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Abu Zeid ST, Alamoudi RA, Alothmani OS, Mokeem Saleh AA, Siddiqui AY. A Prospective Study of Long-Term Regenerative Endodontics Outcomes of Necrotic Immature Permanent Teeth: An 8-Year Follow-Up. Healthcare (Basel) 2021; 9:healthcare9121670. [PMID: 34946396 PMCID: PMC8701996 DOI: 10.3390/healthcare9121670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 11/21/2021] [Accepted: 11/23/2021] [Indexed: 11/16/2022] Open
Abstract
For the management of necrotic immature teeth, regenerative endodontics offers the advantage of further root lengthening, thickening of dentin wall, and apical closure. This prospective study aimed to evaluate the long-term outcome of regenerative endodontics in immature necrotic permanent teeth. A total of 23 immature roots were medicated by triple antibiotic paste. After 21 days, bleeding was induced by over-instrumentation, and then mineral trioxide aggregate and coronal restoration were applied. Patients were scheduled for clinical and radiographic follow-up for 8 years. The radiographic changes of root dimensions were assessed using the ImageJ Plugin and statistically analyzed by Kruskal-Wallis test at a 95% confidence level. For qualitative evaluation, images were overlapped and analyzed using Photoshop software. All teeth were asymptomatic one month after the treatment. All teeth (n = 18) with preoperative periapical radiolucency showed complete resolution within 6-9 months. Recall rate at two, three, and eight years was 69.6%, 56.5%, and 34.8%, respectively. Continuous root development with a significant increase in root length and thickening of dentin wall accompanied by a significant decrease in apical canal diameter was seen at the end of the observation period (p < 0.001). In conclusion, the long-term outcome of regenerative endodontics revealed successful clinical and radiographic results with appropriate case selection.
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Affiliation(s)
- Sawsan T. Abu Zeid
- Department of Endodontics, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (R.A.A.); (O.S.A.); (A.A.M.S.); (A.Y.S.)
- Department of Endodontics, Cairo University, Cairo 12613, Egypt
- Correspondence: ; Tel.: +966-509528971
| | - Ruaa A. Alamoudi
- Department of Endodontics, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (R.A.A.); (O.S.A.); (A.A.M.S.); (A.Y.S.)
| | - Osama S. Alothmani
- Department of Endodontics, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (R.A.A.); (O.S.A.); (A.A.M.S.); (A.Y.S.)
| | - Abeer A. Mokeem Saleh
- Department of Endodontics, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (R.A.A.); (O.S.A.); (A.A.M.S.); (A.Y.S.)
| | - Amna Y. Siddiqui
- Department of Endodontics, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (R.A.A.); (O.S.A.); (A.A.M.S.); (A.Y.S.)
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Betancourt P, Bucchi C, Arroyo-Bote S. Determination of crown discoloration and fluorescence induced by different medications used in regenerative endodontic procedures: An ex vivo study. J Clin Exp Dent 2021; 13:e755-e761. [PMID: 34512913 PMCID: PMC8412810 DOI: 10.4317/jced.58114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 04/16/2021] [Indexed: 01/18/2023] Open
Abstract
Background Crown discoloration is an undesirable side effect of the use of triple antibiotic paste (TAP) in regenerative endodontic procedures (REPs). The aim of this ex vivo study was to assess the potential for tooth discoloration and induction of fluorescence associated with the use of TAP containing either doxycycline (DOX) or clindamycin (CLIN), and of calcium hydroxide (Ca(OH)2), by spectrophotometric analysis and confocal laser scanning microscopy (CLSM).
Material and Methods A total of forty single-rooted human teeth extracted by therapeutic indication were used. The root canals were enlarged using the step-back technique up to a K #80 file and were randomly divided into four experimental groups (10 specimens each): i)Ca(OH)2 group, ii)TAP with DOX group, iii) TAP with CLIN group, iv) Control group (no treatment). To quantify the change of color of the different groups of teeth included, the Vita Easyshade advance 4.0 spectrophotometer was used. CLSM was used to determine fluorescence.
