Residual antibacterial activity of chlorhexidine and MTAD in human root dentin in vitro

The purpose of this in vitro study was to compare the antimicrobial substantivity of BioPure MTAD, 2% chlorhexidine (CHX) and 2.6% sodium hypochlorite (NaOCl) in human root dentin. One hundred and ten dentin tubes prepared from human maxillary incisors were infected in vitro for 14 days with Enterococcus faecalis. The specimens were divided into five groups as follows: CHX; BioPure MTAD; NaOCl; infected dentin tubes (positive control); and sterile dentin tubes (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. In all experimental groups, CFU was minimum after treatment (day 0), and the results obtained were significantly different from each other at any time period (P < 0.05). After treatment, the NaOCI group and BioPure MTAD group showed the lowest and highest number of CFU, respectively. In each group, the number of CFUs increased significantly by time-lapse (P < 0.05). In conclusion, the substantivity of BioPure MTAD was significantly greater than CHX and NaOCl.     

Viable bacteria in root dentinal tubules of teeth with apical periodontitis

Two sets of teeth with apical periodontitis were collected at different geographic locations to study the identity of bacteria left in the root dentinal tubules. Root dentin of 20 of these teeth was cultured from three locations between pulp and cementum (A, B, and C). In addition dentin from eight teeth was examined histologically. Using the culturing technique bacteria were found in 77% of the dentin samples from set 1 (Amsterdam) and in 87.5% of the dentin samples from set 2 (Glasgow). At greater distance, in layer C, from the pulp bacteria were found in 62% (13 of 21) of the dentin samples. Twenty-three percent (3 of 13) of set 1 and 25% (2 of 8) of set 2 contained >50,000 colony-forming units/mg of dentin in layer C. In layers closer to the pulp higher numbers of anaerobic bacteria and gram-positive rods were found, as well as a larger number of bacterial species. Histological sections showed bacterial penetration in dentinal tubules in 5 of 8 teeth. In the other three teeth where the colony-forming units/mg recovered was <10,000, no histological signs of tubule penetration was seen. It seems clear that, in more than half of the infected roots, bacteria are present in the deep dentin close to the cementum and that anaerobic culturing of dentin is more sensitive than histology to detect these bacteria.     

Effect of inorganic ions and surface active organic compounds on the adherence of oral streptococci.

A reduction in the adherence of oral streptococci was observed after topical application of aluminum ions to standardized dentin test pieces whereas pyrophosphate and tripolyphosphate seemed to inhibit the adherence after incorporation in the incubation solution. A pronounced effect was recorded after topical application of surfactants with the positively charged primary amino group as end group. Hydrofluorides of several such aliphatic amines effectively reduced the number of colony-forming units washed off from the test pieces. Also the free base of hexadecylamine showed a similar effect. Inhibition of adherence was also obtained with long chain esters of lysine, with an optimum at 16 carbon atoms in the alcohol group. These compounds have the advantage of being built up from molecules known to the body.     

Effect of inorganic ions and surface active organic compounds on the adherence of oral streptococci

abstract — A reduction in the adherence of oral streptococci was observed after topical application of aluminum ions to standardized dentin test pieces whereas pyrophosphate and tripolyphosphate seemed to inhibit the adherence after incorporation in the incubation solution. A pronounced effect was recorded after topical application of surfactants with the positively charged primary amino group as end group. Hydrofluorides of several such aliphatic amines effectively reduced the number of colony-forming units washed off from the test pieces. Also the free base of hexadecylamine showed a similar effect. Inhibition of adherence was also obtained with long chain esters of lysine, with an optimum at 16 carbon atoms in the alcohol group. These compounds have the advantage of being built up from molecules known to the body.     

