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Introduction Wound infection following burn injury can be clinically challenging to manage. Its presence in a thermally compromised patient can detrimentally affect the ability of the wound to heal leading not only to wound progression but ultimately contribute to a large part of the economic health burden expenditure in the National Health Service. Despite meticulous wound care and infection control measures the colonisation of burn wounds by bacterial pathogens has and continues to be the case. There has been a growing interest in the use of antimicrobial applications when managing localised burn wound infections due to a constantly increasing number of antibiotic-resistant organisms. Aim To survey which antimicrobial dressings are currently being used across UK burns services when managing localised pseudomonas wound infections. Methods We conducted a nationwide telephone survey of UK burns services during October 2019 to determine which topical antimicrobial agent was used to treat local pseudomonas burn wound infections. Results Six burns services (31.6%) used acetic acid-soaked dressings, one of which alternates acetic acid with sodium hypochlorite solution. Silver-based dressings were also used by six burns services (31.6%) – again, one department alternates silver-based dressings with sodium hypochlorite solution. Betadine-soaked, gauze-based dressings were used across five burns services (26.3%) and the remaining two burns services (10.5%) used sodium hypochlorite solution and non-medicated dressings respectively. Conclusion We have identified a significant difference in the UK burns services’ approach to pseudomonas burn wound infections. Our literature review demonstrates that a daily dressing regime of 2.5–3% acetic acid (AA) is a well-tolerated treatment regime in burn patients and that it is in use in UK burns services. There are no current randomised controlled trials that evaluate the usage of AA. The variation in usage suggests that there is scope for further study in order to develop evidence to generate a UK wide approach based on national standardised guidelines.

Objective: The present study aimed to establish the efficacy of sodium hypochlorite mouthwash (NaOCl-MW) compared with a control mouthwash on plaque and clinical parameters of periodontal disease. Methods: MEDLINE-PubMed, Embase and Cochrane-CENTRAL databases were searched for clinical trials on patients with gingivitis or periodontitis that assessed the effect of NaOCl-MW in comparison with a negative or positive control on plaque index (PI), gingival index (GI), and bleeding index (BI) scores and probing pocket depth (PPD). Data were extracted from the eligible studies. Results: Seven eligible papers were retrieved, which together represented six clinical trials. The studies showed considerable heterogeneity regarding methodological and clinical aspects that did not permit a meta-analysis. Two of the three studies in which NaOCl-MW was compared with a negative control showed that NaOCl-MW significantly reduced PI, GI and BI, and no effect was found on PPD. In three studies, NaOCl-MW was assessed using chlorhexidine mouthwash (CHX-MW) as a positive control; no difference was found for GI and BI. One of the three comparisons showed a statistically significant PI score favouring NaOCl-MW. One study measured PPD and found it to be significant in favour of NaOCl-MW. Conclusions: Studies with a negative control group provided very weak quality evidence for a very small beneficial effect of NaOCl-MW on PI, GI and BI scores. Studies with a positive control group provided very weak quality evidence that NaOCl-MW had a similar effect as CHX-MW on PI, GI and BI scores. The outcome for PPD was inconclusive.

The highest viral loads of the newly emerged Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) are detectable in the oral cavity, thus, a potential reduction of infectious virus by nasal sprays could lower transmission. Therefore, the inactivation capacity of nine nasal and oral sprays was evaluated according to EN 14476. One nasal spray based on sodium hypochlorite and an oral spray containing essential oils reduced viral titres between 2 to 3 orders of magnitude. Although clinical data is still sparse, nasal and oral sprays display a more convenient application for elderly people or those who are unable to rinse/gargle.

Introduction The aim of this study was to compare the effect of different application techniques of ozone on the prevalence of postendodontic pain in patients undergoing single-visit root canal treatment. Methods hundred eight patients with necrotic pulp in single-rooted teeth and apical periodontitis participated in the trial. A standard single-visit endodontics protocol was followed with 5.25% sodium hypochlorite and rotary nickel-titanium files. After shaping and cleaning, patients were randomly allocated into the following groups: group 1 (n = 21), ozone treatment with no activation (NA); group 2 (n = 22), ozone treatment with manual dynamic activation (MDA); group 3, (n = 21), ozone treatment with passive ultrasonic activation (PUA); group 4 (n = 23), ozone treatment with sonic activation (SA); and group 5 (n = 21), no ozone treatment (the control group). Patient levels of discomfort were recorded at 6 different time intervals using the visual analog scale (VAS). Comparison of the mean difference between the groups and time intervals was performed using 2-way analysis of variance followed by a post hoc Bonferroni test. The level of significance was set at 5%. Results VAS scores were highest for the control > NA > MDA > SA > PUA groups. A statistically significant reduction in VAS scores was observed in the PUA and SA groups in comparison with the NA, control, and MDA groups. Timewise comparison showed a highly significant decline in VAS scores at all time intervals (P Conclusions Ultrasonic and sonic activation of ozone resulted in less pain in patients undergoing single-visit endodontics compared with no ozone treatment.

Made available in DSpace on 2022-04-29T08:35:58Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01 Extrusion of sodium hypochlorite (NaOCl) is a very rare accident with the most common complications including pain, swelling, and hematoma. It can occur even if procedural guidelines, predisposing conditions, and risk factors are taken into consideration. A 59-year-old female patient was admitted to the endodontics department to treat a left maxillary first premolar (World Dental Federation tooth 24). The medical history included osteoporosis and systemic medication with alendronate. Initially, the diagnosis was “symptomatic irreversible pulpitis” with “normal apical tissues.” During instrumentation of the buccal canal, accidental extrusion of 2.5% NaOCl occurred into the periapical tissues, resulting from misinterpretation of the working length, and caused severe pain and bleeding. The canal was immediately flushed using copious irrigation with saline solution. An analgesic and corticosteroid were prescribed. At 3 and 7 days, ecchymosis and slight hematoma were observed extraorally in the area of the affected tooth and an intraoral ulceration at the apex of the affected tooth. At 15 days, minimal signs of ecchymosis were observed, and the treatment was resumed. At 30 days after the accident, there was complete remission of the sequelae. The clinical, radiographic, and tomographic assessment after 1 month, 1 year, and 8 years showed favorable case evolution. During the 8-year follow-up, the patient maintained the systemic use of alendronate. It can be concluded that NaOCl extrusion is an accident that causes patients and clinicians to experience an unpleasant consequence. The radiographic working length should always be determined carefully. A successful outcome can be achieved in patients who take alendronate. Department of Restorative Dentistry Araraquara School of Dentistry São Paulo State University Department of Endodontics Cayetano Heredia Peruvian University Department of Restorative Dentistry Araraquara School of Dentistry São Paulo State University

Due to the dissemination of airborne conidia and spores, molds can contaminate various surfaces. In the food industry sector, their presence and development can have health and economic implications. In order to control these undesirable microorganisms, various approaches can be used but the main one relies on the use of disinfectants. The objective of this review is to report the existing studies on the effect of various disinfectant molecules (i.e., sodium hypochlorite, chlorine dioxide, ethanol and other alcohols, hydrogen peroxide, peracetic acid, and quaternary ammonium compounds) on the inactivation of fungal spores. These studies were sorted depending on the targeted fungal species. Noteworthy, in the food industry, four log and three log reductions are required to claim a fungicidal activity for suspension (European Standard 1650, 2019) and surface (European Standard 13697/IN1, 2019) treatments, respectively. Most of the presented studies concerned Penicillium and Aspergillus species (44 and 31% of the literature, respectively). In general, for a given disinfection procedure, ascospores were more resistant than conidia, and Aspergillus conidia were more resistant than Penicillium ones. However, the variability of encountered molds (e.g. species, strains, physiological state) and disinfection procedures (e.g. molecules, concentrations, contact time) affected the efficacy of disinfectants.

BACKGROUND/PURPOSE The aim was to assess the effectiveness of antimicrobial photodynamic therapy (aPDT) as an adjunct to mechanical instrumentation (MI) in reducing Enterococcus faecalis (E faecalis) and Candida albicans (C albicans) counts from C-shaped root-canals. METHODS Teeth with C-shaped canals as identified on cone beam computed tomographic images were included. Following incubation with E faecalis and C albicans, samples were divided into 4 groups a four follows: Group-1: MI with adjunct aPDT; Group-2: aPDT alone; Group-3: MI alone; and Group-4: no treatment. The pulp chambers of these teeth were exposed and coronal pulp was mechanically derided using sterile endodontic excavators. Using flexible files, all canals were debrided up to size #30 K-files with intermittent irrigation with 2.5% sodium hypochlorite irrigation. In Groups 1 and 3, methylene-blue was injected in all canals and aPDT was performed using a 600 nm diode laser. Sample-size estimation was done on data from a pilot investigation and group-comparisons were done using one way analysis of variance and Bonferroni post-hoc adjustment tests. P < .05 was considered statistically significant. RESULTS Sixty periodontally hopeless mandibular second molars with C-shaped canals were included. There was a statistically significant reduction CFU/mL of E faecalis (P < .001) and C albicans (P < .001). At post-operative microbial assessments in Group-1. There was no difference CFU/mL of E faecalis and C albicans at post-operative microbial assessments in Groups 2-4. CONCLUSION MI with adjunct aPDT is more effective in reducing count of E faecalis and C albicans from C-shaped root canals.