Results After 28 days of action inside the root canal, no extreme discoloration was visible, to the naked eye, in any of the teeth included in the study. Under the conditions of this ex vivo study, TAP with DOX induced the highest crown discoloration among the medicaments tested. In contrast, Ca(OH)2 and TAP with CLIN did not induce crown discoloration after 28 days. The TAP with DOX group presented the highest fluorescence measurements.
Conclusions Considering the discoloration potential and fluorescence changes in TAP with DOX or other tetracyclines, and the cytotoxic effect of TAPs, we recommend the use of Ca(OH)2 for REPs. Key words:Discoloration, doxycycline, clinadamycin, calcium hydroxide, endodontics.
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Affiliation(s)
- Pablo Betancourt
- Research Centre for Dental Sciences (CICO), Department of Integral Adult Dentistry, Universidad de La Frontera, Temuco, Chile
| | - Cristina Bucchi
- Research Centre for Dental Sciences (CICO), Department of Integral Adult Dentistry, Universidad de La Frontera, Temuco, Chile
| | - Sebastiana Arroyo-Bote
- Associate Professor at the Faculty of Medicine and Health Sciences. University of Barcelona. Spain. Coordinating Professor of ADEMA. University of the Balearic Islands. Spain. IDIBELL Researcher
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Zancan RF, Calefi PHS, Borges MMB, Lopes MRM, Andrade FB, Vivan RR, Duarte MAH. Antimicrobial activity of intracanal medications against both
Enterococcus faecalis
and
Candida albicans
biofilm. Microsc Res Tech 2018; 82:494-500. [DOI: 10.1002/jemt.23192] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 10/18/2018] [Accepted: 11/20/2018] [Indexed: 01/09/2023]
Affiliation(s)
- Rafaela Fernandes Zancan
- Department of Restorative Dentistry, Dental Materials and EndodonticsBauru Dental School, University of São Paulo Bauru São Paulo Brazil
| | - Pedro Henrique Souza Calefi
- Department of Restorative Dentistry, Dental Materials and EndodonticsBauru Dental School, University of São Paulo Bauru São Paulo Brazil
| | - Mariana Maciel Batista Borges
- Department of Restorative Dentistry, Dental Materials and EndodonticsBauru Dental School, University of São Paulo Bauru São Paulo Brazil
| | - Marcelo Ribeiro Milanda Lopes
- Department of Restorative Dentistry, Dental Materials and EndodonticsBauru Dental School, University of São Paulo Bauru São Paulo Brazil
| | - Flaviana Bombarda Andrade
- Department of Restorative Dentistry, Dental Materials and EndodonticsBauru Dental School, University of São Paulo Bauru São Paulo Brazil
| | - Rodrigo Ricci Vivan
- Department of Restorative Dentistry, Dental Materials and EndodonticsBauru Dental School, University of São Paulo Bauru São Paulo Brazil
| | - Marco Antonio Hungaro Duarte
- Department of Restorative Dentistry, Dental Materials and EndodonticsBauru Dental School, University of São Paulo Bauru São Paulo Brazil
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Effect of Metronidazole on the Oxidoreductive Processes in the Submandibular and Parotid Glands in Experimental Research. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2018; 2018:7083486. [PMID: 30473741 PMCID: PMC6220377 DOI: 10.1155/2018/7083486] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/23/2018] [Revised: 08/22/2018] [Accepted: 10/11/2018] [Indexed: 01/06/2023]
Abstract
Oxidative stress takes part in the pathomechanisms of many diseases, including oral disorders. The imbalance between oxidative and antioxidative processes may lead to periodontitis, osteitis, or oral cancers. Furthermore, many chemotherapeutics, e.g., metronidazole (MTZ), may also cause toxic reactions and affect oxidative reactions. The research focused on MTZ influence on oxidative destruction in the parotid and submandibular gland tissue in animal experimental model. Therefore, the concentrations of enzymatic and nonenzymatic markers of oxidative stress were measured in these two rat glands in the control and experimental MTZ-treated groups. The material for analysis included parotid and submandibular glands of male Wistar rats, which were treated with metronidazole for 7 days by gastric tube in a dose of 100 mg/kg b.w. On day 8, the material was obtained and frozen in temp. -80°C. Then, the following seven enzymatic and nonenzymatic parameters were measured: GPx, TOS, TAS, SOD, LPO, CAT, and GSH. The data were analysed using Statistica 10.0. Metronidazole treatment in the experimental model showed an increase in LPO, TOS, and TOS/TAS and a decrease in CAT, SOD, GPx, and TAS. The conclusions of this research were made. Metronidazole treatment in a dose of 100 mg/kg b.w. caused imbalance between oxidative and antioxidative reactions in the rat parotid and submandibular glands. An increase was observed in LPO, TOS, and TOS/TAS in both glands exposed to metronidazole. Decreased activity of CAT, SOD, GPx, and TAS was noted, which indicates attenuation of the gland antioxidative protective barrier.
