Sterile Paper Points Research Articles

Determination of the Microbial Shift in the Gingival Sulcus of Women during Each Trimester of Pregnancy: A Cross-Sectional Study

Background and Objectives: This study aims to identify types of bacterial species in women visiting obstetrics/gynecology centers in Riyadh City, Saudi Arabia, during different pregnancy trimesters. Materials and Methods: This cross-sectional study was conducted among pregnant and nonpregnant women seeking care at Alyamamah Hospital, obstetrics/gynecology center, Riyadh, Saudi Arabia. A total of 110 [pregnant = 90 and nonpregnant = 20] individuals were recruited based on inclusion/exclusion criteria. Personal data, plaque index (PI), and gingival index (GI) were recorded. Bacterial samples were collected using sterile absorbent paper points from the gingival sulcus of pregnant females during the first, second, and third trimesters and compared to a control group of nonpregnant females. Thioglycolate broth containing the absorbent paper points was incubated at 37 °C for 24–48 h. After growth, the microorganisms were subjected to a Gram stain. The VITEK 2 system and conventional methods were used to identify various types of bacterial species from the gingival sulcus of pregnant and nonpregnant women. Chi-square tests and nonparametric tests were applied to the data. Results: The bacterial characterization indicated that Actinomyces naeslundii (AN) was the most predominant bacteria found in the study participants, followed by Lactobacillus fermentum (LF) (23.6%), Veillonella (VL) (10%), and unidentified organisms (9.1%). When the presence of subgingival bacterial species was compared between pregnant and nonpregnant women, a statistically significant difference was observed (p < 0.001). LF was the predominant bacteria in 9 nonpregnant women (45%) and 8 pregnant women in the first pregnancy trimester (44.4%). However, during the second (17 women: 48.6%) and third pregnancy (17 women: 45.9%) trimesters, AN becomes the predominant bacteria. A statistically significant difference was observed when the prevalence of various bacterial species was compared across the three pregnancy trimesters (p = 0.010). The plaque and gingival scores of pregnant and nonpregnant women showed no significant difference. Conclusions: In different trimesters of pregnancy, pregnant women’s gingival crevices showed significant microbial changes without affecting gingival inflammation.

Molecular analyses indicate profuse bacterial diversity in primary and post- treatment endodontic infections within a cohort from the United Arab Emirates-A preliminary study.

Endodontic microbiota appears to undergo evolutionary changes during disease progression from inflammation to necrosis and post-treatment. The aim of this study was to compare microbiome composition and diversity in primary and post-treatment endodontic infections from a cohort of patients from the UAE. Intracanal samples were collected from primarily infected (n = 10) and post-treatment infected (n = 10) root canals of human teeth using sterile paper points. Bacterial DNA was amplified from seven hypervariable regions (V2-V4 and V6-V9) of the 16S rRNA gene, then sequenced using next-generation sequencing technology. The data was analyzed using appropriate bioinformatic tools. Analyses of all the samples revealed eight major bacterial phyla, 112 genera and 260 species. Firmicutes was the most representative phylum in both groups and was significantly more abundant in the post-treatment (54.4%) than in primary (32.2%) infections (p>0.05). A total of 260 operational taxonomic units (OTUs) were identified, of which 126 (48.5%) were shared between the groups, while 83 (31.9%) and 51 (19.6%) disparate species were isolated from primary and post-treatment infections, respectively. A significant difference in beta, but not alpha diversity was noted using several different indices (p< 0.05). Differential abundance analysis indicated that, Prevotella maculosa, Streptococcus constellatus, Novosphigobium sediminicola and Anaerococcus octavius were more abundant in primary infections while Enterrococcus faecalis, Bifidobacterium dentium, Olsenella profusa and Actinomyces dentalis were more abundant in post-treatment infections (p <0.05). Significant differences in the microbiome composition and diversity in primary and post-treatment endodontic infections were noted in our UAE cohort. Such compositional differences of microbiota at various stages of infection could be due to both intrinsic and extrinsic factors impacting the root canal ecosystem during disease progression, as well as during their therapeutic management. Identification of the key microbiota in primarily and secondarily infected root canals can guide in the management of these infections.

Antimicrobial Efficacy of Saline, Chlorhexidine, and Zataria Multiflora and Mentha Piperita Essential Oils in Root Canal Irrigation of Primary Molars.

