Root canal dentinal tubule disinfection

doi:10.1016/S0099-2399(06)81670-5

Journal of Endodontics

Volume 16, Issue 5, May 1990, Pages 207-210

https://doi.org/10.1016/S0099-2399(06)81670-5 Get rights and content

Dentinal tubules of the root canal walls of human teeth were infected in vitro with a known bacterial isolate. The roots were exposed to either calcium hydroxide or iodine potassium-iodide for various periods of time and the viability of microorganisms was determined by incubation of entire root samples in a culture medium. The effects of the two agents on microbial viability were evaluated and compared. Iodine potassium-iodide disinfected dentin effectively. In contrast, bacteria remained viable in the dentin after relatively extended periods of calcium hydroxide treatment.

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Ex Vivo Evaluation of the Efficacy of Photodynamic Therapy in Eliminating Enterococcus faecalis from Dentinal Tubules by Confocal Laser Scanning Microscopy
2023, Journal of Endodontics
The aim of the present study was to investigate ex vivo by confocal laser scanning microscopy the antibacterial effect of photodynamic therapy (PDT) on dentinal tubules in the apical 5 mm of human mandibular premolars contaminated with Enterococcus faecalis.
Thirty-four teeth were standardized to 20 mm and foraminal anatomic diameters using a #20 K-file (Dentsply Maillefer). Samples were contaminated for 21 days and divided into the following 3 experimental groups (n = 10): the PDT group (instrumented canals and PDT), the passive ultrasonic irrigation (PUI) group (instrumented canals and PUI), and the PUI-PDT group (instrumented canals, PUI, and PDT), along with a control group (n = 4) (noninstrumented canals). The canals in the experimental groups were instrumented with ProTaper Next (Dentsply Maillefer) up to X3 and rinsed with EDTA and sodium hypochlorite. The photosensitizer used was 0.01% methylene blue with a preirradiation time of 5 minutes and a diode laser with 4 J energy and a 660-nm wavelength. Cross sections were made 5 mm from the apex of all samples, which were analyzed using confocal laser scanning microscopy. The results were analyzed using the Shapiro-Wilk and Kruskal-Wallis (Dunn) tests.
There was a lower percentage of live bacteria in the PUI-PDT group, with a statistical difference compared with the control and PDT groups (P < .05). There was no statistical difference in the percentage of live bacteria between PUI-PDT and PUI (P > .05).
It was concluded that the PUI-PDT association was most effective in disinfecting root canals compared with the control group and PDT.
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2022, Biomaterials in Endodontics
The successful treatment of the root canal requires the elimination of pulp tissue and bacteria and the alteration of its environment to prevent further colonization. The root canal irrigation is the introduction of chemicals for antimicrobial activity, demineralization, tissue dissolution, bleaching, deodorizing, and hemorrhage control through a flushing mechanism. Several irrigating solutions have cytotoxic potential, and they may cause damage if they gain access into the periapical tissues, high concentration can also cause erosion on the canal dentinal walls. The disinfection of the root canal system is challenging due to the complex internal anatomy and dentin composition, mechanical preparation cannot achieve the complete removal of pulp tissue and bacteria, and current irrigants cannot accomplish all the tasks required; a detailed understanding of the mode of action of various solutions is essential for optimal irrigation. We will discuss new developments on broad antimicrobial agents against bacteria and fungi typical of the root canal infection without cytotoxicity and mechanical devices for safe and adequate irrigation.
Effect of calcium hydroxide alone or in combination with ibuprofen and ciprofloxacin on postoperative pain and periapical prostaglandin E2 level: A randomized clinical study
2021, Prostaglandins and Other Lipid Mediators
The aim of the present study was to compare pure Ca(OH)2, Ca(OH)2 + ibuprofen and Ca(OH)2 + ciprofloxacin in terms of postoperative pain and prostaglandin E2 (PGE2) level in previously treated teeth with periapical lesions.
Sixty-six patients were randomly assigned into 3 groups according to the intracanal medication (Ca(OH)2, Ca(OH)2 + ibuprofen and Ca(OH)2 + ciprofloxacin). After removing gutta-percha from the root canals, the PGE2 sample collection was obtained by introducing three sterile paper points into the root canals through the root apex (2 mm). Selected intracanal medicament was placed into the root canal and the participants were told to record postoperative pain levels at 24, 48, and 72 h and on 1 week after treatment using visual analog scale (VAS). At the second appointment, the medicaments were removed and second sampling was performed using the same method. The PGE2 levels measured by enzyme-linked immunosorbent assay kits, and the data were statistically analyzed.
All the tested Ca(OH)₂ pastes were found to be significantly effective in lowering the preoperative PGE2 levels. However, intergroup analyses revealed that the Ca(OH)2 + ciprofloxacin group had the highest effectiveness in lowering PGE2 with a significant difference when compared with the pure Ca(OH)2 group. There was no statistically significant difference among the groups in terms of pre- and post-operative pain levels.
