Купить СНПЧ А7 Архангельск, оперативня доставка

crosscheckdeposited

A Ação do Hidróxido de Cálcio Frente ao Enterococcus faecalis nos Casos de Periodontite Apical Secundária

DOI: http://dx.doi.org/10.15603/2176-1000/odonto.v18n36p95-105

https://www.metodista.br/revistas/revistas-ims/index.php/O1/index 

downloadpdf

Bruno M. da Silva1, Flávia S. F. Tomazinho2, Juliana A. Anele1, Denise P. Leonardi3 & Flares Baratto Filho4

 

Resumo: Introdução: a infecção da polpa e dos tecidos periapicais tem a sua etiologia discutida há anos. A periodontite apical é caracterizada por ser de origem polimicrobiana, sendo o Enterococcus faecalis o microorganismo mais comumente encontrado. Em situações clínicas, o objetivo do tratamento endodôntico é eliminar micro-organismos do sistema de canais radiculares. As medicações intracanal são um importante passo no tratamento e devem ser efetivas frente aos micro-organismos que resistem ao preparo do canal radicular. Dentre as medicações empregadas, o hidróxido de cálcio é utilizado rotineiramente como medicação intracanal. Sua ação se deve ao fato de estabelecer um pH altamente alcalino dentro do canal radicular, 12,5 aproximadamente, no qual a maioria dos microorganismos não consegue sobreviver. Objetivo: realizar uma revisão de literatura sobre a relação do Enterococcus faecalis no insucesso endodôntico e a efetividade do hidróxido de cálcio nesta situação clínica. Conclusão: a ação do hidróxido de cálcio frente ao Enterococcus faecalis é limitada.

Palavras-chave: Enterococcus Faecalis; Hidróxido de Cálcio; Periodontite Apical.

 

Abstract: Introduction: Pulp and periapical tissue infection etiology has been discussed for many years. Apical periodontitis is characterized by multimicrobial flora origin, in which Enterococcus faecalis is the microorganism more frequently found. In clinical situations, the aim of endodontic treatment is to remove microorganisms of the system of root canals. Intra canal medications are an important step in the treatment and they must be effective in microorganisms that resist the preparation of the root canal. Among all used medications, the calcium hydroxide is frequently used. It acts establishing a highly alkaline pH inside the root canal, 12.5 approximately, in which most of the microorganisms do not manage to survive. Aim: to make a review of the literature about the relationship on the Enterococcus faecalis on endodontic failure and calcium hydroxide effectiveness in this clinical situation. Conclusion: Calcium hydroxide has limited action against Enterococcus faecalis.

Key words: Enterococcus Faecalis; Calcium Hydroxide; Apical Periodontitis.

 

1 Especialista em Endodontia – Universidade Positivo (Curitiba – PR), Mestrando em Odontologia – Universidade Positivo (Curitiba – PR).
2 Professora da Disciplina de Endodontia – Universidade Positivo (Curitiba – PR), Mestre em Endodontia – C. P. O. São Leopoldo Mandic (Campinas – SP), Doutoranda em Endodontia – Universidade de Ribeirão Preto (Ribeirão Preto – SP).
3 Professora do Mestrado em Odontologia – Universidade Positivo (Curitiba – PR), Especialista, Mestre e Doutora em Endodontia – Universidade Estadual de São Paulo (Araraquara – SP).
4 Coordenador do Mestrado em Odontologia – Universidade Positivo (Curitiba – PR), Especialista em Endodontia – Pontifícia Universidade Católica do Paraná (Curitiba – PR), Mestre em Endodontia – Universidade de Ribeirão Preto (Ribeirão Preto – SP) e Doutor em Endodontia – Universidade de Pernambuco (Recife – PE).

 

Literatura Citada

1. Kakehashi S, Stanley HR, Fitzgerald RJ. The Effects of Surgical Exposures of Dental Pulps in Germ-Free and Conventional Laboratory Rats. Oral Surg Oral Med Oral Pathol 1965;20:340-9. https://doi.org/10.1016/0030-4220(65)90166-0

2. Gomes BPFA, Pinheiro ET, Gadê-Neto CR, Souza ELR, Ferraz CCR, Zaia AA. Microbiological examination of infected dental root canals. Oral Microbiol Immunol 2004;19(2):71-6. https://doi.org/10.1046/j.0902-0055.2003.00116.x

3. Siqueira JF, Rocas IN. Polymerase chain reaction-based analysis of microorganisms associated with failed endodontic treatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2004;97(1):85-94. https://doi.org/10.1016/S1079-2104(03)00353-6

