Failure Of Root Canal Treatment Research Articles

Antibacterial Potential Test of Ethanol Extract of Basic Leaf (Ocimum Basilicum) against Enterococcus Faecalis ATCC 29212

Introduction: Enterococcus faecalis is a bacteria found in failed root canal treatment cases. Enterococcus faecalis can tolerate significant environmental changes and invade the dentinal tubules, so under certain conditions, irrigants cannot altogether remove them in the chemomechanical process. Basil ( Ocimum basilicum ) is a natural ingredient with many benefits and is known to have high antibacterial activity against Gram-positive and Gram-negative bacteria. This study aimed to determine the antibacterial effect of ethanol extract from basil leaves ( Ocimum basilicum ) against Enterococcus faecalis ATCC 29212. Methods: This research was conducted by testing the bacteria Enterococcus faecalis ATCC 29212 with ethanol extract of basil ( Ocimum basilicum ) leaves made from 256,000 ppm – 1,000 ppm, using the disc diffusion method, carried out with three repetitions. Precise zone measurements were carried out using a caliper. Results: There were no clear zones produced by the ethanol extract of basil leaves ( Ocimum basilicum ) against Enterococcus faecalis ATCC 29212 at various test concentrations. Discussion: the test results in this study can be influenced by (i) the solubility factor of the extract, (ii) the active compounds contained in the plant, and (iii) the method used in this study. Conclusion: The ethanol extract of basil leaves ( Ocimum basilicum ) has no antibacterial potential against Enterococcus faecalis ATCC 29212. Further research can be carried out using the agar diffusion method or by conducting a minimum inhibitory concentration (MIC) test to confirm the antibacterial effect

The Effect of Failure Root Canal Treatment on the Tooth: A Systematic Review

The failure of root canal treatment occurs due to lack of standards or aspects of procedure were not followed accurately. Root canal treatment’s failure can be justified by response ratio of teeth and procedural errors that limits the intracanal endodontic infection, but not control it properly as preventive measure. Although there was very little evidence regarding the predictive factors for tooth preservation, effects of failure of root canal system and tooth survival was investigated. Very few studies have been conducted to evaluate the clinical outcomes of failure of root canal treatment on tooth survival. Therefore, we will aim to design a systematic review to evaluate clinical outcomes of failure of root canal treatment on tooth survival. We conducted a systematic review by following “Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)” guidelines related to title which was “The effect of failure root canal treatment on the tooth” according to study aims. The study selection criteria (as including both inclusion and exclusion criteria) were designed for screening and selection of collected data in recent systematic review. For recent systematic review, we collected about 67 studies related to the effect of failure root canal treatment on the tooth through searching from above mentioned databases About 7 out of remaining papers were up to the standard and met the above-mentioned criteria. The above included 7 studies were relevant to study aims and evaluated the effects of failed toot treatments or root canal treatment (RCT) on tooth survival, tooth health and safety. All included studies coded the major effects of failure root canal treatment as the swelling, (Topçuoğlu & Topçuoğlu, 2017 & Ulin et al., 2020) prospective pain, (Ballal et al., 2020, Wang et al., 2010 & inflammation, (Verma et al., 2019) and microbial attack (Chen et al., 2017 & Jordan et al., 2014) intensity. However, all studies have evaluated different root canal treatment with different non-surgical treatments. Overall, the clinical effects of failure of root canal treatment are severe and should be overcome with retreatment.

The potential of reuterin derived from Indonesian strain of Lactobacillus reuteri against endodontic pathogen biofilms in vitro and ex vivo

