endodontics in immature necrotic permanent teeth. A total of 23 immature roots were medicated by triple antibiotic paste. After 21 days, bleeding was induced by over-instrumentation, and then mineral trioxide aggregate and coronal restoration were applied. Patients were scheduled for clinical and radiographic follow-up for 8 years. The radiographic changes of root dimensions were assessed using the ImageJ Plugin and statistically analyzed by Kruskal-Wallis test at a 95% confidence level. For qualitative evaluation, images were overlapped and analyzed using Photoshop software. All teeth were asymptomatic one month after the treatment. All teeth (n = 18) with preoperative periapical radiolucency showed complete resolution within 6-9 months. Recall rate at two, three, and eight years was 69.6%, 56.5%, and 34.8%, respectively. Continuous root development with a significant increase in root length and thickening of dentin wall accompanied by a significant decrease in apical canal diameter was seen at the end of the observation period (p < 0.001). In conclusion, the long-term outcome of regenerative endodontics revealed successful clinical and radiographic results with appropriate case selection.
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Affiliation(s)
- Sawsan T. Abu Zeid
- Department of Endodontics, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (R.A.A.); (O.S.A.); (A.A.M.S.); (A.Y.S.)
- Department of Endodontics, Cairo University, Cairo 12613, Egypt
- Correspondence: ; Tel.: +966-509528971
| | - Ruaa A. Alamoudi
- Department of Endodontics, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (R.A.A.); (O.S.A.); (A.A.M.S.); (A.Y.S.)
| | - Osama S. Alothmani
- Department of Endodontics, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (R.A.A.); (O.S.A.); (A.A.M.S.); (A.Y.S.)
| | - Abeer A. Mokeem Saleh
- Department of Endodontics, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (R.A.A.); (O.S.A.); (A.A.M.S.); (A.Y.S.)
| | - Amna Y. Siddiqui
- Department of Endodontics, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (R.A.A.); (O.S.A.); (A.A.M.S.); (A.Y.S.)
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18
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El-Din SN, Ali MM, Hassan R. Comparison of Apically Extruded Debris Associated with Different Irrigation Techniques after Removal of Intracanal Medicaments. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.6094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
This study aimed to compare the effect of XP-endo Finisher file (XPF), passive ultrasonic irrigation (PUI) and conventional irrigation technique using side-vented needle (SVN) on the amount of apically extruded debris after the removal of calcium hydroxide Ca(OH)2 and double antibiotic paste (DAP). Materials and Methods: Sixty extracted human mandibular premolars were used. After decronation, all canals were prepared up to the ProTaper Next X4 file (Dentsply Maillefer, Ballaigues, Switzerland). After dryness, teeth were randomly assigned into 2 groups (n=30) according to the Type of intracanal medication used; Ca(OH)2 and DAP then incubated at 37 °C and 100% humidity. After one week, Samples in each group were randomly assigned to 3 subgroups (n=10) according to the method used for medicament removal: XPF, PUI and SVN. Debris extruded during the removal procedure were collected into pre-weighed Eppendorf tubes then left to dry in an incubator at 37°C for 15 days. The amount of extruded debris was assessed with an analytical balance and calculated by subtracting the initial weight from the final weight of the tube. Data were statistically analyzed using Kruskal-Wallis and Mann-Whitney U test. Results: there was no statistically significant difference regarding the amount of apically extruded debris after using the three irrigation techniques in removal of both Ca(OH)2 and DAP (P-value = 0.141, Effect size = 0.160) and (P-value = 0.237, Effect size = 0.073) respectively. Conclusions: Neither XPF nor PUI increase the risk of intracanal medicament extrusion beyond the apex.
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Panyakorn T, Makeudom A, Kangvonkit P, Pattamapun K, Wanachantararak P, Charumanee S, Krisanaprakornkit S. Efficacy of double antibiotics in hydroxypropyl methylcellulose for bactericidal activity against Enterococcus faecalis and Streptococcus gordonii in biofilm. Arch Oral Biol 2021; 129:105210. [PMID: 34293645 DOI: 10.1016/j.archoralbio.2021.105210] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 07/09/2021] [Accepted: 07/14/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVE This study aimed to investigate the efficacy of double antibiotics, including ciprofloxacin and metronidazole, in a new vehicle, hydroxypropyl methylcellulose (HPMC), against Enterococcus faecalis and Streptococcus gordonii grown in biofilm. DESIGN Human mandibular premolars were prepared and divided into four groups: (i) negative control, (ii) positive control, (iii) infected with E. faecalis and S. gordonii for 21 days and intracanally medicated with double antibiotics in HPMC, and (iv) infected with E. faecalis and S. gordonii for 21 days and intracanally medicated with calcium hydroxide (UltraCal™). The efficacy of medication for 14 or 28 days was determined by bacterial cultures and RT-qPCR for absolute quantities of E. faecalis and S. gordonii cDNA and for relative mRNA expressions of pbp5 and gtfG genes. RESULTS There were significant decreases in the mean colony forming units and mean cDNA amounts of E. faecalis and S. gordonii in group (iii) on days 14 and 28 compared to those in group (ii) (p < 0.01). However, the mean cDNA amounts of E. faecalis and S. gordonii in group (iv) were found to be significantly increased on day 28 (p < 0.05). The mRNA expression of gtfG was significantly decreased in groups (iii) and (iv) on days 14 and 28, whereas that of pbp5 was significantly increased in group (iv) on days 14 and 28 (p < 0.01). CONCLUSION Double antibiotics in HPMC gel showed an in vitro efficacy against E. faecalis and S. gordonii grown in biofilm, suggesting its clinical application as an intracanal medicament for both primary and persistent infections.
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Affiliation(s)
- Theeraphop Panyakorn
- Department of Restorative Dentistry and Periodontology, Faculty of Dentistry, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Anupong Makeudom
- School of Dentistry, Mae Fah Luang University, Chiang Rai, 57100, Thailand
| | - Paisan Kangvonkit
- School of Dentistry, Mae Fah Luang University, Chiang Rai, 57100, Thailand
| | - Kassara Pattamapun
- Department of Restorative Dentistry and Periodontology, Faculty of Dentistry, Chiang Mai University, Chiang Mai, 50200, Thailand
| | | | - Suporn Charumanee
- Department of Pharmaceutical Sciences, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Suttichai Krisanaprakornkit
- Center of Excellence in Oral and Maxillofacial Biology, Department of Oral Biology and Diagnostic Sciences, Faculty of Dentistry, Chiang Mai University, Chiang Mai, 50200, Thailand.
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Platform technologies for regenerative endodontics from multifunctional biomaterials to tooth-on-a-chip strategies. Clin Oral Investig 2021; 25:4749-4779. [PMID: 34181097 DOI: 10.1007/s00784-021-04013-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 05/24/2021] [Indexed: 12/20/2022]
Abstract
OBJECTIVES The aim of this review is to highlight recent progress in the field of biomaterials-mediated dental pulp tissue engineering. Specifically, we aim to underscore the critical design criteria of biomaterial platforms that are advantageous for pulp tissue engineering, discuss models for preclinical evaluation, and present new and innovative multifunctional strategies that hold promise for clinical translation. MATERIALS AND METHODS The current article is a comprehensive overview of recent progress over the last 5 years. In detail, we surveyed the literature in regenerative pulp biology, including novel biologic and biomaterials approaches, and those that combined multiple strategies, towards more clinically relevant models. PubMed searches were performed using the keywords: "regenerative dentistry," "dental pulp regeneration," "regenerative endodontics," and "dental pulp therapy." RESULTS Significant contributions to the field of regenerative dentistry have been made in the last 5 years, as evidenced by a significant body of publications. We chose exemplary studies that we believe are progressive towards clinically translatable solutions. We close this review with an outlook towards the future of pulp regeneration strategies and their clinical translation. CONCLUSIONS Current clinical treatments lack functional and predictable pulp regeneration and are more focused on the treatment of the consequences of pulp exposure, rather than the restoration of healthy dental pulp. CLINICAL RELEVANCE Clinically, there is great demand for bioinspired biomaterial strategies that are safe, efficacious, and easy to use, and clinicians are eager for their clinical translation. In particular, we place emphasis on strategies that combine favorable angiogenesis, mineralization, and functional tissue formation, while limiting immune reaction, risk of microbial infection, and pulp necrosis.
