Elimination of an intraradicular biofilm composed of Enterococcus faecalis and Candida albicans using a negative apical pressure irrigation system.

  • Verónica Méndez-González Endodontics Postgraduate Program, Faculty of Dentistry, The Autonomous University of San Luis Potosí, SLP, Mexico.
  • Marlen Vitales-Noyola Endodontics Postgraduate Program, Faculty of Dentistry, The Autonomous University of San Luis Potosí, SLP, Mexico.
  • Ana González-Amaro Endodontics Postgraduate Program, Faculty of Dentistry, The Autonomous University of San Luis Potosí, SLP, Mexico.
  • Carlos Muñoz-Viveros Kavo Kerr group, Orange County, California, United States.
  • Francisco Ducoing-Hernández Endodontics Postgraduate Program, Faculty of Dentistry, The Autonomous University of San Luis Potosí, SLP, Mexico.

Abstract

Endodontic treatment consists of the cleaning and disinfecting the root canal system, which is achieved using adequate mechanical instru-mentation and chemical irrigation. Endodontic microorganisms are present in root canals in the form of a biofilm, and their elimination ensures the success of endodontic treatment. Irrigation is a key factor contributing to the elimination of this intraconduct biofilm, and different irrigator agents and irrigation techniques, such as irrigation with negative apical pressure, a novel automated irrigation mechanism based on suction intraconduct, have been used. In this study, we evaluated the ability of a negative apical pressure system with different concentrations of sodium hypochlorite and  durations to reduce the microbial load. Materials and Methods: An intraradicular biofilm composed of Enterococcus faecalis and Candida albicans was generated during twenty-one days of static culture on one hundred mesio-vestibular roots of upper molars with complex curvatures greater than 30°C, and the roots were classified in six groups with different concentrations and contact times of sodium hypochlorite. Subsequently, the reduction in the microbial load was measured with McFarland scale and the enumeration of colony forming units and was evaluated with scanning electronic microscopy. Results: We observed a significant difference in the reduction of the microbial load prior to instrumentation compared with postinstrumentation between the groups treated with 2.25% and 5.25% NaOCl for 30, 60 and 90 seconds of contact time (p<0.05), but we did not observe differences in the reduction of microbial load between different contact times and concentrations of sodium hypochlorite employed (p>0.05). Conclusion: Negative apical pressure is a good option for irrigation in endodontics, as it allows the passage of the irrigation fluid along the total length of the root canal and produces a better antimicrobial effect. 

References

1. Kuttler Y . Endodoncia Práctica. México. Ed.Alpha. 1961.
2. Vera-Rojas J, Benavides-Garciá M, Moreno-Silva E, Romero-Viñas M. Conceptos y Técnicas Actuales en la Irrigación Endodóntica. Asoc Española Endod. 2012; 30, 31-44.
3. Haapasalo M, Endal U, Zandi H, Coil J. Eradication of Endodontic Infection by Instrumentation and Irrigation Solutions. Endod Top. 2005; 2010, 77-102.
4. Grossman L. Irrigation of root canals. J Amer Dent Assoc. 1943; 30, 1915–7.