4. Peciuliene V, Reynaud AH, Balciuniene I, Haapasalo M. Isolation of yeasts and enteric bacteria in root-filled teeth with chronic apical periodontitis. Int Endod J 2001;34(6):429- 34. https://doi.org/10.1046/j.1365-2591.2001.00411.x

5. Love RM. Enterococcus faecalis - a mechanism for its role in endodontic failure. Int Endod J 2001;34(5):399-405. https://doi.org/10.1046/j.1365-2591.2001.00437.x

6. Neelakantan P, Sanjeev K, Subbarao CV. Duration-dependent susceptibility of endodontic pathogens to calcium hydroxide and chlorhexidene gel used as intracanal medicament: an in vitro evaluation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007;104(4):e138-41. https://doi.org/10.1016/j.tripleo.2007.04.035

7. Gomes BP, Vianna ME, Sena NT, Zaia AA, Ferraz CC, de Souza Filho FJ. In vitro evaluation of the antimicrobial activity of calcium hydroxide combined with chlorhexidine gel used as intracanal medicament. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006;102(4):544-50. https://doi.org/10.1016/j.tripleo.2006.04.010

8. Siqueira JF. Aetiology of root canal treatment failure: why well-treated teeth can fail. Int Endod J 2001;34(1):1-10. https://doi.org/10.1046/j.1365-2591.2001.00396.x

9. Sundqvist GF. Life as an endodontic pathogen Ecological differences between the untreated and root-filled root canals. Endod Topics 2003;6:3-28. https://doi.org/10.1111/j.1601-1546.2003.00054.x

10. Nair PN. Apical periodontitis: a dynamic encounter between root canal infection and host response. Periodontol 2000 1997;13:121-48. https://doi.org/10.1111/j.1600-0757.1997.tb00098.x

11. Waltimo TM, Sen BH, Meurman JH, Orstavik D, Haapasalo MP. Yeasts in apical periodontitis. Crit Rev Oral Biol Med 2003;14(2):128-37. https://doi.org/10.1177/154411130301400206

12. Molander A, Reit C, Dahlen G, Kvist T. Microbiological status of root-filled teeth with apical periodontitis. Int Endod J 1998;31(1):1-7. https://doi.org/10.1046/j.1365-2591.1998.t01-1-00111.x

13. Sundqvist G, Figdor D, Persson S, Sjogren U. Microbiologic analysis of teeth with failed endodontic treatment and the outcome of conservative re-treatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1998;85(1):86-93. https://doi.org/10.1016/S1079-2104(98)90404-8

14. Pinheiro ET, Gomes BP, Ferraz CC, Sousa EL, Teixeira FB, Souza-Filho FJ. Microorganisms from canals of root-filled teeth with periapical lesions. Int Endod J 2003;36(1):1-11. https://doi.org/10.1046/j.1365-2591.2003.00603.x

15. Gomes BP, Pinheiro ET, Jacinto RC, Zaia AA, Ferraz CC, Souza-Filho FJ. Microbial analysis of canals of root-filled teeth with periapical lesions using polymerase chain reaction. J Endod 2008;34(5):537-40. https://doi.org/10.1016/j.joen.2008.01.016

16. Sakamoto M, Siqueira JF, Rocas IN, Benno Y. Molecular analysis of the root canal microbiota associated with endodontic treatment failures. Oral Microbiol Immunol 2008;23(4):275-81. https://doi.org/10.1111/j.1399-302X.2007.00423.x

17. Saleh IM, Ruyter IE, Haapasalo M, Orstavik D. Survival of Enterococcus faecalis in infected dentinal tubules after root canal filling with different root canal sealers in vitro. Int Endod J 2004;37(3):193-8. https://doi.org/10.1111/j.0143-2885.2004.00785.x

18. Kayaoglu G, Erten H, Orstavik D. Possible role of the adhesin ace and collagen adherence in conveying resistance to disinfectants on Enterococcus faecalis. Oral Microbiol Immunol 2008;23(6):449-54. https://doi.org/10.1111/j.1399-302X.2008.00446.x

19. Figdor D, Davies JK, Sundqvist G. Starvation survival, growth and recovery of Enterococcus faecalis in human serum. Oral Microbiol Immunol 2003;18(4):234-9. https://doi.org/10.1034/j.1399-302X.2003.00072.x

20. McHugh CP, Zhang P, Michalek S, Eleazer PD. pH required to kill Enterococcus faecalis in vitro. J Endod 2004;30(4):218-9. https://doi.org/10.1097/00004770-200404000-00008

21. Ballal V, Kundabala M, Acharya S, Ballal M. Antimicrobial action of calcium hydroxide, chlorhexidine and their combination on endodontic pathogens. Aust Dent J 2007;52(2):118-21. https://doi.org/10.1111/j.1834-7819.2007.tb00475.x

22. Siqueira JF, Lopes HP. Mechanisms of antimicrobial activity of calcium hydroxide: a critical review. Int Endod J 1999;32(5):361-9. https://doi.org/10.1046/j.1365-2591.1999.00275.x

23. Estrela C, Sydney GB, Bammann LL, Felippe Junior O. Mechanism of action of calcium and hydroxyl ions of calcium hydroxide on tissue and bacteria. Braz Dent J 1995;6(2):85-90.

