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| 4. |
- Andersson, Lars, et al.
(författare)
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Reprint of: Jens Ove Andreasen, 1935-2020 Father of Dental Traumatology
- 2021
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Ingår i: Journal of Endodontics. - : Elsevier. - 0099-2399 .- 1878-3554. ; 47:6, s. 852-861
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- The life and professional contributions to dental traumatology of Dr Jens Ove Andreasen are described in terms of his research, writing, teaching, and leadership.
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| 5. |
- Brundin, Malin, et al.
(författare)
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DNA Binding to hydroxyapatite : a potential mechanism for preservation of microbial DNA
- 2013
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Ingår i: Journal of Endodontics. - : Elsevier. - 0099-2399 .- 1878-3554. ; 39:2, s. 211-216
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Molecular methods are increasingly being deployed for analysis of the microbial flora in the root canal. Such methods are based on the assumption that recovered DNA is associated with the active endodontic infection, yet paleomicrobiology research is based on the recovery of ancient DNA from centuriesold tooth and bone samples, which points to considerable longevity of the DNA molecule in these tissues. The main component of dentin and bone is the mineral hydroxyapatite. This study assessed DNA binding to hydroxyapatite and whether thiS binding affinity stabilizes the DNA molecule in various media.Methods: DNA was extracted from Fusobacterium nucleatum and added to ceramic hydroxyapatite for 90 minutes. The DNA-bound hydroxyapatite was incubated in different media (ie, water, sera, and DNase I) for up to 3 months. At predetermined intervals, the recovery of detectable DNA was assessed by releasing the DNA from the hydroxyapatite using EDTA and evaluating the presence of DNA by gel electrophoresis and polymerase chain reaction (PCR) amplification.Results: When incubated with hydroxyapatite, nonamplified DNA was detectable after 3 months in water, sera, and DNase I. In contrast, DNA incubated in the same media (without hydroxyapatite) decomposed to levels below the detection level of PCR within 3 weeks, with the exception of DNA in sera in which PCR revealed a weak positive amplification product.Conclusions: These results confirm a specific binding affinity of hydroxyapatite for DNA. Hydroxyapatite-bound DNA is more resistant to decay and less susceptible to degradation by serum and nucleases, which may account for the long-term persistence of DNA in bone and tooth.
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| 6. |
- Brundin, Malin, et al.
(författare)
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Preservation of bacterial dna by human dentin
- 2014
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Ingår i: Journal of Endodontics. - : Elsevier BV. - 0099-2399 .- 1878-3554. ; 40:2, s. 241-245
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: The capacity of dentin and collagen to bind DNA and protect against spontaneous and nuclease-induced degradation was evaluated individually and by the incubation of DNA with nuclease-producing bacteria in a mixed culture.METHODS: Extracted Fusobacterium nucleatum DNA was incubated with dentin shavings or collagen for 90 minutes. The DNA-bound substrates were incubated in different media (water, sera, and DNase I) for up to 3 months. Amplifiable DNA was released from dentin using EDTA,or from collagen using proteinase K, and evaluated by polymerase chain reaction (PCR). The stability of dentin-bound DNA was also assessed in a mixed culture (Parvimonas micra and Pseudoramibacter alactolyticus) containing a DNase-producing species, Prevotella intermedia. Samples were analyzed for amplifiable DNA.RESULTS: In water, dentin-bound DNA was recoverable by PCR at 3 months compared with no detectable DNA after 4 weeks in controls (no dentin). DNA bound to collagen was detectable by PCR after 3 months of incubation in water. In 10% human sera, amplifiable DNA was detectable at 3 months when dentin bound and in controls (no dentin). In mixed bacterial culture, dentin-bound DNA was recoverable throughout the experimental period (3 months), compared with no recoverable F. nucleatum DNA within 24 hours in controls (no dentin).CONCLUSIONS: There is a strong binding affinity between DNA and dentin, and between DNA and serum proteins or collagen. These substrates preserve DNA against natural decomposition and protect DNA from nuclease activity, factors that may confound molecular analysis of the endodontic microbiota yet favor paleomicrobiological studies of ancient DNA.
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| 9. |
- Chávez de Paz, Luis E.
(författare)
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Development of a Multispecies Biofilm Community by Four Root Canal Bacteria
- 2012
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Ingår i: Journal of Endodontics. - : Elsevier. - 0099-2399 .- 1878-3554. ; 38:3, s. 318-323
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Tidskriftsartikel (refereegranskat)abstract
- The development of multispecies biofilm models are needed to explain the interactions that take place in root canal biofilms during apical periodontitis. The aim of this study was to investigate the ability of 4 root canal bacteria to establish a multispecies biofilm community and to characterize the main structural, compositional, and physiological features of this community. Methods Four clinical isolates isolated from infected root canals, Actinomyces naeslundii, Lactobacillus salivarius, Streptococcus gordonii, and Enterococcus faecalis, were grown together in a miniflow cell system. Simultaneous detection of the 4 species in the biofilm communities was achieved by fluorescence in situ hybridization in combination with confocal microscopy at different time points. The LIVE/DEAD BacLight technique (Molecular Probes, Carlsbad, CA) was used to assess cell viability and to calculate 3-dimensional architectural parameters such as biovolume (μm3). Redox fluorescence dye 5-cyano-2,3-ditolyl tetrazolium chloride was used to assess the metabolic activity of biofilm bacteria. Results The 4 species tested were able to form stable and reproducible biofilm communities. The biofilms formed in rich medium generally showed continuous growth over time, however, in the absence of glucose biofilms showed significantly smaller biovolumes. A high proportion of viable cells (>90%) were generally observed, and biofilm growth was correlated with high metabolic activity of cells. The community structure of biofilms formed in rich medium did not change considerably over the 120-hour period, during which E. faecalis, L. salivarius, and S. gordonii were most abundant. Conclusions The ability of 4 root canal bacteria to form multispecies biofilm communities shown in this study give insights into assessing the community lifestyle of these microorganisms in vivo. This multispecies model could be useful for further research simulating stresses representative of in vivo conditions.
