Abstract
This study investigated the antibiofilm and antibacterial effects of farnesol and xylitol in a series of experiments in order to evaluate their potential use as root canal irrigants. The following substances were tested: 0.2% farnesol; 5% and 20% xylitol; 0.2% farnesol plus 20% xylitol; and saline (control). For comparison with an established endodontic irrigant, 2.5% NaOCl was included in each test. Three experiments were conducted: the crystal violet assay, to evaluate the effects on the biofilm biomass; the dentin disinfection test, to evaluate the effects on bacterial viability in biofilms; and the root canal disinfection test, to simulate the use in the root canal environment. Farnesol was the most effective substance in reducing the biofilm biomass, followed by 20% xylitol. All substances affected bacterial viability in biofilms; farnesol showed the best results followed by the farnesol/xylitol combination. Irrigation with all substances significantly reduced the bacterial load (p<0.001), but only the farnesol/xylitol combination was significantly more effective than saline (p=0.02). NaOCl was more effective than any other substance tested in the three experiments (p<0.001). The findings demonstrated that farnesol affected both the biofilm biomass and the viability of cells in the biofilm, while 20% xylitol affected only the biofilm biomass. Although not more effective than NaOCl, the combination of these two antibiofilm substances has potential to be used in endodontics in certain situations.
Highlights
Apical periodontitis is an infectious disease associated with intraradicular bacterial biofilms [1]
The prevalence of bacterial biofilms in the apical part of the root canal system is very high in teeth with either primary or post-treatment apical periodontitis [1]
Because biofilms are very frequently observed in the apical root canal system of teeth with apical periodontitis, they should be regarded as targets in endodontic treatment
Summary
Apical periodontitis is an infectious disease associated with intraradicular bacterial biofilms [1]. Because biofilms may be very difficult to eliminate and considering that persistent infectious bioburden in the root canal system is the most important barrier to periradicular tissue healing after endodontic treatment [2], special strategies may be required for successful control of endodontic infections. Mechanical debridement plays an important role in the treatment of biofilms by significantly reducing the bacterial bioburden and removing organic matter that might hamper the antimicrobial effects of irrigants. Biofilms have the ability to reconstitute themselves after being partially affected [4], which makes mechanical debridement alone insufficient in endodontic therapy. This reinforces the need of using antimicrobial and/or antibiofilm agents as irrigants
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