The efficacy of Salvadora persica extract in the elimination of the intracanal smear layer: A SEM study

AbstractAimTo evaluate the efficacy of an ethanolic Salvadora persica extract in removing the smear layer following a root canal procedure.MethodsSixty extracted, single-rooted human teeth were cleaned, shaped, and divided into four groups. Experimental groups 1 (n=20) and 2 (n=20) were irrigated with 1mg/ml and 5mg/ml of S. persica, respectively. The positive controls (n=10) were irrigated with 17% ethylenediaminetetraacetic acid (EDTA), while the negative controls (n=10) were irrigated with saline. Approximately 5ml of the irrigating solution was delivered into the root canals for 5min, and the final rinse was performed with 5ml of 1% sodium hypochlorite. Scanning electron microscopy was used to evaluate the endodontic smear layer removal at the coronal, middle, and apical thirds of the specimens.ResultsA significant difference in smear layer removal between groups 1 and 2 at the coronal and middle thirds of the canal was observed, and no significant difference was seen between group 2 and the positive control at the coronal third. At the apical third, both concentrations of S. persica had similar effects and were less effective than the positive control in removing the smear layer.ConclusionThe 5mg/ml S. persica solution was significantly more effective than the 1mg/ml solution. In addition, the 5mg/ml S. persica solution was as effective as 17% EDTA in removing the smear layer from the coronal third of the canal wall

A Newly Prepared Solution for the Removal of the Smear Layer

Aims: The aim of the study was to evaluate the ability of a mixture of (castor detergent and papain enzyme) MCP to remove the smear layer by using scanning electron microscope. Materials and Methods: Samples of 45 human extracted was divided in to 3 groups (A, B, and C) n = 15 and prepared endodontically using pro taper system up to size F 3, each group was irrigated with corresponding solution 3 ml in between each file size and 5 minutes as a final irrigant as following: Group A irrigated with distilled water (control negative). Group B irrigated with 2.5% (Sodium hypo chloride) NaOCL and 17% (Ethylene di amine tetra acetic acid) EDTA (control positive). Group C irrigated with 20% castor detergent and 4% papain enzyme as a mixture (MCP). Each sample was irrigated with 15 ml of distilled water and dried with paper points. The samples were sent for SEM photograph. Each sample was evaluated at three levels (apical, middle, and cervical part of the canal) Results: MCP solution showed partial removal of both organic and inorganic parts (dual action) of smear layer from the 3 levels of root canals, but the apical one was significantly less clean than the other two, also it has a more gentle effect of erosion than EDTA with NaOCl. EDTA with NaOCl has the ability to remove the smear layer completely from the canal, but still the apical third was significantly less clean than that of other two. It is impossible to remove the smear layer completely by NaOCl and EDTA without erosion of the inner surface of irrigated canal when EDTA was used as a final irrigant for 5 minutes. Conclusion: solution had the ability to remove the smear layer partially at the three levels of a root canal without dentin erosion. While EDTA had the ability to remove the smear layer completely at the three levels of canal with obvious dentinal erosion. Still the apical area has mechanical and anatomical limitation in root canal irrigation

Scanning electron microscope evaluation of the cut root surface and root end preparation using various techniques

Hanan Ballcx BDS, Saad Al-Nazhan, BDS, MSB King Saud University College of Dentistry, P.O.Box 60169, Riyadh, Saudi ArabiaRoot end preparation was performed in the apical third of 20 endodontically treated extracted human teeth using high speed, low speed, straight surgical low speed handpieces and ultrasonic machine. The surface properties of the cut root surface was evaluated using a scanning electron microscope (SEM). In addition, the degree of superficial debris and those retained in the cavity of the retropreparation was also examined. Results showed that the smoothest cut surface with minimal debris was produced by #169 plain tapered fissure bur on both high and low speed handpieces. The ultrasonic tip disturbs the gutta-percha filling. Frequent and continuous irrigation is better used during the cutting procedure to remove a greater amount of debris

The synergistic effect of ultrasonic activation and irrigation on Enterococcus faecalis biofilm

