sodium-hypochlorite and Gram-Positive-Bacterial-Infections

This study examined the bactericidal effect of diode laser irradiation against intracanal Enterococcus faecalis.. m total of 128 extracted single-rooted and single-canal teeth were treated with ProTaper instruments (Dentsply Maillefer, Ballaigues, Switzerland). A total of 120 root canals were inoculated with E. faecalis for 21 days, and the samples were randomly divided into five groups: Group 1 (n = 24) samples were irrigated with only saline solution (positive controls); Group 2 (n = 24) was treated with only 5.25% sodium hypochlorite; Group 3 (n = 24) was irrigated with saline solutions activated by diode laser; Group 4 (n = 24) was treated with 5.25% sodium hypochlorite activated by diode laser; and Group 5 (n = 24) was irrigated with saline solution with methylene blue dye activated by the diode laser Fox (Sweden & Martina, Padova, Italy); additionally, eight teeth were not contaminated and their canals were irrigated with saline solution and used as a negative control. The Uro-Quick system was used to determine the microbial residual charge. The data were analyzed using Pearson's chi-square test (p < 0.001).. A statistically significant reduction in bacterial count was observed in Group 2 and Group 4 (p < 0.001). There were no statistically significant differences among the other groups (p > 0.001).. Evidence indicates that the diode laser was not more effective than sodium hypochlorite in reducing free bacteria.

Topics: Bacterial Load; Dental Pulp Cavity; Enterococcus faecalis; Gram-Positive Bacterial Infections; Humans; In Vitro Techniques; Lasers, Semiconductor; Low-Level Light Therapy; Reference Values; Root Canal Therapy; Sensitivity and Specificity; Sodium Hypochlorite; Tooth Extraction

This study compared the antibacterial effects of 1% sodium hypochlorite (NaOCl) and 2% chlorhexidine digluconate (CHX) during retreatment of teeth with apical periodontitis.. Root canal-treated teeth with apical periodontitis were randomly distributed into 2 groups. Bacteriological samples were taken from the canals before (S1) and after (S2) preparation using either NaOCl or CHX irrigation and after calcium hydroxide medication (S3); 16S ribosomal RNA gene-based real-time quantitative polymerase chain reaction was performed to quantify total bacteria, streptococci, and Enterococcus faecalis.. Forty-nine teeth were available for analysis (NaOCl, n = 20; CHX, n = 29). Bacterial DNA occurred in all S1 samples, streptococci in 57% and E. faecalis in 6%. The total bacterial counts decreased from S1 to S2 in both groups (P < .01) but were higher in S3 than S2 (P < .01). Thirty-five percent of the teeth in the NaOCl group were positive in S2, decreasing to 20% in S3. In the CHX group, 41% were positive in S2, decreasing to 31% in S3. The bacterial load in S1 influenced the incidence of bacteria in S2 (P < .01). Streptococci were significantly reduced in both groups, and E. faecalis was found in only 1 S2 sample and not in S3. No significant difference between NaOCl and CHX was found.. NaOCl and CHX both reduced bacterial counts and the number of infected canals. Intracanal medication with calcium hydroxide reduced the number of canals with persistent infection but resulted in overall larger bacterial counts in the cases positive for bacteria. The effectiveness of antimicrobial treatment can be influenced by the initial bacterial load.

Topics: Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Bacterial Load; Chlorhexidine; Dental Pulp Cavity; Enterococcus faecalis; Female; Gram-Positive Bacterial Infections; Humans; Male; Middle Aged; Periapical Periodontitis; Real-Time Polymerase Chain Reaction; Root Canal Irrigants; Sodium Hypochlorite; Streptococcal Infections; Streptococcus; Young Adult

To evaluate the ability of two root canal sealers (Epoxy resin-based AH Plus or polydimethylsiloxane-based GuttaFlow) and five root filling techniques (continuous wave of condensation, Thermafil, lateral condensation, matched taper single gutta-percha point, laterally condensed-matched taper gutta-percha point) to kill bacteria in experimentally infected dentinal tubules.. An infected dentine block model was used. One hundred and twenty extracted, single-rooted human teeth were randomly divided into 10 test (n = 10) and 2 control (n = 10) groups. The roots, except negative controls, were infected with Enterococcus faecalis for 21 days. The root canals were then filled using the test materials and methods. Positive controls were not filled. Sterile roots were used as negative controls. Dentine powder was obtained from all root canals using gates glidden drills using a standard method. The dentine powder was diluted and inoculated into bacterial growth media. Total colony-forming units (CFU) were calculated for each sample. Statistical analysis was performed using the Kruskal-Wallis and Mann-Whitney U test.. The epoxy resin-based sealer was effective in killing E. faecalis except when using Thermafil (P < 0.05), but the polydimethylsiloxane-based sealer was not effective in killing this microorganism except in the continuous wave group (P < 0.05).. In the test model, AH Plus killed bacteria in infected dentine more effectively than GuttaFlow. The filling method was less important than the sealer material.

Topics: Anti-Bacterial Agents; Bacterial Load; Bacteriological Techniques; Dental Pulp Cavity; Dentin; Dimethylpolysiloxanes; Drug Combinations; Enterococcus faecalis; Epoxy Resins; Gram-Positive Bacterial Infections; Gutta-Percha; Humans; Humidity; Materials Testing; Microscopy, Electron, Scanning; Root Canal Filling Materials; Root Canal Irrigants; Root Canal Obturation; Root Canal Preparation; Sodium Hypochlorite; Temperature; Time Factors

