sodium-hypochlorite and Dental-Plaque

The present study aimed to establish the efficacy of sodium hypochlorite mouthwash (NaOCl-MW) compared with a control mouthwash on plaque and clinical parameters of periodontal disease.. MEDLINE-PubMed, Embase and Cochrane-CENTRAL databases were searched for clinical trials on patients with gingivitis or periodontitis that assessed the effect of NaOCl-MW in comparison with a negative or positive control on plaque index (PI), gingival index (GI), and bleeding index (BI) scores and probing pocket depth (PPD). Data were extracted from the eligible studies.. Seven eligible papers were retrieved, which together represented six clinical trials. The studies showed considerable heterogeneity regarding methodological and clinical aspects that did not permit a meta-analysis. Two of the three studies in which NaOCl-MW was compared with a negative control showed that NaOCl-MW significantly reduced PI, GI and BI, and no effect was found on PPD. In three studies, NaOCl-MW was assessed using chlorhexidine mouthwash (CHX-MW) as a positive control; no difference was found for GI and BI. One of the three comparisons showed a statistically significant PI score favouring NaOCl-MW. One study measured PPD and found it to be significant in favour of NaOCl-MW.. Studies with a negative control group provided very weak quality evidence for a very small beneficial effect of NaOCl-MW on PI, GI and BI scores. Studies with a positive control group provided very weak quality evidence that NaOCl-MW had a similar effect as CHX-MW on PI, GI and BI scores. The outcome for PPD was inconclusive.

Topics: Chlorhexidine; Dental Plaque; Gingivitis; Humans; Mouthwashes; Periodontal Diseases; Sodium Hypochlorite

Sodium hypochlorite (NaOCl), commonly known as "bleach," is widely accepted as being a safe and effective antiseptic against bacteria, fungi, and viruses. For over a century, bleach has been used to control or overcome infection in homes, hospitals, and even on battlefields, and in endodontics for disinfection of root canals. This paper reviews clinical studies on the efficacy of sodium hypochlorite oral rinse to combat dental plaque and gingival inflammation. Sodium hypochlorite is readily available as inexpensive household bleach, and we suggest that oral rinsing twice weekly with dilute bleach (0.25% sodium hypochlorite) constitutes a valuable adjunct to current methods of plaque removal.

Topics: Anti-Infective Agents, Local; Dental Plaque; Gingivitis; Humans; Mouthwashes; Oral Hygiene; Self Care; Sodium Hypochlorite

The study aimed to evaluate the effect of 0.25% sodium hypochlorite twice-weekly oral rinse on plaque and gingivitis in patients with minimally treated periodontitis.. The study included 30 patients with periodontitis, it lasted 3 mo, and it was performed as a randomized, controlled, single-blinded, clinical trial in parallel groups. Fifteen patients rinsed for 30 s with 15 mL of a fresh solution of 0.25% sodium hypochlorite (test) and 15 patients rinsed with 15 mL of water (control). Clorox(®) regular bleach was the source of the sodium hypochlorite. At baseline and at 2 wk, the study patients received professional subgingival irrigation for 5 min with either 0.25% sodium hypochlorite or water, but no subgingival or supragingival scaling. The presence or absence of supragingival plaque on facial and lingual surfaces was determined by visual inspection; each tooth was dried with air and mouth mirror rotation was used to provide light reflection to identify plaque on smooth surfaces and at the tooth line angles. Gingival bleeding within 30 s after probing to full pocket depth was assessed in six sites of each tooth. Adverse events were evaluated by questionnaire and visual examination.. All 30 patients in the study completed the baseline and the 2 wk parts of the study and a subset of 12 participants completed the 3 mo part of the study. The sodium hypochlorite rinse group and the water rinse group, respectively, showed increases from baseline to 3 mo of 94% and 29% (3.2-fold difference) in plaque-free facial surfaces, of 195% and 30% (6.5-fold difference) in plaque-free lingual surfaces, and of 421% and 29% (14.5-fold difference) in number of teeth with no bleeding on probing. The differences in clinical improvement between the sodium hypochlorite rinse group and the water rinse group were statistically significant. No adverse events were identified in any of the study patients, except for minor complaints about the taste of bleach.. A twice-weekly oral rinse with 0.25% sodium hypochlorite produced marked decreases in dental plaque level and bleeding on probing and may constitute a promising new approach to the management of periodontal disease. Long-term controlled studies on the effectiveness of sodium hypochlorite oral rinse are needed and encouraged.

