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      Vitality of Enterococcus faecalis inside dentinal tubules after five root canal disinfection methods

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          Abstract

          Aim:

          To compare the vitality of Enterococcus faecalis within dentinal tubules after subjected to five root canal disinfection methods.

          Materials and Methods:

          Dentin blocks ( n = 60) were colonized with E. faecalis. After 4 weeks of incubation, the dentin blocks were divided into one control and five test groups ( n = 10 each). The root canals of test groups were subjected to one of the disinfection methods, namely, normal saline (NS), sodium hypochlorite (NaOCl), chlorhexidine digluconate (CHX), neodymium-doped yttrium aluminum garnet (Nd: YAG) laser, and diode laser. The effect of disinfection methods was assessed by LIVE/DEAD BacLight stain under the confocal laser scanning microscopy to determine the “zone of dead bacteria” (ZDB). Mean values were calculated for ZDB and the difference between groups was established.

          Results:

          Penetration of E. faecalis was seen to a depth of >1000 μm. Viable bacteria were detected with NS irrigation. NaOCl and CHX showed partial ZDB. When the root canals were disinfected with Nd: YAG and diode lasers, no viable bacteria were found.

          Conclusion:

          E. faecalis has the ability to colonize inside dentinal tubules to a depth of >1000 μm. In contrast to conventional irrigants, both Nd: YAG and diode lasers were effective in eliminating the vitality of E. faecalis. NS, NaOCl, and CHX showed viable bacteria remaining in dentinal tubules.

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          Most cited references43

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          Microbiologic analysis of teeth with failed endodontic treatment and the outcome of conservative re-treatment.

          The purposes of this study were to determine what microbial flora were present in teeth after failed root canal therapy and to establish the outcome of conservative re-treatment. Fifty-four root-filled teeth with persisting periapical lesions were selected for re-treatment. After removal of the root filling, canals were sampled by means of advanced microbiologic techniques. The teeth were then re-treated and followed for up to 5 years. The microbial flora was mainly single species of predominantly gram-positive organisms. The isolates most commonly recovered were bacteria of the species Enterococcus faecalis. The overall success rate of re-treatment was 74%. The microbial flora in canals after failed endodontic therapy differed markedly from the flora in untreated teeth. Infection at the time of root filling and size of the periapical lesion were factors that had a negative influence on the prognosis. Three of four endodontic failures were successfully managed by re-treatment.
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            Bacteriologic evaluation of the efficacy of mechanical root canal instrumentation in endodontic therapy.

            The presence of bacteria in 17 single-rooted teeth, with periapical lesions, was studied throughout a whole period of treatment. The root canals were irrigated with physiologic saline solution during instrumentation. No antibacterial solutions or dressings were used. Bacteria were found in all initial specimens from the teeth (median number of bacterial cells 4 x 10(5), range 10(2) - 10(7)) and the number of strains in the specimens ranged from 1 to 10.88% of the strains were anaerobic. The most commonly isolated species were: Peptostreptococcus micros, Peptostreptococcus anaerobius, Fusobacterium nucleatum, Bacteroides oralis, Bacteroides melaninogenicus subsp intermedius and Eubacterium alactolyticum. Mechanical instrumentation reduced the number of bacteria considerably. Specimens taken at the beginning of each appointment usually contained 10(4) - 10(6) bacterial cells and at the end 10(2) - 10(3) fewer. Bacteria were eliminated from the root canals of eight teeth during the treatment. In seven root canals bacteria persisted despite treatment on five successive occasions. There was no evidence that specific microorganisms were implicated in these persistent infections. Teeth where the infection persisted despite being treated five times were those with a high number of bacteria in the initial sample.
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              In vitro infection and disinfection of dentinal tubules.

              An in vitro model for dentinal tubule infection of root canals was developed. Cylindrical dentin specimens, 4 mm high with a diameter of 6 mm and a canal 2.3 mm wide, were prepared from freshly extracted bovine incisors. The cementum was removed from all dentin blocks. The tubules were opened by four-minute treatments with 17% EDTA and 5.25% NaOCl before being infected with Enterococcus faecalis ATCC 29212 in yeast extract-glucose broth. Bacteria rapidly invaded the tubules. After three weeks of incubation, a heavy infection was found 400 micron from the canal lumen, and the front of the infection reached 1000 micron in some blocks. Camphorated paramonochlorophenol (CMCP) and a calcium hydroxide compound, Calasept, were tested for their disinfecting efficacy toward E. faecalis-infected dentin. Liquid CMCP rapidly and completely disinfected the dentinal tubules, whereas CMCP in gaseous form disinfected tubules less rapidly. Calasept failed to eliminate, even superficially, E. faecalis in the tubules. The method used in bacteriological sampling allowed for sequential removal of 100-micron-thick zones of dentin from the central canal toward the periphery. Control specimens were uniformly infected and yielded growth in bur samples up to some 500 microns from the surface. The model proved quite sensitive and seems suitable for in vitro testing of root canal medicaments.
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                Author and article information

                Journal
                J Conserv Dent
                J Conserv Dent
                JCD
                Journal of Conservative Dentistry : JCD
                Medknow Publications & Media Pvt Ltd (India )
                0972-0707
                0974-5203
                Sep-Oct 2016
                : 19
                : 5
                : 445-449
                Affiliations
                [1]Department of Endodontics, M.A. Rangoonwala Dental College and Hospital, Pune, Maharashtra, India
                Author notes
                Address for correspondence: Dr. Niranjan Ashok Vatkar, Shram Safalya, Sector 24, Plot 71, Pradhikaran, Nigdi, Pune - 411 044, Maharashtra, India. E-mail: drniranjanvatkar@ 123456gmail.com
                Article
                JCD-19-445
                10.4103/0972-0707.190019
                5026105
                27656064
                f79449ca-9a1a-45d5-8921-97a9aad0bb65
                Copyright: © Journal of Conservative Dentistry

                This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

                History
                : 02 May 2016
                : 06 July 2016
                : 12 August 2016
                Categories
                Original Research Article

                Dentistry
                chlorhexidine digluconate,confocal laser scanning microscopy,enterococcus faecalis,neodymium-doped yttrium aluminum garnet laser and diode laser,normal saline,sodium hypochlorite

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