ObjectivesDespite the use of common irrigating solution with antimicrobial properties, failed root canal treatment remains a significant problem in endodontics. In the present study, we examined the efficacy of reuterin derived from probiotic bacteria, Lactobacillus reuteri on the biofilms of major endodontic pathogens using ex vivo model of root canal infections. MethodsBiofilms of major endodontic pathogens namely Enteoroccus faecalis, Fusobacterim nucleatum, Porphyromonas gingivalis, and Candida albicans were formed on root canals of 60 human premolar tooth samples accordingly a standard protocol. Thereafter, teeth were treated with either 2.5 % NaOCl (positive control), various concentrations of reuterin (test-group) or sterilized-distilled water (negative control) in a time-dependent assay. The efficacy of irrigation was evaluated by a time-dependent assay at 5 min and 30 min after irrigation by colony-forming units assay. The findings were further confirmed by species-specific real-time PCR. Data were statistically analysed using one way ANOVA with a significance level of P < 0.05. ResultsReuterin isolated from L. reuteri was effective against E. faecalis, C. albicans, F. nucleatum, and P. gingivalis biofilms, with a concentration of 100 µg/mL being the most effective compared to the negative control (P < 0.05) and also showed similar efficacy when compared with NaOCl. ConclusionReuterin isolated from L. reuteri has ability to inhibit in vitro and ex-vivo biofilms of endodontic pathogens, namely E. faecalis, F. nucleatum, P. gingivalis, and C. albicans. Reuterin has potential as a root canal irrigating solution due to its antibiofilm activity. Further research is warranted to determine the potential of probiotic bacteriotherapy in root canal systems.

Influencing factors and detection methods of microleakage in root canal therapy

Root canal therapy is a common and effective method to treat pulp and periapical diseases. Thorough root canal disinfection, good root canal shaping, perfect crown seal and apical seal are the keys to successful root canal treatment. The failure of root canal treatment can be attributed to the microleakage of bacteria and other irritants into the root canal and periapical tissues when the root canal system is not tightly filled. This paper will discuss the influencing factors of microleakage in root canal therapy and the research progress of microleakage detection methods.

Evaluation of the risk of Enterococcus faecalis cross-contamination of gutta-percha cartridges

BackgroundGutta-percha (GP) cartridges are intended for a single patient and are not considered sterile. Providers may use these cartridges in multiple canals of a single tooth or multiple teeth on the same patient without disinfection between uses, creating the potential for bacteria to be transferred between canal systems. Enterococcus faecalis is a hardy bacterial species often isolated from failed root canal treatments. This study tested if GP cartridges have the potential to cross-contaminate root canals with E. faecalis. Methods for GP cartridge disinfection were also evaluated. MethodsTwenty-three–gauge medium-body GP cartridges placed in an obturation unit were purposefully contaminated with 1 of 3 concentrations of E. faecalis strain OG1RF. Contaminated cartridges were either (1) wiped with an alcohol swab, (2) heated with GP extrusion while in the bacterial culture, (3) heated with GP extrusion while in the bacterial culture and then wiped with an alcohol swab, or (4) not disinfected after removal from the bacterial culture (control). Bacteria were dislodged into a fresh medium by sonication, and the number of viable bacteria recovered from the tips was measured. ResultsViable cultures of E. faecalis could not be recovered consistently from tips in the control and disinfection treatment conditions. ConclusionsCross-contamination of root canals with E. faecalis with the GP cartridge is unlikely.

Decision-Making of Patients Towards Treatment Modalities of Failed Root Canal Therapy

OBJECTIVES To determine the awareness and perception of patients towards treatment modalities of failed root canal therapy. METHODOLOGY A cross-sectional study was conducted at the department of Operative Dentistry and Endodontics, Altamash Institute of Dental Medicine, Karachi, from 15 August’2021 to 14 October’2021. A total of 292 participants, 155(63%) female and 104(37%) males, were selected for the study. All the participants included had at least one root canal-treated tooth. A well-constructed and validated performa was used to evaluate the patient’s decision for different treatment modalities against a tooth with failed root canal treatment. RESULTS Among the subjects, most patients opted for endodontic re-treatment (60%) in case of root canal treatment failure, whereas the remaining opted for extraction (40%). Out of this, 40% (8%) choose removal of partial denture, (12%) bridge, and implant (20%). CONCLUSION Re-treatment is the first-line treatment option for the previously failed root canal. Our study concluded that most patients would opt for an endodontic re-treatment. The patient's education and awareness level affected the treatment options.