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Pereira TC, Vasconcelos LRSMD, Graeff MSZ, Duarte MAH, Bramante CM, Andrade FBD. Intratubular disinfection with tri-antibiotic and calcium hydroxide pastes. Acta Odontol Scand 2017; 75:87-93. [PMID: 27866468 DOI: 10.1080/00016357.2016.1256427] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The aim of this study was to compare the in vitro intradentinal antimicrobial ability of the calcium hydroxide and tri-antibiotic pastes. MATERIALS AND METHODS Standard bovine dentin tubes were sterilized and then infected with Enterococcus faecalis by a new contamination protocol of great depths of dentin. The specimens were filled with the medications, divided into two test-groups: calcium hydroxide (Group 1) and tri-antibiotic (Group 2) pastes. After 15 days, the teeth were evaluated by microbiological culture and confocal laser scanning microscopy (CLSM) with viability dye assay LIVE/DEAD inside dentinal tubules. In experiment of culture, the bacterial collection of the dentin fragments was done for counting the colony-forming units. RESULTS The tri-antibiotic paste had a slightly greater antimicrobial effect; however, there was no statistical difference between the groups. CONCLUSIONS It was concluded that the tri-antibiotic paste and the calcium hydroxide paste exercise the same effect on intra-tubular decontamination against E. faecalis. So, due the multiples advantages, the calcium hydroxide paste can be the choice for dentinal decontamination in regenerative procedures.
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Affiliation(s)
- Thais Cristina Pereira
- Department of Dentistry, Endodontics and Dental Materials, Bauru Dental School, University of São Paulo, Bauru, SP, Brazil
| | | | - Marcia Sirlene Zardin Graeff
- Department of Dentistry, Endodontics and Dental Materials, Bauru Dental School, University of São Paulo, Bauru, SP, Brazil
| | - Marco Antonio Hungaro Duarte
- Department of Dentistry, Endodontics and Dental Materials, Bauru Dental School, University of São Paulo, Bauru, SP, Brazil
| | - Clóvis Monteiro Bramante
- Department of Dentistry, Endodontics and Dental Materials, Bauru Dental School, University of São Paulo, Bauru, SP, Brazil
| | - Flaviana Bombarda De Andrade
- Department of Dentistry, Endodontics and Dental Materials, Bauru Dental School, University of São Paulo, Bauru, SP, Brazil
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Conde MCM, Chisini LA, Sarkis-Onofre R, Schuch HS, Nör JE, Demarco FF. A scoping review of root canal revascularization: relevant aspects for clinical success and tissue formation. Int Endod J 2016; 50:860-874. [DOI: 10.1111/iej.12711] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Accepted: 10/19/2016] [Indexed: 12/11/2022]
Affiliation(s)
- M. C. M. Conde
- Post-Graduate Program in Dentistry; School of Dentistry; Federal University of Pelotas; Pelotas Brazil
| | - L. A. Chisini
- Post-Graduate Program in Dentistry; School of Dentistry; Federal University of Pelotas; Pelotas Brazil
| | - R. Sarkis-Onofre
- Post-Graduate Program in Dentistry; School of Dentistry; Federal University of Pelotas; Pelotas Brazil
| | - H. S. Schuch
- Australian Research Centre for Population Oral Health (ARCPOH); School of Dentistry; The University of Adelaide; Adelaide Australia
| | - J. E. Nör
- Department of Cariology, Restorative Sciences and Endodontics; School of Dentistry; University of Michigan; Ann Arbor MI USA
| | - F. F. Demarco
- Post-Graduate Program in Dentistry; School of Dentistry; Federal University of Pelotas; Pelotas Brazil
- Post-Graduate Program in Epidemiology; Federal University of Pelotas; Pelotas Brazil
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In vitro evaluation of the antimicrobial effects of different intracanal medications in necrotic immature teeth. Eur Arch Paediatr Dent 2016; 17:251-5. [DOI: 10.1007/s40368-016-0236-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Accepted: 05/12/2016] [Indexed: 10/21/2022]