Objectives: This study aimed to compare the antimicrobial efficacy of saline, 0.5% and 2% Zataria multiflora (Z. multiflora) essential oil, 0.5% and 2% Mentha piperita (M. piperita) essential oil, and 0.2% chlorhexidine (CHX) as root canal irrigants for primary molar teeth. Materials and Methods: A total of 64 primary molars were used in this in vitro study. The teeth were randomly assigned to six groups (N=10). The root canals were prepared up to file #35, and all teeth were sterilized before contamination with Enterococcus faecalis (E. faecalis; ATCC 29212) suspension. After 48 hours of incubation, the root canals in each group were irrigated with the respective irrigants. Sterile paper points were then used to collect microbial samples from the root canals. A colony counter was used to count the number of colony-forming units (CFUs). Data were analyzed by SPSS version 20 (alpha=0.05). Results: The colony count was significantly different among the groups (P<0.001), and 2% M. piperita (P=0.009), 0.5% Z. multiflora (P=0.021), and 0.2% CHX (P=0.002) were significantly more effective than saline in elimination of E. faecalis. The ascending order of microbial count after irrigation was as follows: saline > 0.5% M. piperita > 0.2% CHX > 2% M. piperita > 0.5% Z. multiflora. Conclusion: The current study showed the optimal antibacterial activity of 0.5% Z. multiflora essential oil and 2% M. piperita essential oil against E. faecalis, and indicated their possible efficacy for use as an irrigant for root canal irrigation of primary molars.

Comparative Evaluation of Microbial Reduction Using Silver Diamine Fluoride, Azadirachta indica (Neem) and Sodium Hypochlorite as Root Canal Irrigants after Biomechanical Preparation in Uniradicular Canals: An In Vivo Study.

It is difficult to completely eradicate microorganisms from the infected root canal system. Intracanal irrigants seem necessary for eradication of infected tissues and microorganisms in addition to mechanical debridement. Continuous use of chemical antimicrobial agents leads to serious side effects. Therefore, the need arises for alternative agents to overcome the disadvantages of their chemical counterparts. To evaluate and compare the antimicrobial efficacy of three endodontic irrigants against clinically isolated bacteria found in root canals containing necrotic pulp. Preirrigation sample were collected using sterile paper points and sent for microbial count. Chemomechanical preparation was performed, and the root canals were irrigated with 5 mL of test samples. After 3 days, the patient was recalled, and a postirrigation sample was collected and sent for microbial count. Both 3.8% silver diamine fluoride (SDF) and 3% sodium hypochlorite (NaOCl) showed a superior capacity to sterilize the root canals compared to the neem group. The use of SDF as an endodontic irrigant is feasible as it effectively removes the microbes present in the canal. Silver diamine fluoride has not been shown to be cytotoxic or carcinogenic, unlike NaOCl, suggesting it could be used as a potential endodontic irrigant. However, few studies have evaluated the antimicrobial efficacy of SDF as an endodontic irrigant. Raj S, Sharma A, Dhinsa K, et al. Comparative Evaluation of Microbial Reduction Using Silver Diamine Fluoride, Azadirachta indica (Neem) and Sodium Hypochlorite as Root Canal Irrigants after Biomechanical Preparation in Uniradicular Canals: An In Vivo Study. Int J Clin Pediatr Dent 2024;17(6):625-629.

Comparative Evaluation of Residual Antibacterial Substantivity of Chlorhexidine, MTAD and Chitosan Against Enterococcus Faecalis in Human Root Dentin - An In vitro Study.

Complex anatomy of the root canal system results in incomplete debridement with mechanical instrumentation, leaving some areas or root canal walls untouched. There comes the significance of endodontic irrigants with residual antibacterial substantivity which prolongs the post-antibiotic effect, thereby improving the success and predictability of endodontic treatment. To comparatively evaluate the residual antibacterial substantivity of 2% chlorhexidine, Biopure MTAD and 2% chitosan against Enterococcus faecalis at intervals of 1, 14 and 28 days. Seventy-five therapeutically extracted permanent single rooted mandibular premolars teeth were selected. Dentin blocks of 4 mm thickness were prepared and enlarged to 1.6 mm. The autoclaved blocks were inoculated with 24-hour colonies of pure cultures of E. faecalis for 14 days. After the contamination period, canals of each dentin block were irrigated with 5 ml of sterile saline and dried with sterile paper points. A total of 75 dentin blocks were randomly divided into five groups as follows: Group A (21 specimens): 2% chlorhexidine, Group B (21 specimens): Biopure MTAD, Group C (21 specimens): 2% chitosan, Group D (6 specimens): positive control (infected dentin tubes) and Group E (six specimens): negative control (sterile dentin tubes). Then, the lumens of dentin blocks were irrigated with the respective irrigants for 10 mins and were dried using sterile paper points. The specimens were then incubated at 37°C for 28 days to maintain humidity. At experimental intervals of 1, 14 and 28 days, dentin shavings were removed from the canals of respective groups by circumferential filing with sterile no. 35 Hedstrom files. The powdered dentin samples obtained with each dentin block were observed for colony forming units (CFUs) using a Digital Colony counter and were expressed as CFUs/mL. All the irrigants in the study showed a significant decrease in CFUs from day 1 to day 28 indicating that they have residual antibacterial substantivity against E. faecalis. Group B (Biopure MTAD) showed significantly least mean CFUs compared to Group A (2% CHX) and Group C (2% chitosan) against E. faecalis at B1(day 1), B2(day 14) and B3(day 28). Group A (2% CHX) showed significantly higher mean CFUs than Group C (2% chitosan) at A1(day 1). Group C (2% chitosan) showed significantly higher mean CFUs compared to Group A (2% CHX) at C2(day 14) and C3 (day 28). MTAD showed statistically higher residual antibacterial substantivity against E. faecalis at experimental periods of 1, 14 and 28 days. The residual antibacterial effect of 2% chitosan was better compared to 2% CHX at day 1. The residual antimicrobial substantivity of 2% CHX was higher compared to 2% chitosan at intervals of 14 and 28 days.