Background: the main idea behind the pulpotomy of a primary tooth is to remove the infected or inflamed coronal pulp tissues and cover the pulp with a suitable medicament or dressing which promotes healing and preserve the vitality of the teeth especially in young permanent teeth. A medicament should be biologically compatible, have healing capabilities, should be non cytotoxic, or mutagenic and with no carcinogenic potential. Aim: the main aim of the study was to compare and evaluate the efficacy of commonly used two medicaments i.e. formocresol and sodium hypochlorite in pulpotomy of mandibular primary teeth. Material and methodology: a randomized controlled single blinded clinical trial was done on 50 subjects of age ranging from 3 to 6 years with bilateral mandibular first or second molar requiring pulpotomy. The subjects were randomly divided into two groups with 25 subjects in each. Group I, consisted of subjects on which formocresol medicament was used after extirpation of coronal pulp while in Group II, 3% sodium hypochlorite was used. Clinical along with the radiographic signs and symptoms were blindly recorded at an interval of 1, 3, 6 and 12 months respectively. Results: Statistically significant results were obtained in group II, when patients treated with 3% sodium hypochlorite. There was no major difference between the two medicaments used, but to the various adverse effects of formocresol, its usage has been limited. Conclusion: within the limitation of the study, it was concluded that sodium hypochlorite medicament proved to have better prognosis and can be suggested as a pulpotomy agent for primary teeth. Although formocresol was found to have similar significant results can also be used as a medicament. Keywords: Formocresol, Pulpotomy, Primary Teeth, Sodium Hypochlorite

The purpose of this review was to assess the literature regarding the decontamination of resin cement before the luting procedure in order to provide clinicians with a comparative overview of decontamination effects. A total of 19 articles were selected for inclusion in this review. The results indicated that bonding effectiveness is reduced due to residual adhesion inhibitors such as saliva, blood, hemostatic agents, and temporary/provisional cement. Self-etching and self-adhesive systems tend to be more negatively affected by adhesion inhibitors than do etch and rinse systems. Cleaning with an ultrasonic scaler or rotating brush have demonstrated conflicting effects in several studies. Some studies have reported that phosphoric acid has negative effects and recommend mild acid for decontamination. The application of phosphoric acid followed by sodium hypochlorite has been shown to help avoid negative effects. Alumina blasting has been investigated as a mechanical cleaning method in a relatively large number of experiments, most of which have confirmed its effectiveness. An intraoral cleaner containing functional monomers that has become commercially available in recent years is a promising method in clinical practice because it can easily and effectively remove temporary adhesive material. In addition, adhesion inhibitors can be easily removed from resin-coated dentin surfaces. ispartof: JAPANESE DENTAL SCIENCE REVIEW vol:57 pages:147-153 ispartof: location:Netherlands status: published

Outcome expectations of direct pulp capping in carious teeth are obscured by a clinically unknown infiltration and breakdown of the dental pulp tissue. Histologic studies showed that this soft tissue breakdown is related to the innate immune system. We hypothesized 1) that a neutrophil biomarker could predict the outcome of direct pulp capping and 2) that using sodium hypochlorite (NaOCl) as a lavage solution to remove necrotized infected pulp tissue could improve it. In this randomized trial in mature posterior teeth causing no or mild discomfort with carious pulpal exposures, pulpal fluid was collected to assess neutrophil gelatinase (matrix metalloproteinase 9 [MMP-9]) per total protein (TP) levels as a predictive local biomarker. Subsequently, the dentin-pulp wound was randomly washed with a 2.5% NaOCl or a physiologic saline solution (1:1 allocation), capped with mineral trioxide aggregate, and the tooth was immediately restored with a resin-based composite restoration. Ninety-six patients were included, and 84 individuals could be followed up to treatment failure or clinically confirmed pulp survival after a minimum of 1 y. The entire data were fitted to a Cox proportional hazards model to assess the influence of the observational variables MMP-9/TP and discomfort with the randomized lavage treatment on pulp survival. The Kaplan-Meier pulp survival rates after 1 y were 55% for saline and 89% for NaOCl lavage. The inflammatory state of the pulp tissue as reflected by MMP-9/TP levels and NaOCl lavage had a highly significant ( P

Background. Recently, an outbreak of a novel human coronavirus SARS-CoV-2 has become a world health concern leading to severe respiratory tract infections in humans. Virus transmission occurs through person-to-person contact, respiratory droplets, and contaminated hands or surfaces. Accordingly, we aim at reviewing the literature on all information available about the persistence of coronaviruses, including human and animal coronaviruses, on inanimate surfaces and inactivation strategies with biocides employed for chemical and physical disinfection. Method. A comprehensive search was systematically conducted in main databases from 1998 to 2020 to identify various viral disinfectants associated with HCoV and methods for control and prevention of this newly emerged virus. Results. The analysis of 62 studies shows that human coronaviruses such as severe acute respiratory syndrome (SARS) coronavirus, Middle East respiratory syndrome (MERS) coronavirus or endemic human coronaviruses (HCoV), canine coronavirus (CCV), transmissible gastroenteritis virus (TGEV), and mouse hepatitis virus (MHV) can be efficiently inactivated by physical and chemical disinfectants at different concentrations (70, 80, 85, and 95%) of 2-propanol (70 and 80%) in less than or equal to 60 s and 0.5% hydrogen peroxide or 0.1% sodium hypochlorite within 1 minute. Additionally, glutaraldehyde (0.5–2%), formaldehyde (0.7–1%), and povidone-iodine (0.1–0.75%) could readily inactivate coronaviruses. Moreover, dry heat at 56°C, ultraviolet light dose of 0.2 to 140 J/cm2, and gamma irradiation could effectively inactivate coronavirus. The WHO recommends the use of 0.1% sodium hypochlorite solution or an ethanol-based disinfectant with an ethanol concentration between 62% and 71%. Conclusion. The results of the present study can help researchers, policymakers, health decision makers, and people perceive and take the correct measures to control and prevent further transmission of COVID-19. Prevention and decontamination will be the main ways to stop the ongoing outbreak of COVID-19.

Dilute sodium hypochlorite (bleach) baths have been used in routine care for many dermatologic conditions, namely atopic dermatitis. The benefits of bleach baths in reducing bacterial carriage have been well documented; however, the instructions often require subjective interpretation of bathtub size and may result in varying concentrations of bleach. Herein, we review the evidence for use of bleach baths and provide a method for ensuring that proper bleach concentrations are achieved.

Aim and Objective The present in vitro study was done to comparatively evaluate the effect of different endodontic irrigation protocols on the microhardness at coronal, middle, and apical levels of root canal dentin. Method The total sample size for the study was 100. Each sample consisted of a longitudinally sectioned half of a root of a single-rooted tooth, which was then embedded in acrylic resin. The prepared samples were divided randomly into five groups of twenty samples each. Each group was treated with its respective irrigant to be tested. Group I was the control—the specimens were treated with distilled water. The specimens in group II were treated with sodium hypochlorite (NaOCl), followed by ethylenediamine tetra-acetic acid (EDTA). Specimens in group III were treated with NaOCl, followed by CHX. Specimens in group IV were treated with NaOCl, followed by hydroxyethylidene bisphosphonate (HEBP), and specimens in group V were treated with NaOCl, followed by propolis. Following this, all the samples were placed on the Vickers microhardness tester, and the results were tabulated and statistically analyzed to determine the irrigant solutions' effect on the microhardness of root dentin at coronal, middle, and apical third. Results Intergroup comparison of various irrigants showed that 18% HEBP showed the least reduction in the microhardness values of root canal dentin, and 17% EDTA caused the maximum decrease in microhardness values with a significant difference. When the baseline values were compared with the values after the use of experimental solutions in all the groups, it was observed that the microhardness gradually decreased from coronal to apical third of root dentin. Conclusion On the basis of the results obtained, it can be concluded that weak chelators such as 18% HEBP do not affect the microhardness considerably, and that they can be used in future in place of strong chelators, that is, EDTA, which make root dentin weak by more microhardness reduction.

OBJECTIVE To systematically evaluate the effect of microwave disinfection on the dimensional stability of denture base acrylic resins. BACKGROUND Microwave disinfection has been considered as an alternative method for disinfecting complete dentures to help prevent and treat denture stomatitis. However, data on the impact of microwave disinfection on the dimensional stability of acrylic resins are still scarce. METHODS The PubMed/Medline, SCOPUS and EMBASE databases were searched in order to assess articles published in English up to January 2021 (CRD42021212267). We included studies that have assessed the effect of microwave disinfection, on the dimensional stability of acrylic resins, comparing them with negative or positive controls. RESULTS A total of seven in vitro studies were included. The qualitative synthesis demonstrated that, in general, microwave disinfection produced more distortion on the materials than do immersion in sodium hypochlorite, chloride solution, chlorhexidine, and water immersion. However, considering the dimensional stability of the specimens, microwave disinfection at 500 W for 3 minutes, and at 450 W for 5 minutes, produced similar or better outcomes than did control groups. CONCLUSION In general, microwave disinfection promotes changes in the dimensional stability of denture base acrylic resins, and should thus be used with caution. However, microwave disinfection protocols at lower power settings (500 and 450 W) and exposure times (3 and 5 minutes) produces similar or less distortion than chemical disinfection. More studies are still required in order to evaluate the clinical and long-term implications of microwave disinfection.