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Aldakak MMN, Capar ID, Rekab MS, Abboud S. Single-Visit Pulp Revascularization of a Nonvital Immature Permanent Tooth Using Biodentine. IRANIAN ENDODONTIC JOURNAL 2016; 11:246-9. [PMID: 27471541 PMCID: PMC4947854 DOI: 10.7508/iej.2016.03.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Revised: 02/13/2016] [Accepted: 04/09/2016] [Indexed: 12/12/2022]
Abstract
UNLABELLED An 11-year-old female patient was referred with a chief complaint of pain in the right mandibular second premolar. Clinical and radiographic examinations showed secondary caries under an old composite restoration, a negative response to a pulp test and an immature root with an open apex. After root canal cleaning and shaping, bleeding was invoked in the canal up to 2 mm short of the cemento-enamel junction (CEJ). After 10 min to allow clotting at this level, a plug of Biodentine was placed over the blood clot and the tooth was temporized with glass ionomer cement. At the next visit, the tooth was free of symptoms and a permanent filling was placed. Clinical and radiographic examinations during a two-year follow-up showed complete root maturation and intact supporting soft tissues without sinus tract, pain or swelling. CONCLUSION The use of Biodentine in a single-visit apexification protocol to treat an immature permanent tooth with necrotic pulp can create a suitable environment for revascularization, resulting in the completion of root maturation.
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Kahler B, Rossi-Fedele G. A Review of Tooth Discoloration after Regenerative Endodontic Therapy. J Endod 2016; 42:563-9. [DOI: 10.1016/j.joen.2015.12.022] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2015] [Revised: 11/21/2015] [Accepted: 12/22/2015] [Indexed: 12/31/2022]
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Effects of a triple antibiotic solution on pulpal dynamics after intentionally delayed tooth replantation in mice. J Endod 2014; 40:1566-72. [PMID: 25260727 DOI: 10.1016/j.joen.2014.05.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2014] [Revised: 04/05/2014] [Accepted: 05/09/2014] [Indexed: 01/09/2023]
Abstract
INTRODUCTION This study analyzed the detailed biological events underlying pulpal dynamics evoked by 3Mix (the mixture of ciprofloxacin, metronidazole, and minocycline) solution after intentionally delayed tooth replantation because 3Mix improves pulpal healing after tooth injuries. METHODS The maxillary first molars of 3-week-old mice were extracted and immersed in 3Mix solution for 30 minutes in comparison with phosphate buffered saline (PBS) alone. Cell proliferation, apoptosis, and differentiation were assessed in extracted/replanted teeth during days 0-14 using immunohistochemistry, apoptosis assay, and reverse-transcriptase polymerase chain reaction. RESULTS 3Mix solution accelerated odontoblast differentiation in the coronal pulp on day 7 and tertiary dentin formation on day 14, whereas the regenerative process was delayed in the PBS group. Cell proliferation and apoptosis occurred in the pulp of the 3Mix group during days 5-7 and subsequently decreased from days 7-14. On day 5, dentin sialophosphoprotein and nestin were first recovered in the 3Mix group, whereas expression levels for alkaline phosphatase, osteopontin, and osteocalcin increased in the PBS group. The expression levels for octamer-binding factor 3/4A and 3/4B reached the maximum level on day 1 and were sharply decreased on day 3 in both groups. High expression levels of Cd11c were first observed in the 3Mix group on day 1 and later at days 5 and 7. CONCLUSIONS The results suggest that the application of 3Mix may suppress osteoblast differentiation by the migration of dendritic cells to the injury site and via the activation of stem/progenitor cells, resulting in the acceleration of odontoblastlike cell differentiation.
