scholarly journals Biofilm reduction potential of 0.02% polyhexanide irrigation solution in several types of urethral catheters

2021 ◽  
Author(s):  
Florian H. H. Brill ◽  
Julia Hambach ◽  
Christian Utpatel ◽  
Diana Mogrovejo ◽  
Henrik Gabriel ◽  
...  
Keyword(s):  
Membrane Filtration ◽  
Saline Solution ◽  
Bacterial Biofilm ◽  
Plate Count ◽  
Microbial Biofilms ◽  
Significant Difference ◽  
Irrigation Solution ◽  
Term Tolerability

Abstract Background Long-term use of urethral catheters is associated with high risk of urinary tract infection (UTI) and blockage. Microbial biofilms are a common cause of catheter blockage, reducing their lifetime and significantly increasing morbidity of UTIs. A 0.02% polyhexanide irrigation solution developed for routine mechanical rinsing shows potential for bacterial decolonization of urethral catheters and has the potential to reduce or prevent biofilm formation.Methods Using an in vitro assay with standard market-leading types of catheters artificially contaminated with clinically relevant bacteria, assays were carried out to evaluate the biofilm reduction and prevention potential of a 0.02% polyhexanide solution vs. no intervention (standard approach) and irrigation with saline solution (NaCl 0.9%). The efficiency of decolonization was measured through microbial plate count and membrane filtration.Results Irrigation using a 0.02% polyhexanide solution is suitable for the decolonization of a variety of transurethral catheters. The effect observed is significant compared to irrigation with 0.9% saline solution (p = 0.001) or no treatment (p = 0.018). No significant difference was found between irrigation with 0.9% saline solution and no treatment (p = 0.94). Conclusions The polyhexanide and standard saline solutions are able to reduce bacterial biofilm from urinary catheters, showing a combination of mechanical and antibacterial effects. The data supports a prevention strategy to reduce thick biofilms, which are characteristically difficult to be efficiently removed. Further research is required to evaluate the long-term tolerability and efficacy of polyhexanide in clinical practice.

scholarly journals Biofilm reduction potential of 0.02% polyhexanide irrigation solution in several types of urethral catheters

BMC Urology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Florian H. H. Brill ◽  
Julia Hambach ◽  
Christian Utpatel ◽  
Diana C. Mogrovejo ◽  
Henrik Gabriel ◽  
...  
Keyword(s):  
Membrane Filtration ◽  
Saline Solution ◽  
Bacterial Biofilm ◽  
Plate Count ◽  
Vitro Assay ◽  
Significant Difference ◽  
Irrigation Solution ◽  
Clinically Relevant Bacteria

Abstract Background Long-term use of urethral catheters is associated with high risk of urinary tract infection (UTI) and blockage. Microbial biofilms are a common cause of catheter blockage, reducing their lifetime and significantly increasing morbidity of UTIs. A 0.02% polyhexanide irrigation solution developed for routine mechanical rinsing shows potential for bacterial decolonization of urethral catheters and has the potential to reduce or prevent biofilm formation. Methods Using an in vitro assay with standard market-leading types of catheters artificially contaminated with clinically relevant bacteria, assays were carried out to evaluate the biofilm reduction and prevention potential of a 0.02% polyhexanide solution versus no intervention (standard approach) and irrigation with saline solution (NaCl 0.9%). The efficiency of decolonization was measured through microbial plate count and membrane filtration. Results Irrigation using a 0.02% polyhexanide solution is suitable for the decolonization of a variety of transurethral catheters. The effect observed is significant compared to irrigation with 0.9% saline solution (p = 0.002) or no treatment (p = 0.011). No significant difference was found between irrigation with 0.9% saline solution and no treatment (p = 0.74). Conclusions A 0.02% polyhexanide solution is able to reduce bacterial biofilm from catheters artificially contaminated with clinically relevant bacteria in vitro. The data shows a reduction of the viability of thick bacterial biofilms in a variety of commercially available urinary catheters made from silicone, latex-free silicone, hydrogel-coated silicone and PVC. Further research is required to evaluate the long-term tolerability and efficacy of polyhexanide in clinical practice.

