Antimicrobial activity of Chlorhexidine, Peracetic acid and Sodium hypochlorite/etidronate irrigant solutions against <i>Enterococcus faecalis</i> biofilms

Arias-Moliz, María Teresa; Ordinola‐Zapata, Ronald; Baca, Pilar; Ruiz-Linares, Matilde; García, E. García; Duarte, M. A. H.; Bramante, Clóvis Monteiro; Ferrer-Luque, Carmen Marı́a

doi:10.1111/iej.12424

Cited by 86 publications

(70 citation statements)

References 34 publications

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“…The antibacterial effect of HEDP/NaOCl combinations against endodontic pathogens is well demonstrated in previous in vitro studies (Arias‐Moliz et al . , ). However, hitherto there has been no clinical trial evaluating possible influences that cannot be simulated in vitro .…”

Section: Discussionmentioning

confidence: 99%

Safety assessment of an etidronate in a sodium hypochlorite solution: randomized double‐blind trial

et al. 2019

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Aim To assess whether Dual Rinse HEDP, an etidronate that can be combined with NaOCl to create an endodontic irrigating solution containing both hypochlorite and a chelator in the form of 1‐hydroxyethane 1,1‐diphosphonic acid (HEDP), alters the clinical efficacy of NaOCl or adds any untoward clinical effects. Methodology In this randomized controlled double‐blind single‐centre trial, a pure NaOCl solution was compared to a HEDP‐containing counterpart regarding antimicrobial efficacy, postoperative pain, and the host response by means of changes in MMP‐9 levels in periapical fluid. Sixty patients presenting with asymptomatic apical periodontitis (one tooth each) were randomly divided into two groups (N = 30) based on irrigation regime. Pre‐ and post‐treatment microbial aerobic and anaerobic cultures and MMP‐9/total protein (TP) periapical fluid samples were collected. Postoperative pain levels were assessed 24 h after treatment. Categorical data were compared between groups using the Fisher's exact test, continuous data using the Wilcoxon signed‐rank test, α = 0.05. Results Irrigation with pure NaOCl rendered 40% canals free of culturable microorganisms, compared to 50% with the NaOCl/HEDP mixture (P = 0.60). As assessed by matrix‐assisted laser desorption/ionization‐time‐of‐flight analysis (MALDI‐TOF), no apparent selection of aerobic or anaerobic taxa occurred in either group. One patient in the NaOCl group experienced moderate pain, whilst two patients in the NaOCl/HEDP group experienced mild postoperative pain. MMP‐9/TP levels in periapical fluid declined significantly (P < 0.001) after 1 week with no medication in the root canal, without significant difference between treatment groups (P > 0.05). Conclusions This trial found no influence of HEDP on clinical NaOCl effects.

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Section: Discussionmentioning

confidence: 99%

Safety assessment of an etidronate in a sodium hypochlorite solution: randomized double‐blind trial

et al. 2019

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“…It is important to highlight that the behavior of the irrigating solutions is different on root canal walls where biofilms were completely or almost completely destroyed when NaOCl was tested in combination with a chelating agent (Ferrer‐Luque et al, ; Neelakantan et al, ). Most studies focus on the bacterial viability of surface biofilms (Arias‐Moliz et al, ; Guerreiro‐Tanomaru et al, ) and very few consider areas of difficult access such as dentine tubules (Morago et al, ; Wang et al, ). The results presented here show that the irrigation protocols NaOCl/HEBP and NaOCl+EDTA exert a significant antimicrobial activity against infected dentinal tubules in the coronal third of the roots.…”

Section: Discussionmentioning

confidence: 99%

Dentine tubule disinfection by different irrigation protocols

Morago

Ruiz-Linares

Ferrer-Luque

et al. 2019

Microscopy Res & Technique

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The purpose of this study was to test the antimicrobial activity and the smear layer removal of different irrigation protocols—sodium hypochlorite (NaOCl), NaOCl followed by ethylenediaminetetraacetic acid (EDTA), and NaOCl combined with etidronic acid (HEBP)—against infected dentine tubules during root canal preparation. Single rooted premolars contaminated with Enterococcus faecalis were chemomechanically prepared. Depending on the irrigation protocols, the roots were divided into the following groups: (1) distilled water during and after instrumentation; (2) 2.5% NaOCl during and after instrumentation; (3) 2.5% NaOCl/9% HEBP during and after instrumentation; and (4) 2.5% NaOCl during instrumentation followed by 17% EDTA after instrumentation. The percentage of dead cells and the biovolume in infected dentine tubules were measured using confocal laser scanning microscopy and the live/dead technique. Smear layer removal on root canal wall surfaces was observed by means of scanning electron microscopy. Results were compared through parametric tests (p < .05). The groups NaOCl, NaOCl/HEBP, and NaOCl+EDTA exerted the highest antimicrobial activity (p > .05), followed by the group irrigated with water. All the irrigation protocols—including water—significantly reduced the bacteria biovolume. No dentine tubules free of smear layer were found in the positive control or the 2.5% NaOCl group. With NaOCl/HEBP and NaOCl+EDTA, respectively, 90.41% ± 7.33 and 76.54% ± 15.30 of dentine tubules were free of smear layer (p = .01). NaOCl/HEBP and NaOCl+EDTA exerted an important antimicrobial activity against bacteria inside dentine tubules, lowering the bacteria biovolume and eliminating a high amount of the smear layer, particularly in the NaOCl/HEBP group.

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“…20 For E. faecalis biofilms formation, the MBEC-high-throughput (HTP) device (Innovotech, Edmonton, Alberta, Canada) was used. 21 The MBEC-HTP has two parts.…”

Section: Antibiofilm Activity Testmentioning

confidence: 99%

The effect of benzalkonium chloride additions to AH Plus sealer. Antimicrobial, physical and chemical properties

Arias-Moliz

Ruiz-Linares

Cassar

et al. 2015

Journal of Dentistry

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Antimicrobial activity of Chlorhexidine, Peracetic acid and Sodium hypochlorite/etidronate irrigant solutions against Enterococcus faecalis biofilms

Abstract: NaOCl alone or associated with HEBP were the most effective irrigant solutions in dissolving and killing E. faecalis biofilms.

Cited by 86 publications

References 34 publications

Safety assessment of an etidronate in a sodium hypochlorite solution: randomized double‐blind trial

Safety assessment of an etidronate in a sodium hypochlorite solution: randomized double‐blind trial

Dentine tubule disinfection by different irrigation protocols

The effect of benzalkonium chloride additions to AH Plus sealer. Antimicrobial, physical and chemical properties

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