Antimicrobial activity of calcium hydroxide pastes on Enterococcus faecalis cultivated in Root Canal Systems

The effectiveness of calcium hydroxide pastes: Calen™ and PMCC-Calen™ associated to chemo-mechanical preparation was assessed on Enterococcus faecalis grown within root canals. Seventy incisors were inserted into TSB medium, sterilized and contaminated with E. faecalis. Culture medium was replaced each 24 h and incubated at 37oC for 72 h. After chemo-mechanical preparation, root canals were filled with Calen™ or PMCC-Calen™ (7 or 14 days). Pastes were removed and teeth were inserted into test tubes containing Enterococcosel broth. Calen™ paste (maintained for 7 and 14 days) induced 70% elimination of enterococci and PMCC-Calen™ 100% elimination only after maintenance for 14 days. These medications were significantly more effective (p<0.001) than chemo-mechanical protocol alone and PMCC-Calen™ maintained for 7 days, both incapable to eliminate the viability of enterococci. Calcium hydroxide pastes demonstrated important adjuvant effects in the elimination of enterococci during chemo-mechanical preparation of root canal systems. When associated with PMCC, calcium hydroxide pastes should be maintained for at least 14 days.

Download Full-text

Action of Chlorhexidine, Zingiber officinale, and Calcium Hydroxide on Candida albicans, Enterococcus faecalis, Escherichia coli, and Endotoxin in the Root Canals

The Journal of Contemporary Dental Practice ◽

10.5005/jp-journals-10024-1812 ◽

2016 ◽

Vol 17 (2) ◽

pp. 114-118 ◽

Cited By ~ 6

Author(s):

Marcia C Valera ◽

Sarah AC Oliveira ◽

Lilian E Maekawa ◽

Flávia GR Cardoso ◽

Adriana Chung ◽

...

Keyword(s):

Escherichia Coli ◽

Antimicrobial Activity ◽

Candida Albicans ◽

Calcium Hydroxide ◽

Enterococcus Faecalis ◽

Root Canal ◽

Zingiber Officinale ◽

Human Teeth ◽

Root Canals

ABSTRACT Aim The purpose of this in vitro study was to evaluate the antimicrobial activity of 2% chlorhexidine gel (CHX) as auxiliary chemical substance and intracanal medications on Candida albicans, Candida albicans, Enterococcus faecalis, Escherichia coli, and their endotoxins in the root canals. Materials and methods The study was conducted on 48 single-rooted human teeth divided into four groups (n = 12), according to intracanal medications used: (1) Calcium hydroxide + apyrogenic saline solution (Ca(OH)2 + SS), (2) 20% ginger glycolic extract (GEN), (3) calcium hydroxide + 20% ginger glycolic extract (Ca(OH)2 + GEN), (4) apyrogenic SS (control). Collections were made from the root canal content before preparation (baseline–S1), immediately after instrumentation (S2), 7 days after instrumentation (S3), after 14 days the action of intracanal medication (S4), and 7 days after removal of the intracanal medication (S5). The antimicrobial activity and endotoxin content were analyzed for all collections. The results were statistically analyzed by the Kruskal–Wallis and Dunn tests at a significance level of 5%. Results After instrumentation with CHX, there was complete elimination of E. coli and C. albicans, except for E. faecalis, which was significantly reduced and then completely eliminated after intracanal medication. There was significant reduction of endotoxin after instrumentation. Comparison of collection after instrumentation and intracanal medication revealed reduction of endotoxins in all groups; this reduction was greater in group Ca(OH)2 followed by the group GEN. Conclusion It was concluded that the instrumentation using CHX and intracanal medication used were able to eliminate the microorganisms from the root canal; the endotoxins were reduced, yet not completely eliminated. Clinical significance This study is important and relevant for searching alternatives during endodontic therapy, since it aims to study the effect of Zingiber officinale on microorganisms and endotoxins present in root canals. How to cite this article Valera MC, Oliveira SAC, Maekawa LE, Cardoso FGR, Chung A, Silva SFP, Carvalho CAT. Action of Chlorhexidine, Zingiber officinale, and Calcium Hydroxide on Candida albicans, Candida albicans, Enterococcus faecalis, Escherichia coli, and Endotoxin in the Root Canals. J Contemp Dent Pract 2016; 17(2):114-118.