Biofilm prevention potential of 0.02% polyhexanide irrigation solution in urethral catheters under practice-like in vitro conditions

2020 ◽  
Author(s):  
Florian H. H. Brill ◽  
Julia Hambach ◽  
Christian Utpatel ◽  
Diana Mogrovejo ◽  
Henrik Gabriel ◽  
...  
Keyword(s):  
Fluorescence Microscopy ◽  
Saline Solution ◽  
Bacterial Biofilm ◽  
Microbial Biofilms ◽  
Irrigation Solution ◽  
Term Tolerability ◽  
Prevention Potential ◽  
Saline Solutions

Abstract Background Long-term use of indwelling urethral catheters is associated with high risk of urinary tract infection (UTI) and blockage. Microbial biofilms are a common cause of catheter blockage, reduce their lifetime and significantly increase morbidity of UTIs. A 0.02% polyhexanide irrigation solution developed for routine mechanical rinsing shows potential for bacterial decolonization of suprapubic and indwelling urethral catheters and has the potential to reduce or prevent biofilm formation. Methods Using a practice-like in vitro assay and standard silicon catheters, artificially contaminated with clinically relevant bacteria, assays were carried out to evaluate the biofilm reduction and prevention potential of polyhexanide vs. no intervention (standard approach) and irrigation with saline solution (NaCl 0.9%). The biofilm mass was measured by crystal violet staining and fluorescence microscopy. Results Irrigation with a 0.02% polyhexanide solution reduced the biofilm mass by approx. 85% vs. non-treated catheters. Standard 0.9% saline solution was able to reduce the biofilm mass by approx. 50%. Fluorescence microscopy showed that polyhexanide is able to destroy bacteria in the biofilm, albeit only those cells on the upper layers. Conclusions The polyhexanide and standard saline solutions are able to reduce bacterial biofilm from urinary catheters, showing a combination of mechanical and antibacterial effects. The data supports a prevention strategy to avoid the formation of a thick biofilm, which is characteristically difficult to be efficiently removed. Further research is required to evaluate the long-term tolerability and efficacy of polyhexanide in clinical practice.

scholarly journals 2287. Real-world Use of Tedizolid Phosphate: A Case Series of Long-Term Tolerability

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S784-S784
Author(s):  
Taylor Morrisette ◽  
Beatriz Da Silva ◽  
Scott W Mueller ◽  
Laura Damioli ◽  
Martin Krsak ◽  
...  
Keyword(s):  
White Blood Cells ◽  
Case Series ◽  
Multidrug Resistant ◽  
Primary Objective ◽  
Term Therapy ◽  
Gram Positive ◽  
Safe Alternative ◽  
Term Tolerability

Abstract Background Tedizolid is an oxazolidinone antibiotic with broad-spectrum Gram-positive activity approved for the treatment of skin and skin structure infections with a 6-day course. Oxazolidinone antibiotics represent appealing options for prolonged antimicrobial therapy due to their available oral formulations with excellent bioavailability and potent in vitro activity against various multidrug-resistant Gram-positive organisms, Mycobacterium spp., and Nocardia spp. Although tedizolid and linezolid offer a similar clinical spectrum based on antimicrobial activity alone, long-term use of linezolid is often limited by serious adverse effects. Preliminary assessments have suggested better tolerability with tedizolid; however, these are limited by shorter exposure duration. The objective of this study was to evaluate the long-term safety and tolerability of tedizolid. Methods Retrospective cohort of adult patients receiving tedizolid for ≥ 28 days, with baseline complete blood cell (CBC) indices available, and CBC indices drawn ≥ 14 days into tedizolid course. The primary objective was to evaluate the long-term tolerability of tedizolid. Results 13 patients met inclusion criteria: median age 61 years (IQR, 51–64 years), 69% male, 85% Caucasian. The majority of patients utilized tedizolid for suppression (85%), and the median duration of tedizolid was 113 days (IQR, 71–204 days). There were no differences in CBC indices when comparing baseline to last laboratory draw throughout tedizolid exposure: platelets (baseline: 203 x 109/L (IQR, 186–283 x 109/L) vs. last: 196 x 109/L (IQR, 161–303 x 109/L; p = 0.65), hemoglobin (baseline: 9.8 g/dL (IQR, 8.8–11.1 g/dL) vs. last: 11.7 g/dL (IQR, 11.0–13.1 g/dL; p = 0.10), and white blood cells (baseline: 6.2 x 109/L (IQR, 5.6–7.6 x 109/L) vs. last: 6.5 x 109/L (IQR, 6.3–7.3 x 109/L; p = 0.45). The final laboratory draws were obtained a median of 78 days (IQR, 44–119 days) into therapy. No patients experienced peripheral neuropathy, optic neuritis/visual changes, or serotonin syndrome during treatment/suppression with tedizolid during the period evaluated. Conclusion Long-term therapy with tedizolid appears to be well-tolerated. Treatment and suppression with tedizolid seems to be a safe alternative to linezolid. Disclosures All authors: No reported disclosures.

