title: Effect of the Association of Nonsteroidal Anti-inflammatory and Antibiotic Drugs on Antibiofilm Activity and pH of Calcium Hydroxide Pastes.
abstract: BACKGROUND
  The objective of the present study was to evaluate the in vitro antibiofilm activity and pH of calcium hydroxide associated with different nonsteroidal anti-inflammatory drugs (NSAIDs).
  
  
  METHODS
  The groups analyzed were as follows: group 1, calcium hydroxide paste with propylene glycol; group 2, calcium hydroxide paste with propylene glycol + 5% diclofenac sodium; group 3, calcium hydroxide paste with propylene glycol + 5% ibuprofen; group 4, calcium hydroxide paste with propylene glycol + 5% ciprofloxacin; and group 6, positive control (without medication). For analysis of the pH, the pastes were inserted into tubes and immersed in flasks containing ultrapure water. At the time intervals of 3, 24, 72, and 168 hours, the pH was measured with a calibrated pH meter. For microbial analysis, biofilm was induced in 30 bovine dentin blocks for 21 days. Subsequently, the pastes were placed on the blocks with biofilm for 7 days. Afterward, the pastes were removed by irrigation with sterile water, and the specimens were analyzed with a laser scanning confocal microscope with the 50 μL Live/Dead BacLight Bacterial Viability solution L7012 Kit (Molecular Probes, Inc, Eugene, OR). Data were subjected to statistical analysis at a significance level of 5%.
  
  
  RESULTS
  The highest pH values were found for calcium hydroxide associated with ciprofloxacin in all periods analyzed. With the exception of pure calcium hydroxide paste, the other groups showed statistically significant differences (P < .05) in comparison with the positive control.
  
  
  CONCLUSIONS
  The association of NSAIDs or antibiotic did not interfere with the pH of calcium hydroxide paste and increased the antimicrobial action of calcium hydroxide paste against Enterococcus faecalis biofilm formation.
authors.affiliation: Universidade do Sagrado Coração, Pro-Rectory of Research and Post Graduation, Bauru, Sao Paulo, Brazil.
authors.forename: Rafaela Pignatti
authors.initials: RP
authors.lastname: de Freitas
authors.affiliation: Department of Drugs and Medical, Pharmaceutical Biotechnology Laboratory, School of Pharmaceutical Sciences, São Paulo State University, Araraquara, Sao Paulo, Brazil.
authors.forename: Vanessa Raquel
authors.initials: VR
authors.lastname: Greatti
authors.affiliation: Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, Sao Paulo, Brazil.
authors.forename: Murilo Priori
authors.initials: MP
authors.lastname: Alcalde
authors.affiliation: Department of Restorative Dentistry, Federal University of Paraná, Curitiba, Parana, Brazil.
authors.forename: Bruno Cavalini
authors.initials: BC
authors.lastname: Cavenago
authors.affiliation: Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, Sao Paulo, Brazil. Electronic address: rodrigo.vivan@fob.usp.br.
authors.forename: Rodrigo Ricci
authors.initials: RR
authors.lastname: Vivan
authors.affiliation: Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, Sao Paulo, Brazil.
authors.forename: Marco Antonio Hungaro
authors.initials: MA
authors.lastname: Duarte
authors.affiliation: Lauro de Souza Lima Institute, Micology Department, Bauru, Sao Paulo, Brazil.
authors.forename: Ana Carolina Villas Bôas
authors.initials: AC
authors.lastname: Weckwerth
authors.affiliation: Universidade do Sagrado Coração, Pro-Rectory of Research and Post Graduation, Bauru, Sao Paulo, Brazil.
authors.forename: Paulo Henrique
authors.initials: PH
authors.lastname: Weckwerth
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000627:therapeutic use*; D018441:Biofilms / Q000187:drug effects*; D002126:Calcium Hydroxide / Q000627:therapeutic use*; D003738:Dental Cements / Q000627:therapeutic use*; D004008:Diclofenac / Q000008:administration & dosage / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D013293:Enterococcus faecalis / Q000187:drug effects* / Q000254:growth & development; D006863:Hydrogen-Ion Concentration / Q000187:drug effects; D066298:In Vitro Techniques
chemical_list: D000900:Anti-Bacterial Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D003738:Dental Cements; D004008:Diclofenac; D002126:Calcium Hydroxide
keywords: Antibiofilm action; calcium hydroxide; diclofenac; ibuprofen; intracanal medication