Cytotoxicity test of apple cider vinegar as a root canal irrigant against fibroblast cells

Background: Apple cider vinegar potentially can be used as an alternative to irrigation solutions because of its antibacterial compounds that can inhibit Enterococcus faecalis, a pioneer bacteria that cause root canal treatment failure. One of the ideal irrigation solution requirements is that it isn’t toxic to oral cavity tissues, so it’s necessary to run a cytotoxicity test on apple vinegar solution. Cytotoxicity test is the initial part of the evaluation of a dental material before it can be used by humans. Cytotoxicity test was performed on fibroblast cells because the irrigation solution can contact with fibroblast, which are the main cells in the periodontal ligament around the apical. The purpose of this study was to analyze the in vitro cytotoxicity effect of ACV on fibroblast cells. Method: Apple vinegar with concentrations of 0.31%, 0.63%, 1.25%, 2.5%, and 5% was tested using the MTS assay method. Result: The results showed that there was a cytotoxicity effect of apple vinegar solution as a root canal irrigation agent against fibroblasts cell. Apple cider vinegar with concentrations of 1.25%, 2.5%, and 5% are potentially toxic because the percentage of cell viability is less than 70%. Conclusion: There is a cytotoxicity effect of apple cider vinegar solution as a root canal irrigant on fibroblast cells

The influence of patient race on the outcome of endodontic treatments: a pooled analysis of one-year recall data from four cone beam computed tomography outcome studies.

Objectives The aim of this pooled data analysis was to establish if there is an association between a patient's race and the proportion of successful outcomes of endodontic treatments, and if so, what factors may determine this association.Methodology Data collected from four prospective clinical outcome studies were pooled. Patients were recalled 12 months after the completion of the treatment. Treatment outcome was determined by clinical findings and cone beam computed tomography examination. Statistical analysis included the description of categorical and continuous variables and simple binary logistic regression models, chi-squared tests and Kruskal-Wallis tests.Results Data from 301 patients were available. Of these patients, 43 were Black (14.3%), 50 were from a Non-Black Minority Ethnic (NBME) group (16.6%) and 208 were white (69.1%). The risk of an unfavourable outcome was higher in teeth with short root canal fillings (OR = 3.36; p = 0.002), when a preoperative radiolucency was present (OR = 2.59; p = 0.019) and when an intra-operative root canal perforation was detected (OR = 5.25; p = 0.016).Multiple regression models showed that Black (OR = 2.28; p = 0.05) and NBME patients (OR = 3.07; p = 0.008) had a higher risk of an unfavourable result compared to white patients.Conclusions Black and NBME patients had a significantly higher failure rate of root canal treatments compared to white patients. All other known pre-, intra- and post-operative risk factors for root canal treatment failure were present in similar proportions in BME and white patients.

Shock wave enhanced emission photoacoustic streaming (SWEEPS): An alternative to conventional irrigation in endodontic treatment

Background: Irrigation is an essential step in root canal treatment (RCT). However, the complex structure of the root canal can limit the penetration of irrigants, causing RCT failure. Shock wave enhanced emission of photoacoustic streaming (SWEEPS) has been developed to improve root canal cleaning by increasing the penetration of irrigants. SWEEPS utilized the Er:YAG laser to generate micropulse, producing bubbles delivered in liquid, causing powerful photodynamic streaming. However, its superiority compared to conventional irrigation remains unclear. Thus, we aim to review the available evidence to assess the benefits of SWEEPS over conventional irrigation. Purpose: This study aims to review the available evidence to assess the benefits of SWEEPS over conventional irrigation. Reviewa: Article searches were conducted on Pubmed, ScienceDirect, EBSCOhost, and ProQuest using SWEEPS and root canal irrigation as keywords. Articles were included if they aim to assess the benefits of SWEEPS over conventional irrigation in removing smear layer, debris, pulp tissues, or bacteria. A total of 833 articles were initially retrieved from systemic search of literature and 6 articles following inclusion criteria were included in the review. Out of 6 articles, 4 articles suggested that SWEEPS could increase the removal of smear layer, debris, pulp tissues, and bacteria in the root canal compared to conventional irrigation. However, 2 articles found contradictory results, in which SWEEPS and conventional irrigation had similar outcomes in terms of penetration depth and could not completely eradicate biofilm. Conclusion: This review suggests that SWEEPS offers more benefits over conventional irrigation since it can improve the removal of smear layer, debris, pulp tissues, and bacteria in the root canal.