AIM: The study was done to assess the antimicrobial effectiveness of Chitosan Nanoparticles (CNPs), Chlorhexidine (CHX), and their combination (CHX/CNPs) versus that of Sodium hypochlorite (NaOCl) in patients with mandibular necrotic premolars and to evaluate their effects on post-operative pain after single-visit endodontic treatment. MATERIALS AND METHODS: Sixty patients with necrotic mandibular premolars were divided randomly to four groups (n = 15) according to the used irrigating solution. Instrumentation was done using rotary ProTaper files. During instrumentation, irrigation was done using 2.5% NaOCl; afterward, canals were flushed with sterile saline. A final flush with the study irrigants was done as follows: 3% CNPs for Group A, 2% CHX for Group B, CHX/CNPs for Group C, and 5.25% NaOCl for Group D. Samples were collected from root canals before and after canal preparation then cultured to assess the number of colony-forming units/ml. All patients were instructed to record their pre- and post-operative pain levels on a numerical rating scale. RESULTS: CNPs and CHX/CNPs were significantly more effective than either CHX or NaOCl; however, there was no significant difference between them against anaerobic bacteria. All tested irrigants were similarly effective against aerobic bacteria. CNPs and CHX/CNPs were associated with significantly lower post-operative pain levels in the first 24 h after treatment. CONCLUSIONS: CNPs and its combination with CHX are significantly more effective than both CHX and NaOCl against anaerobic bacteria isolated from necrotic mandibular premolars. Post-operative pain intensity was significantly lower with CNPs and CNPs/CHX combination than with either NaOCl or CHX.

Introduction More data are needed before affirming that single-visit approaches are effective and safe for regenerative endodontic procedures (REPs). This study compared clinical and radiographic outcomes of REPs between interappointment dressing or single-visit protocols. Methods Twenty young patients presenting traumatized immature teeth with pulp necrosis were divided into 2 groups. Teeth were submitted to 6% sodium hypochlorite and 2% chlorhexidine irrigation and to 17% EDTA use before blood clot induction. In the interappointment dressing group (n = 11), calcium hydroxide was used with 2% chlorhexidine gel for 21 days before scaffold induction. In the single-visit group (n = 9), the scaffold was induced during the only appointment. Patients were followed up for 24 months. Primary, secondary, and tertiary outcomes were assessed by 3 independent evaluators. Preoperative and follow-up radiographs were assessed for quantitative measurements of the apical diameter, root width, root length, and cervical barrier placement and compared between groups using the t test or Mann-Whitney U test. Categoric variables were assessed with the G test and the Fisher exact test and continuous variables with the Mann-Whitney U test. Statistical significance was set at 5%. Results One tooth showed persistence of infection. No difference was observed in cervical barrier placement (P > .05); between groups regarding primary, secondary, and tertiary outcomes (P > .05); and in parameters of quantitative radiographic outcomes (P > .05). Conclusions Completing REPs with an interappointment dressing or a single-visit protocol presented similar clinical and radiographic outcomes. A single-visit protocol of REPs using 6% sodium hypochlorite, 2% chlorhexidine, and 17% EDTA permitted satisfactory outcomes in necrotic immature permanent teeth.

BackgroundIn recent years, the concept of minimally invasive endodontics has been proposed, which could be described as preventing or treating diseases by preserving more dental tissue and creating minimal damage. In the process of root canal preparation, it was recommended to use instruments with a smaller taper to preserve more tooth tissue and improve the preservation rate of the affected teeth. Photon-induced photoacoustic streaming (PIPS) was a new type of laser-activated irrigation technology, which was now widely used in endodontic treatment. The purpose of this article was to evaluate the bactericidal effect of PIPS with NaOCl in root canals with different widths or tapers.MethodsTwenty-three maxillary first molars with three independent root canals were included in this study. The mesiobuccal (MB), distobuccal (DB), and palatal (P) root canals were prepared at sizes of #10/.02, #25/.02, and #25/.06, respectively. After being incubated with a bacterial suspension for 4 weeks, the specimen were irrigated with 2% NaOCl activated by conventional needle irrigation (CNI) (n = 10) or PIPS (n = 10). Three specimen were not treated (control group). Before and after irrigation, the presence of bacteria was assessed with an adenosine 5'-triphosphate (ATP) assay kit and biofilms were assessed using confocal laser scanning microscopy and scanning electron microscopy.ResultsIn specimen prepared using PIPS irrigation, the ATP was reduced by more than 98%. When the root canal taper was 0.02, the size #25 root canals had a higher percentage of dead bacteria than the size #10 root canals in all regions (P .05) in the PIPS group. When the root canal width was #25, the 0.02 taper group had a higher percentage of dead bacteria than the 0.06 taper group in the apical region (P .05), except coronal and middle regions (P > 0.05). PIPS irrigation results in a greater percentage of dead bacteria and reduction of ATP in size #10/.02 root canals than CNI in size #25/.06 root canals in three regions (P .05).ConclusionIncreasing the width from #10 to #25 improves the bactericidal effect of PIPS in the root canal. Increasing the taper of the root canal from 0.02 to 0.06 at size #25 did not affect the bactericidal effects of PIPS. PIPS resulted in more dead bacteria in specimen with smaller tapers and root canal widths than CNI. PIPS can be used to clean the smear layer in the coronal region and open the dentin tubules.Clinical significance: Activation of irrigants with PIPS brought about significant bacterial reduction smaller tapers and width root canals compared to CNI, which was beneficial to prevent excessive loss of tooth tissue and conserve the structural integrity of teeth.

Aim: This study aimed to compare ethylenediaminetetraacetic acid (EDTA), phytic acid, and citric acid as chelation agents in final irrigation procedures on teeth with apical impermeability. Methodology: We used 66 mandibular premolar teeth with a single root and single canal extracted for periodontal or orthodontic reasons. All teeth crowns were removed to achieve a 14-mm root length. Mechanical preparation of the root canal was completed with a Reciproc R25 (VDW, Munich, Germany) file system. Teeth were randomly separated into three groups: Group 1: 5 ml 17% EDTA, Group 2: 5 ml 1% phytic acid, and Group 3: 5 ml 20% citric acid. We used 6 ml 5.25% sodium hypochlorite (NaOCl) in the mechanical preparation of all groups. Three teeth were selected for both the positive and negative control groups. All teeth in the experimental groups were filled by the lateral condensation method using AH Plus canal sealer and gutta-percha. For hardening of the canal sealer, samples were kept at 37 oC and at 100% humidity in a drying oven for 7 days. Later, following removal from the drying oven, two layers of nail polish were used to cover all but the apical 2 mm of each tooth. The teeth were then kept in 2% methylene blue solution at 37 oC for 7 days. The root was divided by cutting in the buccolingual direction and gutta-percha was removed. The dye leakage was measured linearly in millimeters (mm) under a stereomicroscope. Results: As a result of the apical leakage assessment, the lowest apical leakage is observed in the phytic acid group. There was a statistically significant difference between the phytic acid group and citric acid group. There was no statistically significant difference between other groups. Conclusion: While phytic acid showed similar results with EDTA on apical impermeability, it was more effective than citric acid. How to cite this article: Akın Tartuk G, Kaya S, Adıgüzel Ö. The effect of different final irrigation solutions on apical impermeability. Int Dent Res 2021;11(Suppl.1):201-5. https://doi.org/10.5577/intdentres.2021.vol11.suppl1.28 Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

The aim of this study was to assess the effect of antimicrobial photodynamic therapy (aPDT) with curcumin and riboflavin on three-week Enterococcus faecalis biofilm. At first the 15-mm root canals of 65 single rooted extracted human teeth (including maxillary incisors, mandibular and maxillary canines and mandibular premolars) were separated from the crown and were prepared with ProTaper instruments. After autoclave sterilisation, samples were inoculated with E. faecalis suspension, and incubated for three weeks. After ensuring biofilm formation by scanning electron microscopy (SEM) in two teeth, the remaining 63 teeth were randomly divided into seven groups (n = 9): aPDT + curcumin, aPDT + riboflavin, LED, curcumin, riboflavin, 5.25% NaOCl (positive control) and no intervention (negative control). For light source a LED unit with 390-480 nm wavelength (peak of 460 nm), power density of 1000 ± 100 mW cm-2 and mean energy density of 60 J cm-2 was used. The roots were horizontally sectioned into coronal, middle and apical thirds each with 5 mm thicknesses. Dentin chips with equal weight (1 ± 0.005 g) were collected from the root canal walls with Gates Glidden drills and were transferred into microtubes containing 1 mL of sterile saline and vortexed for 30 s. Next, 10 µL of the contents of each tube was serially diluted and eventually, 10 µL of each solution was cultured on BHI agar. The number of colony-forming units was determined. Data were analysed using the Kruskal-Wallis and Friedman tests. The colony reduction was not significantly different between NaOCl and either riboflavin + LED or Curcumin + LED. The 5.25% NaOCl group showed maximum reduction in colony count, compared with the negative control (P = 0.00). Groups with aPDT with Curcumin + LED (P = 0.005), and with riboflavin + LED (P = 0.011) showed significant reduction in colony count in all three canal thirds (P

Purpose. Development of a method for the regeneration of highly porous fillers for biofilters after slagging of their pores with biofilm residues in the process of growing aquaculture objects in recirculating aquaculture systems (RAS). Methodology. Regeneration of fillers was performed with solutions of sodium hypochlorite of different concentrations (2.5%, 1%, 0.5% of active chlorine) after their exploitation for 6 months. The cleaning efficiency was monitored by the difference in fillers weights after cleaning. Findings. According to the study, the use of sodium hypochlorite for cleaning highly porous fillers for biofilters (using an example of porous ceramic filler and foamed glass «JBL Micromec») is efficient and cost-effective. A reduction in the weight of the test samples averaged 12.95% for porous ceramics and 15.01% for foamed glass. Based on the obtained data, aqueous solutions with different concentrations of sodium hypochlorite do not have a pronounced difference in efficiency, respectively; the optimal for use is a 0.5% solution. Originality. The use of highly porous fillers for biofilters has long been unprofitable in fish farming due to the rapid loss of their main advantages - a high specific area per unit volume as a result of micropore slagging with biofilm residues. As a result, complete regeneration of these filter materials was required annually, which, given the significantly higher cost compared to polymeric fillers, made their use unprofitable. The described technique allows the use of porous ceramics and foamed glass, after their restoration, for a long time, with replacement only after mechanical wear. Practical value. The described method allows using highly porous fillers for biofilters in the process of growing aquaculture objects without their main disadvantage - a rapid decrease in efficiency as a result of pore slagging with biofilm residues. Keywords: RAS, biofilter, filler, restoration, sodium hypochlorite.