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| 10. |
- Chávez de Paz, Luis Eduardo
(författare)
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Redefining the Persistent Infection in Root Canals : Possible Role of Biofilm Communities
- 2007
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Ingår i: Journal of Endodontics. - : Elsevier BV. - 0099-2399 .- 1878-3554. ; 33:6, s. 652-662
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Tidskriftsartikel (refereegranskat)abstract
- Current concepts suggest that persisting infections subsequent to endodontic therapy are caused by one or two bacterial species that are "too robust" to be eliminated by conventional treatment measures. As a consequence, numerous studies are exploring the characteristics of these "most" resistant organisms to define an effective treatment strategy to eradicate them from root canals. By taking an ecological perspective, the main objective of this review is to present evidence that the nature of persisting endodontic infections depends not on the robustness of the organisms in the infected site, but on their capability of adapting their physiology to the new environmental conditions set by the treatment. Changes in the environment, such as an increase in pH by calcium hydroxide or the effect of antimicrobials, are capable of triggering genetic cascades that modify the physiological characteristics of bacterial cells. Surface adherence by bacteria to form biofilms is a good example of bacterial adaptation and one that is pertinent to endodontic infections. Increasing information is now available on the existence of polymicrobial biofilm communities on root canal walls, coupled with new data showing that the adaptive mechanisms of bacteria in these biofilms are significantly augmented for increased survival. This ecological view on the persisting infection problem in endodontics suggests that the action of individual species in persisting endodontic infections is secondary when compared to the adaptive changes of a polymicrobial biofilm community undergoing physiological and genetic changes in response to changes in the root canal environment.
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| 11. |
- Chávez de Paz, Luis Eduardo, et al.
(författare)
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The effects of antimicrobials on endodontic biofilm bacteria
- 2010
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Ingår i: Journal of Endodontics. - : Elsevier. - 0099-2399 .- 1878-3554. ; 36:1, s. 70-77
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Tidskriftsartikel (refereegranskat)abstract
- Introduction In the present study, confocal microscopy, a miniflow cell system, and image analysis were combined to test in situ the effect of antimicrobials and alkali on biofilms of Enterococcus faecalis, Lactobacillus paracasei, Streptococcus anginosus, and Streptococcus gordonii isolated from root canals with persistent infections. Methods Biofilms formed for 24 hours were exposed for 5 minutes to alkali (pH = 12), chlorhexidine digluconate (2.5%), EDTA (50 mmol/L), and sodium hypochlorite (1%). The biofilms were then characterized by using fluorescent markers targeting cell membrane integrity (LIVE/DEAD) and metabolic activity (5-cyano-2,3-ditolyl tetrazolium chloride and fluorescein diacetate). In addition, the biofilm architecture and the extent to which coating of the substrate surface with collagen influenced the resistance pattern to the chemicals were also analyzed. Results NaOCl (1%) affected the membrane integrity of all organisms and removed most biofilm cells. Exposure to EDTA (50 mmol/L) affected the membrane integrity in all organisms but failed to remove more than a few cells in biofilms of E. faecalis, L. paracasei, and S. anginosus. Chlorhexidine (2.5%) had a mild effect on the membrane integrity of E. faecalis and removed only 50% of its biofilm cells The effects were substratum-dependent, and most organisms displayed increased resistance to the antimicrobials on collagen-coated surfaces. Conclusions The biofilm system developed here was sensitive and differences in cell membrane integrity and removal of biofilm cells after exposure to antimicrobials commonly used in endodontics was discernible.
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| 12. |
- Dawson, Victoria, et al.
(författare)
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Further Treatments of Root-filled Teeth in the Swedish Adult Population: A Comparison of Teeth Restored with Direct and Indirect Coronal Restorations
- 2017
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Ingår i: Journal of Endodontics. - : Elsevier BV. - 0099-2399 .- 1878-3554. ; 43:9, s. 1428-1432
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: The aim of this study was to evaluate the frequencies of nonsurgical retreatment, root -end surgery, extraction, and further restoration of root -filled teeth in Sweden in 2009 during a follow-up period of 5 years and to compare the outcomes in teeth restored with direct or indirect restorations. Methods: Data from the Swedish Social Insurance Agency were analyzed, and the frequencies of nonsurgical retreatment, root end surgery, extractions, and further restoration were calculated for all teeth registered as root filled during 2009. Chi-square tests were applied to detect any significant differences in the frequency of further treatment in teeth registered as restored with either a direct or an indirect restoration within 6 months of root filling. Results: Of the 248,299 teeth reported root filled in Sweden in 2009, nonsurgical retreatment was registered in 2.2%, root -end surgery in 1.0%, and extractions in 9.2% during the follow-up period. Of the teeth restored with a direct restoration within 6 months after the root filling, 30.3% were registered as having undergone at least 1 further direct restoration; the corresponding percentage of teeth with indirect restorations was 6.4%. A statistically significant difference in the frequency of nonsurgical retreatment, extraction, and further restoration was found; teeth restored with an indirect restoration within 6 months of root filling had fewer of these treatments than those restored by direct restoration. Conclusions: Low frequencies of nonsurgical retreatment and root -end surgery were reported 5 years after root filling, whereas extraction was more common. Fewer additional treatment procedures were registered for teeth with indirect restorations than for those with direct restorations.
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| 13. |
- Dawson, Victoria, et al.
(författare)
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Periapical status of non-root-filled teeth with resin composite, amalgam, or full crown restorations : a cross-sectional study of a Swedish adult population
- 2014
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Ingår i: Journal of Endodontics. - : Elsevier. - 0099-2399 .- 1878-3554. ; 40:9, s. 1303-1308
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Experimental studies show that dental pulp cells respond unfavorably to contact with resin composite restorative material. Hypothetically, in a random population, the frequency of apical periodontitis should be higher for teeth restored with resin composite than with amalgam. Therefore, the aim was to compare the periapical status of non-root-filled teeth restored with resin composite, amalgam, or laboratory-fabricated crowns in an adult Swedish population. METHODS: The subjects comprised 440 individuals from a randomly selected sample of 1,000 adult residents of a Swedish county. The type, material, and quality of the restorations were recorded for all non-root-filled teeth by clinical examination and intraoral clinical photographs. Periapical status was evaluated on panoramic radiographs. The association between periapical status and type, material, and quality of the restorations was analyzed using the chi-square test and logistic regression analysis. RESULTS: There was no significant difference in the frequency of apical periodontitis (AP) between teeth restored with resin composite or amalgam (1.3% and 1.1%, respectively). The frequency of AP for teeth restored with laboratory-fabricated crowns was significantly higher (6.3%). Regression analysis showed no association between AP and resin composite restorations but a significant association with laboratory-fabricated crowns. CONCLUSIONS: The results indicate that the risk of damage to the pulp-dentin complex from exposure to resin composite material and dentin bonding agents shown in experimental studies is not reflected in the clinical setting. However, in the study sample, AP was diagnosed in a significantly higher proportion of teeth restored with laboratory-fabricated crowns.