Bactericidal efficacy of metronidazole against bacteria of human carious dentin in vivo

The bactericidal efficacy of metronidazole (MN) against bacteria of carious dentin was estimated by measuring bacterial recovery with or without application of MN to dentinal lesions in vivo. More than 10(3) colony-forming units of bacteria per milligram of sample were recovered from the samples of carious dentin. However, none were recovered from the samples of dentinal lesions which had been covered by alpha-tricalcium phosphate (TCP) cement containing MN in situ for 1 day, 1 month, 1 year and/or 2 years in vivo. Placebo experiments in which carious dentin was covered by TCP cement without MN showed that TCP itself was not bactericidal. Bactericidal efficacy of MN in situ is clearly demonstrated, indicating that MN is a valuable material in caries treatment to disinfect carious dentin.     

Bacterial penetration and proliferation in root canal dentinal tubules after applying dentin adhesives in vitro

Endodontic treatment is aimed at eliminating infection and preventing bacterial regrowth in the root canal and dentinal tubules. In the present study the ability of two dentin adhesives to prevent bacterial penetration and subsequent proliferation in dentinal tubules was evaluated. Cylindrical root specimens prepared from freshly extracted bovine teeth were used in an in vitro model of dentinal tubule infection. After removal of the smear layer the intracanal dentinal tubules of the specimens were acid-etched and treated with either Gluma or EBS. Untreated specimens served as controls. Specimens were infected with Enterococcus faecalis and incubated in Brain Heart Infusion for 21 days. Powder dentin samples obtained from within the canal lumina, using ISO 025 to 033 burs, were examined for the presence of vital bacteria by inoculating on agar plates and counting colony-forming units. A significant difference was found between the experimental groups and the untreated group. After application with Gluma specimens showed the least viable bacteria in dentinal tubules. Data suggested that dentin adhesives reduced bacterial invasion into dentin and therefore have a potential role in endodontic treatment.     

Antibacterial effect of an ozone device and its comparison with two dentin-bonding systems

Microorganisms remaining beneath restorations can cause secondary caries and pulp damage. Because of this, antimicrobial treatment could be useful. The aim of this study was to evaluate the antibacterial effect of the HealOzone device on Streptococcus mutans and to compare it with the already proven activity of two dentin-bonding systems. Thirty-five human molars were divided into 5 groups. Cavities were then cut into the teeth (n = 28 cavities per group). After sterilization, the teeth were left in broth cultures of 10(6) colony-forming units (CFU) ml(-1) of S. mutans at 36 degrees C for 48 h. The appropriate treatment followed (group A, control; group B, Clearfil SE Bond; group C, Clearfil Protect Bond; group D, 40 s of treatment with ozone; and group E, 80 s of treatment with ozone), and the cavities were then filled with composite resin. After 72 h, the restorations were removed, dentin chips were collected with an excavator, and the total number of microorganisms was determined. All treatments significantly reduced the number of S. mutans present compared with the control group. The antimicrobial effect of both bonding systems and treatment with 80 s of ozone was significantly higher than the 40 s ozone treatment. In conclusion, HealOzone and the bonding systems show striking antimicrobial effects against S. mutans.     

Efficacy of bacterial removal from instrumented root canals in vitro related to instrumentation technique and size

OBJECTIVE: This in vitro investigation assessed the efficacy of removing radioactively labeled bacteria from infected canals with 2 engine-driven rotary nickel titanium instrumentation techniques differing in sequence and apical enlargement size. STUDY DESIGN: A standard quantity of (3)H-thymidine-labeled Enterococcus faecalis (3.70 x 10(4) cpm, 2.0 x 10(7) colony-forming units) was used to inoculate the mesiobuccal canals of 50 extracted mandibular molars. The teeth were incubated for 5 days to allow infection of the surrounding dentin from the canals. Five of the teeth were used as controls to determine the number of cycles of irrigation and drying necessary to reduce the (3)H counts recovered from the canals to baseline levels. After this process, the unbound bacteria in the root canals of the remaining 45 teeth then were washed out with buffer until baseline levels of radioactivity were obtained. The mesiobuccal root of 1 of these 45 teeth was removed, decalcified, and digested, and the total radioactivity released from the root dentin was measured. Of the remaining 44 teeth, 22 then were instrumented with GT and Profile (Dentsply/Tulsa Dental Co, Tulsa, Okla) instruments to apical size #35 (group 1) and 22 teeth with Pow-R instruments (Moyco/Union Broach, York, Pa) to apical size #50 (group 2), in the presence of a standard quantity of phosphate-buffered saline solution placed in the canal. After instrumentation, the medium from each canal was collected with paper points and its radioactivity was counted with liquid scintillation spectrometry. RESULTS: The mean (3)H level recovered with instrumentation of canals in group 1 was 75 cpm (+/- 29, standard deviation) and in group 2 was 123 cpm (+/- 50, standard deviation). A 2-tailed Mann-Whitney test indicated that the radioactivity of samples from group 2 was significantly higher than that of samples from group 1. CONCLUSION: The results suggested that instrumentation to an apical size of #50, as performed with the Pow-R instruments, was more effective in debriding infected root canals than instrumentation to an apical size of #35, as performed with the GT and Profile instruments.     