Summary Objective The aim of this in vitro study was to evaluate the effects of enamel deproteinization on the shear bond strength of a self-etching primer Transbond Plus™(TBP), with different application times of sodium hypochlorite (NaOCl 5.25%), primarily and secondarily on the adhesive remnant index score. Materials and methods One hundred twenty-five freshly extracted human premolars were randomly and blindly divided into five groups according to the enamel surface preparation, as follows (n = 25): group 1(control): Etching with 37% phosphoric acid for 15 seconds + Bonding; group 2 (control): TBP™ without NaOCl, group 3: 60 seconds NaOCl + TBP™, group 4: 30 seconds NaOCl + TBP™, group 5: 15 seconds NaOCl + TBP™. The same composite resin was used (Transbond XT™) to bond the orthodontic metal brackets. After the immersion of the teeth in distilled water at 37 °C for 24 hours the shear bond strength was measured using the universal testing machine and the adhesive remnant index score (ARI) was evaluated under an optical microscope (25 × ). Results The mean SBS values (in MPa) of the groups were respectively: group 1: 13.03 ± 5.36; group 2: 12.28 ± 3.06; group 3: 12.38 ± 4.55; group 4: 12.98 ± 5.76; and group 5: 11.73 ± 5.67. Enamel deproteinization increased the SBS for groups 3 and 4, but no statistically significant difference was found between the five groups (P = 0.883). Group 1 showed the highest ARI scores, with 52% of the teeth retaining all the adhesive (score 3). However, for all the other groups, scores 0 and 1 were predominant, with less than half of the adhesive or no adhesive at all remaining on the teeth. Conclusions Enamel deproteinization with sodium hypochlorite (5.25%) and the variation of its application time has no effect on the SBS of the self-etching primer Transbond Plus ™.

Aim: To evaluate the effect of intra-canal cryotherapy on interleukin-1βand interleukin-10 expression in teeth with symptomatic apical periodontitis.Methodology: Forty-eight single rooted teeth in patients with symptomatic apical periodontitiswere randomly divided into 4 groups according to the irrigation protocol.Group I (control); 5% sodium hypochlorite at room temperature. Group II; 5% coldsodium hypochlorite (2-5°C). Group III; final rinse with 20 mL of 5% cold sodiumhypochlorite (2-5°C) for 5 minutes. Group IV; final rinse with 20 mL of cold saline (2-5°C) for 5 minutes. Paper point passing 2 mm beyond the apex was used to collect periapicalfluid before, immediately after mechanical instrumentation and after one week tocharacterize the mRNA expression of IL-1β and Il-10 using real-time polymerase chainreaction (PCR). Statistical analysis was performed using one-way ANOVA to comparebetween all groups. Results: Our results revealed statistically significant (at P≤ 0.05)down regulation of IL-1β gene expression levels in all groups after one week with nostatistically significant difference between the four groups and statistically significant(at P≤ 0.05) up regulation of IL-10 gene expression levels in all groups after one week.Conclusion: All the cryotherapy irrigation protocols showed lower levels of expressionof the pro-inflammatory mediators (interleukin-1β) and higher levels of expression ofthe anti-inflammatory mediator (interleukin-10) than the control group after one week.

Objective: To compare the clinical efficacy of 2.5% non-heated sodium hypochlorite and 2.5% heated sodium hypochlorite as irrigation to control postoperative pain in single visit root canal treatment. Study Design: Comparative analytical study Place and Duration: Operative dentistry department of Liaquat University of Medical and Health Sciences, Jamshoro for 6 months duration from March 2017 to September 2017. Material and Methods: A total of 60 patients with single rooted maxillary and mandibular permanent teeth were randomly allocated into two groups. 30 patients were in group A and treated with non heated sodium hypochlorite solution and 30 patients in group B were treated with 2.5% heated sodium hypochlorite solution. In both groups, the level of pain was measured postoperatively after 48 hours by using Heft Parker visual Analog Scale of 10 and information was collected on Performa. Results: The average age of the patients was 28.62±6.06 years. There were 40(66.7%) male and 20(33.3%) female. Pain was reduced in both groups but there were no significant difference in reduction of pain between groups (p=0.640). Conclusion: Severity of pain was not statistically significant between groups. At 48 hours, Pain was reduced in both groups but there were no significant difference in reduction of pain between groups. Heated sodium hypochlorite to relieve postoperative pain, it should be new trend for recommendation for treatment of irreversible pulpitis in single visit root canal treatment. Key Words: Root canal, Heated sodium hypochlorite, Postoperative pain.

To investigate the effect of enamel deproteinization and air abrasion on shear bond strength (SBS), adhesive remnant index (ARI) scores, and surface topography when bonding orthodontic brackets to fluorosed enamel.The sample included 90 fluorosed and 30 normal premolars divided into four groups: group I (fluorosed premolars subjected to air abrasion before acid etching), group II (fluorosed premolars subjected to deproteinization before acid etching), group III (fluorosed premolars; control for groups I and II), and group IV (normal premolars; control for group III). Bonding procedures included etching with 37% phosphoric acid, priming with TransbondFluorosed premolars subjected to deproteinization showed the lowest (median = 6.57 MPa) SBS among the four groups, followed by 8.14, 8.90, 8.14 MPa for groups I, III, and IV respectively. ARI scores were significantly different between the four groups (p = 0.006). Fluorosed enamel etched after air abrasion or deproteinization with NaOCl showed a predominance of type 4 etching pattern with some areas appearing unetched.Shear bond strength of all groups was within the 6-8 MPa acceptable range for orthodontic purposes. Fluorosed premolars subjected to deproteinization showed the lowest values. Further studies are recommended to scrutinize the deproteinization technique.ZIELSETZUNG: Untersucht werden sollte die Auswirkung der Schmelzdeproteinisierung und der Luftabrasion auf die Scherhaftung (SBS), den Adhäsivrestindex (ARI) und die Oberflächentopographie beim Kleben von kieferorthopädischen Brackets auf von Fluorose betroffenem Schmelz.Die Stichprobe umfasste 90 fluorierte und 30 normale Prämolaren, die in 4 Gruppen eingeteilt wurden: Gruppe I (Prämolaren mit Fluorose, die vor der Säureätzung einer Luftabrasion unterzogen wurden), Gruppe II (Prämolaren mit Fluorose, die vor der Säureätzung deproteinisiert wurden), Gruppe III (Prämolaren mit Fluorose; Kontrolle für die Gruppen I und II) und Gruppe IV (normale Prämolaren; Kontrolle für Gruppe III). Das Bondingverfahren umfasste die Ätzung mit 37%iger Phosphorsäure, die Grundierung mit TransbondPrämolaren mit Fluorose, die einer Deproteinisierung unterzogen wurden, zeigten den niedrigsten (Median 6,57 MPa) SBS unter den 4 Gruppen, gefolgt von 8,14, 8,90 und 8,14 MPa für die Gruppen I, III bzw. IV. Die ARI-Scores waren signifikant unterschiedlich zwischen den 4 Gruppen (p = 0,006). Von einer Fluorose betroffener Schmelz, der nach Luftabrasion oder Deproteinisierung mit NaOCl geätzt wurde, zeigte überwiegend ein Ätzmuster vom Typ 4, wobei einige Bereiche ungeätzt erschienen.Die Scherhaftung aller Gruppen lag innerhalb des kieferorthopädisch akzeptablen Bereichs von 6‑8 MPa. Prämolaren mit einer Fluorose, die einer Deproteinisierung unterzogen wurden, zeigten die niedrigsten Werte. Es werden weitere Studien empfohlen, um die Deproteinisierungstechnik zu überprüfen.