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Güven Polat G, Yıldırım C, Akgün OM, Altun C, Dinçer D, Ozkan CK. The use of platelet rich plasma in the treatment of immature tooth with periapical lesion: a case report. Restor Dent Endod 2014; 39:230-4. [PMID: 25110649 PMCID: PMC4125589 DOI: 10.5395/rde.2014.39.3.230] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2014] [Accepted: 04/23/2014] [Indexed: 01/08/2023] Open
Abstract
This study describes the treatment of an immature permanent tooth with periapical lesion which was treated with regenerative approach using platelet rich plasma (PRP). The root canal of immature human permanent tooth with periapical lesion was gently debrided of necrotic tissue and disinfected with 2.5% NaOCl, and then medicated with triple antibiotic paste comprised of ciprofloxacin, metronidazole, and tetracycline. When the tooth was asymptomatic, PRP and mineral trioxide aggregate (MTA) were placed into the root canal. Six months after PRP treatment, radiographical examination revealed resolution of the radiolucency and progressive thickening of the root wall and apical closure. Our findings suggest that PRP can be used for the treatment of immature permanent teeth with periapical lesion, as part of a regenerative endodontic treatment procedure.
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Affiliation(s)
- Günseli Güven Polat
- Department of Pediatric Dentistry, Center for Dental Sciences, Gulhane Medical Academy, Ankara, Turkey
| | - Ceren Yıldırım
- Department of Pediatric Dentistry, Center for Dental Sciences, Gulhane Medical Academy, Ankara, Turkey
| | - Ozlem Martı Akgün
- Department of Pediatric Dentistry, Center for Dental Sciences, Gulhane Medical Academy, Ankara, Turkey
| | - Ceyhan Altun
- Department of Pediatric Dentistry, Center for Dental Sciences, Gulhane Medical Academy, Ankara, Turkey
| | - Didem Dinçer
- Department of Dermatology, Gulhane Medical Academy, Ankara, Turkey
| | - Cansel Köse Ozkan
- Center for Pharmaceutical Sciences, Gulhane Medical Academy, Ankara, Turkey
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Pereira MSS, Rossi MA, Cardoso CR, da Silva JS, Bezerra da Silva LA, Kuga MC, Faria G. Cellular and molecular tissue response to triple antibiotic intracanal dressing. J Endod 2014; 40:499-504. [PMID: 24666899 DOI: 10.1016/j.joen.2013.10.029] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2013] [Revised: 09/26/2013] [Accepted: 10/18/2013] [Indexed: 02/09/2023]
Abstract
INTRODUCTION The aim of this study was to characterize the response of mouse subcutaneous tissue to triple antibiotic paste (TAP) using conventional light microscopy and real-time PCR (qRT-PCR). METHODS Polyethylene tubes containing TAP or calcium hydroxide (CH) (ie, the control group) were implanted in mouse subcutaneous tissue. Animals that received empty tubes or no tubes were used as additional controls. After periods of 7, 21, and 63 days postimplantation, the specimens were removed and subjected to histologic processing. The number of inflammatory cells and vessels, vessel areas, vascular density, and relative percentage of collagen were evaluated. Gene expression of proinflammatory (interleukin-1 beta, tumor necrosis factor alpha, and interleukin 17) and anti-inflammatory (transforming growth factor beta) cytokines and angiogenic factors (vascular endothelial growth factor and hypoxia-inducible factor-1 alpha) was quantified by 7 and 21 days postimplantation. Results were analyzed using the Student t test, analysis of variance, and the Tukey test (α = 0.05). RESULTS TAP induced an exuberant inflammatory and angiogenic response, with higher numbers of inflammatory cells, higher vascular area and density, and lower relative percentage of collagen compared with CH. In general, the expression of genes involved in inflammation and angiogenesis was higher in the TAP group compared with animals that received CH or empty tubes. CONCLUSIONS The response of mouse subcutaneous tissue to TAP was characterized by exuberant and persistent inflammatory and angiogenic responses with no repair and high gene expression of biomarkers associated with inflammation and angiogenesis.