Efficacy of calcium hydroxide: chlorhexidine paste as an intracanal medication in bovine dentin

The purpose of this study was to evaluate the antibacterial efficacy of an intracanal medication composed of calcium hydroxide with 2% chlorhexidine. Dentin from 24 bovine incisors was used. The incisors were made into standardized cylindrical segments of dentin and infected with Enterococcus faecalis. They were then treated with an intracanal paste composed of calcium hydroxide and sterile water or an intracanal paste composed of calcium hydroxide and 2% chlorhexidine for 1 week. Dentin shavings were collected, suspended in solution, and spread on brain-heart infusion agar. After incubation, colony-forming units were enumerated. The amount of bacteria per mg of dentin was determined. The calcium hydroxide paste with 2% chlorhexidine was significantly more effective at killing E. faecalis in the dentinal tubules than calcium hydroxide with water.     

Bacterial invasion in root cementum and radicular dentin of periodontally diseased teeth in humans. A reservoir of periodontopathic bacteria

In this study the viability and the distribution of bacteria within the radicular dentin and pulp of periodontally diseased caries-free teeth were studied. Healthy teeth served as controls. Samples were obtained from the pulp tissue and from the radicular dentin. Dentin samples were taken from the interdental surfaces in the subgingival area. Starting from the pulpal side, three to five successive dentin layers of approximately 1 mm thickness were sampled. The samples were processed and cultured using an anaerobic technique. Bacterial growth was detected in 87% of the periodontally diseased teeth. In 83% of the teeth, bacteria were present in at least one of the dentin layers. Fifty-nine percent of the diseased teeth, from which the pulp tissue was cultured, contained bacteria in the pulp samples. The mean bacterial concentrations in the pulp and dentin layers ranged from 1,399 to 16,537 colony-forming units (CFU) per mg of tissue. These concentrations were 259 to 7,190 times greater than concentrations found in healthy teeth. It is suggested that the roots of periodontally diseased teeth could act as bacterial reservoirs from which recolonization of mechanically treated root surfaces can occur, as well as infection of the dental pulp. These findings might change current concepts concerning root surface debridement in periodontal therapy.     

Anti-biofilm dentin primer with quaternary ammonium and silver nanoparticles

Antibacterial bonding agents could combat recurrent caries at the tooth-composite margins. The objectives of this study were to develop novel antibacterial dentin primers containing quaternary ammonium dimethacrylate (QADM) and nanoparticles of silver (NAg), and to investigate the effects on dentin bond strength and dental plaque microcosm biofilms for the first time. Scotchbond Multi-Purpose ("SBMP") bonding agent was used. QADM and NAg were incorporated into SBMP primer, yielding 4 primers: SBMP primer (control), control + 10% QADM (mass), control + 0.05% NAg, and control + 10% QADM + 0.05% NAg. Human saliva was collected to grow microcosm biofilms. The NAg particle size (mean ± SD; n = 100) was 2.7 ± 0.6 nm. Dentin shear bond strengths (n = 10) with human third molars were approximately 30 MPa for all groups (p > 0.1). QADM-NAg-containing primer increased the bacteria inhibition zone by 9-fold, compared with control primer (p < 0.05). QADM-NAg-containing primer reduced lactic acid production and colony-forming units of total micro-organisms, total streptococci, and mutans streptococci by an order of magnitude. In conclusion, novel QADM-NAg-containing primers were strongly antibacterial without compromising dentin bond strength, and hence are promising to inhibit biofilms and secondary caries. The processing method of incorporating QADM and NAg together into the same primer produced the strongest antibacterial effect, which could have a wide applicability to other bonding systems.     

