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Research Article

Microbiological assessment of success and failure in pulp revitalization: a randomized clinical trial using calcium hydroxide and chlorhexidine gluconate in traumatized immature necrotic teeth

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Article: 2343518 | Received 26 Jul 2023, Accepted 19 Mar 2024, Published online: 24 Apr 2024

References

  • Glendor U. Aetiology and risk factors related to traumatic dental injuries–a review of the literature. Dent Traumatol. 2009;25(1):19–20. doi: 10.1111/j.1600-9657.2008.00694.x
  • Oldin A, Lundgren J, Nilsson M, et al. Traumatic dental injuries among children aged 0-17 years in the BITA study - a longitudinal Swedish multicenter study. Dent Traumatol. 2015;31(1):9–17. doi: 10.1111/edt.12125
  • Lexomboon D, Carlson C, Andersson R, et al. Incidence and causes of dental trauma in children living in the county of Värmland, Sweden. Dent Traumatol. 2016;32(1):58–64. doi: 10.1111/edt.12218
  • Borum MK, Andreasen JO. Therapeutic and economic implications of traumatic dental injuries in Denmark: an estimate based on 7549 patients treated at a major trauma centre. Int J Paediatr Dentistry/The British Paedodontic Soc [And] The Int Assoc Dentistry For Child. 2001;11(4):249–258. doi: 10.1046/j.1365-263X.2001.00277.x
  • Haapasalo M, Endal U, Zandi H, et al. Eradication of endodontic infection by instrumentation and irrigation solutions.
  • Ridell K, Petersson A, Matsson L, et al. Periapical status and technical quality of root-filled teeth in Swedish adolescents and young adults. A retrospective study. Acta Odontol Scand. 2006;64(2):104–110. doi: 10.1080/00016350500367637
  • Kakoli P, Nandakumar R, Romberg E, et al. The effect of age on bacterial penetration of radicular dentin. J Endod. 2009;35(1):78–81. doi: 10.1016/j.joen.2008.10.004
  • Carrigan PJ, Morse DR, Furst ML, et al. A scanning electron microscopic evaluation of human dentinal tubules according to age and location. J Endod. 1984;10(8):359–363. doi: 10.1016/S0099-2399(84)80155-7
  • Hristov K, Gateva N, Stanimirov P, et al. Comparative analysis of root dentin loss when using modern mechanical cleaning instruments in immature permanent teeth. Folia Med (Plovdiv). 2020;62(2):352–357. doi: 10.3897/folmed.62.e39515
  • Almutairi W, Yassen GH, Aminoshariae A, et al. Regenerative endodontics: a systematic analysis of the failed cases. J Endod. 2019;45(5):567–577. doi: 10.1016/j.joen.2019.02.004
  • Botero T, Tang X, Gardner R, et al. Clinical evidence for regenerative endodontic procedures: immediate versus delayed induction? J Endodontics [Internet]. 2017;43(9s):S75–S81. Available from: https://www.cochranelibrary.com/central/doi/10.1002/central/CN-01618459/full. doi: 10.1016/j.joen.2017.07.009
  • Ding RY, Cheung GSP, Chen J, et al. Pulp revascularization of immature teeth with apical periodontitis: a clinical study. J Endod. 2009;35(5):745–749. doi: 10.1016/j.joen.2009.02.009
  • Ricucci D, Siqueira JF Jr. Biofilms and apical periodontitis: study of prevalence and association with clinical and histopathologic findings. J Endod. 2010;36(8):1277–1288. doi: 10.1016/j.joen.2010.04.007
  • Petridis X, van der Sluis LWM, Dijkstra RJB, et al. Secreted products of oral bacteria and biofilms impede mineralization of apical papilla stem cells in TLR-, species-, and culture-dependent fashion. Sci Rep. 2018;8(1):12529. doi: 10.1038/s41598-018-30658-5
  • Lin JC, Lu JX, Zeng Q, et al. Comparison of mineral trioxide aggregate and calcium hydroxide for apexification of immature permanent teeth: a systematic review and meta-analysis. J Formos Med Assoc. 2016;115(7):523–530. doi: 10.1016/j.jfma.2016.01.010
  • Bose R, Nummikoski P, Hargreaves K. A retrospective evaluation of radiographic outcomes in immature teeth with necrotic root canal systems treated with regenerative endodontic procedures. J Endod. 2009;35(10):1343–1349. doi: 10.1016/j.joen.2009.06.021
