Antibacterial Effect Of Calcium Hydroxide Research Articles

Combination Calcium Hydroxide and Epigallocatechin-3-gallate in Dentistry: A Narrative Review

Background: Pulp capping and pulpotomy are treatments for exposed pulp due to injury. Calcium hydroxide is the gold standard material in pulp capping and pulpotomy because it stimulates reparative dentin formation in exposed pulp. Calcium hydroxide has the disadvantage of causing chronic inflammation, cell necrosis, the formation of tunnel defects, and weak antibacterial properties against certain bacteria. Epigallocatechin-3-gallate (EGCG) is the main catechin component of green tea and has potent anti-inflammatory and antibacterial properties against both gram-negative and positive bacteria. The addition of EGCG to calcium hydroxide has the potential to prevent chronic inflammation and improve the antibacterial properties of calcium hydroxide. Purpose: This review aims to explain the potential of the combination of calcium hydroxide and EGCG in dentistry. Review(s): EGCG has potent anti-inflammatory and antibacterial effects against Enterococcus faecalis. The addition of EGCG to calcium hydroxide has the potential to reduce the inflammatory effect and improve the antibacterial properties of calcium hydroxide. Conclusion: This review concludes that the combination of calcium hydroxide and EGCG has the potential to reduce the inflammatory effect and promote the antibacterial effect of calcium hydroxide. Further research is needed to prove the potential of the combination of calcium hydroxide and EGCG in dentistry as a material for pulp capping and pulpotomy.

Investigating the Potential of 2%Chlorhexidine as a Vehicle for Enhancing the Antibacterial Effect of Calcium Hydroxide and Triple Antibiotic Paste Intracanal Medicaments in Primary Teeth

Investigating the Potential of 2%Chlorhexidine as a Vehicle for Enhancing the Antibacterial Effect of Calcium Hydroxide and Triple Antibiotic Paste Intracanal Medicaments in Primary Teeth

Residual antibacterial effect of calcium hydroxide combined with chlorhexidine gel as an intracanal medicament.

Bacterial elimination from the root canal system is considered as an essential factor for a successful endodontic treatment. To investigate both in vitro and in vivo efficacy of calcium hydroxide paste (CH) combined with 2% chlorhexidine gel (CHX) at various time intervals on Enterococcus faecalis (E.f) when used as an intracanal medicament (ICM). For the in vitro study, 45 single-rooted teeth were used. After instrumentation, roots were infected with E.f and then divided into three groups (gps) (15 n/gp) according to the time interval for the medicament to be left inside the canal (1 week, 2 weeks and 3 weeks). ICM used was 2% CHX combined with CH (CH + CHX). At the end of each time interval, the antibacterial effect was evaluated using the agar diffusion test. For the in vivo study, 45 single-rooted teeth were selected. After sterilisation and access opening, the first pre-treatment sample was taken, then after instrumentation second post-instrumentation sample was obtained. Later, teeth were divided into 3 gps (15 n/gp) (1 week, 2 weeks and 3 weeks) according to the time interval for the medicament to be left inside the canal. ICM used was 2% CH + CHX. After each period, the third post-medication sample was taken. ANOVA and Tukey post hoc tests were used for statistical analysis. Both in vitro and in vivo studies have found that 2% of CH + CHX had a significant antibacterial effect for 1 week and 2 weeks. However, the antibacterial effect was significantly decreased after 3 weeks. CH + CHX can be used successfully for the reduction of E.f for 14 days when used as ICM.

Comparison of Antibacterial Effect of Calcium Hydroxide Combined With Chlorhexidine and Povidone-Iodine Against Enterococcus faecalis in Dentinal Tubules of Human Incisors: An In Vitro Comparative Study.

