Comparative evaluation of the concentration-dependent effect of proton-pump inhibitor in association with calcium hydroxide and chlorhexidine on Enterococcus faecalis

Anija, R; Kalita, Chandana; Bhuyan, AC; Hussain, Mustafa; Saikia, Anindita; Das, Lima

doi:10.4103/jomfp.jomfp_303_20

Cited by 3 publications

(3 citation statements)

References 30 publications

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“…However, adding low doses of lansoprazole to CH decreased the antibacterial effect, high doses of lansoprazole reinforced CHs antienterococcal effect. Also, they showed that mixture of CH, CHX, and low concentration of lansoprazole had the highest inhibitory effect on E.faecalis (34).…”

Section: Discussionmentioning

confidence: 99%

Combination therapy; a novel strategy for effective eradication of Enterococcus faecalis in vitro

Baseri

Memar

zohdi

et al. 2023

Preprint

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Background: this study aimed to evaluate the effect of the intracanal medicines including Calcium hydroxide (CH), Zinc oxide nanoparticles (nZnO), Pantoprazole (PP), and Chlorhexidine (CHX) on Enterococcus faecalis (E.faecalis) in the individual and combinatorial form in in-vitrodesign in order to introduce an effective medicine for eradication of E.faecalis. Methods: E. faecalis (ATCC 29212) was used for bacterial assays. The powder and gel forms of the tested compounds were used in the analysis. The antibacterial and antibiofilm activities of the medicines were evaluated by the minimum inhibitory concentration (MIC) determination using the broth microdilution method. The anti-biofilm effect of medicines were assessed by minimum biofilm inhibitory concentration (MBIC).The antibacterial and antibiofilm effects of antimicrobial agent combinations were detected using the checkerboard assay and determination of Fractional Inhibitory Concentration Index (FICI). Time-kill kinetics were done at zero, 2, 4, 6, 8 10, 12, and 24 h. Results: Except the MIC of the NaOCl which was significantly lower than CH, there was no statistically significant difference between groups in MIC, and MBIC. Only the mixture of chlorhexidine and zinc oxide nanoparticles (CHX-nZnO) and the mixture of pantoprazole and zinc oxide nanoparticles (PP-nZnO) had synergic effect against planktonic and biofilm form of the E.faecalis. Except for CHX and nZnO in gel form, other medicines did not show significant anti-biofilm effects against E.faecalis. Furthermore, CHX-nZnO in the gel form showed stronger anti-biofilm effects. Conclusion: Combination therapy would lead to higher antibacterial and anti-biofilm effects against E.faecaliscomparing to conventional intracanal medicaments. Among these medicines, CHX-nZnO showed promising results.

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Section: Discussionmentioning

confidence: 99%

Combination therapy; a novel strategy for effective eradication of Enterococcus faecalis in vitro

Baseri

Memar

zohdi

et al. 2023

Preprint

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“…Calcium hydroxide ionizes into calcium and hydroxide ions in the solution, creating a highly alkaline environment of approximately pH 12 in the tooth [ 3 ]. However, due to the buffering effect of dentin, the pH does not usually exceed 11 throughout the root canal, especially in the dentin tubules [ 13 ]. E. faecalis invading the dentinal tubules is likely to survive treatment with calcium hydroxide, and is frequently detected in the root canals of patients with refractory AP [ 6 , 7 ].…”

Section: Discussionmentioning

confidence: 99%

“…Probably, the pH conditions necessary for E. faecalis disinfection are not met deep in the dentin tubules because of the buffering effect of these dentin tubules. [ 11 , 13 ]. Thus, E. faecalis survival may be promoted in real root canal environments.…”

Section: Introductionmentioning

confidence: 99%

A Novel Control Method of Enterococcus faecalis by Co-Treatment with Protamine and Calcium Hydroxide