  • Torabinejad M, Nosrat A, Verma P, et al. Regenerative endodontic treatment or mineral trioxide aggregate apical plug in teeth with necrotic pulps and open apices: a systematic review and meta-analysis. J Endod. 2017;43(11):1806–1820. doi: 10.1016/j.joen.2017.06.029
  • Fouad AF, Abbott PV, Tsilingaridis G, et al. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 2. Avulsion of Permanent Teeth. Dental Traumatol. 2020;36(4):331–342. doi: 10.1111/edt.12573
  • Peters LB, Wesselink PR, Buijs JF, et al. Viable bacteria in root dentinal tubules of teeth with apical periodontitis. J Endod. 2001;27(2):76–81. doi: 10.1097/00004770-200102000-00002
  • Galler KM, Krastl G, Simon S, et al. European Society of Endodontology position statement: Revitalization procedures. Int Endod J. 2016;49(8):717–723. doi: 10.1111/iej.12629
  • Orstavik D, Haapasalo M. Disinfection by endodontic irrigants and dressings of experimentally infected dentinal tubules. Endodontics Dent Traumatol. 1990;6(4):142–149. doi: 10.1111/j.1600-9657.1990.tb00409.x
  • Andreasen JO, Borum MK, Jacobsen HL, et al. Replantation of 400 avulsed permanent incisors. 4. Factors related to periodontal ligament healing. Endodontics Dent Traumatol. 1995;11(2):76–89. doi: 10.1111/j.1600-9657.1995.tb00464.x
  • Bakland LK, Andreasen JO. Will mineral trioxide aggregate replace calcium hydroxide in treating pulpal and periodontal healing complications subsequent to dental trauma? A review. Dental Traumatol. 2012;28(1):- 32. doi: 10.1111/j.1600-9657.2011.01049.x
  • Sjogren U, Figdor D, Spangberg L, et al. The antimicrobial effect of calcium hydroxide as a short-term intracanal dressing. Int Endod J. 1991;24(3):119–125. doi: 10.1111/j.1365-2591.1991.tb00117.x
  • Molander A, Reit C, Dahlen G. The antimicrobial effect of calcium hydroxide in root canals pretreated with 5% iodine potassium iodide. Endodontics Dent Traumatol. 1999;15(5):205–209. doi: 10.1111/j.1600-9657.1999.tb00775.x
  • Molander A, Warfvinge J, Reit C, et al. Clinical and radiographic evaluation of one- and two-visit endodontic treatment of asymptomatic necrotic teeth with apical periodontitis: a randomized clinical trial. J Endod. 2007;33(10):1145–1148. doi: 10.1016/j.joen.2007.07.005
  • Sheehy EC, Roberts GJ. Use of calcium hydroxide for apical barrier formation and healing in non-vital immature permanent teeth: a review. Br Dent J. 1997;183(7):241–246. doi: 10.1038/sj.bdj.4809477
  • Mackie IC, Worthington HV, Hill FJ. A follow-up study of incisor teeth which had been treated by apical closure and root filling. Br Dent J. 1993;175(3):99–101. doi: 10.1038/sj.bdj.4808243
  • Mohammadi Z, Abbott PV. The properties and applications of chlorhexidine in endodontics. Int Endodontic J. 2009;42(4):288–302. doi: 10.1111/j.1365-2591.2008.01540.x
  • Pereira AC, Oliveira ML, Cerqueira-Neto A, et al. Treatment outcomes of pulp revascularization in traumatized immature teeth using calcium hydroxide and 2% chlorhexidine gel as intracanal medication. J Appl Oral Sci. 2020;28:e20200217. doi: 10.1590/1678-7757-2020-0217
  • Nagata JY, Soares AJ, Souza-Filho FJ, et al. Microbial evaluation of traumatized teeth treated with triple antibiotic paste or calcium hydroxide with 2% chlorhexidine gel in pulp revascularization. J Endod. 2014;40(6):778–783. doi: 10.1016/j.joen.2014.01.038
  • Fouad AF, Diogenes AR, Torabinejad M, et al. Microbiome changes during regenerative endodontic treatment using different methods of disinfection. J Endod. 2022;48(10):1273–1284. doi: 10.1016/j.joen.2022.07.004
  • ICMJE. Recommendations for the conduct, reporting, editing and publication of scholarly work in medical journals; 2018 Sep 10. Available from: www.icmje.org/journals-following-the-icmje-recommendations/
  • Puri KS, Suresh Kr F - Gogtay NJ, Gogtay Nj F - Thatte UM, Thatte UM Declaration of Helsinki, 2008: implications for stakeholders in research. (0972-2823 (Electronic)).
