Jörg F. Schirrmeister

New Bacterial Compositions in Root-filled Teeth with Periradicular Lesions

The aim of this study was to isolate and detect microorganisms of root-filled teeth associated with periradicular lesions. Specimens were sampled from patients undergoing root canal retreatment. The bacteria were characterized by morphologic and biochemical analysis and by 16S rRNA gene sequencing. Microorganisms were detected in 10 of 18 teeth. The majority of positive samples revealed a mixed culture of 2-8 species. In 2 teeth Enterococcus faecalis was the only detected species. For the first time Vagococcus fluvialis was detected in root canals. Solobacterium moorei and Fusobacterium nucleatum were the most prevalent species. Presence of F. nucleatum was associated with the presence of S. moorei in 5 of 7 cases. In all teeth with Parvimonas micra and Dialister invisus, F. nucleatum and S. moorei were found. Moreover, members of additional different genera were detected delivering bacterial compositions that have been not described yet.

Cleanliness of dentinal tubules following gutta-percha removal with and without solvents: a scanning electron microscopic study.

AIM To determine the influence of solvents on gutta-percha and sealer remaining on root canal walls and in dentinal tubules. METHODOLOGY The root canals of 70 teeth were prepared chemomechanically to apical size 40. In group 1 (n = 10; control group), the canals remained unfilled. In groups 2-4 (n = 20 each), the canals were filled using lateral compaction with gutta-percha and sealer. Removal of root fillings was undertaken after 2 weeks using Gates Glidden burs and hand files without solvent (group 2), with eucalyptol (60 microL; group 3) and with chloroform (60 microL; group 4) to size 50. After further irrigation using sodium hypochlorite and ethylenediaminetetraacetic acid, the roots were split, photographed and scanning electron microscopy (SEM) was performed. The number of filled dentinal tubules (SEM) and the surface covered by root filling remnants (photographs) were evaluated for the coronal, middle and apical third of each root half. Statistical analysis was performed via mixed model for clustered data followed by Tukeys test. RESULTS After pooling the results of all thirds of the canal, open tubules were more prevalent in the control group, followed by the nonsolvent group, the eucalyptol group and the chloroform group (P < 0.05 between all groups). Less surface was covered by root filling remnants in the nonsolvent group than in the eucalyptol group and the chloroform group (P < 0.05); again, fewer remnants were found in the control group than in all other groups (P < 0.05). CONCLUSIONS Solvents led to more gutta-percha and sealer remnants on root canal walls and inside dentinal tubules.

Effects of various forms of calcium added to chewing gum on initial enamel carious lesions in situ.

The purpose of this randomized, cross-over in situ study was to determine the effects of 4 chewing gums on artificial caries-like subsurface lesions. Two chewing gums (1 with zinc citrate and 1 without) contained dicalcium phosphate (3.9%), calcium gluconate (1.8%) and calcium lactate (0.45%), 1 chewing gum contained casein phosphopeptide-amorphous calcium phosphate nanocomplexes (0.7%), and another one contained no calcium. Fifteen subjects without current caries activity (7 male, 8 female; mean age: 27.5 ± 2.5 years) wore removable buccal appliances in the lower jaw with 4 bovine enamel slabs with subsurface lesions. The appliances were inserted immediately before gum chewing for 20 min and then retained for an additional 20 min. This was performed 4 times per day. Every subject chewed 4 different chewing gums over 4 periods of 14 days each. During a fifth period (control) the subjects only wore the appliances without chewing gum. At completion of each period the enamel slabs were embedded, sectioned and subjected to transversal microradiography. With regard to change of mineral loss and of lesion depth no significant differences could be found between chewing gums containing calcium and calcium-free chewing gums. Moreover, the chewing gum groups and the control group did not differ significantly if adjustments were made for baseline values (p > 0.05; ANCOVA). Under the conditions of the present study it may be concluded that the use of chewing gum offers no additional remineralizing benefit to buccal tooth surfaces, even if the chewing gum contains calcium compounds.

Endodontic and Salivary Isolates of Enterococcus faecalis Integrate into Biofilm from Human Salivary Bacteria Cultivated In Vitro

INTRODUCTION The aim of this study was to examine whether Enterococcus faecalis isolates from endodontic patients (from saliva and from a root canal) are able to prevail against salivary bacteria when grown in coculture in a biofilm reactor. METHODS Saliva that was tested to be free of E. faecalis was used as the inoculum. The fate of E. faecalis was examined by using culture techniques and fluorescence in situ hybridization (FISH). RESULTS The root canal isolate accounted for 37.4% of the biofilm and 31.9% of the planktonic phase when examined by the culture technique, whereas the proportions examined by FISH showed 15.3% in the biofilm and 11.7% in the planktonic phase. The saliva isolate (as examined by the culture technique) accounted for 32.4% in the biofilm and 27.1% in the planktonic phase, respectively, compared with 14.1% in the biofilm and 9.5% in the planktonic phase when examined by FISH analysis. CONCLUSIONS These results led to the suggestion that E. faecalis could persist in the biofilm of the human oral cavity. Because of the ubiquitous presence of E. faecalis, root canal infections may arise from different sources.