Download Full-text

In vitro evaluation of the effectiveness of the chemomechanical preparation against Enterococcus faecalis after single- or multiple-visit root canal treatment

Brazilian Oral Research ◽

10.1590/s1806-83242007000400005 ◽

2007 ◽

Vol 21 (4) ◽

pp. 308-313 ◽

Cited By ~ 8

Author(s):

Eduardo Diogo Gurgel-Filho ◽

Nilton Vivacqua-Gomes ◽

Brenda Paula Figueiredo de Almeida Gomes ◽

Caio Cezar Randi Ferraz ◽

Alexandre Augusto Zaia ◽

...

Keyword(s):

Calcium Hydroxide ◽

Enterococcus Faecalis ◽

Root Canal ◽

Control Groups ◽

Single Visit ◽

Root Canals ◽

Multiple Visit ◽

Microbial Samples ◽

Chlorhexidine Gel

The purpose was to assess the elimination of Enterococcus faecalis in vitro in human mandibular premolars after chemomechanical preparation with or without the use of a calcium hydroxide dressing. After 60 days of contamination with E. faecalis, the root canals were prepared using the Crown-Down technique combined with 2% chlorhexidine gel irrigation. Then, the specimens were divided into two experimental groups, treated in a single visit or in multiple visits, and two control groups. The multiple-visit group received a dressing with calcium hydroxide for 14 days (CalenTM) and the single-visit group did not receive any medication. In the two control groups, the canals were filled with BHI after chemomechanical preparation with 2% chlorhexidine gel or distilled water. Microbial samples were taken from the root canals for colony forming unit count for each phase of the treatment using sterile paper points inside the root canal lumen. Data were ranked and analyzed by the Kruskal-Wallis statistical test. The residual microbial colonies were then assessed. The results showed that chemomechanical preparation using 2% chlorhexidine gel with no intra-canal dressing reduced by 100% the E. faecalis contamination of the root canal lumen. The calcium-hydroxide group that received the 14-day intra-canal dressing allowed a small number of bacteria to grow between visits, but without statistical differences between groups.

Download Full-text

Evaluation of Interference of Calcium Hydroxide-based Intracanal Medication in Filling Root Canal Systems

The Journal of Contemporary Dental Practice ◽

10.5005/jp-journals-10024-1061 ◽

2011 ◽

Vol 12 (5) ◽

pp. 368-371 ◽

Cited By ~ 3

Author(s):

Matheus Melo Pithon ◽

Deyla Duarte Vilela ◽

Manoel Matos Neto ◽

Alexandre Mascarenhas Villela

Keyword(s):

Calcium Hydroxide ◽

Clinical Significance ◽

Root Canal ◽

Canal System ◽

Root Canals ◽

Anterior Teeth ◽

Knowing That ◽

Group I ◽

Canal Systems ◽

Root Canal System

ABSTRACT Aim To evaluate the interference of the intracanal medication Calen® (SSWhite, São Paulo, Brazil) on the filling of simulated lateral canals. Materials and methods Twenty human anterior teeth were used. Before the endodontic filling procedures the access of cavity was made, and after this root canals were made in all the teeth to simulate the presence of lateral canals. After preparation, the teeth were randomly divided into two groups (n=10). In group I, the root canal system was filled directly after chemicalmechanical preparation; in group II, endodontic treatment was performed in multiple sessions, and after preparation the calcium hydroxide-based intracanal medication Calen® was inserted. After the period of 7 days, the root canals were vigorously irrigated and then they were filled. Next, the teeth were radiographed to verify the quality of the filling. Results The results demonstrated that the teeth treated in a single session, without calcium hydroxide medication, presented 47 canals out of 60 with radiographic evidence of filling, whereas the teeth in which intracanal medication was used, only 07 presented a radiographic image compatible with filling (p < 0.05). Conclusion The use of the calcium hydroxide-based medication Calen made it difficult to obtain a hermetic filling of the root canal system. Clinical significance The clinical significance of this work basing on the fact that once the dentist knowing that property obliteration of calcium hydroxide can be taken care when they are used in the presence of lateral canals. How to cite this article Vilela DD, Neto MM, Villela AM, Pithon MM. Evaluation of Interference of Calcium Hydroxide-based Intracanal Medication in Filling Root Canal Systems . J Contemp Dent Pract 2011;12(5):368-371.

