The Efficacy of Different Antibiotic Compounds in Regenerative Treatment of Immature Necrotic Teeth
-
Maryam Gharechahi
,
Mohammad hossein Kafi
,
Maryam Javidi
,
Niloufar Jafari
,
Maryam Joibary Moghaddam
Abstract
Objectives: Endodontic treatment of immature teeth poses a significant challenge, especially in achieving a proper seal using traditional obturation methods. Revascularization presents itself as an alternative approach to this problem, and the application of triple antibiotic paste (TAP) has been suggested as a means to achieve disinfection during the procedure. This study aims to compare the antibacterial properties of three different antibiotic combinations to assess their effectiveness on root canal disinfection.
Materials and Methods: Eighty samples were employed to assess the impact of three antibiotic combinations on Enterococcus faecalis, Escherichia coli, Streptococcus mutans, and a combination thereof. The antibiotics included metronidazole, ciprofloxacin, and cefaclor (CCM), the commonly used TAP, and a double antibiotic paste (DAP) composed of metronidazole and ciprofloxacin. Dentin shavings collected using Gates-Glidden drills were placed in microtubes containing a 2ml standard bacterial suspension. Microtube contents were diluted and cultured on BHI agar plates, with colony counts calculated based on dentine shavings' weight in CFU/mg. Kruskal-Wallis and Dunn’s post-hoc tests were used for statistical analysis and P<0.05 was considered significant.
Results: A significant difference in mean CFU was observed among all bacterial groups (P<0.05). Dunn's post-hoc analysis showed a significant difference only between the control group (methylcellulose) and the other antibiotic groups. There was no significant difference between the other antibiotic groups in two-by-two comparisons.
Conclusion: There was no significant difference in the antimicrobial properties of DAP, TAP and CCM. Therefore, DAP and CCM may be used during regenerative treatment.
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6. Devaraj S, Jagannathan N, Neelakantan P. Antibiofilm efficacy of photoactivated curcumin, triple and double antibiotic paste, 2% chlorhexidine and calcium hydroxide against Enterococcus fecalis in vitro. Sci Rep. 2016 Apr 21;6:24797.
7. Thibodeau B, Trope M. Pulp revascularization of a necrotic infected immature permanent tooth: case report and review of the literature. Pediatr Dent. 2007 Jan-Feb;29(1):47-50.
8. Bakhtiar H, Esmaeili S, Fakhr Tabatabayi S, Ellini MR, Nekoofar MH, Dummer PM. Second-generation Platelet Concentrate (Platelet-rich Fibrin) as a Scaffold in Regenerative Endodontics: A Case Series. J Endod. 2017 Mar;43(3):401-408.
9. Bezgin T, Yilmaz AD, Celik BN, Kolsuz ME, Sonmez H. Efficacy of platelet-rich plasma as a scaffold in regenerative endodontic treatment. J Endod. 2015 Jan;41(1):36-44.
10. Chueh LH, Ho YC, Kuo TC, Lai WH, Chen YH, Chiang CP. Regenerative endodontic treatment for necrotic immature permanent teeth. J Endod. 2009 Feb;35(2):160-4.
11. Shah N, Logani A, Bhaskar U, Aggarwal V. Efficacy of revascularization to induce apexification/apexogensis in infected, nonvital, immature teeth: a pilot clinical study. J Endod. 2008 Aug;34(8):919-25; Discussion 1157.
12. Parhizkar A, Nojehdehian H, Asgary S. Triple antibiotic paste: momentous roles and applications in endodontics: a review. Restor Dent Endod. 2018 Jun 20;43(3):e28.
13. Tilakchand M, Hegde S, Naik B. Evaluation of the efficacy of a novel antibiotic-steroid paste versus conventionally used intracanal antibiotic pastes and irrigating solutions against a 3-week-old biofilm of Enterococcus faecalis. J Conserv Dent. 2020 Sep-Oct;23(5):436-440.
14. Lee Y, Han SH, Hong SH, Lee JK, Ji H, Kum KY. Antimicrobial efficacy of a polymeric chlorhexidine release device using in vitro model of Enterococcus faecalis dentinal tubule infection. J Endod. 2008 Jul;34(7):855-8.
