Antimicrobial Effect and Surface Tension of Some Chelating Solutions with Added Surfactants

Abstract This study assessed the antimicrobial efficacy and surface tension of established irrigating solutions with a new experimental chelating solution in infected dentin tubes. Twenty-five specimens were randomly assigned to each of the irrigating solutions. Twenty specimens were used as negative and positive controls. After 21 days of contamination with E. faecalis, the irrigating solutions MTAD, QMiX and Tetraclean NA were delivered into each infected root canal. The solutions were removed and dentin samples were withdrawn from the root canals with sterile low-speed round burs with increasing ISO diameters. The dentin powder samples obtained with each bur were immediately collected in separate test tubes containing 3 mL of BHI broth. After that, 100 μL from each test tube was cultured on blood agar. The grown colonies were counted and recorded as colony-forming units (CFU). The surface tension of the irrigants was measured using a Cahn DCA-322 Dynamic Contact Angle Analyzer. A Kruskal Wallis nonparametric ANOVA and a Friedman test were used (p<0.05). Tetraclean NA showed lower surface tension and CFU values than MTAD and QMiX. Better antibacterial action and low surface tension were observed for Tetraclean NA, probably due to the improved penetration into the root canal and dentinal tube

Agonistic and Antagonistic Interactions between Chlorhexidine and Other Endodontic Agents: A Critical Review

Root canal irrigants play a significant role in elimination of the microorganisms, tissue remnants, and removal of the debris and smear layer. No single solution is able to fulfill all these actions completely; therefore, a combination of irrigants may be required. The aim of this investigation was to review the agonistic and antagonistic interactions between chlorhexidine (CHX) and other irrigants and medicaments. An English-limited Medline search was performed for articles published from 2002 to 2014. The searched keywords included “chlorhexidine AND sodium hypochlorite/ethylenediaminetetraacetic acid/calcium hydroxide/mineral trioxide aggregate". Subsequently, a hand search was carried out on the references of result articles to find more matching papers. Findings showed that the combination of CHX and sodium hypochlorite (NaOCl) causes color changes and the formation of a neutral and insoluble precipitate; CHX forms a salt with ethylenediaminetetraacetic acid. In addition, it has been demonstrated that the alkalinity of calcium hydroxide (CH) remained unchanged after mixing with CHX. Furthermore, mixing CHX with CH may enhance its antimicrobial activity; mixing mineral trioxide aggregate (MTA) powder with CHX increases its antimicrobial activity but may have a negative effect on its mechanical properties

Residual antibacterial activity of a new modified sodium hypochlorite-based endodontic irrigation solution

Objective: In this in vitro study the antibacterial substantivity of a new sodium hypochlorite-based root canal irrigant (Hypoclean) in bovine root dentin was investigated. Study Design: Ninety dentin tubes prepared from bovine incisor teeth were used. After contamination for 14 days with Enterococcus faecalis, the specimens were divided into five groups as follows: Hypoclean; Tetraclean; 5.25% sodium hypochlorite (NaOCl); infected dentin tubes (positive control); and sterile dentin tubes (negative control). Dentin chips were collected with round burs into tryptic soy broth and after culturing, the number of colony-forming units (CFU) was counted. Results: The number of CFU was minimum in the first cultures in all experimental groups, and the results obtained were significantly different from each other at any time period (P < 0.05). At all five experimental periods, the Tetraclean group showed the most effective antibacterial action (P < 0.05). Regular 5.25% NaOCl group showed the worst result at all periods. Hypoclean group demonstrated no bacterial growth after treatment. In each group, the number of CFU increased significantly by time-lapse (P < 0.05). Conclusion: The residual antibacterial activity of Tetraclean was significantly greater than Hypoclean and 5.25% NaOCl. © Medicina Oral S. L

Microbial Biofilms in Endodontic Infections: An Update Review

Biofilms and microbial aggregates are the common mechanisms for the survival of bacteria in nature. In other words, the ability to form biofilms has been regarded as a virulence factor. Microbial biofilms play an essential role in several infectious diseases such as pulp and periradicular pathosis. The aim of this article was to review the adaptation mechanisms of biofilms, their roles in pulpal and periapical pathosis, factors influencing biofilm formation, mechanisms of their antimicrobial resistance, models developed to create biofilms, observation techniques of endodontic biofilms, and the effects of root canal irrigants and medicaments as well as lasers on endodontic biofilms. The search was performed from 1982 to December 2010, and was limited to papers in English language. The keywords searched on Medline were "biofilms and endodontics," "biofilms and root canal irrigation," "biofilms and intra-canal medicament," and "biofilms and lasers." The reference section of each article was manually searched to find other suitable sources of information

Endodontic Considerations in Three-canalled Premolars: A Practical Update

The most difficult clinical considertions in orthograde root canal treatment are generally related to the anatomy of the teeth. Three-canalled maxillary and mandibular premolars (mini-molars) have been reported in several studies. The purpose of this paper was to review various aspects of three-canalled premolars including incidence, clinical and radiographic diagnosis, racial predisposition, access cavity preparation, instrumentation and obturation.Keywords: Mandibular Premolars; Maxillary Premolars; Mini-Molars; Root Canal Anatomy; Three-Canalled Premolar

Debridement effectiveness of two different techniques using negative pressure irrigation system