Download Full-text

Effects of Contemporary Irrigant Activation Schemes and Subsequent Placement of an Interim Dressing on Bacterial Presence and Activity in Root Canals Associated with Asymptomatic Apical Periodontitis

Journal of Clinical Medicine ◽

10.3390/jcm9030854 ◽

2020 ◽

Vol 9 (3) ◽

pp. 854 ◽

Cited By ~ 7

Author(s):

Alexandre P. L. Carvalho ◽

Laura C. L. Nardello ◽

Fernanda S. Fernandes ◽

Fernanda P. Bruno ◽

Luiza R. Paz ◽

...

Keyword(s):

Calcium Hydroxide ◽

Root Canal ◽

Quantitative Polymerase Chain Reaction ◽

Apical Periodontitis ◽

Universal Primers ◽

Rrna Gene ◽

Root Canal Preparation ◽

Root Canals ◽

Mechanical Preparation ◽

Root Canal Disinfection

New tools for activating endodontic irrigants have evolved, yet their impact on root canal disinfection, in comparison to the passive placing of an inter-visit medication, have not yet been fully elucidated. The use of DNA- and rRNA-based methods may cast some new light on this issue, as they allow a comparison to be made between microbial presence and activity. Therefore, the aim of this single-arm intervention trial is to evaluate the antibacterial effect of endodontic procedures using both molecular methods. Root canal samples were obtained from 20 patients with asymptomatic apical periodontitis after each treatment step: access cavity, chemo-mechanical preparation, adjunctive procedures (XP-endo Finisher file and passive ultrasonic irrigation), calcium hydroxide medication, and 2nd-visit root canal preparation. DNA and cDNA from the samples were subjected to quantitative polymerase chain reaction with universal primers for the bacterial 16S rRNA gene. Chemo-mechanical preparation promoted a drastic reduction in bacterial levels and activity, whereas the adjunctive procedures did not make a significant contribution to further disinfection. At the 2nd visit, bacteria were active after the use of calcium hydroxide medication; however, they were significantly reduced after a 2nd-visit preparation. Consequently, the lowest bacterial levels were found at the end of the treatment. This clinical trial, which used an rRNA and rDNA combined approach, confirmed previous studies showing that root canal preparation represents the main strategy for root canal disinfection.

Download Full-text

In Vivo Study of Calcium Hydroxide Endodontic Treatment in Chronic Apical Periodontitis

ARS Medica Tomitana ◽

10.2478/arsm-2018-0034 ◽

2018 ◽

Vol 24 (4) ◽

pp. 164-167

Author(s):

Gheorghiu Irina-Maria ◽

Mitran Loredana ◽

M. Mitran ◽

Temelcea Anca-Nicoleta ◽

Scarlatesc Sanziana ◽

...

Keyword(s):

Antimicrobial Activity ◽

Calcium Hydroxide ◽

Root Canal ◽

Essential Role ◽

Apical Periodontitis ◽

Endodontic Treatment ◽

Microbial Load ◽

Root Canals

Abstract The aim of this study was to evaluate the in vivo efficiency of endodontic treatment with calcium hydroxide in chronic apical periodontitis by determining the microbial load from the endodontic space in different stages of treatment. The microbiological determinations that have been made have led to the conclusion that calcium hydroxide possesses a redoubltable antimicrobial activity, but only with the condition of long-lasting contact with the root canals. Another important result is the essential role of the rigorous biomechanical treatment of the root canals, intracanal medication with calcium hydroxide is addresses mostly to microorganisms located in root canal ramifications.