Topics: Adult; Anti-Infective Agents, Local; Bacterial Load; Dental Plaque; Female; Follow-Up Studies; Fusobacterium; Gingival Hemorrhage; Gingivitis; Gram-Negative Bacteria; Humans; Male; Mouthwashes; Patient Satisfaction; Periodontal Pocket; Periodontitis; Pilot Projects; Single-Blind Method; Sodium Hypochlorite; Therapeutic Irrigation

This study aimed to evaluate the clinical effects of 0.05% sodium hypochlorite mouth rinse on supragingival biofilm and gingival inflammation.. The study was performed as a controlled, randomised, investigator-blinded, parallel group trial in 40 prison inmates. Following a preparatory period to obtain a plaque- and gingivitis-free dentition, tooth-brushing was substituted for 21 days by supervised twice daily rinsing with either 15 ml of fresh solution 0.05% sodium hypochlorite or 15 ml of distilled water. Clinical outcomes were assessed using the Quigley-Hein Plaque Index (QHPI), the Löe and Silness Gingival Index (L&SGI) and bleeding on probing. Adverse events were evaluated by questionnaire, visual examination and clinical photographs..   At day 21, the average QHPI score had increased to 3.82 in the water rinse group and 1.98 in the sodium hypochlorite rinse group. The average L&SGI score had increased to 2.1 in the water rinse group and 1.0 in the sodium hypochlorite rinse group, and the average percentage of sites that bled on probing had increased to 93.1% in the water rinse group and 56.7% in the sodium hypochlorite rinse group. Differences were statistically significant (P = 0.001). A brown extrinsic tooth stain along the gingival margin appeared in 100% of participants in the sodium hypochlorite rinse group and in 35.0% of participants in the water rinse group (P < 0.05)..   An oral rinse with 0.05% sodium hypochlorite resulted in significant reductions in supragingival biofilm accumulation and gingival inflammation. Dilute sodium hypochlorite may represent an efficacious, safe and affordable antimicrobial agent in the prevention and treatment of periodontal disease.

Topics: Adult; Anti-Infective Agents; Biofilms; Dental Plaque; Dental Plaque Index; Gingival Diseases; Humans; Male; Mouthwashes; Periodontal Index; Prisoners; Single-Blind Method; Sodium Hypochlorite; Treatment Outcome

To compare the effectiveness of bacterial plaque removal of six denture hygiene procedures used by patients to clean their dentures.. Fifteen students randomly divided into groups G1, G2, G3, G4, G5 and G6 used maxillary intraoral appliances for 24 h without cleaning them. Afterwards, the appliances were submitted to the following procedures: P1: washing under running water for 20 s; P2 and P3: cleaning with alkaline peroxide (Corega Tabs®) for 5 and 30 min, respectively; P4: brushing with water and liquid soap for 40 s; P5: alkaline hypochlorite for 10 minutes; P6: home use chlorine solution (Q'boa® at 0.45% for 10 min), throughout a period of 6 consecutive weeks. The procedures followed a circulating scheme, so that all the appliances were submitted to all the hygiene methods studied. After the hygiene procedures, the appliances were stained, photographed and submitted to the weighing method.. After ANOVA and Tukey's test, differences were observed: P5 = 0.73 ± 0.3 (b), P6 = 1.27 ± 0.4(b,c), P4 = 1.92 ± 0.5 (b,c), P3 = 2.24 ± 1.0 (b,c), P2 = 7.53 ± 2.5 (c) and P1 = 26.86 ± 15. 3 (a).. From the results of the study, it could be concluded that the use of alkaline hypochlorite is the best way to remove bacterial plaque, followed by the home-use chlorine solution and brushing with water and liquid soap. Corega Tabs® must be used for 30 min of immersion to have a cleaning effectiveness similar to that of alkaline hypochlorite.