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Jayadevan V, Gehlot PM, Manjunath V, Madhunapantula SV, Lakshmikanth JS. A comparative evaluation of Advanced Platelet-Rich Fibrin (A-PRF) and Platelet-Rich Fibrin (PRF) as a Scaffold in Regenerative Endodontic Treatment of Traumatized Immature Non-vital permanent anterior teeth: A Prospective clinical study. J Clin Exp Dent 2021; 13:e463-e472. [PMID: 33981393 PMCID: PMC8106940 DOI: 10.4317/jced.57902] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 12/20/2020] [Indexed: 11/17/2022] Open
Abstract
Background Regenerative endodontic treatment (RET) is a promising treatment alternative for traumatized immature non-vital teeth. Advanced platelet-rich fibrin (A-PRF) contains significantly more growth factors than Platelet-rich fibrin (PRF) and has not been evaluated as a scaffold in RET. The aim of the present study was to evaluate and compare A-PRF and PRF as scaffolds in the RET concerning periapical healing, and root development of traumatized immature non-vital teeth.
Material and Methods In the present study, RET was performed on 30 traumatized immature non-vital maxillary incisors in 28 patients aged between 8-27 years. Minimal mechanical debridement and irrigation with 1.5% sodium hypochlorite and 17% ethylenediaminetetraacetic acid was performed. Canals were disinfected using modified triple antibiotic paste consisting of ciprofloxacin, metronidazole and cefaclor. Based on the type of scaffold, teeth were randomly assigned into A-PRF (n=15) and PRF groups (n=15). Periapical healing, apical response and quantitative root dimensions (length and thickness) were analyzed radiographically after 12 months follow-up.
Results Nineteen patients with 21 teeth (A-PRF n=11, PRF n=10) completed the follow-up and 9 patients were excluded. Clinically, patients in both the groups were asymptomatic. The survival rates for A-PRF and PRF were 78.5% and 77.5%, respectively. No statistically significant differences were detected between A-PRF and PRF regarding periapical healing and type of apical response (p& 0.05). The difference in the pre-operative and follow-up root thickness and root length in both A-PRF and PRF groups were statistically significant (p< 0.05).
Conclusions Based on short-term results of 13 months, both A-PRF and PRF can be used as scaffold in regenerative endodontic treatment of traumatized immature non-vital teeth. A-PRF could be recommended in such cases since it yielded more root dentin thickness which is crucial for reinforcing immature teeth. Key words:Regenerative endodontic treatment, dental trauma, Non-vital teeth, immature teeth, platelet-rich fibrin, advanced platelet-rich fibrin.
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Affiliation(s)
- Veena Jayadevan
- BDS. Department of Conservative Dentistry and Endodontics. JSS Dental College and Hospital. JSS Academy of Higher Education and Research. Sri Shivarathreeshwara Nagar. Mysuru- 570015, Karnataka, India
| | - Paras-Mull Gehlot
- MDS. Department of Conservative Dentistry and Endodontics. JSS Dental College and Hospital. JSS Academy of Higher Education and Research. Sri Shivarathreeshwara Nagar. Mysuru- 570015, Karnataka, India
| | - Vinutha Manjunath
- MDS. Department of Conservative Dentistry and Endodontics. JSS Dental College and Hospital. JSS Academy of Higher Education and Research. Sri Shivarathreeshwara Nagar. Mysuru- 570015, Karnataka, India
| | - Subbarao V Madhunapantula
- BSc, B.Ed, M.Sc, Ph.D. Department of Biochemistry. JSS Medical College and Hospital. JSS Academy of Higher Education and Research. Sri Shivarathreeshwara Nagar. Mysuru- 570015, Karnataka, India
| | - Jyothi-Swandenahalli Lakshmikanth
- M Pharm. Department of Pharmaceutics. JSS College of Pharmacy. JSS Academy of Higher Education and Research. Sri Shivarathreeshwara Nagar. Mysuru- 570015, Karnataka, India
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Dahake PT, Baliga SM, Kumbar VM, Bhat KG. Cytotoxicity of Novel Polymeric Gel Matrix Triple Antibiotic Paste—an In Vitro Study. REGENERATIVE ENGINEERING AND TRANSLATIONAL MEDICINE 2020. [DOI: 10.1007/s40883-020-00191-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Antimicrobial Activity and Biocompatibility of Antibiotic-Loaded Chitosan Hydrogels as a Potential Scaffold in Regenerative Endodontic Treatment. J Endod 2020; 46:1867-1875. [DOI: 10.1016/j.joen.2020.09.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 08/15/2020] [Accepted: 09/08/2020] [Indexed: 12/31/2022]
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Responses of oral-microflora-exposed dental pulp to capping with a triple antibiotic paste or calcium hydroxide cement in mouse molars. Regen Ther 2020; 15:216-225. [PMID: 33426222 PMCID: PMC7770410 DOI: 10.1016/j.reth.2020.10.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 09/13/2020] [Accepted: 10/01/2020] [Indexed: 02/07/2023] Open
Abstract
Introduction Responses of oral-microflora-exposed dental pulp to a triple antibiotic paste (TAP), a mixture of ciprofloxacin, metronidazole, and minocycline in ointment with macrogol and propylene glycol, remain to be fully clarified at the cellular level. This study aimed to elucidate responses of oral-microflora-exposed dental pulp to capping with TAP in mouse molars. Methods A cavity was prepared on the first molars of 6-week-old mice to expose the dental pulp for 24 h. The exposed pulp was capped with TAP (TAP group) or calcium hydroxide cement (CH group), in addition to the combination of macrogol (M) and propylene glycol (P) (MP, control group), followed by a glass ionomer cement filling. The samples were collected at intervals of 1, 2, and 3 weeks, and immunohistochemistry for nestin and Ki-67 and deoxyuride-5′-triphosphate biotin nick end labeling (TUNEL) assay were performed in addition to quantitative real-time polymerase chain reaction (qRT-PCR) analyses. Results The highest occurrence rate of pulp necrosis was found in the control group followed by the CH group at Weeks 2 and 3, whereas the highest occurrence rate of healed areas in the dental pulp was observed in the TAP group at each time point. Tertiary dentin formation was first observed in the dental pulp of the TAP group at Week 2. In contrast, bone-like and/or fibrous tissues were frequently observed in the CH group. qRT-PCR analyses clarified that TAP activated the stem and dendritic cells at Weeks 1 and 2, respectively. Conclusions The use of TAP as a pulp-capping agent improved the healing process of oral-microflora-exposed dental pulp in mouse molars.
