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

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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.

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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.

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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.

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In vitro antimicrobial activity of auxiliary chemical substances and natural extracts on Candida albicans and Enterococcus faecalis in root canals

Journal of Applied Oral Science ◽

10.1590/1678-7757201302135 ◽

2013 ◽

Vol 21 (2) ◽

pp. 118-123 ◽

Cited By ~ 15

Author(s):

Marcia Carneiro Valera ◽

Lilian Eiko Maekawa ◽

Luciane Dias de Oliveira ◽

Antonio Olavo Cardoso Jorge ◽

Erika Shygei ◽

...

Keyword(s):

Antimicrobial Activity ◽

Candida Albicans ◽

Enterococcus Faecalis ◽

Chemical Substances ◽

In Vitro Antimicrobial Activity ◽

Root Canals ◽

Natural Extracts

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An Analysis of the Antimicrobial Activity of Ten Root Canal Sealers - A Duration Based in vitro Evaluation

Journal of Clinical Pediatric Dentistry ◽

10.17796/jcpd.33.2.d526512310970142 ◽

2008 ◽

Vol 33 (2) ◽

pp. 117-122 ◽

Cited By ~ 3

Author(s):

Prasanna Neelakantan ◽

Subbarao CV

Keyword(s):

Antimicrobial Activity ◽

Candida Albicans ◽

Enterococcus Faecalis ◽

Root Canal ◽

Antimicrobial Action ◽

Agar Diffusion Test ◽

Significant Difference ◽

Ah Plus ◽

Root Canal Sealers

Aim and Design: Sealers with prolonged antimicrobial activity are needed by the fact that microorganisms are commonly recovered from teeth with failed endodontic therapy. The aim of this study was to evaluate the duration of antimicrobial activity of ten root canal sealers (Apexit plus, Tubli Seal Xpress, Endoflas FS,Endomethasone, Endomethasone N, AH Plus, Epiphany, EndoRez, Ketac Endo, Roeko Seal) against Enterococcus faecalis and Candida albicans by the agar diffusion test. The zones of inhibition were examined immediately and after 24, 48, 72 hours, 5 and 7 days. Statistical analysis was done using Kruskal - Wallis test and Mann Whitney U test. Results and conclusions: Against Enterococcus faecalis, Endoflas FS showed the largest inhibitory zones immediately and 24 hours after manipulation, whereas, there was no significant difference between Endoflas FS and Endomethasone after 48 hours. Against Candida albicans, Endoflas FS performed better than the other sealers. All the sealers (except AH Plus, Epiphany and Roeko Seal) demonstrated higher antimicrobial action in the first 24 hours after manipulation The antimicrobial action of all the sealers (except AH Plus and Roeko Seal which showed no antimicrobial activity in any studied time and Epiphany which ceased to show any antimicrobial action after 24 hours) decreased significantly with time.

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Effect of calcium hydroxide intracanal dressing on the bond strength of a resin-based endodontic sealer

Brazilian Dental Journal ◽

10.1590/s0103-64402008000300009 ◽

2008 ◽

Vol 19 (3) ◽

pp. 224-227 ◽

Cited By ~ 45

Author(s):

João Vicente Baroni Barbizam ◽

Martin Trope ◽

Érica C.N. Teixeira ◽

Mário Tanomaru-Filho ◽

Fabrício B. Teixeira

Keyword(s):

