Abstract
This study evaluated the in vitro effects of four natural substances on the biomass of bacterial biofilms to assess their potential use as root canal irrigants. The following substances and their combinations were tested: 0.2% farnesol; 5% xylitol; 20% xylitol; 0.2% farnesol and 5% xylitol; 0.2% farnesol, 5% xylitol, and 0.1% lactoferrin; 5% xylitol and 0.1% lactoferrin; and 20 mM salicylic acid. The crystal violet assay was used to evaluate the effects of these substances on the biomass of biofilms formed by Enterococcus faecalis and Staphylococcus epidermidis. All substances except for 20 mM salicylic acid and 20% xylitol reduced biofilm mass when compared to controls. The combination of farnesol and xylitol was the most effective agent against E. faecalis ATCC 29212 (p < 0.05). Farnesol combined with xylitol and lactoferrin was the most effective against biofilms of the endodontic strain of E. faecalis MB35 (p < 0.05). Similarly, combinations involving farnesol, xylitol, and lactoferrin reduced the biomass of S. epidermidis biofilms. In general, farnesol, xylitol, and lactoferrin or farnesol and xylitol reduced biofilm biomass most effectively. Therefore, it was concluded that combinations of antibiofilm substances have potential use in endodontic treatment to combat biofilms.
Highlights
Current evidence indicates that apical periodontitis is a disease caused by biofilm infection.[1]
Studies have demonstrated that instrumentation and irrigation are effective in substantially reducing the bacterial bioburden in infected canals, in many cases bacteria remain in the main root canal even when sodium hypochlorite (NaOCl) is used as the irrigant.[2]
The most substantial biofilms were produced by S. epidermidis, followed by E. faecalis strain MB35 and ATCC 29212
Summary
Current evidence indicates that apical periodontitis is a disease caused by biofilm infection.[1] Bacteria organized in biofilm communities are often observed in the apical root canal system of teeth with primary or post-treatment apical periodontitis.[1] treatment of apical periodontitis involves targeting the biofilm with specific substances and delivery strategies. Mechanical debridement is of utmost importance to remove biofilms and organic matter that might hinder the potency of antimicrobials or serve as nutrients for residual bacteria. Studies have demonstrated that instrumentation and irrigation are effective in substantially reducing the bacterial bioburden in infected canals, in many cases bacteria remain in the main root canal even when sodium hypochlorite (NaOCl) is used as the irrigant.[2] In addition to exhibiting a clinical performance that does not match its in vitro antibacterial potential, NaOCl has many disadvantages, including cytotoxicity to
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