We established a mouse model to evaluate the pulpal responses to capping materials. TAP induced odontoblast-like cell differentiation faster than calcium hydroxide. Tertiary dentin was predominantly seen at the exposure site in the TAP group. TAC-P tends to activate dental pulp stem cells earlier than calcium hydroxide. TAP favored the repair process of the oral-microflora-exposed pulpal tissue.
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Key Words
- ANOVA, One-way analysis of variance
- AZAN, Azocarmine and aniline blue
- Anti-bacterial agents
- BMPs, Bone morphogenetic proteins
- Birc5, Baculoviral IAP Repeat Containing 5
- CH, Calcium hydroxide
- Cell differentiation
- Cell proliferation
- Ct, Cycle threshold
- DAP, Double antibiotic paste
- DCs, Dendritic cells
- DNA, Deoxyribonucleic acid
- DPC, Direct pulp capping
- DPSCs, Dental pulp stem cells
- Dental cavity preparation
- Dental pulp
- FGFs, Fibroblast growth factors
- GM-CSF, Granulocyte-macrophage colony-stimulating factor
- H2O2, Hydrogen peroxide
- HE, Hematoxylin-eosin
- HLA-DR-immunopositive cells, Human Leukocyte Antigen – DR isotype-immunopositive cells
- M, Macrogol
- MHC, Major histocompatibility complex
- MP, Macrogol (M) mixed with propylene glycol (P)
- MSCs, Mesenchymal stem cells
- MTA, Mineral trioxide aggregate
- Mice (crlj:CD1)
- Oct 3/4 A, Octamer binding transcription factor 3/4 A
- Oct 3/4 B, Octamer binding transcription factor 3/4 B
- P, Propylene glycol
- PBS, Phosphate-buffered saline
- Pcna, Proliferating cell nuclear antigen
- REP, Regenerative endodontic procedures
- RNA, Ribonucleic acid
- RT, Reverse transcription
- SCAP, Stem cells of the apical papilla
- Sox 10, SRY-related HMG-box 10
- TAC, Triple antibiotic combination (a mixture of metronidazole, ciprofloxacin, and minocycline)
- TAC-P, Triple antibiotic combination and propylene glycol
- TAP, Triple antibiotic paste
- TAS, Triple antibiotic solution
- TGFβ, Transforming growth factor β
- TUNEL assay, Terminal deoxynucleotidyl transferase dUTP nick end labeling assay
- Tris–HCl buffer, Tris (hydroxymethyl) aminomethane (THAM) hydrochloride buffer
- Yap1, Yes-associated protein 1
- cDNA, Complementary deoxyribonucleic acid
- mRNA, Messenger ribonucleic acid
- mTAP, Modified triple antibiotic paste
- qRT-PCR, Quantitative real-time polymerase chain reaction
- αTCP, Alpha tricalcium phosphate
- β-actin, Beta-actin
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Dewi A, Upara C, Krongbaramee T, Louwakul P, Srisuwan T, Khemaleelakul S. Optimal antimicrobial concentration of mixed antibiotic pastes in eliminating Enterococcus faecalis from root dentin. AUST ENDOD J 2020; 47:273-280. [PMID: 32914516 DOI: 10.1111/aej.12437] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Revised: 07/02/2020] [Accepted: 08/08/2020] [Indexed: 11/28/2022]
Abstract
This study aims to identify the optimal concentrations of triple antibiotic paste (TAP), modified triple antibiotic paste (mTAP) and double antibiotic paste (DAP) that could completely eradicate Enterococcus faecalis in dentinal tubules. One hundred and ninety extracted human premolars inoculated with E. faecalis were medicated with calcium hydroxide and mixed antibiotic pastes (TAP, mTAP and DAP at 0.1, 1.25, 5, 10 and 20 mg mL-1 of each drug) for seven days before being frozen, pulverised and cultured. Specimens treated with the lowest concentration of the mixed antibiotics capable of eradicating E. faecalis were examined using scanning electron and confocal laser scanning microscopy to confirm the eradication of the microbial. TAP at 10 mg mL-1 of each drug was able to completely eliminate bacteria inside dentinal tubules, whereas mTAP and DAP required 20 mg mL-1 of each drug. Calcium hydroxide was not effective in eradicating E. faecalis inside dentinal tubules.
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Affiliation(s)
- Anat Dewi
- Division of Endodontics, Department of Restorative Dentistry and Periodontology, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand
| | - Chawin Upara
- School of Dentistry, Mae Fah Luang University, Chiang Rai, Thailand
| | - Tadkamol Krongbaramee
- Division of Endodontics, Department of Restorative Dentistry and Periodontology, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand
| | - Phumisak Louwakul
- Division of Endodontics, Department of Restorative Dentistry and Periodontology, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand
| | - Tanida Srisuwan
- Division of Endodontics, Department of Restorative Dentistry and Periodontology, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand
| | - Saengusa Khemaleelakul
- Division of Endodontics, Department of Restorative Dentistry and Periodontology, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand
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Ayoub S, Cheayto A, Bassam S, Najar M, Berbéri A, Fayyad-Kazan M. The Effects of Intracanal Irrigants and Medicaments on Dental-Derived Stem Cells Fate in Regenerative Endodontics: An update. Stem Cell Rev Rep 2020; 16:650-660. [PMID: 32394343 DOI: 10.1007/s12015-020-09982-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Regenerative endodontics is a biologically based treatment designed for immature permanent teeth with necrotic pulp to replace dentin and root structures, as well as dental pulp cells. This procedure has become a part of novel modality in endodontics therapeutic manner, and it is considered as an alternative to apexification. In the last decade, numerous case reports, which describe this procedure, have been published. This therapeutic approach succeeded due to its lower financial cost and ease of performance. Although the clinical protocol of this procedure is not standardized and the effects of irrigants and medicaments on dental stem cells fate remain somewhat ambiguous, however when successful, it is an improvement of endodontics treatment protocols which leads to continued root development, increased dentinal wall thickness, and apical closure of immature teeth. To ensure a successful regenerative procedure, it is essential to investigate the appropriate disinfection protocols and the use of biocompatible molecules in order to control the release of growth factors and the differentiation of stem cells. This is the first review in the literature to summarize the present knowledge regarding the effect of intracanal irrigants and medicaments on the dental derived stem cells fate in regenerative endodontic procedures.
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Affiliation(s)
- Sara Ayoub
- Department of Prosthodontics, Faculty of Dental Medicine, Lebanese University, Hadath, Beirut, Lebanon
| | - Ali Cheayto
- Department of Restorative Dentistry and Endodontics, Faculty of Dental Medicine, Lebanese University, Hadath, Beirut, Lebanon
| | - Sanaa Bassam
- Department of Restorative Dentistry and Endodontics, Faculty of Dental Medicine, Lebanese University, Hadath, Beirut, Lebanon
| | - Mehdi Najar
- Genetics and Immune Cell Therapy Unit, Faculty of Sciences, University Mohammed Premier, Oujda, Morocco
- Osteoarthritis Research Unit, Department of Medicine, Research Center (CRCHUM), University of Montreal Hospital, University of Montreal, Montreal, QC, Canada
| | - Antoine Berbéri
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Lebanese University, Hadath, Beirut, Lebanon
| | - Mohammad Fayyad-Kazan
- Laboratory of Cancer biology and Molecular Immunology, Faculty of Sciences-I, Lebanese University, Hadath, Beirut, Lebanon.
- Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, Beirut, Lebanon.