Honda

2023

Pharmaceutics

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Enterococcus faecalis (E. faecalis), a gram-positive facultative anaerobic bacterium, is likely to survive root canal treatment because of its extremely high alkaline tolerance, which may contribute to the refractory nature of apical periodontitis (AP). In this study, protamine was combined with calcium hydroxide to evaluate its efficacy in killing E. faecalis. First, the antibacterial activity of protamine against E. faecalis was investigated. Protamine reduced the E. faecalis growth rate at concentrations above the MIC (250 μg/mL), but was not bactericidal at any of the concentrations tested. Next, we investigated the calcium hydroxide tolerance of E. faecalis, using a 10% 310 medium, adjusted for pH by adding a calcium hydroxide solution. The results showed that E. faecalis could survive and proliferate in alkaline environments up to pH 10. However, the complete killing of E. faecalis was observed when protamine (250 μg/mL) was added. In addition, compared with treatment with protamine and calcium hydroxide alone, membrane damage and internalization of protamine into the cytoplasm of E. faecalis were enhanced. Therefore, the synergistic increase in antibacterial activity may be related to the action of both antimicrobial agents on the cell membrane. In conclusion, co-treatment with protamine and calcium hydroxide seems to be very effective in sterilizing E. faecalis, and has the potential to provide a novel control method against E. faecalis for root canal treatment.

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Antimicrobial and anti-endotoxin activity of N-acetylcysteine, calcium hydroxide and their combination against Enterococcus faecalis, Escherichia coli and lipopolysaccharides

Khoury,

Abu Hasna,

Gagliardi

et al. 2024

PeerJ

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Background The management of endodontic infections is a complex challenge, mainly due to the involvement of diverse microorganisms and their by-products. This study aimed to evaluate the efficacy of N-acetylcysteine (NAC), calcium hydroxide (Ca(OH)2), and their combined application as intracanal medications in combating Enterococcus faecalis, Escherichia coli, and lipopolysaccharides (LPS) from E. coli. Methods A total of 60 single-rooted human teeth were carefully selected and divided into six groups. These tooth canals were deliberately exposed to E. faecalis (ATCC 29212) and E. coli (ATCC 25922) to induce biofilm formation. Subsequently, the specimens were treated with NAC, Ca(OH)2, or a combination of both substances. Three samples of the root canals were collected at three moments: the first sample (S1) was to confirm the initial contamination, the second sample (S2) was immediately post-instrumentation, and the third sample (S3) was collected after the use of the intracanal medication. The antimicrobial efficacy of these intracanal medications was assessed by enumerating colony-forming units per milliliter (CFU/mL). In addition to this, the kinetic chromogenic Limulus Amebocyte Lysate (LAL) assay by Lonza was used to quantify LPS from E. coli. Data tested for normality; then, Kruskal-Wallis and Friedman tests were used, and Dunn’s for multiple comparisons. Results The findings of this study showed significant reductions in the microbial load of E. faecalis and E. coli by S3. Notably, there were no statistically significant differences among the treatment groups concerning these microorganisms. However, it was observed that only the combination of NAC and Ca(OH)2 led to a noteworthy decrease in the quantity of E. coli’s LPS after 7-days, demonstrating a statistically significant difference from the other treatment groups. NAC + Ca(OH)2 combination, applied for a duration of 7-days, proved to be more suitable in reducing the presence of E. faecalis, E. coli, and LPS from E. coli within the context of endodontic infections.

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Comparative evaluation of the concentration-dependent effect of proton-pump inhibitor in association with calcium hydroxide and chlorhexidine on Enterococcus faecalis

Cited by 3 publications

References 30 publications

Combination therapy; a novel strategy for effective eradication of Enterococcus faecalis in vitro

Combination therapy; a novel strategy for effective eradication of Enterococcus faecalis in vitro

A Novel Control Method of Enterococcus faecalis by Co-Treatment with Protamine and Calcium Hydroxide

Antimicrobial and anti-endotoxin activity of N-acetylcysteine, calcium hydroxide and their combination against Enterococcus faecalis, Escherichia coli and lipopolysaccharides

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