Evaluation of Antibacterial Effects of Cold Atmospheric Plasma, Calcium Hydroxide, and Triple Antibiotic Paste on Enterococcus faecalis Biofilm in the Root Canal System: An In Vitro Study
Journal of Lasers in Medical Sciences,
Vol. 13 (2022),
10 January 2022
,
Page e50
Abstract
Introduction: One of the essential factors in successful endodontic therapy is effective cleaning and disinfection of the root canal. This study aims to determine the effect of the cold plasma on the infected root canals with Enterococcus faecalis and compare its antibacterial effect with the conventional medicaments in vitro.
Methods: 63 single-root teeth were extracted. Canals were cleaned and shaped. Ten teeth were selected as a negative control randomly. The rest of the teeth were incubated at 37°C for 21 days to form Enterococcus faecalis biofilm. The specimens were divided into five groups; 2 positive control groups of medicaments and plasma, 1 group treated with calcium hydroxide; 1 group treated with 10 mg/ml of TAP; 1 group treated helium/oxygen plasma. After treatment, F4 Pro-Taper rotary file was used to collect root canal microbial biofilms. Bacterial suspensions are serially diluted, and the percentage of growth reduction for each group was obtained by dividing the logarithm of CFU /mL of each group by CFU /mL of the control of the same group.
Results: The CFU/mL of TAP and plasma-treated samples was significantly lower than the control groups; however, there were no significant differences between the control group and samples treated by calcium hydroxide. The most percentage of CFU reduction was in the TAP-treated group compared with plasma and calcium hydroxide-treated groups.
Conclusion: The application of cold plasma effectively inhibits the growth of Enterococcus faecalis and reduces bacterial biofilm. Also, in the present study, 10 mg/ml of TAP caused the complete elimination of Enterococcus faecalis. Calcium hydroxide had the most negligible effect on Enterococcus faecalis biofilm elimination.
- Keywords: Cold atmospheric plasma, Enterococcus faecalis biofilm, root canal, calcium hydroxide, triple antibiotic paste
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References
2. Basrani B, Tjäderhane L, Santos JM, Pascon E, Grad H, Lawrence HP, et al. Efficacy of chlorhexidine-and calcium hydroxide–containing medicaments against Enterococcus faecalis in vitro. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 2003;96(5):618-24.
3. Schäfer E, Bössmann K. Antimicrobial efficacy of chlorhexidine and two calcium hydroxide formulations against Enterococcus faecalis. Journal of endodontics. 2005;31(1):53-6.
4. Cha S, Park Y-S. Plasma in dentistry. Clinical plasma medicine. 2014;2(1):4-10.
5. Arora V, Nikhil V, Suri N, Arora P. Cold atmospheric plasma (CAP) in dentistry. Dentistry. 2014;4(1):1.
6. Wong J, Manoil D, Näsman P, Belibasakis GN, Neelakantan P. Microbiological aspects of root canal infections and disinfection strategies: an update review on the current knowledge and challenges. Frontiers in Oral Health. 2021:34.
7. Reyhani MF, Rahimi S, Fathi Z, Shakouie S, Milani AS, Barhaghi MHS, et al. Evaluation of antimicrobial effects of different concentrations of triple antibiotic paste on mature biofilm of Enterococcus faecalis. Journal of dental research, dental clinics, dental prospects. 2015;9(3):138.
8. Benítez Robles M. Tratamiento de dientes permanentes inmaduros con ápice necrótico. 2016.
9. Vatkar NA, Hegde V, Sathe S. Vitality of Enterococcus faecalis inside dentinal tubules after five root canal disinfection methods. Journal of conservative dentistry: JCD. 2016;19(5):445.
10. Zou L, Shen Y, Li W, Haapasalo M. Penetration of sodium hypochlorite into dentin. Journal of endodontics. 2010;36(5):793-6.
11. Sher BM, Mulder R, Gutknecht N. The Photobiomodulation Effect of 940nm Laser Irradiation on Enterococcus faecalis in Human Root Dentin Slices of Varying Thicknesses. Journal of Lasers in Medical Sciences. 2021;12.
12. Zand V, Lotfi M, Soroush MH, Abdollahi AA, Sadeghi M, Mojadadi A. Antibacterial efficacy of different concentrations of sodium hypochlorite gel and solution on Enterococcus faecalis biofilm. Iranian endodontic journal. 2016;11(4):315.
13. Hasselgren G, Olsson B, Cvek M. Effects of calcium hydroxide and sodium hypochlorite on the dissolution of necrotic porcine muscle tissue. Journal of endodontics. 1988;14(3):125-7.
14. Mohammadi Z, Shalavi S, Yazdizadeh M. Antimicrobial activity of calcium hydroxide in endodontics: a review. Chonnam medical journal. 2012;48(3):133-40.
15. Sathorn C, Parashos P, Messer H. Antibacterial efficacy of calcium hydroxide intracanal dressing: a systematic review and meta‐analysis. International endodontic journal. 2007;40(1):2-10.
16. Vijayaraghavan R, Mathian VM, Sundaram AM, Karunakaran R, Vinodh S. Triple antibiotic paste in root canal therapy. Journal of pharmacy & bioallied sciences. 2012;4(Suppl 2):S230.
17. Mohammadi Z, Jafarzadeh H, Shalavi S, Yaripour S, Sharifi F, Kinoshita J-I. A review on triple antibiotic paste as a suitable material used in regenerative endodontics. Iranian endodontic journal. 2018;13(1):1.
