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  1. Nocca G, Ahmed HMA, Martorana GE, Callà C, Gambarini G, Rengo S, et al.
    J Endod, 2017 Sep;43(9):1545-1552.
    PMID: 28734651 DOI: 10.1016/j.joen.2017.04.025
    INTRODUCTION: The literature reveals controversies regarding the formation of para-chloroaniline (PCA) when chlorhexidine (CHX) is mixed with sodium hypochlorite (NaOCl). This study aimed to investigate the stability of PCA in the presence of NaOCl and to examine the in vitro cytotoxic effects of CHX/NaOCl reaction mixtures.

    METHODS: Different volumes of NaOCl were added to CHX (mix 1) or PCA (mix 2). Upon centrifugation, the supernatant and precipitate fractions collected from samples were analyzed using high-performance liquid chromatography. The cytotoxic effects of both fractions were examined on human periodontal ligament and 3T3 fibroblast cell lines.

    RESULTS: High-performance liquid chromatographic analysis showed no PCA signal when NaOCl was mixed with CHX (mix 1). In mix 2, the intensity of PCA was decreased when NaOCl was added to PCA, and chromatographic signals, similar to that of CHX/NaOCl, were also observed. The mortality of precipitates exerted on both cell lines was lower compared with that of supernatants.

    CONCLUSIONS: The discrepancy in the data from the literature could be caused by the instability of the PCA in the presence of NaOCl. The CHX/NaOCl reaction mixture exhibits a wide range of cytotoxic effects.

    Matched MeSH terms: Sodium Hypochlorite/pharmacology*
  2. Mavani HAK, Tew IM, Wong L, Yew HZ, Mahyuddin A, Ahmad Ghazali R, et al.
    Int J Environ Res Public Health, 2020 Jul 15;17(14).
    PMID: 32679828 DOI: 10.3390/ijerph17145107
    Sodium hypochlorite (NaOCl), an effective endodontic irrigant against Enterococcus faecalis (EF), is harmful to periapical tissues. Natural pineapple-orange eco-enzymes (M-EE) and papaya eco-enzyme (P-EE) could be potential alternatives. This study aimed to assess the antimicrobial efficacy of M-EE and P-EE at different concentrations and fermentation periods against EF, compared to 2.5% NaOCl. Fermented M-EE and P-EE (3 and 6 months) at various concentrations were mixed with EF in a 96-well plate incubated for 24 h anaerobically. Minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of M-EE and P-EE were determined via EF growth observation. EF inhibition was quantitatively measured and compared between different irrigants using the one-way analysis of variance (ANOVA), and different fermentation periods using the independent-samples T-test. M-EE and P-EE showed MIC at 50% and MBC at 100% concentrations. There was no significant difference in antimicrobial effect when comparing M-EE and P-EE at 50% and 100% to 2.5% NaOCl. P-EE at 6 months fermentation exhibited higher EF inhibition compared to 3 months at concentrations of 25% (p = 0.017) and 0.78% (p = 0.009). The antimicrobial properties of M-EE and P-EE, at both 100% and 50% concentrations, are comparable to 2.5% NaOCl. They could therefore be potential alternative endodontic irrigants, but further studies are required.
    Matched MeSH terms: Sodium Hypochlorite/pharmacology
  3. Chandraseharan P, Sockalingam SNM, Shafiei Z, Zakaria ASI, Mahyuddin A, Rahman MA
    J Contemp Dent Pract, 2023 Oct 01;24(10):779-786.
    PMID: 38152911 DOI: 10.5005/jp-journals-10024-3581
    AIMS AND BACKGROUND: This study evaluates the antimicrobial activities of commercially available 5% apple cider vinegar (ACV) against Enterococcus faecalis, Streptococcus mutans, and Lactobacillus casei. Materials and methods: Minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) were conducted using the broth microdilution method. Sodium hypochlorite (NaOCl) of 5.25% was used as a positive control, and comparisons were also made with acetic acid (AA) as the main ingredient in ACV. The three test bacteria treated with the most effective ACV dilution were visualized under a transmission electron microscope (TEM) for structural changes.