Topics: Acrylic Resins; Adult; Chlorine; Cross-Over Studies; Dental Materials; Dental Plaque; Dental Prosthesis; Denture Cleansers; Double-Blind Method; Humans; Immersion; Oral Hygiene; Oxidants; Peroxides; Soaps; Sodium Hypochlorite; Time Factors; Toothbrushing; Water; Young Adult

Soft denture lining-materials are more susceptible to microbial adhesion than hard denture base acrylic resin. Poor oral hygiene and Candida albicans infection are common among elderly denture wearers as these patients usually have difficulty in keeping them clean.. To evaluate the influence of the oral hygiene methods on the formation of a biofilm over a soft denture-lining material.. Twenty volunteers were randomly separated into two groups: G1 and G2. Ten volunteers performed daily hygiene of the prostheses with a soft toothbrush and toothpaste. The G2 performed a treatment identical to G1 but also immersed the prostheses in sodium hypochlorite 0.5% for 20 min, once a week. Quantification of the mean score values of biofilm formation at different times were statistically analysed using analysis of variance and Tukey's test (alpha = 0.05).. G1 (0.65 +/- 0.52) showed the lowest mean score values of biofilm formation. There was statistical difference between G1 and G2. The highest mean score values were found at 6 weeks (1.3 +/- 1.08) and were statistically different from other times.. The oral hygiene methods had a significant effect in the formation of the biofilm over a soft denture-lining material.

Topics: Aged; Analysis of Variance; Biofilms; Candida albicans; Cell Adhesion; Dental Plaque; Dental Plaque Index; Denture Cleansers; Denture Liners; Denture, Complete, Upper; Disinfectants; Humans; Jaw, Edentulous; Maxilla; Oral Hygiene; Single-Blind Method; Sodium Hypochlorite; Toothbrushing

The aim of this investigation was to compare the effectiveness of several different methods of root instrumentation by measuring and comparing the amount of residual stained material following treatment. Also, 2 different methods of quantitating residual stained material were compared. A total of 90 periodontally-involved teeth were extracted and randomly assigned to 1 of 8 treatment groups or to the untreated control group. Experimental treatments consisted of one or a combination of the following: Columbia 13-14 curet, P-10 ultrasonic instrument, diamond-coated P-10 ultrasonic instrument, or antiformin/citric acid chemical treatment. Selected samples were examined using light microscopy in order to determine the amount of cementum removed during root instrumentation. Residual stained material was quantitated using a method of grid-square analysis as well as by the use of photographs and a digitizing tablet. Following instrumentation, it was noted in histologic sections that the complete removal of cementum was rare, although all of the cementum was removed by some experimental treatments in some areas. All mechanical methods of root instrumentation were found to be essentially equal in effectiveness with respect to the removal of plaque and calculus. Chemical debridement alone was found to be ineffective. It was further noted that the grid-square method of analysis produced measurements that were 2 to 8 times higher than measurements produced by the digitizing tablet.

Topics: Analysis of Variance; Carbon; Citrates; Citric Acid; Curettage; Dental Calculus; Dental Cementum; Dental Plaque; Dental Scaling; Diamond; Equipment Design; Humans; Root Planing; Sodium Hypochlorite; Staining and Labeling; Tooth Root; Ultrasonic Therapy

This study investigated the hypothesis that antiformin-citric acid chemical curettage combined with scaling and root planing (SRP/AF) would significantly reduce pathogenic bacteria of the periodontal pocket when compared to scaling and root planing alone (SRP). Ten patients with moderate periodontitis participated. Four pockets per patient, one in each posterior sextant, were chosen. Pocket depths, attachment levels, and gingival index (GI) were measured. Bacterial samples were examined under dark-field microscope for: (1) spirochetes, (2) motile rods, and (3) all others. A randomized four-sextant treatment design was used. One sextant received no treatment, a second received SRP, and the two remaining sextants received identical treatments of SRP/AF. Of these two sextants, one was sampled at baseline and 12 weeks only in order to serve as an additional control. The remaining sextants were sampled at 1, 4, 8, and 12 weeks. Both SRP and SRP/AF significantly reduced the percentage of spirochetes and motile rods. A significant reduction in GI and pocket depths was also noted. Attachment level showed no significant change. Results of both treatment groups showed no significant differences among any of the parameters. A comparison of the two SRP/AF groups indicated no significant difference among clinical or bacterial parameters due to sampling.