  • Moher D, Hopewell S, Fau - Schulz KF, et al. CONSORT 2010 explanation and elaboration: updated guidelines for reporting parallel group randomised trials. (1743–9159 (Electronic)).
  • Manoharan L, Brundin M, Rakhimova O, et al. New insights into the microbial profiles of infected root canals in traumatized teeth.LID - LID - 3877. (2077-0383 (Print)). doi: 10.3390/jcm9123877
  • Holgerson PL, Claesson R, Ohman C, et al. Oral microbial profile discriminates breast-fed from formula-fed infants.J Paediatr Gastroenterol Nutr. 2013. doi: 10.1097/MPG.0b013e31826f2bc6
  • Noordzij M, Dekker FW, Zoccali C, et al. Sample size calculations. Nephron Clin Pract. 2011;118(4):c319–23. doi: 10.1159/000322830
  • Lenhard WLA. Computation of effect sizes; 2016. https://www.psychometrica.de/effect_size.html.
  • Sadeghi S, Abdollahi S, Tarighi P, et al. Comparative evaluation of hydrogen peroxide sporicidal efficacy by different standard test methods. Iran J Microbiol. 2020;12(2):113–120. doi: 10.18502/ijm.v12i2.2616
  • Ltd AE. alsenvironmental.Co.uk2017. Available from: https://www.alsenvironmental.co.uk/media-uk/pdf/datasheets/micro-lp/als_micro_limit-of-detection—microbiology_uk_2017.pdf
  • Wikström A, Brundin M, Romani Vestman N, et al. Endodontic pulp revitalization in traumatized necrotic immature permanent incisors: Early failures and long-term outcomes—a longitudinal cohort study. Int Endodontic J. 2022;55(6):630–645. doi: 10.1111/iej.13735
  • Sullivan GM, Feinn R. Using effect size-or why the P value is not enough. J Grad Med Educ. 2012;4(3):279–282. doi: 10.4300/JGME-D-12-00156.1
  • Yarza P, Yilmaz P, Pruesse E, et al. Uniting the classification of cultured and uncultured bacteria and archaea using 16S rRNA gene sequences. 1740-1534 (Electronic).
  • Sjogren U, Figdor D, Persson S, et al. Influence of infection at the time of root filling on the outcome of endodontic treatment of teeth with apical periodontitis. Int Endodontic J. 1997;30(5):297–306. doi: 10.1046/j.1365-2591.1997.00092.x
  • Cvek M, Nord CE, Hollender L. Antimicrobial effect of root canal débridement in teeth with immature root. A clinical and microbiologic study. Odontol Revy. 1976;27(1):1–10.
  • de-Jesus-Soares A, Prado MC, Nardello LCL, et al. Clinical and molecular microbiological evaluation of regenerative endodontic procedures in immature permanent teeth. J Endod. 2020;46(10):1448–1454. doi: 10.1016/j.joen.2020.07.005
  • Fouad AF. Microbiological aspects of traumatic injuries. J Endod. 2019;45(12s):S39–s48. doi: 10.1016/j.joen.2019.05.011
  • Ricucci D, Siqueira JF Jr., Loghin S, et al. Pulp and apical tissue response to deep caries in immature teeth: a histologic and histobacteriologic study. 1879–176X (Electronic)).