    RESULTS: Minimal inhibitory concentration was determined at 0.625% of the concentration of ACV against S. mutans and E. faecalis and 1.25% of the concentration of ACV against L. casei with two-fold serial dilutions. A concentration of 5 × 10-1% with 10-fold serial dilutions was found to be the MIC value for all three bacteria. No significant differences were found when compared with the positive control (NaOCl) (p = 0.182, p = 0.171, and p = 0.234), respectively, for two-fold serial dilutions and (p = 1.000, p = 0.658, and p = 0.110), respectively for 10-fold serial dilutions. MBC was observed to be 5% ACV for both E. faecalis and S. mutans. However, positive microbial growth was observed on the agar plate when cultured with L. casei. An independent sample t-test showed no significant differences (p > 0.05) in the antimicrobial activities between 5% ACV and 5% pure AA. TEM revealed cell wall and cytoplasmic membrane disruptions on all three bacteria at MIC value.

    CONCLUSION: Apple cider vinegar has antimicrobial activities against Enterococcus faecalis, Streptococcus mutans, and Lactobacillus casei at their respective MIC values.

    CLINICAL SIGNIFICANCE: Apple cider vinegar can be an alternative antimicrobial dental pulp disinfectant to sodium hypochlorite. Apple cider vinegar can be used safely, especially in children's dental pulp therapy and deep caries management, when adequate tooth isolation is not readily achievable. Thus, adverse reactions commonly associated with other frequently used chemical disinfectants can be avoided.

    Matched MeSH terms: Sodium Hypochlorite/pharmacology
  4. Maria Rajan S, Shrestha B, Elkholy MMA, Ahmed HMA, Fawzy A
    Eur Endod J, 2025 Mar;10(2):116-126.
    PMID: 40143565 DOI: 10.14744/eej.2024.77487
    OBJECTIVE: High-intensity focused ultrasound (HIFU) has demonstrated significant efficacy in eradicating bacteria from substrates emerging as a promising solution for root canal disinfection. This in-vitro study investigated the effects of HIFU on reducing intracanal bacteria and its impact on the chemical and mechanical properties of root dentine. It also aimed to demonstrate acoustic wave penetration and distribution within the root canal system (RCS) and characterize the associated temperature changes.

    METHODS: Eighty-two extracted premolar teeth with single canals, infected with Enterococcus faecalis (E. faecalis) and cultured for two weeks, were randomly assigned to four groups: negative control, 4% sodium hypochlorite (NaOCl), 60 s HIFU, and 120 s HIFU (operated at 250 kHz/20W). Post-treatment, biofilm samples were collected from the root canals to assess viable bacterial cells using colony-forming unit (CFU) and 3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide (MTT) assays. The root canal surfaces were subsequently examined using scanning electron microscopy, confocal laser scanning microscopy (CLSM), microhardness, and Raman spectroscopy. Acoustic wave penetration, distribution, and temperature changes within the RCS were examined using CLSM and thermal camera.

    RESULTS: HIFU at 60 s and 120 s consistently demonstrated superior anti-bacterial efficacy against E. faecalis biofilms compared to 4% NaOCl. MTT and CFU assays revealed a significant reduction in biofilm viability, particularly at 120 s of HIFU exposure (p<0.05). CLSM and SEM analyses demonstrated enhanced penetration and detachment of biofilms, as well as improved smear layer removal and preservation of dentinal tubules, especially at 120 s of HIFU exposure. HIFU treatment did not adversely affect the amide/mineral content of root dentine or its surface microhardness. Additionally, HIFU enhanced acoustic wave propagation and resulted in a controlled increase in temperature within the root canal over time.

    CONCLUSION: This minimally invasive approach shows promise for removing bacterial biofilms in the RCS, positioning HIFU as a valuable adjunctive treatment for enhancing root canal disinfection. (EEJ-2024-08-123).

    Matched MeSH terms: Sodium Hypochlorite/pharmacology
  5. Ahmad M, Pitt Ford TR, Crum LA, Wilson RF
    Oral Surg. Oral Med. Oral Pathol., 1990 Sep;70(3):328-32.
    PMID: 2216361
    The physical mechanisms of ultrasound, namely cavitation and acoustic streaming, generated by the Enac-Osada ultrasonic unit were investigated for effectiveness in disrupting Streptococcus mitis. In addition, the bactericidal effect of ultrasound in the presence of 2.5% sodium hypochlorite was examined. Bacterial suspensions were irradiated directly with ultrasound in simulated root canals, and the viability of bacteria was examined after growth on a blood agar medium under anaerobic conditions at 37 degrees C for 5 days. The results indicated that ultrasound per se failed to disrupt bacteria but resulted in increases in the viable counts; the former was considered to be because of the lack of cavitation and the latter because of the dispersal effects of acoustic streaming. The 2.5% sodium hypochlorite solution demonstrated powerful bactericidal activity.
    Matched MeSH terms: Sodium Hypochlorite/pharmacology
  6. Moharam LM, Salem HN, Abdou A, Afifi RH
    BMC Oral Health, 2025 Jan 15;25(1):66.
    PMID: 39810132 DOI: 10.1186/s12903-024-05390-4
    BACKGROUND: This study aimed to assess the influence of different pretreatment protocols and antioxidants application on the shear bond strength (SBS) of universal adhesive to sound (SoD) and caries-induced dentin (CID).