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Coaguila-Llerena H, Rodrigues EM, Santos CS, Ramos SG, Medeiros MC, Chavez-Andrade GM, Guerreiro-Tanomaru JM, Tanomaru-Filho M, Faria G. Effects of octenidine applied alone or mixed with sodium hypochlorite on eukaryotic cells. Int Endod J 2020; 53:1264-1274. [PMID: 32535966 DOI: 10.1111/iej.13347] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 06/05/2020] [Accepted: 06/08/2020] [Indexed: 11/30/2022]
Abstract
AIM To assess the effects of octenidine dihydrochloride (OCT) on eukaryotic cells and the cytotoxicity of OCT associated with sodium hypochlorite - NaOCl (NaOCl/OCT). METHODOLOGY L929 fibroblasts and human osteoblast-like cells (Saos-2) were exposed to 0.1% OCT, 2% CHX, 2.5% NaOCl, 5.25% NaOCl and mixtures of 5.25% NaOCl and 0.1% OCT (NaOCl/OCT) at 90 : 10, 80 : 20 and 50 : 50 ratios. Cell viability was assessed by methyl-thiazol-tetrazolium (MTT) and neutral red (NR) assays; type of cell death, by flow cytometry; cytoskeleton, by actin and α-tubulin fluorescence; and alkaline phosphatase (ALP) activity, by thymolphthalein release. The data were analysed by two-way ANOVA and Bonferroni tests (α = 0.05). RESULTS MTT and NR assays revealed that 0.1% OCT had the lowest cytotoxicity (P < 0.05), followed by 2% CHX (P < 0.05). The 2.5% NaOCl, NaOCl/OCT 80 : 20 and NaOCl/OCT 50 : 50 solutions had intermediate cytotoxicity. NaOCl 5.25% and NaOCl/OCT 90 : 10 had the highest cytotoxicity (P < 0.05). The OCT group had a higher percentage of viable cells than the NaOCl and CHX groups (P < 0.05), and induced apoptosis at higher doses. The cytoskeleton alterations were observed at 0.12%, 0.6% and 2.02% for the NaOCl, CHX and OCT groups, respectively. The solutions did not induce ALP activity. CONCLUSION Octenidine dihydrochloride was less cytotoxic, induced apoptosis at higher doses, caused few changes in the cytoskeleton and did not induce alkaline phosphatase activity. In addition, octenidine dihydrochloride reduced the cytotoxicity of 5.25% NaOCl when combined at 20 and 50%.
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Affiliation(s)
- H Coaguila-Llerena
- Department of Restorative Dentistry, Araraquara School of Dentistry, São Paulo State University - UNESP, Araraquara, Brazil
| | - E M Rodrigues
- Department of Restorative Dentistry, Araraquara School of Dentistry, São Paulo State University - UNESP, Araraquara, Brazil
| | - C S Santos
- Department of Restorative Dentistry, Araraquara School of Dentistry, São Paulo State University - UNESP, Araraquara, Brazil
| | - S G Ramos
- Department of Pathology, Ribeirão Preto Medical School, University of São Paulo - USP, Ribeirão Preto, Brazil
| | - M C Medeiros
- Department of Oral Diagnosis and Surgery, Araraquara School of Dentistry, São Paulo State University - UNESP, Araraquara, Brazil
| | - G M Chavez-Andrade
- Department of Restorative Dentistry, Araraquara School of Dentistry, São Paulo State University - UNESP, Araraquara, Brazil
| | - J M Guerreiro-Tanomaru
- Department of Restorative Dentistry, Araraquara School of Dentistry, São Paulo State University - UNESP, Araraquara, Brazil
| | - M Tanomaru-Filho
- Department of Restorative Dentistry, Araraquara School of Dentistry, São Paulo State University - UNESP, Araraquara, Brazil
| | - G Faria
- Department of Restorative Dentistry, Araraquara School of Dentistry, São Paulo State University - UNESP, Araraquara, Brazil
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Khoshkhounejad M, Sobhi Afshar M, Jabalameli F, Emaneini M, Sharifian M. Cytotoxicity Evaluation of Minimum Antibacterial Values of Different Medicaments Used in Endodontic Regenerative Procedures. Eur J Dent 2019; 13:514-520. [PMID: 31891968 PMCID: PMC6938419 DOI: 10.1055/s-0039-3401369] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVES This study aimed to evaluate the cytotoxicity of minimum antibacterial values of medicaments used in endodontic regeneration on stem cells. MATERIALS AND METHODS "Minimum inhibitory concentration," "minimum bactericidal concentration," and "minimum biofilm inhibitory concentration" of triple and double antibiotic paste, a modified triple antibiotic paste (minocycline replaced by clindamycin), Augmentin, and calcium hydroxide were determined using Enterococcus faecalis (ATCC 29212) by microtiter plate method. Direct cytotoxic effects of drugs were evaluated by lactate dehydrogenase and water-soluble tetrazolium salt-1 assays using stem cells of apical papilla obtained from immature third molars via enzymatic digestion. STATISTICAL ANALYSIS Data were analyzed using IBM SPSS Statistics 24, one-way analysis of variance and post hoc comparisons. The statistical power was set at p < 0.05. RESULTS All medicaments caused similar cytotoxicity and cell proliferation at "minimum inhibitory concentration" (p > 0.05) except Augmentin which was significantly more toxic than others (p < 0.05). At "minimum bactericidal concentration," calcium hydroxide was more toxic than other drugs (p < 0.001), but its adverse effect on cell proliferation was the same as Augmentin (p > 0.05). Triple and double antibiotic paste revealed similar favorable effects in terms of toxicity and proliferation rate at most of the tested concentrations (p > 0.05). At "minimum biofilm inhibitory concentration" both the modified paste and Augmentin caused less proliferation rate than triple and double antibiotic paste (p < 0.001and p < 0.05, respectively) and Augmentin induced more cytotoxicity (p < 0.05). CONCLUSIONS Considering the antimicrobial potency, triple antibiotic paste seems to be the safest drug for the stem cells of apical papilla, while Augmentin may have some adverse effects.
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Affiliation(s)
- Mehrfam Khoshkhounejad
- Department of Endodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.,Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahsa Sobhi Afshar
- Department of Endodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Fereshteh Jabalameli
- Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Emaneini
- Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Sharifian
- Department of Endodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
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Sadek RW, Moussa SM, El Backly RM, Hammouda AF. Evaluation of the Efficacy of Three Antimicrobial Agents Used for Regenerative Endodontics: AnIn VitroStudy. Microb Drug Resist 2019; 25:761-771. [DOI: 10.1089/mdr.2018.0228] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Affiliation(s)
- Reem W. Sadek
- Moharam Beik Dental Center, Ministry of Health, Alexandria, Egypt
| | - Sybel M. Moussa
- Endodontics, Conservative Dentistry Department, Alexandria University, Alexandria, Egypt
| | - Rania M. El Backly
- Endodontics, Conservative Dentistry Department, Alexandria University, Alexandria, Egypt
| | - Abdel Fattah Hammouda
- Department of Microbiology, High Institute of Public Health, Alexandria University, Alexandria, Egypt
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Coaguila-Llerena H, Rodrigues EM, Tanomaru-Filho M, Guerreiro-Tanomaru JM, Faria G. Effects of Calcium Hypochlorite and Octenidine Hydrochloride on L929 And Human Periodontal Ligament Cells. Braz Dent J 2019; 30:213-219. [DOI: 10.1590/0103-6440201902280] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Accepted: 12/05/2018] [Indexed: 02/05/2023] Open
Abstract
Abstract The aim of this study was to assess cytotoxicity and cell migration of calcium hypochlorite [Ca(OCl)2] and octenidine hydrochloride - OCT (Octenisept®, Schülke & Mayr, Norderstedt, Germany) in L929 and human periodontal ligament (hPDL) cells. The cells were exposed to different doses of different solutions: 2.5% and 5% Ca(OCl)2, 0.1% OCT, 2.5% NaOCl and 2% CHX for 10 min. Cell viability was assessed by methyl-thiazol-tetrazolium (MTT) and neutral red (NR) assays, and cell migration was determined by wound-healing assay. Statistical analysis was performed by two-way ANOVA and Bonferroni tests (α=0.05). The MTT and NR assays revealed that 0.1% OCT was less cytotoxic in hPDL cells (p<0.05), followed by 2% CHX and 2.5% Ca(OCl)2 (p<0.05). There was no significant difference between 2.5% NaOCl and 5% Ca(OCl)2 (p>0.05), but these solutions showed greater cytotoxicity than the others. The result was the same for L929 cells, except that there was no significant difference between 2% CHX and 2.5% Ca(OCl)2 (p>0.05). Wound-healing assay in L929 and hPDL cells showed that cell migration of 0.1% OCT, 2% CHX and 2.5% Ca(OCl)2 groups was higher than 5% Ca(OCl)2 and 2.5% NaOCl groups at 24 h (p<0.05). In conclusion, 0.1% OCT had lower cytotoxicity in tested cell lines than CHX, Ca(OCl)2 and NaOCl. Cell migration was higher for 0.1% OCT, 2% CHX and 2.5% Ca(OCl)2. Therefore, in terms of cytotoxicity, OCT and Ca(OCl)2 have the potential to be used as root canal irrigants.
