Antibacterial efficacy of intracanal medicaments on bacterial biofilm: a critical review

Estrela, Carlos; Sydney, Gilson Blitzkow; Figueiredo, José Antônio Poli de; Estrela, Cyntia Rodrigues de Araújo

doi:10.1590/s1678-77572009000100002

Cited by 64 publications

(53 citation statements)

References 43 publications

(69 reference statements)

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“…This fact reinforces the concept of eliminating empty spaces that can harbor microorganisms (8,9,23,24). The RCT excellency is associated with the disinfection process, which involves removing microorganisms from the root canal system by emptying, cleaning and enlarging/shaping, combined with the use of antibacterial therapies (8,9,16,23,25,26). Based on the need to control the microbiota of infected root canals, some aspects are necessary in a therapeutic protocol.…”

Section: Operational Strategies That May Interfere On Successmentioning

confidence: 73%

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Characterization of Successful Root Canal Treatment

et al. 2014

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Knowing the outcome of root canal treatment (RCT) is determinant to substantiate the clinical decision making process, especially when RCT is weighed against the extraction of natural teeth or replacement by prosthetic elements. The ideal scenario in all clinical situations should combine healing/prevention of disease (apical periodontitis) and the functional retention of the tooth. Understanding the risk factors associated with endodontic failure is a key factor to increase the chances of success. The logical action is to reverse the existing disease, which requires intervention to neutralize the bacterial invasion and disrupt the bacterial biofilm within the complex anatomy. Success is more predictable when the immune host defenses are favorable. However, success has different meanings to the dentist, to the patient and to the tooth itself. The life of an endodontically treated tooth depends on the accuracy of the diagnosis and planning, excellence of disinfection, instrumentation and filling procedures (antimicrobial strategies, root canal shaping and coronal and apical seal) and finally the rehabilitation management. The interpretation of constant or intermittent pain and/or discomfort associated with apical periodontitis (AP) in endodontically treated tooth may be suggestive of endodontic failure. The success features of RCT, namely absence of pain, regression of AP, tight seal of canal and coronal spaces, and recovery of tooth function, must be reevaluated over time. In case of doubt between success and failure, cone beam computed tomography (CBCT) could be indicated for detection and precise localization of AP. The possibility of map reading on CBCT images characterizes the real multidimensional structure, providing accurate information on the presence, absence or regression of AP. The survival of an endodontically treated tooth implies understanding the biological and mechanical outcomes as multifactorial events over the individual's life span. The objective of this review of literature is to discuss relevant factors associated with patient's health, tooth and dentist that could account for a successful RCT.

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Section: Operational Strategies That May Interfere On Successmentioning

confidence: 73%

“…The presence of biofilm in the root canal system is a challenge to the outcome of RCT (26,37). The active participation of mechanical action of endodontic instruments combined with antimicrobial strategies appears to be crucial for decreasing root canal infection.…”

Section: Sanitization Processmentioning

confidence: 99%

Characterization of Successful Root Canal Treatment

et al. 2014

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“…Several studies have considered sodium hypochlorite as the substance that agglutinates the largest number of characteristics for its use as irrigant in infected root canals [4,5,8,9]. Bhardwaj et al [34] reported that passive ultrasonic irrigation with1% sodium hypochlorite was effective to completely remove E. faecalis biofilms compared to natural substances (Aloe Vera, Nona juice and propolis).…”

Section: Discussionmentioning

confidence: 99%

“…Bacterial growth is enhanced by complex anatomy of root canal system, inaccessible areas to endodontic instruments, which represent an ideal environment for bacterial biofilm structuring [2,3]. Bacterial biofilm is structured from microorganisms attachment on a solid surface embedded in an extracellular matrix, resistant to antimicrobial agents, what favors the maintenance of infection process and represents a special challenge for successful root canal treatment [4,5].…”

Section: Introductionmentioning

confidence: 99%

Antibacterial action of red and green propolis extract in infected root canal

Endo

Estrela

Alencar

et al. 2017

Rev. Odonto Ciênc. (Online)

