Impact of N-acetylcysteine (NAC) and calcium hydroxide intracanal medications in primary endodontic infection: a randomized clinical trial
Autor(a) principal: | |
---|---|
Data de Publicação: | 2022 |
Outros Autores: | , , , , , |
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. |
id |
UNSP_762e58b213674699dd350f4c589a9d7b |
---|---|
oai_identifier_str |
oai:repositorio.unesp.br:11449/240267 |
network_acronym_str |
UNSP |
network_name_str |
Repositório Institucional da UNESP |
repository_id_str |
2946 |
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 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.source.none.fl_str_mv |
Scopus reponame:Repositório Institucional da UNESP instname:Universidade Estadual Paulista (UNESP) instacron:UNESP |
instname_str |
Universidade Estadual Paulista (UNESP) |
instacron_str |
UNESP |
institution |
UNESP |
reponame_str |
Repositório Institucional da UNESP |
collection |
Repositório Institucional da UNESP |
repository.name.fl_str_mv |
Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP) |
repository.mail.fl_str_mv |
|
_version_ |
1808128629468561408 |