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Faria G, Rodrigues EM, Coaguila-Llerena H, Gomes-Cornélio AL, Neto Angéloco RR, Swerts Pereira MS, Tanomaru Filho M. Influence of the Vehicle and Antibiotic Formulation on Cytotoxicity of Triple Antibiotic Paste. J Endod 2019; 44:1812-1816. [PMID: 30477667 DOI: 10.1016/j.joen.2018.09.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 09/05/2018] [Accepted: 09/10/2018] [Indexed: 12/19/2022]
Abstract
INTRODUCTION The aim of this study was to assess the influence of antibiotic formulations (tablet/capsule [TC] or United States Pharmacopeia [USP]-grade antibiotics) and vehicles (water [H2O] or macrogol + propylene glycol [MP]) on the cytotoxicity and pH of triple antibiotic pastes (TAPs). METHODS L929 fibroblasts were exposed to TAPs prepared with TC or USP-grade antibiotics mixed with H2O or MP for 72 hours. Each isolated antibiotic with each vehicle, each isolated vehicle, and the culture medium were used as controls. Cytotoxicity was evaluated by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide and neutral red assays. The pH was measured after 3 and 8 hours of immersion of the pastes in water. Data were analyzed using analysis of variance, the Bonferroni or Tukey posttests (α = 0.05), and the Pearson correlation test (α = 0.05). RESULTS The pastes prepared with TC were less cytotoxic than pastes prepared with USP-grade antibiotics (P < .05), and pastes with the MP vehicle were less cytotoxic than pastes with H2O (P < .05). TC TAP + MP showed the lowest cytotoxicity, whereas USP-grade TAP + H2O showed the highest cytotoxicity (P < .05). All TAPs showed a pH ranging from 4.64-5.20. Irrespective of the vehicle, USP-grade TAP showed a lower pH than TC TAP (P < .05). TAPs with H2O had a lower pH than TAPs with MP (P < .05). CONCLUSIONS The vehicle and the antibiotic formulations influenced the cytotoxicity and pH of TAP. The pastes prepared with TC and MP were less acidic and less cytotoxic than the type prepared with USP-grade antibiotics and H2O.
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Affiliation(s)
- Gisele Faria
- Department of Restorative Dentistry, Araraquara School of Dentistry, São Paulo State University-UNESP, Araraquara, São Paulo, Brazil.
| | - Elisandra Márcia Rodrigues
- Department of Restorative Dentistry, Araraquara School of Dentistry, São Paulo State University-UNESP, Araraquara, São Paulo, Brazil
| | - Hernán Coaguila-Llerena
- Department of Restorative Dentistry, Araraquara School of Dentistry, São Paulo State University-UNESP, Araraquara, São Paulo, Brazil
| | - Ana Lívia Gomes-Cornélio
- Department of Restorative Dentistry, Araraquara School of Dentistry, São Paulo State University-UNESP, Araraquara, São Paulo, Brazil
| | - Renan Rodrigues Neto Angéloco
- Department of Restorative Dentistry, Araraquara School of Dentistry, São Paulo State University-UNESP, Araraquara, São Paulo, Brazil
| | - Maristela Soares Swerts Pereira
- Department of Pediatric Dentistry, Alfenas School of Dentistry, Jose Rosario Vellano University-Unifenas, Alfenas, Minas Gerais, Brazil
| | - Mario Tanomaru Filho
- Department of Restorative Dentistry, Araraquara School of Dentistry, São Paulo State University-UNESP, Araraquara, São Paulo, Brazil
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Wang J, Mei Q, Lin L, Sun F, Li J, Zou Q, Zuo Y, Li Y. A comparison of the characteristics of polyurethane-based sealers including various antimicrobial agents. RSC Adv 2019; 9:7043-7056. [PMID: 35519981 PMCID: PMC9061074 DOI: 10.1039/c8ra09374a] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Accepted: 02/09/2019] [Indexed: 01/31/2023] Open
Abstract
An obturation biomaterial that possess inherent antibacterial activity has been developed to create a tight seal for the root canal space in treatment. Novel castor oil-based polyurethane sealers composited with different proportions of silver phosphate or zinc oxide nanoparticles were synthesized to investigate the physicochemical properties, antibacterial effect on Enterococcus faecalis, and cytotoxicity on murine fibroblasts compared with commercially available products. The results showed that the physical properties of all of the polyurethane sealers could meet with the standards expected. The microdilatancy character of the polyurethane sealers was particularly preferable for the three dimensional obturation of root canal space. Compared with the silver-loaded polyurethane series, the zinc-loaded polyurethane series showed better antibacterial properties based on the contact mode. Analysis of the kinetics indicated that the setting process of the polyurethane sealers supported a first-order reaction and the setting process was highly effective, with more than 90% of the isocyanate groups participating in the setting reaction within 12 h. This is beneficial for the rapid consumption of monomers, efficiently avoiding inflammation. The in vitro results showed that the polyurethane sealers loaded with zinc oxide nanoparticles or 1 wt% silver phosphate were desirable for cell attachment and proliferation compared with the commercial sealers. In conclusion, the castor oil-based polyurethane-zinc sealers, especially PU-Zn5, present good physicochemical and antibacterial properties and cytocompatibility, and could be a promising candidate for application in the field of root canal treatment.
