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Decrease from main root canal and intratubular Fusobacterium nucleatum and its endotoxin after ultrasonic activation
Mirela Cesar Barros1, Victor Feliz Pedrinha1, Felipe Eduardo Oliveira2
1Department of Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil.
Biofouling
|November 27, 2024
Summary
Ultrasonic irrigant activation (UIA) enhanced root canal disinfection against Fusobacterium nucleatum and its endotoxin. Alternative solutions like propolis extract showed promise comparable to sodium hypochlorite when used with UIA.
Area of Science:
- Endodontics
- Microbiology
- Dental Materials Science
Background:
- Root canal infections often involve Fusobacterium nucleatum, a key pathogen contributing to persistent inflammation.
- Endotoxins (LPS) from Gram-negative bacteria like F. nucleatum can exacerbate the host inflammatory response.
- Effective disinfection of root canals and dentinal tubules is crucial for successful endodontic treatment.
Purpose of the Study:
- To evaluate the efficacy of conventional and alternative irrigation solutions with ultrasonic irrigant activation (UIA) against F. nucleatum and its endotoxin.
- To assess the impact of UIA on bacterial membrane integrity and endotoxin reduction within dentinal tubules.
- To compare the effectiveness of syringe irrigation (SI) versus UIA for different irrigant solutions.
Main Methods:
- A novel intratubular infection model using F. nucleatum-infected dentin cylinders was developed.
- Treatments included 2.5% sodium hypochlorite (NaOCl), limewater + 2.5% NaOCl, and 10% ethanolic propolis extract (EEP) via SI or UIA.
- Bacterial load (CFU/mL), LPS levels, and bacterial membrane damage (Live/Dead staining) were quantified pre- and post-treatment.
Main Results:
- All irrigation solutions significantly reduced bacterial CFU/mL.
- UIA demonstrated superior bacterial membrane damage and greater reduction in LPS levels compared to SI.
- Ultrasonic activation of 10% EEP and limewater + 2.5% NaOCl showed efficacy comparable to 2.5% NaOCl alone.
- UIA significantly enhanced the antimicrobial and endotoxin-reducing capabilities of all tested irrigants.
Conclusions:
- Ultrasonic irrigant activation is a valuable adjunct for improving root canal disinfection efficacy.
- Alternative irrigants, such as ethanolic propolis extract, show potential for endodontic use when combined with UIA.
- Further randomized clinical trials are warranted to validate these findings in clinical settings.