ABSTRACTBackground and Objectives:It has been found that the microorganism behind the failure of root-filled teeth is Enterococcus faecalis, which shows resistance to most of the intra-canal medicaments. Therefore, the purpose of this study was to evaluate the antibacterial efficacy of three intra-canal medications—calcium hydroxide with saline, combinations of calcium hydroxide with 2% chlorhexidine (CHX), and calcium hydroxide with 5% povidone-iodine—against E. faecalis in dentinal tubules of human incisors.Materials and Methods:Forty permanent maxillary central incisors were made into standardized segments and infected with E. faecalis. They were treated with a paste made of calcium hydroxide and 2% CHX, calcium hydroxide and 5% povidone-iodine, and calcium hydroxide and saline for 1 week. Dentinal shavings collected from the canal were suspended in thioglycollate broth solution and spread on brain heart infusion agar. Colony-forming units (CFUs) were enumerated and the CFU per milligram of dentin was calculated. The pH of the medicaments used was measured with the help of pH meter.Results:The results showed that the paste made from calcium hydroxide and 2% CHX was significantly more effective than that made from calcium hydroxide and povidone-iodine, and calcium hydroxide and saline. The addition of CHX or povidone-iodine did not affect the alkalinity of calcium hydroxide.Conclusion:This study concludes that Ca(OH)2 + 2% CHX are effective against E. faecalis. Combinations of calcium hydroxide and 5% povidone-iodine showed better antibacterial effect than calcium hydroxide and saline. Ca(OH)2 + saline was ineffective against E. faecalis.

Antibacterial effect of calcium hydroxide combined with chlorhexidine on Enterococcus faecalis: a systematic review and meta-analysis.

ObjectiveEnterococcus faecalis (E. faecalis) is the most frequently isolated strain in failed endodontic therapy cases since it is resistant to calcium hydroxide (CH). Whether a combination of CH and chlorhexidine (CHX) is more effective than CH alone against E. faecalis is a matter of controversy. Thus, the aim of this study was to conduct a systematic review and meta-analysis of the literature.Material and MethodsA comprehensive search in PubMed, EMbase, EBSCOhost, The Cochrane Library, SciELO, and BBO databases, Clinical trials registers, Open Grey, and conference proceedings from the earliest available date to February 1, 2013 was carried out and the relevant articles were identified by two independent reviewers. Backward and forward search was performed and then inclusion and exclusion criteria were applied. The included studies were divided into "comparisons" according to the depth of sampling and dressing period of each medicament. Meta-analysis was performed using Stata software 10.0. The level of significance was set at 0.05.ResultsEighty-five studies were retrieved from databases and backward/forward searches. Fortyfive studies were considered as relevant (5 in vivo, 18 in vitro, 18 ex vivo, and 4 review articles). Nine studies were included for meta-analysis. Inter-observer agreement (Cohen kappa) was 0.93. The included studies were divided into 21 comparisons for meta-analysis. Chi-square test showed the comparisons were heterogeneous (p<0.001). Random effect model demonstrated no significant difference between CH/CHX mixture and CH alone in their effect on E. faecalis (p=0.115).ConclusionsAccording to the evidence available now, mixing CH with CHX does not significantly increase the antimicrobial activity of CH against E. faecalis. It appears that mixing CH with CHX does not improve its ex vivo antibacterial property as an intracanal medicament against E. faecalis. Further in vivo studies are necessary to confirm and correlate the findings of this study with the clinical outcomes.

Antibacterial effect of triantibiotic mixture versus calcium hydroxide in combination with active agents against Enterococcus faecalis biofilm.

The aim of the present study was to compare the antibacterial effect of calcium hydroxide (CH), triantibiotic mixture (TAM), and CH in combination with chlorhexidine (CHX), sodium hypochlorite (NaOCl) or colchicine (COL) against Enterococcus faecalis (E. faecalis) in surface and deep dentinal tubules. Seventy five fresh single-rooted human teeth were infected and divided into five experimental groups (n=15). The experimental groups were treated with CH+distilled water, CH+CHX, CH+NaOCl, CH+COL+distilled water and TAM+distilled water. Dentin chips obtained from surface and deep dentin of these root canals were prepared and analyzed by counting the number of colony forming units. There was significant difference between groups in the surface dentin (p<0.05). TAM showed higher antibacterial activity compared to CH-containing groups. There was no significant difference between TAM and CH-containing groups in the deep dentin (p>0.05). CH-containing medications and TAM can be used as effective disinfectants in treatment of infected root canals.