This study investigated the effectiveness of XP-Endo Finisher (XPF) associated with XP-Endo Shaper (XPS) or Reciproc Blue (RB) files in reducing bacterial load in oval-shaped root canals (RC) during chemomechanical preparation (CMP) using 0.9% saline solution (NaCl) or 2.5% sodium hypochlorite (NaOCl). Eighty mandibular incisors with single oval-shaped RC were contaminated with Enterococcus faecalis. The teeth were randomly assigned to eight experimental groups (n = 10) according to the CMP, as follows: G1: XPS, G2: XPS + XPF, G3: RB, and G4: RB + XPF. CMP was performed with NaCl or NaOCl. The reduction of bacterial load was assessed by colony-forming unit count before (S1) and after (S2) CMP. Data normality was verified by using Shapiro-Wilk test. ANOVA, Tukey's test, and Bonferroni post-hoc test were used at a 5% significance level. Culturable bacteria were present in all S1 samples (p>0.05). All instrumentation techniques were effective in reducing bacterial load, irrespective of the irrigating solution (p < 0.05). With the use of NaCl, RB was more effective than XPS (p = 0.035). With the use of NaOCl, XPS and RB presented similar effectiveness (p = 0.779). XPF enhanced the bacterial reduction of both systems tested (p < 0.05). The use of NaOCl improved the CMP, irrespective of the instrumentation technique used (p < 0.05). In conclusion, XPS and RB files are effective in reducing bacterial levels in oval-shaped RC. The use of XPF as a method of agitation of the irrigating solution improved the cleaning efficiency of both file systems tested. Mechanical preparation performed with saline solution decreased culturable bacteria from the root canal, but antimicrobial substances such as NaOCl should be used to achieve a significantly better disinfection.

Topics: Bacterial Load; Dental Instruments; Dental Pulp Cavity; Disinfectants; Enterococcus faecalis; Gram-Positive Bacterial Infections; Humans; Incisor; Materials Testing; Root Canal Preparation; Saline Solution; Sodium Hypochlorite

The successful treatment of infected or inflamed endodontic tissues requires chemomechanical debridement of the canal spaces and proper sealing of the coronal and apical canal openings. Only a few methods are available to further disinfect areas or initiate regeneration of local tissues. In this study, we assessed the ability of 255-nm and 405-nm light-emitting diode (LED) treatment to kill planktonic cultures of Enterococcus faecalis and induce the production of cellular biomarkers related to endodontic tissue regeneration.. We determined the antimicrobial effects of 255-nm and 405-nm LED treatment on E. faecalis and the effects of 255-nm and 405-nm LED treatment on the production of osteoinductive, angiogenic, proliferative, and proinflammatory biomarkers from human embryonic palatal mesenchyme (HEPM) cells and gingival fibroblasts.. We showed that 255-nm LED but not 405-nm LED treatment killed E. faecalis; the 255-nm LED and sodium hypochlorite more efficiently killed E. faecalis; neither 255-nm nor 405-nm LED treatment affected the viability of HEPM cells and gingival fibroblasts; and 255-nm LED treatment, alone or in combination with 405-nm LED treatment, of HEPM cells and gingival fibroblasts induced the production of biomarkers related to endodontic tissue regeneration.. The results of this study suggest a new treatment modality using short periods of 255-nm LED treatment as an adjunct to chemomechanical debridement for the disinfection of inflamed sites and the production of biomarkers related to endodontic tissue regeneration.

Topics: Biomarkers; Enterococcus faecalis; Fibroblasts; Gingiva; Gram-Positive Bacterial Infections; Humans; Mesoderm; Photosensitizing Agents; Phototherapy; Sodium Hypochlorite

Topics: Biofilms; Dental Pulp Cavity; Enterococcus faecalis; Gram-Positive Bacterial Infections; Microscopy, Confocal; Root Canal Irrigants; Root Canal Therapy; Sodium Hypochlorite

This research focused on the effects of low electric current (μE)-assisted sonic agitation of sodium hypochlorite on Enterococcus faecalis infected human root dentin.. Extracted human canine roots were instrumented, sterilized, and experimentally contaminated with E. faecalis. After incubation for 21 days, the presence of the biofilm was confirmed by scanning electron microscopy (n = 3). Roots were randomly divided into seven groups according to decontamination procedures: G1: no treatment; G2: sterile saline; G3: 5.25% sodium hypochlorite; G4: passive ultrasonic irrigation; G5: EndoActivator (Dentsply Tulsa Dental Specialties, Tulsa, OK) agitation (EA); G6: μE agitation; and G7: μE-assisted sonic agitation. Fixed μE amperage and intensities were applied in G6 and G7. Following microbial sampling, bacterial colonies were counted using the direct plating method.. Biofilm was not eradicated in any sample. The μE-assisted sonic agitation of sodium hypochlorite revealed the lowest cfu values (p<0.05), whereas there were no significant differences among the passive ultrasonic irrigation, EndoActivator and μE agitation alone (p>0.05).. Based on available evidence, the following conclusions were drawn: The μE-assisted sonic agitation increased the antibiofilm efficiency of sodium hypochlorite than passive ultrasonic irrigation and EndoActivator. The μE-assisted sonic agitation on 5.25% sodium hypochlorite is not capable to eradicate biofilms at 10mA energy level in 60s.

Topics: Anti-Bacterial Agents; Biofilms; Dental Pulp Cavity; Disinfectants; Electricity; Enterococcus faecalis; Gram-Positive Bacterial Infections; Humans; Root Canal Therapy; Sodium Hypochlorite; Sonication

Topics: Anti-Bacterial Agents; Chlorhexidine; Dental Pulp Cavity; Enterococcus faecalis; Gram-Positive Bacterial Infections; Humans; In Vitro Techniques; Lasers, Semiconductor; Materials Testing; Microscopy, Electron, Scanning; Ozone; Photochemotherapy; Propolis; Random Allocation; Root Canal Irrigants; Sodium Hypochlorite; Stem Cells; Surface Properties