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Affiliation(s)
- Jian Wang
- Research Center for Nano Biomaterials, Analytical & Testing Center, Sichuan University Chengdu 610064 P. R. China +86 28 85418178 +86 28 85418178
| | - Quanjing Mei
- Research Center for Nano Biomaterials, Analytical & Testing Center, Sichuan University Chengdu 610064 P. R. China +86 28 85418178 +86 28 85418178
| | - Lili Lin
- Research Center for Nano Biomaterials, Analytical & Testing Center, Sichuan University Chengdu 610064 P. R. China +86 28 85418178 +86 28 85418178
| | - Fuhua Sun
- Research Center for Nano Biomaterials, Analytical & Testing Center, Sichuan University Chengdu 610064 P. R. China +86 28 85418178 +86 28 85418178
| | - Jidong Li
- Research Center for Nano Biomaterials, Analytical & Testing Center, Sichuan University Chengdu 610064 P. R. China +86 28 85418178 +86 28 85418178
| | - Qin Zou
- Research Center for Nano Biomaterials, Analytical & Testing Center, Sichuan University Chengdu 610064 P. R. China +86 28 85418178 +86 28 85418178
| | - Yi Zuo
- Research Center for Nano Biomaterials, Analytical & Testing Center, Sichuan University Chengdu 610064 P. R. China +86 28 85418178 +86 28 85418178
| | - Yubao Li
- Research Center for Nano Biomaterials, Analytical & Testing Center, Sichuan University Chengdu 610064 P. R. China +86 28 85418178 +86 28 85418178
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Simsek H, Coruh M, Cakici F, Fundaoglu Kucukekenci F, Gurbuz T, Cakici EB. Investigation of mineral content of root canal dentin after the application of various antibiotic paste using energy‐dispersive X‐ray detector. Microsc Res Tech 2018; 82:144-148. [DOI: 10.1002/jemt.23155] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 08/09/2018] [Accepted: 09/19/2018] [Indexed: 11/11/2022]
Affiliation(s)
- H. Simsek
- Department of Pedodontics, Faculty of DentistryOrdu University Ordu Turkey
| | - M. Coruh
- Department of Pedodontics, Faculty of DentistryAtaturk University Erzurum Turkey
| | - F. Cakici
- Department of Endodontics, Faculty of DentistryOrdu University Ordu Turkey
| | | | - T. Gurbuz
- Department of Pedodontics, Faculty of DentistryAtaturk University Erzurum Turkey
| | - E. B. Cakici
- Department of Endodontics, Faculty of DentistryOrdu University Ordu Turkey
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Arruda ME, Neves MA, Diogenes A, Mdala I, Guilherme BP, Siqueira JF, Rôças IN. Infection Control in Teeth with Apical Periodontitis Using a Triple Antibiotic Solution or Calcium Hydroxide with Chlorhexidine: A Randomized Clinical Trial. J Endod 2018; 44:1474-1479. [DOI: 10.1016/j.joen.2018.07.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 06/28/2018] [Accepted: 07/02/2018] [Indexed: 01/03/2023]
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Antibacterial Efficacy and Discoloration Potential of Endodontic Topical Antibiotics. J Endod 2018; 44:1110-1114. [DOI: 10.1016/j.joen.2018.03.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 02/22/2018] [Accepted: 03/04/2018] [Indexed: 11/22/2022]
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McIntyre PW, Wu JL, Kolte R, Zhang R, Gregory RL, Bruzzaniti A, Yassen GH. The antimicrobial properties, cytotoxicity, and differentiation potential of double antibiotic intracanal medicaments loaded into hydrogel system. Clin Oral Investig 2018; 23:1051-1059. [DOI: 10.1007/s00784-018-2542-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 06/20/2018] [Indexed: 12/18/2022]
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Parhizkar A, Nojehdehian H, Asgary S. Triple antibiotic paste: momentous roles and applications in endodontics: a review. Restor Dent Endod 2018; 43:e28. [PMID: 30135847 PMCID: PMC6103545 DOI: 10.5395/rde.2018.43.e28] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 04/10/2018] [Indexed: 12/23/2022] Open
Abstract
This study investigated the latest findings and notions regarding ‘triple antibiotic paste’ (TAP) and its applications in dentistry, particularly endodontics. TAP is a combination of 3 antibiotics, ciprofloxacin, metronidazole, and minocycline. Despite the problems and pitfalls research pertaining to this paste has unveiled, it has been vastly used in endodontic treatments. The paste's applications vary, from vital pulp therapy to the recently introduced regeneration and revascularisation protocol. Studies have shown that the paste can eliminate the root canal microorganisms and prepare an appropriate matrix for further treatments. This combination is able to remove diverse groups of obligate and facultative gram-positive and gram-negative bacteria, providing an environment for healing. In regeneration protocol cases, this allows the development, disinfection, and possible sterilization of the root canal system, so that new tissue can infiltrate and grow into the radicular area. Moreover, TAP is capable of creating a discipline in which other wanted and needed treatments can be successfully performed. In conclusion, TAP, as an antibacterial intracanal medication, has diverse uses. Nevertheless, despite its positive effects, the paste has shown drawbacks. Further research concerning the combined paste and other intracanal medications to control microbiota is a must.
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Affiliation(s)
- Ardavan Parhizkar
- Department of Dental Biomaterials, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hanieh Nojehdehian
- Department of Dental Biomaterials, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saeed Asgary
- Iranian Center for Endodontic Research, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Yanling C, Hongyan L, Xi W, Wim C, Dongmei D. Efficacy of relacin combined with sodium hypochlorite against Enterococcus faecalis biofilms. J Appl Oral Sci 2018; 26:e20160608. [PMID: 29898172 PMCID: PMC6010329 DOI: 10.1590/1678-7757-2016-0608] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2016] [Accepted: 05/21/2017] [Indexed: 01/21/2023] Open
Abstract
Objective Relacin is a synthetic molecule that targets RelA, an essential protein in a conserved bacterial stress response system. It was shown to inhibit bacterial growth. The aims of this study were to evaluate the antimicrobial effect of relacin combined with sodium hypochlorite (NaOCl) on Enterococcus faecalis biofilms and to evaluate the cytotoxicity of relacin. Material and Methods 48-h E. faecalis OG1RF biofilms were treated by various concentrations of relacin in order to determine its inhibitory concentration. Then, the 48-h biofilms were treated either with 1-min NaOCl (0.01%, 0.05%) alone, or in combination of relacin. As a means of comparison, the biofilms of ΔrelA were also treated by 1-min NaOCl (0.01%, 0.05%, 0.25%). The treatment efficacy was determined by agar plate count assays. The cytotoxicity of relacin was examined on human gingival epithelial cells Ca9-22 and murine fibroblasts NIH-3T3 by a methyl thiazolyltetrazolium (MTT) assay and a lactate dehydrogenase assay. Statistical analysis was performed by one-way or two-way analysis of variance (ANOVA) with Bonferroni’s post-hoc test and an independent Student’s t-test. A significance level of p<0.05 was used. Results Relacin inhibited the growth of OG1RF biofilms partially at 8 mM and fully at 14 mM. The relacin (14 mM) and NaOCl combined treatment resulted in significantly higher treatment efficacy than NaOCl treatment alone. At 0.05% NaOCl, the combined treatment resulted in 5.65 (±0.19) log reduction in biofilm viability. The ΔrelA biofilms were more susceptible to NaOCl treatment than the wild type biofilms at 0.25% NaOCl. Relacin at 14 mM was not toxic to host epithelial cells and fibroblasts. Conclusions The combination of relacin with a low concentration of NaOCl was effective and not cytotoxic.
