Impact of N-acetylcysteine (NAC) and calcium hydroxide intracanal medications in primary endodontic infection: a randomized clinical trial

Detalhes bibliográficos
Autor(a) principal: Martinho, Frederico C.
Data de Publicação: 2022
Outros Autores: Corazza, Bruna J. M. [UNESP], Khoury, Rayana D. [UNESP], Orozco, Esteban I. F. [UNESP], Toia, Cassia C. [UNESP], Machado, Felipe P. [UNESP], Valera, Marcia C. [UNESP]
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da UNESP
Texto Completo: http://dx.doi.org/10.1007/s00784-022-04585-9
http://hdl.handle.net/11449/240267
Resumo: Objectives: This RCT investigated the impact of N-acetylcysteine (NAC) and calcium hydroxide [Ca(OH)2] intracanal medications (ICMs) in primary endodontic infection with apical periodontitis (PEIAP). Materials and methods: Thirty-six teeth with PEIAP were randomly divided into groups according to the ICM: NAC, Ca(OH)2 + saline solution (SSL), and Ca(OH)2 + 2% chlorhexidine-gel (2% CHX-gel) (all, n = 12). Root canal samples (RCSs) were collected before (s1) and after instrumentation (s2) and after 14 days of ICM (s3). Chemomechanical preparation (CMP) was performed with a Reciproc file and 2.5% NaOCl. Checkerboard DNA–DNA hybridization was used to assess 40 target bacteria species. Results: At s1, bacterial DNA was detected in 100% of RCSs (36/36). All 40 bacterial species were found in PEIAP. The mean number of species per RCS was 17.92 ± 13.18. The most frequent bacteria were S. mitis (65%), E. nodatum (63%), E. faecalis (63%), F. nucl sp vicentii (58%), T. forsythia (58%), and F. periodonticum (56%). CMP reduced the mean number of species per RCS to 6.8 ± 2.36 (p < 0.05). At s3, the intragroup analysis revealed a broader antimicrobial activity for Ca (OH)2 + 2% CHX-gel and NAC than Ca(OH)2 + SSL (p < 0.05). NAC eliminated 8/12 bacteria species resistant to both Ca (OH)2 ICMs, including P. micra, P. nigrescens, T. denticola, A. israelii, P. endodontalis, P. acnes, C. ochracea, and E. corrodens. Conclusions: Ca (OH)2 + 2% chlorhexidine gel (2% CHX gel) showed a greater bacterial elimination over the number of bacterial species; however, NAC eliminated 8/12 bacteria species resistant to both Ca (OH)2 ICMs (RBR-3xbnnn). Clinical relevance: The use of intracanal medication with a broad antimicrobial activity can optimize root canal disinfection. Ca(OH)2 + 2% CHX gel and NAC showed a broader antimicrobial activity than Ca(OH)2 + SSL against endodontic pathogens in primary root canal infection. Trial registration: Brazilian Registry of Clinical Trials (REBEC), No. RBR-3xbnnn.
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spelling Impact of N-acetylcysteine (NAC) and calcium hydroxide intracanal medications in primary endodontic infection: a randomized clinical trialBacteriaCalcium hydroxideIntracanal medicationN-acetylcysteineNACRoot canalObjectives: This RCT investigated the impact of N-acetylcysteine (NAC) and calcium hydroxide [Ca(OH)2] intracanal medications (ICMs) in primary endodontic infection with apical periodontitis (PEIAP). Materials and methods: Thirty-six teeth with PEIAP were randomly divided into groups according to the ICM: NAC, Ca(OH)2 + saline solution (SSL), and Ca(OH)2 + 2% chlorhexidine-gel (2% CHX-gel) (all, n = 12). Root canal samples (RCSs) were collected before (s1) and after instrumentation (s2) and after 14 days of ICM (s3). Chemomechanical preparation (CMP) was performed with a Reciproc file and 2.5% NaOCl. Checkerboard DNA–DNA hybridization was used to assess 40 target bacteria species. Results: At s1, bacterial DNA was detected in 100% of RCSs (36/36). All 40 bacterial species were found in PEIAP. The mean number of species per RCS was 17.92 ± 13.18. The most frequent bacteria were S. mitis (65%), E. nodatum (63%), E. faecalis (63%), F. nucl sp vicentii (58%), T. forsythia (58%), and F. periodonticum (56%). CMP reduced the mean number of species per RCS to 6.8 ± 2.36 (p < 0.05). At s3, the intragroup analysis revealed a broader antimicrobial activity for Ca (OH)2 + 2% CHX-gel and NAC than Ca(OH)2 + SSL (p < 0.05). NAC eliminated 8/12 bacteria species resistant to both Ca (OH)2 ICMs, including P. micra, P. nigrescens, T. denticola, A. israelii, P. endodontalis, P. acnes, C. ochracea, and E. corrodens. Conclusions: Ca (OH)2 + 2% chlorhexidine gel (2% CHX gel) showed a greater bacterial elimination over the number of bacterial species; however, NAC eliminated 8/12 bacteria species resistant to both Ca (OH)2 ICMs (RBR-3xbnnn). Clinical relevance: The use of intracanal medication with a broad antimicrobial activity can optimize root canal disinfection. Ca(OH)2 + 2% CHX gel and NAC showed a broader antimicrobial activity than Ca(OH)2 + SSL against endodontic pathogens in primary root canal infection. Trial registration: Brazilian Registry of Clinical Trials (REBEC), No. RBR-3xbnnn.Division of Endodontics Department of Advanced Oral Sciences and Therapeutics School of Dentistry University of Maryland, 650 West Baltimore Street, 6th floor, Suite 6253Department of Restorative Dentistry Endodontic Division Institute of Science and Technology São Paulo State University - UNESPDepartment of Restorative Dentistry Endodontic Division Institute of Science and Technology São Paulo State University - UNESPUniversity of MarylandUniversidade Estadual Paulista (UNESP)Martinho, Frederico C.Corazza, Bruna J. M. [UNESP]Khoury, Rayana D. [UNESP]Orozco, Esteban I. F. [UNESP]Toia, Cassia C. [UNESP]Machado, Felipe P. [UNESP]Valera, Marcia C. [UNESP]2023-03-01T20:09:10Z2023-03-01T20:09:10Z2022-01-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlehttp://dx.doi.org/10.1007/s00784-022-04585-9Clinical Oral Investigations.1436-37711432-6981http://hdl.handle.net/11449/24026710.1007/s00784-022-04585-92-s2.0-85132145610Scopusreponame:Repositório Institucional da UNESPinstname:Universidade Estadual Paulista (UNESP)instacron:UNESPengClinical Oral Investigationsinfo:eu-repo/semantics/openAccess2023-03-01T20:09:10Zoai:repositorio.unesp.br:11449/240267Repositório InstitucionalPUBhttp://repositorio.unesp.br/oai/requestopendoar:29462024-08-05T16:17:18.713809Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP)false
dc.title.none.fl_str_mv Impact of N-acetylcysteine (NAC) and calcium hydroxide intracanal medications in primary endodontic infection: a randomized clinical trial
title Impact of N-acetylcysteine (NAC) and calcium hydroxide intracanal medications in primary endodontic infection: a randomized clinical trial
spellingShingle Impact of N-acetylcysteine (NAC) and calcium hydroxide intracanal medications in primary endodontic infection: a randomized clinical trial
Martinho, Frederico C.
Bacteria
Calcium hydroxide
Intracanal medication
N-acetylcysteine
NAC
Root canal
title_short Impact of N-acetylcysteine (NAC) and calcium hydroxide intracanal medications in primary endodontic infection: a randomized clinical trial
title_full Impact of N-acetylcysteine (NAC) and calcium hydroxide intracanal medications in primary endodontic infection: a randomized clinical trial
title_fullStr Impact of N-acetylcysteine (NAC) and calcium hydroxide intracanal medications in primary endodontic infection: a randomized clinical trial
title_full_unstemmed Impact of N-acetylcysteine (NAC) and calcium hydroxide intracanal medications in primary endodontic infection: a randomized clinical trial
title_sort Impact of N-acetylcysteine (NAC) and calcium hydroxide intracanal medications in primary endodontic infection: a randomized clinical trial
author Martinho, Frederico C.
author_facet Martinho, Frederico C.