To evaluate antibacterial and residual antimicrobial activities of five root canal irrigants including Qmix, MTAD(mixture of a tetracycline isomer, an acid, and a detergent), 0.2% cetrimide(CTR), 2% chlorhexidine(CHX) and 17% ethylene diaminetetraacetic acid(EDTA) and to find the most optimal final irrigants for using in root canal therapy.. The standard enterococcus infection models were built up in 100 single rooted incisors with single canal. Totally 30 teeth were selected by using random number tablefor detecting the quality of the bacteria model. Crown-down technique with rotary ProTaper system was used to prepare the root canals. Then the teeth were randomly divided into seven groups of which five groups were irrigated with five different irrigants respectively, one group was irrigated with distilled water(distilled water group) and one group was no-irrigation group. Each tooth was sectioned into three parts: apical 1/3, middle 1/3 and coronal 1/3. After irrigation, specimenswere cultivated from day 0 to day 14. All statistical analyses were performed by means of SPSS 17.0 software. Chi-squared test was used to evaluate antibacterial activities. Generalized estimating equations was used to evaluate residual antimicrobial activities.. All samples rinsed with Qmix, MTAD, CTR, CHX were bacteria-free in 0 day. The samples rinsed with EDTA and distilled water had no bacteria in 7 coronal sections, 6 middle sections and 9 apical sections, respectively. The results of Qmix, MTAD, CTR and CHX groups showed significant difference when compared with that of distilled water, EDTA and control groups(P<0.05). Residual antimicrobial resultsin EDTA, distilled water, no-irrigation groups showed significant differences compared with that of Qmix, MTAD, CTR, CHX groups according to pairwise comparison(P<0.05) on day 1, 2 and 3. There was no significant difference between the other two groups(P>0.05). Antimicrobial properties on the coronal 1/3 and apical 1/3, middle 1/3 and apical 1/3 showed significant difference(P<0.05) while middle 1/3 and coronal 1/3 showed no significant difference(P>0.05).. Qmix, MTAD, CTR and CHX had an antimicrobial activity, but could not destroy Enterococcus faecalis completely. Antimicrobial activity in coronal 1/3 was better than in apical 1/3. Qmix, MTAD, CTR and CHX had a residual antimicrobial activity with various lasting times. The lasting time of residual antimicrobial activity was as follow: MTAD> CTR>Qmix>CHX. EDTA had no antibacterial and residual antimicrobial activities.

Topics: Anti-Bacterial Agents; Anti-Infective Agents; Cetrimonium; Cetrimonium Compounds; Chlorhexidine; Dental Pulp Cavity; Edetic Acid; Enterococcus faecalis; Gram-Positive Bacterial Infections; Humans; Molar; Periodontitis; Root Canal Irrigants; Root Canal Therapy; Sodium Hypochlorite; Tooth Root

Some lasers have demonstrated to provide effective disinfection when used as adjunctive device to the conventional treatment. The aim of this in vitro study was to determine the effectiveness of the erbium, chromium:yttrium scandium gallium garnet (Er, Cr:YSGG) laser by measuring its bactericidal effect inside the root canal experimentally colonized with Enterococcus faecalis. The laser was tested at different irradiation times (30 and 60 s) and energy of impulses (75 and 25 mJ). A total of 52 single-rooted extracted human teeth were endodontically prepared with rotary instrumentation. All were sterilized and inoculated with a suspension of E. faecalis (105 bacteria/ml). The teeth were randomized into three treatment (group 1, group 2, and group 3) and one control groups. In all groups, teeth were chemically irrigated with 5.25% sodium hypochlorite and 17% ethylenediaminetetraacetic acid. Groups 1 and 2 were also irradiated at 30 and 60 s, respectively, with an Er, Cr:YSGG laser at 75 mJ. Teeth of group 3 were treated with laser for 60 s at 25 mJ. Samples were processed to detect the presence of E. faecalis. For all groups, a bactericidal effect was observed. The use of laser at 75 mJ with an irradiation time of 30 and 60 s eliminated a percentage of 92.3 and 100% of E. faecalis, respectively. In the control group, a reduction of 92.3% was observed. Lower percentage of reduction (46.1%) was obtained in teeth treated with laser at 25 mJ for 60 s. No statistical differences were observed between the groups (P = 0.543, Fisher's exact test). The results indicated a bactericidal effect of Er, Cr:YSGG laser irradiation at the settings used in this study. The highest bactericidal effect of this laser was observed at 60 s of irradiation time, using an energy pulse of 75 mJ.

Topics: Dental Caries; Dental Pulp Cavity; Disinfectants; Disinfection; Enterococcus faecalis; Erbium; Gram-Positive Bacterial Infections; Humans; Lasers; Lasers, Solid-State; Models, Dental; Periodontal Diseases; Root Canal Therapy; Sodium Hypochlorite; Tooth Root

The objective of the present study was to assess the effectiveness of reciprocating instrumentation in disinfecting oval-shaped root canals infected with Enterococcus faecalis. Forty-five human lower premolars were infected with a culture of E. faecalis (ATCC 29212) for 28 days. Five other teeth that were neither contaminated nor instrumented were used as controls. The 45 specimens were divided into three experimental groups (n = 15) based on the root canal preparation technique used: manual (K-type, Dentsply Maillefer, Ballaigues, Switzerland); rotary (MTwo, VDW GmbH, Munich, Germany); and reciprocating (Reciproc R50, VDW GmbH, Munich, Germany) instruments. During chemomechanical preparation, 21 mL of 2.5% NaOCl was used as the irrigating solution. Microbiological sampling was performed before (S1) and immediately after (S2) the chemomechanical preparation using sterilized paper points. Specimens were then cleaved, and 0.02 g of dentine chips was collected from the root thirds to verify the presence of microorganisms in dentinal tubules. All three preparation techniques reduced the number of microorganisms in the root canal lumen and dentine chips from the root thirds, but no significant differences were observed between the three groups (p > 0.05). Reciprocating instrumentation with Reciproc R50 was effective in reducing the number of microorganisms within the root canal system. Although this technique involves the use of only one file to perform the root canal therapy, it is as effective as conventional rotary instrumentation in reducing the E. faecalis biofilm from the root canal system. However, further clinical investigations are warranted in order to ratify these results.