Topics: Adult; Bacteria; Bacterial Physiological Phenomena; Citrates; Citric Acid; Dental Plaque; Dental Prophylaxis; Dental Scaling; Female; Humans; Male; Middle Aged; Periodontal Index; Periodontal Pocket; Periodontitis; Sodium Hypochlorite; Subgingival Curettage; Tooth Root

NaClO is not suitable as a root canal irrigant because of its cytotoxicity. Good biocompatibility irrigants are required to have antibacterial activity. Many herbal products like Bee glue, Noni juice and Azadirachta indica have such properties. This study aims to investigate the possible effects of propolis, MCJ and Neem on bacterial infections and cytotoxicity in primary plaque colonizers. Direct contact and agar diffusion tests evaluated the antibacterial activity of herbal products against Fusobacterium, Candida albicans and Prevotella. The CCK 8 test determined the influence of these herbal products on the proliferation of human apical papilla stem cells (hSCAPs) and human periodontal fibroblasts (hPDLFs). A migration assay test was performed in addition to quantitative real-time PCR which measured osteogenic differentiation in hSCAPs. All herbal extracts tested in this study exhibited antibacterial activity comparable to NaClO against bacterial infections, while the strongest bacteriostatic effect was shown in the herbal treated group. These extracts had much weaker effects on the proliferation and migration of hSCAPs and hPDLFs as calculated by the CCK-8 assay against NaClO. Bee glue treatment had the most potent effect on osteogenic differentiation, followed by treatment with Noni juice and Azadirachta indica (Neem), while NaClO showed the lowest effect. For primary plaque colonizers of immature or advanced permanent teeth, Bee glue, Noni juice, and Azadirachta indica can be promising irrigants with good biocompatibility. Direct contact process and agar diffusion studies have tested the antibacterial activity against Fusobacterium, Candida albicans and Prevotella. The CCK 8 test determined the influence of these three plants on the proliferation of human apical papilla stem cells (hSCAPs) and human periodontal fibroblasts (hPDLFs). In order to examine migration ability, migration assay test was performed. Alizarin red staining, alkaline phosphatase (ALP) staining and quantitative real-time PCR measured osteo-/odontogenic differentiation in hSCAPs. All herbal extracts tested in this study exhibited antibacterial activity comparable to NaClO against bacterial infections, while the strongest bacteriostatic effect was shown in the treated group. These extracts had much weaker effects on the proliferation and migration of hSCAPs and hPDLFs as calculated by the CCK-8 assay against NaClO. Bee glue treatment had the most potent effect on osteo-odontogenic

Topics: Azadirachta; Cell Survival; Cells, Cultured; Dental Plaque; Humans; Microbial Sensitivity Tests; Morinda; Osteogenesis; Plant Extracts; Propolis; Root Canal Irrigants; Sodium Hypochlorite

The present study evaluated the effect of the source of biofilm bacteria on their susceptibility in dentinal tubules to disinfecting solutions using an infected dentin model.. Infected dentin blocks were prepared. Enterococcus faecalis strains VP3-181 and Gel 31 were introduced into dentinal tubules by centrifugation to form monospecies biofilms, whereas 3 specimens of pooled plaque bacteria collected from different donors were used to grow multispecies biofilms in dentin. After 1 and 3 weeks of incubation, the samples were subjected to sterile water, 2% chlorhexidine (CHX), and 2% sodium hypochlorite (NaOCl). After the 3-minute exposure, the proportions of killed bacteria in dentin canals were assessed by viability staining and confocal laser scanning microscopy.. The proportion of killed bacteria in mature (3 weeks) mono- and multispecies biofilms was lower than in young biofilms (1 week) after treatment (P < .05). E. faecalis Gel 31 biofilms and multispecies biofilms were more resistant than VP3-181 biofilms. No differences in the susceptibilities to the disinfecting agents of the 3 multispecies biofilms were detected; 2% NaOCl was more effective against multispecies biofilms in dentin than 2% CHX (P < .05), whereas no significant difference was detected between 2% CHX and 2% NaOCl against the E. faecalis strains.. Mature mono- and multispecies biofilms in dentinal tubules are more resistant to disinfectants than corresponding young biofilms. The susceptibility of the monospecies E. faecalis dentin biofilm showed strain-related differences, whereas the multispecies biofilms from different donors showed similar susceptibility.