BACKGROUND Sodium hypochlorite & chlorhexidine are usually employed as endodontic irrigants due to their antimicrobial properties, however, their cytotoxicity & allergenicity issues demand an equally effective but safer irrigant. The purpose of the study was to compare the antimicrobial efficacy of octenidine hydrochloride (OCT), green tea, sodium hypochlorite and chlorhexidine (CHX) at various concentrations against E. faecalis, C. albicans and its mixture. METHODS The study was conducted in Hitkarini Dental College, Jabalpur. Various concentrations of irrigants were prepared. Muller Hinton agar media plates were swabbed with the culture broth of E faecalis ATCC 29212, Candida albicans ATCC 10231 or a mixture of these. Five Whatman paper disks (6 mm), each loaded with experimental concentration of the irrigant, were placed at equal distance on to the plate. The plates were incubated at 370 C for 48 hours. This was done in 6 replicates. The plates were evaluated for clear zone of inhibition measured in mm. RESULTS The diameter readings were analysed using Kruskal Wallis and Mann Whitney U tests. There was a significant difference between the groups against Enterococcus faecalis; candida, & mixed culture (P < 0.01). CONCLUSIONS 5 % Sodium hypochlorite is better than all others whereas 2 % CHX is better than OCT & Green tea. 0.1 % OCT is better than 3 % Green tea. OCT can be used as a contributory irrigant along with NaOCl to achieve antimicrobial advantage. KEY WORDS Antimicrobial Efficacy, Candida Albicans, Chlorhexidine Gluconate, E Faecalis, Green Tea, Octenidine Hydrochloride, Sodium Hypochlorite

Made available in DSpace on 2022-04-28T19:40:51Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-08-01 Wounds are conditions largely present in the clinical routine, and even though frequent, their complete resolution can be challenging. Several solutions can aid or stimulate the healing process, and for this reason, this work used a stabilized solution of 4% sodium hypochlorite for the treatment of excisional wounds in mice. This study was carried out in two distinct stages: in the first stage, the optimal concentration of the chlorinated solution was determined by using the sponge implantation technique in mouse subcutaneous tissue to evaluate the dose-response curve; and in the second phase, this concentration was tested in an experimental model of excisional skin wounds in mice. Soluble collagen, hemoglobin, myeloperoxidase (MPO) and N-acetyl-β-D-glycosaminidase (NAG) activity were assessed, and total, type I and type III collagen deposition were quantified in both stages. Based on the results presented in the sponge implantation study, the chlorinated solution at 150 ppm (0.015%) was chosen for use in a preclinical trial of skin healing in mice. At 1, 3, 7 and 14 days of treatment, the % wound area repair in the group treated with 150 ppm chlorinated solution was higher when compared to the control group, with statistical differences at all time points (*p≤ 0.05 and **p≤ 0.01). 150 ppm chlorinated solution obtained from a stabilized 4% sodium hypochlorite solution was effective in accelerating cutaneous excision wound repair in mice, showing a positive influence on tissue repair. Department of Veterinary Surgery Paulista State University Júlio de Mesquita Filho Access Road Highway Professor Paulo Donato Castelane Castelane S / N Vila Industrial Institute of Biomedical Sciences Federal University of Uberlândia Avenue. João Naves de Ávila, 2121 - Santa Monica, [Zip Code]: 1720 Institute of Biology Campinas State University, Street Monteiro Lobato, 255. [Zip Code]: 1308-862 Veterinarian Federal University of Uberlândia, Avenue Mato Grosso, 3289 – Código postal [Zip Code]: 38405-314, Bloco 2S - Umuarama Department of Veterinary Surgery Federal University of Uberlândia, Av. Mato Grosso, 3289 - [Zip Code]: 38405-314, Bloco 2S - Umuarama Department of Veterinary Surgery Paulista State University Júlio de Mesquita Filho Access Road Highway Professor Paulo Donato Castelane Castelane S / N Vila Industrial

Objectives The goal of endodontic therapy is to prevent apical periodontitis. This is achieved by biomechanical preparation, microbial control using endodontic irrigants, and complete obturation of the canal space. In order to prevent possible post‐obturation complications and for an added antimicrobial effect, substantivity is a desired characteristic of endodontic irrigants. Currently the most commonly used endodontic irrigant that produces an antibacterial substantivity effect is chlorohexidine (CHX). Silver diamine fluoride (SDF) is a topically applied agent for managing dental caries and has shown to stop caries lesion progression. The objective of this study was to compare the antimicrobial substantivity effect of 3.8% SDF against other commonly used endodontic irrigants such as 2% CHX and 6.25% Sodium hypochlorite (NaOCl). Material and methods Using a diffusion disc assay we determined the antimicrobial activities of 38%, 3.8%, 0.38%, and 0.038% of SDF against the bacterium Enterococcus faecalis OG1RF. Subsequently, we compared the levels of colonization of E. faecalis by scanning electron microscopy (SEM) at 1.5‐ and 3‐week time intervals on dentin pretreated with 3.8% SDF, 6.25% NaOCl, 2% CHX or sterile phosphate buffered saline (PBS). Results The diffusion disc assay demonstrated that 38% and 3.8% of SDF inhibited the growth of E. faecalis. Moreover, the substantivity of 3.8% SDF (p

Background The present study aimed to evaluate and compare the efficacy of 17% ethylenediaminetetraacetic acid (EDTA), 18% etidronic acid, 10% citric acid, and 7% maleic acid in the removal of smear layer at the apical third of the root canals. Materials and methods Sixty single-rooted teeth were equally divided into four study groups (n = 15), according to the type of irrigant used (17% EDTA, 18% etidronic acid, 10% citric acid, and 7% maleic acid) to remove the smear layer effectively from apical third of root canal. In each group, respective irrigant was used with 5.25% of sodium hypochlorite during instrumentation. Each study sample was then sectioned longitudinally and removal of smear layer was observed using a scanning electron microscope (SEM) at 2000×. Results A 7% maleic acid revealed better smear layer removal than all other three groups at apical third. A 10% citric acid was found to be more efficient than EDTA and etidronic acid. The intergroup comparison was performed using Mann-Whitney U test, and there was no significant difference between all the study groups, except maleic acid. Conclusion The present study compared the effect of various irrigants as an adjunct with 5.25% of sodium hypochlorite for root canal irrigation during and after instrumentation. The use of irrigants aids in the removal of the smear layer from the root canals, thereby increasing the success rate of endodontic therapy. Clinical significance This study supports the hypothesis that a thorough use of root canal irrigants can efficiently remove the smear layer which is the key for successful root canal treatment. The present study helps in choosing an appropriate irrigant that can ensure complete root canal debridement from all thirds, especially from the apical third of the root canal. How to cite this article: Mankeliya S, Singhal RK, Gupta A, et al. A Comparative Evaluation of Smear Layer Removal by Using Four Different Irrigation Solutions like Root Canal Irrigants: An In Vitro SEM Study. J Contemp Dent Pract 2021;22(5):527-531.

Introduction: Atopic dermatitis (AD) is a disease of multifactorial ethology. However, the bacterial microflora of the skin, especially Staphylococcus aureus, plays an important role in its the pathogenesis. Continuously, new therapies are sought which will block factors exacerbating the disease and significantly support the AD treatment. The aim of the study was to determine the effect of sodium hypochlorite baths on the eradication of St. aureus from the skin and to assess their effect on AD severity. Material and methods: The study was conducted among 56 patients suffering from AD. A half of the patients were randomly assigned to the group treated with sodium hypochlorite baths (study group) in addition to the standard therapy of AD, the remaining patients were treated with conventional treatment (control group). The severity of the disease and the intensity of the itch were assessed in each patient at the time of enrollment into the study and 6 weeks later. A skin smear was taken for microbiological examination with pathogen identification and semi-quantitative evaluation of the isolated bacteria strains. Results: Patients using baths in diluted sodium hypochlorite showed a greater improvement of AD severity compared to those using conventional treatment only (relative EASI improvement: 42.0% ± 32.9% vs. –33.1% ± 88.6%, p < 0.01; relative SCORAD improvement: 33.5 ± 25.9% vs. –6.7 ± 36.8%, p < 0.001). Additionally, a greater reduction of itch was observed in the study group compared to the control group (ΔNRS: 1.8 ± 2.2 vs. 0.7 ± 2.2, p = 0.04) as well as significant improvement of quality of life was noted (study group: mean DLQI before treatment: 12.7 ± 6.7 points, mean DLQI after treatment: 7.3 ± 5.4, p < 0.001; control group: mean DLQI before treatment: 10.8 ± 7.5 points, mean DLQI after treatment: 8.7 ± 5.6, p < 0.82). However, the relationship between the applied therapy and the eradication of St. aureus has not been confirmed. Conclusions: Bathing in diluted sodium hypochlorite allowed to reduce the intensity of AD and to improve the quality of life, while ensuring good tolerability and safety of the therapy. However, no significant effect of the therapy was observed on the reduction of the number of St. aureus colonies on the skin.

Background XP-Endo Finisher (XPF) and passive ultrasonic irrigation (PUI) are commonly used in intracanal medicament removal. The effectiveness of these two techniques needs to be compared, and evidence-based research should be conducted. Methods A comprehensive literature search was conducted in PubMed, Web of Science, Embase, Cochrane Library, and Google Scholar up to December 20th, 2020. The outcomes of the included trials were pooled into the Cochrane Collaboration’s Review Manager 5.3 software. Cochrane’s risk-of-bias tool 2.0 was applied to assess the risk of bias. Results Nine articles were included in this systematic review and processed for data extraction, and eight studies were identified for meta-analysis. In general, the use of PUI showed better medicament removal effectiveness than XPF (odds ratio [OR]: 3.09; 95% confidence interval [CI], 1.96–4.86; P P = 0.01). For trials using sodium hypochlorite (NaOCl) alone, PUI was also significantly more effective than XPF on intracanal medicaments removal (OR: 5.23; 95% CI, 2.79–9.82; P P = 0.26). In addition, for studies whose intracanal medicament periods were two weeks, the effectiveness of PUI was statistically better than the XPF (OR: 7.73; 95% CI, 3.71–16.07; P P = 0.25) (OR: 1.42; 95% CI, 0.44–4.61; P = 0.56). Conclusions The meta-analysis is the first study to quantitatively compare the effectiveness of XPF and PUI techniques on intracanal medicaments removal. With rigorous eligibility criteria, the study only included high-quality randomised controlled trials. The study indicated that PUI might be superior over XPF techniques for removing intracanal medicaments from artificial standardized grooves and cavities in the root canal system. The anatomical areas, irrigation protocol, and intracanal medicaments time may influence the cleaning efficacy.