18. Latham J, Fong H, Jewett A, Johnson JD, Paranjpe A. Disinfection efficacy of current regenerative endodontic protocols in simulated necrotic immature permanent teeth. Journal of endodontics. 2016;42(8):1218-25.
19. Hoffmann C, Berganza C, Zhang J. Cold Atmospheric Plasma: methods of production and application in dentistry and oncology. Medical gas research. 2013;3(1):1-15.
20. Asnaashari M, Motamedi S, Asnaashari N, Azari-Marhabi S. Antimicrobial Activity of Cold Plasma Treatment on Acrylic Denture Bases: An In Vitro Evaluation. Journal of Lasers in Medical Sciences. 2019;10(Suppl 1):S13.
21. Armand A, Khani M, Asnaashari M, AliAhmadi A, Shokri B. Comparison study of root canal disinfection by cold plasma jet and photodynamic therapy. Photodiagnosis and Photodynamic Therapy. 2019;26:327-33.
22. Mai-Prochnow A, Zhou R, Zhang T, Ostrikov KK, Mugunthan S, Rice SA, et al. Interactions of plasma-activated water with biofilms: inactivation, dispersal effects and mechanisms of action. npj Biofilms and Microbiomes. 2021;7(1):1-12.
23. Park G, Park S, Choi M, Koo I, Byun J, Hong J, et al. Atmospheric-pressure plasma sources for biomedical applications. Plasma Sources Science and Technology. 2012;21(4):043001.
24. Li Q, Li J-T, Zhu W-C, Zhu X-M, Pu Y-K. Effects of gas flow rate on the length of atmospheric pressure nonequilibrium plasma jets. Applied Physics Letters. 2009;95(14):141502.
25. Prather BT, Ehrlich Y, Spolnik K, Platt JA, Yassen GH. Effects of two combinations of triple antibiotic paste used in endodontic regeneration on root microhardness and chemical structure of radicular dentine. Journal of oral science. 2014;56(4):245-51.
26. Sabrah AH, Yassen GH, Spolnik KJ, Hara AT, Platt JA, Gregory RL. Evaluation of residual antibacterial effect of human radicular dentin treated with triple and double antibiotic pastes. Journal of endodontics. 2015;41(7):1081-4.
27. Asnaashari M, Eghbal MJ, Yaghmayi AS, Shokri M, Azari-Marhabi S. Comparison of antibacterial effects of photodynamic therapy, modified triple antibiotic paste and calcium hydroxide on root canals infected with Enterococcus faecalis: an in vitro study. Journal of Lasers in Medical Sciences. 2019;10(Suppl 1):S23.
28. Pan J, Sun K, Liang Y, Sun P, Yang X, Wang J, et al. Cold plasma therapy of a tooth root canal infected with Enterococcus faecalis biofilms in vitro. Journal of endodontics. 2013;39(1):105-10.
29. Jiang C, Schaudinn C, Jaramillo DE, Webster P, Costerton JW. In vitro antimicrobial effect of a cold plasma jet against Enterococcus faecalis biofilms. International Scholarly Research Notices. 2012;2012.
30. Jungbauer G, Moser D, Müller S, Pfister W, Sculean A, Eick S. The antimicrobial effect of cold atmospheric plasma against dental pathogens—a systematic review of in-vitro studies. Antibiotics. 2021;10(2):211.
31. Miguéns-Vila R, Martín-Biedma B, Aboy-Pazos S, Uroz-Torres D, Álvarez-Nóvoa P, Dablanca-Blanco AB, et al. Effectiveness of Different Irrigant Activation Systems on Smear Layer Removal: A Scanning Electron Microscopic Study. Journal of Clinical Medicine. 2022;11(4):1003.
32. Martins KB, Ferreira AM, Pereira VC, Pinheiro L, Oliveira Ad, Cunha MdLRdSd. In vitro effects of antimicrobial agents on planktonic and biofilm forms of Staphylococcus saprophyticus isolated from patients with urinary tract infections. Frontiers in Microbiology. 2019:40.
33. Evans M, Davies JK, Sundqvist G, Figdor D. Mechanisms involved in the resistance of Enterococcus faecalis to calcium hydroxide. International endodontic journal. 2002;35(3):221-8.
34. Labban N, Yassen GH, Windsor LJ, Platt JA. The direct cytotoxic effects of medicaments used in endodontic regeneration on human dental pulp cells. Dental Traumatology. 2014;30(6):429-34.
35. Pereira MSS, Rossi MA, Cardoso CR, da Silva JS, da Silva LAB, Kuga MC, et al. Cellular and molecular tissue response to triple antibiotic intracanal dressing. Journal of endodontics. 2014;40(4):499-504.
36. Zargar N, Nasiri MJ, Ashraf H, Hajikhani B, Esfahani SE, Esfahani ME. Antimicrobial Susceptibility of Enterococcus faecalis Isolated From Root Canal: An In Vitro Study. Avicenna Journal of Pharmaceutical Research. 2020;1(2):60-4.
37. Li Y, Sun K, Ye G, Liang Y, Pan H, Wang G, et al. Evaluation of cold plasma treatment and safety in disinfecting 3-week root canal Enterococcus faecalis biofilm in vitro. Journal of endodontics. 2015;41(8):1325-30.
38. Du T, Ma J, Yang P, Xiong Z, Lu X, Cao Y. Evaluation of antibacterial effects by atmospheric pressure nonequilibrium plasmas against Enterococcus faecalis biofilms in vitro. Journal of endodontics. 2012;38(4):545-9.
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