Evaluation of quality of life following dental extraction.

Among several treatment modalities done in dental clinics, dental extractions are the most frequently carried out treatment. Tooth extraction is indicated in cases such as chronic periodontal disease, abscess, root caries, root stumps, fractured teeth, and failed root canal treatments with the persistence of periapical cysts or granulomas, impacted teeth, or to facilitate orthodontic or prosthodontic rehabilitation. The consequence of routine tooth extraction could lead to dentoalveolar diseases, which cause tooth loss. The various complications of surgical procedures are delayed wound healing, postoperative bleeding, remnant bony spicules, and nerve paresthesia. This study aimed to assess the impact of nonsurgical tooth extraction on the quality of life of patients. Institutional patient data from January 2021 to April 2021 were analyzed, in which 2000 patients who had undergone extractions at our dental institution were included in our study. The data evaluating the patients' quality-of-life postextraction were recorded. It included speech variation, social interaction, postoperative pain, sleep impairment, and inability to work. Data obtained were statistically analyzed using SPSS, and results were obtained. Most men (49%) experienced an inability to work compared to women (25%). 38% of females had moderate-to-severe pain, whereas males (21%) had only mild pain. 21% of males are isolated socially due to feeling sick, whereas 20% of females are isolated socially due to pain. Speech was affected more postextraction. Most of the patients could not go to work for 1-3 days following the removal of the tooth. Most of the patients were pleased with the procedure, with their symptoms disappearing after the procedure, and were not worried about dental extractions.

The outcome of single-visit nonsurgical retreatment and patients’ perception of retreatment: a retrospective cohort study with 1-year follow-up

Aim: To evaluate the outcome of single visit nonsurgical retreatment by clinical examination and PAI (Periapical Index) and, patients’ feedback regarding the nonsurgical retreatment after 1 year.&#x0D; Material and Method: 115 patients who previously had nonsurgical retreatment were recalled after 1 year and after dropouts, 84 patients were examined clinically and radiographical examinations were completed pre-and postoperatively using Periapical Index. Patients were also asked if they would still choose nonsurgical retreatment for teeth with previously failed root canal treatment.&#x0D; Results: The healing rate after 1 year was 88%. The tooth type did not influence the outcome (p=0.756). While the failure rate was lower in males (3.3%) than in females (16.7%), gender did not affect the outcome (p=0.088). 97.6% of patients had a positive approach to nonsurgical retreatment. There was a statistically significant relationship between treatment outcome and patients' feedback (p=0.013). There is a statistically significant positive correlation between postoperative VAS (Visual Analogue Scale) pain score and postoperative PAI score (p=0.002).&#x0D; Conclusion: Single-visit nonsurgical retreatment is a viable option for teeth where certain periapical diseases such as symptomatic apical abscess are excluded. Patients, who experienced successful nonsurgical retreatment, are eager to preserve their tooth with failed primary root canal treatment when nonsurgical retreatment option is available.

Evaluation of preliminary anti-microbial efficacy of curcumin and chitosan nanoparticles with and without photoactivation against – An invitro study

: The success of endodontic treatment lies in adequate debridement of the root canal. There are various microorganisms responsible for the failure of root canal treatment, one among them is . Sodium hypochlorite is considered as the gold standard. Since it has various disadvantages newer irrigants like Curcumin and Chitosan nanoparticles have been tried.: The aim of this study was to evaluate the preliminary anti-microbial efficacy of Curcumin and Chitosan nanoparticles with and without photoactivation against : The antimicrobial activity of Curcumin, Chitosan nanoparticles with and without Photoactivation, Saline and Sodium hypochlorite was assessed. MIC was done with serial dilution method, incubated for 48-72 hours and observed for turbidity.MBC was done from the MIC dilutions tubes, first 3 tubes were plated, incubated for 24 hrs and the colony was counted. For Time kill assay broth with the compound was mixed, plated and inoculated at 1hr, 2hrs and 4hrsinterval and colony count was noted. Results were tabulated and statistical analysis was done using Analysis of Variance (ANOVA) and Tukey multiple comparison test.Photoactivated Curcumin has shown the best antimicrobial results as compared to Curcumin, Chitosan nanoparticles (photoactivated and nonphotoactivated) and 3% Sodium hypochlorite.: Curcumin with and without photo activation and Chitosan nanoparticles can be considered as an alternate endodontic irrigants against sodium hypochlorite.

