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Atila D, Kumaravel V. Advances in antimicrobial hydrogels for dental tissue engineering: regenerative strategies for endodontics and periodontics. Biomater Sci 2023; 11:6711-6747. [PMID: 37656064 DOI: 10.1039/d3bm00719g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
Dental tissue infections have been affecting millions of patients globally leading to pain, severe tissue damage, or even tooth loss. Commercial sterilizers may not be adequate to prevent frequent dental infections. Antimicrobial hydrogels have been introduced as an effective therapeutic strategy for endodontics and periodontics since they have the capability of imitating the native extracellular matrix of soft tissues. Hydrogel networks are considered excellent drug delivery platforms due to their high-water retention capacity. In this regard, drugs or nanoparticles can be incorporated into the hydrogels to endow antimicrobial properties as well as to improve their regenerative potential, once biocompatibility criteria are met avoiding high dosages. Herein, novel antimicrobial hydrogel formulations were discussed for the first time in the scope of endodontics and periodontics. Such hydrogels seem outstanding candidates especially when designed not only as simple volume fillers but also as smart biomaterials with condition-specific adaptability within the dynamic microenvironment of the defect site. Multifunctional hydrogels play a pivotal role against infections, inflammation, oxidative stress, etc. along the way of dental regeneration. Modern techniques (e.g., 3D and 4D-printing) hold promise to develop the next generation of antimicrobial hydrogels together with their limitations such as infeasibility of implantation.
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Affiliation(s)
- Deniz Atila
- International Centre for Research on Innovative Biobased Materials (ICRI-BioM) - International Research Agenda, Lodz University of Technology, Żeromskiego 116, 90-924, Lodz, Poland.
| | - Vignesh Kumaravel
- International Centre for Research on Innovative Biobased Materials (ICRI-BioM) - International Research Agenda, Lodz University of Technology, Żeromskiego 116, 90-924, Lodz, Poland.
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Balbinot GS, Leitune VCB, Zatta KC, Benin T, Guterres SS, Collares FM. Controlled drug delivery from metronidazole-containing bioactive endodontic cements. Dent Mater 2023; 39:839-845. [PMID: 37500315 DOI: 10.1016/j.dental.2023.07.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 07/17/2023] [Accepted: 07/18/2023] [Indexed: 07/29/2023]
Abstract
OBJECTIVES This study aims to formulate metronidazole liquid nanocapsules (MTZLNC) and evaluate their effect on the physicochemical and biological properties of calcium silicate-based bioactive endodontic cements, in vitro. METHODS A MTZLNC suspension was formulated by deposition of the preformed polymer and characterized by laser diffraction and high-performance liquid chromatography (HPLC). Calcium silicate (CS) was mixed with a radiopaque agent (calcium tungstate - CaWO4), at 10 wt%, to produce the cement powder. Cements liquids were used with two concentrations of MTZLNC suspension: 0.3 mg/ml and 0.15 mg/ml. Cements prepared with distilled water were used as the control. The radiopacity, setting time, and flow were evaluated following ISO 6876:2012. The compressive strength analysis was conducted according to ISO 9917:2007. pH and mineral deposition were evaluated after immersion in simulated body fluid (SBF). Cell behavior was evaluated by the viability of pre-osteoblastic cells and pulp fibroblasts by SRB and MTT and the antibacterial activity against Enterococcus faecalis was analyzed immediately and after nine months of water storage. RESULTS MTZLNCs were formulated with a median diameter of 148 nm and 83.44 % load efficiency. Increased flow and reduced strength were observed for both MTZLNCs concentrations. The incorporation of MTZLNCs maintained the ability of cements to increase pH media and promote mineral deposition over the samples, without promoting cytotoxicity. A 2 log10 reduction in E. faecalis CFU was observed immediately and after nine months in water storage. CONCLUSION The formulation of MTZLNCs allowed the development of antibacterial calcium silicate-based-cements with suitable physicochemical properties and bioactivity, with a reduction in mechanical strength. The 0.3 mg/ml concentration in cements liquid promoted effective and sustainable antibacterial activity.