scholarly journals THE EFFECTIVENESS OF SOURSOP LEAF EXTRACT AGAINST GROWTH OF AGGREGATIBACTER ACTINOMYCETEMCOMITANS ATCC® 6514™ IN VITRO

2018 ◽  
Vol 11 (12) ◽  
pp. 411
Author(s):  
Ameta Primasari ◽  
Minasari Nasution ◽  
Nurul Hidayati Arbi ◽  
Dini Permata Sari ◽  
Mohammad Basyuni
Keyword(s):  
Leaf Extract ◽  
Brain Heart Infusion ◽  
Aggregatibacter Actinomycetemcomitans ◽  
Negative Control ◽  
Plate Count ◽  
Control Group ◽  
Control Group Design ◽  
Significant Difference ◽  
Mueller Hinton Agar

Objective: The objective of this study was to determine the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) antibacterial power of soursop leaf extract on Aggregatibacter actinomycetemcomitans (Aa) ATCC® 6514™ growth.Methods: This study was experimental laboratory with post-test only control group design and consists of 8 treatment groups that were soursop leaf extract group with concentration 50%, 25%, 12.5%, 6.25%, 3.125%, and 1.5625% as well as negative control groups were brain heart infusion broth (BHIB) media and chlorhexidine as positive controls. Each treatment was done 3 repetitions. Testing the effectiveness of soursop leaf extract using dilution methods on BHIB and subculture media on Mueller Hinton Agar (MHA) media. The number of Aa ATCC® 6514 ™ colonies was calculated manually using the total plate count method on the MHA media. Data were analyzed using Kruskal–Wallis test (p<0.05) followed by least significance different (LSD) test to see the significant mean difference between treatment groups.Results: Concentration of MIC from soursop leaf extract on Aa ATCC® 6514™ growth was 1.5625% and MBC was 6.25%. LSD assay results showed significant difference effect (p<0.05) Aa ATCC® 6514™ from each treatment group.Conclusion: Soursop leaf extract has antibacterial effectivity against Aa ATCC® 6514 ™.

scholarly journals Pulp tissue dissolution capacity of QMix 2in1 irrigation solution

2015 ◽  
Vol 09 (03) ◽  
pp. 423-427 ◽  
Author(s):  
Dilara Arslan ◽  
Mehmet Burak Guneser ◽  
Alper Kustarci ◽  
Kursat Er ◽  
Seyda Herguner Siso
Keyword(s):  
Saline Solution ◽  
In Vitro Study ◽  
Control Group ◽  
Pulp Tissue ◽  
Tissue Samples ◽  
Canal Irrigation ◽  
Root Canal Irrigation ◽  
Significant Difference ◽  
Group 2

ABSTRACT Objective: The aim of this study was to evaluate the tissue dissolution efficacy of four root canal irrigation solutions (sodium hypochlorite [NaOCl], chlorhexidine gluconate [CHX], Octenidine [OCT], and QMix 2in1) on bovine pulp tissue. Materials and Methods: Fifty bovine pulp tissue samples, each weighing 6.55 mg, were prepared and randomly divided into four experimental groups and one control group (n = 10) according to the dissolution irrigants used: (1) 5.25% NaOCl group; (2) 2% CHX group; (3) OCT group; (4) QMix 2in1 group; and (5) control group (saline solution). These samples were then placed into special bovine dentin reservoir models and immersed for 1 h with each test solution (0.1 mL of each) at room temperature. The pulp samples were then blotted dry and weighed again. The percentage of weight loss was calculated. Statistically analyzed with one-way analysis of variance and post-hoc Tukey tests (P = 0.05). Results: Saline solution did not dissolve the bovine pulp tissue. All groups, except OCT, dissolved pulp samples more effectively than the control group (P < 0.05). The highest tissue dissolution was observed in 5.25% NaOCl group (P < 0.05). No statistically significant difference was found between the tissue-dissolving effect between QMix 2in1 and those of 2% CHX. Conclusions: Within the limitations of this in vitro study, NaOCl exhibited the best tissue-dissolving effect out of all solutions tested. CHX and QMix 2in1 were able to dissolve pulp tissue but less than NaOCl. OCT and saline solutions could not exhibit significantly tissue-dissolving effectiveness. This study shown that QMix 2in1 has little capacity to dissolve pulp tissue therefore used alone is not sufficient for this purpose.