Download Full-text

Antimicrobial activity of calcium hydroxide associated with a new vehicle (Triethanolamine)

Brazilian Dental Science ◽

10.14295/bds.2016.v19i1.1179 ◽

2016 ◽

Vol 19 (1) ◽

pp. 43

Author(s):

Jaci Simi Junior ◽

Ricardo Machado ◽

Rafael Stiz ◽

Cristiane Figueiredo ◽

Luiz Pascoal Vansan ◽

...

Keyword(s):

Antimicrobial Activity ◽

Growth Inhibition ◽

Olive Oil ◽

Calcium Hydroxide ◽

Root Canal ◽

Culture Medium ◽

Significance Level ◽

Petri Dishes ◽

Antimicrobial Effectiveness

Objective: The aim of this study was to evaluate the antimicrobial effectiveness of calcium hydroxide associated with a two conventional (anesthetic liquid and olive oil) and a new vehicle (Triethanolamine). Material and methods: Initially, microorganisms were collected from four upper incisors presenting unsatisfactory root canal treatments and persistent apical periodontitis from the same patient using sterile absorbent paper cones placed inside the root canal following initial access and root filling removal. Next, they were grown in a BHI culture medium for 24 h. Afterwards, they were placed in 10 Petri dishes with 3 holes, where different formulations of the medications studied were placed. After 48 and 72 h, readings were taken of the growth inhibition halos. Results: After using Kruskal-Wallis test with significance level of 1% (α = 0.01) it was observed that, calcium hydroxide associated with Triethanolamine, produced results similar to those produced by the anesthetic liquid. Both combinations were superior to the association with olive oil. Conclusion: Considering the results of this in vitro study, it is possible to consider that Triethanolamine can be a viable alternative to be used as a vehicle associated with the calcium hydroxide.Keywords: Vehicles; Calcium hydroxide; Endodontics.

Download Full-text

Comparison of Antibacterial Effects of Photodynamic Therapy, Modified Triple Antibiotic Paste and Calcium Hydroxide on Root Canals Infected With Enterococcus faecalis: An In Vitro Study

Journal of lasers in medical sciences ◽

10.15171/jlms.2019.s5 ◽

2019 ◽

Vol 10 (5) ◽

pp. S23-S29 ◽

Cited By ~ 3

Author(s):

Mohammad Asnaashari ◽

Mohammad Jafar Eghbal ◽

Amirali Sahba Yaghmayi ◽

Mehdi Shokri ◽

Saranaz Azari-Marhabi

Keyword(s):

