Beruflich Dokumente
Kultur Dokumente
Abstract
Aim/Objective: The aim of this study is to compare the antimicrobial efficacy of QMixTM 2 in 1, sodium hypochlorite (NaOCl),
and chlorhexidine (CHX) against Enterococcus faecalis and Candida albicans.
Materials and Methods: Eighty freshly extracted, single-rooted human mandibular premolar teeth were instrumented and
autoclaved. Samples were divided into two groups of 40 teeth each based on the type of microorganism used. Group I was
inoculated with E. faecalis and Group II with C. albicans and incubated for 3 days. Each group was subdivided into four
subgroups based on the type of irrigant used. Group IA, IIA, 5.25% NaOCl; Group IB, IIB, 2% CHX; Group IC, IIC, QMixTM
2 in 1; and Group ID, IID, 0.9% saline (the control group). Ten microliters of the sample from each canal was taken and was
placed on Brain Heart Infusion agar and Sabouraud dextrose agar. The plates were incubated at 37C for 24 h and colony
forming units (CFUs) that were grown were counted. Data was analyzed with analysis of variance (ANOVA) followed by posthoc Games-Howell test.
Results: The greatest antimicrobial effects were observed in samples treated with QMixTM 2 in 1 (P < 0.001). No statistical
significant difference was found between 5.25% NaOCl and 2% CHX (P > 0.001) against E. faecalis and C. albicans.
Conclusion: QMixTM 2 in 1 demonstrated significant antimicrobial efficacy against E. faecalis and C. albicans.
Keywords: Candida albicans; chlorhexidine; Enterococcus faecalis; QMixTM 2 in 1; sodium hypochlorite
INTRODUCTION
One of the most important objectives of endodontic therapy
is to completely eliminate intracanal microorganisms from
the root canal system to create favorable environment for
healing and to prevent reinfection in order to achieve longterm success.[1]
Endodontic infections are polymicrobial in nature with
predominant anaerobic microorganisms. Bacteria and their
metabolic products, enzymes, and toxins play a vital role
in the initiation, propagation, and persistence of pulpal
and periradicular pathosis.[2] Although several factors
contribute to endodontic failures, the literature reported
that persistent intraradicular or secondary infection is
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128
Website:
www.jcd.org.in
DOI:
10.4103/0972-0707.153067
129
RESULTS
Results were analyzed with the Statistical Package for
Social Sciences (SPSS)/Predictive Analytics Software
(PASW) version 18 software. Table 1 shows the mean CFUs
of E. faecalis and C. albicans. QMixTM 2 in 1 was the most
effective and statistically significant when compared with
5.25% NaOCl and 2% CHX (P < 0.001). There is no statistical
significant difference between 5.25% NaOCl and 2% CHX
(P > 0.001).
DISCUSSION
The main goal of chemomechanical preparation of infected
root canals is to completely eliminate intracanal bacteria
and prevention of recontamination after treatment.[1] This
laboratory study was aimed to evaluate the antimicrobial
efficacy of QMixTM 2 in 1, NaOCl, and CHX against E. faecalis
Table 1: Comparison of CFUs among the study groups
Group I
Subgroups
Mean (N = 10)
SD
2.88
2.76
1.36*
3.20
2.46
2.37
1.06*
3.33
0.09
0.18
1.18
0.08
0.87
0.85
1.12
0.30
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CONCLUSION
Within the limitations of this study, QMixTM 2 in 1
demonstrated significant antimicrobial efficacy against
E.faecalis and C. albicans.
REFERENCES
1.
Brito PR, Souza LC, Machado de Oliveira JC, Alves FR, De-Deus G,
Lopes HP, et al. Comparison of the effectiveness of three irrigation
techniques in reducing intracanal Enterococcus faecalis populations:
An in vitro study. J Endod 2009;35:1422-7.
2. Liu H, Wei X, Ling J, Wang W, Huang X. Biofilm formation capability of
Enterococcus faecalis cells in starvation phase and its susceptibility to
sodium hypochlorite. J Endod 2010;36:630-5.
3. Hoelscher AA, Bahcall JK, Maki JS. In vitro evaluation of the antimicrobial
effects of a root canal sealer-antibiotic combination against Enterococcus
faecalis. J Endod 2006;32:145-7.
4. Tirali RE, Turan Y, Akal N, Karahan ZC. In vitro antimicrobial activity
of several concentrations of NaOCl and Octenisept in elimination of
endodontic pathogens. Oral Surg Oral Med Oral Pathol Oral Radiol
Endod 2009;108:e117-20.
5. Shon W, Lim S, Bae KS, Baek S, Lee W. The expression of
alpha 4 integrins by human polymorphonuclear neutrophils in
response to sonicated extracts of Enterococcus faecalis. J Endod
2005;31:369-72.
6. Kayaoglu G, Erten H, Bodrumlu E, rstavik D. The resistance of
collagen-associated, planktonic cells of Enterococcus faecalis to
calcium hydroxide. J Endod 2009;35:46-9.
7. Chandra SS, Miglani R, Srinivasan MR, Indira R. Antifungal efficacy
of 5.25% sodium hypochlorite, 2% chlorhexidine gluconate, and 17%
EDTA with and without an antifungal agent. J Endod 2010;36:675-8.