Topics: Adult; Anti-Infective Agents, Local; Biofilms; Chlorhexidine; Dental Plaque; Dentin; Disinfection; Enterococcus faecalis; Humans; In Vitro Techniques; Microbial Viability; Microscopy, Confocal; Middle Aged; Root Canal Irrigants; Sodium Hypochlorite

Biofilm development is a dynamic process that begins with the initial attachment of planktonic bacteria to a surface, eventually leading through different stages to a mature, structurally complex biofilm. The aim of this study was to assess the effect of the source of biofilm bacteria, the level of biofilm maturation, and the type of disinfecting agent on the susceptibility of biofilm bacteria to antibacterial agents.. Multispecies biofilms from plaque bacteria of 6 donors were grown for up to 8 weeks on collagen-coated hydroxyapatite disks. After 1, 2, 3, 4, and 8 weeks of growth the biofilms were exposed to 1% sodium hypochlorite, 0.2/0.4% iodine-potassium iodide, and 2% chlorhexidine for 1 and 3 minutes. The percentage of killed biofilm bacteria was determined by using LIVE/DEAD viability staining and confocal laser scanning microscopy. One-way analysis of variance was used for statistical analysis.. One- and 2-week-old biofilms were moderately or very sensitive to the tested disinfecting agents, which killed 20%-100% of the biofilm bacteria. After 3 weeks of growth the biofilm bacteria were more resistant to the same agents, and only 10%-30% of the bacteria were killed (P< .001). The same pattern of the effect of biofilm age (maturation) on the resistance of bacteria was observed in all 6 biofilms and with all 3 disinfecting agents.. The change of biofilm bacteria from sensitive to resistant against disinfecting agents occurred between 2 and 3 weeks of biofilm maturation. This development took place simultaneously in all biofilms grown from plaque bacteria from 6 different donors and was independent of the type of disinfecting agent used. The results emphasize the importance of knowing the maturation timeline of each biofilm model used to test the effectiveness of endodontic disinfecting agents against biofilm bacteria.

Topics: Adult; Biofilms; Chlorhexidine; Dental Disinfectants; Dental Plaque; Drug Resistance, Bacterial; Humans; Iodine Compounds; Sodium Hypochlorite

This study examines the antibacterial properties of sodium hypochlorite (NaOCl), chlorhexidine gluconate (CHX), Listerine®, and high purity chlorine dioxide (Solumium, ClO2) on selected common oral pathogen microorganisms and on dental biofilm in vitro. Antimicrobial activity of oral antiseptics was compared to the gold standard phenol. We investigated Streptococcus mutans, Lactobacillus acidophilus, Enterococcus faecalis, Veillonella alcalescens, Eikenella corrodens, Actinobacillus actinomycetemcomitans and Candida albicans as some important representatives of the oral pathogens. Furthermore, we collected dental plaque from the upper first molars of healthy young students. Massive biofilm was formed in vitro and its reduction was measured after treating it with mouthrinses: CHX, Listerine® or hyper pure ClO2. Their biofilm disrupting effect was measured after dissolving the crystal violet stain from biofilm by photometer. The results have showed that hyper pure ClO2 solution is more effective than other currently used disinfectants in case of aerobic bacteria and Candida yeast. In case of anaerobes its efficiency is similar to CHX solution. The biofilm dissolving effect of hyper pure ClO2 is significantly stronger compared to CHX and Listerine® after 5 min treatment. In conclusion, hyper pure ClO2 has a potent disinfectant efficacy on oral pathogenic microorganisms and a powerful biofilm dissolving effect compared to the current antiseptics, therefore high purity ClO2 may be a new promising preventive and therapeutic adjuvant in home oral care and in dental or oral surgery practice.

Topics: Adolescent; Anti-Infective Agents, Local; Biofilms; Candida albicans; Chlorhexidine; Chlorine Compounds; Dental Disinfectants; Dental Plaque; Drug Combinations; Gram-Negative Bacteria; Gram-Positive Bacteria; Humans; Mouthwashes; Oxides; Phenol; Salicylates; Sodium Hypochlorite; Students; Terpenes; Young Adult