15. Bose R, Nummikoski P, Hargreaves K. A retrospective evaluation of radiographic outcomes in immature teeth with necrotic root canal systems treated with regenerative endodontic procedures. J Endod. 2009 Oct;35(10):1343-9.
16. Hargreaves KM, Geisler T, Henry M, Wang Y. Regeneration potential of the young permanent tooth: what does the future hold? Pediatr Dent. 2008 May-Jun;30(3):253-60. Erratum in: Pediatr Dent. 2008 Jul-Aug;30(4):288. Giesler, Todd [corrected to Geisler, Todd].
17. Roberts-Clark DJ, Smith AJ. Angiogenic growth factors in human dentine matrix. Arch Oral Biol. 2000 Nov;45(11):1013-6.
18. Rotstein I, Ingle JI. Ingle’s Endodontics. 7th ed. Raleigh, NC: PMPH; 2019.
19. Mohammadi Z, Abbott PV. On the local applications of antibiotics and antibiotic-based agents in endodontics and dental traumatology. Int Endod J. 2009 Jul;42(7):555-67.
20. Mohammadi Z, Jafarzadeh H, Shalavi S, Yaripour S, Sharifi F, Kinoshita JI. A Review on Triple Antibiotic Paste as a Suitable Material Used in Regenerative Endodontics. Iran Endod J. 2018 Winter;13(1):1-6.
21. Dunavant TR, Regan JD, Glickman GN, Solomon ES, Honeyman AL. Comparative evaluation of endodontic irrigants against Enterococcus faecalis biofilms. J Endod. 2006 Jun;32(6):527-31.
22. Basrani B, Tjäderhane L, Santos JM, Pascon E, Grad H, Lawrence HP, et all. Efficacy of chlorhexidine- and calcium hydroxide-containing medicaments against Enterococcus faecalis in vitro. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003 Nov;96(5):618-24.
23. Hahn CL, Best AM, Tew JG. Cytokine induction by Streptococcus mutans and pulpal pathogenesis. Infect Immun. 2000 Dec;68(12):6785-9.
24. Haapasalo M, Orstavik D. In vitro infection and disinfection of dentinal tubules. J Dent Res. 1987 Aug;66(8):1375-9.
25. Shen Y, Gao Y, Lin J, Ma J, Wang Z, Haapasalo M. Methods and models to study irrigation. Endod Topics. 2012;27(1):3–34.
26. Sato T, Hoshino E, Uematsu H, Noda T. In vitro antimicrobial susceptibility to combinations of drugs on bacteria from carious and endodontic lesions of human deciduous teeth. Oral Microbiol Immunol. 1993 Jun;8(3):172-6.
27. Roche Y, Yoshimori RN. In-vitro activity of spiramycin and metronidazole alone or in combination against clinical isolates from odontogenic abscesses. J Antimicrob Chemother. 1997 Sep;40(3):353-7.
28. Windley W 3rd, Teixeira F, Levin L, Sigurdsson A, Trope M. Disinfection of immature teeth with a triple antibiotic paste. J Endod. 2005 Jun;31(6):439-43.
29. Chuensombat S, Khemaleelakul S, Chattipakorn S, Srisuwan T. Cytotoxic effects and antibacterial efficacy of a 3-antibiotic combination: an in vitro study. J Endod. 2013 Jun;39(6):813-9.
30. Kim JH, Kim Y, Shin SJ, Park JW, Jung IY. Tooth discoloration of immature permanent incisor associated with triple antibiotic therapy: a case report. J Endod. 2010 Jun;36(6):1086-91.
31. Akcay M, Arslan H, Yasa B, Kavrık F, Yasa E. Spectrophotometric analysis of crown discoloration induced by various antibiotic pastes used in revascularization. J Endod. 2014 Jun;40(6):845-8.
32. Reynolds K, Johnson JD, Cohenca N. Pulp revascularization of necrotic bilateral bicuspids using a modified novel technique to eliminate potential coronal discolouration: a case report. Int Endod J. 2009 Jan;42(1):84-92.
33. Li CL, Martini LG, Ford JL, Roberts M. The use of hypromellose in oral drug delivery. J Pharm Pharmacol. 2005 May;57(5):533-46.