Fluoride Uptake and Remineralisation of Enamel Lesions after Weekly Application of Differently Concentrated Fluoride Gels

There is only little information on the remineralising capability of regularly applied highly concentrated fluoride gels. The aim of this in situ study was to test the hypothesis that weekly application of a 1.25% fluoride gel results in a significantly higher fluoride uptake and a significantly higher mineral gain compared to a 0.5% fluoride or a placebo gel, respectively. Thirty-six subjects were included in this double-blind, three-way, crossover, placebo-controlled study and randomly assigned to a treatment scheme. Two weeks before the study, between treatment periods as well as during the study periods, subjects were instructed to abstain from any fluoride source other than the study medication. At the beginning of each of three 4-week periods specimen holders, each containing 10 bovine enamel slabs, were placed in the subjects’ mouths. During the experimental periods the volunteers brushed the specimens with placebo gel, 0.5% fluoride gel or 1.25% fluoride gel once a week. Fluoride uptake was significantly higher after treatment with the 1.25% fluoride gel than after treatment with the 0.5% fluoride gel (p = 0.007) or the placebo gel (p < 0.001). Treatment with 0.5% fluoride gel led to a significantly higher fluoride uptake compared to placebo treatment (p < 0.001). Changes in mineral gain and lesion depth were not statistically significantly different between the three groups. Under the present experimental conditions repeated application of highly concentrated fluoride gels did not promote remineralisation significantly.

Characterization of the First Oral Vagococcus Isolate from a Root-Filled Tooth with Periradicular Lesions

Strain Endo-EH was isolated from a root-filled tooth associated with periradicular lesions. After subculturing on Columbia blood agar, phenotypic and genomic characterizations using different biochemical test systems, automated ribotyping, MALDI-TOF mass spectronomy, antibiotic susceptibility testing, and 16S rRNA gene sequence analysis were applied for further analysis. Phenotypic characterization identified this strain as Vagococcus fluvialis. Riboprint pattern analysis and 16S rRNA sequencing clearly separated it from relevant genera such as Enterococcus and Tetragenococcus and also from other Vagococcus species. This taxon is a new entry to the list of more than 200 microbial species detected in infected root canal systems.

In situ fluoride retention and remineralization of incipient carious lesions after the application of different concentrations of fluoride

Limited information is available on the time-dependent or dosage-dependent cariostatic efficacy of highly concentrated fluoride compounds. This good clinical practice-conforming, double-blind, placebo-controlled, crossover in situ study tested the hypothesis that a 1.0% amine fluoride fluid is superior to a 0.5% amine fluoride fluid regarding fluoride retention and mineral change in initial caries enamel lesions over a period of 28 d. Fluoride retention was significantly higher after application of the two fluoride fluids compared with placebo but had decreased in both groups to similar levels after only 1 wk. Mineral gain was significantly higher for both verum groups compared with placebo. The use of 1% fluoride fluid resulted in significantly higher remineralization compared with the use of 0.5% fluoride fluid. For both fluoride fluids mineral gain followed a linear relationship with time during the experimental period, indicating a possible further uptake of mineral, even after 4 wk.

Combination of apex locator and endodontic motor for continuous length control during root canal treatment.

AIM To compare ex vivo an experimental setup consisting of an electronic apex locator (EAL) and endodontic motor with an established product (Tri Auto ZX) for accuracy of length control during root canal treatment with three different types of files. METHODOLOGY An experimental setup consisting of porous spongy material and an electrolyte was used. Sixty anterior teeth were randomly assigned to six groups. Access cavities were prepared. During root canal treatment, constant length monitoring was performed either with the Tri Auto ZX or the Raypex5 apex locator attached to an endodontic motor (Endo IT professional) using ProTaper, M(two) or FlexMaster files. After root canal preparation the distances between file tip and major apical foramen and file tip and minor apical foramen were measured using a microscope and analysed using two-way anova to evaluate the accuracy of the two systems. RESULTS Distances between the file tip and the major apical foramen were not significantly different between the file systems and the two EALs. In cases treated with FlexMaster significantly larger distances between file tip and minor apical foramen were found compared to M(two) and ProTaper. No significant differences were observed between the two EALs. After preparation of the root canals with the Tri Auto ZX, multiple minor apical foramina were mechanically widened. CONCLUSION With the limitation of this laboratory study the combination of EAL and endodontic motor was as accurate as the Tri Auto ZX system in terms of length control during root canal preparation.