Photodynamic Therapy ◽

Calcium Hydroxide ◽

Enterococcus Faecalis ◽

Root Canal ◽

Control Group ◽

Root Canals ◽

Anterior Teeth ◽

Triple Antibiotic Paste ◽

Working Length

Introduction: A pivotal issue to achieve success in the treatment of the root canal is root canal disinfection. One of the most important bacteria that infect the root canal is Enterococcus faecalis. This study seeks to examine the effectiveness of 3 methods for disinfecting the root canal: photodynamic therapy, modified triple antibiotic paste (MTAP), and calcium hydroxide. Methods: Sixty-two single-rooted extracted anterior teeth were collected. After cleaning and disinfecting the teeth, their crowns were cut at the CEJ point. The root canals were shaped to the working length up to file F3 ProTaper (F1, F2, F3). EDTA 17% and sodium hypochlorite 2.5% were used for 5 minutes to wash and remove the smear layer, and then the apical foramen was sealed using composite. After that, the teeth were sterilized in an autoclave at 121°C for 15 minutes. Then 10 samples were taken randomly as the negative control. The remaining samples were immersed and cultivated in a suspension containing E. faecalis for 21 days. Then the samples were divided into 5 groups: 2 positive control groups, 1 group treated with the antibiotic paste with the concentration of 1 mg/mL, 1 group treated with calcium hydroxide, and 1 group treated with photodynamic therapy. Then, to collect the biofilm, the ProTaper file F4 was used. After that, the microbial suspension was provided and counting the colonies was carried out to compare the groups. Results: The findings indicated that the amount of CFU/mg of MTAP samples, including clindamycin, metronidazole, ciprofloxacin in the concentration of 1 mg/mL and photodynamic therapy and calcium hydroxide was lower than that in the control group. Antibiotic paste cleansed the root canal up to 99.9%. Photodynamic therapy reduced the amount of CFU/mg to 98.8%, and calcium hydroxide reduced the amount of CFU/mg to 94.13%. Conclusion: Using photodynamic therapy causes a reduction in the biofilm and inhibits the growth of the E. faecalis bacterium. In addition, in this study, MTAP with a concentration of 1 mg/mL was used, which expunged the bacteria completely. Meanwhile, calcium hydroxide had the weakest effect of all on the E. faecalis bacterium.

Download Full-text

Antimicrobial Activity of Calcium Hydroxide Synthesized from Indonesian Limestone against Enterococcus faecalis

Materials Science Forum ◽

10.4028/www.scientific.net/msf.1044.171 ◽

2021 ◽

Vol 1044 ◽

pp. 171-177

Author(s):

Myrna Nurlatifah Zakaria ◽

Ida Rodiyah Siti Halimah ◽

Atia Nurul Sidiqa ◽

Ira Artilia ◽

Arief Cahyanto

Keyword(s):

Calcium Hydroxide ◽

Enterococcus Faecalis ◽

Root Canal ◽

Antimicrobial Property ◽

Antimicrobial Effect ◽

Antimicrobial Activities ◽

Negative Control ◽

Root Canals ◽

Infected Root

Recurrent endodontic infections of treated teeth are mainly linked to microbial persistency in the root canal system. Enterococcus faecalis is a bacterium that is often identified in these recurrent infections. Calcium hydroxide (Ca(OH)2) is a widely used root canal medicament and is now being developed to be produced from natural materials. Ca(OH)2, which is synthesized from natural limestone from Palimanan, Indonesia, has a structure similar to Ca(OH)2, which is often used as a root canal medicament. The purpose of this study was to determine the antimicrobial property of Ca(OH)2 paste synthesized from natural limestone compared to conventional Ca(OH)2 paste. This study is an in vitro experimental study consists of 3 groups (n=24, namely, conventional Ca(OH)2 paste, limestone synthesized Ca(OH)2 paste, and saline as the negative control, for 2 intervals of time and evaluated by Total Plate Counting (TPC) method. Samples were mandibular first premolar root canal prepared by root canal preparation and contaminated with E. faecalis (ATCC 29212). The infected root canals of each group were treated by the medicaments, and samples from the root canals were taken on day 7 (n=4) and 14 (n=4). Results showed that both Ca(OH)2 groups had antimicrobial activities against E. faecalis. The limestone Ca(OH)2 paste group had the least amount of bacterial colonies on the 7th day compared to other groups. In contrast, on the 14th day, the conventional Ca(OH)2 paste had the least bacterial colonies. It can be concluded that the Ca(OH)2 paste synthesized from natural limestone has an antimicrobial effect on E. faecalis, the antimicrobial effect was higher on the 7th day but decreases on the 14th day, whereas the conventional Ca(OH)2 had a higher antimicrobial effect on day 14 compared to day 7. Further studies are expected to improve the long-term antimicrobial effectiveness and sustainability of the natural limestone synthesized Ca(OH)2 paste.