Topics: Bacterial Load; Biofilms; Dental Instruments; Dental Pulp Cavity; Disinfection; Enterococcus faecalis; Equipment Design; Gram-Positive Bacterial Infections; Humans; Reproducibility of Results; Root Canal Irrigants; Root Canal Preparation; Sodium Hypochlorite; Statistics, Nonparametric

The present study aimed to evaluate the antibacterial effect of the combined use of sodium hypochlorite (NaOCl) and root canal sealers on Enterococcus faecalis biofilms using a dentin infection model.. Cells of E. faecalis were introduced into the dentinal tubules by centrifugation and incubated in brain-heart infusion for 3 weeks. The biofilms in dentin were first subjected to 5% NaOCl or sterile water for 10 minutes followed by an equal thickness of AH Plus (Dentsply International Inc, York, PA), Endosequence BC Sealer (Brasseler USA, Savannah, GA), or MTA Fillapex (Angelus Indústria de Produtos Odontológicos S/A, Londrina, Brazil) placed on the root canal wall of the dentin specimens for 7, 30, and 60 days. Gutta-percha and water were used in a similar manner as controls. The proportions of dead and live bacteria inside the dentinal tubules were assessed by confocal laser scanning microscopy and viability staining.. The combined use of NaOCl and sealers (30 and 60 days) killed significantly more bacteria than NaOCl or sealers alone (P < .05). NaOCl + MTA Fillapex was the most effective antibacterial combination by killing 83% bacteria in dentin tubules in 60 days. Thirty and 60 days of exposure to the sealers resulted in significantly more dead bacteria in dentin biofilms than 7-day exposures (P < .05).. The placement of root canal sealer after NaOCl treatment enhanced antibacterial effects against E. faecalis in the dentinal tubules. Little additional effect was obtained after 30 days of exposure to sealers.

Topics: Anti-Bacterial Agents; Biofilms; Dentin; Drug Therapy, Combination; Enterococcus faecalis; Epoxy Resins; Gram-Positive Bacterial Infections; Humans; Microscopy, Confocal; Root Canal Filling Materials; Sodium Hypochlorite; Time Factors

Complete sterilization of an infected root canal is an important challenge in endodontic treatment. Traditional methods often cannot achieve high-efficiency sterilization because of the complexity of the root canal system. The objective of the study was to investigate in vitro the feasibility of using a cold plasma treatment of a root canal infected with Enterococcus faecalis biofilms.. Seventy single-root teeth infected with E. faecalis biofilms were divided into 7 groups. Group 1 served as the negative control group (no treatment), and group 7 was the positive control group with teeth treated with calcium hydroxide intracanal medication for 7 days. Groups 2 to 6 included teeth treated by cold plasma for 2, 4, 6, 8, and 10 minutes, respectively. The disinfection of the E. faecalis biofilm was evaluated by colony-forming unit (CFU) counting. Scanning electron microscopy was used to evaluate the structural changes of the E. faecalis biofilm before and after plasma treatment. Confocal scanning laser microscopy was used to investigate the vitality of the microorganisms in the biofilm before and after plasma treatment.. A significant decrease in the number of CFUs was observed after prolonged cold plasma treatment (based on the statistical analysis of the teeth in groups 2-6). Compared with the positive control group, cold plasma treatment of 8 or 10 minutes (groups 5 and 6) had a significantly higher antimicrobial efficacy (P < .05). The scanning electron microscopic analysis showed that the bacteria membrane was ruptured, and the structure of the biofilm was fully destroyed by the plasma. Confocal scanning laser microscopic studies indicated that the plasma treatment induced E. faecalis death and destruction of the biofilm.. The cold plasma had a high efficiency in disinfecting the E. faecalis biofilms in in vitro dental root canal treatment.

Topics: Bacterial Load; Biofilms; Calcium Hydroxide; Dental Disinfectants; Dental Pulp Cavity; Disinfection; Enterococcus faecalis; Feasibility Studies; Gram-Positive Bacterial Infections; Humans; Microscopy, Confocal; Microscopy, Electron, Scanning; Plasma Gases; Root Canal Irrigants; Root Canal Preparation; Root Canal Therapy; Smear Layer; Sodium Hypochlorite; Time Factors

To establish a refined model of artificially infected root canals and confirm its suitability as a sensitive ex vivo method to assess the efficacy of disinfecting agents. Disinfection was evaluated using sodium hypochlorite (NaOCl), either blocked or unblocked by sodium thiosulphate, and a recently promoted method of disinfection, the antibacterial photodynamic therapy (PDT).. The roots of bovine incisors were sectioned into three parts, the canals of coronal and middle regions were filled with a suspension of Enterococcus faecalis and the apical region with culture medium. After 7 days, coronal sections were disinfected using NaOCl (0.5%, 1.0% and 3.0% for 30, 60 and 600 s) or a system for photoactivated chemotherapy (PACT; Cumdente, Tübingen, Germany) for antibacterial PDT. Apical sections served as sterile controls and middle sections as bacterial growth controls. In half of the NaOCl-treated specimens, disinfection was arrested. Dentine chips from biopsies at different depths from the central canal towards the periphery were plated and assessed for colony-forming units (CFU). Disinfection was considered biologically relevant if the reduction of CFU was at least three log10 orders of magnitude.. Colony-forming units of 10³ - 10⁴ in growth controls indicated effective artificial infection. A biologically relevant reduction of CFU was accomplished with unblocked NaOCl, but not after blocking with NaOCl nor with PDT.. The system reliably detected disinfection of the root canal and dentinal tubules and proved suitable for ex vivo testing of root canal disinfection. The effect of NaOCl depended on the duration of impact. Under the present experimental conditions, the antibacterial PDT system did not achieve sufficient disinfection.

Topics: Animals; Bacterial Load; Cattle; Chelating Agents; Dental Disinfectants; Dental Pulp Cavity; Dentin; Disinfection; Dose-Response Relationship, Drug; Enterococcus faecalis; Gram-Positive Bacterial Infections; Low-Level Light Therapy; Microscopy, Electron, Scanning; Photochemotherapy; Photosensitizing Agents; Root Canal Irrigants; Sodium Hypochlorite; Thiosulfates; Tissue Culture Techniques; Tolonium Chloride