The Ca(OH)2 + ciprofloxacin medication is more effective than the pure Ca(OH)2 medication in lowering periapical PGE2 level. However, addition of ibuprofen or ciprofloxacin to the Ca(OH)2 paste does not provide extra benefit in terms of post-operative pain relief.
Antimicrobial action of NeoMTA Plus on mono- and dual-species biofilms of Enterococcus faecalis and Candida albicans: An in vitro study
2020, Archives of Oral Biology
To evaluate the antimicrobial action of NeoMTA Plus on mono- and dual-species biofilms of Enterococcus faecalis and Candida albicans.
A total of 171 sterile dentin blocks, measuring 4 mm × 4 mm × 1 mm, were incubated in media containing E. faecalis (3.1 × 10⁸ cells/mL) and/or C. albicans (1 × 10⁷ cells/mL) for 2 d. These blocks were randomly divided into three groups: the control (no treatment with biomaterials), MTA (treated with an MTA sample with width and thickness same as those of the dentin block after the material was set), and NeoMTA Plus (treated with NeoMTA Plus in a fashion similar to the treatment of the MTA group) groups. The biomaterials remained in contact with the biofilms for 24 h. Quantitative analyses of the number of colony-forming units (CFUs) and metabolic activity (XTT), were performed. Furthermore, qualitative analysis of biofilm structure was performed by scanning electron microscopy. Data were statistically analyzed considering a significance level of 5%.
XTT and the number of CFUs were similar among the groups (p > 0.05). The type of biofilm (mono- or dual-species) or the biomaterial used (MTA or NeoMTA Plus) did not affect the results. Biofilm structure exhibited a robust architecture composed of yeast and bacterial cell multilayers and was homogeneous among the groups.
NeoMTA Plus was not effective against mono- and dual-species biofilms of E. faecalis and C. albicans. Further research investigating biofilm removal methods including those involving the use of biomaterials with antiseptics and other supporting therapies is warranted.
Assessment of root dentin pH changes in primary and permanent molars with different types of calcium hydroxide intracanal medication
2019, Pediatric Dental Journal
To evaluate root dentin pH changes using different calcium hydroxide medications in primary and permanent molar root canals.
Sixty primary and 60 permanent molar roots were prepared with Twisted files and assigned in two subgroups: Group1, nonsetting calcium hydroxide (n = 30); group 2, viscous vehicle-based material (ApexCal^®) (n = 30). The assigned materials were delivered in root canals and then stored for 24 h, 7 days and 14 days. All specimens were transversely cut in three sections and pH change was determined by Expandable Ion Analyzer cooperating with Flat Membrane pH Electrode and Reference Half-Cell Electrode at sample root surfaces. Two-way ANOVA was used for statistical analysis.
No significant difference was observed in primary teeth at all test periods. The mean pH values of the nonsetting calcium hydroxide group (pH10.39–10.90) were greater than those in viscous vehicle-based group (pH 9.84–10.12), but significant difference was observed only at 24 h. Among permanent teeth, the highest pH values of both materials were observed at 7 days. The pH values of the nonsetting calcium hydroxide group (pH 10.40–11.10) were greater than those in the viscous vehicle-based group (pH 9.80–10.41); however, no significant difference was observed at any test period.
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2019, Advanced Dental Biomaterials
The field of endodontics has been the focus of many recent advances in material sciences and equipment. Besides the new successful materials, there are few old materials that are still being used due to their proven efficacy throughout the years. The purpose of this chapter is to summarize the materials that have been used in various endodontic procedures, from old obsolete ones to the latest innovations that require further development and thorough research. Furthermore, this chapter encompasses the wide range of endodontic materials from vital pulp therapy to root repair. The continuous evolution in endodontic materials is very promising, considering the dependence of this dental field on materials with ideal properties to achieve successful outcomes.

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^*: This study was supported by the University of Connecticut Research Foundation.

¹: Drs. Safavi, Spngberg, and Langeland are affiliated with the School of Dental Medicine, University of Connecticut Health Center, Farmington, CT.

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Root canal dentinal tubule disinfection*

Bacteriological studies of necrotic dental pulps

Ume University Odontological Dissertations No. 7

Endodontic medicaments

The correlation between positive culture and the prognosis of root canal therapy after pulpectomy

Odontol Revy

Bacteriologic evaluation of the efficacy of mechanical root canal instrumentation in endodontic therapy

Scand J Dent Res

Bacteriologic evaluation of the effect of 0.5 percent sodium hypochlorite in endodontic therapy

Oral Surg

The antimicrobial action of sodium hypochlorite and EDTA in 60 cases of endodontic therapy

Int Endod J

The significance of enterococci in root canal treatment

Odontol Revy

The incidence and identity of microorganisms present in root canals at filling following culture reversals

Oral Surg

A comparison of antimicrobial effects of calcium hydroxide and iodine potassium iodide

J Endodon

The bacteriological status of dentine around infected pulp canals

New Zealand Dent J