Comparison of Three Topical Fluorides Using Computer Imaging

2006 ◽  
Vol 30 (2) ◽  
pp. 139-144 ◽  
Author(s):  
Muhammad Faisal Khattak ◽  
John Patrick Conry ◽  
Ching-Chang Ko
Keyword(s):  
In Vitro Study ◽  
Analysis Of Covariance ◽  
Fluoride Varnish ◽  
Permanent Teeth ◽  
P Value ◽  
P Values ◽  
Significant Difference ◽  
Topical Fluorides

The purpose of this in vitro study was to evaluate the short and long-term effectiveness of fluoride varnish and compare it with the two most commonly used topical fluorides, i.e., fluoride gel and foam.A second purpose of the study was to compare the effectiveness of these preparations on primary and permanent teeth. Enamel slabs with a thickness of 500 microns were obtained from caries free primary molars and premolars. They were divided into four groups: control, foam (F), gel (G) and varnish (V). Fluorides were applied to the enamel slabs according to the manufacturer's instructions and were placed in a 5.1 pH acidic gel for one week. The amount of demineralization from the enamel was measured by calculating the amount of light reflected from these surfaces. This was done by using a Charged Couple Device attached to a high resolution microscope with image processing software, Optima 5.22. The enamel slabs were placed in a freshly prepared acidic gel for a second week without application of fluorides. This was done to mimic a situation where fluoride is eventually brushed away from teeth. Reflective images were recorded under the previously described conditions. A two-way analysis of covariance was used to compare the treatments. The results showed no statistically significant difference (with Bonferroni correction) in the effectiveness of different fluoride preparations over the short-term (Week I comparison; p-values: F vs. G 0.079, F vs.V 0.030, G vs.V 0.44). However, the long-term protection provided by fluoride varnish was far more than fluoride gel and foam (Week II comparison; p-values: F vs. G 9X10-5 , F vs.V 7X10-8, G vs.V 1X10-4). Fluorides were equally effective for both primary and permanent enamels (p-value 0.24). The results of this study suggest that fluoride varnish is beneficial for use with white spot lesions, newly erupted permanent teeth and early decalcification in primary dentition.

scholarly journals In vitro Inhibition of Biofilm Formation on Silicon Rubber Voice Prosthesis: Α Systematic Review and Meta-Analysis

ORL ◽  
2021 ◽  
pp. 1-20
Author(s):  
Alexios Tsikopoulos ◽  
Efi Petinaki ◽  
Charalampos Festas ◽  
Konstantinos Tsikopoulos ◽  
Gabriele Meroni ◽  
...  
Keyword(s):  
Surface Modification ◽  
Silicone Rubber ◽  
Subgroup Analysis ◽  
Biofilm Formation ◽  
Meta Analysis ◽  
Bacterial Biofilm ◽  
Biofilm Inhibition ◽  
Voice Prostheses ◽  
Significant Difference