Comparison of fracture resistance of mandibular central incisors following the use of two different spreaders during lateral condensation obturation technique- An in vitro study

The lateral condensation is the most commonly practiced obturation technique during root canal treatment. In this method, the use of spreaders is instrumental in acheiving 3-D obturation. These spreaders can create an unnecessary stress during use, by means of wedging force that might lead to vertical root fracture, resulting in failure of root canal treatment. Sixty extracted mandibular central incisors were taken. All teeth were sectioned 2 mm coronal to CEJ and were wrapped in aluminium foil. The specimens were embedded in acrylic mould. Aluminium foil was scratched and the created space was filled with light body silicone impression material. Then, after working length determination, apical preparation was done with 40 no. K- file. Rest of the canal was prepared using step back technique. The samples were then randomly divided into 3 groups of 20 samples each. Group 1 No obturation (control group). Group 2 Obturation done using stainless steel finger spreaders. Group 3 Obturation done using nickel titanium finger spreaders. After the obturation, all samples were subjected to fracture using metal indenter on the universal testing machine. The load at which fracture occur was recorded. Data thus obtained was subjected to statistical analysis using ANOVA and TUKEY test. The mean fracture resistance of group 1 was highest followed by group 3 (NiTi spreader) and least in group 2 (SS spreader). NITI or SS spreaders can affect the fracture resistance of teeth during lateral condensation obturation technique.

Selective Root Retreatment: A Randomized Clinical Trial

AbstractObjectives: Post-treatment apical periodontitis is an inflammatory disorder of peri-radicular tissues caused by either persistent or secondary intra-radicular infection . The present study compared the prognosis of cases treated with the “selective root retreatment” concept to the traditional retreatment approach. Material and Methods: Forty patients complaining of failed root canal treatment having a periapical lesion in one root were selected. The cases were randomly divided into two groups; group (S): selective root canal retreatment in which only the affected root was retreated and group (T): traditional root canal retreatment in which all canals were retreated. The peri-radicular condition was evaluated radiographically using the Periapical Index (PAI) for one year. The chi-square test statistical tests analyzed the outcome data. Results: At the baseline examination, There was no significant difference between the two groups regarding the patients’ baseline mean periapical indices . After one year, we found that the mean periapical index declined without a significant difference between the two groups. Conclusions: The present study points to selective root retreatment as a successful “minimally invasive alternative” in cases of an independently diseased root. The remaining treated roots can be retained without intervention provided that they are confirmed: “healthy”. Clinical Relevance: Selective root retreatment is a promising conservative option in the treatment of failed endodontic cases with periapical pathosis related to an individual root.

Development of Lipidic Nanoplatform for Intra-Oral Delivery of Chlorhexidine: Characterization, Biocompatibility, and Assessment of Depth of Penetration in Extracted Human Teeth.