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| 14. |
- Dawson, Victoria, et al.
(författare)
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Periapical status of root-filled teeth restored with composite, amalgam, or full crown restorations : a cross-sectional study of a Swedish adult population
- 2016
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Ingår i: Journal of Endodontics. - : Elsevier. - 0099-2399 .- 1878-3554. ; 42:9, s. 1326-1333
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: The aim was to compare the periapical status of root-filled teeth restored with resin composite, laboratory-fabricated crowns, or amalgam in a Swedish adult population. METHODS: The subjects consisted of 440 individuals from a randomly selected sample of 1000 adult residents of a Swedish county. The type, material, and quality of the restorations were recorded for all root-filled teeth by using clinical examination and intraoral clinical photographs. Periapical status, root-filling quality, and marginal bone loss were evaluated on panoramic radiographs. The association between periapical status and type, material, and quality of the restorations was analyzed by using the χ2 test and logistic regression. RESULTS: No difference in the frequency of apical periodontitis (AP) between teeth restored with resin composite, laboratory-fabricated crowns, or amalgam (29.7%, 26.2%, and 43.1%, respectively) of adequate quality was found. No association between AP and resin composite restorations was disclosed; however, there was an association between AP and inadequate root-filling quality and marginal bone loss >1/3 of the root length. CONCLUSIONS: The results did not indicate any association between AP and resin composite restorations. Neither the type nor the material of the restoration was of significance for periapical status as long as the quality was adequate.
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| 15. |
- Dawson, Victoria S., et al.
(författare)
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Further Interventions After Root Canal Treatment Are Most Common in Molars and Teeth Restored with Direct Restorations : A 10–11-Year Follow-Up of the Adult Swedish Population
- 2024
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Ingår i: Journal of Endodontics. - : Elsevier. - 0099-2399 .- 1878-3554.
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: The aims were to investigate 1) the frequency of nonsurgical retreatment, root-end surgery, extraction, and further restorative treatment during a follow-up of 10 to 11 years after root filling and compare the frequencies according to tooth group and type of coronal restoration, and 2) the timing of nonsurgical retreatment, root-end surgery, and extraction.Methods: Data were collected from the Swedish Social Insurance Agency's register. A search for treatment codes identified teeth root filled in 2009 and the type of coronal restoration (direct, indirect, unspecified) registered within 6 months of root filling. The root-filled teeth were followed 10-11 years, and further interventions were recorded. Descriptive statistics and Chi-square tests were used for statistical analysis.Results: In 2009, root fillings were registered for 215,611 individuals/teeth. Nonsurgical retreatment, root-end surgery, and extraction were undertaken in 3.5%, 1.4%, and 20% teeth, respectively. The frequency of further interventions varied with respect to tooth group and type of coronal restoration, but only slightly for endodontic retreatments. Further interventions, except for root-end surgery, were registered more often for molars and directly restored teeth (P < 0.001). The majority of endodontic retreatments were undertaken within 4 years, while extractions were evenly distributed over 10-11 years.Conclusions: The frequency numbers of nonsurgical retreatment and root-end surgery were low, despite one in five root-filled teeth registered as extracted. Further interventions were most common in molars and directly restored teeth. Endodontic retreatments were performed more often during the first 4 years.
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| 16. |
- Dawson, Victoria S., et al.
(författare)
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Further Interventions after Root Canal Treatment Are Most Common in Molars and Teeth Restored with Direct Restorations : A 10–11-Year Follow-Up of the Adult Swedish Population
- 2024
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Ingår i: Journal of Endodontics. - : Elsevier. - 0099-2399 .- 1878-3554.
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: The aims were to investigate 1) the frequency of nonsurgical retreatment, root-end surgery, extraction, and further restorative treatment during a follow-up of 10–11 years after root filling and compare the frequencies according to tooth group and type of coronal restoration and 2) the timing of nonsurgical retreatment, root-end surgery, and extraction. Methods: Data were collected from the Swedish Social Insurance Agency's register. A search for treatment codes identified teeth root filled in 2009 and the type of coronal restoration (direct, indirect, and unspecified) registered within 6 months of root filling. The root-filled teeth were followed 10–11 years, and further interventions were recorded. Descriptive statistics and chi-square tests were used for statistical analysis. Results: In 2009, root fillings were registered for 215,611 individuals/teeth. Nonsurgical retreatment, root-end surgery, and extraction were undertaken in 3.5%, 1.4%, and 20% teeth, respectively. The frequency of further interventions varied with respect to tooth group and type of coronal restoration, but only slightly for endodontic retreatments. Further interventions, except for root-end surgery, were registered more often for molars and directly restored teeth (P < .001). The majority of endodontic retreatments were undertaken within 4 years, while extractions were evenly distributed over 10–11 years. Conclusions: The frequency numbers of nonsurgical retreatment and root-end surgery were low, despite 1 in 5 root-filled teeth registered as extracted. Further interventions were most common in molars and directly restored teeth. Endodontic retreatments were performed more often during the first 4 years.
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| 17. |
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| 18. |
- Figdor, David, et al.
(författare)
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Contamination Controls for Analysis of Root Canal Samples by Molecular Methods : An Overlooked and Unsolved Problem
- 2016
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Ingår i: Journal of Endodontics. - : Elsevier. - 0099-2399 .- 1878-3554. ; 42:7, s. 1003-1008
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Forskningsöversikt (refereegranskat)abstract
- Introduction: It has been almost 20 years since molecular methods were first described for the analysis of root canal microbial flora. Contamination control samples are essential to establish DNA decontamination before taking root canal samples, and this review assessed those studies. Methods: Using PubMed, a search was conducted for studies using molecular microbial analysis for the investigation of endodontic samples. Studies were grouped according to the cleaning protocol, acquisition methods, and processing of control samples taken to check for contamination. Results: Of 136 studies applying molecular analysis to root canal samples, 21 studies performed surface cleaning and checking nucleotide decontamination with contamination control samples processed by polymerase chain reaction. Only 1 study described disinfection, sampling from the access cavity,, and processing by polymerase chain reaction and reported the result; that study reported that all samples contained contaminating bacterial DNA. Conclusions: Cleaning, disinfection, and checking for contamination are basic scientific prerequisites for this type of investigation; yet, this review identifies it as an overlooked issue. On the basis of this review, we call for improved scientific practice in this field.
