RESUMEN
The potential of H. virginiana L. was evaluated against Candida spp. (C. albicans, C. dubliniensis, C. glabrata, C. guilliermondii, C. krusei, and C. tropicalis) and bacteria (Acinetobacter baumannii, Escherichia coli, Enterococcus faecalis, Klebsiella pneumoniae, Staphylococcus aureus, and Streptococcus mutans). Effect on murine macrophages (RAW 264.7) was also evaluated with respect to cytotoxicity and production of cytokines (IL-1ß and TNF-α) and nitric oxide (NO). The most effective concentrations of the extract were determined by microdilution broth. These concentrations were analyzed on biofilms, after 5 min or 24 h exposure. Cytotoxicity was performed by MTT assay and quantification of cytokines and NO by ELISA and Griess reagent, respectively. The extract acted against the planktonic forms and provided significant reductions of all the microbial biofilms; besides, showed no cytotoxic effect, except at 100 mg/mL, after 24 h exposure. There was cytokine production; however, a modulatory effect was observed in groups exposed to lipopolysaccharide (LPS) from E. coli. NO production was similar or higher than the control group. Thus, H. virginiana L. extract showed antimicrobial and antibiofilm effects; absence of cytotoxicity for RAW 264.7; anti-inflammatory action; and potential to fight infections through the NO production.
Asunto(s)
Antiinfecciosos , Candida , Óxido Nítrico , Animales , Ratones , Hamamelis , Candida albicans , Escherichia coli , Extractos Vegetales/farmacología , Antiinfecciosos/farmacología , Macrófagos , Antiinflamatorios/farmacología , Citocinas , BiopelículasRESUMEN
Cryptococcus neoformans is an encapsulated yeast that can cause cryptococcosis and cryptococcal meningitis, which conventional treatment involves antifungal drugs such as polyenes, flucytosine, azoles, and their combinations. However, the high cost, toxicity, and increase in fungi resistance to antifungal agents stimulate the search for therapeutic strategies such as drug repurposing and combination therapy. This study evaluated the activity of the antihypertensive verapamil (VEH) alone and combined with amphotericin B (AmB) against C. neoformans. VEH exhibited antifungal activity against C. neoformans with minimum inhibitory concentration and minimum fungicidal concentration of 118 µg per mL. The combination of VEH and AmB exhibited synergism, reducing at least eightfold both drugs' concentrations. Moreover, the combination decreased the size and glucuronoxylomannnan content of C. neoformans capsule. However, no difference was observed in ergosterol levels of C. neoformans after treatment with VEH and AmB in combination. Altogether, VEH in combination with AmB exhibits potential as a candidate as for the development of anti-cryptococcal drug.
Asunto(s)
Criptococosis , Cryptococcus neoformans , Anfotericina B/farmacología , Anfotericina B/uso terapéutico , Antifúngicos/farmacología , Antifúngicos/uso terapéutico , Criptococosis/tratamiento farmacológico , Criptococosis/microbiología , Flucitosina/farmacología , Flucitosina/uso terapéutico , Pruebas de Sensibilidad MicrobianaRESUMEN
BACKGROUND: Bacterial resistance is defined as a microorganism's capacity to develop mechanisms for resisting a determined antimicrobial. Gram-positive bacteria, such as Staphylococcus aureus (S. aureus) and Enterococcus faecalis (E. faecalis), are internationally recognized among the isolates with this resistance profile. In this context, the demand for new medicines has risen, and silver nanoparticles (AgNPs) have been highlighted, especially for their anti-bacterial effects. To develop a nano-antibiotic for treating these Gram-positive strains, we herein report synthesizing and characterizing a nano-antibiotic based on AgNPs functionalized with the complex vancomycin-cysteamine. METHODS: AgNPs were produced using the bottom-up methodology and functionalized with vancomycin modified by the carbodiimide chemistry, forming Ag@vancomycin. Susceptibility tests were performed using S. aureus and E. faecalis strains to assess the bacteriostatic and bactericidal potential of the developed nano-antibiotic. RESULTS: Fourier transform infrared spectroscopy measurements showed the efficacy of vancomycin chemical modification, and the characteristic bands of AgNPs functionalization with the antibiotic. The increase in the nano-antibiotic average hydrodynamic diameter observed by dynamic light scattering proved the presence of vancomycin at the surface of AgNPs. The data from the minimum inhibitory concentration and minimal bactericidal concentration assays tested on standard and clinical planktonic strains of S. aureus and E. faecalis presented excellent performance. CONCLUSION: The results indicate the promising development of a new nano-antibiotic in which the functionalization potentiates the bacteriostatic action of AgNPs and vancomycin with greater efficacy against Gram-positive strains.