  • Orlowski NB, Schimdt TF, Teixeira CDS, et al. Smear layer removal using passive ultrasonic irrigation and different concentrations of sodium hypochlorite. J Endod. 2020;46(11):1738–1744. doi: 10.1016/j.joen.2020.07.020
  • Razghonova Y, Zymovets V, Wadelius P, et al. Transcriptome analysis reveals modulation of human stem cells from the apical papilla by species associated with dental root canal infection. Int J Mol Sci. 2022;23(22):14420. doi: 10.3390/ijms232214420
  • Martin DE, De Almeida JF, Henry MA, et al. Concentration-dependent effect of sodium hypochlorite on stem cells of apical papilla survival and differentiation. J Endod. 2014;40(1):51–55. doi: 10.1016/j.joen.2013.07.026
  • Trevino EG, Patwardhan AN, Henry MA, et al. Effect of irrigants on the survival of human stem cells of the apical papilla in a platelet-rich plasma scaffold in human root tips. J Endod. 2011;37(8):1109–1115. doi: 10.1016/j.joen.2011.05.013
  • Ulin C, Magunacelaya-Barria M, Dahlén G, et al. Immediate clinical and microbiological evaluation of the effectiveness of 0.5% versus 3% sodium hypochlorite in root canal treatment: a quasi-randomized controlled trial. Int Endodontic J. 2020;53(5):591–603. doi: 10.1111/iej.13258
  • Chávez de Paz LE, Bergenholtz G, Svensäter G. The effects of antimicrobials on endodontic biofilm bacteria. J Endod. 2010;36(1):70–77. doi: 10.1016/j.joen.2009.09.017
  • Rosenfeld Ef F - James GA, James Ga F - Burch BS, Burch BS. Vital pulp tissue response to sodium hypochlorite. 0099–2399 (Print)).
  • Zamany A, Safavi K, Spangberg LS. The effect of chlorhexidine as an endodontic disinfectant. Oral Surg Oral Med Oral Pathol Oral Radiol. 2003;96(5):578–581. doi: 10.1016/S1079-2104(03)00168-9
  • Mohammadi Z. Chlorhexidine gluconate, its properties and applications in endodontics. Iran Endod J. 2008;2(4):113–125.
  • Zamany A, Spångberg LS. An effective method of inactivating chlorhexidine. 1079–2104 (Print)).
  • Fouad AF, Diogenes AR, Torabinejad M, et al. Microbiome changes during regenerative endodontic treatment using different methods of disinfection. 1878–3554 (Electronic).
  • Möller AJ. Microbiological examination of root canals and periapical tissues of human teeth. Methodological studies. Odontologisk tidskrift. 1966;74(5):1–380.
  • Shin JM, Luo T, Lee KH, et al. Deciphering endodontic microbial communities by next-generation sequencing. J Endod. 2018;44(7):1080–1087. doi: 10.1016/j.joen.2018.04.003
  • Sundqvist G. Pathogenicity and virulence of black-pigmented gram-negative anaerobes. FEMS Immunol Med Microbiol. 1993;6(2–3):125–137. doi: 10.1111/j.1574-695X.1993.tb00315.x
  • Nóbrega LM, Montagner F, Ribeiro AC, et al. Bacterial diversity of symptomatic primary endodontic infection by clonal analysis. Braz Oral Res. 2016;30(1):e103. doi: 10.1590/1807-3107BOR-2016.vol30.0103
  • Haapasalo M, Ranta H, Ranta K, et al. Black-pigmented bacteroides spp. In human apical periodontitis. Infect Immun. 1986;53(1):149–153. doi: 10.1128/iai.53.1.149-153.1986
  • Gomes BPFA, Lilley JD, Drucker DB. Associations of endodontic symptoms and signs with particular combinations of specific bacteria. Int Endodontic J. 1996;29(2):69–75. doi: 10.1111/j.1365-2591.1996.tb01164.x
  • Siqueira JF Jr. Microbial causes of endodontic flare-ups. Int Endodontic J. 2003;36(7):453–463. doi: 10.1046/j.1365-2591.2003.00671.x
  • Siqueira JF Jr., RôçRôçAs IN. Campylobacter gracilis and Campylobacter rectus in primary endodontic infections. 0143–2885 (Print)).