<b><i>Introduction:</i></b> Biofilm formation on voice prostheses is the primary reason for their premature implant dysfunction. Multiple strategies have been proposed over the last decades to achieve inhibition of biofilm formation on these devices. The purpose of this study was to assess the results of the available in vitro biofilm inhibition modalities on silicone rubber voice prostheses. <b><i>Methods:</i></b> We conducted a systematic search in PubMed, Embase, and the Cochrane Central Register of Controlled Trials databases up to February 29, 2020. A total of 33 in vitro laboratory studies investigating the efficacy of different coating methods against <i>Candida</i>, <i>Staphylococcus</i>, <i>Streptococcus</i>, <i>Lactobacilli</i>, and <i>Rothia</i> biofilm growth on silicone rubber medical devices were included. Subgroup analysis linked to the type of prevention modality was carried out, and quality assessment was performed with the use of the modified CONSORT tool. <b><i>Results:</i></b> Data from 33 studies were included in qualitative analysis, of which 12 qualified for quantitative analysis. For yeast biofilm formation assessment, there was a statistically significant difference in favor of the intervention group (standardized mean difference [SMD] = −1.20; 95% confidence interval [CI] [−1.73, −0.66]; <i>p</i> &#x3c; 0.0001). Subgroup analysis showed that combined methods (active and passive surface modification) are the most effective for biofilm inhibition in yeast (SMD = −2.53; 95% CI [−4.02, −1.03]; <i>p</i> = 0.00001). No statistically significant differences between intervention and control groups were shown for bacterial biofilm inhibition (SMD = −0.09; 95% CI [−0.68, 0.46]; <i>p</i> = 0.65), and the results from the subgroup analysis found no notable differences between the surface modification methods. After analyzing data on polymicrobial biofilms, a statistically significant difference in favor of prevention methods in comparison with the control group was detected (SMD = −2.59; 95% CI [−7.48, 2.31]; <i>p</i> = 0.30). <b><i>Conclusions:</i></b> The meta-analysis on biofilm inhibition demonstrated significant differences in favor of yeast biofilm inhibition compared to bacteria. A stronger inhibition with the application of passive or combined active and passive surface modification techniques was reported.

scholarly journals Antifungal Activity of Beluntas “Indian Camphorweed” (Pluchea indica) Ethanol Extract on Candida albicans In Vitro Using Different Solvent Concentrations

2021 ◽  
Author(s):  
Wayan Larissa Demolsky ◽  
Vinna Kurniawati Sugiaman ◽  
Natallia Pranata
Keyword(s):  
Candida Albicans ◽  
Oral Candidiasis ◽  
Ethanolic Extract ◽  
Ethanol Extract ◽  
Pathogenic Fungi ◽  
Inhibitory Effect ◽  
Plate Count ◽  
Minimum Fungicidal Concentration ◽  
Significant Difference

Abstract Objective Oral candidiasis is an infection caused by pathogenic fungi Candida albicans, with a considerably high prevalence of 20 to 72%. Indian camphorweed (Pluchea indica) also known as “beluntas” as the local name has been known as a traditional medicine in Indonesia. The objective of this study is to research the minimum inhibitory concentration (MIC) and the minimum fungicidal concentration (MFC) of beluntas ethanolic extract against the growth of C. albicans. Materials and Methods The MIC and MFC were measured by microdilution assay and total plate count respectively with a variation of solvents (DMSO 1%, 10%, and 4%) and beluntas extract with concentrations between 0.3125 and 200 mg/mL. Amphotericin and nystatin were used as a comparison. Statistical Analysis One-way analysis of variance and posthoc Tukey test were used to determine the significant difference between treatments. Results It was found that the MIC ranged from 50 to 200 mg/mL in the test with DMSO 10% solvent and MFC was found to be at a concentration of 200 mg/mL. However, there is a significant inhibitory effect and killing effect from DMSO 10% against C. albicans (p = 0.000). MIC was also found within concentrations of 100 mg/mL of beluntas extract in DMSO 4%. In this study, the DMSO 4% concentration neither showed significant inhibitory effects nor killing effects; therefore, the result was acceptable (p = 0.357). Conclusion Ethanol extract of beluntas (P. Indica) has the potential of being an antifungal agent with inhibitory activity in concentrations ≥100 mg/mL, which is similar to nystatin (p = 0.278). The MFC for the extract was above 100 mg/mL, which cannot be measured with this method as a higher concentration of DMSO is needed, which had a toxic effect on the tested fungi.

scholarly journals Comparison of Sealing Efficiency of Mineral Trioxide Aggregate and Biodentine used in Perforation Repair in Acidic and Neutral Environments- An In-vitro Study

2021 ◽  
Author(s):  
Güney Mustafa Yüzer ◽  
Sadullah Kaya
Keyword(s):  
Statistical Significance ◽  
Mineral Trioxide Aggregate ◽  
In Vitro Study ◽  
P Value ◽  
Technology Application ◽  
Significant Difference ◽  
Acid Environment ◽  
Materials Used