To evaluate the disinfection efficacy of MTAD on Enterococcus faecalis biofilm and smear layer colonization in apical isthums of the root canal system.. Fifteen extracted human maxillary first premolars with isthmus anatomic structure which confirmed by stereo-microscope were contaminated with E. faecalis in vitro and randomly divided into 5 groups: the first group was not treated serving as a baseline control, the second group was treated by normal saline (NS) serving as negative control, the third group was treated by MTAD , the forth group by 5.25% NaOCl, and the fifth group by 5.25% NaOCl + EDTA. All roots in the latter four groups were instrumented by Protaper rotary files and irrigated with respective irrigant, then the roots were split longitudinally and a scanning electron microscope was used to evaluate the antibacterial activity and smear layer cleaning ability of irrigants on isthmus.. In the first group, E. faecalis colonized on the isthmus surface and aggregated together to form biofilm-like microorganism community, some bacteria also colonized in the dentinal tubules. When treated with NS, both smear layer and bacteria remained (median of smear layer score was 5). MTAD can remove partial smear layer, and have limited antibacterial activity, some bacteria embedded in smear layer (the median was 3) and were destroyed; In 5.25% NaOCl treatmentgroup, the smear layer was not removed (median of smear layer score was also 5), but all bacteria on the surface were extinguished. The combined use of 5.25% NaOCl and EDTA produced a cleaner isthmus surface and had marked antimicrobial effect, with the median of smear layer score being only 1.. MTAD may permeate into the isthmus area of apical root canal system, but only performed a partial effect of disinfection and limited antibacterial activity. Sodium hypochlorite cooperated with EDTA can remove infection effectively in the isthmus area.

Topics: Biofilms; Citric Acid; Doxycycline; Enterococcus faecalis; Gram-Positive Bacterial Infections; Humans; In Vitro Techniques; Periapical Periodontitis; Periapical Tissue; Polysorbates; Root Canal Irrigants; Sodium Hypochlorite

Vancomycin-resistant enterococcus (VRE) colonization and infection have increased at our hospital, despite adherence to standard VRE control guidelines.. We implemented a multi-modal, hospital-wide improvement programme including a bleach-based cleaning-disinfection programme ('Bleach-Clean'). VRE colonization, infection and environmental contamination were compared pre and post implementation.. The programme included a new product (sodium hypochlorite 1000 ppm + detergent), standardized cleaning-disinfection practices, employment of cleaning supervisors, and modified protocols to rely on alcohol-based hand hygiene and sleeveless aprons instead of long-sleeved gowns and gloves. VRE was isolated using chromogenic agar and/or routine laboratory methods. Outcomes were assessed during the 6 months pre and 12 months post implementation, including proportions (per 100 patients screened) of VRE colonization in high-risk wards (HRWs: intensive care, liver transplant, renal, haematology/oncology); proportions of environmental contamination; and episodes of VRE bacteraemia throughout the entire hospital.. Significant reductions in newly recognized VRE colonizations (208/1948 patients screened vs 324/4035, a 24.8% reduction, P = 0.001) and environmental contamination (66.4% reduction, P = 0.012) were observed, but the proportion of patients colonized on admission was stable. The total burden of inpatients with VRE in the HRWs also declined (median percentage of colonized inpatients per week, 19.4% vs 17.3%, P = 0.016). Hospital-wide VRE bacteraemia declined from 14/2935 patients investigated to 5/6194 (83.1% reduction; P < 0.001), but there was no change in vancomycin-susceptible enterococcal bacteraemia (P = 0.54).. The Bleach-Clean programme was associated with marked reductions in new VRE colonizations in high-risk patients, and VRE bacteraemia across the entire hospital. These findings have important implications for VRE control in endemic healthcare settings.

Topics: Bleaching Agents; Carrier State; Cross Infection; Disinfectants; Disinfection; Enterococcus; Gram-Positive Bacterial Infections; Humans; Incidence; Sodium Hypochlorite; Vancomycin Resistance

In recent years, various laser systems have been introduced into the field of laser-assisted endodontic therapy. The aim of this study was to evaluate the bactericidal effect of Nd:YAG, Er:YAG, Er,Cr:YSGG laser radiation, and antimicrobial photodynamic therapy (aPDT) in experimentally infected root canals compared with standard endodontic treatment of 5.25% sodium hypochlorite (NaClO) irrigation.. Two hundred and twenty infected root canals from extracted human teeth (contaminated with Enterococcus faecalis ATCC 4083 for 4 weeks) were randomly divided into five experimental groups (Nd:YAG, Er:YAG + 5.25% NaClO + 0.9% normal saline + distilled water (Er:YAG/NaClO/NS/DW), Er:YAG + 0.9% normal saline + distilled water (Er:YAG/NS/DW), Er,Cr:YSGG, and aPDT) and two control groups (5.25% NaClO as positive control and 0.9% normal saline (NS) as negative control). The numbers of bacteria on the surface of root canal walls and at different depths inside dentinal tubules before and after treatment were analyzed by means of one-way analysis of variance (one-way ANOVA). The morphology of bacterial cells before and after treatment was examined by scanning electron microscopy (SEM).. After treatment, the bacterial reductions in the experimental groups and the positive control group were significantly greater than that of the negative control group (P < 0.001). However, only Er:YAG/NaClO/NS/DW group showed no bacterial growth (the bacterial reduction reached up to 100%) on the surface of root canal walls or at 100/200 µm inside the dentinal tubules.. All the laser radiation protocols tested, especially Er:YAG/NaClO/NS/DW, have effective bactericidal effect in experimentally infected root canals. Er:YAG/NaClO/NS/DW seems to be an ideal protocol for root canal disinfection during endodontic therapy.

Topics: Anti-Infective Agents, Local; Biofilms; Colony Count, Microbial; Combined Modality Therapy; Dental Pulp Cavity; Enterococcus faecalis; Enzyme Inhibitors; Gram-Positive Bacterial Infections; Humans; In Vitro Techniques; Lasers, Solid-State; Methylene Blue; Microscopy, Electron, Scanning; Photochemotherapy; Sodium Hypochlorite