Background Manufacturers of the extended-pour alginates claimed their dimensional stability through prolonged storage. No data confirmed the ability of these materials to maintain their dimensions and the reproduced oral details following their chemical disinfection. Therefore, this study evaluated the dimensional stability and surface detail reproduction of gypsum casts obtained from disinfected extended-pour alginate impressions through different storage time intervals. Methods Two hundred and forty three hydrocolloid impressions were made from one conventional (Tropicalgin) and two extended-pour (Hydrogum 5 and Chromaprint premium) alginates. These impressions were subjected to none, spray and immersion disinfection before their storage in 100% humidity for 0, 72 and 120 h. The dimensional stability and the surface detail reproduction were indirectly evaluated under low angle illumination on the resulted gypsum casts. At α = 0.05, the parametric dimensional stability data were analyzed using One-Way ANOVA and Tukey’s comparisons, while the nonparametric detail reproduction data were analyzed using KrusKal Wallis and Mann–Whitney's tests. Results All gypsum casts exhibited a degree of expansion; however, the recorded expansion values did not differ between test categories (P > 0.05). Generally, casts obtained from spray-disinfected impressions showed lower detail accuracy (P P Conclusion All alginates materials offer comparable cast dimensions under different testing circumstances. Extended-pour alginates offer casts with superior surface details following their immersion disinfection and 120 h of storage. Spray-disinfection using 5.25% sodium hypochlorite affects the surface details of casts obtained from conventional and extended-pour alginates adversely.

Background This study aimed to compare the use of photon-initiated photoacoustic streaming (PIPS) and conventional needle irrigation (CNI) in conjunction with different concentrations of sodium hypochlorite (NaOCl) to remove Enterococcus faecalis (E. faecalis) suspended bacteria and biofilms from root canal systems with different diameters or tapers. Methods Artificial root canal samples (n = 480) were randomly divided into three groups (n = 160/group). The canals were prepared to fit file sizes #10/.02, #25/.02, or #25/.06. The size #10/.02 group was incubated for seven days. The size #25/.02 or #25/.06 group was incubated for 2 days. A stable biological model of E. faecalis infection was established. The root canals were washed with distilled water or with 1%, 2%, or 5.25% NaOCl combined with CNI or PIPS. Bacterial suspensions and biofilms were assessed using an ATP assay kit and fluorescence microscopy. Image-Pro Plus was used to analyse the average fluorescence intensity to determine the most suitable root canal irrigation solution. Results In the CNI and PIPS groups, the ATP value of the 5.25% NaOCl subgroup was the lowest, followed by that of the 2% and 1% NaOCl subgroups. The ATP value of the distilled water subgroup was the highest (P P P P P Conclusions Compared with CNI, PIPS has greater ability to remove bacteria in root canals with a small preparation diameter and a small taper. PIPS with 2% and 5.25% NaOCl exhibited superior antibacterial and bacteriostatic effects.

Background. Enteral insufficiency syndrome accompanies the development of many acute diseases of the abdominal cavity. According to the statistics, advanced and multi-organ surgical intervention in oncosurgery within the period from 2019 to 2020 resulted in enteral insufficiency being a complication in 39% of all cases, regardless of anatomical and physiological area, while complications in the form of endogenous intoxication syndrome made up 68% of cases. Purpose – studying the effectiveness of treatment of enteral insufficiency syndrome in cancer patients after multiorgan surgery with severe endogenous intoxication by means of indirect electrochemical detoxification with sodium hypochlorite solution. Materials and methods. The study involved 71 cancer patients who underwent multi-organ surgery on different anatomical and physiological areas. The patients were divided into 2 groups: treatment group (n=36) provided with indirect electrochemical detoxification by means of sodium hypochlorite solution at a concentration of 0.06%, comparison group (n=35) undergoing treatment according to standard schemes. The groups were comparable in age and anatomical and physiological areas that were operated on (surgery was performed on the chest and mediastinum as well as abdominal organs). Results. The method of electrochemical detoxification with sodium hypochlorite reducing the indicators that reflect blood toxicity and intoxication level was used for treating patients with enteral insufficiency. This was evidenced by decreased concentration of bilirubin by 23.1%, urea by 91.6%, creatinine by 99.4%, LII (leukocytal intoxication index) by 47.2% and procalcitonin by 68.2%. Being applied this method has made it possible to achieve a detoxifying effect early on day one. Conclusions. The findings of complete physical examination of cancer patients after multiorgan surgery with severe endogenous intoxication have shown a practical significance of sodium hypochlorite being included in comprehensive post-surgery treatment in enteral insufficiency syndrome cases. Infusions of 0.06% NaClO solution within 24 hours have been proved to provide a detoxifying effect: they significantly reduce elevated concentrations of bilirubin, creatinine, urea, LII and improve blood rheology. Administering sodium hypochlorite in the suppre-ssion of antioxidant defense mechanisms leads to the activation of oxidative processes. Including sodium hypochlorite in comprehensive post-surgery treatment in enteric insufficiency syndrome has shown a high efficiency., Актуальність. Синдром ентеральної недостатності супроводжує розвиток багатьох гострих захворювань органів черевної порожнини. Згідно зі статистичними даними, у результаті розширених та мультиорганних оперативних утручань в онкохірургії за 2019–2020 рр., ентеральна недостатність стала ускладненням у 39 % усіх випадків, незалежно від анатомо-фізіологічної ділянки, а ускладнення у вигляді синдрому ендогенної інтоксикації – у 68% випадків. Мета роботи – вивчити ефективність лікування синдрому ентеральної недостатності на тлі вираженої ендогенної інтоксикації в онкологічних хворих після мультиорганних операцій з використанням непрямої електрохімічної детоксикації за допомогою розчину гіпохлориту натрію. Матеріали і методи. Було обстежено 71 пацієнта з онкопатологією, яким виконані мультиорганні оперативні втручання на різних анатомо- фізіологічних ділянках. Хворі були розподілені на дві групи: основна група (n=36), в якій проводилась непряма електрохімічна детоксикація за допомогою розчину гіпохлориту натрію у концентрації 0,06 %, група порівняння (n=35) – проведено лікування за стандартними схемами. Групи були зіставні за віком та анатомо-фізіологічними ділянками, які оперувались (оперативне втручання проведено на органах грудної клітки і середостінні та на органах черевної порожнини). Результати та їх обговорення. Для лікування хворих з ентеральною недостатністю використовували методику електрохімічної детоксикації за допомогою гіпохлориту натрію, що знижує показники, які відображають токсичність крові та ступінь інтоксикації. Про це свідчило зниження концентрації білірубіну на 23,1%, сечовини на 91,6%, креатиніну на 99,4%, лейкоцитарного індексу інтоксикації (ЛІІ) на 47,2% та прокальцитоніну на 68,2%. При застосуванні цього методу вже на першу добу вдалося отримати детоксикаційний ефект. Висновки. За результатами комплексного дослідження онкологічних хворих після мультиорганних операцій з вираженою ендогенною ін- токсикацією показана доцільність включення натрію гіпохлориту в комп- лексну післяопераційну терапію при синдромі ентеральної недостатності. Доведено, що використання інфузій 0,06% розчину NaClO проявляє детоксикаційний ефект: достовірно знижує підвищені концентрації білі- рубіну, креатиніну, сечовини, ЛІІ, покращує реологічні властивості крові. Виявлено, що використання натрію гіпохлориту при пригніченні механізмів антиоксидантного захисту, приводить до активації окис- нювальних процесів. Показано, що включення натрію гіпохлориту в комплексну після- операційну терапію при синдромі ентеральної недостатності вже з першої доби має високу ефективність.

Aim: To evaluate the effectiveness of photodynamic therapy (PDT), sodium hypochlorite (NaOCl) and chlorhexidine gluconate (CHO) in the endodontic re-treatment in the removing of microorganisms from previously filled infected root canals. Materials and Methods: The study samples consist of 54 root canal treated anterior teeth with apical periodontitis were randomly divided into three groups according to the disinfection protocol. Microbiological samples from the root canals were collected after removing the gutta-percha (S1) and following the endodontic re-treatment (S2) with either 5% NaOCl, 2% CHO or PDT procedure for 1 minute. Microbiological samples were cultivated on selective plates to assess the presence or absence of microbial growth and determine the average reduction of viable microorganisms. Results: Significant reduction in the total bacterial count in all the groups at post treatment ( P < .001). PDT provided statistically higher (99.74%) elimination of Enterococcus faecalis in comparison to NaOCl (95%) and CHO (88%). Conclusions: The use of PDT in endodontic re-treatment led to the significant reduction of the remaining bacterial species. So, PDT can be used for routine endodontic disinfection in failed root canal cases.