Combining periodic and continuous sodium hypochlorite treatment to control biofilms in dental unit water systems.

BACKGROUND: This study evaluated the efficacy of combined intermittent and continuous treatment with diluted sodium hypochlorite, or NaClO, to improve dental unit water quality in a clinical setting. METHODS: In this prospective study, 10 dental units were fitted with separate water reservoir systems. Dental units were maintained with weekly rinses with 1:10 NaClO. Treatment water consisted of 750 milliliters of tap water and one drop of undiluted commercial bleach. Bacterial contamination in the effluent coolant water was assayed via microbiologic culture on a weekly basis. At the end of the study, scanning electron microscopy of the inner surfaces of the dental unit waterlines corroborated the results. RESULTS: All 10 dental units consistently delivered water with less than 10 colony-forming units per milliliter, or CFU/mL, with a mean bacterial contamination of less than 1 CFU/mL. Baseline scanning electron microscopy demonstrated biofilm formation. Scanning electron microscopy at the end of the study demonstrated the lack of features consistent with biofilm formation. Although tri-halomethanes were detected in output water, all samples were below Environmental Protection Agency limits for drinking water. CONCLUSIONS: Weekly treatment with 5.25 percent NaClO diluted 1:10, and concomitant use of chlorinated treatment water (3 parts per million chlorine) consistently attained the proposed American Dental Association goal of fewer than 200 CFU/mL in the unfiltered output. The effects of continuous treatment on dentin and enamel bond strength may require further evaluation. CLINICAL IMPLICATIONS: The success of this protocol suggests that optimal attainment of dental water quality goals may require a combination of approaches.     

Reduction of viable bacteria in dentinal tubules treated with clindamycin or tetracycline

AIM: We sought to evaluate and compare the antibacterial effect of clindamycin and tetracycline in bovine dentinal tubules. METHODS: Dentinal tubules of 32 cylindrical bovine root specimens were infected with Streptococcus sanguis N1. Clindamycin 2% or tetracycline 2% (Ledermix) was placed in the root canal for 1 week. Powder dentin samples obtained from within the canal lumina by using International Standards Organization No. 25 to No. 31 burs were examined for the presence of vital bacteria after the brain-heart infusion plates were inoculated and the colony-forming units were counted. The potent effect of the medicaments was also evaluated through the use of the agar diffusion test. RESULTS: Heavy bacterial infection was observed in the control bovine root specimens at the layer close to the lumen. This decreased rapidly from layer to layer up to the deepest layer tested (300-400 microm), which contained several hundred colony-forming units. Clindamycin significantly reduced the amount of viable bacteria in each dentin layer compared with the positive control and tetracycline (P <.01). The agar diffusion test, wherein dilutions in increments of 1/3 and 1/9 were used, revealed that both medicaments had antibacterial activity, but clindamycin was significantly better. In the 1/27 dilution, clindamycin had a minor effect and tetracycline had no effect at all. CONCLUSION: Under the experimental conditions used in this study, the commercial preparations of clindamycin were more effective than those of tetracycline (Ledermix) in the agar diffusion test and clindamycin penetrated into dentinal tubules up to 400 microm. Thus, it has the potential to serve as an effective intracanal medicament in persistent infections when other medicaments fail.     

