Bohora Aarti A, Kokate Sharad R
Department of Conservative Dentistry and Endodontics Siddhpur Dental College & Hospital, Siddhpur, Gujarat, India, Phone: +919766787431, e-mail:
Department of Conservative Dentistry and Endodontics YMT Ayurvedic Medical College, Hospital & PG Institute, Navi Mumbai, Maharashtra, India.
J Contemp Dent Pract. 2017 Apr 1;18(4):312-316. doi: 10.5005/jp-journals-10024-2037.
The main goal of endodontics is the prevention of apical periodontitis. This is due to the presence of persistent pathogenic microorganisms, such as Enterococcus faecalis, and its ability to directly cause acute and chronic inflammation in the periapical tissues. Lactobacillus has been shown to promote health in the intestines as well as to inhibit the growth of certain problematic oral bacteria. This study explores shifting the established paradigm of endodontic treatment, which has focused on eliminating all bacteria from the canal system and on elimination of the problematic bacteria through introducing probiotics. A preliminary work was performed to evaluate the possible effectiveness of probiotics in preventing the growth of E. faecalis.
Two probiotic cultures Lactobacillus plantarum ATCC 8041 and Lactobacillus rhamnosus ATCC 7408 were selected to check their antimicrobial activity against E. faecalis ATCC 29212 by two methods: agar cup/well diffusion method and deferred antagonism test. Agar cup method: A total of 0.5 mL of requisite test pathogen culture was inoculated into 20 mL of molten sterile Mueller and Hinton agar and cooled to 45 ± 2°C. Circular wells of diameter 10 mm were punched in each of the poured plates. Appropriately diluted test samples were added to the above-punched wells. The plates were incubated upright position at 37°C for 24 hours in aerobic conditions. Postincubation, zone of inhibition was measured. The cell-free supernatant of Lactobacillus species was also evaluated for antimicrobial activity. Deferred antagonism test: The test probiotic strain was standardized to 0.1 optical density (OD) at 600 nm and inoculated in a 1 cm wide diametric streak across the surface of trypticase soy agar + yeast extract + calcium carbonate (TSYCa) agar using a sterile cotton swab. Then, the plate agar containing the test strain was incubated at 37°C for 24 hours under aero-philic condition and then standardized to 0.1 OD at 600 nm for overnight (18 hours, 37°C). A purified culture of indicator strain (pathogen) was streaked at right angles to the line of original producer growth. Postincubation plates were observed for the inhibition zone width of the indicator strain.
Under the conditions of this study, Lactobacilli had an inhibitory effect on the growth of E. faecalis by agar cup method but not by deferred antagonism test.
This pilot study demonstrated that probiotics show a potential in root canal therapy.
If probioitcs are effective against end-odontic pathogens, they can be potentially used as intracanal medicaments. This will be a novel concept of introducing bac-teriotherapy in endodontics and replacing pathogenic bacteria by healthy bacteria, normal flora.
牙髓病学的主要目标是预防根尖周炎。这是由于存在持久性致病微生物，如粪肠球菌，及其直接导致根尖周组织急性和慢性炎症的能力。已证明乳酸杆菌可促进肠道健康，并抑制某些有问题的口腔细菌的生长。本研究探索改变既定的牙髓治疗模式，该模式一直专注于从根管系统中清除所有细菌，并通过引入益生菌来消除有问题的细菌。进行了一项初步工作，以评估益生菌在预防粪肠球菌生长方面的可能效果。
选择两种益生菌培养物，植物乳杆菌ATCC 8041和鼠李糖乳杆菌ATCC 7408，通过两种方法检查它们对粪肠球菌ATCC 29212的抗菌活性：琼脂杯/孔扩散法和延迟拮抗试验。琼脂杯法：将总共0.5 mL所需的测试病原菌培养物接种到20 mL融化的无菌穆勒-欣顿琼脂中，冷却至45±2°C。在每个倾注的平板上打孔直径为10 mm的圆形孔。将适当稀释的测试样品加入上述打孔的孔中。平板在37°C有氧条件下直立培养24小时。培养后，测量抑菌圈。还评估了乳酸杆菌属的无细胞上清液的抗菌活性。延迟拮抗试验：将测试益生菌菌株在600 nm处标准化至0.1光密度（OD），并用无菌棉拭子在胰蛋白酶大豆琼脂+酵母提取物+碳酸钙（TSYCa）琼脂表面接种一条1 cm宽的直径条纹。然后，将含有测试菌株的平板琼脂在37°C需氧条件下培养24小时，然后在600 nm处标准化至0.1 OD过夜（18小时，37°C）。将指示菌株（病原菌）的纯化培养物与原始生产者生长线成直角划线。培养后的平板观察指示菌株的抑菌圈宽度。
在本研究条件下，乳酸杆菌通过琼脂杯法对粪肠球菌的生长有抑制作用，但通过延迟拮抗试验则没有。
这项初步研究表明益生菌在根管治疗中显示出潜力。
如果益生菌对牙髓病病原体有效，它们有可能用作根管内药物。这将是在牙髓病学中引入细菌疗法并用健康细菌、正常菌群替代病原菌的一个新概念。