Evaluation of Antimicrobial Efficacy of Etidronic Acid against Enterococcus faecalis in Primary Teeth: An In Vivo Study.

In pulpectomy, to remove the inflamed or diseased pulp tissues and smear layer, the root canal is disinfected with mechanical instrumentation and copious irrigation. The purpose of this present study is to evaluate the antibacterial efficacy of etidronic acid as an irrigant in primary teeth. A total of 60 necrotic primary teeth in children aged 3-8 years were included. Of these, 30 were irrigated with 2% chlorhexidine (CHX) gluconate (group I) and 30 with 9% etidronic acid (group II). Two microbiological samples were collected with sterile paper points from the canal in both groups during the pulpectomy process-first after access opening and before the first irrigation (S1), and second after instrumentation and final irrigation, before filling (S2). The presence of Enterococcus faecalis was determined using colony-forming units per milliliter (CFU/mL) in all samples (S1 and S2). After analyzing the samples before and after irrigation in groups I and II, there was a statistically significant reduction in CFU/mL (p < 0.05). Group II had a statistically significant advantage when the two groups were compared after irrigation. As a result, etidronic acid can be recommended as a pulpectomy irrigating solution for necrotic primary teeth. Supraja AN, Arali V, Rapala H, et al. Evaluation of Antimicrobial Efficacy of Etidronic Acid against Enterococcus faecalis in Primary Teeth: An In Vivo Study. Int J Clin Pediatr Dent 2024;17(4):433-436.

Turmeric Gel as alternative Non-Vital Pulpotomy medicament in Primary teeth- A Randomized Controlled Trial

&lt;p&gt;&lt;strong&gt;Background and objective: &lt;/strong&gt;Formocresol is a gold standard medicament in both vital and non-vital Pulpotomies due to its potent antibacterial potential but, it has a controversial nature due to its side effects. Therefore, the demand for natural alternatives of Formocresol as a pulp dressing material, with few or no side effects, became imperative. The purpose of the study was to introduce Turmeric gel as non-vital Pulpotomy medicament in primary teeth by evaluating its antibacterial effect against&lt;em&gt; Streptococcus mutans&lt;/em&gt; and &lt;em&gt;Lactobacillus acidophilus&lt;/em&gt;.&lt;/p&gt;&#x0D; &lt;p&gt;&lt;strong&gt;Method: &lt;/strong&gt;It was a multi-arm parallel Randomized Controlled Trial in which sixty patients aged between 4 to 8 years, each containing at-least one non-vital primary molar, were selected and randomly divided into Group A (Formocresol) and Group B (Turmeric gel). Non-vital Pulpotomy was performed by removing the coronal necrotic pulp. Sterile paper points were dipped in the root canals and taken to the laboratory. Cotton pellets soaked in the respective medicaments were placed over the root canal orifices and filled temporarily. Patients were recalled after one week. Samples were again taken, and tooth restored. Comparison between bacterial count at baseline and after one week of treatment was made and expressed as Colony-Forming Units/ml (CFU/ml).&lt;/p&gt;&#x0D; &lt;p&gt;&lt;strong&gt;Results:&lt;/strong&gt; There was a significant reduction in median &lt;em&gt;Streptococcus mutans&lt;/em&gt; and &lt;em&gt;Lactobacillus acidophilus&lt;/em&gt; bacterial count in each group after one week of treatment (p &amp;lt; 0.001). Formocresol showed higher average reduction than Turmeric gel. However, statistically, the difference was insignificant indicating that both the medicaments possessed comparable antibacterial effect.&lt;/p&gt;&#x0D; &lt;p&gt;&lt;strong&gt;Conclusion:&lt;/strong&gt; Turmeric gel was found as effective alternative to Formocresol.&lt;/p&gt;&#x0D; &lt;p&gt;&lt;strong&gt;Randomized Controlled Trial registration number in ClinicalTrials.gov:&lt;/strong&gt; NCT05801354&lt;/p&gt;&#x0D; &lt;p&gt;&amp;nbsp;&lt;/p&gt;

