Influence of Adjuncts to Irrigation in the Disinfection of Large Root Canals

Sasanakul, Parnwad; Ampornaramveth, Ruchanee Salingcarnboriboon; Chivatxaranukul, Pavena

doi:10.1016/j.joen.2018.11.015

Cited by 39 publications

(50 citation statements)

References 33 publications

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“…To date, a plethora of antimicrobial strategies have been applied for biofilm dispersal in dental medicine, and especially in regard with root canal disinfection [14][15][16][17]. However, due to several limitations of antimicrobials e.g., low effectiveness against mature biofilms, chemical treatment protocols can be supplemented by enzymatic methods.…”

Section: Discussionmentioning

confidence: 99%

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Combined DNase and Proteinase Treatment Interferes with Composition and Structural Integrity of Multispecies Oral Biofilms

Karygianni

Attin

Thurnheer

2020

JCM

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Modification of oral biofilms adhering to dental hard tissues could lead to new treatment approaches in cariology and periodontology. In this study the impact of DNase I and/or proteinase K on the formation of a simulated supragingival biofilm was investigated in vitro. Six-species biofilms were grown anaerobically in the presence of DNase I and proteinase K. After 64 h biofilms were either harvested and quantified by culture analysis or proceeded to staining followed by confocal laser scanning microscopy. Microbial cells were stained using DNA-dyes or fluorescent in situ hybridization. Exopolysaccharides, eDNA and exoproteins were stained with Calcofluor, anti-DNA-antibody, and SyproTM Ruby, respectively. Overall, results showed that neither DNase I nor proteinase K had an impact on total colony-forming units (CFUs) compared to the control without enzymes. However, DNase I significantly suppressed the growth of Actinomyces oris, Fusobacterium nucleatum, Streptococcus mutans, Streptococcus oralis and Candida albicans. Proteinase K treatment induced significant increase in S. mutans and S. oralis CFUs (p < 0.001), whereas C. albicans and V. dispar showed lower CFUs compared to the control. Interestingly, confocal images visualized the biofilm degradation caused by DNase I and proteinase K. Thus, enzymatic treatment should be combined with conventional antimicrobial agents aiming at both bactericidal effectiveness and biofilm dispersal.

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Section: Discussionmentioning

confidence: 99%

“…Over the years, several studies in the field of endodontology have provided an excellent source of information about the disinfection of root canals by solely eliminating pathogens [14][15][16][17]. However, the fundamental role of biofilm matrix to combat biofilm-related diseases has been overlooked so far.…”

Section: Introductionmentioning

confidence: 99%

Combined DNase and Proteinase Treatment Interferes with Composition and Structural Integrity of Multispecies Oral Biofilms

Karygianni

Attin

Thurnheer

2020

JCM

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“…The mechanical shaping of root canals [18][19][20][21] was done prior to biofilm formation and disinfection. As has been shown, the complete insertion of the electrode into the root canal is required for achieving adequate disinfection.…”

Section: Discussionmentioning

confidence: 99%

“…In the light of these problems, a huge body of literature exists regarding instrumentation techniques for chemo-mechanical preparation of root canals (for example, see [18][19][20][21]) and various irrigation protocols, including ultrasonic-assisted irrigation [22,23], which have been tested with at least partially contradictive results. Even advanced methods of disinfection, such as photodynamic therapy [24], laser-activated irrigation [25], or ozone application [26], as well as combined measures for disinfection, fail to completely eliminate bacteria from root canals [27].…”

Section: Introductionmentioning

confidence: 99%

Electrochemical Disinfection of Experimentally Infected Teeth by Boron-Doped Diamond Electrode Treatment

Böhm

Koch

Rosiwal

et al. 2019

JCM

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Disinfection and prevention of re-infection are the decisive treatment steps in endodontic therapy. In this study, boron-doped diamond (BDD) electrodes have been fabricated and used for disinfecting the root canals of extracted human teeth, which had been covered with bacterial biofilms formed by Bacillus subtilis and Staphylococcus epidermidis. The growth of B. subtilis could be successfully impaired, achieving a complete disinfection after 8.5 min treatment time with the success of disinfection depending on the insertion depth of the electrode in the root canal. S. epidermidis could completely be removed after 3.5 min treatment time. A clinically applicable electrode array led to complete disinfection after treatment times of 10 min for S. epidermidis and 25 min for B. subtilis. BDD electrode application allowed for the improved disinfection of root canals and dentin tubules based on a continuous production of reactive oxygen species and their enhanced penetration of dentin tubules most likely due the formation of a continuous stream of small gas bubbles. The treatment times that are required here will be shortened in clinical application, as mechanical shaping of the canal system would precede the disinfection process.

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“…Biocompatible and anti-inflammatory Low minimum inhibitory concentration for key pathogens Infiltrates biofilm Minimal effect on dentin matrix proteins Reduced discoloration of enamel and dentin Substantivity and residual antibiofilm effect Ability to be incorporated into, and remain effective in, common carriers and biodegradable scaffolds Specific efficacy to patient's own microflora instrumentation with XP-Endo Finisher (FKG Dentaire SA, La Chaux-de-Fonds, Switzerland) or the Self-adjusting File (Redent-Nova, Ra'anana, Israel) were recently shown to aid in disinfecting large root canals 81 . The same recommendation was also made previously about microbial sampling of the root canal 82 , because paper point sampling, without biofilm disruption with a file, would most likely sample only planktonic bacteria.…”

Section: Broad Spectrummentioning

confidence: 99%

Contemporary Microbial and Antimicrobial Considerations in Regenerative Endodontic Therapy

Fouad

2020

Journal of Endodontics

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Introduction: Regenerative endodontic therapy (RET) has gained considerable attention and wide approval. Although it is being performed routinely, the outcomes remain unpredictable, and the optimal approaches for treatment are not established. It has been shown that bacterial persistence in root canals in these cases significantly interferes with healing and root maturation. However, few objective clinical studies have evaluated the complex microflora present in the infections or the efficacy of various clinical procedures. In addition, the extent of the infection and biofilm maturation in immature teeth with necrotic pulp has been understudied. Furthermore, most models used in preclinical evaluation of these issues do not fully elucidate the complexity or variability of the clinical situation. Results and Conclusion: In this review, the main biological and clinical problems pertaining to RET will be discussed. Contemporary analysis of complex microbial communities will be reviewed with emphasis on how these types of analyses can provide clinically useful data. In addition, current and proposed approaches for the effective disinfection of the root canal environment without interference with stem cell viability or integrity of the dentin matrix in these cases will be explored. The future of research in this field, including better and more customizable approaches in RET, in light of recent technological advances and progress in endodontics, will be outlined.

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Influence of Adjuncts to Irrigation in the Disinfection of Large Root Canals

Cited by 39 publications

References 33 publications

Combined DNase and Proteinase Treatment Interferes with Composition and Structural Integrity of Multispecies Oral Biofilms

Combined DNase and Proteinase Treatment Interferes with Composition and Structural Integrity of Multispecies Oral Biofilms

Electrochemical Disinfection of Experimentally Infected Teeth by Boron-Doped Diamond Electrode Treatment

Contemporary Microbial and Antimicrobial Considerations in Regenerative Endodontic Therapy

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