Uncontrolled bacteria of dental plaque generate formation of oral biofilm located on teeth and subgingival surfaces. It may induce local inflammation (gingivitis) with further development of periodontal diseases. A variety of oral bacteria such as Streptococcus mutans and Porhyromonas gingivalis are involved in pathogenesis of dental carries and periodontitis. Very often bacterial infections are associated with candidiasis (Candida albicans). Chlorhexidine (CHX) is the most commonly used antiseptic in dentistry due to its strong antibacterial activity and capacity to reduce the accumulation of oral biofilms. However, other antiseptics, especially endodontic irrigants, are still tested to improve their preventive and therapeutic effects in oral cavity infections. In this in vitro study we have compared antimicrobial activity of CHX with that of taurine chloramine (TauC1) and taurine bromamine (TauBr), natural taurine derivatives with known antibacterial and anti-inflammatory properties.. Antimicrobial activity of CHX, TauC1 and TauBr was tested by incubation of the compounds with S. mutans, P gingivalis and C. albicans. The agents were incubated in low (105/ml) and high (108/ml) density microbe suspensions, related to early and late biofilm infections, respectively. In some experiments bacteria were incubated with a combination of CHX + NaOCl and CHX + TauBr. MIC was determined by the pour-plate method.. CHX showed the strongest antimicrobial activity against all tested pathogens. On the contrary, TauC1 was the weakest antiseptics used without effect on the growth of C. albicans. TauBr at non-cytotoxic concentrations inhibited the growth of S. mutans and P gingivalis with slight effect on the low density C. albicans. All tested agents showed weaker antiseptic properties in the presence of serum. Moreover, we have shown that interactions between CHX and sodium hypochlorite (NaOC1), the main endodontic irrigant, but not between CHX and TauBr,resulted in precipitation. Therefore, it may restrict their simultaneous application in root canal treatment. However, in spite of this unwanted reaction, the mixture of CHX with NaOCl kills pathogens more effectively then CHX alone.. The results confirmed CHX exceptional potential as primary antiseptic in dentistry, especially in prevention and treatment of dental carries, periodontal diseases and mouth candidiasis. Moreover, our study shows that TauBr may be used alternatively or in combination with CHX in killing of oral pathogens, due to its strong antibacterial and anti-inflammatory properties.

Topics: Anti-Infective Agents, Local; Anti-Inflammatory Agents; Chlorhexidine; Dental Caries; Dental Plaque; Drug Interactions; Drug Therapy, Combination; Humans; Microbial Sensitivity Tests; Microbiota; Periodontitis; Porphyromonas gingivalis; Sodium Hypochlorite; Streptococcus mutans; Taurine

To compare the efficacy of conventional and modified photoactivated disinfection (PAD) against Enterococcus faecalis and mixed plaque bacteria in suspension and biofilms.. Enterococcus faecalis (four strains) and mixed plaque bacteria from three adult volunteers were suspended in water, added to methylene blue (MB, 15 μmol L⁻¹), MB mixed with 0.5% hydrogen peroxide and 0.05% chlorhexidine (CHX), MB mixed with 0.5% hydrogen peroxide and 0.05% EDTA or MB mixed with 0.05% EDTA and 0.05% CHX and exposed to laser irradiation from 10 s to 5 min. After exposure, samples were taken, serially diluted and grown aerobically and anaerobically on Tryptic Soy Agar plates or on blood agar plates for 24 and 72 h, respectively. For biofilm experiments, E. faecalis and mixed plaque biofilms were grown on sterile hydroxyapatite (HA) discs coated overnight with bovine dermal collagen type I for 3 weeks. After exposure to MB or MB and low concentration of EDTA with either hydrogen peroxide or CHX, the percentage of killed bacteria by PAD was evaluated using viability staining and confocal laser scanning microscope. For statistical analysis, one-way analysis of variance was performed.. Conventional PAD killed from 90.76% to 100% E. faecalis for 3 min, but failed to kill all plaque bacteria even after 5 min of laser irradiation. In modified PAD, up to 100% of suspended E. faecalis and mixed plaque bacteria were killed after 1 min and 30 s of irradiation. Up to twenty times more biofilm bacteria were killed by modified PAD than by conventional PAD with 15 μmol L⁻¹ MB (P < 0.001) and up to eight times more than 2% CHX (P < 0.001) and 1% sodium hypochlorite (P < 0.001).. Modified PAD was superior to conventional PAD against planktonic and biofilm bacteria.