An invitro comparison of antimicrobial efficacy of sodium hypochlorite gel with twin kleen irrigating solution against enterococcus feacalis

The Enterococcus faecalis (E. faecalis) is a normal inhabitant of the oral cavity and is the most commonly identified species in post treatment asymptomatic persistent endodontic diseases (both intra-radicular and extra- radicular). Its prevalence ranges from 24% to 77%. To completely eliminate microorganisms from the root canal system, combination of instrumentation and irrigation with antibacterial solutions is necessary. Hence, the purpose of this study was to evaluate and compare the antibacterial efficacy of sodium hypochlorite gel with twin kleen irrigating solution against E. faecalis.40 non-carious, single-rooted teeth with straight canals were selected and instrumented till F3 (30.06) ProTaper Universal (Dentsply Maillefer, Ballaigues, Switzerland). E faecalis was prepared and incubated in teeth and were randomly divided into four groups of 10 each, Group A – 5.25% NaOCl gel, Group B – Twin Kleen Irrigating solution, Group C – 3% NaOCl solution and Group D – Saline. Sterile paper points were used to collect the samples after irrigation and then they were transferred to blood agar culture plates to check the presence of E. faecalis. Significant statistical difference was seen between the four groups. The effect of 5.25% NaOCl gel was superior as compared to Twin Kleen irrigating solution.Under the limitations of this study, 5.25% NaOCl gel was effective in reducing E. faecalis count followed by Twin kleen irrigating solutions.

Comparative Evaluation of Microbial Flora of Endodontic Origin in Teeth with Endo-Perio Lesions

ABSTRACT Background: Endodontic microbial flora plays a pivotal role in the development and persistence of periodontal endodontic lesions (PELs). Understanding the composition and prevalence of microbial species in PELs is essential for effective treatment strategies Materials and Methods: Microbial samples were collected from 50 teeth diagnosed with PELs. Sterile paper points were used to obtain samples from the root canals. Deoxyribonucleic acid (DNA) was extracted and subjected to polymerase chain reaction (PCR) amplification of the 16S ribosomal RNA (rRNA) gene to identify bacterial species. The obtained data were analyzed using statistical methods. Results: The microbial analysis revealed a diverse range of bacterial species in PELs. The most prevalent species were Porphyromonas gingivalis (32.5%), Treponema denticola (28.0%), and Fusobacterium nucleatum (22.5%). Streptococcus mutans (9.0%) and Actinomyces naeslundii (8.0%) were also frequently detected. Additionally, Prevotella intermedia (7.0%), Aggregatibacter actinomycetemcomitans (3.5%), and Enterococcus faecalis (2.5%) were present in lower frequencies Conclusion: The presence of a diverse microbial flora in teeth with PELs underscores the polymicrobial nature of these lesions. The predominance of periodontal pathogens such as Porphyromonas gingivalis, Treponema denticola, and Fusobacterium nucleatum suggests a strong association between periodontal and endodontic infections. A comprehensive understanding of the microbial profile in PELs is crucial for tailored therapeutic approaches targeting the specific pathogens involved.

Evaluation of Antimicrobial Efficacy of 3.8% Silver Diamine Fluoride as a Root Canal Irrigant against Enterococcus Faecalis in Primary Teeth: A Randomised Clinical Trial

Introduction: During a pulpectomy, the infected or inflamed pulp tissues are removed, and the root canal is thoroughly cleaned with mechanical instrumentation and copious irrigation. Various endodontic irrigants are available, such as Sodium Hypochlorite (NaOCl), Chlorhexidine (CHX) gluconate, Ethylene Diamine Tetra Acetic Acid (EDTA), Mixture of doxycycline, citric acid, and a detergent (MTAD), etc. Among these, CHX gluconate is widely used as an endodontic irrigant and medicament due to its antibacterial effect and substantivity. Enterococcus faecalis is the most common bacterial species found in necrotic teeth, with high viability and antibiotic resistance. A 3.8% Silver Diamine Fluoride (SDF) has antimicrobial properties and has been shown to eliminate E. faecalis from the root canals of permanent teeth. However, there are no studies in the literature that have evaluated its efficacy as a root canal irrigant in primary teeth. Aim: To evaluate the antimicrobial efficacy of 3.8% SDF against E. faecalis in primary teeth. Materials and Methods: This was a in-vivo double-blinded randomised clinical trial conducted at Department of Paediatric and Preventive Dentistry, GSL Dental College and Hospital, Rajahmundry, Andhra Pradesh, India in children aged 3-8 years old. The study included 60 primary teeth that required pulpectomy. The teeth were divided into two groups and irrigated: 30 teeth with 3.8% SDF (Group I) and 30 teeth with 2% CHX (Group II). In all cases, two microbiological samples were taken using sterile absorbent paper points: the first after access opening and the second after the final irrigation. All samples were assessed using the agar plate method. The results were analysed statistically using a Student's paired t-test. Results: After analysing the pre- and postirrigation samples, there was a statistically significant reduction in Colony Forming Units (CFU)mL (p&lt;0.05) in both groups. When comparing the two groups, no statistical difference was observed in the percentage reduction of bacterial colonies (p&gt;0.05). Conclusion: The reduction in CFU/mL of E. faecalis was comparable in both groups. Thus, 3.8% SDF can be used as an alternative root canal irrigant to 2% CHX.