Asunto(s)
Antibacterianos , Nanopartículas del Metal , Antibacterianos/farmacología , Vancomicina/farmacología , Vancomicina/química , Staphylococcus aureus , Enterococcus faecalis , Plata/farmacología , Cisteamina/farmacología , Nanopartículas del Metal/química , Pruebas de Sensibilidad MicrobianaRESUMEN
Objective was evaluated the therapeutic effect of Juglans regia (J) and Zingiber officinale (Z) extracts, alone or associated (Z75% + J25%, Z50% + J50% and Z25% + J75%) applied on planktonic cultures and biofilms of Propionibacterium acnes, Staphylococcus epidermidis and Staphylococcus aureus, as well as analyzing the cytotoxic effects of plant extracts on mouse macrophages (Raw 264-7). Broth microdilution assay was performed (M7-A6 - CLSI). Anti-biofilm activities and cytotoxicity on Raw 264-7 were studied using MTT assay and scanning electron microscopy. ANOVA with post-hoc Tukey HSD applied for parametric data and Kruskal-Wallis with Conover-Iman test, for non-parametric (p<0.05). On P. acnes biofilm, Z50% + J50% reduced 46.9% in 5 min and Z25% + J75% reduced 74.1% in 24hs. On S. aureus, Z75% + J25% reduced 23.1% in 5 min Z25% +J75% reduced 79.4% in 24hs. On S. epidermidis, Z75% + J25% reduced 74.6% in 5 min and 82.05% in 24 h. The treatments on macrophages for 24 h promoted a maximum reduction by 14,5% for groups of extracts associations. On multispecies biofilm, Z75%+J25% reduced 84.3% in 24 h. In conclusion association of glycolic extracts provided therapeutic effect, demonstrated antimicrobial activity and low cytotoxicity.
Asunto(s)
Juglans , Infecciones Estafilocócicas , Zingiber officinale , Animales , Ratones , Staphylococcus epidermidis , Staphylococcus aureus , Propionibacterium acnes , Infecciones Estafilocócicas/tratamiento farmacológico , BiopelículasRESUMEN
This study aimed to evaluate the effect of duloxetine hydrochloride (DH) on Cryptococcus neoformans. DH minimum inhibitory concentration (MIC) and minimum fungicidal concentration (MFC) were 18.5 µg/mL, and the combination with fluconazole (FLZ) reduced the MIC value by 16-and 4-fold for DH and FLZ, respectively. The capsule size decreased by 67% ââand 16% when treated with DH and DH with FLZ, respectively. Therefore, this study showed that DH is active against C. neoformans alone and in combination with FLZ, leading to the reduction of the capsule size of this yeast.