Introduction: Furcation perforation is one of the complications that occur during endodontic treatment due to anatomical differences or iatrogenic causes. Repairing the perforation with a biocompatible material eliminates the connection with the gingival sulcus and positively affects the prognosis. The sealing ability of the repair materials is very important and is affected by the conditions of the environment in which they are applied. Aim: To compare the sealing efficiency of Mineral Trioxide Aggregate (MTA) (Angelus, Londrina, PR, Brazil) and Biodentine (Septodont, Saint Maur des Fosses, France) materials used in the repair of furcation perforations in acidic and neutral environments. Materials and Methods: This in-vitro experimental study was carried out in the Department of Endodontics at Dicle University Faculty of Dentistry, Diyarbakır, Türkiye and Dicle University Science and Technology Application and Research Center from 10th June 2020 to 22nd July 2020. A total of 96 mandibular molars were used in the study. The specimens were randomly divided into two equal groups (n=48). When the perforations were repaired with MTA and Biodentine materials, each group was divided into four subgroups (n=12). These subgroups were kept in Phosphate Buffered Saline (PBS) and Acetic Acid (AA) solutions for different periods of time from 4 or 34 days, and all groups were immersed in methylene blue solution. The dye penetration level of the divided sections was examined under a stereomicroscope (Leica, Wetzlar, Germany). Microleakage data of all groups were statistically analysed using Kolmogorov Smirnov, Shapiro Wilk’s and Mann-Whitney U Test. Statistical significance was set at 0.05, it was stated that there was a significant difference when p-value <0.05. Results: The short-term (4 days) microleakage level of biodentine material in the AA environment was significantly lower than that of MTA material (p-value=0.005). There was no statistically significant difference between the materials in terms of long-term (34 days) microleakage levels in the AA environment (p-value >0.05). The long-term microleakage level in PBS environment of biodentine material was significantly lower than that of the AA environment (p-value=0.008). Conclusion: Lower microleakage levels were observed in the neutral environment than the acid environment with both MTA and biodentine during both holding periods.

scholarly journals Evaluation of 4% Sodium Hypochlorite in eliminating Enterococcus faecalis from the Root Canal when Used with Three Irrigation Methods: An in vitro Study

2017 ◽  
Vol 18 (3) ◽  
pp. 214-217
Author(s):  
Vinisha Pandey ◽  
Harsh Priyank ◽  
Abhishek Bagul ◽  
Kishore Kumar Majety ◽  
Parul Verma ◽  
...  
Keyword(s):  
Enterococcus Faecalis ◽  
Sodium Hypochlorite ◽  
Root Canal ◽  
Saline Solution ◽  
Brain Heart Infusion ◽  
Root Canals ◽  
Irrigation Methods ◽  
Group I ◽  
Significant Difference

ABSTRACT Introduction Endodontic treatment removes all pathogens, such as Enterococcus faecalis from pulp and root canals. The aim of this study is to assess the usefulness of sodium hypochlorite (NaOCl) in removing E. faecalis from the root canal used with three different irrigation methods. Materials and methods This study was conducted on freshly extracted maxillary incisors. After biomechanical preparation, root canals were injected with E. faecalis. Three groups were made which contained 30 teeth in each group; 2 mL of NaOCl solution was used for irrigation followed by agitation with K-files in group I; 2 mL of NaOCl solution was used for irrigation and ultrasonic agitation was done in group II. In group III, an alternate irrigation with NaOCl and 3% hydrogen peroxide was done. The fourth group (control) was irrigated with sterile saline solution. E. faecalis bacteria were sampled to the root canals with paper points and were transferred to tubes that contained 5 mL of brain heart infusion broth. Tubes were incubated and the presence of broth turbidity was suggestive of bacteria remaining in the root canal. Results All three groups showed no statistically significant difference. However, difference existed between experimental groups and control groups. Conclusion The author concluded that all three methods of application of NaOCl were effective in disinfecting the root canal than the saline solution. Clinical significance No single irrigant has 100% efficiency. Thus by this study, a best irrigating solution with maximum properties can be established. How to cite this article Priyank H, Pandey V, Bagul A, Majety KK, Verma P, Choudhury BK. Evaluation of 4% Sodium Hypochlorite in eliminating Enterococcus faecalis from the Root Canal when Used with Three Irrigation Methods: An in vitro Study. J Contemp Dent Pract 2017;18(3):214-217.

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