  • de Paz LE C, Hamilton IR, Svensäter G. Oral bacteria in biofilms exhibit slow reactivation from nutrient deprivation. 1350–0872 (Print)).
  • Siqueira JF Jr., Antunes HS, RôçRôçAs IN, et al. Microbiome in the apical root canal system of teeth with post-treatment apical periodontitis. (1932–6203 (Electronic)).
  • Sharaf PH, El Backly RM, Sherif RA, et al. Microbial identification from traumatized immature permanent teeth with periapical lesions using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. (1472-6831 (Electronic)).
  • Gabrielli ES, Lima AR, Francisco PA, et al. Comparative analysis of bacterial content, levels of lipopolysaccharides and lipoteichoic acid in symptomatic and asymptomatic endodontic infections at different stages of endodontic treatment. Clin Oral Investig. 2022;26(1):287–302. doi: 10.1007/s00784-021-03998-2
  • Gomes BP, Martinho FC, Vianna ME. Comparison of 2.5% sodium hypochlorite and 2% chlorhexidine gel on oral bacterial lipopolysaccharide reduction from primarily infected root canals. J Endod. 2009;35(10):1350–1353. doi: 10.1016/j.joen.2009.06.011
  • Ginsburg I. Role of lipoteichoic acid in infection and inflammation. Lancet Infect Dis. 2002;2(3):171–179. doi: 10.1016/S1473-3099(02)00226-8
  • Fabretti F, Theilacker C, Baldassarri L, et al. Alanine esters of enterococcal lipoteichoic acid play a role in biofilm formation and resistance to antimicrobial peptides. Infect Immun. 2006;74(7):4164–4171. doi: 10.1128/IAI.00111-06
  • Structure, function and diversity of the healthy human microbiome. 1476–4687 (Electronic)).
  • Zheng Z, Yin W, Zara JN, et al. The use of BMP-2 coupled - Nanosilver-PLGA composite grafts to induce bone repair in grossly infected segmental defects. Biomaterials. 2010;31(35):9293–9300. doi: 10.1016/j.biomaterials.2010.08.041
  • Moojen DJ, van Hellemondt G, Vogely HC, et al. Incidence of low-grade infection in aseptic loosening of total hip arthroplasty. Acta Orthop. 2010;81(6):667–673. doi: 10.3109/17453674.2010.525201
  • Molander A, Reit C, Dahlen G, et al. Microbiological status of root-filled teeth with apical periodontitis. Int Endodontic J. 1998;31(1):1–7. doi: 10.1046/j.1365-2591.1998.t01-1-00111.x
  • Ferchichi M, Sebei K, Boukerb A-O, et al. Enterococcus spp.: is it a bad choice for a good use-a conundrum to solve? LID - LID - 2222. (2076-2607 (Print)). doi: 10.3390/microorganisms9112222
  • Sáez-Nieto JA, Medina-Pascual MJ, Carrasco G, et al. Paenibacillus spp. isolated from human and environmental samples in Spain: detection of 11 new species. New Microbes New Infect. 2017;19:19–27. doi: 10.1016/j.nmni.2017.05.006
  • Gomes B, Montagner F, Jacinto RC, et al. Polymerase chain reaction of Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia in primary endodontic infections. J Endod. 2007;33(9):1049–1052. doi: 10.1016/j.joen.2007.05.017
  • Gharbia SE, Shah HN. Interactions between black-pigmented gram-negative anaerobes and other species which may be important in disease development. FEMS Immunol Med Microbiol. 1993;6(2–3):173–177. doi: 10.1111/j.1574-695X.1993.tb00321.x
  • Paster BJ, Olsen I, Aas JA, et al. The breadth of bacterial diversity in the human periodontal pocket and other oral sites. Periodontol 2000. 2006;42(1):80–87. doi: 10.1111/j.1600-0757.2006.00174.x
  • Dewhirst FE, Chen T, Izard J, et al. The human oral microbiome. J bacteriol. 2010;192(19):5002–5017. doi: 10.1128/JB.00542-10
  • Figdor DMFDPF, Brundin MDDSP. Contamination controls for analysis of root canal samples by molecular methods: an overlooked and unsolved problem. J Endod. 2016;42(7):1003–1008. doi: 10.1016/j.joen.2016.04.015