Download Full-text

Effect of biomechanical preparation and calcium hydroxide pastes on the antisepsis of root canal systems in dogs

Journal of Applied Oral Science ◽

10.1590/s1678-77572005000100019 ◽

2005 ◽

Vol 13 (1) ◽

pp. 93-100 ◽

Cited By ~ 6

Author(s):

Janir Alves Soares ◽

Mario Roberto Leonardo ◽

Léa Assed Bezerra da Silva ◽

Mário Tanomaru Filho ◽

Izabel Yoko Ito

Keyword(s):

Calcium Hydroxide ◽

Root Canal ◽

Conventional Technique ◽

Canal System ◽

Root Canals ◽

Significant Difference ◽

Canal Systems ◽

Root Canal System ◽

Low Incidence ◽

Level Of Significance

In the endodontic treatment of root canals with necrotic pulps associated with periapical radiolucent areas, one of the main objectives of treatment consists in eliminating the microorganisms spread throughout the ramifications of the root canal system. The scope of this study was to evaluate the antiseptic efficacy of biomechanical preparation and two calcium hydroxide-based pastes, in dogs' teeth with experimentally induced chronic periapical lesions. After initial microbiological sampling, instrumentation of the root canals was undertaken using the conventional technique, using K type files used in conjunction with a solution of 5.25% sodium hypochlorite. After ninety-six hours, further microbiological sampling was undertaken and Calen/CPMC or Calasept pastes were applied for 15 and 30 days. Ninety six hours after the removal of the medication, the third microbiological sampling was undertaken and finally histomicrobiological analysis followed using Brown & Brenn staining. The results were analyzed using the Kruskall-Wallis test, with a level of significance established at 5% (p<0.05). It was shown that the biomechanical preparation significantly reduced the number of colony forming units of microorganisms in root canals. In contrast, there was no significant difference between the antiseptic action of long-term dressings over two periods of action, although 30 days produced a greater reduction in the quantity of microorganisms and of positive microbiological cultures. In histological sections of the four experimental groups, similar microbiological patterns were shown (p>0.05), characterized by an elevated incidence of cocci, bacilli and filaments, predominantly gram-positive, in root canals, secondary canals and accessories, apical cementoplasts and dentinal tubules, but with a low incidence of microorganisms in areas of cementum resorption and the periapical lesion. The biomechanical preparation and intracanal dressing based on calcium hydroxide were important in the antisepsis of the root canal; however, both procedures did not produce significant changes in the microbiological aspects of the root canal system.

Download Full-text

Obturation Techniques in Primary Teeth

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v11i4.3254 ◽

2020 ◽

Vol 11 (4) ◽

pp. 5956-5959

Author(s):

Ahsana Asif ◽

Subramanian EMG

Keyword(s):

Calcium Hydroxide ◽

Root Canal ◽

Primary Teeth ◽

Clinical Success ◽

Three Dimensional ◽

Current Evidence ◽

Root Canals ◽

Advantages And Disadvantages ◽

Canal Systems ◽

Choice Of Technique

Dental caries is a global concern affecting children and adults. A pulpectomy is considered to be the treatment of choice to preserve the pulpally involved primary teeth. Among the various factors determining the clinical success of pulpectomy, proper obturation of the root canals plays an important role. Different obturation materials are being used for the obturation of the primary teeth root canal, which includes zinc oxide eugenol, calcium hydroxide, calcium hydroxide iodoform paste and combinations. These materials are available in different forms such as powder, powder and liquid, paste forms. Various techniques are available to introduce the obturation materials into the root canal systems. These techniques have been tried to create a three-dimensional fluid-tight seal of the root canals. This review article aims to highlight the different techniques that are being used for the obturation of primary teeth. Each technique has its advantages and disadvantages. Creation of voids within the obturation, underfilling or overfilling are the common problems that can be encountered during root canal obturation. These factors can compromise the clinical and radiographic success of pulpectomy treatment. With the current evidence, no definitive conclusions can be made to decide which is the best obturation technique in terms of clinical and radiographic success. The choice of technique selection depends on the clinician’s preference, cost-effectiveness, time consumption, ease of handling.

Download Full-text