Can Probiotics Emerge as Effective Therapeutic Agents in Apical Periodontitis? A Review

How Adding Chlorhexidine or Metallic Nanoparticles Affects the Antimicrobial Performance of Calcium Hydroxide Paste as an Intracanal Medication: An In Vitro Study

“…The present study compared the in vitro antimicrobial activity of a CH paste mixed with different metallic salts (Ag 2 SO 4 , CuSO 4 , ZnCl 2 ) or CHT/CDP metallic nanoparticles to CH alone as a negative control and the CH + CHX paste as a positive control. The aim was to explore the potential value of metallic salts and CHT and CDP metallic nanoparticles as antimicrobial adjuvants for CH paste for eradicating E. faecalis and C. albicans , which are associated with root canal infections and are resistant to CH [ 3 , 10 , 11 ]. According to our results, only CHX was an effective antimicrobial adjuvant for CH paste, reducing the number of E. faecalis colonies after 24-h incubation.…”

“…Enterococcus faecalis ( E. faecalis ), a facultative anaerobic Gram-positive bacterium, and Candida albicans ( C. albicans ), the most common yeast in the oral cavity, are the species most frequently associated with root canal treatment failure and refractory apical periodontitis [ 3 ]. They have been detected in 22–77% [ 3 , 7 ] to 1–17% [ 11 ] of samples taken from infected root canals. They share characteristics such as dentin penetration ability and high pH tolerance, which may explain their resistance to CH-based intracanal medications [ 3 , 10 , 11 ].…”

“…They have been detected in 22–77% [ 3 , 7 ] to 1–17% [ 11 ] of samples taken from infected root canals. They share characteristics such as dentin penetration ability and high pH tolerance, which may explain their resistance to CH-based intracanal medications [ 3 , 10 , 11 ].…”

“…Although a number of in vitro and clinical studies have reported that CH + CHX is more effective in eliminating bacteria than CH alone [ 13 , 15 , 18 , 19 , 20 ], other studies have failed to replicate this effect [ 9 , 21 , 22 , 23 ]. Differences in drug concentrations, solubility related to the form of the vehicle (aqueous, viscous, or oil), and antimicrobial testing methods may have contributed to this discrepancy [ 11 , 13 , 16 ]. Metallic nanoparticles (MNPs) have also proven to be effective in controlling oral infections when coated on or incorporated into various materials [ 24 , 25 , 26 ].…”

Oral Osteomicrobiology: The Role of Oral Microbiota in Alveolar Bone Homeostasis

“…Probiotics have been used to induce beneficial skeletal effects for it can alter the composition and/or the metabolic activity of the gut microbiota, and regulate the immune response in the host, thereby providing beneficial effects for bone health ( Abboud and Papandreou, 2019 ; Pan et al., 2019 ; Schepper et al., 2020 ). Randomized clinical studies and animal studies demonstrated that oral administration of certain probiotics is a useful strategy for the management of periodontitis, periapical periodontitis, and peri-implantitis ( Huck et al., 2020 ; Cosme-Silva et al., 2021 ; Kumar et al., 2021 ). Increasing evidence have shown that these factors impact the alveolar bone metabolism mainly through modulating the oral microbiota and the host immune response (osteomicrobiological modulatory effects).…”