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| 19. |
- Fransson, Helena, et al.
(författare)
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Survival of Root-filled Teeth in the Swedish Adult Population
- 2016
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Ingår i: Journal of Endodontics. - : Elsevier BV. - 0099-2399 .- 1878-3554. ; 42:2, s. 216-220
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Tidskriftsartikel (refereegranskat)abstract
- © 2016 American Association of Endodontists. Introduction The aim was to assess survival in the Swedish population of teeth treated by nonsurgical root canal treatment during 2009. Methods Data from the Swedish Social Insurance Agency were analyzed by Kaplan-Meier analysis to assess cumulative tooth survival during a period of 5-6 years of all teeth that were root-filled during 2009. Results In 2009, 248,299 teeth were reported as root-filled. The average age of the patients at the time of the root filling was 55 years (range, 20-102 years). The teeth most frequently root-filled were the maxillary and mandibular first molars. During the 5- to 6-year period 25,228 of the root-filled teeth (10.2%) were reported to have been extracted; thus 223,071 teeth (89.8%) survived. Tooth survival was highest in the youngest age group (93.2%). The highest survival (93.0%) was for the mandibular premolars, and the lowest (87.5%) was for the mandibular molars. Teeth restored with indirect restorations within 6 months of the root filling had higher survival rates (93.1%) than those restored with a direct filling (89.6%). Conclusions In the adult population of Sweden, teeth that are root-filled by general practitioners under the tax-funded Swedish Social Insurance Agency have a 5- to 6-year survival rate of approximately 90%.
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| 20. |
- Granevik Lindström, Maria, et al.
(författare)
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The Antibacterial Effect of Nd:YAG Laser Treatment of Teeth with Apical Periodontitis : A Randomized Controlled Trial
- 2017
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Ingår i: Journal of Endodontics. - : Elsevier. - 0099-2399 .- 1878-3554. ; 43:6, s. 857-863
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: The aim of this blind, in vivo, randomized controlled trial was to evaluate the antibacterial effect of Nd:YAG laser irradiation in endodontic treatment of single-rooted teeth with apical periodontitis. The hypothesis was that mechanical enlargement of the root canal and Nd:YAG laser irradiation would yield more negative bacterial samples than conventional treatment. METHODS: Forty-one patients (45 teeth) were allocated to the laser (n = 22) or control (n = 23) group. The teeth in the laser group were instrumented, irrigated with saline, and irradiated with Nd:YAG laser according to a standard protocol. The teeth in the control group were similarly instrumented but irrigated with 1% unbuffered sodium hypochlorite and 15% EDTA solution. Bacterial samples were taken before and after treatment, blinded, and immediately sent for culturing and analysis. RESULTS: The initial bacterial samples were positive in 20 of 22 teeth in the laser group and 18 of 23 (P = .414) in the control group. After the initial treatment, negative bacterial samples were found in 11 teeth in the laser group and 13 (P = .768) in the control group. After 2 to 4 days with no antibacterial dressing in the root canals, 5 teeth in the laser group and 9 (P = .337) in the control group yielded negative bacterial samples. CONCLUSIONS: After intervention, neither the test group nor the control group yielded predictable negative bacterial samples. Thus, the results failed to verify the hypothesis that Nd:YAG laser irradiation would yield significantly more negative bacterial samples than conventional irrigation with 1% unbuffered sodium hypochlorite solution.
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| 21. |
- Jaramillo, David E., et al.
(författare)
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Decreased Bacterial Adherence and Biofilm Growth on Surfaces Coated with a Solution of Benzalkonium Chloride
- 2012
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Ingår i: Journal of Endodontics. - : Elsevier. - 0099-2399 .- 1878-3554. ; 38:6, s. 821-825
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Tidskriftsartikel (refereegranskat)abstract
- Introduction Secondary biofilm formation by oral bacteria after breakdown/fracture of temporary or permanent restorations imposes a challenge to the outcome of root canal treatment. This study focuses on benzalkonium chloride (BAK) coating on dentin or polystyrene surfaces and its influence on the early adhesion and biofilm formation by oral and root canal bacteria. Methods Microbial adhesion and biofilm growth on surfaces coated with BAK were analyzed qualitatively with a dentin disk model and quantitatively with a mini-flow cell biofilm model. Cell viability and total biovolume were analyzed by the LIVE/DEAD technique. The repelling effect of surfaces coated with BAK was compared with NaOCl. Uncoated surfaces were used as controls. Results Scanning electron microscope images in the dentin disk model revealed that very sparse biofilms were formed on NaOCl- and BAK-coated dentin surfaces. In contrast, biofilms formed on uncoated dentin were clearly visible as numerous irregularly distributed aggregates of rods and cocci. In the mini-flow cell system, confocal laser scanning microscope analysis confirmed that biofilms formed on NaOCl- and BAK-coated surfaces showed significantly less adhesion (2 hours) and biovolume accumulation (24 and 96 hours) compared with the uncoated controls (P < .01). Furthermore, cell viability assessments showed that on uncoated controls the viability measurements were high (>89%) as well as on BAK-coated surfaces (88% viable cells). However, cell viability was significantly reduced on NaOCl-coated surfaces (59% viable cells). Conclusions This study illustrates that surface coating with a surfactant solution containing BAK does not cause cell membrane damage but might interfere with cell mechanisms of adhesion. Investigations into the clinical utility of BAK as an antibiofilm medication are warranted.
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| 22. |
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| 23. |
- Malmgren, B
(författare)
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Ridge preservation/decoronation
- 2013
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Ingår i: Journal of endodontics. - : Elsevier BV. - 1878-3554 .- 0099-2399. ; 35:2, s. 164-169
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Tidskriftsartikel (refereegranskat)
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| 24. |
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| 25. |
- Merdad, Khalid, et al.
(författare)
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Caries susceptibility of endodontically versus nonendodontically treated teeth.