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OBJECTIVE: This study investigated the antibacterial action of 30% red propolis, 40% green propolis and 2.5% sodium hypochlorite with irrigation protocols in infected root canals. METHODS: During 60 days, twenty-four root canals were inoculated with E. faecalis. In all experimental groups were performed root canal preparation and two irrigation protocols -passive ultrasonic irrigation and conventional irrigation. In the groups 1, 3, 5 and 7 it were made root canal preparation associated to conventional irrigation with 30% propolis, 40% propolis, 2.5% sodium hypochlorite and distilled water, respectively. In groups 2, 4, 6 and 8 it was made root canal preparation associated with passive ultrasonic irrigation with the solutions described above. The groups 9 and 10 were the controls (negative and positive). Samples of the root canals were collected and immersed in 7 mL of BHI, for 48 hours, at 37ºC. Bacterial growth was analyzed by turbidity of the culture medium. RESULTS: Antibacterial action was observed of 30% red propolis and 2.5% sodium hypochlorite when used passive ultrasonic irrigation and conventional irrigation after 20 minutes, but in 72 hours it was not effective. CONCLUSION: The irrigating agents and protocols were not effective to eliminate the microorganisms of the infected root canals. Clinical Significance: Propolis presents potential for clinical application due to its antimicrobial, anti-inflammatory, antioxidant and low toxicity properties. Key words: Endodontic; Propolis; Sodium hypochlorite Ação antimicrobiana do extrato de própolis vermelho e verde em canais radiculares infectados RESUMO OBJETIVO: Investigar a ação antibacteriana do própolis vermelhos 30%, do própolis verde 40% e do hipoclorito de sódio 2,5% com protocolos de irrigação em canais radiculares infectados. MÉTODOS: Durante 60 dias, vinte e quatro canais radiculares foram inoculados com E. faecalis. Em todos os grupos experimentais foi realizado o preparo do canal radicular e dois protocolos de irrigação -irrigação ultra-sônica passiva e irrigação convencional. Nos grupos 1, 3, 5 e 7 foi feito o preparo do canal radicular associado à irrigação convencional com própolis 30%, própolis 40%, hipoclorito de sódio 2,5% e água destilada, respectivamente. Nos grupos 2, 4, 6 e 8 foi feito o preparo do canal radicular associado à irrigação ultra-sônica passiva com as soluções descritas acima. Os grupos 9 e 10 foram os controles (negativos e positivos). Amostras dos canais radiculares foram coletadas e imersas em 7 mL de BHI, durante 48 horas, a 37ºC. O crescimento bacteriano foi analisado por turvação do meio de cultura. RESULTADOS: Ação antibacteriana foi observada com própolis vermelho 30% e hipoclorito de sódio 2,5% quando utilizado irrigação ultra-sônica passiva e irrigação convencional após 20 minutos, porém, após 72 horas as substâncias não foram efetivas. CONCLUSÃO: Os agentes de irrigação e os protocolos não foram efetivos para eliminar os microorganismos dos canais radiculares infectados.

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“…27 The microorganisms used as antimicrobial activity indicators were strains of Enterocococus faecalis, Pseudomonas aeruginosa, Candida albicans, and Kocuria rizophila, selected because of their association with either primary or persistent endodontic infections. 28 BRETAS LP et al All groups presented antimicrobial activity against E. faecalis. This finding corroborates various studies 20,22,23,29 that have shown acceptable bactericide effects among various natural extracts and Ca(OH) 2 associated with CPMC and chlorhexidine against E. faecalis.…”

Section: Antimicrobial Activitymentioning

confidence: 99%

Atividade antimicrobiana e biocompatibilidade de um medicamento intracanal à base de hidróxido de cálcio e aloe vera

Bretas

Lima

Raposo

et al. 2017

Rev. Bras. Odontol.

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Objective: to investigate the antimicrobial activity and biocompatibility of the calcium hydroxide [Ca(OH)2] + propylene glycol (PG) + aloe vera (AV) paste in comparison with other pastes used as intracanal medication. Material and Methods: there was evaluated 3 intracanal medication based on calcium hydroxide and propylene glycol, varying only the third component. In group 1, the third component was camphorated paramonochlorophenol (CPMC); in group II, chlorhexidine (CHX); and in group III, aloe vera. The antimicrobial activity was analyzed through the direct contact of the intracanal medication pastes with strains of Enterococcus faecalis; Kocuria rhizophila; Pseudomonas aeruginosa and Candida albicans. The biocompatibility was evaluated in subcutaneous tissue of rats during experimental 7, 21 and 63 days. Results: it was observed that the Group II showed the best results regarding antimicrobial activity, followed by group III and I. The Ca(OH)2 + PG + AV paste was considered biocompatible since it presented discrete fibrosis and suggestive histological characteristics of normal healing after 63 days, approaching the control group. Conclusion: the association of Ca (OH)2 + PG + AV showed antibacterial activity and adequate biocompatibility when compared with commonly pastes used as intracanal medication.

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Antibacterial efficacy of intracanal medicaments on bacterial biofilm: a critical review

Cited by 64 publications

References 43 publications

Characterization of Successful Root Canal Treatment

Characterization of Successful Root Canal Treatment

Antibacterial action of red and green propolis extract in infected root canal

Atividade antimicrobiana e biocompatibilidade de um medicamento intracanal à base de hidróxido de cálcio e aloe vera

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