Antibacterial substantivity of a new antibiotic‐based endodontic irrigation solution

The aim of this study was to evaluate the residual antibacterial activity of Tetraclean, MTAD and 5.25% sodium hypochlorite (NaOCl) in bovine root dentin in vitro. One hundred and ten dentin tubes prepared from bovine incisor teeth were infected in vitro for 14 days with Enterococcus faecalis. Thereafter, the specimens were divided into five groups as follows: Tetraclean; MTAD; 5.25% NaOCl; infected dentin tubes (positive control); and sterile dentin tubes (negative control). Dentin chips were collected using round burs into tryptic soy broth and after culturing, the number of colony‐forming units (CFU) was counted. The number of CFU in all experimental groups was minimum after treatment, and the results obtained were significantly different from each other at any time period (P < 0.05). The Tetraclean group showed the most effective antibacterial action at all five experimental periods (P < 0.05). MTAD group showed the least antibacterial activity after treatment. However, at days 7, 14, 21 and 28 MTAD showed more effective antibacterial action than NaOCl. In each group, the number of CFU increased significantly by time‐lapse (P < 0.05). In conclusion, the residual antibacterial activity of Tetraclean was significantly greater than MTAD and 5.25% NaOCl.     

Detection frequencies and the colony-forming unit recovery of oral treponemes by different cultivation methods

Selected media were compared for primary isolation and detection of oral treponemes from clinical samples. Forty-eight subgingival plaque samples from 45 patients suffering from periodontitis were anaerobically cultivated for 2 weeks at 37°C. Of the 9 media studied, Medium 10 (M10), which was supplemented with 10% rabbit serum and incubated using the plate-in-bottle method, supported the highest colony-forming units of the anaerobes. The treponemal colonies were detected at least on one medium from 83% of the subgingival plaque samples. The new oral spirochete medium in an anaerobic chamber supported the highest detection frequency of the oral treponemes (64% of samples); however, M10 in the plate-in-bottle was found to produce the highest colony-forming unit recovery of the oral treponemes (median 3.6% of the total colony-forming units). This study suggests that M10 in the plate-in-bottle and new oral spirochete medium in the anaerobic chamber are essential in cultivating oral treponemes.     

An evaluation of the CO2 laser for endodontic disinfection

The goal of this study was to evaluate the bactericidal action of the CO2 laser on animal teeth infected with an endodontic bacterial species. After instrumentation, 24 freshly extracted incisors were inoculated with a known concentration of Actinomyces odontolyticus and incubated anaerobically for 18 h. The incisors were separated into three groups: group 1--untreated control teeth; group 2--teeth treated with 3% NaOCl; and group 3--teeth lased with a CO2 laser at 5 W using three successive 9.9 s irradiation periods with 10 s between treatments. For each of the three groups, 60 microliters samples were removed using gel loading capillary pipette tips, and the diluted samples were plated in triplicate on Columbia agar plates. After a 5- to 6-day incubation, the colony-forming units were counted, and the quantitative results were subjected to an analysis of variance. The results of this analysis indicated an average 85% decrease in the colony-forming units in the laser-treated group, compared with the control group. According to Fisher and Scheffé tests, the differences in the averages between the control and laser groups were statistically significant (p < 0.05). The NaOCl treatment was statistically superior to the CO2 laser treatment.     

Microbiologic effects of SnF2 and NaF mouthrinses in subjects with high caries activity: results after one year

Twenty-two adults, considered to have high caries activity, rinsed for one yr with either SnF2 or acidulated NaF mouthrinses. Total colony-forming units and numbers of S. mutans and lactobacilli were estimated from saliva samples. Large reductions were found in the number of recoverable S. mutans in subjects rinsing with SnF2 but not in the NaF group.     

10-MDP-钙盐形成对牙本质粘接成绩影响的评价

目的 分析10-MDP-钙盐形成对牙本质粘接成绩的影响.方法 采用酸蚀冲洗粘接模式,根据牙本质表面的处理方式和选择粘接剂的不同将牙齿随机分为以下4组(n=5)进行处理,制作牙本质/树脂粘接试件:①对照组,直接使用全酸蚀粘接剂Single bond 2(SB2)处理后粘接;②10-MDP组,使用SB2处理进行粘接前,牙本...     