Topics: Adult; Animals; Bacteriological Techniques; Biofilms; Cattle; Chlorhexidine; Collagen Type I; Dental Disinfectants; Dental Plaque; Durapatite; Edetic Acid; Enterococcus faecalis; Humans; Hydrogen Peroxide; Lasers, Semiconductor; Methylene Blue; Microbial Viability; Oxidants; Photochemotherapy; Photosensitizing Agents; Sodium Hypochlorite; Time Factors

To assess in a laboratory experimental model the efficacy of a novel root canal irrigant, QMiX, against Enterococcus faecalis and mixed plaque bacteria in planktonic phase and biofilms. In addition, its ability to remove smear layer was examined.. Enterococcus faecalis and mixed plaque bacteria were exposed to QMiX, 2% chlorhexidine (CHX), MTAD and 1% sodium hypochlorite (NaOCl) for 5 s, 30 s and 3 min. Following exposure, samples were taken, serially diluted and grown aerobically and anaerobically on tryptic soy agar (TSA) plates or on blood agar plates for 24 and 72 h, respectively, to measure killing of bacteria. E. faecalis and plaque biofilms were grown for 3 weeks on collagen-coated hydroxyapatite or dentine discs and exposed for 1 and 3 min to QMiX, 2% CHX, MTAD, 1% and 2% NaOCl. The amount of killed bacteria in biofilms was analysed by confocal laser scanning microscopy using viability staining. Dentine blocks were exposed to QMiX and 17% EDTA for 5 min. The effectiveness of smear layer removal by the solution was evaluated using scanning electron microscopy. For statistical analysis, one-way analysis of variance and comparison of two proportions were used.. QMiX and 1% NaOCl killed all planktonic E. faecalis and plaque bacteria in 5 s, while 2% CHX and MTAD were unable to kill all plaque bacteria in 30 s, and some E. faecalis cells survived even 3 min of exposure. QMiX and 2% NaOCl killed up to 12 times more biofilm bacteria than 1% NaOCl (P < 0.01), 2% CHX (P < 0.05; P < 0.001) and MTAD (P < 0.05; P < 0.001). QMiX removed smear layer equally well as EDTA (P = 0.18 × 10(-5)).. QMiX and NaOCl were superior to CHX and MTAD under laboratory conditions in killing E. faecalis and plaque bacteria in planktonic and biofilm culture. Ability to remove smear layer by QMiX was comparable to EDTA.

Topics: Anti-Infective Agents, Local; Biguanides; Biofilms; Chlorhexidine; Citric Acid; Dental Plaque; Dentin; Doxycycline; Drug Combinations; Microscopy, Confocal; Plankton; Polymers; Polysorbates; Root Canal Irrigants; Smear Layer; Sodium Hypochlorite

This study investigated the long-term (1-4 years) outcome of the endodontic treatment of teeth with apical periodontitis lesions performed by undergraduate students using a defined antimicrobial protocol.. Treatment protocol included a crown-down instrumentation technique, apical enlargement to predetermined sizes and apical level, irrigation with 2.5% sodium hypochlorite, and intracanal medication with calcium hydroxide/camphorated paramonochlorophenol (CPMC) paste. The first 100 teeth from patients who returned for follow-up were examined. The outcome was assessed based on radiographic and clinical criteria as healed (success), healing (uncertain), or not healed (failure).. Overall results showed that 76% of the teeth healed, 19% were healing, and 5% had not healed. Most healed cases (75%) or failed cases (80%) were already evident at 2 years. Seven cases took 4 years to heal completely.. The low failure rate observed in this study reinforces the importance of using an evidence-based antimicrobial strategy during endodontic treatment of teeth with apical periodontitis.

Topics: Anti-Infective Agents, Local; Bismuth; Calcium Hydroxide; Camphor; Chlorophenols; Clinical Protocols; Dental Plaque; Dental Pulp Necrosis; Dental Restoration Failure; Drug Combinations; Follow-Up Studies; Gutta-Percha; Humans; Periapical Periodontitis; Root Canal Filling Materials; Root Canal Irrigants; Root Canal Obturation; Root Canal Preparation; Root Canal Therapy; Rubber Dams; Sodium Hypochlorite; Treatment Outcome

