Oral bacterial infections are fairly common in patients with diabetes mellitus; however, due to limited treatment options, herbal medicines are considered an alternate solution. This study aimed to formulate a stable essential-oil-loaded nanoemulsion for the treatment of oral bacterial infections. Essential oils from edible sources including coriander, clove, cinnamon and cardamom were extracted by hydrodistillation. The response surface methodology was used to optimize the nanoemulsion formulation by applying the Box–Behnken design. The oil concentration, surfactant concentration and stirring speed were three independent factors, and particle size and polydispersity index were two responses. The particle size, polydispersity index and zeta potential of the optimized formulation were 130 mm, 0.222 and −22.9, respectively. The ATR-FTIR analysis revealed that there was no incompatibility between the active ingredients and the excipients. A significant release profile in active ingredients of nanoemulsion, i.e., 88.75% of the cinnamaldehyde and 89.33% of eugenol, was recorded after 24 h. In the ex vivo goat mucosal permeation study, 71.67% of the cinnamaldehyde permeated and that of the eugenol 70.75% from the nanoemulsion. The optimized formulation of the essential-oil-loaded nanoemulsion showed a 9 mm zone of inhibition against Staphylococcus aureus and Staphylococcus epidermidis, whereas in anti-quorum sensing analysis, the optimized nanoemulsion formulation showed an 18 mm zone of inhibition. It was concluded that formulated essential-oil-loaded nanoemulsion can be used against S. epidermidis and S. aureus infections in oral cavity.

Ched to different conclusions on the importance of removing or maintaining this layer. Removing the smear layer allows for more cleaning and disinfecting root canal walls and better adaptation of root canal filling materials. However, the presence of smear layer can act as a seal to the dentinal tubules and minimize the ability of bacteria and its toxins from penetrating the dentinal tubules. The ability to remove smear layer depends primarily on chemomechanical preparation. There are three main methods to remove smear layer: chemically, mechanically (ultrasonically), laser, or combinations. No one single irrigant has the ability to kill microorganisms, dissolve organic tissues, and demineralize smear layer. Thus, alternating between organic and inorganic solvents and the use of different methods and techniques have been recommended. Indeed, there is little relevance attributed to the influence of smear layer on the clinical treatment outcomes. Moreover, there is critical lack of clinical studies to determine the role of smear layer since all previous studies were carried out on laboratory based. Further experimental model with a longitudinal observational characteristic should be applied....

The American Association of Endodontists (AAE) released a case difficulty assessment form to help general dentists and students treat cases within their expertise or refer advanced cases to reduce the risk of iatrogenic errors. The purpose of this study was to determine the incidence of iatrogenic complications after the use of the case difficulty assessment form. Arandom sample of 1000 cases that received root canal treatment in undergraduate clinics during the academicyear (2016–2017) was selected. Case difficulty assessment was made for each case before treatment onset. Once the case was approved for treatment in the undergraduate clinics, the endodontic treatments were performed following the standard procedure the endodontic department of the Dentistry School of King Abdulaziz University mandates. Digital radiographs were obtained during routine root canal treatment and were evaluated by four observers to detect any iatrogenic errors, after which the data were analyzed statistically. Iatrogenic errors were correlated significantly with case difficulty (p= 0.003), and were detected in 22.1% of all teeth treated in the undergraduate clinics. Underfilling accounted for the highestpercent of errors detected (8.4%), followed by ledge formation (4.2%). Molar teeth had the highest frequency of errors, and mesio-buccal roots of maxillary molars showed the highest percentage of errors. The AAE developed asignificantly useful tool to determine the difficulty of each case treated in undergraduate clinics, and following their recommendations will minimize the risk of iatrogenic errors.

This study aimed to evaluate the morphology and chemistry of an apatite layer induced by fast-set versus regular-set EndoSequence root repair materials using spectroscopic analysis. Holes of a 4 mm diameter were created in the root canal dentin, which were filled with the test material. Fetal calf serum was used as the incubation medium, and the samples incubated in deionized water were used as controls. The material-surface and material-dentin interfaces were analyzed after 28 days using Raman and infrared spectroscopy, scanning electron microscopy/energy dispersive X-ray, and X-ray diffraction. After incubation in fetal calf serum, both materials formed a uniform layer of calcium phosphate precipitate on their surfaces, with the dentinal interface. This precipitated layer was a combination of hydroxyapatite and calcite or aragonite, and had a high mineral maturity with the regular-set paste. However, its crystallinity index was high with the fast-set putty. Typically, both consistencies (putty and paste) of root repair material have an apatite formation ability when they are incubated in fetal calf serum. This property could be beneficial in improving their sealing ability for root canal dentin.

Aimed to evaluate the effect of water solubility on chemical properties and surface structure of bioceramic-based (BC-HiFlow and BC-EndoSeqence) compared with resin-based (Adseal) root canal sealers. Fresh mix was inserted into polyethylene mold (n = 10) and subjected to Vicat needle to evaluate the setting time. The set discs were analyzed by Fourier transform infrared (FTIR) spectroscopy then immersed in deionized water for 1, 7, 14 and 28 days. The solubility%, pH changes, released calcium (Ca²⁺), phosphate (PO₄³⁻) and silicon (Si⁴⁺) ions were evaluated after each immersion period. The discs were analyzed by scanning electron microscopy/Energy dispersed X-ray (SEM/EDX) before and after solubility test. Although FTIR detected similar composition of both bioceramic-sealers, BC-EndoSequence determined the prolonged setting times. At the end of solubility test, both bioceramic-sealers exhibited significant greater solubility (>3%), alkaline pH (>11) at p < 0.001. Adseal displayed the significant greatest Ca²⁺ and PO₄³⁻ released, while BC-HiFlow displayed the significant greatest Si⁴⁺ release (p < 0.001). SEM revealed voids and pores on the surface of all tested sealers with the greatest value on Adseal surface. In conclusion, although both bioceramic-sealers had high solubility, BC-Hiflow complied the ISO standard regarding setting time and least surface micropores better than that of BC-EndoSequence.

The purpose of this study was to compare different irrigants’ effect on two EndoSequence root repair materials’ push-out bond strength. Sixty root slices were filled either with EndoSequence premixed fast-set putty or regular-set paste, and then immersed either in sodium hypochlorite, chlorhexidine gluconate, or saline (as control) for 30 min, after which the slices were subjected to the push-out test. The surface structures were evaluated with Scanning Electron Microscopy and Fourier Transform Infrared. Fast-set putty exhibited greater displacement resistance when immersed in saline and subjected to adhesive failure mode, while regular-set paste showed greater resistance when immersed in chlorhexidine and subjected to cohesive failure mode. Infrared analysis showed changes in organic filler, and carbonate and phosphate bands after using irrigants. The lowest carbonate/phosphate ratio was found for chlorhexidine in both materials. Therefore, sodium hypochlorite reduced EndoSequence root repair materials’ displacement resistance markedly.