34. Zargar N, Rayat Hosein Abadi M, Sabeti M, Yadegari Z, Akbarzadeh Baghban A, Dianat O. Antimicrobial efficacy of clindamycin and triple antibiotic paste as root canal medicaments on tubular infection: An in vitro study. Aust Endod J. 2019 Apr;45(1):86-91.
apexogenesis and apexification. Int Endod J. 2009 Nov;42(11):955-62.
2. Galler KM, Krastl G, Simon S, Van Gorp G, Meschi N, Vahedi B, Lambrechts P. European Society of Endodontology position statement: Revitalization procedures. Int Endod J. 2016 Aug;49(8):717-23.
3. American Association of Endodontics. Clinical considerations for regenerative procedures. Available at: http://www.aae.org/uploadedfiles/publications_and_research/research/currentregenerativeendodonticconsiderations.pdf .
4. Sabrah AHA, Al-Asmar AA, Alsoleihat F, Al-Zer H. The discoloration effect of diluted minocycline containing triple antibiotic gel used in revascularization. J Dent Sci. 2020 Jun;15(2):181-185
5. Sabrah AH, Yassen GH, Gregory RL. Effectiveness of antibiotic medicaments against biofilm formation of Enterococcus faecalis and Porphyromonas gingivalis. J Endod. 2013 Nov;39(11):1385-9.
6. Devaraj S, Jagannathan N, Neelakantan P. Antibiofilm efficacy of photoactivated curcumin, triple and double antibiotic paste, 2% chlorhexidine and calcium hydroxide against Enterococcus fecalis in vitro. Sci Rep. 2016 Apr 21;6:24797.
7. Thibodeau B, Trope M. Pulp revascularization of a necrotic infected immature permanent tooth: case report and review of the literature. Pediatr Dent. 2007 Jan-Feb;29(1):47-50.
8. Bakhtiar H, Esmaeili S, Fakhr Tabatabayi S, Ellini MR, Nekoofar MH, Dummer PM. Second-generation Platelet Concentrate (Platelet-rich Fibrin) as a Scaffold in Regenerative Endodontics: A Case Series. J Endod. 2017 Mar;43(3):401-408.
9. Bezgin T, Yilmaz AD, Celik BN, Kolsuz ME, Sonmez H. Efficacy of platelet-rich plasma as a scaffold in regenerative endodontic treatment. J Endod. 2015 Jan;41(1):36-44.
10. Chueh LH, Ho YC, Kuo TC, Lai WH, Chen YH, Chiang CP. Regenerative endodontic treatment for necrotic immature permanent teeth. J Endod. 2009 Feb;35(2):160-4.
11. Shah N, Logani A, Bhaskar U, Aggarwal V. Efficacy of revascularization to induce apexification/apexogensis in infected, nonvital, immature teeth: a pilot clinical study. J Endod. 2008 Aug;34(8):919-25; Discussion 1157.
12. Parhizkar A, Nojehdehian H, Asgary S. Triple antibiotic paste: momentous roles and applications in endodontics: a review. Restor Dent Endod. 2018 Jun 20;43(3):e28.
13. Tilakchand M, Hegde S, Naik B. Evaluation of the efficacy of a novel antibiotic-steroid paste versus conventionally used intracanal antibiotic pastes and irrigating solutions against a 3-week-old biofilm of Enterococcus faecalis. J Conserv Dent. 2020 Sep-Oct;23(5):436-440.
14. Lee Y, Han SH, Hong SH, Lee JK, Ji H, Kum KY. Antimicrobial efficacy of a polymeric chlorhexidine release device using in vitro model of Enterococcus faecalis dentinal tubule infection. J Endod. 2008 Jul;34(7):855-8.
15. Bose R, Nummikoski P, Hargreaves K. A retrospective evaluation of radiographic outcomes in immature teeth with necrotic root canal systems treated with regenerative endodontic procedures. J Endod. 2009 Oct;35(10):1343-9.
16. Hargreaves KM, Geisler T, Henry M, Wang Y. Regeneration potential of the young permanent tooth: what does the future hold? Pediatr Dent. 2008 May-Jun;30(3):253-60. Erratum in: Pediatr Dent. 2008 Jul-Aug;30(4):288. Giesler, Todd [corrected to Geisler, Todd].
17. Roberts-Clark DJ, Smith AJ. Angiogenic growth factors in human dentine matrix. Arch Oral Biol. 2000 Nov;45(11):1013-6.