Asunto(s)
Cryptococcus neoformans , Fluconazol , Antifúngicos/farmacología , Clorhidrato de Duloxetina/farmacología , Fluconazol/farmacología , Pruebas de Sensibilidad MicrobianaRESUMEN
BACKGROUND AND OBJECTIVE: Previous studies have demonstrated an association between the IL10 promoter rs6667202 (C > A) single-nucleotide polymorphism (SNP) and grade C, stage 3 or 4 periodontitis (Perio4C) in the Brazilian population, where the altered A allele was detected more frequently in these patients. However, no functional analysis of this variation has yet been performed. Thus, the objective of this preliminary study was to evaluate the functionality of rs6667202 in gingival fibroblasts (GFs) of individuals with Perio4C and with periodontal health (PH) stimulated with Aggregatibacter actinomycetencomitans protein extract (AaPE). METHODS: Patients with PH and Perio4C were segregated according to their genotype (AA, AC, or CC), and a biopsy was performed to establish the culture of the GFs. After GFs exposure to AaPE at 5 µg/ml for 1.5 h, RNA was extracted to analyze IL10 expression by qPCR. Aliquots of the cell's supernatant were subjected to immunoenzymatic analysis (MAGpix) to detect interleukin-10 (IL-10). RESULTS: In PH, the genotypes AA and AC are related to less expression of IL10 (p = 0.027 and p < 0.0001) and less production of IL-10 (p = 0.002 and p = 0.001), when compared to CC. In Perio4C, there was no statistical difference between the genotypes (p > 0.05), although a lower IL-10 expression and release compared with PH CC was seen (p = 0.033 and p < 0.001). CONCLUSION: The rs6667202 SNP is functional in PH, as it decreases the expression and production of IL-10. In Perio4C, other factors may be masking its action by altering the IL-10's response.
Asunto(s)
Interleucina-10 , Periodontitis , Estudios de Casos y Controles , Frecuencia de los Genes , Predisposición Genética a la Enfermedad , Genotipo , Humanos , Interleucina-10/genética , Periodontitis/genética , Proyectos Piloto , Polimorfismo de Nucleótido Simple/genética , Regiones Promotoras Genéticas/genéticaRESUMEN
Candida spp. are naturally opportunistic and can promote infections. These yeasts can form biofilm, after penetration and adhesion to the biotic or abiotic surfaces. Preexisting diseases, treatments with drugs and radiation therapy, medical procedures, and parafunctional habits favor the installation of a fungal infection. Increased resistance to the available antifungals has become a concern. Therefore, alternative methods to control them have been evaluated, including the use of plant substances. In this study, the antibiofilm effect of R. officinalis L. extract was analyzed on C. albicans, C. dubliniensis, C. glabrata, C. krusei, and C. tropicalis. A phytochemical analysis of the extract was performed. Biofilms were formed for 48 h and exposed to the different concentrations of the extract (50, 100, and 200 mg/mL) for 5 min or 24 h. The effect of the plant extract was compared to the antifungal nystatin. Rosmarinus officinalis L. extract was constituted of phenols and flavonoids, highlighting the presence of chlorogenic acid derivatives in its composition. Biofilm reductions were observed after exposure to the plant extract for both periods. The plant extract provided a reduction similar to the antifungal. Thus, R. officinalis L. extract showed antibiofilm effect on Candida spp. comparable to the nystatin.
Asunto(s)
Candida , Rosmarinus , Antifúngicos/farmacología , Biopelículas , Candida albicans , Pruebas de Sensibilidad Microbiana , Nistatina/farmacología , Extractos Vegetales/farmacologíaRESUMEN
Candida is a human fungal pathogen that causes a wide range of diseases. Candida albicans is the main etiologic agent in these diseases; however, infections can be caused by non-albicans Candida species. Virulence factors such as biofilm production, which protect the fungus from host immunity and anti-fungal drugs, are important for the infection. Therefore, available antifungal drugs for candidiasis treatment are limited and the investigation of new and effective drugs is needed. Verapamil is a calcium channel blocker with an inhibitory effect on hyphae development, adhesion, and colonization of C. albicans. In this study, we investigated the effect of verapamil on cell viability and its antifungal and anti-biofilm activity in non-albicans Candida species. Verapamil was not toxic to keratinocyte cells; moreover, C. krusei, C. parapsilosis, and C. glabrata were susceptible to verapamil with a minimal inhibitory concentration (MIC) of 1250 µM; in addition, this drug displayed fungistatic effect at the evaluated concentrations. After treatment with verapamil, reduced viability, biomass, and mitochondrial activity were observed in biofilms of the non-albicans Candida species C. krusei, C. glabrata, and C. parapsilosis. These findings highlight the importance of the study of verapamil as an alternative treatment for infections caused by non-albicans Candida species.
