Avaliação do efeito sinérgico da associação do hipoclorito de sódio com dióxido de carbono contra o biofilme de Enterococcus faecalis
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2022-11-22
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Universidade Estadual Paulista (Unesp)
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Objetivo: Avaliar a eficácia da associação do dióxido de carbono (CO2) pressurizado ao hipoclorito de sódio (NaOCl) na inativação do biofilme de Enterococcus faecalis presentes no interior dos canais radiculares e nos túbulos dentinários por meio de cultura microbiológica. Material e métodos: 40 pré-molares inferiores humanos extraídos, previamente esterilizados, com único canal, foram contaminados com E. faecalis por um período de 10 dias. Os dentes, então, foram distribuídos aleatoriamente em quatro grupos experimentais (n=10) de acordo com o protocolo de irrigação, conforme segue: irrigação convencional com hipoclorito de sódio 2,5% (NaOCl); irrigação convencional com NaOCl 2,5% associado ao dióxido de carbono (CO2); solução salina estéril; solução salina estéril associada ao CO2. O pH e temperatura da solução de NaOCl 2,5% foram analisados puro e em combinação com a adição de CO2 em diferentes pressões (1 a 10) usando um pHmetro digital calibrado a 25°C. As medições foram registradas em 30 e 60 segundos após cada adição de CO2. A carga microbiana no interior dos canais radiculares, foi avaliada pela contagem de unidades formadoras de colônias nas placas comparando a coleta inicial (S1) com a coleta do canal após a irrigação (S2) e nos túbulos dentinários, avaliada por meio da contagem de unidades formadoras de colônia através da coleta de raspas de dentina dos túbulos dentinários após a irrigação nos 3 terços da raiz. O teste Two Way Repeated Measures ANOVA seguido de Post-Hoc de Student-Newman-Keuls foi usado para Comparação intergrupos e diferentes tempos de amostragem. Uma comparação intragrupo com terços radiculares também foi realizada por meio do teste Two Way Repeated Measures ANOVA seguido de Student-Newman-Keuls ao nível de significância estabelecido em 5% (p < 0,05). Resultados: Bactérias cultiváveis estavam presentes em todas as amostras S1 (p > 0,05). Todos os protocolos de irrigação foram eficazes na redução da carga bacteriana, independente da solução utilizada (p < 0,05). Houve diferença estatística nos grupos do NaOCl 2,5% e NaOCl 2,5% associado ao CO2 comparados à solução fisiológica, no interior dos canais radiculares. Em relação à análise dentinária, o grupo NaOCl 2,5% + CO2 apresentou diferença significativa em todos os terços, com maior redução de UFC/ml no terço cervical. Não foi observada diferença significativa ao comparar os terços nos grupos de solução salina estéril. Após 10 pressões, houve redução do valor do pH para 7,43 e aumento da temperatura da solução para 28°C. Conclusão: Embora a associação de CO2 com NaOCl 2,5% favoreça sua capacidade de reduzir bactérias no interior do canal radicular, não potencializou seu efeito bactericida no interior dos túbulos dentinários.
