Evidence map›Paper›PMID 41928154›Full record

ArticleBMC oral health2026

Enterococcus faecalis biofilm removal efficacy, cytotoxicity and alkaline phosphatase activity on stem cells after the application of conventional medicaments and novel hydrogels used in regenerative endodontics.

Adem Öztürk, Tuğçe Duran, Ayce Unverdi Eldeniz

Abstract readComparative Study
In one paragraph

Article in BMC oral health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Adem ÖztürkDepartment of Endodontics, Faculty of Dentistry, Selcuk University, Konya, Turkey.ORCID 0009-0008-5512-8729
Tuğçe DuranDepartment of Medical Genetics, Faculty of Medicine, KTO Karatay University, Konya, Turkey.ORCID 0000-0002-7353-4527
Ayce Unverdi EldenizDepartment of Endodontics, Faculty of Dentistry, Selcuk University, Konya, Turkey. aunverdi@selcuk.edu.tr.ORCID 0000-0001-7733-3055

Funding

Selçuk University Research Foundation 23132018
6 · The paper itself

Abstract

backgroundTo compare the antibacterial activity of conventional intracanal medicaments used in regenerative endodontic treatment (TAP, DAP, Ca(OH)₂, CHX gel) with novel hydrogel-based formulations (chitosan, CHX, hyaluronic acid, metronidazole, and diclofenac hydrogels) against Enterococcus faecalis biofilms, and to assess their cytotoxic effects on dental pulp stem cells (DPSCs).

methodsAntibacterial activity was evaluated using an E. faecalis biofilm model in single-rooted incisors. For cytotoxicity testing, dentine discs were treated with the medicaments and seeded with DPSCs. Cell viability was assessed using the WST-1 assay, and mineralization-related responses were evaluated by alkaline phosphatase (ALP) activity. Data were analyzed using the Kruskal–Wallis test with Bonferroni-adjusted post-hoc comparisons (p < 0.05).

resultsTAP, DAP, diclofenac hydrogel, and CHX hydrogel completely eliminated the E. faecalis biofilm in the CFU analysis, whereas CHX gel reduced the biofilm but did not achieve full eradication. In contrast, Ca(OH)₂, chitosan, HA, and MTR hydrogels exhibited limited antibacterial effects. Ca(OH)₂ and chitosan hydrogel preserved the highest levels of cell viability, while DAP, TAP, HA, MTR, and diclofenac hydrogels caused moderate reductions; CHX gel and CHX hydrogel showed the lowest survival. ALP activity was maintained in the Ca(OH)₂, chitosan, HA, MTR, and diclofenac hydrogels but decreased in the CHX based groups (all relevant comparisons, p < 0.05).

conclusionsHydrogel-based systems demonstrated a favorable balance between biofilm control and stem-cell biocompatibility. The diclofenac-loaded hydrogel achieved TAP/DAP-level biofilm reduction while preserving cell viability, supporting its potential as an antibiotic-free disinfection alternative. CHX hydrogel showed higher antibacterial performance than CHX gel, whereas hyaluronic acid hydrogel maintained high biocompatibility and demonstrated applicability as a biofunctional carrier system.

Indexed as

Alkaline PhosphataseAnti-Bacterial AgentsBiofilmsEnterococcus faecalisHydrogelsRegenerative EndodonticsRoot Canal IrrigantsStem CellsCalcium HydroxideCell SurvivalChitosanDental PulpDiclofenacHumansHyaluronic AcidMetronidazoleAlkaline PhosphataseAnti-Bacterial AgentsCalcium HydroxideChitosanDiclofenacHyaluronic AcidHydrogelsMetronidazoleRoot Canal IrrigantsEnterococcus faecalishydrogelintracanal medicamentsregenerative endodonticsstem cells

Identifiers

PMID41928154
PMCPMC13135702

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.