Asunto(s)
Antifúngicos , Candida , Antifúngicos/farmacología , Biopelículas , Bloqueadores de los Canales de Calcio/farmacología , Candida albicans , Humanos , Pruebas de Sensibilidad Microbiana , Verapamilo/farmacologíaRESUMEN
Aim: Plant products have been evaluated to control opportunistic micro-organisms, as well as fortify immune system cells. Thus, Curcuma longa L. (turmeric) extract was evaluated in interactions of murine macrophages (RAW 264.7) with Staphylococcus aureus, Pseudomonas aeruginosa and Candida albicans, in order to establish cooperation with defense cells. Materials & methods: Effects of minimal inhibitory concentrations (MIC) of the plant extract were analyzed on phagocytosis, cell viability of RAW 264.7 and production of inflammation-related molecules (IL-1ß, TNF-α, IL-10 and NO). Results: The plant extract was cytocompatible and promoted significant reductions of micro-organisms, and synthesis of inflammation-related molecules, during interactions. Conclusion:C. longa L. extract showed significant antimicrobial response and cooperation with macrophages, by fighting bacteria and yeasts during host-microbe interactions.
Asunto(s)
Antiinfecciosos/farmacología , Macrófagos/efectos de los fármacos , Macrófagos/microbiología , Extractos Vegetales/farmacología , Animales , Antiinfecciosos/química , Candida albicans/efectos de los fármacos , Candida albicans/fisiología , Supervivencia Celular/efectos de los fármacos , Curcuma/química , Citocinas/metabolismo , Interacciones Huésped-Patógeno/efectos de los fármacos , Macrófagos/metabolismo , Ratones , Pruebas de Sensibilidad Microbiana , Óxido Nítrico/metabolismo , Fagocitosis/efectos de los fármacos , Extractos Vegetales/química , Pseudomonas aeruginosa/efectos de los fármacos , Pseudomonas aeruginosa/fisiología , Células RAW 264.7 , Staphylococcus aureus/efectos de los fármacos , Staphylococcus aureus/fisiologíaRESUMEN
Over the past few years, several tridimensional synthetic bone grafts, known as scaffolds, are being developed to overcome the autologous grafts limitations. Among the materials used on the production of scaffolds, the 45S5 bioglass stands out due to its capacity of bonding to hard and soft tissues. Silver nanoparticles are well-known for their antimicrobial properties and their incorporation on the scaffold may promote its antimicrobial response, avoiding microorganism proliferation on the materials surface. This study proposes a simple way to coat 45S5 bioglass-based scaffolds with silver nanoparticles. The scaffolds were obtained by the sponge replication technique and the silver nanoparticles were incorporated by soaking under ultrasonic stirring. The antimicrobial activity of the scaffolds was analyzed against three different microbial strains: S. aureus, P. aeruginosa, and C. albicans. Due to the heat treatment during the scaffold production, the bioglass crystalized mainly in a sodium calcium silicate phase, forming a glass-ceramic scaffold. The silver nanoparticles were coated in a well-distributed manner throughout the scaffold, while avoiding their aggregation. The coated scaffold inhibited the growth of all the analyzed microorganism. Therefore, the use of ultrasonic stirring to coat the bioglass scaffold with silver nanoparticles showed to be an efficient way to promote its antimicrobial response.
