State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology Sichuan University, Chengdu, 610041, China.
Department of Cariology and Endodontics, West China Hospital of Stomatology Sichuan University, Chengdu, 610041, China.
Sci Rep. 2019 Jul 23;9(1):10632. doi: 10.1038/s41598-019-47032-8.
Persistent apical periodontitis, mainly caused by microorganisms infections, represents a critical challenge for endodontists. Dimethylaminododecyl methacrylate (DMADDM) is a well-studied and potent antibacterial agent used in various studies described in the literature. The aim of this study is to develop a novel antibacterial root canal sealer by incorporating DMADDM into EndoREZ and investigate the properties of the resulting material. Different mass fractions (0, 1.25%, 2.5%, and 5%) of DMADDM were incorporated into EndoREZ and the cytotoxicity, apical sealing ability and solubility of the resulting material were evaluated. Furthermore, a direct contact test, determination of colony-forming units, a crystal violet assay, scanning electronic microscopy and live/dead bacteria staining were performed to evaluate the antibacterial effect of the sealer to multispecies bacteria (Enterococcus faecalis, Streptococcus gordonii, Actinomyces naeslundii, and Lactobacillus acidophilus), in planktonic cells or biofilms. Fluorescence in situ hybridization and quantitative real-time polymerase chain reaction were carried out to assess the composition of the multispecies biofilms. No difference on the cytotoxicity, apical sealing ability and solubility between sealers containing DMADDM (1.25%, 2.5%) and EndoREZ (0%) could be determined. However, when the mass fraction of DMADDM increased to 5%, significantly different properties were found compared to the 0% (p < 0.05) group. Moreover, incorporating DMADDM into the sealer could greatly improve the antibacterial properties of EndoREZ. In addition, the composition ratio of E. faecalis could be decreased in multispecies microecology in sealers containing DMADDM. Therefore, a EndoREZ sealer material containing DMADDM could be considered useful in clinical applications for preventing and treating persistent apical periodontitis.
持续性根尖周炎主要由微生物感染引起，是牙髓病医生面临的重大挑战。二甲氨基十二烷基甲基丙烯酸酯（DMADDM）是一种经过广泛研究的有效抗菌剂，已在文献中描述的各种研究中使用。本研究旨在通过将 DMADDM 掺入 EndoREZ 来开发一种新型的抗菌根管封闭剂，并研究由此产生的材料的性能。将不同质量分数（0、1.25%、2.5%和 5%）的 DMADDM 掺入 EndoREZ，并评估所得材料的细胞毒性、根尖封闭能力和溶解度。此外，还进行了直接接触试验、菌落形成单位测定、结晶紫测定、扫描电子显微镜和活菌/死菌染色，以评估密封剂对多菌种（粪肠球菌、戈登链球菌、奈瑟氏放线菌和嗜酸乳杆菌）浮游细胞或生物膜的抗菌作用。荧光原位杂交和实时定量聚合酶链反应用于评估多菌种生物膜的组成。含有 DMADDM（1.25%、2.5%）和不含 DMADDM 的 EndoREZ（0%）的密封剂在细胞毒性、根尖封闭能力和溶解度方面没有差异。然而，当 DMADDM 的质量分数增加到 5%时，与 0%（p<0.05）组相比，发现了明显不同的性质。此外，将 DMADDM 掺入密封剂中可以极大地提高 EndoREZ 的抗菌性能。此外，在含有 DMADDM 的密封剂中，多菌种微生态中粪肠球菌的组成比例可以降低。因此，含有 DMADDM 的 EndoREZ 密封材料可考虑用于预防和治疗持续性根尖周炎的临床应用。