Microorganisms are the major cause for the failure of root canal treatment, due to the penetration ability within the root anatomy. However, irrigation regimens have at times failed due to the biofilm mode of bacterial growth. Liposomes are vesicular structures of the phospholipids which might help in better penetration efficiency into dentinal tubules and in increasing the antibacterial efficacy. Methods: In the present work, chlorhexidine liposomes were formulated. Liposomal chlorhexidine was characterized by size, zeta potential, and cryo-electron microscope (Cryo-EM). Twenty-one single-rooted premolars were extracted and irrigated with liposomal chlorhexidine and 2% chlorhexidine solution to evaluate the depth of penetration. In vitro cytotoxicity study was performed for liposomal chlorhexidine on the L929 mouse fibroblast cell line. Results: The average particle size of liposomes ranged from 48 ± 4.52 nm to 223 ± 3.63 nm with a polydispersity index value of <0.4. Cryo-EM microscopic images showed spherical vesicular structures. Depth of penetration of liposomal chlorhexidine was higher in the coronal, middle, and apical thirds of roots compared with plain chlorhexidine in human extracted teeth when observed under the confocal laser scanning microscope. The pure drug exhibited a cytotoxic concentration at which 50% of the cells are dead after a drug exposure (IC50) value of 12.32 ± 3.65 µg/mL and 29.04 ± 2.14 µg/mL (on L929 and 3T3 cells, respectively) and liposomal chlorhexidine exhibited an IC50 value of 37.9 ± 1.05 µg/mL and 85.24 ± 3.22 µg/mL (on L929 and 3T3 cells, respectively). Discussion: Antimicrobial analysis showed a decrease in colony counts of bacteria when treated with liposomal chlorhexidine compared with 2% chlorhexidine solution. Nano-liposomal novel chlorhexidine was less cytotoxic when treated on mouse fibroblast L929 cells and more effective as an antimicrobial agent along with higher penetration ability.

Enterococcus faecalis rnc gene modulates its susceptibility to disinfection agents: a novel approach against biofilm

BackgroundEnterococcus faecalis (E. faecalis) plays an important role in the failure of root canal treatment and refractory periapical periodontitis. As an important virulence factor of E. faecalis, extracellular polysaccharide (EPS) serves as a matrix to wrap bacteria and form biofilms. The homologous rnc gene, encoding Ribonuclease III, has been reported as a regulator of EPS synthesis. In order to develop novel anti-biofilm targets, we investigated the effects of the rnc gene on the biological characteristics of E. faecalis, and compared the biofilm tolerance towards the typical root canal irrigation agents and traditional Chinese medicine fluid Pudilan.MethodsE. faecalis rnc gene overexpression (rnc+) and low-expression (rnc−) strains were constructed. The growth curves of E. faecalis ATCC29212, rnc+, and rnc− strains were obtained to study the regulatory effect of the rnc gene on E. faecalis. Scanning electron microscopy (SEM), confocal laser scanning microscopy (CLSM), and crystal violet staining assays were performed to evaluate the morphology and composition of E. faecalis biofilms. Furthermore, the wild-type and mutant biofilms were treated with 5% sodium hypochlorite (NaOCl), 2% chlorhexidine (CHX), and Pudilan. The residual viabilities of E. faecalis biofilms were evaluated using crystal violet staining and colony counting assays.ResultsThe results demonstrated that the rnc gene could promote bacterial growth and EPS synthesis, causing the EPS-barren biofilm morphology and low EPS/bacteria ratio. Both the rnc+ and rnc− biofilms showed increased susceptibility to the root canal irrigation agents. The 5% NaOCl group showed the highest biofilm removing effect followed by Pudilan and 2% CHX. The colony counting results showed almost complete removal of bacteria in the 5% NaOCl, 2% CHX, and Chinese medicine agents’ groups.ConclusionsThis study concluded that the rnc gene could positively regulate bacterial proliferation, EPS synthesis, and biofilm formation in E. faecalis. The rnc mutation caused an increase in the disinfectant sensitivity of biofilm, indicating a potential anti-biofilm target. In addition, Pudilan exhibited an excellent ability to remove E. faecalis biofilm.

Root and root canal morphology of mandibular second permanent molars in the Gansu province population: A CBCT study.