Aim: The aim of this investigation was to compare the efficacy of passive ultrasonic irrigation (PUI) with either 2.5% sodium hypochlorite (NaOCl) or saline, with that of conventional syringe irrigation on intraradicular Enterococcus faecalis biofilm. Materials and Methods: Biofilms of E. faecalis were established over 21 days in 80 single roots that had undergone biomechanical preparation followed by gamma radiation. Biofilms were treated for 1 min with 2.5% NaOCl/PUI (Group 1), 2.5% NaOCl (Group 2), sterile saline/PUI (Group 3), and sterile saline (Group 4). The positive control (n = 4) was used to confirm the presence of biofilm before various treatments. Additional four samples that served as a negative control were used to confirm the sterility of the samples. Biofilm eradication was evaluated by Colony Forming Unit (CFU) quantification and scanning electron microscopy (SEM). Results: The median of CFUs of S1 was significantly higher than that of S2 in all experimental groups. SEM examination showed a significant difference between the positive control and the experimental groups (P < 0.001), with the highest score of biofilm in the positive control group followed by Group 4 and both groups were not statistically significant from each other (P = 0.067). Following various treatments, the highest scores of biofilm were observed in the coronal third and the least were in the apical third. Conclusions: PUI did not increase the effectiveness of NaOCl irrigation on biofilm removal, however, PUI enhanced biofilm disturbance when used with saline. The least mean score of remaining biofilm was in the apical third of all treatment groups compared to other thirds

Effectiveness of Salvadora persica extracts against common oral pathogens

Objective: The purpose of this study was to evaluate the antibacterial activity of ethanol and hexane extracts of Salvadora persica against common oral pathogens. Materials and methods: Well diffusion, Minimum Inhibition Concentration (MIC), Minimum Bactericidal Concentration (MBC), and Broth microdilution tests were used to determine the optimum antimicrobial concentrations of S. persica extracts against Streptococcus mutans (S. mutans), Streptococcus sanguis (S. sanguis), and Streptococcus salivarius (S. salivarius) over 1, 3, 6, 12, and 24 h. Chlorhexidine (CHX) 0.2% was used as a positive control. Results: The findings showed that the microbial activity of both extracts was concentration-dependent. Ethanol extract of S. persica at 25, 50, and 100 mg/ml had more growth inhibitory effect against all isolates compared to hexane extract. In addition, ethanol extract at 8 mg/ml (MBC value) was able to eradicate the growth of all isolates. S. sanguis and S. salivarius were very sensitive to hexane extract and required 4 mg/ml (MBC value) for their eradication while S. mutans was the most resistant (MBC = 8 mg/ml).The statistical findings of CFU counts showed no significant difference (p = 1.000) in antibacterial effectiveness between the two extracts against all isolates. A significant decline overtime in CFU counts was noted, except at 12 h and 24 h where no significant difference (p = 0.793) was observed and was comparable to CHX. Conclusion: Ethanol and hexane extracts of S. persica were found to exhibit maximum antimicrobial activity against S. mutans, S. sanguis and S. salivarius at high concentrations. Keywords: Antimicrobial, Salvadora persica, Streptococcus mutans, Streptococcus sanguis, Streptococcus salivariu

Silver Nanoparticles Alone or in Combination with Calcium Hydroxide Modulate the Viability, Attachment, Migration, and Osteogenic Differentiation of Human Mesenchymal Stem Cells

This study aimed to evaluate the effect of silver nanoparticles (AgNPs) alone or in combination with calcium hydroxide (Ca(OH)2) on the proliferation, viability, attachment, migration, and osteogenic differentiation of human mesenchymal stem cells (hMSCs). Different concentrations of AgNPs alone or mixed with Ca(OH)2 were prepared. Cell proliferation was measured using AlamarBlue, and hMSCs attachment to dentin disks was evaluated using scanning electron microscopy. Live–dead imaging was performed to assess apoptosis. Wound healing ability was determined using the scratch-migration assay. To evaluate osteogenic differentiation, the expression of Runt-related transcription factor (RUNX2), Transforming growth factor beta-1 (TGF-β1), Alkaline Phosphatase (ALP), and Osteocalcin (OCN) were measured using real-time reverse transcriptase polymerase chain reaction. ALP staining and activity were also performed as indicators of osteogenic differentiation. AgNPs alone seemed to favor cell attachment. Lower concentrations of AgNPs enhanced cell proliferation. AgNP groups showed markedly less apoptosis. None of the medicaments had adverse effects on wound closure. The expression of TGF-β1 was significantly upregulated in all groups, and OCN was highly expressed in the AgNP groups. AgNPs 0.06% showed the most enhanced ALP gene expression levels, activity, and marked cytochemical staining. In conclusion, AgNPs positively affect hMSCs, making them a potential biomaterial for various clinical applications

