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      The in Vitro Antibacterial Efficacy of Persian Green Tea Extract as an Intracanal Irrigant on Enterococcus faecalis Biofilm

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          Abstract

          Introduction:

          The aim of this study was to compare the antibacterial effect of Persian green tea extract (GTE) and 2.5% sodium hypochlorite (NaOCl) against Enterococcus faecalis ( E. faecalis) as an intracanal irrigant.

          Methods and Materials:

          Thirty freshly extracted teeth were instrumented and sectioned into mesial and distal segments. The specimens were put into wells containing 2 mL of E. faecalis-containing medium. After 3 weeks, the specimens were removed and divided randomly into three groups ( n=20). Each group was exposed to 3 mL of different irrigants for 3 min. Groups 1, 2 and 3 were irrigated with GTE, 2.5% NaOCl and normal saline, respectively. Biofilm formed in the middle third of the root canal was carved by sterile scalpel and cultured in Mueller-Hinton medium. Number of colony forming units (CFU) was counted on each plate. In addition, antimicrobial activity of the irrigants was evaluated by the agar disc diffusion test. The diameter of inhibition zone (IZ) around each irrigant was evaluated. The Kruskal-Wallis and Dunn tests were used to analysis the data.

          Results:

          While in NaOCl group no bacterial colonies were observed, the mean number of E. faecalis in GTE and control groups were 275±74 CFU/mL ( P<0.001) and 119×10 8±11×10 8 ( P<0.001), respectively. The mean of IZ in NaOCl and GTE groups were 24.35±0.78 and 6.9±0.87 mm, in order of appearance ( P<0.001). Zone of inhibition was not observed around the control group ( P<0.001).

          Conclusion:

          This research highlighted the potential role of plant extracts in antimicrobial root canal irrigation protocol.

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          Most cited references30

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          Mechanisms of biofilm resistance to antimicrobial agents.

          Biofilms are communities of microorganisms attached to a surface. It has become clear that biofilm-grown cells express properties distinct from planktonic cells, one of which is an increased resistance to antimicrobial agents. Recent work has indicated that slow growth and/or induction of an rpoS-mediated stress response could contribute to biocide resistance. The physical and/or chemical structure of exopolysaccharides or other aspects of biofilm architecture could also confer resistance by exclusion of biocides from the bacterial community. Finally, biofilm-grown bacteria might develop a biofilm-specific biocide-resistant phenotype. Owing to the heterogeneous nature of the biofilm, it is likely that there are multiple resistance mechanisms at work within a single community. Recent research has begun to shed light on how and why surface-attached microbial communities develop resistance to antimicrobial agents.
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            Traditional Medicinal Plant Extracts and Natural Products with Activity against Oral Bacteria: Potential Application in the Prevention and Treatment of Oral Diseases

            Oral diseases are major health problems with dental caries and periodontal diseases among the most important preventable global infectious diseases. Oral health influences the general quality of life and poor oral health is linked to chronic conditions and systemic diseases. The association between oral diseases and the oral microbiota is well established. Of the more than 750 species of bacteria that inhabit the oral cavity, a number are implicated in oral diseases. The development of dental caries involves acidogenic and aciduric Gram-positive bacteria (mutans streptococci, lactobacilli and actinomycetes). Periodontal diseases have been linked to anaerobic Gram-negative bacteria (Porphyromonas gingivalis, Actinobacillus, Prevotella and Fusobacterium). Given the incidence of oral disease, increased resistance by bacteria to antibiotics, adverse affects of some antibacterial agents currently used in dentistry and financial considerations in developing countries, there is a need for alternative prevention and treatment options that are safe, effective and economical. While several agents are commercially available, these chemicals can alter oral microbiota and have undesirable side-effects such as vomiting, diarrhea and tooth staining. Hence, the search for alternative products continues and natural phytochemicals isolated from plants used as traditional medicines are considered as good alternatives. In this review, plant extracts or phytochemicals that inhibit the growth of oral pathogens, reduce the development of biofilms and dental plaque, influence the adhesion of bacteria to surfaces and reduce the symptoms of oral diseases will be discussed further. Clinical studies that have investigated the safety and efficacy of such plant-derived medicines will also be described.
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              Isolation of yeasts and enteric bacteria in root-filled teeth with chronic apical periodontitis.

              The aim of this study was to determine the occurrence and role of yeasts, enteric gram-negative rods and Enterococcus species in root-filled teeth with chronic apical periodontitis, and the antimicrobial effect of iodine potassium iodide (IKI) irrigation. Forty symptom-free root-filled teeth with chronic apical periodontitis were included in the study. The patients were divided into two groups. In group A the canals were filled with calcium hydroxide for 10-14 days after cleaning and shaping; in group B the canals were irrigated with IKI for 5 min after cleaning and shaping followed by a permanent root filling. Microbiological samples were taken from the canals before and after the chemomechanical preparation and after iodine irrigation (group B). Microbes were isolated from 33 of 40 teeth in the initial sampling. Yeasts were isolated from six teeth, three of them together with E. faecalis. Enteric rods (Escherichia coli, Klebsiella pneumoniae and Proteus mirabilis) were present in three teeth and E. faecalis was isolated from 21 of the 33 culture positive teeth, 11 in pure culture. Growth was detected in 10 teeth of the second samples. Six of the 10 cases were E. faecalis, with five being a pure culture. All third samples (after IKI) except one were negative. The number of microbial cells per sample did not correlate with lesion size. Two flare-ups were recorded, both in teeth with a mixed infection. The high prevalence of enteric bacteria and yeasts in root-filled teeth with chronic apical periodontitis was established. IKI improved the antimicrobial effect of the treatment.
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                Author and article information

                Journal
                Iran Endod J
                Iran Endod J
                IEJ
                Iranian Endodontic Journal
                Iranian Center for Endodontic Research (Tehran, Iran )
                1735-7497
                2008-2746
                Fall 2016
                : 11
                : 4
                : 304-308
                Affiliations
                [a ] Department of Endodontics, Dental School, Tehran University of Medical Sciences, International Campus, Tehran, Iran;
                [b ] General Dentist, Tehran, Iran;
                [c ] Statistical Consultant, Dental Research Center, Tehran University of Medical Sciences, Tehran, Iran;
                [d ] Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
                Author notes
                [* ]Corresponding author: Farzaneh Afkhami, Department of Endodontics, Dental School, Tehran University of Medical Sciences, International Campus, Tehran, Iran. Tel: +98-21 55851131, E-mail: f-afkhami@tums.ac.ir
                Article
                10.22037/iej.2016.9
                5069907
                27790260
                27b7a2cd-2ddc-4e67-880d-72e75d666e07

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License, ( http://creativecommons.org/licenses/by/3.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 21 December 2015
                : 5 April 2016
                : 23 April 2016
                Categories
                Original Article

                Dentistry
                biofilm,enterococcus faecalis,green tea extract,root canal irrigant,sodium hypochlorite
                Dentistry
                biofilm, enterococcus faecalis, green tea extract, root canal irrigant, sodium hypochlorite

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