Corazza, Bruna J. M. [UNESP]
Khoury, Rayana D. [UNESP]
Orozco, Esteban I. F. [UNESP]
Toia, Cassia C. [UNESP]
Machado, Felipe P. [UNESP]
Valera, Marcia C. [UNESP]
author_role author
author2 Corazza, Bruna J. M. [UNESP]
Khoury, Rayana D. [UNESP]
Orozco, Esteban I. F. [UNESP]
Toia, Cassia C. [UNESP]
Machado, Felipe P. [UNESP]
Valera, Marcia C. [UNESP]
author2_role author
author
author
author
author
author
dc.contributor.none.fl_str_mv University of Maryland
Universidade Estadual Paulista (UNESP)
dc.contributor.author.fl_str_mv Martinho, Frederico C.
Corazza, Bruna J. M. [UNESP]
Khoury, Rayana D. [UNESP]
Orozco, Esteban I. F. [UNESP]
Toia, Cassia C. [UNESP]
Machado, Felipe P. [UNESP]
Valera, Marcia C. [UNESP]
dc.subject.por.fl_str_mv Bacteria
Calcium hydroxide
Intracanal medication
N-acetylcysteine
NAC
Root canal
topic Bacteria
Calcium hydroxide
Intracanal medication
N-acetylcysteine
NAC
Root canal
description Objectives: This RCT investigated the impact of N-acetylcysteine (NAC) and calcium hydroxide [Ca(OH)2] intracanal medications (ICMs) in primary endodontic infection with apical periodontitis (PEIAP). Materials and methods: Thirty-six teeth with PEIAP were randomly divided into groups according to the ICM: NAC, Ca(OH)2 + saline solution (SSL), and Ca(OH)2 + 2% chlorhexidine-gel (2% CHX-gel) (all, n = 12). Root canal samples (RCSs) were collected before (s1) and after instrumentation (s2) and after 14 days of ICM (s3). Chemomechanical preparation (CMP) was performed with a Reciproc file and 2.5% NaOCl. Checkerboard DNA–DNA hybridization was used to assess 40 target bacteria species. Results: At s1, bacterial DNA was detected in 100% of RCSs (36/36). All 40 bacterial species were found in PEIAP. The mean number of species per RCS was 17.92 ± 13.18. The most frequent bacteria were S. mitis (65%), E. nodatum (63%), E. faecalis (63%), F. nucl sp vicentii (58%), T. forsythia (58%), and F. periodonticum (56%). CMP reduced the mean number of species per RCS to 6.8 ± 2.36 (p < 0.05). At s3, the intragroup analysis revealed a broader antimicrobial activity for Ca (OH)2 + 2% CHX-gel and NAC than Ca(OH)2 + SSL (p < 0.05). NAC eliminated 8/12 bacteria species resistant to both Ca (OH)2 ICMs, including P. micra, P. nigrescens, T. denticola, A. israelii, P. endodontalis, P. acnes, C. ochracea, and E. corrodens. Conclusions: Ca (OH)2 + 2% chlorhexidine gel (2% CHX gel) showed a greater bacterial elimination over the number of bacterial species; however, NAC eliminated 8/12 bacteria species resistant to both Ca (OH)2 ICMs (RBR-3xbnnn). Clinical relevance: The use of intracanal medication with a broad antimicrobial activity can optimize root canal disinfection. Ca(OH)2 + 2% CHX gel and NAC showed a broader antimicrobial activity than Ca(OH)2 + SSL against endodontic pathogens in primary root canal infection. Trial registration: Brazilian Registry of Clinical Trials (REBEC), No. RBR-3xbnnn.
publishDate 2022
dc.date.none.fl_str_mv 2022-01-01
2023-03-01T20:09:10Z
2023-03-01T20:09:10Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://dx.doi.org/10.1007/s00784-022-04585-9
Clinical Oral Investigations.
1436-3771
1432-6981
http://hdl.handle.net/11449/240267
10.1007/s00784-022-04585-9
2-s2.0-85132145610
url http://dx.doi.org/10.1007/s00784-022-04585-9
http://hdl.handle.net/11449/240267
identifier_str_mv Clinical Oral Investigations.
1436-3771
1432-6981
10.1007/s00784-022-04585-9
2-s2.0-85132145610
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv Clinical Oral Investigations
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eu_rights_str_mv openAccess
dc.source.none.fl_str_mv Scopus
reponame:Repositório Institucional da UNESP
instname:Universidade Estadual Paulista (UNESP)
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instname_str Universidade Estadual Paulista (UNESP)
instacron_str UNESP
institution UNESP
reponame_str Repositório Institucional da UNESP
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repository.name.fl_str_mv Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP)
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