Antibacterial activity ex vivo of different irrigating solutions on Enterococcus faecalis biofilms on dentin matrix

O presente trabalho teve por objetivo avaliar ex vivo a atividade antimicrobiana hipoclorito de sódio (NaOCl) 2,5% e 5,25%, clorexidina (CHX) gel e líquida 2% e MTAD em biofilme de Enterococcus faecalis, sobre matriz dentinária humana. 118 incisivos inferiores humanos, com canal único, foram instrumentados e seccionados transversal e longitudinalmente. Os fragmentos radiculares obtidos foram imersos em caldo TSB e autoclavados e em seguida foram inoculados com suspensão de E. faecalis e incubados em estufa a 37C, por 72 horas, para permitir a formação do biofilme. As amostras foram randomicamente divididas em 5 grupos experimentais, com 40 amostras para cada grupo, e dois grupos controle, com 3 amostras cada. O biofilme formado sobre a matriz dentinária foi submetido à ação das soluções antimicrobianas pelos tempos 1, 5, 15 e 30 minutos. A atividade antimicrobiana foi avaliada por meio da contagem de UFCs. Após a ação das soluções antimicrobianas, os fragmentos foram imersos em meio seletivo para enterococos, incubados em estufa a 37 C por 72 horas e avaliados quanto à turbidez do meio. A avaliação do percentual de redução bacteriana em função do tempo e da solução demonstrou não haver diferença estatística entre CHX gel, NaOCl 2,5% e NaOCl 5,25% (p>0,05). Entretanto a CHX líquida e o MTAD foram menos efetivos que NaOCl 2,5% e NaOCl 5,25% (p0.05). However, the CHX liquid and MTAD were less effective than NaOCl 2,5% and NaOCl 5,25% (p<0.05) and similar to CHX gel. Only CHX liquid and MTAD had statistical differences in its efficacy depending on the time. CHX was less effective in 1 and 5 minutes (p<0.05) and MTAD in 1 minute. When analyzing the bacterial viability in the dentin, NaOCl 5.25% and MTAD were superior to CHX gel, CHX liquid and NaOCl 2,5%; and the time of 30 minutes was statistically different than the others (p<0.05). Based on the results obtained it seems licit to conclude that NaOCl 2,5% and 5,25% and CHX gel 2% were the most effective in the elimination of E. faecalis at all times tested. MTAD presented effective antimicrobial action after 5 minutes of action. However, when the bacterial survival in the dentin was assessed, NaOCl 5.25% and MTAD were the most effective, and the minimum time for wide bacterial elimination in the dentinal tubules was 30 minutes

