Objective: The aim of this study is to compare the cytotoxicity of triple antibiotic paste (TAP) with an anti-inflammatory drug (TAP+Catafast-TAPC) in nano and regular formulations versus calcium hydroxide as intracanal medicaments. Methods: The TAPC drugs extraction were made in cell culture media MEM-E (Eagle’s minimal essential medium) using concentration of 10 mg/mL of each sample for seven days. Inhibitory concentrations (IC50 values) were determined for each extract. A human fibroblasts cell line was used to evaluate the cytotoxicity of different concentrations (10, 0.625 and 0.07 mg/mL) using MTT essay. The cell viability was measured after 24 h, 48 h and 7 days for all concentrations of the drugs. Flow cytometry analysis was carried out to identify the effect of materials on apoptosis/necrosis. Statistical analysis for the obtained results was done by one-way ANOVA. Results: The results revealed that cell viability was inversely proportional to the duration of treatment in all of the groups. Calcium hydroxide (Control group) demonstrated a significantly greater cytotoxic effect, followed by Nano Triple Antibiotic Paste with Catafast as an anti-inflamatory drug (Nano TAPC), while Triple Antibiotic Paste with Catafast (TAPC) had the least cytotoxic effect. Nano TAPC has the greatest apoptotic value, while TAPC had the least when compared with the reference group, with no significant difference between groups (P<0.05). Conclusion: The cytotoxic effect of Nano TAPC was lower than that of calcium hydroxide and higher than that of TAPC. Although Nano TAPC has the highest apoptotic value when compared to TAPC and calcium hydroxide but still there is no statistically significant difference between them.

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Background: Flare-ups may occur after root canal treatment which consist of acute exacerbation of asymptomatic pulpal and/or periradicular pathologic condition. The causative factors of interappointment pain include mechanical, chemical or microbial irritation to the pulp or periradicular tissues. The potential role of microorganisms in interappointment pain is why the success of endodontic treatment depends on complete eradication of microorganisms capable of causing an intraradicular or extraradicular infection. This can be achieved by mechanical cleaning and shaping, in conjunction with irrigation and antibacterial agents. The aim of this study was to assess the ability of triple antibiotic paste with the anti-inflammatory drug diclofenac potassium versus calcium hydroxide used as an intra-canal medication in reducing post-operative pain. Methods: 84 patients with asymptomatic uniradicular necrotic teeth were randomly assigned into two groups according to the intra-canal medication used: calcium hydroxide group (CH) and triple antibiotic paste with diclofenac potassium group (TAPC). In the first treatment session, intracoronal cavity preparation was performed after rubber dam isolation followed by chemo-mechanical preparation using rotary Protaper Universal files with saline irrigation followed by intra-canal medication placement then postoperative pain was assessed at 24, 48 and 72 hours postoperatively using Visual Analogue Scale (VAS). In the second treatment session, intracanal medications were removed by irrigation using saline followed by obturation. Results: Both intracanal medicaments resulted in a statistically significant decrease in mean pain value from 24 to 48 and 72 hours postoperatively. While when comparing both groups, TAPC intracanal medication showed less post-operative pain compared to that of the CH group at 24, 48 and 72 hours with a statistically significant difference at 48 hours only. Conclusion: Both intracanal medicaments were efficient in reducing post-operative pain in asymptomatic uniradicular necrotic teeth. Trial registration: Clinicaltrial.gov NCT02907489, 20/09/2016.

The root end filling materials antibacterial properties is a must nowadays as there is none of the available root canal filling materials can provide a hermetic seal.The aim of the current study isto compare the antibacterial effect of Gray Portland cement and white MTA angelus in the conventional and nano-particle forms. Agar diffusion test was used to examine the tested materials, where Enterococcus faecalis ATCC29212 (American Type Culture Collection 29212) cultured in agar BHI (brain heart infusion) in anaerobic condition at 37 o Cfor 72 hours.Then, the agar was added to 12 sterile petri plates and the prepared bacterial suspension was inoculated. Punch holes of 6 mm diameter were formed on each agar plate and each 3 plates were filled with the materials tested (Portland cement, Nano-Portland cement, MTA angelus, and Nano-MTA angelus). The results showed that conventional Portland cement has the highest antibacterial property, followed by Nano-Portland cement, MTA angelus, Nano-MTA angelus respectively with significant difference according to Kruskal Wallis ANOVA test followed by Mann-Whitney U test.