Environmental monitoring for Listeria monocytogenes in food processing environments is key for ensuring the safety of ready-to-eat foods. For sampling, swabs are often hydrated with a wetting or transport medium that may contain neutralizers and other ingredients. After swabbing the environment, the swabs may then be transported or shipped cold to an off-site laboratory for testing, ideally within 48 h. Extended shipping times may subject the pathogen to increased temperatures in the presence of the wetting medium, organics, and other chemicals from the processing facility that could confound detection. This study evaluated growth and detection of L. monocytogenes on stainless steel exposed to either buffer or sodium hypochlorite before drying. Swabs were rehydrated with Butterfield's phosphate buffer, neutralizing buffer, Letheen broth, or Dey-Engley neutralizing broth before swabbing. Swabs were stored in the presence of no added food, cheese whey, or ice cream under both optimal (4°C) and suboptimal (15°C) temperatures for up to 72 h. Overall, there was no growth of L. monocytogenes at 4°C through 72 h of storage, although enrichment from these swabs was dependent on the presence and type of food matrix. Pathogen growth during storage at 15°C was more variable and depended on both the food matrix and transport media used, with Dey-Engley and Letheen broths allowing for the highest population increases. Overall, more enrichments resulting in L. monocytogenes detections were observed when using Letheen broth and neutralizing buffer than Dey-Engley broth, which resulted in fewer detections at 15°C. Logistic regression and Cochran-Mantel-Haenszel analyses determined that storage temperature, transport media, and food matrix all significantly affected detection of L. monocytogenes, whereas storage time did not have a clear effect on recovery from swabs. HIGHLIGHTS

SUMMARY Objectives: This systematic review of in vitro studies investigated the influence of the post-space treatment used to remove the smear layer on the bond strength of the post to root canal dentin. Methods and Materials: In vitro studies included in this study were identified from PubMed/MEDLINE, Lilacs, and Scopus databases up until March 2019, without limits on publication year or language. Two reviewers independently selected the studies based on the inclusion and exclusion criteria, extracted the data, and evaluated the risk of bias of all studies. A random effects model was used for pairwise meta-analyses (control vs. post-space preparation groups) at a significance level of p Results: Of the 2,832 potentially eligible studies, 453 studies were selected for full-text analysis, and 75 were included in this systematic review. Only one study was considered to have a low risk of bias. Overall, post-space treatment significantly improves the bond strength to root canal dentin (p Conclusion: Post-space treatment has a positive influence on the bond strength of the post to root canal dentin. In this review, the post-space treatments that improve the adhesive resistance of the post were ethanol, sodium hypochlorite, and ethylene diamine tetra-acetic acid (NaOCl + EDTA), NaOCl + EDTA + ultrasound, erbium-doped yttrium aluminium garnet laser (Er:YAG laser), neodymium-doped yttrium aluminium garnet laser (Nd:YAG laser), and diode laser.

Aims Periprosthetic joint infections (PJIs) are among the most devastating complications after joint arthroplasty. There is limited evidence on the efficacy of different antiseptic solutions on reducing biofilm burden. The purpose of the present study was to test the efficacy of different antiseptic solutions against clinically relevant microorganisms in biofilm. Methods We conducted an in vitro study examining the efficacy of several antiseptic solutions against clinically relevant microorganisms. We tested antiseptic irrigants against nascent (four-hour) and mature (three-day) single-species biofilm created in vitro using a drip-flow reactor model. Results With regard to irrigant efficacy against biofilms, Povidone-iodine treatment resulted in greater reductions in nascent MRSA biofilms (logarithmic reduction (LR) = 3.12; p < 0.001) compared to other solutions. Bactisure treatment had the greatest reduction of mature Pseudomonas aeruginosa biofilms (LR = 1.94; p = 0.032) and a larger reduction than Vashe or Irrisept for mature Staphylococcus epidermidis biofilms (LR = 2.12; p = 0.025). Pooled data for all biofilms tested resulted in Bactisure and Povidone-iodine with significantly greater reductions compared to Vashe, Prontosan, and Irrisept solutions (p < 0.001). Conclusion Treatment failure in PJI is often due to failure to clear the biofilm; antiseptics are often used as an adjunct to biofilm clearance. We tested irrigants against clinically relevant microorganisms in biofilm in vitro and showed significant differences in efficacy among the different solutions. Further clinical outcome data is necessary to determine whether these solutions can impact PJI outcome in vivo. Cite this article: Bone Joint J 2021;103-B(5):908–915.

Objective The removal of residual pulpal debris (RPD) from the root canal walls, especially in necrotic teeth is important for successful endodontic outcome. The aim of this study was to evaluate the RPD removal efficacy of handpiece mounted continuous irrigation with simultaneous root canal preparation from the apical third of root canals as compared to conventional syringe irrigation (SI). Materials and Methods Ninety extracted teeth were randomly divided into three groups: SI; handpiece mounted continuous irrigation (CI); and both syringe and continuous irrigation (CI+SI). After root canal preparation, roots were sectioned at 1 (a), 3 (b) and 5 (c) mm from apex and prepared for Hematoxylin-Eosin staining. Sections were microscopically examined for presence of RPD. Statistical Analysis Intergroup difference in average percentage of RPD at different root levels was calculated by using analysis of variance test (ANOVA). Tuckey test was used for pairwise comparison. Results ANOVA showed significant difference between all three groups (p < 0.05). SI group showed a significantly higher percentage of RPD as compared with CI and CI+ SI groups at all root levels (p < 0.01). At root level a, CI showed a significantly higher percentage of RPD as compared with CI+SI (p < 0.01). Conclusion Handpiece mounted CI during rotary instrumentation showed a significant reduction in RPD as compared with conventional syringe irrigation. This technique was found to be an effective method for an enhanced root canal debridement.

Purpose To evaluate the effects of 0.2% sodium hypochlorite, Efferdent (Prestige Consumer Healthcare), and 6.25% Ricinus communis on biofilm removal and antimicrobial action on dentures and brushes using nonimmersion or immersion protocols for the brushes. Materials and methods A total of 45 denture wearers were randomly assigned to a denture immersion protocol for 7 days: 0.85% saline solution for 20 minutes (control); 0.2% sodium hypochlorite for 20 minutes (SH); Efferdent for 3 minutes; or 6.25% Ricinus communis for 20 minutes (RC). The participants were also randomized to immersion (n = 23) or no immersion (n = 22) of their brushes with their dentures in the same solutions. For biofilm evaluation, the dentures were stained and photographed, and the area of the biofilm was measured using Image Tool 3.0 (University of Texas Health Science Center). To evaluate microbial load on dentures and brushes, the biofilm was collected, and the Candida spp and Streptococcus mutans colonies were counted. Results The SH, Efferdent, and RC groups showed reduced biofilm and Candida spp on dentures regardless of the immersion protocol for the brushes. However, no difference was found in the Candida spp counts collected from the brushes immersed compared to the brushes not immersed in the solutions. The SH and Efferdent groups showed reduced S mutans on both dentures and brushes, except for in the nonimmersion subgroups. Conclusion All solutions reduced denture biofilm and microbial load. However, immersion of brushes in the solutions did not contribute to reducing the microbial load.

AIM To determine the anatomical reasons for sodium hypochlorite (NaOCl) accidents by testing whether this mishap is likely to occur in cases where the anatomical apex of the teeth fenestrates the overlying buccal cortical alveolar bone, allowing NaOCl to gain direct access to buccal soft tissues. METHODOLOGY Following a cross-sectional, nonrandomized design, 13 patients who suffered unintentional NaOCl accidents whilst undergoing root canal treatment were included. After remission of symptoms, the root canals were fully irrigated with an innocuous radiopaque solution (saline diluted Claritrast 300) and subsequently CBCT scanned to create a 3D-map of the periapex and tracking of the irrigant pathway throughout the periapical tissues. An extra group of five control patients, who underwent root canal treatment with no NaOCl accident, was also CBCT-scanned after irrigation with the tracking radiopaque solution. The anatomical relationship of the cortical bone and the root apex, as well as the distribution of irrigation solution in the periapical tissue, was associated with patients undergoing a NaOCl accident or not, using a Fisher's exact test. RESULTS The frequency of teeth with apical cortical fenestration was significantly higher in the NaOCl accident-positive group, compared to the negative (P

Objectives: The aim of this study was to investigate the sealing ability of three adhesives bonded to modified dentinal surfaces after short and long storage periods. Methods: Three adhesives were used in this study; two-step etch-and-rinse “Adper Single Bond 2”, two-step self-etch “AdheSE” and one-step self-etch “G-Bond” adhesives. Modifications of the dentinal surface was performed by application of adhesives after oxalate application, application of adhesive after oxalate application to sodium hypochlorite (NaOCl)-deproteinized dentinal surface, compared to control groups (application of adhesive without any surface pretreatment). Dentinal sealing was investigated by measuring dentin permeability, using a fluid transport apparatus, after two storage periods; 24 hours and 2 months. Results: After 24 hours, the control group bonded with “Adper Single Bond 2” without any surface treatment had the highest permeability (25.3%) followed by “G-Bond” (16.2%) and finally “AdheSE” (11%). Significant reductions in permeability values were observed on application of oxalate in conjunction with both “Adper Single Bond 2” and “AdheSE” (11.7% and 2.6% respectively). Further significant reductions in permeability values of those two adhesives were noted when the combined NaOCl and oxalate pretreatments were used (5.7% and 0.8% respectively). Permeability means for all groups increased after storage for 2 months. Conclusions: Dentin surface deproteinization plus oxalate application produced the best dentin sealing for two step adhesives. Key words: Etch-and-rinse adhesives, self-etching adhesives, oxalate-desensitizing agent, NaOCl-deproteinizing agent, dentin permeability.

