Combined Effect of Levofloxacin and N-Acetylcysteine against Enterococcus faecalis Biofilm for Regenerative Endodontics: An in Vitro Study

Introduction: Endodontic treatment of necrotic immature teeth poses several clinical challenges. A major problem is the elimination of microorganisms from the root canal system. This study evaluates the in vitro antibacterial efficacy of ciprofloxacin (CIP), levofloxacin (LEV), and their combination with N-acetylcysteine (NAC) in root canals infected with Enterococcus faecalis (E. faecalis). Methods and Materials: A total of 120 human extracted teeth with single canals were prepared and randomly divided into six groups: Calcium hydroxide (CH), ciprofloxacin (CIP), levofloxacin (LEV), ciprofloxacin and N-acetylcysteine (CIP+NAC), levofloxacin and N-acetylcysteine (LEV+NAC), and normal saline as a positive control. According to the name of the groups, intracanal medicaments were placed into the canals and the teeth were restored with a temporary filling. After one week, intracanal medicament was removed and the final count of bacteria was measured. Antibacterial effect of medicament was assessed by measuring the percentage reduction in the colony counts (RCC) and scanning electron microscopy (SEM). The Mann-Whitney U test and the Kruskal-Wallis test were used to compare the overall antibacterial efficacy of the intracanal medicaments at significance level of 0.05. Results: All intracanal medicaments were significantly more effective than calcium hydroxide (P<0.05). The combination of LEV and NAC caused significantly higher reduction in colony count in comparison with other tested medicaments (P=0.001). Conclusion: The combination of LEV and NAC showed greater antibacterial activity compared with other tested medicaments against biofilm of E. faecalis. Thus, it has the potential to be used in regenerative endodontic treatments.Keywords: Antibiotics; Biofilm; Enterococcus faecalis; Regenerative Endodontic

Use of rubber dam among dentists working in the west part of Iran

BACKGROUND AND AIM: Although Rubber dam (RD) usage is one of the ideal and standard methods for isolating the teeth in several operative procedures of dentistry, General Dental Practitioners often neglect it. Many studies within several countries have reported various frequencies for RD application. There is no such study for Iran, so we conducted a study to report the frequency of its application and the effective factors. METHODS: This cross-sectional study carried out across the west part of Iran in 2013. A total of 525 general Dental Practitioners from the public and private sectors selected by stratified random sampling using a list from 3 big western cities of Iran. The data were collected using self-administrated checklist. RESULTS: The prevalence of RD application among General Dental Practitioner was 0.2% (confidence interval 95%: 0.196-0.204). RD instrument was existed in around 7.0% of cases. The main reason of the General Dental Practitioner to avoid RD application was supposing it is time-consuming procedure and causing patients stress (58.9%). CONCLUSION: Despite the advantages of RD application, its usage is not recognized as a routine and common method of isolation during dental procedures even roots canal therapy by Iranian General Dental Practitioners. KEYWORDS: Rubber Dam, Isolation, Endodontic Treatment, General Dental Practitione

Prevalence of metabolic syndrome and its association with oral health: First results from the Kurdish cohort study

Abstract Aims Investigate the association between oral and dental health (ODH) and metabolic syndrome (MetS) in adults aged 35–70 years. Methods The study utilized data from the enrollment phase of Dehgolan prospective cohort study in the west of Iran. A cross‐sectional assessment was conducted on a total of 3996 participants, involving a comprehensive oral examination and the assessment of their oral hygiene behavior (ODH). MetS was defined according to the updated National Cholesterol Education Program Adult Treatment Panel III. Logistic regression used to calculate odds ratios (ORs) and 95% confidence intervals (CIs), adjusting for sociodemographic characteristics. Results MetS was more prevalent among those who not daily brushing and flossing. Participants with missing teeth (MT) show higher prevalent of MetS. Being female, lower age, illiteracy, family history of diabetes, low physical activity, and salt at table were independently associated with increase odds of MetS (p < 0.05). Odds of MetS were significantly decreased with use flossing (OR = 0.75; CI = 0.60–0.93), decayed (OR = 0.83; CI = 0.72–0.97), filled (OR = 0.84; CI = 0.71–0.99), and increased with MT (OR = 1.45; CI = 1.16–1.81) as long as adjusted for ODH factors. When other potential confounder such as sociodemographic, personal and nutritional habits were adjusted, daily flossing was the only factor that still statistically decreased (OR = 0.79; CI = 0.62–0.99) the odds of MetS. Conclusion Daily flossing was the only factor that independently associated with MetS. Relationship of other ODH factors with Mets were confounded by sociodemographic characteristics of the participants