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Affiliation(s)
- Cai Yanling
- Sun Yat-sen University, Hospital of Stomatology, Guanghua School of Stomatology, Department of Operative Dentistry and Endodontics, Guangzhou, Guangdong, China.,Guangdong Province Key Laboratory of Stomatology, Guangzhou, Guangdong, China
| | - Liu Hongyan
- Sun Yat-sen University, Hospital of Stomatology, Guanghua School of Stomatology, Department of Operative Dentistry and Endodontics, Guangzhou, Guangdong, China.,Guangdong Province Key Laboratory of Stomatology, Guangzhou, Guangdong, China
| | - Wei Xi
- Sun Yat-sen University, Hospital of Stomatology, Guanghua School of Stomatology, Department of Operative Dentistry and Endodontics, Guangzhou, Guangdong, China.,Guangdong Province Key Laboratory of Stomatology, Guangzhou, Guangdong, China
| | | | - Deng Dongmei
- Guangdong Province Key Laboratory of Stomatology, Guangzhou, Guangdong, China.,University of Amsterdam andNetherlands.,VU University, Academic Centre for Dentistry Amsterdam (ACTA), Department of Preventive Dentistry, Amsterdam, The Netherlands
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Bi J, Liu Y, Liu XM, Jiang LM, Chen X. iRoot FM exerts an antibacterial effect on Porphyromonas endodontalis
and improves the properties of stem cells from the apical papilla. Int Endod J 2018. [DOI: 10.1111/iej.12923] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- J. Bi
- Department of Paediatric Dentistry; School of Stomatology; China Medical University; Shenyang China
- Liaoning Province Key Laboratory of Oral Disease; Shenyang China
| | - Y. Liu
- Department of Paediatric Dentistry; School of Stomatology; China Medical University; Shenyang China
- Liaoning Province Key Laboratory of Oral Disease; Shenyang China
| | - X. M. Liu
- Department of Paediatric Dentistry; School of Stomatology; China Medical University; Shenyang China
- Liaoning Province Key Laboratory of Oral Disease; Shenyang China
| | - L. M. Jiang
- Department of Paediatric Dentistry; School of Stomatology; China Medical University; Shenyang China
- Liaoning Province Key Laboratory of Oral Disease; Shenyang China
| | - X. Chen
- Department of Paediatric Dentistry; School of Stomatology; China Medical University; Shenyang China
- Liaoning Province Key Laboratory of Oral Disease; Shenyang China
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Jun SK, Mahapatra C, Lee HH, Kim HW, Lee JH. Biological Effects of Provisional Resin Materials on Human Dental Pulp Stem Cells. Oper Dent 2018; 42:E81-E92. [PMID: 28257256 DOI: 10.2341/16-137-l] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES This study investigated the in vitro cytotoxicity as well as the proinflammatory cytokine expression of provisional resin materials on primary cultured human dental pulp stem cells (hDPSCs). METHODS Five commercially available provisional resin materials were chosen (SNAP [SN], Luxatemp [LT], Jet [JE], Revotek LC [RL], and Vipi block [VB]). Eluates that were either polymerizing or already set were added to hDPSCs under serially diluted conditions divided into three different setting times (25% set, 50% set, and 100% set) and incubated for 24 hours with 2× concentrated culture media. Cell cytotoxicity tests were performed by LDH assay and live and dead confocal microscope images. The expression of proinflammatory cytokines in SN and VB was measured using cytokine antibody arrays. Data were analyzed using repeated measures analysis of variance (ANOVA) or ANOVA followed by the Tukey post hoc test at a significance level of p<0.05. RESULTS Cytotoxicity greater than 30% was observed in the 50% diluted culture in SN, LT, and JE in the already set stage (p<0.05), while it was detected in SN and LT in early or intermediate stage samples. The cytotoxicity of SN, JE, and LT was greater with eluates from the polymerizing phase compared to that from already set samples (p<0.05), as observed by live and dead images. On the other hand, RL and VB did not exhibit cytotoxicity greater than 30%. Proinflammatory cytokines were not detected in 12.5% diluted culture with eluates from VB and early set stage SN. CONCLUSIONS The eluates from chemical-activated provisional resin materials during polymerization (SN, LT, and JE) were cytotoxic to hDPSCs and may adversely affect pulp tissue.
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Prasad J, de Ataide IDN, Chalakkal P, Likhyani LK. Comparison between the Outcomes of Two Platelet-Rich Concentrates on Apexogenesis in Young Permanent Incisors Requiring Endodontic Retreatment. Contemp Clin Dent 2018; 9:S156-S159. [PMID: 29962783 PMCID: PMC6006877 DOI: 10.4103/ccd.ccd_9_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Platelet-rich fibrin (PRF) and platelet-rich plasma (PRP) have been successfully used for inducing pulp regeneration in nonvital teeth. This case report highlights the difference between the outcomes of using PRF and PRP for pulp regeneration in a 13-year-old male patient, who had reported with endodontic treatment failure in his upper incisors. Gutta-percha and sealant were removed, and triple antibiotic paste (TAP) was placed in all the root canals and sealed with cavit. Subsequently, after TAP removal, 11 and 12 were treated with PRF, while 21 and 22 were treated with PRP. A resorbable matrix was placed over the PRF/PRP, over which mineral trioxide aggregate and glass ionomer cement were placed. After 2 years, all the upper maxillary incisors revealed dentinal wall thickening, root lengthening, and apical closure. However, apical bridge formation occurred only in incisors treated with PRF.
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Affiliation(s)
- Jaya Prasad
- Department of Conservative Dentistry and Endodontics, Goa Dental College and Hospital, Bambolim, Goa, India
| | - Ida de Noronha de Ataide
- Department of Conservative Dentistry and Endodontics, Goa Dental College and Hospital, Bambolim, Goa, India
| | - Paul Chalakkal
- Department of Pedodontics and Preventive Dentistry, Goa Dental College and Hospital, Bambolim, Goa, India
| | - Lalit Kumar Likhyani
- Department of Conservative Dentistry and Endodontics, RUHS College of Dental Sciences, Jaipur, Rajasthan, India
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Fahmy SH, Hassanien EES, Nagy MM, El Batouty KM, Mekhemar M, Fawzy El Sayed K, Hassanein EH, Wiltfang J, Dörfer C. Investigation of the regenerative potential of necrotic mature teeth following different revascularisation protocols. AUST ENDOD J 2017; 43:73-82. [DOI: 10.1111/aej.12210] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2017] [Indexed: 01/09/2023]
Affiliation(s)
- Sarah Hossam Fahmy
- Endodontic Department; Faculty of Dentistry; Ain Shams University; Cairo Egypt
| | | | | | | | - Mohamed Mekhemar
- Universitatsklinikum Schleswig-Holstein; Christian-Albrechts University; Kiel Germany
| | - Karim Fawzy El Sayed
- Universitatsklinikum Schleswig-Holstein; Christian-Albrechts University; Kiel Germany
| | | | - Jörg Wiltfang
- Universitatsklinikum Schleswig-Holstein; Christian-Albrechts University; Kiel Germany
| | - Christof Dörfer
- Universitatsklinikum Schleswig-Holstein; Christian-Albrechts University; Kiel Germany
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Valverde ME, Baca P, Ceballos L, Fuentes MV, Ruiz-Linares M, Ferrer-Luque CM. Antibacterial efficacy of several intracanal medicaments for endodontic therapy. Dent Mater J 2017; 36:319-324. [PMID: 28228624 DOI: 10.4012/dmj.2016-102] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The antibacterial efficacy of intracanal medicaments for 2 and 7 days, in open apex root canals contaminated with Enterococcus faecalis biofilms was compared. One hundred and thirty-eight standardized uniradicular human roots were inoculated with E. faecalis. Colony forming units (CFU) were recorded before and after medication. Samples were divided in two (2/7 days), and subdivided (n=8/group): triple antibiotic paste (TAP); double antibiotic paste (DAP); dental base paste (DBP), consisting of calcium hydroxide, propylene glycol and calcium carbonate; DBP+0.2% chlorhexidine (CHX); DBP+0.2% cetrimide (CTR); DBP+0.2% CHX+0.2% CTR; 2.5% sodium hypochlorite (NaOCl); and distilled water. At both periods TAP, DAP, DBP+0.2% CHX, DBP+0.2% CTR and DBP+0.2% CHX+0.2% CTR exhibited no growth (NG) of E. faecalis. Distilled water and 2.5% NaOCl obtained the lowest CFU reduction. No growth with DBP was reached only at 7 days. CHX and/or CTR pastes were as effective as DAP and TAP. A 2-day period provided an effective disinfection.