A novel 4% hydrogen peroxide disinfectant was effective against methicillin-resistant Staphylococcus aureus (MRSA), Clostridioides difficile spores, carbapenem-resistant Escherichia coli, and 2 strains of Candida auris. In laboratory testing, a sodium hypochlorite disinfectant caused fading and loss of pliability of a hospital mattress, but the hydrogen peroxide disinfectant did not. These findings suggest that the hydrogen peroxide-based disinfectant may be a useful addition to the sporicidal disinfectant products available for use in healthcare settings.

Objective. This study aims to compare the effects of conventional syringe irrigation (CSI), passive ultrasonic irrigation (PUI), and innovative sonic-powered irrigation (EDDY) on the penetration of sodium hypochlorite (NaOCl) solutions into root canal dentinal tubules at different levels of the root canal. Materials and Methods. One hundred ninety-two extracted first mandibular premolars of 17- to 25-year-old patients were decoronated 13 mm from the root apices and separated into two groups according to apical preparation sizes (APS) 25 and 40. The root canals were dried with a paper point and stained in crystal violet for 72 hours. Each APS group was separated into three groups according to irrigation techniques, as follows: CSI, PUI, and EDDY. Roots were perpendicularly resected to the long axis at three levels (coronal, middle, and apical). Photomicrographs were taken of all three cross-sections of each tooth under a stereomicroscope. The depth of the bleached zone was measured with ImageJ software. The data were analyzed by Welch’s analysis of variance and an independent t-test (p = 0.05). Results No penetration was found at the apical level in the CSI25, CSI40, and PUI25 groups. The EDDY25 and EDDY40 groups showed the most significant penetration at the middle and apical levels compared to the other groups (p

Purpose Soft tissue, bone and joint infections are severe complications in orthopedic and traumatological surgery. Lavanox (0.08% NaOCl) and Irrisept (0.05% chlorhexidine gluconate, CHG) are industrially produced antiseptic solutions commonly used in infection treatment. Regarding this clinical indication, the microbicidal effect is often investigated, but toxicity to osteoblasts has rarely been examined. This is important to decide whether these solutions should be used in septic situations in which bone healing must take place. The hypothesis of the present study is that NaOCl and CHG are cytotoxic to osteoblasts even after a short exposure time. Methods Human osteoblasts were isolated from donors with osteoarthritis during total knee and hip arthroplasty. Cells were cultivated and treated with both antiseptic solutions for 2, 5 and 10 min in different dilutions. Toxicity was quantified by counting cells, lactate dehydrogenase (LDH) expression, spectrophotometric quantification via XTT assay and FDA/PI fluorescence microscopy. Results Analyzing viable cells after treatment with both antiseptics showed a significant decrease in viable cells through LDH expression test, XTT assay, fluorescence microscopy and light microscopy, depending on concentration. The time dependence showed a trend to more cell death at longer exposure times, without significance. Conclusion Toxic effects on osteoblasts were shown after treatment with 0.08% NaOCl and 0.05% CHG after an exposure time of 2 min which also was concentration dependent. There was no difference in cytotoxicity between both antiseptics. In conclusion, these antiseptic solutions may be used with caution in situations requiring bone healing. Trial registration number Local ethics committee registration number: 5176–07/16

Aim: The purpose of this study was to assess the effects of sodium hypochlorite (NaOCl) immersion and sterilization on the cyclic fatigue resistance of four heat-treated nickel-titanium (NiTi) rotary instruments. Materials and Methods: Two hundred and forty new nickel-titanium endodontic files were tested for cyclic fatigue resistance in simulated canals. 25/.06 Twisted Files (Sybron Endo, Orange, CA, USA), 25/.06 Hyflex CM (Coltene Whaledent, Cuyahoga Falls, OH), 25/~ Hyflex EDM (Coltene, Whaledent Pvt Ltd) and 25/.06 EdgeFile X3 (EdgeEndo, Albuquerque, NM, USA) files were divided into 4 subgroups (n = 15) for each brand. Subgroup 1 (control group) included new instruments that were not immersed in NaOCl or subjected to autoclave sterilization. Subgroup 2 were composed of instruments dynamically immersed for 3 minutes in 5.25% NaOCl solution. Subgroup 3 consisted of instruments that underwent 3 cycles of autoclave sterilization at 121?C under 15 psi for 15 minutes. Subgroup 4 recruited instruments that received a cycle of both dynamic immersion in NaOCl solution for 3 minutes and 3 cycles of autoclave sterilization. All the files were rotated till fracture occurred. The means and standard deviations of the number of cycles to failure (NCF) were calculated and statistically analyzed using ANOVA with post-hoc Games Howell test. (P < .001). Results: Comparison among the four investigated instruments indicated statistically significant difference of NCF (P > .001). EdgeFile X3 files exhibited highest cyclic fatigue resistance, followed by Hyflex EDM files, Hyflex CM files and lowest resistance exhibited by Twisted Files in all the subgroups. There was also statistical significant difference (P < .001) when comparing the instruments in respect to the four treatment protocols (subgroups). Instruments undergoing dynamic immersion in NaOCl solution for 3 minutes followed by 3 cycles of autoclave sterilization did influence the cyclic fatigue of NiTi fil

Background The mechanical disruption and removal of the subgingival biofilm represent the most important step in the treatment of periodontitis. However, in deep periodontal pockets, mechanical removal of the subgingival biofilm is difficult and frequently incomplete. Preliminary findings indicate that the use of amino acid buffered sodium hypochlorite (NaOCl) gel may chemically destroy the bacterial biofilm and facilitate its mechanical removal. Objectives To clinically evaluate the efficacy of minimally invasive nonsurgical therapy (MINST) of periodontal pockets with or without local application of an amino acid buffered sodium hypochlorite (NaOCl) gel. Materials and methods Forty untreated patients diagnosed with severe/advanced periodontitis (i.e. stage III/IV) with a slow/moderate rate of progression (i.e. grade A/B) were randomly allocated in two treatment groups. In the test group, the periodontal pockets were treated by means of MINST and NaOCl gel application, while in the control group, treatment consisted of MINST alone. Full-mouth plaque scores (FMPS), full-mouth bleeding scores (FMBS), probing depths (PD), clinical attachment levels (CAL) and gingival recessions (GR) were assessed at baseline and at 6 months following therapy. The primary outcome variable was PD reduction at sites with PD ≥ 5 mm at baseline. Results At 6 months, statistically significant differences between the two groups were found (p = 0.001) in terms of PD and CAL change. No statistically significant differences were found in terms of GR (p = 0.81). The number of sites with PD ≥ 5 mm and BOP (+) decreased statistically significantly (p = 0.001), i.e. from 85.3 to 2.2% in the test group and from 81.6 to 7.3% in the control group, respectively. Statistically significant differences between test and control groups were recorded at 6 months (p = 0.001). MINST + NaOCl compared to MINST alone decreased statistically significantly (p = 0.001) the probability of residual PDs ≥ 5 mm with BOP− (14.5% vs 18.3%) and BOP+ (2.2% vs. 7.2%). Conclusions Within their limits, the present results indicate that (a) the use of MINST may represent a clinically valuable approach for nonsurgical therapy and (b) the application of NaOCl gel in conjunction with MINST may additionally improve the clinical outcomes compared to the use of MINST alone. Clinical relevance In patients with untreated periodontitis, treatment of deep pockets by means of MINST in conjunction with a NaOCl gel may represent a valuable approach to additionally improve the clinical outcomes obtained with MINST alone

Aim To compare the effectiveness of smear layer and debris removal in the final rinse of curved canals of permanent molars using different commercially available irrigant activation devices. Methods The mesial roots of 74 extracted maxillary and mandibular molars were instrumented using the Mtwo nickel-titanium rotary system (VDW GmbH, Munich, Germany). They were then randomly assigned to one of three groups, varying in their final rinse protocol. Group 1 (n = 15) - conventional needle irrigation with 4% NaOCl; Group 2 (n = 19) - EndoActivator® (Dentsply Tulsa Dental Specialties, Tulsa, OK, USA) with 4% NaOCl; Group 3 (n = 17) - XP-endo® Finisher (FKG Dentaire SA, La Chaux-de-Fonds, Switzerland) with 4% NaOCl. After the final rinse, all canals were flushed with 1 mL 15% EDTA for 60 s and then flushed with saline. The roots were split longitudinally and prepared for scanning electron microscope imaging. ImageJ for Windows was utilised to assess the images for smear layer removal, while two blinded investigators assessed debris presence in the middle and apical thirds using a 5-point scale. Results There was no significant difference in smear layer and debris removal between treatment and control groups in the same canal zones. A significant difference was noted across different canal zones both within and across the groups. Conclusion There is no statistically significant difference in effectiveness between activated irrigation techniques and manual activation. Further investigations are required to evaluate all methods available and determine the most efficient technique to irrigate successfully.

Bacillus cereus spores are concerns for food spoilage and foodborne disease in food industry due to their high resistance to heat and various disinfectants. The aim of this study was to investigate...