title: Antibacterial Efficacy of Pastes Against E Faecalis in Primary Root Dentin: A Confocal Microscope Study.
abstract: OBJECTIVE
  Management of abscessed primary teeth often present endodontic failure owing to questioned efficiency of dressings or obturating pastes to eliminate Enterococcus faecalis, a resistant bacterium, residing in depth of dentinal tubules. The present study evaluates the antimicrobial efficacy of two antibacterial and two obturating pastes in dentinal tubules of primary teeth infected with Enterococcus faecalis using viability stain and confocal laser scanning microscope (CLSM).
  
  
  METHODS
  Total 28 samples were prepared.Four groups with 6 samples each were made according to antibacterial pastes i.e. 1% or 2%Chlorhexidine (CHX) + calcium hydroxide (CH), CH + iodoform (Metapex) and Zinc Oxide Eugenol (ZOE). Dentinal tubules from the root canal side were infected with E. faecalis by centrifugation of the bacterial suspension. Two specimens from each group were subjected to 1, 7 and 15 days antibacterial pastes exposure. Viability staining followed by CLSM were used to quantitatively analyze the dead cell count directly inside dentin.
  
  
  RESULTS
  Univariate analysis showed that all medicaments were significantly effective (p<.05). Kruskal wallis ANOVA test did not show significant difference among four medicaments at day 1 while it was significantly different at day 7 & 15. Paired sample student's t-test revealed significant difference in efficacy between 1& 15 days for 1%CHX+CH; between 1&15,and 7&15 days; between all days for ZOE. Ranking of antimicrobial efficacy of tested medicament was (most effective to the least): 1%CHX+CH(15)> ZOE(15)> Metapex(15)> 2%CHX+CH(15)> 2%CHX+CH(7)> 2%CHX+CH(1)> 1%CHX+CH(7)> 2%CHX+CH(15)> Metapex(1)> ZOE(1)> ZOE(7).
  
  
  CONCLUSIONS
  All medicaments were effective against E. faecalis in dentine of primary teeth and their efficacy increased with longer contact with 1%CHX+CH being most effective at day 15. Inclusion of 1% CHX in dressings or obturating pastes might minimize the endodontic relapse and maximize the tooth retention in functional state in pediatric dentistry.
authors.affiliation: From the Modern Dental College and Research Centre, Gandhi Nagar, Air Port Road Indore (MP), India.
authors.forename: R
authors.initials: R
authors.lastname: Verma
authors.affiliation: From the Modern Dental College and Research Centre, Gandhi Nagar, Air Port Road Indore (MP), India.
authors.forename: D S
authors.initials: DS
authors.lastname: Sharma
authors.affiliation: From the Modern Dental College and Research Centre, Gandhi Nagar, Air Port Road Indore (MP), India.
authors.forename: A K
authors.initials: AK
authors.lastname: Pathak
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D000891:Anti-Infective Agents, Local / Q000494:pharmacology; D058491:Bacterial Load / Q000187:drug effects; D002126:Calcium Hydroxide / Q000494:pharmacology; D002710:Chlorhexidine / Q000494:pharmacology; D003786:Dental Pulp Cavity / Q000382:microbiology*; D003804:Dentin / Q000382:microbiology*; D013293:Enterococcus faecalis / Q000187:drug effects*; D005456:Fluorescent Dyes; D006801:Humans; D008422:Materials Testing; D050296:Microbial Viability / Q000187:drug effects; D018613:Microscopy, Confocal; D008855:Microscopy, Electron, Scanning; D012387:Root Canal Filling Materials / Q000494:pharmacology*; D012388:Root Canal Irrigants / Q000494:pharmacology*; D012827:Silicone Oils / Q000494:pharmacology; D013997:Time Factors; D014094:Tooth, Deciduous / Q000382:microbiology*; D015035:Zinc Oxide-Eugenol Cement / Q000494:pharmacology
chemical_list: D000900:Anti-Bacterial Agents; D000891:Anti-Infective Agents, Local; D005456:Fluorescent Dyes; C498115:Metapex; D012387:Root Canal Filling Materials; D012388:Root Canal Irrigants; D012827:Silicone Oils; D015035:Zinc Oxide-Eugenol Cement; D002126:Calcium Hydroxide; D002710:Chlorhexidine
keywords: Enterococcus faecalis; Root canals; children; live/dead fluorescent stain Confocal laser scanning microscopy