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Affiliation(s)
- Marta E Valverde
- Stomatology Area, Health Sciences Faculty, Rey Juan Carlos University
| | - Pilar Baca
- Department of Stomatology, School of Dentistry, University of Granada
| | - Laura Ceballos
- Stomatology Area, Health Sciences Faculty, Rey Juan Carlos University
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Abstract
Immature teeth are at risk for pulp necrosis, resulting in arrested root development and poor long-term prognosis. There is growing evidence that regenerative endodontic procedures promote desirable clinical outcomes. Despite significant advances in the field of regenerative endodontics and acceptable clinical outcomes, current evidence suggests that the tissues formed following currently used procedures do not completely recapitulate the former pulp-dentin complex. Further research is needed to identify prognostic factors and predictors of successful outcomes and to develop different treatment strategies to better predictably achieve all identified clinical outcomes, while favoring tissue formation that more closely resembles the pulp-dentin complex.
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Affiliation(s)
- Anibal Diogenes
- Department of Endodontics, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA.
| | - Nikita B Ruparel
- Department of Endodontics, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA
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Alyas SM, Fischer BI, Ehrlich Y, Spolnik K, Gregory RL, Yassen GH. Direct and indirect antibacterial effects of various concentrations of triple antibiotic pastes loaded in a methylcellulose system. J Oral Sci 2016; 58:575-582. [PMID: 28025443 DOI: 10.2334/josnusd.16-0384] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
We investigated the direct and indirect (residual) antibacterial effects of various concentrations of triple antibiotic paste (TAP) loaded into a methylcellulose system. Enterococcus faecalis (E. faecalis) was grown on sterilized dentin blocks (n = 60) and treated with clinically used TAP (1,000 mg/mL), low concentrations of methylcellulose-based TAP (100, 10, and 1 mg/mL), placebo paste, or 1.5% NaOCl (n = 10). The pastes were then removed, and biofilm disruption assays were performed. Additional dentin blocks (n = 120) were pretreated with the same experimental groups (n = 20). The pastes were rinsed off, and the samples were immersed independently in phosphate-buffered saline for 2 and 4 weeks (n = 10). E.faecalis was then grown on the dentin blocks, and biofilm disruption assays were performed. Fisher's Exact and Wilcoxon rank sum tests were used for statistical analyses. With regard to direct antibacterial effects, all treatment groups demonstrated complete eradication of biofilms in comparison to placebo paste, while 10 mg/mL of TAP or higher provided substantial residual antibacterial effects. However, dentin treated with 1 mg/mL of TAP or 1.5% NaOCl did not provide substantial residual antibacterial effects. Dentin pretreated with 10 mg/mL of TAP or higher exhibited extended residual antibacterial effects and can thus be used during endodontic regeneration.(J Oral Sci 58, 575-582, 2016).
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Affiliation(s)
- Sarmad M Alyas
- Department of Endodontics, Indiana University School of Dentistry
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Residual antibiofilm effects of various concentrations of double antibiotic paste used during regenerative endodontics after different application times. Arch Oral Biol 2016; 70:88-93. [DOI: 10.1016/j.archoralbio.2016.06.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Revised: 05/09/2016] [Accepted: 06/06/2016] [Indexed: 11/17/2022]
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Kishen A, Peters OA, Zehnder M, Diogenes AR, Nair MK. Advances in endodontics: Potential applications in clinical practice. J Conserv Dent 2016; 19:199-206. [PMID: 27217630 PMCID: PMC4872571 DOI: 10.4103/0972-0707.181925] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Contemporary endodontics has seen an unprecedented advance in technology and materials. This article aimed to review some of the challenges and advances in the following sections: (1) endodontic imaging, (2) root canal preparation, (3) root canal disinfection, (4) root canal filling, and (4) regenerative endodontic procedures (REPs). Jointly, these advances are aimed at improving the state of the art and science of root canal treatment.
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Affiliation(s)
- Anil Kishen
- Department of Endodontics, University of Toronto, Toronto, Ontario, Canada
| | - Ove A Peters
- Department of Endodontics, Arthur A Dugoni School of Dentistry, University of the Pacific, San Francisco, California, USA
| | - Matthias Zehnder
- Department of Preventive Dentistry, Periodontology and Cariology, Division of Endodontology, University of Zürich Center for Dental Medicine, Zürich, Switzerland
| | - Anibal R Diogenes
- Department of Endodontics, University of Texas Health Science Center, San Antonio, Texas, USA
| | - Madhu K Nair
- Department of Radiology, College of Medicine, University of Florida, Gainesville, Florida, USA
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Yang J, Yuan G, Chen Z. Pulp Regeneration: Current Approaches and Future Challenges. Front Physiol 2016; 7:58. [PMID: 27014076 PMCID: PMC4779938 DOI: 10.3389/fphys.2016.00058] [Citation(s) in RCA: 81] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Accepted: 02/05/2016] [Indexed: 01/06/2023] Open
Abstract
Regenerative endodontics aims to replace inflamed/necrotic pulp tissues with regenerated pulp-like tissues to revitalize teeth and improve life quality. Pulp revascularization case reports, which showed successful clinical and radiographic outcomes, indicated the possible clinical application of pulp regeneration via cell homing strategy. From a clinical point of view, functional pulp-like tissues should be regenerated with the characterization of vascularization, re-innervation, and dentin deposition with a regulated rate similar to that of normal pulp. Efficient root canal disinfection and proper size of the apical foramen are the two requisite preconditions for pulp regeneration. Progress has been made on pulp regeneration via cell homing strategies. This review focused on the requisite preconditions and cell homing strategies for pulp regeneration. In addition to the traditionally used mechanical preparation and irrigation, antibiotics, irrigation assisted with EndoVac apical negative-pressure system, and ultrasonic and laser irradiation are now being used in root canal disinfection. In addition, pulp-like tissues could be formed with the apical foramen less than 1 mm, although more studies are needed to determine the appropriate size. Moreover, signaling molecules including stromal cell derived factor (SDF-1α), basic Fibroblast Growth Factor (bFGF), Platelet Derived Growth Factor (PDGF), stem cell factor (SCF), and Granulocyte Colony-Stimulating Factor (G-CSF) were used to achieve pulp-like tissue formation via a cell homing strategy. Studies on the cell sources of pulp regeneration might give some indications on the signaling molecular selection. The active recruitment of endogenous cells into root canals to regenerate pulp-like tissues is a novel concept that may offer an unprecedented opportunity for the near-term clinical translation of current biology-based therapies for dental pulp regeneration.
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Affiliation(s)
- Jingwen Yang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan UniversityWuhan, China; Department of Pediatric Dentistry, School and Hospital of Stomatology, Wuhan UniversityWuhan, China
| | - Guohua Yuan
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan UniversityWuhan, China; Department of Pediatric Dentistry, School and Hospital of Stomatology, Wuhan UniversityWuhan, China
| | - Zhi Chen
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University Wuhan, China
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