Temporary Root Canal Obturation with a Calcium Hydroxide-Based Dressing: A Randomized Controlled Clinical Trial.

Successful bacterial inactivation or elimination is essential for successful outcomes in endodontics. This study investigated the efficacy of a calcium hydroxide paste (Ca(OH)2) as a temporary medical dressing for 1 week after chemomechanical root canal treatment (CMRCT). Microbiological samples from 26 patients were collected after endodontic emergency treatment as follows: (1) removal of the provisional filling material; (2) CMRCT; (3) irrigation with sodium hypochlorite I (3%); (4) medicinal insertion of Ca(OH)2; and (5) irrigation with sodium hypochlorite II (3%). A microbiological examination was carried out after the specimens had been taken from the root canals via saline and sterile paper points. CMRCT resulted in a significant reduction in total bacterial load (TBL) in the root canal (p < 0.05). Additional irrigation (3) resulted in a further significant reduction in TBL (p < 0.05). In contrast, Ca(OH)2 medication did not prevent the bacterial load from returning to the previous level immediately after CMRCT, but did not increase above that level either (p < 0.05). However, the increase in TBL was significant (p < 0.05) in comparison with the disinfection groups (I/II). Administration of Ca(OH)2 for 1 week shows that in combination with an additional disinfection procedure, an increase in TBL must be expected, but not above the level of conditions after CMRCT.

Comparative Evaluation of the Efficacy of Chlorhexidine, Diode Laser, and Saline in Reducing the Microbial Count in Primary Teeth Root Canals: An In Vivo Study.

Different irrigation materials in pediatric endodontics. To evaluate the efficacy of chlorhexidine (CHX), diode laser, and saline in primary teeth root canals. This manuscript is designed to know the effectiveness of the different root canal irrigants and laser irradiation technology in primary teeth root canals. A total of 60 primary teeth from 60 children were selected and divided into three groups of 20 each. Group I (CHX), group II (diode laser), and group III (saline). Pulp tissue was extirpated from the root canals of primary teeth, and samples were collected using sterile paper points. After cleaning and shaping, the root canals of the teeth in each group were disinfected using CHX and saline or irradiated with a diode laser. The samples were collected again and sent for microbiological examination. Statistical analyzes were performed using the Wilcoxon signed-rank test, Mann-Whitney U test, and Kruskal-Wallis one-way analysis of variance. All analyzes were conducted using the Statistical Package for the Social Sciences version 23.0. The colony-forming unit (CFU) of the predisinfection sample served as a baseline for comparisons throughout the study. The mean microbial counts of all the postdisinfected samples were reduced after disinfection. Intergroup comparisons showed significant results between groups I and III (CHX and saline) and groups II and III (diode laser and saline) (p < 0.01), whereas groups I and II (CHX and diode laser) showed nonsignificant results (p < 0.092). Diode laser irradiation succeeded in reducing root canal infection when compared with 2% CHX. Diode laser irradiation can also be used for disinfecting the root canal in primary teeth. Botu RK, Rachuri P, Martha S, et al. Comparative Evaluation of the Efficacy of Chlorhexidine, Diode Laser, and Saline in Reducing the Microbial Count in Primary Teeth Root Canals: An In Vivo Study. Int J Clin Pediatr Dent 2023;16(3):459-463.

Comparative Evaluation of Antimicrobial Efficacy of Calcium Hydroxide, Chlorhexidine, and Triple Antibiotic Paste in Different Combination Forms as Intracanal Medicaments against Enterococcus faecalis in Primary Teeth: An In Vivo Randomized Clinical Trial.