Influence of Preclinical Training on Root Canal Treatment Technical Quality and Confidence Level of Undergraduate Dental Students

Objectives. The aim of this study was to investigate the influence of exposure to additional preclinical endodontic training on undergraduate students’ technical quality of root canal treatment and overall confidence levels in endodontics. Methods. Technical quality of root canal treatment performed clinically by fifth-year undergraduate students was evaluated and divided into two groups: Group 1, teeth treated by students who had attended both a preclinical endodontic block course and an elective preclinical course. Group 2: teeth treated by students who had not attended the elective preclinical course. All students were also invited to participate in a survey to rate their undergraduate endodontic training and confidence levels performing endodontic treatment. Statistical analysis of data was performed using Person chi-square test, Fisher Freeman Halton exact test, and t-test. A p-value <0.05 was considered statistically significant. Results. There was no significant difference between the two groups in overall obturation quality (p=0.619). However, more teeth treated by attendees were of adequate obturation length (p=0.015) and lacked procedural errors (p=0.004). Significantly more elective course attendees rated their undergraduate endodontic training as adequate (p=0.002), but there was no significant difference in the level of confidence between the attendees and the non-attendees. Conclusion. Within the limitations of this study, additional preclinical training showed minimal effect on overall quality of root canal treatment performed clinically by undergraduate students and did not enhance their confidence levels; however, it was associated with more satisfaction with their undergraduate endodontic education

The efficacy of Salvadora persica extracts in preserving the viability of human foreskin fibroblasts

Objective: To evaluate the efficacy of Salvadora persica hexane and ethanol extracts in preserving the viability of human foreskin fibroblasts. Materials and methods: Normal human foreskin cells were cultivated in Dulbecco modified Minimum Essential Medium (D-MEM) supplemented with 10% fetal bovine serum and 2 mM of l-glutamine. Cell pellets were suspended in the following test solutions: (1) Hank’s Balanced Salt Solution (HBSS); (2) homogenized milk; (3) hexane extract of S. persica; or (4) ethanol extract of S. persica. D-MEM with no serum was used as a positive control. For each condition, cell count was adjusted to 8 × 105 cells/ml, and the cells were incubated in the solutions for either 30, 60, or 120 min. Subsequently, the nonviable cells were separated from the viable cells using the trypan blue dye stain. The ratio of viable to nonviable cells was recorded using a cell counter. Statistical analysis of the data was accomplished by one-way analysis of variance using SPSS Version 16. The level of significance was 5% (p < .05). Results: We did not detect a significant difference when comparing the percentage of viable cells in test solutions at the three incubation periods (30 min, p = 0.478; 60 min, p = 0.606; 120 min, p = 0.091). Homogenized milk preserved the viability of foreskin fibroblasts better than all other tested solutions. Incubation of cells in S. persica hexane and ethanol extracts resulted in a similar percentage of viable cells to incubation of cells in HBSS for each incubation period. Conclusions: S. persica hexane and ethanol extracts should be considered an alternative storage medium to HBSS. Keywords: Avulsion, Cell viability, Fibroblasts, Human foreskin fibroblasts, Storage mediu