The application of a final irrigating solution that remains active over a fairly long period of time stands as one strategy for preventing bacterial recolonization or eliminating the bacteria that persist after root canal treatment. The aim of this study was to evaluate the residual antimicrobial activity of four final irrigation regimens in root canals contaminated with Enterococcus faecalis.. Biofilms of E. faecalis were grown in uniradicular roots for 4 weeks. After preparing the roots chemomechanically, four final irrigation regimens were applied: (1) group EDTA-NaOCl, 17% EDTA followed by 5.25% sodium hypochlorite (NaOCl); (2) group MA-NaOCl, 7% maleic acid (MA) followed by 5.25% NaOCl; (3) group EDTA-CHX + CTR, 17% EDTA followed by 2% chlorhexidine (CHX) + 0.2% cetrimide (CTR); and (4) group MA-CHX + CTR, 7% MA followed by 2% CHX + 0.2% CTR. Samples were collected for 60 days to denote the presence of bacterial growth. The Fisher exact test was used to compare the percentages of specimens without E. faecalis regrowth.. All root canals in which the final irrigant was 5.25% NaOCl yielded positive cultures on the fifth day. Groups EDTA-CHX + CTR and MA-CHX + CTR with a final irrigation of 2% CHX + 0.2% CTR showed respective percentages of samples without regrowth of 72.1% and 66.8% at 60 days. There were no statistically significant differences between these groups.. The combination of 2% CHX + 0.2% CTR would be an effective alternative final irrigation regimen given its antimicrobial action over time.

Topics: Anti-Infective Agents, Local; Biofilms; Cetrimonium; Cetrimonium Compounds; Chlorhexidine; Dental Pulp Cavity; Drug Combinations; Edetic Acid; Enterococcus faecalis; Gram-Positive Bacterial Infections; Humans; Malates; Root Canal Irrigants; Sodium Hypochlorite

The aim of this study was to investigate the effectiveness of the erbium, chromium:yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser by measuring its bactericidal effect inside root canals experimentally colonized with Enterococcus faecalis. We also determined the optimal conditions for the Er,Cr:YSGG laser to achieve the maximal bactericidal effect. An Er,Cr:YSGG Waterlase laser was used, and its antimicrobial effect was compared with that of sodium hypochlorite (NaOCl) at various concentrations as widely used in clinics. This laser emits photons at a wavelength of 2.78 microm. It is a pulsed laser operating at 20 Hz (20 pulses/s). Significant differences between measurements in the different groups (P < 0.05) were observed, depending on time and power used. The use of NaOCl 5% was the most effective procedure, with NaOCl 0.5% being the least effective; however, laser treatment was as effective as NaOCl 5% when applied at 2 W for 60 s.

Topics: Bacterial Load; Dental Disinfectants; Dental Pulp Cavity; Disinfection; Enterococcus faecalis; Gram-Positive Bacterial Infections; Humans; In Vitro Techniques; Lasers, Solid-State; Low-Level Light Therapy; Root Canal Therapy; Sodium Hypochlorite

In this study, presence of dentin infection in root canals, obturated with 4 techniques submitted to the bacterial leakage test, was evaluated using histologic methods.. The canals of palatal roots of 160 molars were instrumented and divided into different groups, according to the obturation technique used (lateral condensation, MicroSeal system, Touch 'n Heat + Ultrafil, and Tagger's hybrid technique) and extent of the remaining obturation material (5 mm and 10 mm). Ten additional roots were used as control samples. The roots were sterilized in ethylene oxide and mounted on a device for evaluation of bacterial leakage using the bacteria Enterococcus faecalis for 120 days. After the leakage test, roots were microscopically analyzed for the presence of dentin infection in the root canals and dentinal tubules.. A total of 154 specimens were analyzed using both methodologies in the experimental groups; 50 root canals (32.4%) showed bacterial leakage at the end of the experimental period, and 118 (76.6%) showed the presence of bacteria in the root canals using the histologic criteria. The lateral condensation technique allowed lower penetration of bacteria in the root canals and dentinal tubules, followed by Touch 'n Heat + Ultrafil, MicroSeal, and Tagger's hybrid technique, which allowed significantly greater penetration of bacteria. Root canals with 10 mm of remaining obturation material presented similar bacterial penetration as root canals with 5 mm.. Even when an adequate seal of the apical foramen was shown by the absence of turbidity in the bacterial leakage test, E. faecalis dentin infection was present in a high percentage of the root canals after 120 days of root filling exposure to the bacteria. Tagger's hybrid technique presented greater quantity of bacteria in histologic sections than root canals obturated with the other techniques.

Topics: Dental Bonding; Dental Disinfectants; Dental Leakage; Dental Pulp Cavity; Dentin; Enterococcus faecalis; Ethylene Oxide; Gram-Positive Bacterial Infections; Gutta-Percha; Humans; Root Canal Filling Materials; Root Canal Irrigants; Root Canal Obturation; Sodium Hypochlorite; Sterilization; Time Factors; Tooth Apex

The purpose of this study was to determine the antimicrobial efficacy of sodium hypochlorite adjusted to pH 12, 7.5, and 6.5 in human root canals infected by Enterococcus faecalis.. One hundred sixty-five human single-rooted teeth were prepared and inoculated with E. faecalis for 48 h. Teeth were divided into 3 experimental groups according to the irrigation pattern used: group 1, 4.2% NaOCl pH 12; group 2, 4.2% NaOCl pH 7.5; and group 3, 4.2% NaOCl pH 6.5. Samples from the root canals were collected, and bacterial growth was analyzed by turbidity of the culture medium.. None of the irrigating solutions used in this study demonstrated 100% effectiveness against E. faecalis. The antibacterial effectiveness of 4.2% NaOCl at pH 6.5 was significantly increased (P = .03) compared with 4.2% NaOCl at pH 12 (chi-squared test: P < .05).. Bactericidal activity of NaOCl solution is enhanced by weak acidification of 4.2% NaOCl solution at pH 6.5.