Background: Flare-ups may occur after root canal treatment which consist of acute exacerbation of asymptomatic pulpal and/or periradicular pathologic condition. The causative factors of interappointment pain include mechanical, chemical or microbial irritation to the pulp or periradicular tissues. The potential role of microorganisms in interappointment pain is why the success of endodontic treatment depends on complete eradication of microorganisms capable of causing an intraradicular or extraradicular infection. This can be achieved by mechanical cleaning and shaping, in conjunction with irrigation and antibacterial agents. The aim of this study was to assess the ability of triple antibiotic paste with the anti-inflammatory drug diclofenac potassium versus calcium hydroxide used as an intra-canal medication in reducing post-operative pain. Methods: 84 patients with asymptomatic uniradicular necrotic teeth were randomly assigned into two groups according to the intra-canal medication used: calcium hydroxide group (CH) and triple antibiotic paste with diclofenac potassium group (TAPC). In the first treatment session, intracoronal cavity preparation was performed after rubber dam isolation followed by chemo-mechanical preparation using rotary Protaper Universal files with saline irrigation followed by intra-canal medication placement then postoperative pain was assessed at 24, 48 and 72 hours postoperatively using Visual Analogue Scale (VAS). In the second treatment session, intracanal medications were removed by irrigation using saline followed by obturation. Results: Both intracanal medicaments resulted in a statistically significant decrease in mean pain value from 24 to 48 and 72 hours postoperatively. While when comparing both groups, TAPC intracanal medication showed less post-operative pain compared to that of the CH group at 24, 48 and 72 hours with a statistically significant difference at 48 hours only. Conclusion: Both intracanal medicaments were efficient in reducing post-operative pain in asymptomatic uniradicular necrotic teeth. Trial registration: Clinicaltrial.gov NCT02907489, 20/09/2016.

This study aimed to compare the antimicrobial effect of Nano-Silver Irrigant, Sodium Hypochlorite and Chlorohexidine against Enterococcus Faecalis bifilm. 60 Sixty, recently extracted, sound maxillary anterior teeth with completely formed apices and straight roots were selected in this study. Canals were instrumented using the Protaper Next system (Dentsply Sirona) 1 mm shorter from the apical foramen up to size X5 ( size# 50/06). Sterility of the teeth after complete root canal cleaning and shaping were achieved by autoclaving for 15 min at 121ºC with the teeth immersed in distilled water. Enterococcus Faecalis Biofilm was prepared by mixing 5 mL of the bacterial inoculum with sterilized BHI, then inoculated in teeth samples for 60 days. Teeth were then divided after the incubation period into three groups; 20 teeth each, and were treated by delivering the each of the tested irrigating solution using sterile plastic syringes. The first group was treated with Nano-Silver 0.02mol/L (2000ppm) while the second was treated using with Sodium Hypochlorite (NaOCl) 5.25% and the third was treated usinwith Chlorohexidine (CHX) 2.0%. Serial rinses ensured 5 minutes contact period between the aseptic solution and the bacteria. Sterile paper points size 50 were introduced into the canals and maintained for 3 min for sample collection, after which the paper points were placed in test tubes containing 2ml of sterile saline and several dilutions were prepared. 100 µL of each dilution was applied to the blood agar culture plates and incubated at 37ºC for 24 hours. A classical bacterial counting technique was used for each group after the treatment application for the recovery of viable E. faecalis on agar plates The results showed that the NaOCl had the highest antibacterial activity with high statistically significant difference with the other groups followed by the chlorhexidine group which also show statistically significant difference than the other two groups, then came the nano silver irrigant group which showed the lowest antibacterial activity among all the groups with statistically significant difference with them.

Silver ions and Nano silver particles have a great importance as they used as root canal sealers due to their antimicrobial properties. However biocompatibility and satisfactory physico-chemical properties should be achieved to directly contact the root canal sealers with the surrounding tissues. This study aimed to compare the cytotoxicity and genotoxicity of silver-zeolite with silver nanoparticles. MRC-5 cell line was used as an in vitro model. The cell viability was assessed using MTT cytotoxicity assay. Genotoxicity was tested by alkaline single cell gel electrophoresis (comet assay) for measuring DNA damage. Each material was tested in different concentrations (100mg/ml, 50mg/ml, 25mg/ml, 12.5mg/ml, and 6.25mg/ml). The results showed that silver zeolite has lower cytotoxic effect than silver nanoparticles among all different concentrations used in the study. Also the results showed unaccepted cytotoxicity levels for silver nanoparticles on concentrations of 100mg/ml and 50mg/ml. Data obtained from the Comet assay indicated that both silver nanoparticles and silver zeolite causes DNA damage with no significant difference between the two treated groups.(3996) Yousra Mohamed Nashaat, et al.

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