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Affiliation(s)
- Maristela Soares Swerts Pereira
- Department of Paediatric Dentistry, Preventive and Community Dentistry, Ribeirão Preto Dentistry School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil; Department of Paediatric Dentistry, Alfenas Dentistry School, University José Rosário Vellano, Unifenas, Alfenas, Minas Gerais, Brazil
| | | | - Cristina Ribeiro Cardoso
- Department of Clinical Analyzes, Toxixology and Food Sciences, Ribeirão Preto Pharmaceutical Sciences School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - João Santana da Silva
- Department of Biochemistry and Immunology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Léa Assed Bezerra da Silva
- Department of Paediatric Dentistry, Preventive and Community Dentistry, Ribeirão Preto Dentistry School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Milton Carlos Kuga
- Department of Restorative Dentistry, Araraquara Dental School, UNESP - Univ Estadual Paulista, Araraquara, São Paulo, Brazil
| | - Gisele Faria
- Department of Restorative Dentistry, Araraquara Dental School, UNESP - Univ Estadual Paulista, Araraquara, São Paulo, Brazil.
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Moreno-Hidalgo MC, Caleza-Jimenez C, Mendoza-Mendoza A, Iglesias-Linares A. Revascularization of immature permanent teeth with apical periodontitis. Int Endod J 2013; 47:321-31. [PMID: 23889557 DOI: 10.1111/iej.12154] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2013] [Accepted: 06/29/2013] [Indexed: 01/04/2023]
Abstract
The aim of this minireview was to identify and review the scientific evidence regarding regenerative endodontic protocols claiming to revascularize permanent immature teeth with apical periodontitis. The literature was identified using the PubMed/MEDLINE, Scopus, Scirus, EMBASE and Cochrane databases up to February 2013. Studies were selected independently by two different researchers (kappa index: 0.88), based on established inclusion/exclusion criteria. The methodological quality of the reviewed papers was classified as high, medium or low (HQ, MQ, LQ). The search strategy identified 285 titles. Nine studies, both human and animal based, were selected after application of the criteria (LQ:5; MQ:4). In most of these studies (seven of nine), the revascularization protocol included a triple antibiotic combination as canal disinfectant for a period of 1-4 weeks after blood clot formation (LQ:5; MQ:4), although there is no clear consensus about the treatment protocol. Two studies reported tooth discoloration after the revascularization process (LQ:2), and only three (LQ:1; MQ:2) reported a success rate of 54.9% in dogs and 73.6% and 80% in humans, respectively. Revascularization of immature permanent teeth with apical periodontitis is possible and preferable to apexification. Nevertheless, there is a widespread lack of randomized clinical trials and blinded measures. In addition, the small sample sizes that are common in these studies as well as the generally low quality of the analysed publications require the results to be viewed with caution. There is a high risk of bias, with a low quality of available information, for developing clinical guidelines for regenerative endodontic protocols; rigorous randomized clinical trials are therefore needed.