Objective: to evaluate the effectiveness of the association of pressurized carbon dioxide (CO2) with sodium hypochlorite (NaOCl) in the inactivation of the Enterococcus faecalis biofilm present inside the root canals and in the dentinal tubules through microbiological culture. Material and methods: 40 extracted human lower premolars previously sterilized, with a single canal, were contaminated with E. faecalis for a period of 10 days. The teeth were randomly distributed into four experimental groups (n=10) according to the irrigation protocol, as follows: conventional irrigation with 2.5% sodium hypochlorite (NaOCl); conventional irrigation with 2.5% NaOCl associated with carbon dioxide (CO2); sterile saline solution; sterile saline solution associated with CO2. The pH and temperature of the 2.5% NaOCl solution were analyzed neat and in combination with the addition of CO2 at different pressures (1 to 10) using a digital pH meter calibrated at 25° C. Measurements were recorded at 30 and 60 seconds after each CO2 addition. The microbial load inside the root canals was evaluated by counting colony forming units in the plates comparing the initial collection (S1) with the collection of the canal after irrigation (S2) and in the dentinal tubules, evaluated by counting colony forming units by collecting dentin shavings from dentinal tubules after irrigation in the 3 thirds of the root. Data normality was verified by the Shapiro-Wilk test. The Two Way Repeated Measures ANOVA Student-Newman-Keuls Post-Hoc test was used for intergroup comparison and different sampling times. One Way Analysis of Variance on Ranks was used for % of CFU reduction. An intragroup comparison with root thirds was also performed using the Student-Newman-Keuls test. The Two Way Repeated Measures ANOVA Student-Newman-Keuls Post-Hoc test was used for intergroup comparison and different sampling times. An intragroup comparison with root thirds was also performed using the Student-Newman-Keuls test. The significance level was set at 5% (p < 0.05). Results: Cultivable bacteria were present in all S1 samples (p>0.05). All protocols and irrigation were effective in reducing bacterial load, regardless of the solution used (p < 0.05). There was a statistical difference in the 2.5% NaOCl and 2.5% NaOCl groups associated with CO2 compared to saline solution. Regarding the dentin analysis, the 2.5% NaOCl + CO2 group showed a significant difference in all thirds, with a greater reduction of CFU/ml in the cervical third. No significant difference was observed when comparing the thirds in the sterile saline groups. After 10 pressures, there was a reduction in the pH value to 7.43 and an increase in the temperature of the solution to 28°C. Conclusion: Although the association of CO2 with 2.5% NaOCl favors its ability to reduce bacteria inside the root canal, it did not potentiate its bactericidal effect on the inside of the dentinal tubules.
Objective: to evaluate the effectiveness of the association of pressurized carbon dioxide (CO2) with sodium hypochlorite (NaOCl) in the inactivation of the Enterococcus faecalis biofilm present inside the root canals and in the dentinal tubules through microbiological culture. Material and methods: 40 extracted human lower premolars previously sterilized, with a single canal, were contaminated with E. faecalis for a period of 10 days. The teeth were randomly distributed into four experimental groups (n=10) according to the irrigation protocol, as follows: conventional irrigation with 2.5% sodium hypochlorite (NaOCl); conventional irrigation with 2.5% NaOCl associated with carbon dioxide (CO2); sterile saline solution; sterile saline solution associated with CO2. The pH and temperature of the 2.5% NaOCl solution were analyzed neat and in combination with the addition of CO2 at different pressures (1 to 10) using a digital pH meter calibrated at 25° C. Measurements were recorded at 30 and 60 seconds after each CO2 addition. The microbial load inside the root canals was evaluated by counting colony forming units in the plates comparing the initial collection (S1) with the collection of the canal after irrigation (S2) and in the dentinal tubules, evaluated by counting colony forming units by collecting dentin shavings from dentinal tubules after irrigation in the 3 thirds of the root. Data normality was verified by the Shapiro-Wilk test. The Two Way Repeated Measures ANOVA Student-Newman-Keuls Post-Hoc test was used for intergroup comparison and different sampling times. One Way Analysis of Variance on Ranks was used for % of CFU reduction. An intragroup comparison with root thirds was also performed using the Student-Newman-Keuls test. The Two Way Repeated Measures ANOVA Student-Newman-Keuls Post-Hoc test was used for intergroup comparison and different sampling times. An intragroup comparison with root thirds was also performed using the Student-Newman-Keuls test. The significance level was set at 5% (p < 0.05). Results: Cultivable bacteria were present in all S1 samples (p>0.05). All protocols and irrigation were effective in reducing bacterial load, regardless of the solution used (p < 0.05). There was a statistical difference in the 2.5% NaOCl and 2.5% NaOCl groups associated with CO2 compared to saline solution. Regarding the dentin analysis, the 2.5% NaOCl + CO2 group showed a significant difference in all thirds, with a greater reduction of CFU/ml in the cervical third. No significant difference was observed when comparing the thirds in the sterile saline groups. After 10 pressures, there was a reduction in the pH value to 7.43 and an increase in the temperature of the solution to 28°C. Conclusion: Although the association of CO2 with 2.5% NaOCl favors its ability to reduce bacteria inside the root canal, it did not potentiate its bactericidal effect on the inside of the dentinal tubules.
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Palavras-chave
Irrigantes do canal radicular, Hipoclorito de sódio, Dioxido de carbono, Bactérias, Biofilmes, Dióxido de carbono, Carbon dioxide