- 2011
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Ingår i: Journal of endodontics. - : Elsevier BV. - 1878-3554 .- 0099-2399. ; 37:2, s. 139-42
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Tidskriftsartikel (refereegranskat)abstract
- NTRODUCTION: The aim of the present investigation was to evaluate the caries susceptibility of endodontically versus nonendodontically treated teeth in relation to dental plaque-related factors. METHODS: Twenty patients with 2 endodontically treated teeth (ETT) each were examined regarding cariogenic microflora of proximal plaque, in situ plaque pH drop after a sucrose rinse (Stephan curve), and de novo plaque formation. Recurrent caries and the quality of the coronal fillings/crowns of these teeth were also evaluated. ETT were compared with contralateral, nonendodontically treated teeth (NETT). RESULTS: Irrespective to the type of restoration, Streptococcus mutans count, de novo plaque formation, and recurrent caries were higher on the surface of ETT compared with NETT (P < .05). Moreover, the initial (resting) pH in plaque was significantly lower (P < 0.05) in ETT. CONCLUSIONS: ETT showed an increased susceptibility to caries as a result of either alteration in their biological environment or inadequacy of the marginal fit of the dental restoration. Clinicians should be aware of this risk.
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| 26. |
- Mota de Almeida, Fernando José, et al.
(författare)
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Additional treatment indicative of an unfavorable endodontic outcome in a Swedish county : a 10-year observational study
- 2023
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Ingår i: Journal of Endodontics. - : Elsevier. - 0099-2399 .- 1878-3554. ; 49:3, s. 267-275.e4
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: This study's aim was to calculate the incidence of first additional endodontic treatment or extraction as the result of an unfavorable endodontic outcome following orthograde root canal treatment (RCT) performed by general dental practitioners during a 10-year period and to identify possible predictors for outcomes.Methods: A randomized cohort of 280 individuals (and as many teeth) with an orthograde RCT was followed for over 10 years. Dental records were reviewed, and individuals were recalled when data were missing. The following terminal events indicative of unfavorable endodontic treatment outcome were orthograde retreatment, surgical endodontics, and tooth extractions exclusively due to endodontic reasons. Selected variables related to individuals and treatment (pre-, intra-, and postoperative) were harvested to analyze possible associations with the terminal events. Unadjusted survival analysis and Cox regression analysis were performed and P < .05 was considered statistically significant.Results: Terminal events were registered for 22 teeth/individuals and 17 of these were orthograde retreatments. The cumulative 10-year survival of RCTs was 92.7% (standard error 1.7%), with a higher yearly incidence during the first 2 years. The univariate analysis identified 5 factors associated with the outcome. There were too few events to perform a multivariate analysis.Conclusions: The mean incidence of additional treatment indicative of unfavorable endodontic outcome was 0.7% per year during the first 10 years, but the mean incidence was greater during the first 2 years. Five factors were associated with an unfavorable outcome; however, confounders cannot be excluded from the associations.
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| 27. |
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| 28. |
- Pigg, Maria, et al.
(författare)
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New International Classification of Orofacial Pain : What Is in It For Endodontists?
- 2021
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Ingår i: Journal of Endodontics. - : Elsevier. - 0099-2399 .- 1878-3554. ; 47:3, s. 345-357
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Tidskriftsartikel (refereegranskat)abstract
- Pain is a common symptom in endodontic conditions, but differential diagnostic procedures are often needed to exclude other pain origins. General dentists and endodontists thus need to be aware of alternative painful orofacial conditions, and be able to identify them. The new International Classification of Orofacial Pain (ICOP, 2020) is the first comprehensive classification that uniquely deals with orofacial pain. The ICOP is a hierarchical classification, modelled on the International Classification of Headache Disorders (ICHD-3) and covers pain in dentoalveolar and anatomically related tissues, muscle pain, temporomandibular joint (TMJ) pain, neuropathic pain affecting cranial nerves, pain resembling primary headaches, and idiopathic pain in the orofacial region. A description of each condition is given, and structured diagnostic criteria for each condition are proposed based on research data when available. This narrative review aims to (i) give an overview and brief explanation of the ICOP system, (ii) describe and give examples of how it can be of use to general dentists and endodontists with special attention to differential diagnosis of tooth pain, and (iii) highlight how endodontic research can contribute to validation and improvement of the classification. A comparison to other classification and diagnostic systems is also included.
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| 29. |
- Pigg, Maria, et al.
(författare)
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Validity of preoperative clinical findings to identify dental pulp status : A National Dental Practice-Based Research Network Study
- 2016
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Ingår i: Journal of Endodontics. - : Elsevier. - 0099-2399 .- 1878-3554. ; 42:6, s. 935-942
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Endodontic diagnostic tests are often used clinically to assess pulp status as a basis for the diagnosis and determination of whether root canal treatment (RCT) is indicated. Response to cold and pain on percussion are 2 common tests, yet their validity in identifying nonvital pulp in regular dental practice has not been reported. METHODS: We assessed the validity of cold and percussion tests to identify nonvital pulp in teeth requiring RCT in a dental practice setting performed by 46 general dentists and 16 endodontists in the National Dental Practice-Based Research Network. The influence of patient-, tooth-, and dentist-related characteristics was investigated. Observed bleeding from the pulp chamber was the clinical reference. Sensitivity (SN), specificity (SP), overall test accuracy (TA), positive (PPV) and negative (NPV) predictive values, and likelihood and diagnostic odds ratios (LR+, LR-, dORs) were calculated for each single test and the combined cold and percussion tests. RESULTS: Seven hundred eight patient teeth were included. Cold test showed high validity to identify a nonvital pulp status (SN = 89%, SP = 80%, TA = 84%, PPV = 81%, NPV = 88%, LR+ = 4.35, LR- = 0.14, dOR = 31.4), whereas pain on percussion had lower validity (SN = 72%, SP = 41%, TA = 56%, PPV = 54%, NPV = 60%, LR+ = 1.22, LR- = 0.69, dOR = 1.78). Combining the 2 tests did not increase validity, whereas preoperative pain, medication intake, patient age and sex, and dentist training level affected test validity significantly. CONCLUSIONS: In regular dental practice, the cold test exhibits higher validity to discriminate between vital and nonvital pulp than the tooth percussion test.
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| 30. |
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| 31. |
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| 32. |
- Wigsten, Emma, 1984, et al.