Asunto(s)
Antiinfecciosos , Candida albicans/crecimiento & desarrollo , Materiales Biocompatibles Revestidos , Vidrio/química , Nanopartículas del Metal/química , Pseudomonas aeruginosa/crecimiento & desarrollo , Plata/química , Staphylococcus aureus/crecimiento & desarrollo , Antiinfecciosos/síntesis química , Antiinfecciosos/química , Antiinfecciosos/farmacología , Materiales Biocompatibles Revestidos/síntesis química , Materiales Biocompatibles Revestidos/química , Materiales Biocompatibles Revestidos/farmacologíaRESUMEN
BACKGROUND: To assess the clinical and microbiological responses of amoxicillin + metronidazole (AMX + MET) versus clarithromycin (CLM) as adjuncts to one-stage full-mouth ultrasonic debridement (FMUD) in the treatment of generalized aggressive periodontitis (GAgP). METHODS: For this parallel, double-masked, pilot randomized clinical trial, 46 patients with GAgP were selected and randomly assigned into two groups: AMX+MET group (n = 23): FMUD associated with AMX (500 mg three times a day) and MET (400 mg three times a day) for 7 days; and CLM group (n = 23): FMUD associated with CLM (500 mg twice a day) for 7 days. Clinical parameters were evaluated at baseline, 3, and 6 months post-treatment. The levels of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, and Fusobacterium nucleatum from subgingival biofilm were determined by quantitative polymerase chain reaction. RESULTS: Both treatments significantly improved all clinical parameters compared with baseline and promoted a significant reduction of A. actinomycetemcomitans and P. gingivalis counts (P > 0.05). CLM succeeded in decreasing T. forsythia at 6 months (P < 0.05), but no antibiotic was able to reduce F. nucleatum. There was no difference between the two protocols regarding the reported adverse effects (P > 0.05). CONCLUSIONS: The results suggest that CLM is not superior than AMX + MET in the treatment of GAgP. However, this antibiotic led to good clinical outcomes and may be a possible alternative to AMX+MET in the treatment of severe periodontitis in young patients. Future studies with larger sample sizes are needed to confirm this statement (NCT02969928).
Asunto(s)
Periodontitis Agresiva , Aggregatibacter actinomycetemcomitans , Amoxicilina , Antibacterianos , Desbridamiento , Humanos , Metronidazol , Porphyromonas gingivalis , UltrasonidoRESUMEN
Galleria mellonella is a well-accepted insect model for the study of pathogen-host interactions and antimicrobial compounds. The main advantages of this model include the low cost of maintenance, the fast life cycle, the possibility of using a large number of caterpillars and the innate immune system, which is evolutionarily conserved relative to mammals. Because of these advantages, different research groups have been working to implement the rearing of G. mellonella in laboratory conditions. This protocol describes our experience in the rearing of G. mellonella caterpillars for experimental infection models and the influence of different artificial diets on developmental and physiological parameters. Here, we suggest a diet composition that benefits the life cycle of G. mellonella by accelerating the larval phase length and increasing the caterpillar weight. This diet also stimulated the immune system of G. mellonella by increasing the hemolymph volume and hemocyte concentration. In addition, our rearing protocol generated caterpillars that are more resistant to infection by Staphylococcus aureus, Escherichia coli and Candida albicans. A standard G. mellonella rearing protocol is fundamental to minimize external influences on the results, and this simple and easy protocol can support researchers starting to rear G. mellonella.
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Infecciones Bacterianas/inmunología , Candidiasis/inmunología , Modelos Animales de Enfermedad , Entomología/métodos , Mariposas Nocturnas/crecimiento & desarrollo , Alimentación Animal , Animales , Infecciones Bacterianas/microbiología , Candidiasis/microbiología , Interacciones Huésped-Patógeno , Larva/crecimiento & desarrollo , Larva/microbiología , Mariposas Nocturnas/microbiologíaRESUMEN
Periodontal pathogens and/or inflammatory products from periodontitis participate in the development or progression of systemic diseases. In this context, periodontitis acts as a modifying factor to systemic health, including diabetes and cardiovascular diseases. Osteoporosis is an increasingly prevalent condition in our aging population and considered a risk factor for periodontal disease, but the effect of periodontitis on systemic bone homeostasis is unknown. We thus evaluated the effects of experimental periodontitis (EP) on systemic bone loss and the influence of estrogen deficiency in this context, using a mouse model of combined periodontitis and osteoporosis. Experimental periodontitis (EP) was induced by a ligature insertion around the mandibular first molars and Porphyromonas gingivalis infection. Three-dimensional microcomputed tomographic analyses performed 48days following infection revealed that EP and ovariectomy (OVX) induced a significantly higher femoral and mandibular bone loss compared to EP or OVX alone. EP alone did not induce systemic bone loss. In addition, the EP+OVX and EP groups showed significantly higher levels of tumor necrosis factor (TNF)-α than OVX and control groups at end point. These results suggest that periodontitis could be a risk factor for systemic bone loss, especially in post-menopausal women, and warrant further clinical investigations to confirm this association and propose adapted prophylactic and curative therapies.