Summary Objectives To evaluate the cleaning efficacy of two apical negative pressure irrigation techniques compared to needle irrigation. Materials and Methods Eighty extracted human single canal teeth were shaped and assigned to 3 experimental groups (n = 20) according to the irrigation technique performed and two negative control groups (n = 10) as follows: 1) NI (Max-I-Probe side-vented needle irrigation); 2) EV (EndoVac system); 3) EVM (EndoVac-modified technique); 4) EV-C (EndoVac-negative control); 5) NI-C (needle irrigation-negative control). A scanning electron microscopic evaluation was performed. The presence of debris and smear layer at all levels (coronal, middle, apical) was evaluated. Results and conclusions A new irrigation protocol, using EndoVac System resulted in better removal of the smear layer at all levels

Impact of Ultrasonic Activation on the Effectiveness of Sodium Hypochlorite: A Review

Using ultrasonic devices in endodontics can enhance the antibacterial and tissue dissolving ability of different root canal irrigants such as sodium hypochlorite (NaOCl) which is the most common irrigant with excellent antibacterial and tissue dissolving abilities. However, due to its high surface tension, its penetration into the irregularities of the root canal system is a challenge. The purpose of this paper was to review the different ultrasonic devices, different types of ultrasonic irrigation, the effect(s) of ultrasonic activation on the antibacterial and biofilm-removal abilities of NaOCl as well as the effect of ultrasonic activation on the smear layer removal ability of NaOCl.Keywords: Antibacterial Activity; Biofilm; Root Canal Irrigants; Smear Layer; Sodium Hypochlorite; Ultrasonic Activatio

The in vitro Effect of Irrigants with Low Surface Tension on Enterococcus faecalis

Introduction: Due to the complex anatomy of the root canal system and high surface tension of common root canal irrigants (RCI), conducting an investigation on RCIs containing surfactants is a priority. The aim of this in vitro study was to verify the antibacterial potential of RCI with low surface tension in root canals infected with Enterococcus faecalis (E. faecalis). Methods and Materials: Thirty-five extracted human maxillary anterior teeth were prepared and inoculated with E. faecalis for 60 days. After root canal preparation, the teeth were randomly divided to one positive and one negative control groups and 5 experimental groups: Hypoclean/Tetraclean NA, Hypoclean, Tetraclean, NaOCl/Tetraclean and NaOCl. Bacterial growth was observed by turbidity of culture medium and then measured using a UV spectrophotometer. Data were analyzed in three time intervals (pre-instrumentation and, 20 min and 72 h after canal preparation) using the ANOVA and post hoc Tukey’s tests. The level of significance was set at 0.05. Results: The results indicated the presence of E. faecalis in all post-irrigation samples irrespective of the RCI. However, the optical densities in both post-irrigation periods showed bacterial reduction and significant differences between groups. Conclusion: RCI with low surface tension showed antibacterial potential in E. faecalis infected roots.Keywords: Enterococcus faecalis; Hypoclean; Sodium Hypochlorite; Tetraclea

Influence of Temperature on the Antibacterial Activity of Sodium Hypochlorite

The aim of this study was to compare the antimicrobial activity of 5.25% NaOCl, Hypoclean and Chlor-Xtra at 20 °C and 45 °C in bovine root dentin. One-hundred-and-seventy dentin tubes prepared from bovine maxillary incisors were infected for 21 days with Enterococcus faecalis. The specimens were divided into the following groups: 1. 5.25% NaOCl 20 °C; 2. Hypoclean 20 °C; 3. Chlor-Xtra 20 °C; 4. 5.25% % NaOCl 45 °C; 5. Hypoclean 45 °C; 6. Chlor-Xtra 45 °C; 7. positive control; 8. negative control. Dentin chips were collected with round burs into Brain Heart Infusion (BHI) broth. After culturing, the number of colony- forming units (CFU) was counted. Statistical analyses were performed using descriptive statistics (mean, standard deviation, median), Shapiro-Wilk test, ANOVA and Tukey test. Significance level was set at p<0.05. In all experimental groups, CFU was minimum after treatment (day 0) and the obtained results were significantly different from each other at any period (p<0.05). After treatment, the Hypoclean and Chlor-Xtra showed the lowest numbers of CFU at 20 °C and 45 °C, whereas 5.25% NaOCl showed the highest number of CFU at both temperatures. In each group, the number of CFUs increased significantly with time (p<0.05). The antibacterial activity of Hypoclean and Chlor-Xtra at 45 °C were significantly greater than other tested solutions

Management of Root Resorption Using Chemical Agents: A Review

Root resorption (RR) is defined as the loss of dental hard tissues because of clastic activity inside or outside of tooth the root. In the permanent dentition, RR is a pathologic event; if untreated, it might result in the premature loss of the affected tooth. Several hypotheses have been suggested as the mechanisms of root resorption such as absence of the remnants of Hertwig's epithelial root sheath (HERS) and the absence of some intrinsic factors in cementum and predentin such as amelogenin or osteoprotegerin (OPG). It seems that a barrier is formed by the less-calcified intermediate cementum or the cementodentin junction that prevents external RR. There are several chemical strategies to manage root resorption. The purpose of this paper was to review several chemical agents to manage RR such as tetracycline, sodium hypochlorite, acids (citric acid, phosphoric acid, ascorbic acid and hydrochloric acid), acetazolamide, calcitonin, alendronate, fluoride, Ledermix and Emdogain.Keywords: Alendronate; Calcitonin; Citric Acid; Emdogain; Fluoride; Osteoclast; Root Resorption; Tetracyclin