To compare and evaluate the antimicrobial efficacy against Enterococcus faecalis (E. faecalis) between a mix of calcium hydroxide [Ca(OH)2] powder and normal saline, a mix of Ca(OH)2 powder and 2% chlorhexidine (CHX) gluconate solution, a mix of triple antibiotic powder (TAP) and normal saline, and mix of TAP and 2% CHX gluconate solution. A total of 60 teeth were included in the study. The first sample (S1) was collected after access opening from the widest canal of the tooth by inserting sterile absorbable paper point no 20 up to the full length of the canal for 1 minute. The second sample (S2) was collected after the chemomechanical preparation and irrigation. After that, subjects were randomly divided into four groups-group I-a mix of Ca(OH)2 and normal saline; group II-a mix of Ca(OH)2 and 2% CHX; group III-a mix of TAP and normal saline; and group IV-a mix of TAP and 2% CHX. Assigned intracanal medicaments were placed in the canals, and the teeth were temporarily sealed with a temporary restorative material. On the 7th day, canals were reopened and irrigated, and a third bacteriological sample (S3) was taken out. Later, canals were filled with suitable obturating material, followed by the placement of the permanent restoration. There was a very highly significant (p < 0.005) difference in E. faecalis count in all the groups on day 7 after placement of intracanal medicament, being highest in group IV followed by group II, group III, and group I. Triple antibiotic powder (TAP) mixed with 2% CHX gluconate solution has superior antimicrobial efficacy against E. faecalis in primary teeth. Qamar S, Jayanna R, Ahuja VR. Comparative Evaluation of Antimicrobial Efficacy of Calcium Hydroxide, Chlorhexidine, and Triple Antibiotic Paste in Different Combination Forms as Intracanal Medicaments against Enterococcus faecalis in Primary Teeth: An In Vivo Randomized Clinical Trial. Int J Clin Pediatr Dent 2023;16(3):448-452.

Quantitative analysis of culturable bacteria, levels of endotoxins, inflammatory mediators and substance P in teeth with symptomatic irreversible pulpitis and in teeth with vital normal pulp tissues.

To comparatively analyse the levels of culturable bacteria, endotoxins (LPS), tumour necrosis factor-alpha (TNF-α), interleukin-1 beta (IL-1β) and substance P in teeth with symptomatic irreversible pulpitis (SIP) and vital normal pulp (VNP) tissues. Thirty-two patients were included (20 teeth with SIP and 12 teeth with VNP tissues) in this cross-sectional study. Samples were collected from the full length of the root canals (microbial analysis) and periapical tissues (2 mm beyond the apex for immunological analysis), using sterile absorbent paper points. The levels of culturable bacteria (culture method), endotoxins (LAL Pyrogent 5000), TNF-α, IL-1β and substance P (ELISA) were assessed. The Mann-Whitney test was used for comparisons between the levels of CFU/mL, LPS, TNF-α, IL-1β and substance P in the SIP and VNP groups. The statistical analysis was performed with the significance level set at 5%. Culturable bacteria were recovered from all teeth with SIP. On the other hand, no positive cultures were observed in the VNP tissues group (p > .05). The levels of LPS were approximately four times higher in teeth with SIP than in teeth with VNP tissues (p < .05). Higher levels of TNF-α and substance P were detected in teeth with SIP (p < .05). On the other hand, no difference in the levels of IL-1β was detected between the two groups (p > .05). Teeth with symptomatic irreversible pulpitis present higher levels of culturable bacteria, endotoxins, TNF-α and substance P than those with vital normal pulp tissues. On the other hand, the levels of IL-1β were similar in teeth from both groups suggesting reduced implications of this inflammatory mediator in the early stages of infection.

A pattern of microbiological colonization of orthodontic miniscrew implants

Current orthodontic literature reveals a lack of studies on bacterial colonization of orthodontic miniscrew implants (MSI) and their role in the stability of MSI. This study aimed to determine the pattern of microbiological colonization of miniscrew implants in 2 major age groups, to compare it with the microbial flora of gingival sulci in the same group of patients and to compare microbial flora in successful and failed miniscrews. The study involved 102 MSI placed in 32 orthodontic subjects in 2 age groups: (1) aged≤14 years and (2) aged>14 years. Gingival and peri-mini implant crevicular fluid samples were collected using sterile paper points (International Organization for Standardization no. 35)>3 months and processed by conventional microbiologic culture and biochemical techniques. A microbiologist characterized and identified the bacteria, and the results were subjected to statistical analysis. Initial colonization was reported within 24 hours, with Streptococci being the dominant colonizer. The relative proportion of anaerobic bacteria over aerobic bacteria increased over time in peri-mini implant crevicular fluid. Group 1 had greater Citrobacter (P= 0.036) and Parvimonas micra (P= 0.016) colonizing MSI than group 2. Failed MSI showed a significantly higher presence of Parvimonas micra (P= 0.008) in group 1 and Staphylococci (P= 0.008), Enterococci (P= 0.011), and Parvimonas micra (P<0.001) in group2. Microbial colonization around MSI is established within 24 hours. Compared to gingival crevicular fluid, peri-mini implant crevicular fluid is colonized by a higher proportion of Staphylococci, facultative enteric commensals and anaerobic cocci. The failed miniscrews showed a higher proportion of Staphylococci, Enterobacter, and Parvimonas micra, suggesting their possible role in the stability of MSI. The bacterial profile of MSI varies with age.