Topics: Anti-Infective Agents, Local; Dental Pulp Cavity; Enterococcus faecalis; Gram-Positive Bacterial Infections; Humans; Hydrogen-Ion Concentration; Nephelometry and Turbidimetry; Root Canal Irrigants; Sodium Hypochlorite

To assess the antibacterial action of laser irradiation (Nd:YAG, KTP), photo activated disinfection (PAD) and 2.5% sodium hypochlorite (NaOCl) on Enterococcus faecalis, in an aqueous suspension and in an infected tooth model.. Root canals of 60 human teeth with single straight canals were prepared to apical size 50, autoclaved, inoculated with an E. faecalis suspension and incubated for 48 h. They were randomly allocated to four treatment and one control groups. After treatment, the root canals were sampled by flushing with physiological saline, and the number of surviving bacteria in each canal was determined by plate count and solid phase cytometry. The same experimental or control treatments were completed on aqueous suspensions of E. faecalis, and the number of surviving bacteria was determined in the same way.. In aqueous suspension, PAD and NaOCl resulted in a significant reduction in the number of E. faecalis cells (P < 0.001), whilst Nd:YAG or KTP had no effect. In the infected tooth model, only the PAD and NaOCl treated teeth yielded significantly different results relative to the untreated controls (P < 0.001).. The laser systems as well as PAD were less effective than NaOCl in reducing E. faecalis, both in aqueous suspension and in the infected tooth model.

Topics: Colony Count, Microbial; Dental Pulp Cavity; Dental Pulp Necrosis; Enterococcus faecalis; Gram-Positive Bacterial Infections; Hot Temperature; Humans; Lasers, Solid-State; Microbial Viability; Photochemotherapy; Root Canal Irrigants; Sodium Hypochlorite

The aim was to evaluate the shelf life and the dissolving and antibacterial properties of a neutralized 2.5% NaOCl solution.. The loss of available chlorine and the pH of the neutralized 2.5% NaOCl solution were recorded to determine its shelf life. The dissolving action on bovine dental pulp was assessed measuring weight loss, pH variation, and decrease in available chlorine content. The antibacterial activity was evaluated on artificially infected human teeth. The roots were endodontically prepared, sterilized, and inoculated with Enterococcus faecalis before irrigation with the neutralized solution. The presence of intracanal bacteria after irrigation was recorded.. The neutralized solution presented a shelf life of 2 hours, dissolving capacities equivalent to control for the first 5 minutes, and a better antibacterial efficiency.. The neutralized 2.5% NaOCl solution must be used within 2 hours after mixing, should be frequently renewed to maintain its dissolving capacities, and presented enhanced antibacterial properties.

Topics: Animals; Anti-Infective Agents, Local; Cattle; Dental Pulp; Dental Pulp Cavity; Drug Storage; Enterococcus faecalis; Gram-Positive Bacterial Infections; Humans; Hydrogen-Ion Concentration; Root Canal Irrigants; Sodium Hypochlorite; Time Factors

Topics: Bacillus cereus; Bedding and Linens; Cross Infection; Disinfection; Gram-Positive Bacterial Infections; Humans; Sodium Hypochlorite

Contaminated environmental surfaces may play an important role in transmission of some healthcare-associated pathogens. In this study, we assessed the adequacy of cleaning practices in rooms of patients with Clostridium difficile-associated diarrhea (CDAD) and vancomycin-resistant Enterococcus (VRE) colonization or infection and examined whether an intervention would result in improved decontamination of surfaces.. During a 6-week period, we cultured commonly touched surfaces (i.e. bedrails, telephones, call buttons, door knobs, toilet seats, and bedside tables) in rooms of patients with CDAD and VRE colonization or infection before and after housekeeping cleaning, and again after disinfection with 10% bleach performed by the research staff. After the housekeeping staff received education and feedback, additional cultures were collected before and after housekeeping cleaning during a 10-week follow-up period.. Of the 17 rooms of patients with VRE colonization or infection, 16 (94%) had one or more positive environmental cultures before cleaning versus 12 (71%) after housekeeping cleaning (p = 0.125), whereas none had positive cultures after bleach disinfection by the research staff (p < 0.001). Of the 9 rooms of patients with CDAD, 100% had positive cultures prior to cleaning versus 7 (78%) after housekeeping cleaning (p = 0.50), whereas only 1 (11%) had positive cultures after bleach disinfection by research staff (p = 0.031). After an educational intervention, rates of environmental contamination after housekeeping cleaning were significantly reduced.. Our findings provide additional evidence that simple educational interventions directed at housekeeping staff can result in improved decontamination of environmental surfaces. Such interventions should include efforts to monitor cleaning and disinfection practices and provide feedback to the housekeeping staff.

Topics: Clostridioides difficile; Clostridium Infections; Cross Infection; Disinfection; Education; Enterococcus; Equipment Contamination; Fomites; Gram-Positive Bacterial Infections; Hospitals, Veterans; Housekeeping, Hospital; Humans; Infection Control; Patients' Rooms; Sodium Hypochlorite; Vancomycin Resistance

The authors evaluated the antibacterial effectiveness of laser instrumentation and rotary instrumentation of anterior, single-rooted teeth infected with Enterococcus faecalis.. The authors divided 35 infected samples into five groups: Group A: inoculation, laser, 17 percent ethylene-diamine-tetra-acetate (EDTA), 2.5 percent sodium hypochlorite (NaOCl) (n=10); Group B: inoculation, laser, 17 percent EDTA, sterile saline (n = 10); Group C: inoculation, rotary, 17 percent EDTA, 2.5 percent NaOCl (n=10); Group D: inoculation, no instrumentation (positive control) (n=5); Group E: no inoculation, no instrumentation (negative control) (n=5). They sampled and incubated dentin shavings from each canal for bacterial growth.. In Group A, eight tubes were positive for bacterial growth. In Group B, 10 tubes were positive for bacterial growth. In Group C, six tube were positive for bacterial growth. In Group D, all of the tubes were positive for bacterial growth. In Group E, no tubes showed bacterial growth. The Fisher exact test showed no significant differences among groups A, E and C.. Neither the laser nor the rotary instrumentation was able to eliminate endodontic infection.. Although lasers have been presented as high-tech tools for disinfecting root canals, the laser was ineffective in this study.