In vitro evaluation of antibacterial efficacy of calcium hydroxide in different vehicles.

Aim:This study was aimed to evaluate the antibacterial effect of calcium hydroxide (CH) in different vehicles in an in vitro model.Materials and Methods:Calcium hydroxide paste prepared with two conventionally used vehicles namely, camphorated monochlophenol, distilled water and propylene glycol. The antibacterial activity of these paste were tested against five micro-organisms that can commonly occur in the infected root canals.Results:The results of this study indicate that a paste of CH made with propylene glycol exerts significant antibacterial action. Hence, it can be recommended for use as an intracanal medicament in preference to a paste prepared with a tissue toxic phenolic compound like camphorated monochlorophenol.

Antibacterial activity of calcium hydroxide combined with triple antibiotic paste against enterococcus faecalis; an ın vitro study

Objectives: The aim of the present in vitro study was to investigate the antibacterial efficacy of calcium hydroxide mixed with triple antibiotic paste at various rates. Materials and Methods: Triple antibiotic paste (TAP; metronidizol, minocycline, ciprofloxacin) and calcium hydroxide powder was mixed in different proportions and tested for antibacterial activity against E. faecalis (ATCC 29212)using the agar diffusion method. The samples were divided into 10 different groups;Group 1: 100% Ca(OH) 2 , Group 2: 99,5% Ca(OH) 2 + 0.5% TAP, Group 3: 99% Ca(OH) 2 + 1%TAP, Group 4: 97,5% Ca(OH) 2 + 2,5% TAP, Group 5: 95% Ca(OH) 2 + 5%TAP, Group 6: 90% Ca(OH) 2 + 10%TAP, Group 7: 75% Ca(OH) 2 + 25% TAP, Group 8: 50% Ca(OH) 2 + 50% TAP, Group 9: 25% Ca(OH) 2 + 75% TAP, Group 10: %100 TAP. Standard holes in the cultivated agar plates were filled with one of the samples and the zones of microbial inhibition were measured after incubation period (48 hours). The experiment was performed 8 times with each medicament. Results: Group 1 had no effect against E.faecalis . Group 10 demonstrated high antibacterial activity than any other groups in this study. The antibacterial effects of the groups could be ranked from strongest to weakest as follows: Group 10, 9, 8, 7, 6, 5, 4, 3, 2, 1. Conclusions: Adding the triple antibiotic paste increased he antibacterial efficacy of calcium hydroxide. In addition, the antibacterial effect of calcium hydroxide also increased with higher proportion of TAP.

English

AIM: This study evaluated the antibacterial effect of calcium hydroxide in different vehicles in an in vitro model. MATERIAL AND METHODS: Calcium hydroxide paste prepared with two conventionally used vehicles namely, camphorated monochlophenol, distilled water and also propylene glycol. The antibacterial activity of these paste were tested against five micro- organisms that can commonly occur in the infected root canals. RESULTS AND CONCLUSIONS: The results of the study indicate that a paste of calcium hydroxide made with propylene glycol exerts significant antibacterial action. Hence, it can be recommended for use as an intracanal medicament in preference to a paste prepared with a tissue toxic phenolic compound like camphorated mono chlorophenol.

Evaluation of the antibacterial effect of calcium hydroxide in combination with three different vehicles: An in vitro study

Antimicrobial activity of interappointment intracanal medications is an important consideration in endodontics. Considering the fact that calcium hydroxide (CH) cannot sterilize the root canal system, completing its antimicrobial spectrum seems necessary. The aim of this study was to compare the antibacterial activity of CH combined with three different vehicles in root canal system. In this in vitro experimental study, 61 freshly extracted human single rooted teeth were used. After chemo-mechanical preparation, the teeth were dressed with CH in combination with: G1: Distilled water (DW); G2: 5.25% sodium hypochlorite; G3: 0.2% chlorhexidine solution. All teeth were mounted in a 2-chamber apparatus. After sterilization, the coronal chamber was exposed to bacteria and the apical chamber was filled with broth for 90 days. Leakage was recorded when turbidity was observed in broth. Mean times of leakage and turbidity percentage were recorded for each group. Data were analyzed by One Way ANOVA test (α=0.005). The highest mean time of contamination was for chorhexidine/CH combination (M=66.76 days), and the lowest was for DW/CH combination (M=40.29 days). Statistically significant difference was observed between G3 and G1 (P=0.042), but the difference between G2 and G3 (P=0.76) or G1 and G2 (P=0.18) were not significant. 88.23% of the samples of G1, 70.58% of G2, and 64.70% of G3 were contaminated after 3 months. As an intracanal medication, the chlorhexidine/CH combination had significantly more antibacterial activity than DW/CH combination.

