Effect of sodium hypochlorite solution and gel with/without passive ultrasonic irrigation on Enterococcus faecalis, Escherichia coli and their endotoxins

Abstract

Background: Sodium hypochlorite (NaOCl) is the most commonly used irrigant in endodontics. The purpose of this study was to evaluate the effect of NaOCl solution (2.5%) and gel (3%) with/without passive ultrasonic irrigation (PUI) on Enterococcus faecalis, Escherichia coli, and their endotoxins, lipopolysaccharide (LPS) and lipoteichoic acid (LTA). Methods: 40 human lower premolars were contaminated with E. coli (ATCC 25922) for 28 days and E. faecalis (ATCC 29212) for 21 days. Specimens were randomly divided into four groups: (1) 2.5% NaOCl irrigating the canals without PUI activation; (2) 2.5% NaOCl with PUI; (3) 3% NaOCl gel irrigating the canals without PUI; and (4) 3% NaOCl gel with PUI. 40 mL of irrigant was used for each group. PUI activation was carried out using E1-Irrisonic stainless-steel tip at 10% frequency. After treatment, all specimens were filled with 3mL of 17% ethylenediaminetetraacetic acid (EDTA) for 3min and then washed with nonpyrogenic saline solution. Three samples were collected from the canals: S1, at baseline to confirm biofilm formation; S2 after treatment; and S3 after EDTA. Samples were assessed for E. coli and E. faecalis colony forming units, and LPS and LTA were assessed using chromogenic kinetic LAL assay and ELISA, respectively. Data were analyzed by Kruskal-Wallis, Friedmann and Dunn tests with α≤0.05. Results: All groups were effective in reducing the microbial load of E. coli and E. faecalis after treatment without a significant difference among the groups. NaOCl and NaOCl gel groups had no significant difference in reducing LPS and LTA. Statistically increased reduction was seen for NaOCL + PUI and NaOCl gel + PUI compared for groups without PUI. Conclusions: NaOCl gel has the same antimicrobial action of NaOCl solution and can partially detoxify endotoxins. PUI improves NaOCl (gel or solution) action over E. faecalis and E. coli and their endotoxins.

Endodontic Perforation Closure by Five Mineral Oxides Silicate-Based Cement with/without Collagen Sponge Matrix

“…It was stated in the literature that the adequate disinfection of the root canal system and the sealing site, associated with the sealing ability of 5MO bioceramic cement results in satisfactory clinical and radiographic healing [ 18 ]. This disinfection was achieved in the current case report by the antimicrobial action of sodium hypochlorite as endodontic irrigant [ 29 , 30 ] and calcium hydroxide as a dressing [ 31 ]. Ultrasonic activation was used to improve the endodontic irrigant penetration [ 30 ].…”

Apicoectomy of Perforated Root Canal Using Bioceramic Cement and Photodynamic Therapy

“…In the literature, bioceramic cements have low antimicrobial action; however, this ability to obtain reasonable results in terms of successful management of endodontic complications and accidents is related to the disinfection of the surgical site and root canal in the first place [ 39 ]. In this case report, the root canal was instrumented with the RECIPROC system [ 40 ] and irrigated with sodium hypochlorite which was proved as an effective antimicrobial agent over resistant microorganisms and its endotoxins [ 3 , 8 ] and over the matrix metalloproteinases (MMPs) [ 41 ] responsible of extracellular matrix degradation and tissue destruction in apical periodontitis lesions [ 42 , 43 ].…”

“…The symptomatic periapical periodontitis is an endodontic disease of the necrosed pulp and its management depends mainly on root canal disinfection [ 1 ] in which the manual/automated instruments remove the microorganisms mechanically and the auxiliary chemical substances act chemically [ 2 – 4 ]. However, in some cases, additional complementary techniques are indicated to provide more favorable decontamination using photodynamic therapy (PDT) [ 5 , 6 ] and passive ultrasonic irrigation (PUI) [ 7 , 8 ]. As well, the endodontic irrigants play a principal role in reducing torsional and fatigue resistance during instrumentation [ 9 ].…”

The biocompatibility of Achyrocline satureioides plant extract over human gingival fibroblasts

“…Phytotherapy was used in dentistry and more specifically in endodontics since the last century (Groppo et al, 2008) due to its antimicrobial, anti-inflammatory and antifungal actions and because it is considered biocompatible (Guandalini Cunha et al, 2020;De La Chapa, Singha, Lee, & Gonzales, 2018;Marcia C Valera et al, 2016;Viegas et al, 2020) in addition to other techniques like photodynamic therapy and passive ultrasonic irrigation (Abu Hasna, Ferrari, & Talge Carvalho, 2019;Abu Hasna, Khoury, et al, 2020;Abu Hasna, Pereira Da Silva, et al, 2020). This use was encouraged by the World Health Organization (WHO); however, the agency establishes specific safety requirements including traditional use certificate and toxicity analyzes of the extracts (Organization, 2019).…”