Journal of Dental Medicine

Statement of Problem: Root canal cleaning and elimination of the source of infection are the most important basis and the main requirements for successful root treatment since the main cause of failure in root treatment is the permeation of bacteria or their products into the periapical tissues. Nowadays, the newly designed and prcsented instruments for canal instrumentation can improve root treatment.

Purpose: The aim of this study was to compare the decrease in the number of intracanal Enterococcus-faecalis (Ef) among three mechanical instrumentation methods: manual (K-type) and rotary (Race, Profile).

Materials and Methods: In this experimental study, 30 single rooted teeth were selected. Three cases were considered as negative and three cases as posetive controls and 24 remainder cases were divided into three experimental groups. All root canals were inoculated by Ef and samples were taken from all canals to prepare microbial cultures. The three instrumentation procedures were: - Crown- down technique with K-type manual system file - Crown- down technique with Profile rotary system - Crown- down technique wiht Race rotary system After instrumentation, microbial cultures were taken from root canals and the reduction rate of bacteria were evaluated and compared using one way ANOVA test with P<0.05 as the limit of significance.

Results: There was no significant difference among the three instrumentation procedures regarding bacterial elimination.

Conclusion: According to the finding of this study, K-type manual file, Profile and Race rotary systems, all can be used in canal instrumentaion. However, since manual files are more accessible and require less equipment compared with rotary systems, and since the ability of all of these methods is identical regarding bacterial elimination, manual files can be used in straight canal instead of rotary systems.

Background and Aim: Today several materials have been used for root- end filling in endodontic surgery. Optimal properties of Pro Root MTA in in-vitro and in-vivo studies has been proven. On the other hand, based on some studies, Root MTA (Iranian Pro Root MTA) and Portland cement are similar to Pro Root MTA in physical and biologic properties. The aim of this study was to evaluate bacterial leakage (amount and mean leakage time) of four root- end filling materials.

Materials and Methods: In this experimental in-vitro study, seventy six extracted single- rooted human teeth were randomly divided into six groups for root-end filling with gray Pro Root MTA, white Pro Root MTA, Root MTA (Iranian Pro Root MTA), Portland Cement (type I) and positive and negative control groups. Root canals were instrumented using the step- back technique. Root- end filling materials were placed in 3mm ultra sonic retro preparations. Samples and microleakage model system were sterilized in autoclave. The apical 3-4 mm of the roots were immersed in phenol red with 3% lactose broth culture medium. The coronal access of each specimen was inoculated every 24h with a suspension of Streptococcus sanguis (ATCC 10556). Culture media were observed every 24h for colour change indicating bacterial contamination for 60 days. Statistical analysis was performed using log- rank test with P<0.05 as the limit of significance.

Results: At the end of study 50%, 56.25%, 56.25% and 50% of specimens filled with Gray Pro Root MTA, White Pro Root MTA. Root MTA and Portland Cement (type I) had evidence of leakage respectively. The mean leakage time was 37.19±6.29, 36.44±5.81, 37.69±5.97 and 34.81±6.67 days respectively. Statistical analysis of data showed no significant difference among the leakage (amount and mean leakage time) of the four tested root- end filling materials (P=0.9958).

Conclusion: Based on the results of this study, there were no significant differences in leakage among the four tested groups at 60 days. The results suggest that Root MTA and Portland Cement can be used as less expensive root filling materials.

Background and Aim: Many studies have shown that microorganisms are the main cause of pulpal diseases and the main purpose of root canal therapy is their elimination from the root canal system. Antiseptic agents are used to reduce bacteria but their antibacterial activities differ from in vivo to in vitro studies and might be inactivated by dentin and its components in root canal space. This study was designed to investigate the effect of dentin on antibacterial activity of different antimicrobial agents.

Materials and Methods: In this experimental study, two antibacterial agents (sodium hypochlorite and chlorhexidine) with different concentrations were used in four experimental groups: Group 1: dentin, Group 2: demineralized dentin with EDTA, Group 3: dentin matrix and Group 4: dentin mineral component. The species used in this study was Entrococcus faecalis. Different concentration of agents were added to mixture of each experimental group and bacteria. At the baseline and after one and 24 hours, samples were collected and cultured. After incubation period, colonies were counted. Data were analyzed by Tukey test with p<0.05 as the limit of significance.

