Susceptibilties of two Enterococcus faecalis phenotypes to root canal medications

This study aimed to investigate and compare the efficacy of selected root canal irrigants and a medicament on a clinical isolate of Enterococcus faecalis grown as biofilm or planktonic suspension phenotype. A cell-dense pellet "presentation" prepared from planktonic phenotype was also tested. Each bacterial presentation was exposed to calcium hydroxide (pH 12.3), 0.2% chlorhexidine gluconate, 17% ethylene-diamine-tetra-acetic acid, 10% povidone iodine, or 3.0% sodium hypochlorite (NaOCl) for a range of time periods (1, 2, 4, 8, 15, 30, and 60 min). Phosphate buffered saline was used as a control agent. The difference in gradients of bacterial killing among the biofilm, planktonic suspension or pellet presentation was significant (p < 0.05) and dependent upon the test agent except in the case of NaOCl and calcium hydroxide where no difference could be detected. NaOCl was the most effective agent and achieved 100% kills for all presentations of E. faecalis after a 2 min contact time.     

Harvesting of bone from the iliac crest--comparison of the anterior and posterior sites

In 1998 we harvested a total of 127 bone grafts from the iliac crest of 65 male and 53 female patients aged 8-80 years. We measured the quantity of bone obtained, the operating time and the donor site morbidity of the anterior approach (n=81) compared with the posterior approach (n=46). The mean volume of bone harvested was 15 cm(3) (range: 9-25.5) of monocorticocancellous- or bicortico-cancellous bone chips or those from a trephine bur. The mean operating time for the anterior approach was 35 min (range: 22-48), for the posterior approach 40 min (range: 32-55). There were 15 complications, which were limited to those in whom the volume of bone exceeded 17 cm(3). The posterior approach caused less morbidity, notably in the form of significantly less pain and irregularity of gait. The patient has, however, to be repositioned during operation, which added to its total duration.