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Azerbaycan Saytlari

 »  Home  »  Endodontic Articles 5  »  Bacterial and fungal microleakage of AH26 and AH Plus root canal sealers
Bacterial and fungal microleakage of AH26 and AH Plus root canal sealers
Results - Discussion - References.



Results.
Leakage through the samples varied from 14 to 87 days. All positive controls exhibited bacterial and fungal leakage within 72 h, whilst the broth in lower chambers used for negative controls remained clear throughout the test period. There was no statistically significant difference in leakage amongst the four experimental groups (2 – 1.06, P = 0.787).
Descriptive results for Mantel scores in the four experimental groups are shown in Table 1.
The leakage rate is shown in Figure 2: the percentage of specimens without leakage was uniform for all four groups and no particular intervals of risk were detected.
Biochemical analysis of turbid broth from the apical chambers showed presence of either Streptococcus mutans and Streptococcus mitis, or a mixture of Streptococcus spp. with Lactobacillus acidophilus and/or Prevotella melaninogenica.

Table 1. Descriptive statistic for Mantel scores for four experimental groups.

Descriptive statistic for Mantel scores for four experimental groups

Figure 2. Percentage of specimens without leakage during the experimental period in the four experimental groups.

Percentage of specimens without leakage during the experimental period in the four experimental groups

Discussion.
Both sealers allowed leakage of bacteria and C. albicans during the experimental period. Forty-five per cent of the samples sealed with AH26 leaked bacteria, and 60% leaked C. albicans, whilst amongst the samples sealed with AH Plus, 50% leaked bacteria and 55% leaked C. albicans. There were no statistically significant differences amongst the groups regarding the leakage times and percentages.
Moshonov et al. (1995), in their study of leakage with Staphyloccocus epidermidis in samples sealed with AH26, Roth 801 and Ketac Endo, showed that only two samples with AH26 leaked. Chailertvanitkul et al. (1996a), who used Streptococcus sanguis, found leakage in 16 of 20 samples, whilst the results of our study show leakage in nine of 20 samples sealed with AH26. A number of factors could explain the differences in the results, such as instrumentation technique, obturation technique, the type of microorganisms used, experimental design, and the nature of the irrigant to which the canal was exposed (Chailertvanitkul et al. 1996b).
The number of microorganisms that had caused turbidity was not measured as the purpose was only to prove that some bacteria and yeasts were capable of penetrating root canal fillings. The fact that in some specimens only one microorganism could leak and cause turbidity and in another case more microrganisms could penetrate through the root filling was not considered. However, partial simulation of the complex and dynamic nature of the oral flora was possible by using a mixture of bacterial species, which were changed in the upper chambers every 7 days.
The bacteria most often isolated from the turbid broth were Streptococcus mutans and Streptococcus mitis, whilst Lactobacillus acidophilus and Prevotella melaninogenica were less common and only in combination with Streptococcus spp. Also, Chailertvanitkul et al. (1997) reported that no single Prevotella intermedia sp. alone penetrated through the experimental teeth into the apical chamber. They attributed higher penetration of anaerobic streptococci in comparison with Prevotella intermedia to their smaller size.
The similarity between the leakage of bacteria and fungi in samples sealed with both sealers leads to the conclusion that C. albicans has at least the same capability to penetrate through the sealed root canal as the bacteria. Sen et al. (1997) found that growing hyphae have a tendency to follow cracks and penetrate into dental tubules and this could explain the leakage of C. albicans. Further investigation, both in vitro and in vivo, is needed to establish possible clinical risks of fungal infection.

References.

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Chailertvanitkul P, Saunders WP, Mackenzie D (1996b) An assessment of microbial coronal leakage in teeth root filled with gutta-percha and three different sealers. International Endodontic Journal 29, 387-92.
Chailertvanitkul P, Saunders WP, Mackenzie D (1997) Coronal leakage in teeth root-filled with gutta-percha and two different sealers after long-term storage. Endodontics and Dental Traumatology 13, 82-7.
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