Effectiveness of different antifungal agents, together with triantibiotic paste, for the treatment of Candida albicans in root canals
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Abstract
Introduction: In the oral cavity Candida albicans is a yeast that is commonly present in most humans, it generally does not cause harm, but it is considered an opportunistic microorganism, it can colonize in an exaggerated way in some subjects causing what is known as oral candidiasis, which would be synonymous with an infection by this pathogen. Objectives: The aim of this study is to evaluate the antifungal effectiveness of various antifungals on strains of C. albicans ATCC 90028 inoculated into root canals of teeth extracted for distinct reasons, to provide evidence to improve endodontic therapeutics. The infected ducts were exposed to different antifungals: nystatin, fluconazole, and miconazole. Methodology: The direct observation method was used to evaluate efficacy. Results: The results showed that all the antifungals evaluated showed antifungal activity and showed efficacy when combined with triple antibiotic paste, but with differences in their effectiveness. Conclusions: The conclusions place miconazole as the most effective, but the percentages of effectiveness of the other antifungals are also favorable and may be key to increasing disinfection in root canals infected by C. albicans. General area of study: Dentistry. Specific area of study: Endodontics. Type of study: Original articles.
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Rodríguez Tapia, C. A., & Sarmiento Ordoñez, J. M. (2025). Effectiveness of different antifungal agents, together with triantibiotic paste, for the treatment of Candida albicans in root canals. Anatomía Digital, 8(3.2), 45-59. https://doi.org/10.33262/anatomiadigital.v8i3.2.3460
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Articulos de revisión bibliográfica
References
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20. Saravia-León N, Guillinta-Vallejos G. Actividad antifúngica del extracto de etanol Schinus molle y el fluconazol sobre Candida albicans. Universidad de San Martin de Porres [Internet]. 2012 [citado 24 mayo 2025]; 9(1): 39-41. Disponible en: https://repositorio.usmp.edu.pe/handle/20.500.12727/1868?locale-attribute=en
21. Abraham SB, al Marzooq F, Himratul-Aznita WH, Aly Ahmed HM, Samaranayake LP. Prevalence, virulence and antifungal activity of Candida albicans isolated from infected root canals. BMC Oral Health [Online]. 2020 [cited 2025 May 24]; 20(1): 347. Available from: https://pubmed.ncbi.nlm.nih.gov/33256696/
22. Romero-Salazar DB, Hernández-Solís SE, Rueda-Gordillo F. Identificación mediante PCR de Candida albicans aisladas de conductos radiculares necróticos. Revista Odontológica Latinoamericana [Internet]. 2013 [citado 24 mayo 2025]; 5(2): 51-55. Disponible en: http://www.odontologia.uady.mx/revistas/rol/pdf/V05N2p51.pdf
23. Seleem D, Santana Freitas-Blanco V, Noguti J, Zancope BR, Pardi V, Mendonça Murata R. In vivo antifungal activity of monolaurin against candida albicans biofilms. Biological & Pharmaceutical Bulletin [Internet]. 2018 [cited 2025 May 24]; 41(8): 1299-1302. Available from: https://pubmed.ncbi.nlm.nih.gov/30068882/
2. Du Q, Ren B, Zhou X, Zhang L, Xu X. Cross kingdom interaction between Candida albicans and oral bacteria. Frontiers in Microbiology [Online]. 2022 [cited 2025 May 24]; 13. Available from: https://doi.org/10.3389/fmicb.2022.911623
3. Yoo YJ, Kim AR, Perinpanayagam H, Han SH, Kum KY. Candida albicans virulence factors and pathogenicity for endodontic infections. Microorganisms [Online]. 2020 [cited 2025 May 24]; 8(9), 1300. Available from: https://doi.org/10.3390/microorganisms8091300
4. Santos Kessler SQ, Mastella Lang P, Dal Pizzol TS, Montagner F. Resistance profiles to antifungal agents in Candida albicans isolated from human oral cavities: systematic review and meta analysis. Clinical Oral Investigations [Online]. 2022 [cited 2025 May 24]; 26(11): 6479-6489. Available from: https://doi.org/10.1007/s00784-022-04716-2
5. Gómez Quintero CH. Resistencia de levaduras del género Candida al fluconazol. Infectio [Internet]. 2010 [citado 24 mayo 2025]; 14(Suppl 2): s172-s180. Disponible en: http://www.scielo.org.co/scielo.php?script=sci_arttext&pid=S0123-93922010000600009&lng=en
6. Yang C, Gong W, Lu J, Zhu X, Qi Q. Antifungal drug susceptibility of oral Candida albicans isolates may be associated with apoptotic responses to Amphotericin B. Journal of Oral Pathology and Medicine [Online]. 2010 [cited 2025 May 24]. Available from: https://doi.org/10.1111/j.1600-0714.2009.00832.x
7. Sabharwal S, Bhagat SK, Gami KS, Siddhartha A, Rai K, Ahluwalia Y. An in vivo study to compare anti-microbial activity of triantibiotic paste, 2% chlorhexidine gel, and calcium hydroxide on microorganisms in the root canal of immature teeth. Journal of International Society of Preventive and Community Dentistry [Online]. 2019 [cited 2025 May 24]. Available from: https://pubmed.ncbi.nlm.nih.gov/31198699/