A Newly Prepared Solution for the Removal of the Smear Layer

Aims: The aim of the study was to evaluate the ability of a mixture of (castor detergent and papain enzyme) MCP to remove the smear layer by using scanning electron microscope. Materials and Methods: Samples of 45 human extracted was divided in to 3 groups (A, B, and C) n = 15 and prepared endodontically using pro taper system up to size F 3, each group was irrigated with corresponding solution 3 ml in between each file size and 5 minutes as a final irrigant as following: Group A irrigated with distilled water (control negative). Group B irrigated with 2.5% (Sodium hypo chloride) NaOCL and 17% (Ethylene di amine tetra acetic acid) EDTA (control positive). Group C irrigated with 20% castor detergent and 4% papain enzyme as a mixture (MCP). Each sample was irrigated with 15 ml of distilled water and dried with paper points. The samples were sent for SEM photograph. Each sample was evaluated at three levels (apical, middle, and cervical part of the canal) Results: MCP solution showed partial removal of both organic and inorganic parts (dual action) of smear layer from the 3 levels of root canals, but the apical one was significantly less clean than the other two, also it has a more gentle effect of erosion than EDTA with NaOCl. EDTA with NaOCl has the ability to remove the smear layer completely from the canal, but still the apical third was significantly less clean than that of other two. It is impossible to remove the smear layer completely by NaOCl and EDTA without erosion of the inner surface of irrigated canal when EDTA was used as a final irrigant for 5 minutes. Conclusion: solution had the ability to remove the smear layer partially at the three levels of a root canal without dentin erosion. While EDTA had the ability to remove the smear layer completely at the three levels of canal with obvious dentinal erosion. Still the apical area has mechanical and anatomical limitation in root canal irrigation.This article is published as Zakarea, Nawfal A. A., Talal H. Mohamad, Amer A. Taqa, Scott Chumbley, Salih Al-Juaid, and Hanan Balto. "A Newly Prepared Solution for the Removal of the Smear Layer." International Journal of Dental Sciences and Research 2 no.1 (2014): 19-26. DOI: 10.12691/ijdsr-2-1-6. Posted with permission.</p

Biomarkers of non-communicable chronic disease: an update on contemporary methods

Chronic diseases constitute a major global burden with significant impact on health systems, economies, and quality of life. Chronic diseases include a broad range of diseases that can be communicable or non-communicable. Chronic diseases are often associated with modifications of normal physiological levels of various analytes that are routinely measured in serum and other body fluids, as well as pathological findings, such as chronic inflammation, oxidative stress, and mitochondrial dysfunction. Identification of at-risk populations, early diagnosis, and prediction of prognosis play a major role in preventing or reducing the burden of chronic diseases. Biomarkers are tools that are used by health professionals to aid in the identification and management of chronic diseases. Biomarkers can be diagnostic, predictive, or prognostic. Several individual or grouped biomarkers have been used successfully in the diagnosis and prediction of certain chronic diseases, however, it is generally accepted that a more sophisticated approach to link and interpret various biomarkers involved in chronic disease is necessary to improve our current procedures. In order to ensure a comprehensive and unbiased coverage of the literature, first a primary frame of the manuscript (title, headings and subheadings) was drafted by the authors working on this paper. Second, based on the components drafted in the preliminary skeleton a comprehensive search of the literature was performed using the PubMed and Google Scholar search engines. Multiple keywords related to the topic were used. Out of screened papers, only 190 papers, which are the most relevant, and recent articles were selected to cover the topic in relation to etiological mechanisms of different chronic diseases, the most recently used biomarkers of chronic diseases and finally the advances in the applications of multivariate biomarkers of chronic diseases as statistical and clinically applied tool for the early diagnosis of chronic diseases was discussed. Recently, multivariate biomarkers analysis approach has been employed with promising prospect. A brief discussion of the multivariate approach for the early diagnosis of the most common chronic diseases was highlighted in this review. The use of diagnostic algorithms might show the way for novel criteria and enhanced diagnostic effectiveness inpatients with one or numerous non-communicable chronic diseases. The search for new relevant biomarkers for the better diagnosis of patients with non-communicable chronic diseases according to the risk of progression, sickness, and fatality is ongoing. It is important to determine whether the newly identified biomarkers are purely associations or real biomarkers of underlying pathophysiological processes. Use of multivariate analysis could be of great importance in this regard