To study the anatomical characteristics of the root and root canal system of the mandibular second molars in the population of Gansu province, and to provide theoretical and clinical references for improving the success rate of root canal therapy (RCT) of mandibular second molars. The number of roots and root canals, root canal type and pulp chamber height of mandibular second molars were determined by observing cone-beam computed tomography (CBCT) images of people living in Gansu. The most common type of mandibular second molars in the Gansu province population was a double root with three root canals (47.55%), followed by a C-shaped root (35.56%). There were more females than males with a C-shaped root (p< 0.05). The most common root canal subtype of the C-type root was C3 (13.91%). Most of the population (77.11%) had bilateral mandibular second molars with symmetrical root canal morphology. With an increase in age, the height of the pulp chamber decreased significantly. The incidence of root canal variation of the mandibular second molars is relatively high in the population of Gansu province. Preoperative examination with CBCT is essential for mandibular second molars that need RCT to avoid root canal treatment failure and decrease the occurrence of postoperative pain as much as possible.

Isolation, Characterization and Control of Bacteria from Failed Root Canal Treatment

This cross-sectional type of descriptive study was carried out to isolates, characterization and control of bacteria from failed root canal treatment. The sample size was 101 which was selected purposively. Partially structured questionnaire was used to collect data from the respondents by face to face interview. All efforts were made to collect data accurately. For […]

The Differential Effectiveness of Calcium Hydroxide (Ca(OH)2) Combination with Chlorhexidine Digluconate (CHX) 2% and Clindamycin Hydrochloride 5% Against Enterococcus faecalis (in vitro)

Background: The main factor causing failure of root canal treatment is re-infection of the bacterium Enterococcus faecalis, so it is necessary to give the right intracanal medicament. Calcium hydroxide (Ca(OH)2) is an intracanal medicament often used in endodontic treatment. To increase the effectiveness of calcium hydroxide, a mixing agent is needed. Mixing agents such as Chlorhexidine digluconate (CHX) 2% (aqueous) and Clindamycin hydrochloride 5% (viscous). The viscous mixing agent can penetrate well into the dentinal tubules, and the antibiotic can fight various root canal endodontic pathogens and dentinal tubules without causing discoloration. This study aims to determine the differential effectiveness of calcium hydroxide combination of chlorhexidine digluconate 2% and Clindamycin hydrochloride 5% as an intracanal medicament against Enterococcus faecalis (in vitro). Methods: The design was in vitro experimental laboratories that tested the value of turbidity (Optical Density) using a spectrophotometer before and after being treated. Data were analyzed by the Kruskal-Wallis test and then Mann-Whitney U Test. Results: The positive control group had the largest negative Optical Density (OD) difference, followed by a calcium hydroxide combination of Chlorhexidine digluconate 2%, and the third sequence was a calcium hydroxide combination of Clindamycin hydrochloride 5%. A negative OD difference indicates a decrease in the number of bacterial cells. Conclusion: There are differences in the effectiveness of the antibacterial of intracanal medicament calcium hydroxide combination of Chlorhexidine digluconate 2% and calcium hydroxide combination of Clindamycin hydrochloride 5%.

Adhesive Ability of Different Oral Pathogens to Various Dental Materials: An In Vitro Study.

Introduction In dental treatments, the reason for secondary caries and the failure of root canal treatment is the microbial infection, which concerns most dentists. The challenge of how to reduce the number of bacteria at the filling materials and the number of residual bacteria in the root canal has become a research hotspot. In this study, the bacterial adhesion properties of several common dental materials were compared to provide a theoretical basis for the selection of antibacterial properties of dental materials. Methodology. Three commonly used dental restorative materials and five sealers in root canal treatment were selected. Each material block was immersed in the corresponding supragingival (Streptococcus mutans and Actinomyces viscosus) or subgingival (Porphyromonas gingivalis and Enterococcus faecalis) bacterial solution and cultured under anaerobic conditions at 37°C for 2, 4, 6, 8, 12, 16, 20, and 24 h. The adhesion of bacteria was observed, and the number of different bacteria adhering to various material model disks was calculated at different time intervals under a scanning electron microscope. The adherent CFU load of the materials was determined by colony counting. Results Streptococcus mutans and Actinomyces viscosus exhibited the strongest adhesion ability to the resin material blocks. Porphyromonas gingivalis and Enterococcus faecalis exhibited the highest adhesion ability to the AH-Plus sealer block. Conclusions In dental treatments, dental materials should be selected based on the chemical, physical, and biological properties of materials. In addition, it is necessary to develop new antibacterial dental materials.