Topics: Chelating Agents; Dental Alloys; Dental Pulp; Dental Pulp Cavity; Dentin; Disinfectants; Edetic Acid; Enterococcus faecalis; Gram-Positive Bacterial Infections; Humans; Laser Therapy; Nickel; Root Canal Irrigants; Root Canal Preparation; Sodium Chloride; Sodium Hypochlorite; Titanium

The purpose of this investigation was to compare the antimicrobial effect of MTAD (a mixture of a tetracycline isomer, an acid, and a detergent) with that of NaOCl with and without EDTA. Eighty-five extracted human teeth were contaminated with Enterococcus faecalis for 4 weeks. After biomechanical instrumentation using 1.3% or 5.25% NaOCl as root canal irrigant, the root canal and the external surface of each tooth were exposed to a 5-min application of MTAD, 1.3% NaOCl, 5.25% NaOCl or a 1-min application of EDTA followed by irrigation with 5 ml of 1.3% NaOCl or 5.25% NaOCl. Teeth or dentin shavings were cultured to determine presence or absence of the test bacteria. Fisher's exact test showed that the combination of 1.3% NaOCl as a root canal irrigant and MTAD as a final rinse was significantly more effective against E. faecalis than the other regimens. The chi2 test showed no difference between the other regimens.

Topics: Anti-Bacterial Agents; Chelating Agents; Chi-Square Distribution; Citric Acid; Dental Pulp Cavity; Dentin; Disinfectants; Doxycycline; Edetic Acid; Enterococcus faecalis; Gram-Positive Bacterial Infections; Humans; Polysorbates; Root Canal Irrigants; Root Canal Preparation; Single-Blind Method; Sodium Hypochlorite; Surface-Active Agents

The occurrence of Enterococcus faecalis in root canals of previously root filled teeth with apical periodontitis requiring retreatment was studied in Lithuanian patients. Twenty-five asymptomatic teeth were included in the study. Avoiding contamination microbiological samples were taken from the canals before and after preparation and irrigation with sodium hypochlorite and EDTA. Microbes were isolated from 20 of 25 teeth. E. faecalis was isolated from 14 of those 20 culture positive teeth, usually in pure culture or as a major component of the flora. Second samples taken after preparation revealed growth in 7 of the 20 teeth. Five of the seven cases were E. faecalis in pure culture. Isolation of E. faecalis was not related to the use of any particular root filling material in the original root filling. The results indicate that, rather than previous chemical treatment, it is the ecological conditions present in the incompletely filled root canal that are important for the presence of E. faecalis in these teeth.

Topics: Bacteriological Techniques; Chelating Agents; Dental Pulp Cavity; Disinfectants; Edetic Acid; Enterococcus faecalis; Gram-Positive Bacterial Infections; Humans; Lithuania; Periapical Periodontitis; Retreatment; Root Canal Filling Materials; Root Canal Irrigants; Root Canal Obturation; Root Canal Preparation; Root Canal Therapy; Sodium Hypochlorite; Specimen Handling

The effectiveness of 4.0% sodium hypochlorite (NaOCl) used with three irrigation methods in the elimination of Enterococcus faecalis from the root canal was tested in vitro. Root canals contaminated with E. faecalis were treated as follows: (i) irrigation with 2 mL of NaOCl solution and agitation with hand files; (ii) irrigation with 2 mL of NaOCl solution and ultrasonic agitation; (iii) irrigation with NaOCl alternated with hydrogen peroxide. Contaminated canals irrigated with sterile saline solution served as the control. Paper points used to sample bacteria from the root canals were transferred to tubes containing 5 mL of brain heart infusion (BHI) broth. Tubes were incubated and the appearance of broth turbidity was indicative of bacteria remaining in the root canal. There were no statistically significant differences between the experimental groups. However, NaOCl applied by the three methods tested, was significantly more effective than the saline solution (control group) in disinfecting the root canal.

Topics: Chi-Square Distribution; Cuspid; Dental Disinfectants; Dental Pulp Cavity; Dental Pulp Diseases; Drug Evaluation, Preclinical; Enterococcus faecalis; Gram-Positive Bacterial Infections; Humans; In Vitro Techniques; Root Canal Therapy; Sodium Hypochlorite; Therapeutic Irrigation

Six strains each of Enterococcus faecium and E. faecalis were investigated with respect to their resistance to heat and sodium hypochlorite. All enterococci survived the temperatures and holding times specified by the Department of Health (DoH) for the disinfection of 'foul and used' or 'infected' linen (65 degrees C for 10 min or 71 degrees C for 3 min). In addition, three strains (one E. faecium and two E. faecalis) could withstand 150 ppm available chlorine for 5 min, the treatment suggested by the DoH for the disinfection of heat labile materials. Further, our results showed that four strains of E. faecium were able to survive the British Standard for heat disinfection of bedpans (80 degrees C for 1 min). The significance of these findings with particular reference to the potential for enterococci to survive and disseminate in the hospital environment is discussed.

Topics: Cross Infection; Disinfectants; Disinfection; Enterococcus faecalis; Enterococcus faecium; Gram-Positive Bacterial Infections; Hot Temperature; Humans; Sodium Hypochlorite; Species Specificity

Solutions of 0.2% and 2% chlorhexidine, 0.2% and 2% sodium hypochlorite (NaOCl) and normal saline were tested for their efficacy in disinfecting dentinal tubules following root canal irrigation in vitro. Freshly extracted bovine incisor roots were prepared as cylindrical shapes, 4 mm high and 5 mm wide with a lumen 2.1 mm wide. After mechanical removal of the cementum and elimination of the smear layer on the dentine surface with EDTA and NaOCl, the root sections were autoclaved and the dentinal tubules infected with E. faecalis (NCTC 775) by incubating in yeast extract glucose broth for 1 week. The root canals were irrigated with 20 ml of an irrigant solution using a syringe. Each irrigant was used in six specimens. Dentine was removed from the canal wall by sterile burs of increasing diameter to give samples 100, 100-300 and 300-500 microns deep. The dentine samples were then cultured to determine the presence and quantity of remaining micro-organisms. The results indicated that chlorhexidine and NaOCl were equally effective antibacterial agents at similar concentrations against the test microorganism. They significantly reduced the bacterial counts in the first 100 microns of dentinal tubules, however up to 50% of dentine samples remained infected following use of both agents.

Topics: Analysis of Variance; Animals; Cattle; Chlorhexidine; Dental Pulp Cavity; Dentin; Disinfection; Enterococcus faecalis; Gram-Positive Bacterial Infections; Microbial Sensitivity Tests; Root Canal Irrigants; Sodium Hypochlorite