Aim: The purpose of this study was to evaluate the efficacy of 3% sodium hypochlorite (NaOCl), 2% chlorhexidine (CHX), and chitosan nanoparticles against Candida albicans using the agar disc-diffusion test. Materials and Methods: Strain of C. albicans was cultivated in Sabouraud Dextrose Agar. Chitosan nanoparticles were synthesized using an ionic gelation method. Four groups were made according to the irrigants used. Group 1: 3% NaOCl, Group 2: 2% CHX, Group 3: chitosan nanoparticles, and Group 4: saline as control. Discs were added with the different irrigants and placed in a dish containing C. albicans. The plates were incubated at 37°C for 24h. The zone of inhibition was measured in millimeter. Results: Statistical analysis was performed using the test of one-way variance (ANOVA) and post hoc Tukey. Group 1 showed significantly higher zone of inhibition compared to Groups 2 and 3 (P < 0.05). There were no significant differences between the zones of inhibition of Groups 2 and 3 (P < 0.05). Conclusion: Chitosan nanoparticles and 2% CHX have similar efficacy against C. albicans, whereas 3% NaOCl was significantly better than both chitosan nanoparticles and CHX.

Comparative evaluation of antifungal efficacy of conventional endodontic irrigants and chitosan nanoparticles

Can natural irrigants replace sodium hypochlorite? A systematic review

Introduction: In root canal therapy, the cleaning and shaping of canals are routinely applied by clinicians in order to remove microorganisms. Eradicating bacteria from the root canal system plays a crucial role in long-term success; however, it is not always easy to disinfect root canals properly because of their complicated anatomy and bacterial load. Achieving an optimally disinfected root canal environment requires adjunctive antibacterial therapeutic methods. High-power laser utilization as an adjunctive strategy to conventional treatment is a relatively new approach that helps clinicians. Methods: This study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. Online databases, namely Web of Science, PubMed/MEDLINE, Scopus, and Cochrane Library, were searched electronically regarding lasers and endodontic treatments. Appropriate studies were included according to the inclusion/exclusion criteria. Results: Among 504 obtained studies by search, 48 were considered for a detailed analysis. Ten articles performed in vivo evaluation, while nine assessed the effect of lasers on artificial models, and 29 conducted ex vivo experiments on extracted teeth. When the diode laser, the most frequently used laser, was utilized as an adjunct therapy after NaOCl irrigation, it killed more bacteria than conventional irrigation with NaOCl. Laser-activated irrigation (LAI) with the Er, Cr: YSGG laser and NaOCl disinfects the root canal effectively. Also, photon-induced photoacoustic streaming (PIPS) with Er: YAG and NaOCl exhibited a high bactericidal effect and deep tubular penetration. Conclusion: High-power laser utilization, considering proper case selection and method, can assist in root canal treatment of infected teeth.

The Effect of High-Power Lasers on Root Canal Disinfection: A Systematic Review.

AIM
The purpose of this study was to compare the antibacterial effects of Allium Sativum (garlic extract), calcium hydroxide (Ca (OH)2 ), and their combination as intracanal medicaments in infected mature anterior teeth using real-time PCR.


MATERIAL& METHODS
This prospective double-blind, controlled, parallel, superiority, randomized clinical trial was carried out on sixty-six permanent, necrotic incisors associated with asymptomatic apical periodontitis in sixty-six male patients. Patients were randomly divided into three groups (n =22) according to the intra -canal medications used. After access preparation, four microbiological samples (S) were taken using sterile absorbent paper points as follows: S1: before canal instrumentation. S2: after cleaning and shaping. The third samples (S3) and fourth samples (S4) were taken after the placement of the tested intracanal medications into their corresponding canals for 7 and 14 days, respectively. Total DNA was extracted from microbiological samples and relative quantitative real time PCR reactions were done to quantify the relative gene expression fold change (FC) for Enterococcus faecalis and Streptococcus species. At significance level p ≤ 0.05, the data were statistically analyzed in SPSS software using Kruskal-Wallis and Freidman's tests, followed by Dunn-Bonferroni post-hoc test for pairwise comparisons.


RESULTS
Both bacterial mean FC decreased significantly after mechanical instrumentation (S1 to S2) in all groups. However, no statistically significant differences were found after intra-canal medicament placement (from S2 to S3 and from S3 to S4) except in the garlic group. Garlic significantly reduced Enterococcus faecalis FC in S3 and S4 when compared to Ca (OH) 2 and Ca (OH) 2 + garlic combination. However, garlic and Ca (OH)2 reduced Streptococcus bacteria in S3 similarly. While in S4, garlic showed significantly more reduction than Ca (OH) 2 . The combination of Ca (OH) 2 with garlic extract showed the least significant bacterial reduction.


CONCLUSION
within the study limitations, garlic intra-canal medicament has a comparable anti-Streptococcus efficiency to Ca (OH) 2, while it is more effective against Enterococcus faecalis species. When Ca (OH)2 and garlic are combined, their antibacterial effectiveness is reduced. Increasing the time of application for tested intracanal medicaments by more than one week has no additional antibacterial effectiveness.

Comparative Evaluation of the Antibacterial Effect of Allium Sativum, Calcium hydroxide and Their Combination as Intracanal Medicaments in Infected Mature Anterior Teeth A Randomized Clinical Trial.

Aim: The present study aimed to individually evaluate and compare the aerobic and anaerob?ic antibacterial activity of Allium sativum extract, aqueous ozone, diode laser, and 3% sodium hypochlorite (NaOCl) as root canal irrigants. Materials and Methods: Forty-eight patients were selected and randomly allocated to one of the four groups (n = 12 each) according to the irrigant to be used in each group. For each included tooth, the preirrigation and postirrigation (after irrigation with the test solution) samples were collected through sterile paper points and microbial culturing was done by swabbing on blood agar plates followed by incubation for aerobic and anaerobic bacteria. Statistical Analysis: Manual colony-forming units counting were done, and statistical analysis was performed. Analysis of variance (one-way) followed by post hoc test was performed as a parametric test to compare the difference between the groups for both aerobic and anaerobic bacteria. Results: All the groups showed a statistically significant reduction in bacteria (P Conclusion: A. sativum extract, aqueous zone, diode laser, and 3% NaOCl showed significant antibacterial activity against aerobic and anaerobic bacteria.

Comparative evaluation of antibacterial efficacy of Allium sativum extract, aqueous ozone, diode laser, and 3% sodium hypochlorite in root canal disinfection: An in vivo study

Deepti Sreen

Papers

Comparative evaluation of antibacterial efficacy of Allium sativum extract, aqueous ozone, diode laser, and 3% sodium hypochlorite in root canal disinfection: An in vivo study