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Quispe-Salcedo A, Ida-Yonemochi H, Ohshima H. Use of a triple antibiotic solution affects the healing process of intentionally delayed replanted teeth in mice. J Oral Biosci 2013. [DOI: 10.1016/j.job.2013.03.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Mandras N, Roana J, Allizond V, Pasqualini D, Crosasso P, Burlando M, Banche G, Denisova T, Berutti E, Cuffini A. Antibacterial Efficacy and Drug-Induced Tooth Discolouration of Antibiotic Combinations for Endodontic Regenerative Procedures. Int J Immunopathol Pharmacol 2013; 26:557-63. [DOI: 10.1177/039463201302600232] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Elimination of microbial contamination from the root canal system is a precondition for successful root canal treatment. Teeth with immature root development, necrotic pulps and apical periodontitis present multiple challenges for successful treatment. Disinfection is achieved by irrigation followed by the placement of an intracanal medicament. A mixture of ciprofloxacin, metronidazole and minocycline (3-MIX S) has been shown to be very effective in eliminating endodontic pathogens in vitro and in vivo. Among the components of the mixture, minocycline can induce tooth discolouration after long-term oral use. Therefore, the elimination of minocycline from the above-mentioned combination has been suggested to prevent the occasion of this undesirable effect. The aim of this study was to investigate the potential antimicrobial efficacy of alternative antibiotic combinations [3-MIX C (clarithromycin); 3-MIX F (fosfomycin)] against bacteria from infected root canals. An additional objective was to evaluate their discolouration potential as possible alternatives to minocycline-based intracanal medicaments. Our in vitro results clearly demonstrated that 3-MIX C and 3-MIX F had a greater antimicrobial activity than 3-MIX S, underlying that clarithromycin still had a higher capacity to kill endodontic pathogens in vitro compared to fosfomycin. Both 3-MIX C and 3-MIX F were able to avoid the permanent staining effect of the crown.
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Affiliation(s)
- N. Mandras
- Department of Public Health Sciences and Paediatrics, University of Turin, Turin, Italy
| | - J. Roana
- Department of Public Health Sciences and Paediatrics, University of Turin, Turin, Italy
| | - V. Allizond
- Department of Public Health Sciences and Paediatrics, University of Turin, Turin, Italy
| | - D. Pasqualini
- Department of Surgical Sciences, Dental School, Endodontics, University of Turin, Turin, Italy
| | - P. Crosasso
- Department of Pharmacy, AO Città della Salute e della Scienza of Turin, Turin, Italy
| | - M. Burlando
- Department of Pharmacy, AO Città della Salute e della Scienza of Turin, Turin, Italy
| | - G. Banche
- Department of Public Health Sciences and Paediatrics, University of Turin, Turin, Italy
| | - T. Denisova
- Department of Surgical Sciences, Dental School, Endodontics, University of Turin, Turin, Italy
| | - E. Berutti
- Department of Surgical Sciences, Dental School, Endodontics, University of Turin, Turin, Italy
| | - A.M. Cuffini
- Department of Public Health Sciences and Paediatrics, University of Turin, Turin, Italy
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Vijayaraghavan R, Mathian VM, Sundaram AM, Karunakaran R, Vinodh S. Triple antibiotic paste in root canal therapy. J Pharm Bioallied Sci 2012; 4:S230-3. [PMID: 23066258 PMCID: PMC3467921 DOI: 10.4103/0975-7406.100214] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2011] [Revised: 01/02/2012] [Accepted: 01/26/2012] [Indexed: 11/04/2022] Open
Abstract
The success of the endodontic treatment depends on the microbial suppression in the root canal and periapical region. Endodontic instrumentation alone cannot achieve a sterile condition. With the advent of non-instrumentation endodontic treatment and lesion sterilization and tissue repair, local application of antibiotics has been investigated. Triple antibiotic paste (TAP) containing metronidazole, ciprofloxacin, and minocycline has been reported to be a successful regimen in controlling the root canal pathogen and in managing non-vital young permanent tooth. This paper reviews the existing literature on biocompatibility, efficiency, drawbacks of TAP in endodontic therapy and pulp revascularization.
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Affiliation(s)
- Rangasamy Vijayaraghavan
- Department of Pedodontics and Reventive Dentistry, Vivekanandha Dental College for Women, Tiruchengode, Tamil Nadu, India
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Andreasen JO, Bakland LK. Pulp regeneration after non-infected and infected necrosis, what type of tissue do we want? A review. Dent Traumatol 2011; 28:13-8. [DOI: 10.1111/j.1600-9657.2011.01057.x] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Revascularization and periapical repair after endodontic treatment using apical negative pressure irrigation versus conventional irrigation plus triantibiotic intracanal dressing in dogs' teeth with apical periodontitis. ACTA ACUST UNITED AC 2010; 109:779-87. [DOI: 10.1016/j.tripleo.2009.12.046] [Citation(s) in RCA: 135] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2009] [Revised: 12/15/2009] [Accepted: 12/24/2009] [Indexed: 11/18/2022]
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