Strengthened by promising research data and commercial backing, interest in the field of anti-infective periodontal therapy is rapidly expanding. Management of the periodontal microbiota with antibiotic drugs and antiseptic agents in conjunction with mechanical debridement seems to be more effective than mechanical therapy alone, at least in the treatment of advanced periodontal disease. The choice of a periodontal chemotherapeutic regimen requires an understanding of the usual infecting flora, available antimicrobial agents, and pathogen susceptibility patterns. Systemic administration of combinations of metronidazole and either amoxicillin or ciprofloxacin has been widely used with great success; however the presence of subgingival yeasts and resistant bacteria can be a problem in some periodontitis patients. Valuable antiseptic agents for subgingival application include 10% povidone-iodine for professional use and 0.1-0.5% sodium hypochlorite for patient self-care. These antiseptics have significantly broader spectra of antimicrobial action, are less likely to induce development of resistant bacteria and adverse host reactions, and are considerably less expensive than commercially available antibiotics in controlled release devices. In practice, mechanical debridement combined with subgingival povidone-iodine application in the dental office and sodium hypochlorite irrigation for patient self-care are valuable antimicrobial remedies in the treatment of virtually all types of periodontal disease. Management of moderate to severe periodontitis may require additional systemic antibiotic and/or surgical treatment.

Topics: Adolescent; Amoxicillin; Anti-Bacterial Agents; Anti-Infective Agents, Local; Chlorhexidine; Ciprofloxacin; Dental Plaque; Dental Scaling; Drug Combinations; Female; Gingivitis; Humans; Metronidazole; Periodontitis; Risk Factors; Sodium Hypochlorite

Dentures were examined by scanning electron microscopy to evaluate removal of surface contaminants. Five complete dentures were obtained during patient appointments. The palatal surface of each denture was divided into eight pieces (1 cm2) then each sample cleaned with Corega, Dentipur, Fittydent, sodium hypochloride, Savlon, Ipanol, brushing methods and one sample was also kept as a control. They were prepared for SEM examination and photographed at x500. One photograph of each sample was evaluated in random order by three judges for a total of 120 observations. Photographs were compared with one of a clean denture sample. Statistical analysis of the results showed that soaking dentures in sodium hypochloride and Savlon removed significantly more contaminants than any of the other methods used in this study.

Topics: Bacteria; Cetrimonium Compounds; Cetylpyridinium; Chlorhexidine; Dental Calculus; Dental Deposits; Dental Plaque; Denture Bases; Denture Cleansers; Denture, Complete; Denture, Complete, Upper; Disinfectants; Drug Combinations; Equipment Contamination; Humans; Microscopy, Electron, Scanning; Palate; Sodium Hypochlorite; Surface Properties; Toothbrushing

Three groups of 10 maxillary anterior teeth each, which had been exposed to oral media, were flushed with 9 ml of tap water, physiologic saline solution, and alternating irrigation with NaOCl and hydrogen peroxide respectively. Residual caries, necrotic tissue remnants, intertubular cavitation, and dentinal tubule invasion by bacteria were searched for by means of the scanning electron microscope. Cuboidal sodium chloride crystals were very frequently found deposited in the main root canal, in lateral canals, and inside the dentinal tubules. This study discusses the important role NaOCl may play as a solvent of dental plaque and necrotic tissue remnants in the clinical endodontic treatment of infected teeth that had been exposed to oral media.

Topics: Adolescent; Adult; Bacteria; Dental Plaque; Dental Pulp Cavity; Dentin; Humans; Hydrogen Peroxide; Microscopy, Electron; Middle Aged; Root Canal Irrigants; Sodium Hypochlorite

Topics: Adult; Dental Plaque; Dentifrices; Denture Cleansers; Dentures; Female; Humans; Male; Microscopy, Electron, Scanning; Peroxides; Sodium Hypochlorite; Surface Properties; Ultrasonic Therapy

Topics: Adolescent; Aggressive Periodontitis; Bacteria; Child; Dental Plaque; Gingiva; Humans; Periodontal Diseases; Sodium Hypochlorite; Subgingival Curettage

Topics: Adult; Aged; Dental Plaque; Dentifrices; Denture Cleansers; Denture, Complete; Evaluation Studies as Topic; Female; Humans; Male; Middle Aged; Peroxides; Phosphates; Sodium Hypochlorite

Topics: Adult; Anti-Infective Agents, Local; Dental Plaque; Gingivitis; Humans; Hydrogen Peroxide; Hydrogen-Ion Concentration; Pilot Projects; Pressure; Sodium Hypochlorite; Structure-Activity Relationship; Therapeutic Irrigation