Antibacterial effect of calcium hydroxide on intraluminal and intratubular enterococcus faecalis.

Root canal treatment involves the elimination of intraradicular microorganisms. Calcium hydroxide [Ca(OH)(2)] is the most widely used canal dressing material. Enterococcus faecalis (E. faecalis) has been reported to be resistant to Ca(OH)(2) in-vivo. The purpose of this study was to evaluate the efficacy of Ca(OH)(2) on the elimination of intraluminal and intratubular E. faecalis. Thirty six human single-rooted teeth were contaminated with E. faecalis. Thirty specimens in the experimental group were treated with 10% Ca(OH)(2); six specimens were treated with normal saline as the positive control (n=6). Specimens from experimental group were randomly divided into two subgroups of 15 each. In subgroup A, specimens were incubated and sampled after one day and in subgroup B, they were tested at day seven. Paper points and Gates Glidden burs were used to obtain the intraluminal and intratubular E. faecalis respectively. Samples obtained from these root canal preparations were analyzed for bacterial load by counting the number of colony forming units (CFUs). Mann-Whitney and t-test were used for analysis. Group B had significant decrease in CFUs compared with group A with both sampling methods (P<0.001). No differences were observed between the antimicrobial properties of Ca(OH)(2) against intraluminal and intratubular E. faecalis. After 1 week, there was a significant reduction in CFU load with Ca(OH)(2) intra canal medication. Ca(OH)(2) showed the same antimicrobial efficacy on intraluminal and intratubular E. faecalis.

An in vitro study of antibacterial effect of calcium hydroxide and chlorhexidine on Enterococcus faecalis

To evaluate and compare the antibacterial effects of chlorhexidine and calcium hydroxide on Enterococcus faecalis. Root canal treatment involves a number of steps. In spite of all the steps done thoroughly, root canal treatment might fail due to the remnant microbes. Of all such bacteria, E. faecalis is found in failed root canals. The study tests the antibacterial activity of various intracanal medicaments. Agar diffusion test was used to evaluate the antibacterial effects of the following antibacterial agents: i. hexidine:0.2% chlorhexidine gluconate; ii. periogard:0.12% chlorhexidine gluconate; iii. calcium hydroxide powder plus sterile water; iv. metapaste plus sterile water; v. calcium hydroxide plus hexidine; vi. calcium hydroxide plus periogard; vii. metapaste plus hexidine; viii. metapaste plus periogard. The size of zones of inhibition was measured. The average size of zones of inhibition after 72 hours were hexidine: 5 mm; periogard: 4.25 mm; calcium hydroxide plus sterile water: 0.5 mm; metapaste plus sterile water: 0.5 mm; calcium hydroxide plus hexidine: 4.7 mm; calcium hydroxide plus periogard: 4 mm; metapaste plus hexidine: 4.65 mm; metapaste plus periogard: 4 mm. Results were subjected to statistical analysis using one way analysis of variance and Tukey tests. Chlorhexidine and its preparations are more potent antibacterial agents against E. faecalis in comparison to calcium hydroxide.