(författare)
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Comparing Quality of Life of Patients Undergoing Root Canal Treatment or Tooth Extraction
- 2020
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Ingår i: Journal of Endodontics. - : Elsevier BV. - 0099-2399 .- 1878-3554. ; 46:105, s. 19-28
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: The knowledge of patient-centered outcomes concerning the consequences of root canal treatment in daily life is limited. The treatment option is often tooth extraction with possible prosthetic replacement. This study aimed to achieve a greater understanding of the patient perspective by evaluating the effect of root canal treatment in terms of quality of life and quality-adjusted life year (QALY) weights in comparison with patients who underwent tooth extraction. Methods: Patients with either root canal treatment or extraction were recruited from 6 clinics in the general public dental service during a predetermined period of 8 weeks. Three different instruments were used: the Oral Health Impact Profile evaluating the oral health related quality of life (OHRQOL), the EQ-5D-5L evaluating health-related quality of life (HRQOL) and QALY weights, and a disease-specific questionnaire evaluating satisfaction regarding the root canal treatment. The evaluation was assessed at the initiation of treatment and after 1 month. Patient-based and tooth-specific characteristics were obtained from the dental records. Results: Eighty-five patients were included. The distribution between sexes was even, with 43 women and 42 men. The mean age was 51.1 years. Forty-eight patients (56.5%) had a tooth extraction, and 37 patients (43.5%) initiated root canal treatment. The response rate for the questionnaire at baseline was 95.3%, and at the 1-month follow-up, it was 74.1%. Two relevant and comparable groups were obtained after exclusion of the extracted third molars (n = 20), resulting in 65 patients for further analyses. At follow-up, the patients who initiated root canal treatment registered a significant improvement in perceived HRQOL according to the QALY weights (P = .02 and P < .01, respectively). Patients initiating root canal treatment reported generally high satisfaction. Conclusions: A cohort of patients either initiating root canal treatment or tooth extraction as a control group was established. Initiating root canal treatment had a positive impact on perceived HRQOL. The included patients in general dental practice registered overall high satisfaction regarding root canal treatment.
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| 33. |
- Yan, Hongji, et al.
(författare)
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Regenerative Endodontics by Cell Homing : A Review of Recent Clinical trials
- 2023
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Ingår i: Journal of Endodontics. - : Elsevier BV. - 0099-2399 .- 1878-3554. ; 49:1, s. 4-17
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Forskningsöversikt (refereegranskat)abstract
- Introduction: The conventional treatment for irreversibly inflamed or necrotic teeth is root canal treatment or apexification. Regenerative endodontics aims to regenerate the damaged “pulp-like” tissue, which can preserve the teeth' vitality and sensitivity while avoiding necrosis. The main clinical benefit is root maturation. The “pulp-like” tissue does not refer to regenerated pulp tissue with an odontoblastic layer or the formation of pulp-dentin complexes. The cell homing technique is built on endogenous stem cells and their capacity to regenerate tissue. Cell homing refers to endogenous cells’ migration or infiltration into the cite when stimulated by physiochemical or biological stimuli or by passive flow with a blood clot from the apical tissue. Its Regenerative Endodontic Procedures success criteria are defined by the American Association of Endodontists. The purpose of this article is to provide an overview of vital pulp tissue and various strategies to promote regeneration of damaged pulp tissue. The cell homing technique will be reviewed through clinical trials. Methods: We performed a comprehensive literature review on a total of nine clinical trials of regenerative endodontics using the cell-homing technique based on three databases and duplicate manuscripts were removed. Results: Regenerative endodontics using the cell-homing technique shows promising results that can be translated into clinical practice. However, a favorable result was observed in immature teeth, and the results are contradictory in mature teeth. Conclusion: Regeneration therapy is an attractive new alternative to conventional endodontic treatments. Preservation of vitality and continuation of root development in damaged teeth would be a clear advantage.
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| 34. |
- Young, Geoffrey, et al.
(författare)
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Bacterial DNA persists for extended periods after cell death
- 2007
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Ingår i: Journal of Endodontics. - New York : Elsevier. - 0099-2399 .- 1878-3554. ; 33:12, s. 1417-1420
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Tidskriftsartikel (refereegranskat)abstract
- The fate of DNA from bacteria that infect the root canal but cannot survive is currently unknown, yet such information is essential in establishing the validity of polymerase chain reaction (PCR)-based identification methods for root canal samples. This in vitro study tested the hypothesis that PCR-detectable DNA from dead bacteria might persist after cell death and investigated the efficiency of sodium hypochlorite (NaOCl) as a field decontamination agent. Using heat-killed Enterococcus faecalis, the persistence of DNA encoding the 16S rRNA gene was monitored by PCR. While most probable number analysis showed an approximate 1000-fold decay in amplifiable template, E. faecalis DNA was still PCR-detectable 1 year after cell death. NaOCl (1%) eliminated amplifiable DNA within 60 seconds of exposure. Our findings also disclosed a previously overlooked problem of concentration-dependent inhibition of the PCR reaction by thiosulfate-inactivated NaOCl. These results highlight the challenges of reliably identifying the authentic living root canal flora with PCR techniques.
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| 35. |
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| 36. |
- Robertson, Agneta, 1954, et al.
(författare)
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Incidence of pulp necrosis subsequent to pulp canal obliteration from trauma of permanent incisors.
- 1996
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Ingår i: Journal of endodontics. - 0099-2399. ; 22:10, s. 557-60
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Tidskriftsartikel (refereegranskat)abstract
- Little long-term data are available on the frequency by which pulp canal obliteration (PCO) subsequent to trauma leads to pulp necrosis (PN). In this study, 82 concussed, subluxated, extruded, laterally luxated, and intruded permanent incisors presenting with PCO were followed for a period of 7 to 22 yr (mean 16 yr). At final clinical examination, 51% of the observed teeth responded normally to electric pulp testing (EPT). An additional 40% of the teeth although not responding to EPT were clinically and radiographically within normal limits. Yellow discoloration was a frequent finding. During the observation period, periapical bone lesions suggesting PN developed in seven teeth (8.5%). Twenty-yr pulp survival rate was 84%, as determined from life-table calculations. There was no higher frequency of PN in obliterated teeth subjected to caries, new trauma, orthodontic treatment, or complete crown coverage than intact teeth. Although the incidence of PN in teeth displaying PCO seems to increase over the course of time, prophylactic endodontic intervention on a routine basis does not seem justified.
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| 37. |
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| 38. |
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| 39. |
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| 40. |
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| 41. |
- Kvist, Thomas, 1959, et al.
(författare)
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Microbiological evaluation of one- and two-visit endodontic treatment of teeth with apical periodontitis: a randomized, clinical trial.