Bond Strength ◽

Calcium Hydroxide ◽

Root Canal ◽

In Vitro Study ◽

Saline Control ◽

Control Group ◽

Root Canal Filling ◽

Human Teeth ◽

Root Canals

The aim of this in vitro study was to evaluate the bond strength of Epiphany™ resin-based sealer to dentin walls after placement of calcium hydroxide [Ca(OH)2] dressings. Fifteen extracted single-rooted human teeth were instrumented using 2.5% NaOCl + EDTA as irrigants. The teeth were randomly assigned to 3 groups (n=5), according to the intracanal dressing: G1= Ca(OH)2 + saline; G2= Ca(OH)2 + 2% chlorhexidine gluconate (CHX) gel; and G3= saline (control). After 10 days of storage in 100% humidity at 37ºC, the dressings were removed and the root canals were filled with Epiphany™ sealer. After additional 48 h of storage, the specimens were sectioned transversally into 2-mm-thick discs. Push-out tests were performed (1 mm/min, Instron 4411) and the maximum loads at failure were recorded in MPa. One-way ANOVA and Newman-Keuls tests showed a statistically significant decrease in bond strength when a Ca(OH)2 dressing was used before root canal filling with Epiphany™ (G1= 10.18 ± 1.99 and G2= 9.98 ± 2.97) compared to the control group (13.82 ± 3.9) (p< 0.05). It may be concluded that the use of Ca(OH)2 as an intracanal dressing material affected the adhesion of Epiphany™ to the root canal walls, but even though the values were within the acceptable range found in the literature.

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Improving the Efficiency of Photodynamic Chemotherapy in Root Canals against Enterococcus faecalis In Vitro

Antibiotics ◽

10.3390/antibiotics9090543 ◽

2020 ◽

Vol 9 (9) ◽

pp. 543

Author(s):

Christian Tennert ◽

Yoana Zinovieva ◽

Kalin Shishkov ◽

Lamprini Karygianni ◽

Makus Jörg Altenburger ◽

...

Keyword(s):

Enterococcus Faecalis ◽

Root Canal ◽

Antimicrobial Effect ◽

Antimicrobial Treatment ◽

Human Teeth ◽

Treatment Groups ◽

Root Canals ◽

Negative Root ◽

Culture Negative

The aim of this study was to evaluate the effect of photoactivated chemotherapy (PACT) on Enterococcus faecalis (E. faecalis) biofilms in root canals using an 90% isopropanol (IPA)-based photosensitizer and removing excess photosensitizer before light incubation. Three hundred and seven extracted human teeth with one root canal were infected with E. faecalis for 72 h and treated in groups: IPA irrigation; PACT; PACT and final rinse with IPA; PACT with photosensitizer removal using either 0.9% NaCl solution or sterile paper points or both; PACT using IPA-based photosensitizer with and without a final rinse of IPA. Root canals were sampled using sterile paper points and dentin chips collected from the root canal walls. Additionally, SEM (Scanning Electron Microscopy) images of the specimens were taken to evaluate the root canal walls for residue bacterial contamination. In all antimicrobial treatment groups treatments E. faecalis counts were significantly reduced in the root canals. Using IPA-based photosensitizer the antimicrobial effect of PACT was significantly enhanced. Irrigation with IPA alone or after PACT significantly increased the antimicrobial effect compared to PACT alone. The collected dentin chips revealed the highest amount of culture negative root canals (10%) after PACT using IPA-based photosensitizer. In the other groups, the culture negative samples ranged from only 0–2 specimens of 30 specimens. REM images show remaining E. faecalis cells on the root canal wall and inside dentin tubules. Using IPA-based photosensitizer significantly enhanced the antimicrobial effect of PACT against E. faecalis in the root canals.

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

Brazilian Dental Journal ◽

10.1590/s0103-64402009000100005 ◽

2009 ◽

Vol 20 (1) ◽

pp. 32-36 ◽

Cited By ~ 10

Author(s):

Patricia Elaine Panicali Lana ◽

Miriam Fatima Záccaro Scelza ◽

Licínio Esmeraldo Silva ◽

Ana Luíza de Mattos-Guaraldi ◽

Raphael Hirata Júnior

Keyword(s):

Antimicrobial Activity ◽

Calcium Hydroxide ◽

Enterococcus Faecalis ◽

Root Canal ◽

Culture Medium ◽

Root Canals ◽

Mechanical Preparation ◽

Canal Systems ◽

Adjuvant Effects

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.

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