Elsevier

Journal of Endodontics

Volume 47, Issue 7, July 2021, Pages 1138-1143
Journal of Endodontics

Basic Research
Antibiofilm Activity of Diclofenac and Antibiotic Solutions in Endodontic Therapy

https://doi.org/10.1016/j.joen.2021.04.004Get rights and content

Abstract

Introduction

The aim of this study was to compare the antibiofilm effects of a triple antibiotic solution (TAS); a double antibiotic solution (DAS); and 5%, 2.5%, and 1.25% diclofenac solutions (DCSs) against Enteroccocus faecalis biofilm.

Methods

Eighty-four sterile radicular dentin blocks were used as biofilm substrate for 3 weeks. The study groups were as follows: (1) 1 mg/mL TAS (minocycline, metronidazole, and ciprofloxacin), (2) 1 mg/mL DAS (metronidazole and ciprofloxacin), (3) 5% DCS, (4) 2.5% DCS, (5) 1.25% DCS, and (6) 0.9% saline solution. The antimicrobial activity was evaluated by bacterial count determinations and confocal laser scanning microscopy. The contact time for the antimicrobial tests was 5 minutes. Bacterial counts were expressed as the reduction percentage of colony-forming units; for the confocal laser scanning microscopic evaluation, the log10 total biovolume and percentage of green population (live cells) were calculated.

Results

The colony-forming unit reduction percentage ranged between 62.98 and 98.62, respectively, for TAS and 5% DCS. The DCS showed a concentration-dependent effect.For the confocal laser scanning microscopy, the log10 total biovolume in all groups was very similar and showed a scarce (1.39–1.02) but significant reduction with respect to the control; 5% and 2.5% DCSs gave the lowest viable cell percentage. The TAS and DAS groups showed intermediate values without significant differences between them.

Conclusions

DCSs at 5% and 2.5% have greater antimicrobial effects than TAS and DAS and may be considered a valid alternative for controlling the infection of teeth with apical periodontitis.

Section snippets

Materials and Methods

This protocol was approved by the Ethics Committee of the University of Granada, Granada, Spain (no. 1076 CEIH/2020).

Results

The results in terms of CFU reduction percentage ranged between 62.98 and 98.62 for TAS and 5% DCS, respectively. There were no significant differences between the 2 antibiotic solutions (TAS and DAS), whereas the DCS showed a concentration-dependent effect.

For the antimicrobial test with confocal laser scanning microscopy, a total of 120 operative fields (3-dimensional stacks) were evaluated. The log10 total biovolume in all groups showed a scarce (1.39–1.02) but significant reduction with

Discussion

The persistence of microorganisms that resist disinfection procedures and/or the recontamination of the root canal system can prove determinantal for the healing of teeth with periapical periodontitis24,25.

The emergence of antibiotic resistance is a major concern, which has led to the search for new alternative approaches to disinfection of the root canal, including the use of NSAIDs. In this context, we tested the antimicrobial activity of DCSs and compared them with DASs and TASs to evaluate

CRediT authorship contribution statement

Carmen María Ferrer-Luque: Conceptualization, Methodology, Writing - review & editing. Pilar Baca: Formal analysis, Supervision. Carmen Solana: Investigation, Writing - original draft. Alberto Rodríguez-Archilla: Software, Validation. María Teresa Arias-Moliz: Software, Validation. Matilde Ruiz-Linares: Conceptualization, Methodology, Writing- review & editing.

Acknowledgments

The authors thank Francisca Castillo Pérez, Gertrudis Gomez Villaescusa, and Ana Santos Carro for their technical assistance.

Supported by Research Group CTS-167 of the Junta de Andalucía, Seville, Spain.

The authors deny any conflicts of interest related to this study.

References (37)

Cited by (7)

View all citing articles on Scopus
View full text