- 2004
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Ingår i: Journal of endodontics. - 0099-2399. ; 30:8, s. 572-6
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Tidskriftsartikel (refereegranskat)abstract
- The antimicrobial efficacy of endodontic procedures performed in one-visit (including a 10-min intraappointment dressing with 5% iodine-potassium-iodide) was compared with a two-visit procedure (including an interappointment dressing with calcium-hydroxide paste). Teeth with apical periodontitis (n = 96) were randomly assigned to either group. Root canal sampling and culturing were performed before and immediately after instrumentation, and after medication. Initial sampling demonstrated the presence of microorganisms in 98% of the teeth. Postinstrumentation sampling showed reduction of cultivable microbiota. Antibacterial dressing further reduced the number of teeth with surviving microbes. In the postmedication samples, residual microorganisms were recovered in 29% of the one-visit teeth and in 36% of the two-visit treated teeth. No statistically significant differences between the groups were discerned. It was concluded that from a microbiological point of view, treatment of teeth with apical periodontitis performed in two appointments was not more effective than the investigated one-visit procedure.
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| 42. |
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| 43. |
- Landys Borén, Daniela, et al.
(författare)
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Long-term Survival of Endodontically Treated Teeth at a Public Dental Specialist Clinic
- 2015
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Ingår i: Journal of Endodontics. - : Elsevier BV. - 0099-2399. ; 41:2, s. 176-181
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: The long-term survival of endodontically treated teeth is an issue of high priority focus in modern restorative dentistry. In available literature, survival is generally high and comparable with implants. For more compromised teeth treated in a specialist clinic, survival-rate may be lower. This retrospective study aimed to investigate the 10-year survival rate of teeth treated in a public endodontic specialist clinic. Methods: From a database of 15,000 examined teeth, 420 teeth in 330 patients were randomly selected and included. Available potential preoperative, intraoperative, and postoperative prognotic factors were registered. Ten-year tooth survival was recorded by scrutinizing records and by contacting referring dentists and patients. Results: The overall Kaplan-Meier estimated 10-year survival rate was 81.5% (95% confidence interval [Cl], 76.7%-85.5%). Placement of a crown, adjusted hazard ratio 0.27 (95% Cl, 0.12 0.61), P = .0016, and age-adjusted hazard ratio 1.31 per 10 years (95% Cl, 1.11-1.55), P = .0012, were significant independent predictors for estimated survival rate. Seventy-three teeth (17.4%) in 69 patients were extracted during the 10-year follow-up period. The declared reason for extraction was related to endodontic diagnoses in only 5 of the cases (6.8%). Conclusions: Approximately 80% of the teeth treated at this specialist clinic in endodontics survived at least for 10 years. Teeth in young persons and teeth restored with a crown postoperatively survived significantly better. To further explore the importance of the postoperative restoration in endodontically treated teeth, randomized controlled trials need be carried out. BOTT PV, 1994, JOURNAL OF ENDODONTICS, V20, P93
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| 44. |
- Lew, H. P., et al.
(författare)
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Isolation of Alkaline-tolerant Bacteria from Primary Infected Root Canals
- 2015
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Ingår i: Journal of Endodontics. - : Elsevier BV. - 0099-2399. ; 41:4, s. 451-456
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Alkaline-tolerant bacteria in primary infected root canals could have enhanced survival capacity against antimicrobials commonly used in root canal treatment. The aims of this study were to isolate and characterize alkaline-tolerant bacteria before endodontic treatment (S1), after chemomechariital root canal preparation (S2), and after calcium hydroxide dressing (S3). Methods: Bacteriologic samples were obtained from 43 primary infected root canals. Samples were inoculated into culture media at a pH of 9 and incubated anaerobically. The identities of bacterial isolates were determined by 16S ribosomal RNA sequencing. Results: All S1 samples were culture positive, with 70% harboring bacteria tolerating a pH of 9. Gram-positive bacteria Pseudoramibacter alactolyticus and Streptococcus spp were the most frequently isolated strains with a prevalence of 54%. Of 13 culture-positive S2 samples, 8 isolates tolerated a pH of 9, namely Streptococcus sanguinis, Enterococcus faecalis, Enterobacter cancerogen us, Streptococcus oralis, and Fusobacterium nucleatum. Seven of these 8 isolates (88%) were correspondingly isolated at S1. All 3 culture-positive S3 samples tolerated a pH of 9, namely S. sanguinis and E. faecalis, which were also isolated in the corresponding S1 and S2 samples. Conclusions: We showed that the presence of alkaline-tolerant Streptococcus and Enterococcus spp in primary infected root canals could lead to their persistence during and after root canal treatment and could pose a challenge to current treatment efficacy.
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| 45. |
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| 46. |
- Riis, Andreas, et al.
(författare)
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Tooth Survival after Surgical or Nonsurgical Endodontic Retreatment: Long-term Follow-up of a Randomized Clinical Trial
- 2018
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Ingår i: Journal of Endodontics. - : Elsevier BV. - 0099-2399. ; 44:10, s. 1480-1486
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: The aim of the study was to determine long-term tooth survival after endodontic retreatment and whether the presence of intraradicular posts influences the outcome. Methods: Ninety-five teeth were randomly assigned to surgical or nonsurgical endodontic retreatment. Forty-seven teeth in 45 patients were treated by conventional endodontic surgery and 48 teeth (47 patients) by nonsurgical retreatment, including the removal of intraradicular posts in 37 (77%). The outcome was tooth survival; follow-up continued until the tooth had been extracted, at least 10 years had elapsed since retreatment, the patient declined further follow-up, or the patient died. The Fisher exact test was used to analyze differences between the groups. Results: The median follow-up time was 10.1 years (range, 0.0-15.6 years). The overall survival rate was 76%, with no significant differences in long-term tooth survival between retreatment methods or the presence of an intraradicular post. The reasons for tooth extraction were related to the retreatment method. Vertical root fractures were significantly more frequent in the nonsurgical group when retreatment included post removal (P =.036). Conclusions: There was no significant difference in long-term tooth survival after surgical or nonsurgical retreatment. The presence of intraradicular posts did not affect long-term tooth survival, but for teeth with posts, those retreated nonsurgically were more frequently extracted because of vertical root fractures than those retreated surgically (P =.036). The major limitations of the study were a smaller sample size and the use of outmoded retreatment techniques.
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| 47. |
- Sebring, Dan, 1986, et al.