24. Fava LR, Saunders WP. Calcium hydroxide pastes: classification and clinical indications. Int Endod J 1999;32(4):257-82. https://doi.org/10.1046/j.1365-2591.1999.00232.x

25. Estrela C, Rodrigues de Araujo Estrela C, Bammann LL, Pecora JD. Two methods to evaluate the antimicrobial action of calcium hydroxide paste. J Endod 2001;27(12):720-3. https://doi.org/10.1097/00004770-200112000-00002

26. Peters LB, Van Winkelhoff AJ, Buijs JF, Wesselink PR. Effects of instrumentation, irrigation and dressing with calcium hydroxide on infection in pulpless teeth with periapical bone lesions. Int Endod J 2002;35(1):13-21. https://doi.org/10.1046/j.0143-2885.2001.00447.x

27. Ercan E, Dalli M, Dulgergil CT. In vitro assessment of the effectiveness of chlorhexidine gel and calcium hydroxide paste with chlorhexidine against Enterococcus faecalis and Candida albicans. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006;102(2):e27-31. https://doi.org/10.1016/j.tripleo.2006.02.022

28. Lin YH, Mickel AK, Chogle S. Effectiveness of selected materials against Enterococcusfaecalis: part 3. The antibacterial effect of calcium hydroxide and chlorhexidine on Enterococcus faecalis. J Endod 2003;29(9):565-6. https://doi.org/10.1097/00004770-200309000-00006

29. Sukawat C, Srisuwan T. A comparison of the antimicrobial efficacy of three calcium hydroxide formulations on human dentin infected with Enterococcus faecalis. J Endod 2002;28(2):102-4. https://doi.org/10.1097/00004770-200202000-00013

30. Schafer E, Bossmann K. Antimicrobial efficacy of chlorhexidine and two calcium hydroxide formulations against Enterococcus faecalis. J Endod 2005;31(1):53-6. https://doi.org/10.1097/01.DON.0000134209.28874.1C

31. Siqueira JF, Uzeda M. Disinfection by calcium hydroxide pastes of dentinal tubules infected with two obligate and one facultative anaerobic bacteria. J Endod 1996;22(12):674-6. https://doi.org/10.1016/S0099-2399(96)80062-8

32. Estrela C, Holland R. Calcium hydroxide: study based on scientific evidences. J Appl Oral Sci 2003;11(4):269-82. https://doi.org/10.1590/S1678-77572003000400002

33. Law A, Messer H. An evidence-based analysis of the antibacterial effectiveness of intracanal medicaments. J Endod 2004;30(10):689-94. https://doi.org/10.1097/01.DON.0000129959.20011.EE

34. Sathorn C, Parashos P, Messer H. Antibacterial efficacy of calcium hydroxide intracanal dressing: a systematic review and meta-analysis. Int Endod J 2007;40(1):2-10. https://doi.org/10.1111/j.1365-2591.2006.01197.x

35. Lana PE, Scelza, MF, Silva LE, Mattos-Guaraldi AL, Hirata Júnior R. Antimicrobial activity of calcium hydroxide pastes on Enterococcus faecalis cultivated in root canal systems. Braz Dent J 2009;20(1):32-6. https://doi.org/10.1590/S0103-64402009000100005

36. Gomes BP, Lilley JD, Drucker DB. Variations in the susceptibilities of components of the endodontic microflora to biomechanical procedures. Int Endod J 1996;29(4):235-41. https://doi.org/10.1111/j.1365-2591.1996.tb01375.x

37. Nair PN. On the causes of persistent apical periodontitis: a review. Int Endod J 2006;39(4):249-81. https://doi.org/10.1111/j.1365-2591.2006.01099.x

38. Evans M, Davies JK, Sundqvist G, Figdor D. Mechanisms involved in the resistance of Enterococcus faecalis to calcium hydroxide. Int Endod J 2002;35(3):221-8. https://doi.org/10.1046/j.1365-2591.2002.00504.x

39. Sjogren U, Figdor D, Persson S, Sundqvist G. Influence of infection at the time of root filling on the outcome of endodontic treatment of teeth with apical periodontitis. Int Endod J 1997;30(5):297-306. https://doi.org/10.1111/j.1365-2591.1997.tb00714.x