Efficacy of 5.25% Sodium hypochlorite and 810 diode laser in reduction of microbial count in root canals of primary teeth- An in vivo Study

Aim: Root canal treatment is often carried out in deciduous teeth to relieve pain and make the tooth functional.The main goal of instrumentation in a root canal treatment is to facilitate effective irrigation, disinfection, and filling. Sodium hypochlorite is a widely used irrigant and has been demonstrated to be an effective agent against broad spectrum of bacteria. However its toxic effects on vital tissues can result in haemolysis, skin ulceration and necrosis. The use of diode laser for endodontic applications has been investigated and proven for its efficacy in root canal sterilization. Therefore, this clinical study was conducted to evaluate and compare the efficacies of 5.25% sodium hypochlorite (NaOCl) and 810nm diode laser as disinfectants in root canals of primary teeth. This study evaluated the microbial count and the clinical success of the treatment. Materials and Methods: In 40 subjects selected based on the inclusion and exclusion criteria, Pulp tissue was extirpated from the canals and samples collected using sterile absorbent paper points . Then they were randomly divided into two groups. In Group 1, canals were prepared and irrigated with 5.25% of sodium hypochlorite, and in group 2 canals were prepared and disinfected with 810nm of diode laser. The contents of canals were collected again with a sterile paper point .Samples taken before and after procedures were cultured, and the colony-forming units (CFUs) were counted. The data was evaluated using independent sample test and paired sample test. Patients were recalled for clinical and radiographic evaluation after 3 and 6 months. Results: There was a significant difference between the mean CFU of laser and sodium Hypochlorite ( p&lt;.001). Clinical evaluation after 3 and 6 months showed no pain, swelling, sinus tract or mobility .Radiographically too there was absence of premature exfoliation, periodontal widening, internal/external resorption and periapical or furcal radiolucency. Conclusion: Both 810nm diode laser and 5.25% sodium hypochlorite were effective in reducing bacterial count in root canals of primary teeth. However 810nm diode laser reduced microbial count of root canals more as compared to 5.25% NaOCl.

Microbiological Effectiveness of Sodium Hypochlorite Gel and Aqueous Solution When Implemented for Root Canal Disinfection in Multirooted Teeth: A Randomized Clinical Study

The aim of endodontic therapy is to use various antimicrobial medications for proper cleaning and shaping to create an environment free of microorganisms by eradicating as many as possible from the root canal space. Even although it is a gold standard irrigant, sodium hypochlorite (NaOCl) is known for its cytotoxic effects on vital periapical tissues, making its higher concentrations inappropriate for use in conditions such as wide, underdeveloped, or damaged apices and in cases of perforations. Consequently, if it is ascertained that a gel form of sodium hypochlorite has equivalent antibacterial activity to the aqueous solution form, it could be employed in such situations. The aim of this study was the microbiologic evaluation of 5.25% sodium hypochlorite gel and aqueous solution as root canal disinfectants in multirooted teeth with primary endodontic lesions. Following ethical approval and CTRI registration, 42 patients who gave their consent and had multirooted teeth with pulpal necrosis and asymptomatic apical periodontitis were considered for the study. Following the opening of the access, pre-endodontic build up in case of class-II cavities and working length determination, a pre-operative sample (S1), which was regarded as the pre-operative microbial load of that canal, was acquired from the largest canal using a sterile paper point while maintaining strict isolation and disinfection. The computer randomization approach was used to divide the teeth into two groups at random just before beginning of chemo-mechanical preparation: Group A (n = 21)-canal disinfection with 5.25% sodium hypochlorite gel; Group B (n = 21)-canal disinfection with 5.25% sodium hypochlorite aqueous solution. Following the canal disinfection, a post-operative (S2) sample which was regarded as the postoperative microbial load of that canal was collected from the same canal using a sterile paper point. The Colony-Forming Units (CFUs) for the S1 and S2 samples were determined after 48 h aerobic incubation on Brain Heart Infusion (BHI) agar plates. The patients and the microbiologist were blinded throughout the procedure. Using SPSS 20.0 software (USA), the Shapiro-Wilk test and the Lilliefors Significance Correction were used for normality, followed by the Mann-Whitney U test which was used to compare the CFU difference (×105) between the two groups. A p value of <0.05 was perceived as statistically significant. The mean colony-forming units count difference between the 5.25% sodium hypochlorite gel and aqueous solution groups did not differ in a manner that was statistically significant (p = 0.744). In multirooted teeth with primary endodontic lesions, the 5.25% sodium hypochlorite gel and the aqueous solution demonstrated comparable antimicrobial effectiveness when implemented as root canal disinfectants.