(författare)
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Indications for Extraction before Implant Therapy: Focus on Endodontic Status
- 2019
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Ingår i: Journal of Endodontics. - : Elsevier BV. - 0099-2399. ; 45:5, s. 532-537
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: The aim of the present study was to evaluate endodontic status and diagnosis of teeth before extraction and their impact on treatment planning and treatment outcomes of dental implant therapy. Methods: Data were retrieved from patient files and radiographs of 596 Swedish individuals provided with implant therapy. Patients were categorized according to diagnosis in conjunction with tooth extraction as follows: PERIO (reason for extraction: periodontitis), CARIES (reason for extraction: caries, apical periodontitis, and/or root fracture), OTHER (reason for extraction: trauma and other), and MIX (a combination of these). Details on treatment planning (timing of implant installation and use of prophylactic antibiotics) and outcomes (early/late implant loss and peri-implantitis) were assessed from patient records or by clinical examination. Tooth status (endodontically treated: yes/no; apical lesion: yes/no) and diagnosis category were explored as independent parameters by logistic regression analyses. Results: For the majority of patients (64%), tooth extraction was based on a caries or caries-related diagnosis. Fifty-one percent of all extracted teeth were endodontically treated. Every third tooth showed radiographic signs of an apical lesion. Immediate implant installation at such sites was less common. Endodontic status before extraction was not associated with the use of antibiotics or with treatment outcomes. The diagnosis category MIX was associated with early implant loss. PERIO was indicative of a higher risk for peri-implantitis. Conclusions: Endodontic status before extraction had a limited impact on treatment planning and was not associated with early/late implant loss or peri-implantitis. Immediate implant installation after tooth extraction was less commonly performed at sites with apical lesions.
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| 48. |
- Sedgley, Christine, et al.
(författare)
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Real-time quantitative polymerase chain reaction and culture analyses of Enterococcus faecalis in root canals.
- 2006
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Ingår i: Journal of endodontics. - : Elsevier BV. - 0099-2399. ; 32:3, s. 173-7
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Tidskriftsartikel (refereegranskat)abstract
- Reports on the prevalence of Enterococcus faecalis in root canals vary considerably, potentially because of variations in clinical sampling and sample analysis methods. This study compared culture and real-time quantitative polymerase chain reaction (qPCR) to detect and quantify E. faecalis in the same root canal sample. Consecutive root canal samples obtained from primary infection (n = 40) and retreatment (n = 48) cases were divided into two equal aliquots that were independently analyzed using culture and qPCR by investigators blinded to the analysis results of the other sample. E. faecalis was detected in 10.2% and 79.5% of samples by culture and qPCR, respectively (p < 0.0001; McNemar's test). E. faecalis was detected in more retreatment than primary infection samples (89.6% versus 67.5%; p = 0.01, Fisher's exact test). qPCR reported a significantly higher prevalence of E. faecalis in endodontic samples than culture techniques.
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| 49. |
- Soǧur, Elif, et al.
(författare)
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Does a combination of two radiographs increase accuracy in detecting acid-induced periapical lesions and does it approach the accuracy of cone-beam computed tomography scanning?
- 2012
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Ingår i: Journal of Endodontics. - : Elsevier BV. - 0099-2399. ; 38, s. 131-136
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: The purpose of this study was to determine whether the use of a combination of 2 images (storage phosphor plates [SPPs] and F-speed films [Eastman Kodak, Rochester, NY]) with a 10° difference in horizontal beam angulation resulted in better detectability of chemically created periapical defects than when only 1 image was used and whether a detectability as good as that achieved by limited cone-beam computed tomography (LCBCT) scanning could be achieved. Methods: Lesions were created by 1, 1.5, and 2 hours of acid application apical to extracted teeth in jaw specimens. After repositioning, teeth were radiographed with Accu-I-Tomo LCBCT, Digora Optime SPP system, and F-speed films. The SPPs and films were exposed at 0° and 10° horizontal angulations. The diagnostic accuracy (Az) was compared using 2-way analysis of variance; pair-wise comparisons were performed using the post hoc t test. Kappa was used to measure interobserver agreement. Results: A combination of 2 exposures with a 10° difference in horizontal angulation caused an increase, although not statistically significant, in the accuracy of both films and SPPs for all acid durations (P >.05) compared with when only 1 exposure was used. The accuracy did not approach that of LCBCT. Conclusions: Using a combination of 2 exposures instead of 1 did not significantly increase the accuracy in detecting acid-induced lesions at the apices of single-rooted premolars. The accuracy of LCBCT was superior. Copyright © 2012 American Association of Endodontists.
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| 50. |
- Tan, E. E., et al.
(författare)
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Antibiotics Used in Regenerative Endodontics Modify Immune Response of Macrophages to Bacterial Infection
- 2019
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Ingår i: Journal of Endodontics. - : Elsevier BV. - 0099-2399. ; 45:11, s. 1349-1356
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Ciprofloxacin, amoxicillin, and metronidazole are antibiotics used in regenerative endodontic therapy (RET). Although their antimicrobial properties are well-documented, there is a lack of information on the effects of these antibiotics on the immune response by host macrophages and periapical healing. Thus, this study had 2 objectives: (1) to determine the immune response of macrophages to bacterial infection in response to the combination of ciprofloxacin or amoxicillin and metronidazole and (2) using conditioned media produced by these macrophages to simulate the periapical microenvironment, to determine the impact on the expression of extracellular matrix (ECM) components by periodontal fibroblasts. Methods: Macrophages were treated with ciprofloxacin and metronidazole or amoxicillin and metronidazole at 10–1000 μg/mL. The treated macrophages were exposed to lipopolysaccharide, and the pro- and anti-inflammatory cytokines produced were quantified with enzyme-linked immunosorbent assay. Periodontal fibroblasts were treated with conditioned media from these treated macrophages, and the expression of ECM genes was determined by quantitative polymerase chain reaction. Results: Lipopolysaccharides elicited the production of proinflammatory cytokines interleukin 1 beta and tumor necrosis factor alpha by macrophages, but this was suppressed by ciprofloxacin and metronidazole. Moreover, only conditioned media from macrophages treated with ciprofloxacin and metronidazole rescued microbial-induced down-regulation of ECM genes by periodontal fibroblasts. Specifically, ciprofloxacin was the antibiotic responsible for these observations. In contrast, these effects were not observed with amoxicillin and metronidazole. Conclusions: Apart from disinfection of the root canal system, the combination of ciprofloxacin and metronidazole also exerts an immunomodulatory effect, which may aid in periapical healing. © 2019 American Association of Endodontists
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