    METHODS: One hundred and twenty posterior teeth had their occlusal enamel removed, then the specimens were divided into two main groups according to dentin substrates; SoD and CID, three subgroups according to pretreatments protocols control (no pretreatment), NaOCl-treated, and Er, Cr:YSGG-treated and two divisions according to antioxidant application (with and without sodium ascorbate (SA) application). All-Bond Universal (ABU) universal adhesives was applied in self-etch (SE) mode then resin composite discs were built. The specimens were stored in distilled water for 24-hr at 37°C before SBS testing. Three-way ANOVA and Tukey HSD tests were used for data analysis (a = 0.05).

    RESULTS: 6% NaOCl resulted in a significant reduction in SBS in SoD without antioxidant application. 10% SA application showed significant increase in SBS for 6% NaOCl group only in SoD. Laser application recorded a significantly higher SBS compared to 6% NaOCl group without or with antioxidant application, while 10% SA application revealed a significant increase in SBS for control group only.

    CONCLUSIONS: Er, Cr:YSGG laser irradiation followed by antioxidant application has the potential to enhance the bonding quality of both tested dentin substrates. NaOCl application has significantly compromised the bonding to SoD and CID substrates.

    Matched MeSH terms: Sodium Hypochlorite/pharmacology
  7. Sarjit A, Dykes GA
    Int J Food Microbiol, 2015 Jun 16;203:63-9.
    PMID: 25791251 DOI: 10.1016/j.ijfoodmicro.2015.02.026
    Little work has been reported on the use of commercial antimicrobials against foodborne pathogens on duck meat. We investigated the effectiveness of trisodium phosphate (TSP) and sodium hypochlorite (SH) as antimicrobial treatments against Campylobacter and Salmonella on duck meat under simulated commercial water chilling conditions. The results were compared to the same treatments on well-studied chicken meat. A six strain Campylobacter or Salmonella cocktail was inoculated (5 ml) at two dilution levels (10(4) and 10(8) cfu/ml) onto 25 g duck or chicken meat with skin and allowed to attach for 10 min. The meat was exposed to three concentrations of pH adjusted TSP (8, 10 and 12% (w/v), pH 11.5) or SH (40, 50 and 60 ppm, pH 5.5) in 30 ml water under simulated spin chiller conditions (4 °C, agitation) for 10 min. In a parallel experiment the meat was placed in the antimicrobial treatments before inoculation and bacterial cocktails were added to the meat after the antimicrobial solution was removed while all other parameters were maintained. Untreated controls and controls using water were included in all experiments. Bacterial numbers were determined on Campylobacter blood-free selective agar and Mueller Hinton agar or xylose deoxycholate agar and tryptone soya agar using the thin agar layer method for Campylobacter and Salmonella, respectively. All TSP concentrations significantly (p<0.05) reduced numbers of Campylobacter (~1.2-6.4 log cfu/cm(2)) and Salmonella (~0.4-6.6 log cfu/cm(2)) on both duck and chicken meat. On duck meat, numbers of Campylobacter were less than the limit of detection at higher concentrations of TSP and numbers of Salmonella were less than the limit of detection at all concentrations of TSP except one. On chicken meat, numbers of Campylobacter and Salmonella were less than the limit of detection only at the lower inoculum level and higher TSP concentrations. By contrast only some of the concentrations of SH significantly (p<0.05) reduced numbers of Campylobacter and Salmonella (~0.2-1.5 log cfu/cm(2)) on both duck and chicken meats. None of the SH treatments resulted in numbers of either pathogen being less than limit of detection. Results indicate that chicken meat has the ability to effectively protect Campylobacter and Salmonella against the impact of trisodium phosphate and sodium hypochlorite while duck meat does not. This study suggests that trisodium phosphate has a strong potential for application in a commercial poultry processing to reduce Campylobacter and Salmonella specifically on duck meat.
    Matched MeSH terms: Sodium Hypochlorite/pharmacology*
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