Detection of Actinobacillus actinomycetemcomitans DNA in Patients with Partial and Complete Dentures by Real-Time PCR

Background: The purpose of the present study was to detect Actinobacillus actinomycetemcomitans (Aa) using RT-PCR in patients with complete and partial edentulism before (T0) and three months after (T3) treatment with removable partial dentures (RPD) and complete dentures (CD), respectively, to compare the data between these two research groups. Methods and Results: The sample comprised 60 patients: 33 men and 27 women, aged 48 to 76 years. The patients were divided into two groups. Group 1 included 30 patients with partial edentulism who were treated with RPD. Group 2 included 30 patients with complete edentulism who were treated with CD. The samples from Group 1 were taken from the gingival sulcus of the abutment teeth by means of sterile paper points. For Group 2, the samples were taken with a sterile swab from the dorsum of the tongue. The samples were taken in T0 and T3 intervals. To detect Aa DNA, we used RT-PCR and ParodontoScreen REAL-TIME PCR Detection Kit (DNA-TECHNOLOGY). Bacterial load levels of species were conventionally represented in logarithm (Lg) of genome equivalents per sample. The results were also presented in three ranges depending on the level of bacterial load: normal (&lt; 4.0Lg), light/moderate (≥4.0 Lg), and severe (&gt;5.0 Lg). The study found a significant difference in the amount of Aa between the T0 and T3 intervals only in patients treated with RPD (0.871.58 Lg vs. 1.28 1.96 Lg, P=0.004). Patients treated with CD, however, did not differ significantly in the amount of Aa between the T0 and T3 intervals (0.030.16 Lg vs. 0). The average bacterial load in patients with RPD was significantly higher than in those with CD three months after treatment (P=0.02) (Table 2). The range of bacterial load levels in the groups is presented in Table 3. Of the 30 patients with RPD, 2(6.7%) had a severe range, 2(6.7%) had a mild/moderate range, and 26(86.7%) had a normal range. The 30 CD patients all had a normal range. There was no significant difference in the prevalence range of bacterial load level with Aa between groups (Fisher's Exact Test = 3.537, P=0.113) / Monte Carlo Sig. (2-sided) / 0.105–0.121). However, in general, RPD causes a significant increase in Aa, so the level of periodontal pathogens may be higher in RPD patients than in CD patients.

Microbial Evaluation of Root Canals after Biomechanical Preparation with Manual K-files, Manual H-files, and Kedo-SG Blue Rotary Files: An In Vivo Study.

The purpose of the present study was to comparatively evaluate the efficacy of Kedo-SG blue rotary files, manual K-files, and manual H-files in eliminating the root canal microflora of primary molars. Forty-five primary molars requiring pulpectomy were included in the study. Based on type of instrumentation, the teeth were randomly assigned to one of the three groups: group A: Kedo-SG blue rotary files, group B: manual H-files, and group C: manual K-files. Sterile absorbent paper points were used for sample collection and stored in sterile Eppendorf tubes containing saline as transport medium. Culturing was done on thioglycolate agar and blood agar media for the cultivation of anaerobic and aerobic microbes, respectively, and recorded as colony-forming units (CFU) using digital colony counter. Wilcoxon signed-rank test and one-way analysis of variance (ANOVA) test were performed for statistical analysis. Postinstrumentation, 93-96% reduction of aerobic and anaerobic microbial count was recorded in group A. Whereas, it was 87-91% reduction in group B and 90-91% reduction in group C. No statistically significant difference was noted between the three groups. Kedo-SG blue rotary files showed a better reduction of microbes in root canals when compared to manual instrumentation. However, there was no significant difference between manual and rotary instrumentation in microbial reduction of primary root canals. Lakshmanan L, Jeevanandan G. Microbial Evaluation of Root Canals after Biomechanical Preparation with Manual K-files, Manual H-files, and Kedo-SG Blue Rotary Files: An In Vivo Study. Int J Clin Pediatr Dent 2022;15(6):687-690.

Microbiological profile of peri-implantitis: Analyses of microbiome within dental implants.

To characterize the microbiome composition within dental implants of peri-implantitis subjects and healthy controls using 16S rRNA gene sequencing. Twenty-three subjects with healthy (n=11 implants) and diseased (peri-implantitis, n=21) implants were included in this controlled clinical cross-sectional study. Samples were obtained from internal surfaces of dental implants using sterile paper points for microbiological analysis. DNA was extracted, and the16S rRNA gene was amplified using universal primers targeting the V3-V4 regions. The resulting 16S polymerize chain reaction amplicons were sequenced on Illumina MiSeq, and the sequences were processed using DADA2 and the Human Oral Microbiome Database (HOMD) as references. Alpha and Beta diversity, as well as core microbiome and differential abundance analyses were then performed using the MicrobiomeAnalyst workflow. A significant increase in microbial diversity was observed in the internal implant surface of healthy implants compared with the internal surfaces of peri-implantitis (Shannon p=0.02). Bacterial community structure was significantly different among groups (p=0.012). High levels of Gram-positive bacteria were detected inside implants with peri-implantitis compared to healthy implants, especially Enterococci. There is a shift in bacterial diversity inside implants with peri-implantitis from the healthy control. The microbial colonization within that space might contribute to the etiology of peri-implant disease.