Microbial diversity analysis in persistent root canal infections

O presente trabalho teve por objetivo investigar a microbiota de canais radiculares relacionadas ao insucesso do tratamento endodôntico, buscando a identificação e a quantificação destes micro-organismos. Foram selecionados 36 dentes com infecção endodôntica persistente. O material obturador foi removido do canal radicular e amostras microbiológicas foram coletadas dos canais com o auxílio de limas tipo Hedströen e cones de papel absorvente estéril. A técnica do Checkerboard DNA-DNA hybridization foi utilizada para detecção de até 79 espécies bacterianas em cada amostra, utilizando sondas de DNA específicas. Os dados microbiológicos foram expressos em percentagem média (prevalência), proporção e nível médio de cada espécie em cada amostra. Os testes t independente e de correlação de Pearson foram usados para correlacionar a contagem das bactérias testadas com os dados clínicos (p&#8804; 0,05). Foi encontrada uma média de 11 espécies por amostra. E. faecium (36%), S. epidermidis (36%), E. saburreum (28%), P. micra (28%), S. sanguis (28%), C. sputigena (28%), L. buccalis (28%), E. faecalis (28%) e S. warneri (28%) foram as espécies mais prevalentes, e as espécies encontradas em níveis médios mais altos foram E. faecium, D. pneumosintes, S. epidermidis, H. pylori e C. sputigena. T. socranskii (3%), F. periodonticum (3%), C. gingivalis (3%), S. ixodetis (3%) apresentaram prevalências mais baixas. E. faecium e S. epidermidis apresentaram os maiores valores de prevalência, níveis médios e proporção. Não houve correlação entre a microbiota detectada nas amostras com os sinais e sintomas clínicos apresentados pelos pacientes, porém nas lesões periapicais de maior área foi detectada contagem significativamente maior de bacilos e espécies Gram-negativas (p<0,05). Baseado nos resultados obtidos é possível concluir que a microbiota presente em dentes com periodontite apical persistente possui perfil misto e complexo, e que uma maior área de lesão perirradicular pode estar associada a contagem elevada de bacilos e de espécies Gram-negativas.The present study investigated the composition of the root canal microbiota in endodontic failures, aiming to identify and quantify these microorganisms. Thirty six teeth with persistent endodontic infection were selected. The root-filling materials were removed and microbiological samples were taken from the root canals with a Hedströen-type file and sterile paper points. The Checkerboard DNA-DNA hybridization technique was used for the detection of 79 bacterial species in each sample, using specific DNA probes. Microbiological data were express in mean prevalence, proportions and levels of each species in each sample. t independent test and Pearson correlation test were use to correlate bacterial counts and clinical conditions (p&#8804; 0,05). There were found a mean of 11 different species per sample. E. faecium (36%), S. epidermidis (36%), E. saburreum (28%), P. micra (28%), S. sanguis (28%), C. sputigena (28%), L. buccalis (28%), E. faecalis (28%) and S. warneri (28%) were the most prevalent species, and the species found in highest mean levels were E. faecium, D. pneumosintes, S. epidermidis, H. pylori and C. sputigena. T. socranskii (3%), F. periodonticum (3%), C. gingivalis (3%) and S. ixodetis (3%) were found in low prevalence. E. faecium and S. epidermidis presented the highest values of prevalence, means levels and proportions. No correlation was found between the detected microbiota and clinical findings; however in periapical lesions with highest areas, higher levels of rods and Gram-negative species were detected (p<0.05). Based on these results it may be concluded that the microbiota in teeth with persistent apical periodontitis presents a mixed and complex profile, and periapical lesions with larger area might be high associated with higher counts of rods and Gram-negative species

Refinement influence in the cleaning efficacy of rotary nickel-titanium Mtwo ® instruments in oval-shaped canals by means of optical microscopy

Objective: This study evaluated the cleaning efficacy of the rotary nickel-titanium Mtwo ® by means of optical microscopy in oval-shaped root canals and compared refinement influence using ultrasonic files or Hedströem files. Materials and Methods: Twenty mandibular incisors were accessed, included in epoxy resin blocks, and cut transversely at 3, 6, and 9 mm from the apex. Teeth were instrumented using rotary nickel-titanium Mtwo. Digital images of the root cross sections were obtained before and after instrumentation with a digital camera attached to an optical microscope. Subsequently, samples were randomly divided into two groups for refinement. Group I was refined using ultrasonic files #30 and group II with Hedströem files #30. Final digital images of cross sections after refinement were captured and analyzed. The boundaries for the uninstrumented perimeter were measured by the software ImageTool 3.0. The data obtained were statistically analyzed by analysis of variance (ANOVA) and t-test. Results: Mtwo instrumentation produced 41.48% of the uninstrumented perimeter. The final refinement using Hedströem and ultrasonic files decreased the uninstrumented perimeter. Significant differences (t-test, P = 0.00) were found at the three thirds after the final refinement, except for the apical third that was enhanced by Hedströem file. However, there was no statistical difference between the two refinement techniques used (P > 0.05). Mtwo instrumentation was not capable of cleaning and shaping the entire perimeter of the root canals walls. Conclusions: The final refinement, either with ultrasonic files or with Hedströem files, resulted in significantly less uninstrumented perimeter