Asunto(s)
Resorción Ósea/etiología , Resorción Ósea/patología , Progresión de la Enfermedad , Ovariectomía/efectos adversos , Enfermedades Periodontales/complicaciones , Enfermedades Periodontales/patología , Animales , Peso Corporal , Colágeno Tipo I/sangre , Colágeno Tipo I/orina , Citocinas/sangre , Citocinas/orina , Cemento Dental/patología , Esmalte Dental/patología , Femenino , Fémur/diagnóstico por imagen , Fémur/patología , Mandíbula/diagnóstico por imagen , Mandíbula/patología , Ratones Endogámicos BALB C , Osteocalcina/sangre , Osteocalcina/orina , Péptidos/sangre , Péptidos/orina , Factor de Necrosis Tumoral alfa/sangre , Factor de Necrosis Tumoral alfa/orina , Microtomografía por Rayos XRESUMEN
BACKGROUND: New drugs for the treatment of diabetes, glucagon-like peptide-1 (GLP-1) receptor agonists and inhibitors of dipeptidyl peptidase-4 (DPP-4) have shown pleiotropic effects on bone metabolism and anti-inflammatory properties. The aim of this study is to evaluate the effects of exenatide (GLP-1 agonist) and sitagliptin (DPP-4 inhibitor) during periodontitis induction by ligature insertion in rats. METHODS: Forty rats were divided into four groups: 1) animals with induced periodontitis that received exenatide (EG); 2) animals with induced periodontitis that received sitagliptin (SG); 3) animals with induced periodontitis and without drug treatment (LG); and 4) animals without induced periodontitis and without drug treatment (controls). The drugs were administered for 28 days. On the day the animals were sacrificed, blood was collected for analysis of glucose and DPP-4 levels. The gene expressions of prostaglandin-endoperoxide synthase 2, tissue inhibitor of metalloproteinase 1, Dpp4, nitric oxide synthase 2 (Nos2), interleukin 1ß (Il1b), and matrix metalloproteinase 9 (Mmp9) in the gingiva; support and alveolar bone loss; connective tissue attachment; and the quantity of gingival collagen were evaluated. RESULTS: Exenatide and sitagliptin treatments have led to a lower percentage of weight gain but did not influence glycemia. Sitagliptin reduced the serum concentration of DPP-4. Interestingly, although the gene expression profile has revealed a downregulation of Mmp9, Nos2, and Il1b in both EG and SG compared to LG, a significant protective effect was not observed on alveolar bone and collagen tissue in this model. CONCLUSION: Regardless of the reduction of the expression of Il1b, Nos2, and Mmp9, the drugs were not effective in the stabilization or reduction of alveolar bone loss and collagen degradation in rats.