8. Valera MC, Silva KC, Maekawa LE, Carvalho CA, Koga-Ito CY, CamargoCH,
et al. Antimicrobial activity of sodium hypochlorite associated with
intracanal medication for Candida albicans and Enterococcus faecalis
inoculated in root canals. J Appl Oral Sci 2009;17:555-9.
9. Dametto FR, Ferraz CC, Gomes BP, Zaia AA, Teixeira FB,
de Souza-FilhoFJ. In vitro assessment of the immediate and prolonged
antimicrobial action of chlorhexidine gel as an endodontic irrigant
against Enterococcus faecalis. Oral Surg Oral Med Oral Pathol Oral
Radiol Endod 2005;99:768-72.
10. Oliveira DP, Barbizam JV, Trope M, Teixeira FB. In vitro antibacterial
efficacy of endodontic irrigants against Enterococcus faecalis. Oral Surg
Oral Med Oral Pathol Oral Radiol Endod 2007;103:702-6.
11. Retamozo B, Shabahang S, Johnson N, Aprecio RM, Torabinejad M.
Minimum contact time and concentration of sodium hypochlorite
required to eliminate Enterococcus faecalis. J Endod 2010;36:520-3.
12. Siqueira JF Jr, Paiva SS, Rocas IN. Reduction in the cultivable
bacterial populations in infected root canals by a chlorhexidine-based
antimicrobial protocol. J Endod 2007;33:541-7.
13. Murray PE, Farber RM, Namerow KN, Kuttler S, Garcia-Godoy F.
Evaluation of morinda citrifolia as an endodontic irrigant. J Endod
2008;34:66-70.
14. Wang CS, Arnold RR, Trope M, Teixeira FB. Clinical efficiency of 2%
chlorhexidine gel in reducing intracanal bacteria. J Endod 2007;33:1283-9.
15. Xu Y, Young MJ, Battaglino RA, Morse LR, Fontana CR, Pagonis TC, etal.
Endodontic antimicrobial photodynamic therapy: Safety assessment in
mammalian cell cultures. J Endod 2009;35:1567-72.
16. Dai L, Khechen K, Khan S, Gillen B, Loushine BA, Wimmer CE, et al.
The effect of Qmix, an experimental antibacterial root canal irrigant, on
removal of canal wall smears layer and debris. J Endod 2011;37:80-4.
17. Wang Z, Shen Y, Haapasalo M. Effectiveness of endodontic disinfecting
solutions against young and old Enterococcus faecalis biofilms in dentin
canals. J Endod 2012;38:1376-9.
18. Ma J, Wang Z, Shen Y, Haapasalo M. A new non invasive model to study
the effectiveness of dentin disinfection by using confocal laser scanning
microscopy. J Endod 2011;37:1380-5.
19. Orstavik D, Haapasalo M. Disinfection by endodontic irrigants and
dressings of experimentally infected dentinal tubules. Endod Dent
Traumatol 1990;6:142-9.
20. Ercan E, Dalli M, Dlgergil CT. In vitro assessment of the effectiveness
of chlorhexidine gel and calcium hydroxide paste with chlorhexidine
against Enterococcus faecalis and Candida albicans. Oral Surg Oral
Med Oral Pathol Oral Radiol Endod 2006;102:e27-31.
21. Stojicic S, Shen Y, Qian W, Johnson B, Haapasalo M. Antibacterial and smear
layer removal ability of a novel irrigant, Qmix. Int Endod J 2012;45:363-71.
22. Fidalgo TK, Barcelos R, Portela MB, Soares RM, Gleiser R, Silva-FilhoFC.
Inhibitory activity of root canal irrigants against Candida albicans,
Enterococcus faecalis and Staphylococcus aureus. Braz Oral Res
2010;24:406-12.
23. Berber VB, Gomes BP, Sena NT, Vianna ME, Ferraz CC, Zaia AA,
etal. Efficacy of various concentrations of NaOCl and instrumentation
techniques in reducing Enterococcus faecalis within root canals and
dentinal tubules. Int Endod J 2006;39:10-7.
24. Sassone LM, Fidel RA, Murad CF, Fidel SR, Hirata R Jr. Antimicrobial
activity of sodium hypochlorite and chlorhexidine by two different tests.
Aust Endod J 2008;34:19-24.
25. Mohammadi Z, Abbott PV. The properties and applications of
chlorhexidine in endodontics. Int Endod J 2009;42:288-302.
26. Pavlovic V, Zivkovic S. Chlorhexidine as a root canal
irrigant Antimicrobial and scanning electron microscopic evaluation.
Srp Arh Celok Lek 2010;138:557-63.
27. Arslan S, Ozbilge H, Kaya EG, Er O. In vitro antimicrobial activity of propolis,
BioPure MTAD, sodium hypochlorite, and chlorhexidine on Enterococcus
faecalis and Candida albicans. Saudi Med J 2011;32:479-83.
28. Sen BH, Safavi KE, Spangberg LS. Antifungal effects of sodium
hypochlorite and chlorhexidine in root canals. J Endod 1999;25:235-8.
29. Ruff ML, McClanahan SB, Babel BS. In vitro antifungal efficacy of four
irrigants as a final rinse. J Endod 2006;32:331-3.
30. Kuruvilla JR, Kamathmp MP. Antimicrobial activity of 2.5% sodium
hypochlorite and 0.2% chlorhexidine gluconate separately and
combined, as endodontic irrigants. J Endod 1998;24:472-6.
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