5. Tay FR, Gu L, Schoeffel GJ. The Effect Of Vapor Lock On Root Canal Debridement Using A Side- Vented Needle For Positive- Pressure Irrigant Delivery. J Endod. 2010; 36, 745-50.
6. Cohen S, Hargreaves KM, Berman LH. Vías de la Pulpa. Barcelona España. Elsevier. 2011.
7. Haapasalo M, Shen Y, Wang Z, Gao Y. Irrigation in endod British Dent J. 2014; 216, 299-303.
8. Li G, Ryul J, Junqi H. Review of Contemporary Irrigant Agitation Techniques and Devices. J Endod. 2009; 35, 791-804.
9. Radcliffe C, Potouridou L, Qureshi R, Habahbeh N, Qualtrough A, Worthington H, Drucker Db. Anti-Microbial Activity of Varying Concentrations of Sodium Hypochlorite on the Endodontic Microorganisms Actinomyces Israelii, A. Naeslundii, Candida Albicans and Enterococcus Faecalis. Int Endod J. 2004; 37, 438–6.
10. Narayanan LL, Vaishnavi C. Endodontic microbiology. J Conserv Dent. 2010; 13(4): 233–9.
11. Yoo YJ, Perinpanayagam H, Oh S, Kim AR, Han SH, Kum KY. Endodontic biofilms: contemporary and future treatment options. Restor Dent Endod. 2019; 44(1):e7.
12. Nielsen B, Baumgartner J. Comparison of The Endovac System to Needle Irrigation of Root Canals. Journal of Endod. 2007; 33, 611-5.
13. Fukumoto Y, Kikuchi I, Yoshioka T, Kobayashi C, Suda H. An ex-vivo evaluation of a new root canal irrigation technique with intracanal aspiration. Int Endod J. 2006; 39, 93-9.
14. Schoeffel J. The Endovac method of endodontic irrigation. Dentistry Today. 2007; 30, 92-4.
15. Schneider S. A comparison of canal preparations in straight and curved root canals. Oral Surgery. 1971; 32, 271-5.
16. Haapasalo M, Orstavik D. In vitro infection and disinfection of dentinal tubules. J Dent Restor. 1987; 66, 1375-9.
17. Gonzalez AM, Corpus E, Pozos-Guillen A, Silva-Herzog D, Aragon-Piña A, Cohenca N. Scien World J. 2014;2014:706189.
18. Manzur A. Evaluación in vivo de los efectos de la pre-paración biomecánica y medicación intraconducto sobre los microorganismos de los conductos radiculares. J Dent Restor. 2005; 66, 1375-9.
19. Wayne PA. Performed standards for antimicrobial disk Sus-ceptibility Tests; National Committee for Clinical Laboratory Standards. Approved standard M2-A8. 8th Ed Pa: NCCLS. 2003.
20. Rome W, Doran J, Walker W. The Effectiveness of Gly-Oxide and Sodium Hypochlorite in Preventing Smear Layer Formation. J Endod. 1985; 11, 281-8.
21. Bronnec F, Bouillaguet S, Machtou P. Ex vivo assessment of irrigant penetration and renewal during the final irrigation regimen. Int Endod J. 2010; 43, 663-72.
22. Kapila S, Makkar S, Gupta P. Pressure Alteration Techniques in Endodontics- A Review of Literature. J Clin Diag Res. 2015; 9, 1-6.
23. Marion J, Manhães F, Bajo H, Duque T. Efficiency of different concentrations of sodium hypochlorite during endodontic treatment. Literature review. Dental Press Endodontics. 2012; 2, 32-7.
24. Miller T, Baumgartner C. Comparison of the Antimicrobial Efficacy of Irrigation Using the EndoVac to Endodontic Needle Delivery. J Endod. 2010; 36, 509-11.
25. Morse DJ, Wilson MJ, Wei X, Bradshaw DJ, Lewis MAO, Williams DW. Modulation of Candida albicans virulence in in vitro biofilms by oral bacteria. Lett Appl Microbiol. 2019; 68(4):337-43.
26. Li Z, Xiang Z, Zeng J, Li Y, Li J. A GntR Family Transcription Factor in Streptococcus mutans Regulates Biofilm Formation and Expression of Multiple Sugar Transporter Genes. Front Microbiol. 2019; 9:3224.
27. Brunson M, Heilborn C, Johnson J, Cohenca N. Effect of Apical Preparation Size and Preparation Taper on Irrigant Volume Delivered by Using Negative Pressure Irrigation System. J Endod.2010; 36, 721-4.
28. De Gregorio C, Arias A, Navarrete N, Del Rio V, Oltra E, Cohenca N. Effect of Apical Size and Taper on Volume of Irrigant Delivered at Working Length with Apical Negative Pressure at Different Root Curvatures. J Endod. 2013;39(1):119-24.
Published
2020-02-28
How to Cite
MÉNDEZ-GONZÁLEZ, Verónica et al. Elimination of an intraradicular biofilm composed of Enterococcus faecalis and Candida albicans using a negative apical pressure irrigation system.. Journal of Oral Research, [S.l.], v. 9, n. 1, p. 36-43, feb. 2020. ISSN 0719-2479. Available at: <http://www.joralres.com/index.php/JOR/article/view/joralres.2020.006>. Date accessed: 13 aug. 2020. doi: https://doi.org/10.17126/joralres.2020.006.
Section
Articles