Asunto(s)
Pérdida de Hueso Alveolar , Hipoglucemiantes/farmacología , Péptidos/farmacología , Periodontitis , Fosfato de Sitagliptina/farmacología , Ponzoñas/farmacología , Animales , Exenatida , Interleucina-1beta/metabolismo , Metaloproteinasa 9 de la Matriz , Óxido Nítrico Sintasa de Tipo II/metabolismo , Ratas , Inhibidor Tisular de Metaloproteinasa-1/metabolismoRESUMEN
INTRODUCTION: This study compared the influence of different irrigants with and without ultrasound or laser irradiation on the bond strength of glass fiber posts using a self-etching adhesive in a supplementary dentin pretreatment. METHODS: Ninety bovine incisor roots were divided into 3 groups according to the irrigant tested: 2% chlorhexidine (CHX) (n = 30); 2.5% sodium hypochlorite (NaOCl) (n = 30), and saline solution (control) (n = 30). Each group was randomly divided into 3 subgroups according to the supplementary dentin pretreatment: ultrasound, Nd:YAG laser, and nonsupplemented (control). A self-etching adhesive system (Futurabond DC; VOCO GmbH, Cuxhaven, Germany) was used, and the glass fiber posts were cemented with dual-cure epoxy-based luting agent (Bifix QM, VOCO GmbH). All roots were sectioned transversely, and the push-out test was performed. Failure mode analysis was also evaluated. RESULTS: Bond strength decreased significantly after the use of 2.5% NaOCl in all root thirds (P < .05). CHX showed no difference in the mean bond strength value compared with saline solution (P > .05). The supplementary dentin pretreatment using the Nd:YAG laser or ultrasound did not improve the bond strength values for both NaOCl and CHX (P > .05). Moreover, the apical third exhibited the lowest mean bond strength values (P < .05). Analysis indicated that the predominant failure mode was the mixed type. CONCLUSIONS: Regardless of the irrigant used, the supplementary dentin pretreatment with ultrasound or laser irradiation showed no improvement in bond strength. Also, the use of NaOCl decreased the bond strength of glass fiber posts using a self-etching adhesive system, whereas CHX preserved it.
Asunto(s)
Recubrimiento Dental Adhesivo/métodos , Recubrimientos Dentinarios/química , Dentina/química , Vidrio/química , Técnica de Perno Muñón/instrumentación , Irrigantes del Conducto Radicular/química , Animales , Bovinos , Clorhexidina/química , Preparación de la Cavidad Dental/métodos , Cavidad Pulpar , Dentina/diagnóstico por imagen , Recubrimientos Dentinarios/farmacología , Endodoncia/métodos , Incisivo , Terapia por Luz de Baja Intensidad/métodos , Cementos de Resina/química , Irrigantes del Conducto Radicular/farmacología , Cloruro de Sodio/química , Hipoclorito de Sodio/química , Raíz del Diente , Ondas UltrasónicasRESUMEN
INTRODUCTION: This clinical study was conducted to compare the effectiveness of 1-visit versus 2-visit root canal treatment in removing endotoxins and cultivable bacteria from primarily infected root canals. METHODS: Forty-eight primarily infected root canals were selected and randomly divided into 4 groups: G1, 1% NaOCl; G2, 2% chlorhexidine (CHX) gel; G3, 1% NaOCl + Ca(OH)2; and G4, 2% CHX gel + Ca(OH)2 (all, n = 12). G1 and G2 involved 1-visit treatment, whereas G3 and G4 involved 2-visit treatment with the placement of Ca(OH)2 medication for 14 days. Samples were collected before and after root canal procedures. A chromogenic LAL assay test was used to quantify endotoxins. Culture techniques were used to determine bacterial counts. RESULTS: Endotoxins and cultivable bacteria were detected in 100% of the initial samples. All treatment protocols were effective in reducing bacterial load from infected root canals: G1 (1% NaOCl, 99.97%), G2 (2% CHX gel, 99.75%), G3 (1% NaOCl + Ca(OH)2, 99.90%), and G4 (2% CHX gel + Ca(OH)2, 96.81%), respectively (P < .05). No differences were found in bacterial load reduction when comparing 1-visit and 2-visit treatment groups, irrespective of the irrigant tested (P > .05). Higher median percentage values of endotoxin reduction were achieved in the 2-visit treatment groups (G3, 98.01% and G4, 96.81%) compared with 1-visit treatment groups (G1, 86.33% and G2, 84.77%) (all P < .05). CONCLUSIONS: Both 1-visit and 2-visit root canal treatment protocols were effective in reducing bacteria and endotoxins, but they were not able to eliminate them in all root canals analyzed. Furthermore, 2-visit root canal treatment protocols were more effective in reducing endotoxins than 1-visit root canal treatment protocols.