Results: 2% and 0.2% chlorhexidine, and 5% sodium hypochlorite solutions at the three studied times eliminated Entrococcus faecalis completely. 1% sodium hypochlorite eliminated all bacteria in 1h and 24 hs. Statistical analysis showed significant differences between experimental and control groups (P<0.05). Sodium 1% hypochlorite at time 0, could reduce bacteria significantly (P<0.05) but didn’t eliminate them completely.

Conclusion: Inactivation of intracanal antiseptics was not observed in this study. As elimination of bacteria occurred, application of these antibacterial agents are recommended in endodontic treatment. Further investigations on other antibacterial agents, other concentrations and shorter time intervals are recommended.

Background and Aim: Researches have shown that bacteria play the main role in development of pulpal and periapical diseases. Chemo-mechanical cleaning of infected root-canal system can not remove all of the microorganisms. Thus interappointment medicaments are necessary to aid this goal. Calcium hydroxide is one of the most useful medicaments in root canal therapy, but this medicament can not eliminated all of the bacteria in root canal system. Carvacrol is an edible plant extract that has antimicrobial and anti-inflammatory effects. If this extract is effective against endodontic bacteria, it can be used as an root canal medicament.

Materials and Methods: In this experimental study, Initially, MIC and MBC of carvacrol detected with Macro broth dilution method and determined as 0.3% and 0.6%, respectively. After that, 30 single root and single canal extracted human teeth were used in this study. The number of specimens determined in a pilot study on 4 extracted teeth. After preparation to apical size # 30 with hand and rotary instruments, teeth were randomly divided into two experimental and two control groups. After culturing Enterococcus faecalis in prepared canals, we used emulsion of 0.6% carvacrol and calcium hydroxide in two A and B experimental groups for 7 days as the intracanal medicament. Microbial samples obtained before and after experiment. Then, canals with negative culture selected to obtain dentinal shaving to culture. Data obtained from microbiological samples analyzed with kruskal-wallis and Bonferroni tests.

Results: Results of this study showed that emulsion of 0.6% carvacrol has no significant difference with calcium hydroxide in elimination enterococcus faecalis after 7 days dressing (p>0.05).

Conclusion: Carvacrol can be used as an intrappointment intracanal medicament.

Background and Aims: Instrumentation of the root canals results in formation of smear layer which covers the dentinal tubules. In infected teeth, it is ideal to achieve a material that has the ability to remove the smear layer besides antimicrobial activity. Therefore, this study was designed to evaluate the antimicrobial effect of Citrus aurantifolia extracts (lime juice and rind extract) on Enterococcus faecalis within dentinal tubules in the presence of smear layer.
Materials and Methods: One-hundred and forty dentin tubes were prepared from bovine incisors. After removal the smear layer, the specimens were infected with Enterococcus faecalis. Then, the smear layer was reformed. Test solutions were used as the irrigants in study roups as follows: group 1: 5.25% NaOCl group 2: 17% EDTA group 3: NaOCl+EDTA group 4: Lime juice group 5: ethanolic rind extract of C.aurantifolia group 6: 96% ethanol. Dentin chips were collected from inner and outer layers of dentinal walls and optical density was measured. The data were analyzed using one-way ANOVA and Tamhane tests.
Results: In outer layer of dentin, the efficacy of rind extract was less than that of NaOCl+EDTA (P<0.05). Also Lime juice was less effective than EDTA, NaOCl and NaOCl+EDTA (P<0.05). In inner layer of dentin, Lime juice was significantly less effective than NaOCl and NaOCl+EDTA (P<0.05). The efficacy of rind extract was less than that of NaOCl+EDTA (P<0.05).
Conclusion: In the presence of smear layer, the antimicrobial activity of Lime juice was less than that of NaOCl but the efficacy of rind extract was similar to that of NaOCl.