Novel root canal sealer with dimethylaminohexadecyl methacrylate,nano-silver and nano-calcium phosphate to kill bacteria inside root dentin and increase dentin hardness

ObjectivesRoot canal re-infection and weakening of roots are two main challenges in endodontics. The objectives of the study were: (1) to develop a novel root canal sealer containing dimethylaminohexadecyl methacrylate (DMAHDM), nanoparticles of silver (NAg), and nanoparticles of amorphous calcium phosphate (NACP), and (2) to investigate the effects on the physical, anti-biofilm, remineralizing ions, and hardness of human dentin for the first time.MethodsMethacrylate-resin dual-cured root canal sealer contained 5% DMAHDM, 0.15% NAg, and NACP at 10%, 20% and 30% mass fractions. The flow, film thickness, and Ca and P ions release were investigated. The effects of NACP on radicular dentin hardness after treatment with sodium hypochlorite (NaOCL) and ethylenediaminetetraacetic acid (EDTA) were assessed. Antibacterial properties were measured against Enterococcus faecalis (E. faecalis)-impregnated dentin blocks; colony-forming units (CFU) and live/dead assays were measured.ResultsIncorporating DMAHDM, NAg and NACP did not adversely influence the flow and film thickness properties. Sealer with 30% NACP neutralized the acid and increased the solution pH (p < 0.05). Sealer containing 30% NACP regenerated dentin minerals lost due to NaOCL and EDTA treatment, and increased the dentin hardness to match that of sound dentin (p > 0.1). Incorporating 5% DMAHDM and 0.15% NAg reduced biofilm CFU of E. faecalis-impregnated dentin blocks by nearly 3 logs when compared control group (p < 0.05).SignificanceThe novel therapeutic root canal sealer with triple bioactive agents of DMAHDM, NAg and NACP neutralized acid, raised the pH, regenerated dentin minerals, increased root dentin hardness, and reduced dentin-block-impregnated biofilm CFU by 3 logs. This new sealer with highly desirable antibacterial and remineralization properties are promising to increase the success rate of endodontic therapy and strengthen the tooth root structures.     

Shear Bond Strength of Composite to Deep Dentin After Treatment With Two Different Collagen Cross-linking Agents at Varying Time Intervals

SUMMARY Objective : This in vitro study evaluated the shear bond strength of composite resin to deep dentin using a total etch adhesive after treatment with two collagen cross-linking agents at varying time intervals. Materials and Methods : Thirty freshly extracted human maxillary central incisors were sectioned longitudinally into equal mesial and distal halves (n=60). The proximal deep dentin was exposed, maintaining a remaining dentin thickness (RDT) of approximately 1 mm. The specimens were randomly divided into three groups based on the surface treatment of dentin prior to bonding as follows: group I (n=12, control): no prior dentin surface treatment; group II (n=24): dentin surface pretreated with 10% sodium ascorbate; and group III (n=24): dentin surface pretreated with 6.5% proanthocyanidin. Groups II and III were further subdivided into two subgroups of 12 specimens each, based on the pretreatment time of five minutes (subgroup A) and 10 minutes (subgroup B). Shear bond strength of the specimens was tested with a universal testing machine, and the data were statistically analyzed. Results : Significantly higher shear bond strength to deep dentin was observed in teeth treated with 10% sodium ascorbate (group II) and 6.5% proanthocyanidin (group III) compared to the control group (group I). Among the collagen cross-linkers used, specimens treated with proanthocyanidin showed significantly higher shear bond strength values than those treated with sodium ascorbate. No significant difference was observed between the five-minute and 10-minute pretreatment times in groups II and III. Conclusion : It can be concluded that dentin surface pretreatment with both 10% sodium ascorbate and 6.5% proanthocyanidin resulted in significant improvement in bond strength of resin composite to deep dentin.