18. Rotstein I, Ingle JI. Ingle’s Endodontics. 7th ed. Raleigh, NC: PMPH; 2019.
19. Mohammadi Z, Abbott PV. On the local applications of antibiotics and antibiotic-based agents in endodontics and dental traumatology. Int Endod J. 2009 Jul;42(7):555-67.
20. Mohammadi Z, Jafarzadeh H, Shalavi S, Yaripour S, Sharifi F, Kinoshita JI. A Review on Triple Antibiotic Paste as a Suitable Material Used in Regenerative Endodontics. Iran Endod J. 2018 Winter;13(1):1-6.
21. Dunavant TR, Regan JD, Glickman GN, Solomon ES, Honeyman AL. Comparative evaluation of endodontic irrigants against Enterococcus faecalis biofilms. J Endod. 2006 Jun;32(6):527-31.
22. Basrani B, Tjäderhane L, Santos JM, Pascon E, Grad H, Lawrence HP, et all. Efficacy of chlorhexidine- and calcium hydroxide-containing medicaments against Enterococcus faecalis in vitro. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003 Nov;96(5):618-24.
23. Hahn CL, Best AM, Tew JG. Cytokine induction by Streptococcus mutans and pulpal pathogenesis. Infect Immun. 2000 Dec;68(12):6785-9.
24. Haapasalo M, Orstavik D. In vitro infection and disinfection of dentinal tubules. J Dent Res. 1987 Aug;66(8):1375-9.
25. Shen Y, Gao Y, Lin J, Ma J, Wang Z, Haapasalo M. Methods and models to study irrigation. Endod Topics. 2012;27(1):3–34.
26. Sato T, Hoshino E, Uematsu H, Noda T. In vitro antimicrobial susceptibility to combinations of drugs on bacteria from carious and endodontic lesions of human deciduous teeth. Oral Microbiol Immunol. 1993 Jun;8(3):172-6.
27. Roche Y, Yoshimori RN. In-vitro activity of spiramycin and metronidazole alone or in combination against clinical isolates from odontogenic abscesses. J Antimicrob Chemother. 1997 Sep;40(3):353-7.
28. Windley W 3rd, Teixeira F, Levin L, Sigurdsson A, Trope M. Disinfection of immature teeth with a triple antibiotic paste. J Endod. 2005 Jun;31(6):439-43.
29. Chuensombat S, Khemaleelakul S, Chattipakorn S, Srisuwan T. Cytotoxic effects and antibacterial efficacy of a 3-antibiotic combination: an in vitro study. J Endod. 2013 Jun;39(6):813-9.
30. Kim JH, Kim Y, Shin SJ, Park JW, Jung IY. Tooth discoloration of immature permanent incisor associated with triple antibiotic therapy: a case report. J Endod. 2010 Jun;36(6):1086-91.
31. Akcay M, Arslan H, Yasa B, Kavrık F, Yasa E. Spectrophotometric analysis of crown discoloration induced by various antibiotic pastes used in revascularization. J Endod. 2014 Jun;40(6):845-8.
32. Reynolds K, Johnson JD, Cohenca N. Pulp revascularization of necrotic bilateral bicuspids using a modified novel technique to eliminate potential coronal discolouration: a case report. Int Endod J. 2009 Jan;42(1):84-92.
33. Li CL, Martini LG, Ford JL, Roberts M. The use of hypromellose in oral drug delivery. J Pharm Pharmacol. 2005 May;57(5):533-46.
34. Zargar N, Rayat Hosein Abadi M, Sabeti M, Yadegari Z, Akbarzadeh Baghban A, Dianat O. Antimicrobial efficacy of clindamycin and triple antibiotic paste as root canal medicaments on tubular infection: An in vitro study. Aust Endod J. 2019 Apr;45(1):86-91.
| Issue | Vol 21 (Continuously Published Article-Based) | |
| Section | Original Article | |
| DOI | https://doi.org/10.18502/fid.v21i1.14638 | |
| Keywords | ||
| Cefaclor Minocycline Regeneration Tooth Discoloration Tooth, Nonvital | ||
| Rights and permissions | |
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Gharechahi M, Kafi M hossein, Javidi M, Jafari N, Joibary Moghaddam M. The Efficacy of Different Antibiotic Compounds in Regenerative Treatment of Immature Necrotic Teeth. Front Dent. 2024;21.