EDTA treatment diminishes the antibacterial and anti-adherence effect of calcium hydroxide on Enterococcus faecalis: an in vitro study

ABSTRACTThis study sought to understand the cell surface characteristics, viability and biofilm-forming potential ofEnterococcus faecaliscells sequentially exposed to EDTA and calcium hydroxide, as in endodontic treatment. Bacterial cells exposed to EDTA and calcium hydroxide were assayed for cell viability, membrane integrity, cell surface hydrophobicity and surface charge, while alteration in the surface topography ofE. faecaliscells was examined using atomic force microscopy (AFM). The bacterial adherence potential to type I collagen was also examined to assess the biofilm-forming capacity ofE. faecaliscells exposed to EDTA and calcium hydroxide. It was found that calcium hydroxide treatment reduced the viability ofE. faecalis. However, prior exposure to EDTA significantly reduced the antibacterial effect of calcium hydroxide (P&amp;lt; 0.05). Calcium hydroxide treatment resulted in impaired cell wall morphology, observed as increased surface roughness and pore formation under AFM. However, these topographical changes induced by calcium hydroxide were significantly reduced in EDTA pretreated cells (P&amp;lt; 0.05). Calcium hydroxide treatment caused reduction in hydrophobicity and adherence ofE. faecalisto type I collagen. These effects due to calcium hydroxide were also significantly altered in EDTA-pretreated cells (P&amp;lt; 0.001). The findings from this study showed that the antibacterial and anti-adherence effect of calcium hydroxide was diminished by prior exposure ofE. faecaliscells to EDTA.

In vitro antibacterial effect of calcium hydroxide combined with chlorhexidine or iodine potassium iodide on Enterococcus faecalis.

Several studies have shown a higher success rate of root canal therapy when the canal is free from bacteria at the time of obturation. Treatment strategies that are designed to eliminate this microflora should include agents that can effectively disinfect the root canal. Enterococcus faecalis is often associated with persistent endodontic infections. While in vivo studies have indicated calcium hydroxide to be the most effective all-purpose intracanal medicament, iodine potassium iodide (IKI) and chlorhexidine (CHX) may be able to kill calcium hydroxide-resistant bacteria. Supplementing the antibacterial activity of calcium hydroxide with IPI or CHX preparations was studied in bovine dentine blocks. While calcium hydroxide was unable to kill E. faecalis in the dentine, calcium hydroxide combined with IKI or CHX effectively disinfected the dentine. The addition of CHX or IKI did not affect the alkalinity of the calcium hydroxide suspensions. It may be assumed that combinations also have the potential to be used as long-term medication. Cytotoxicity tests using the neutral red method indicated that the combinations were no more toxic than their pure components.

Reduction of Intracanal Bacteria Using Nickel-Titanium Rotary Instrumentation and Various Medications

The purpose of this study was to evaluate the extent of bacterial reduction with nickel-titanium rotary instrumentation and 1.25% NaOCl irrigation. Also, the additional antibacterial effect of calcium hydroxide for >1 wk was tested. Forty-two subjects with radiographic and clinical signs of chronic apical periodontitis were recruited. The canals were sampled before treatment, during and after instrumentation, and after treatment with calcium hydroxide and the samples incubated anaerobically for 7 days at 37 degrees C. The bacteria from each sample were quantified and the log10 values were used for calculations and comparisons. The initial sample confirmed infection of the canals. There was a significantly greater pattern of reduction of bacteria when NaOCl was used as an irrigant, compared with sterile saline (p < 0.05). After instrumentation with NaOCl irrigation, 61.9% of canals were rendered bacteria-free. The placement of calcium hydroxide for at least 1 wk rendered 92.5% of the canals bacteria free. This was a significant reduction, compared with NaOCl irrigation alone (p = 0.0001). The results of this study indicate that NaOCl irrigation with rotary instrumentation is an important step in the reduction of canal bacteria during endodontic treatment. However this method could not consistently render canals bacteria-free. The addition of calcium hydroxide intracanal medication should be used to more predictably attain this goal.

The antimicrobial effect of calcium hydroxide as a short‐term intracanal dressing

The antibacterial effect of calcium hydroxide as a short-term intracanal dressing was clinically evaluated by applying the medicament for 10 minutes or 7 days in root canals of teeth with periapical lesions. The results showed that the 7-day dressing efficiently eliminated bacteria which survived biomechanical instrumentation of the canal, while the 10-minute application was ineffective.