8. Parhizkar A, Nojehdehian H, Asgary S. Triple antibiotic paste: momentous roles and applications in endodontics: a review. Restorative Dentistry & Endodontics [Online]. 2018 [cited 2025 May 24]; 43(3): e28. Available from: https://doi.org/10.5395/rde.2018.43.e28
9. Dartevelle P, Ehlinger C, Zaet A, Boehler C, Rabineau M, Westermann B, et al. D Cateslytin: a new antifungal agent for the treatment of oral Candida albicans associated infections. Scientific Reports [Online]. 2018 [cited 2025 May 24]. Available from: https://www.nature.com/articles/s41598-018-27417-x
10. Briseida P, Huerta GR. Citotoxicidad de una solución doble antibiótica modificada con antifúngico sobre células madre de papila apical in vitro. León [Tesis de maestría, Universidad Autónoma de Nuevo León, Nuevo León, México]; 2020 [citado 24 mayo 2025]. Disponible en: https://repositorio.uanl.mx/handle/123456789/16272
11. Briones-Cando NA, Alvear-Córdova MC, Sarmiento-Ordoñez JM, Pacurucu-Pinos PE. Eficacia ex vivo de sustancias irrigadoras frente a Enterococcus faecalis en conductos radiculares primarios. Boletín de Malariología y Salud Ambiental [Internet]. 2021 [citado 15 enero 2025]; 61(2); 204-212. Disponible en: https://pesquisa.bvsalud.org/portal/resource/pt/biblio-1411652
12. Jiang L, Zheng L, Sun KA, Zhou P, Xu R, Gu J, et al. In vitro and in vivo evaluation of the antifungal activity of fluoxetine combined with antifungals against Candida albicans biofilms and oral candidiasis. Biofouling [Online]. 2020 [cited 2025 May 24]; 36(5):537-548. Available from: https://pubmed.ncbi.nlm.nih.gov/32551919/
13. Herrera D, Retamal-Valdes B, Alonso B, Feres M. Acute periodontal lesions (periodontal abscesses and necrotizing periodontal diseases) and endo-periodontal lesions. Journal of Periodontology [Online]. 2018 [cited 2025 May 24]; 89(Suppl 1): S85-S102. Available from: https://pubmed.ncbi.nlm.nih.gov/29926942/
14. Chua EG, Parolia A, Ahlawat P, Pau A, Amalraj FD. Antifungal effectiveness of various intracanal medicaments against Candida albicans: an ex-vivo study. BMC Oral Health [Online]. 2014 [cited 2025 May 24]; 13(14):53. Available from: https://pubmed.ncbi.nlm.nih.gov/24886335/
15. Carneiro Valera M, Costa Godinho da Silva K, Maekawa LE, Talge Carvalho CA, Koga-Ito CY, Ribeiro Camargo CH, et al. Antimicrobial activity of sodium hypochlorite associated with intracanal medication for Candida albicans and Enterococcus faecalis inoculated in root canals. Journal of Applied Oral Science [Online]. 2009 [cited 2025 May 24]; 17(6). Available from: https://www.scielo.br/j/jaos/a/RTMzTc86zpZxMQSYStrRVqM/
16. Carrotte P. Endodontics: part 7 preparing the root canal. British Dental Journal [Internet]. 2004 [cited 2025 May 24]; 197: 603-613. Available from: https://www.nature.com/articles/4811823
17. Vera Rojas J, Benavides García M, Moreno Silva E, Romero Viñas M. Conceptos y técnicas actuales en la irrigación endodóntica. Endodoncia [Online]. 2012 [cited 2025 May 24]; 30(1): 31-44. Disponible en: https://www.endodonciaactual.com/articulo-irrigacion-2012
18. Shi Y, Deng Z, Yang Y, Cui L, Chen T, Hu M, et al. Evaluation of sodium hypochlorite irrigant, bingpeng irrigant, and fufang bingpeng irrigant as endodontic irrigants during passive ultrasonic irrigation. Frontiers in Cellular and Infection Microbiology [Online]. 2019 [cited 2025 May 24]; 9:145. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC6522938/
19. Bernal-Treviño A, González-Amaro AM, Méndez González V, Pozos-Guillen A. Frequency of Candida in root canals of teeth with primary and persistent endodontic infections. Revista Iberoamericana de Micología [Online]. 2018 [cited 2025 May 24]; 35(2): 78-82. Available from: https://pubmed.ncbi.nlm.nih.gov/29605495/
20. Saravia-León N, Guillinta-Vallejos G. Actividad antifúngica del extracto de etanol Schinus molle y el fluconazol sobre Candida albicans. Universidad de San Martin de Porres [Internet]. 2012 [citado 24 mayo 2025]; 9(1): 39-41. Disponible en: https://repositorio.usmp.edu.pe/handle/20.500.12727/1868?locale-attribute=en
21. Abraham SB, al Marzooq F, Himratul-Aznita WH, Aly Ahmed HM, Samaranayake LP. Prevalence, virulence and antifungal activity of Candida albicans isolated from infected root canals. BMC Oral Health [Online]. 2020 [cited 2025 May 24]; 20(1): 347. Available from: https://pubmed.ncbi.nlm.nih.gov/33256696/
22. Romero-Salazar DB, Hernández-Solís SE, Rueda-Gordillo F. Identificación mediante PCR de Candida albicans aisladas de conductos radiculares necróticos. Revista Odontológica Latinoamericana [Internet]. 2013 [citado 24 mayo 2025]; 5(2): 51-55. Disponible en: http://www.odontologia.uady.mx/revistas/rol/pdf/V05N2p51.pdf
23. Seleem D, Santana Freitas-Blanco V, Noguti J, Zancope BR, Pardi V, Mendonça Murata R. In vivo antifungal activity of monolaurin against candida albicans biofilms. Biological & Pharmaceutical Bulletin [Internet]. 2018 [cited 2025 May 24]; 41(8): 1299-1302. Available from: https://pubmed.ncbi.nlm.nih.gov/30068882/