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Affiliation(s)
- Gabriela Souza Balbinot
- Department of Dental Materials, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Vicente Castelo Branco Leitune
- Department of Dental Materials, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Kelly Cristina Zatta
- Cosmetology and Pharmaceutical Nanotechnology Laboratory, School of Pharmaceutical Sciences, Universidade Federal do Rio Grande do Sul, Av. Ipiranga 2752, 90610-000 Porto Alegre, RS, Brazil
| | - Tainara Benin
- Pharmaceutical Nanotechnology Laboratory, School of Pharmaceutical Sciences, Universidade Federal do Rio Grande do Sul, Av. Ipiranga 2752, 90610-000 Porto Alegre, RS, Brazil
| | - Silvia Stanisçauski Guterres
- Programa de Pós-Graduação em Ciências Farmacêuticas, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil; Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Fabricio Mezzomo Collares
- Department of Dental Materials, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
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Eskandari F, Ghahramani Y, Abbaszadegan A, Gholami A. The antimicrobial efficacy of nanographene oxide and double antibiotic paste per se and in combination: part II. BMC Oral Health 2023; 23:253. [PMID: 37131216 PMCID: PMC10155346 DOI: 10.1186/s12903-023-02957-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 04/10/2023] [Indexed: 05/04/2023] Open
Abstract
BACKGROUND Finding strategies to overcome the rising trends of antimicrobial resistance against currently available antimicrobial agents has become increasingly relevant. Graphene oxide has recently emerged as a promising material due to its outstanding physicochemical and biological properties. This study aimed to validate previous data on the antibacterial activity of nanographene oxide (nGO), double antibiotic paste (DAP), and their combination (nGO-DAP). METHODS The antibacterial evaluation was performed against a wide range of microbial pathogens. Synthesis of nGO was achieved using a modified Hummers' method, and loading it with ciprofloxacin and metronidazole resulted in nGO-DAP. The microdilution method was utilized to assess the antimicrobial efficacy of nGO, DAP, and nGO-DAP against two gram-positive bacteria (S. aureus and E. faecalis), two gram-negative bacteria (E. coli, and S. typhi), and an opportunistic pathogenic yeast (C. albicans). Statistical analysis was conducted using one-sample t-test and one-way ANOVA (α = 0.05). RESULTS All three antimicrobial agents significantly increased the killing percent of microbial pathogens compared to the control group (P < 0.05). Furthermore, the synthesized nGO-DAP exhibited higher antimicrobial activity than nGO and DAP per se. CONCLUSION The novel synthesized nGO-DAP can be used as an effective antimicrobial nanomaterial for use in dental, biomedical, and pharmaceutical fields against a range of microbial pathogens, including gram-negative and gram-positive bacteria, as well as yeasts.
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Affiliation(s)
- Fateme Eskandari
- Dentist, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Yasamin Ghahramani
- Department of Endodontics, School of Dentistry, Shiraz University of Medical Sciences, Ghasrdasht Street, Shiraz, 71956-15878, Iran
| | - Abbas Abbaszadegan
- Department of Endodontics, School of Dentistry, Shiraz University of Medical Sciences, Ghasrdasht Street, Shiraz, 71956-15878, Iran.
| | - Ahmad Gholami
- Biotechnology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
- Pharmaceutical Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
- Department of Pharmaceutical Biotechnology, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran.
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Rafatjou R, Kamali Sabeti A, Ahmadi B, Soleimani Asl S, Farhadian M. Evaluation of the Cytotoxicity of Two Types of Triple Antibiotic Paste on Human Permanent Dental Apical Papilla Stem Cells: an in vitroin vitro Study. JOURNAL OF DENTISTRY (SHIRAZ, IRAN) 2022; 23:230-237. [PMID: 36380837 PMCID: PMC9652051 DOI: 10.30476/dentjods.2021.89588.1422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 07/17/2021] [Accepted: 08/29/2021] [Indexed: 11/24/2022]
Abstract
Statement of the Problem The use of a new antimicrobial combination in the regenerative endodontic treatment of immature teeth pulp necrosis is a well-known method. Concerns have been raised about the destructive effect of this combination on the stem cells from the apical papilla of permanent human teeth, and there is a study gap. Purpose The main objective of the present study was to investigate the cytotoxic effect of modified triple antibiotic paste (mTAP) on stem cells from the apical papilla (SCAPs) of permanent human teeth. Materials and Method In this in vitro study, stem cells were removed from the immature teeth. After cultivation and third passage, metronidazole, ciprofloxacin, minocycline, and clindamycin were placed in the cell culture medium alone , paired, and in combinations as triple antibiotic paste (TAP) (metronidazole, ciprofloxacin, and minocycline) and mTAP (metronidazole, ciprofloxacin, clindamycin) with doses of 25, 50, 100, 200, 400μg/ml. After 1 and 3 days, cell viability in the culture medium was assessed using the MTT method ([4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide). SPSS software version 24, descriptive statistics methods, and statistical tests such as Kruskal-Wallis and Mann-Whitney tests were adopted to analyze the data. Results Analysis of MTT findings indicated that the use of mTAP at 100μg/ml and TAP at 200μg/ml had no adverse cytotoxic effect on stem cells in the first 24 hours, compared to the control group. The cell viability decreased at higher concentrations, although it was not statistically significant. After 72 hours, the toxicity of concentrations higher than 100μg/ml of mTAP and 400 μg/ml of TAP significantly mitigated the percentage of viable cells. Conclusion The obtained results demonstrated that the concentration of 100 μg/ml of mTAP could replace TAP in regenerative endodontic treatments at the studied time intervals without worrying about the toxicity.
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Affiliation(s)
- Rezvan Rafatjou
- Pedodontist, Dept. of Pediatric Dentistry, Dental School, Hamedan University of Medical Sciences, Hamedan, Iran
| | - Arghavan Kamali Sabeti
- Pedodontist, Dept. of Pediatric Dentistry, Dental School, Hamedan University of Medical Sciences, Hamedan, Iran
| | - Bahar Ahmadi
- Dentist, Resident of Pediatric Dentistry, Dental School, Hamedan University of Medical Sciences, Hamedan, Iran
| | - Sara Soleimani Asl
- Dept. of Anatomy, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Maryam Farhadian
- Dept. of Biostatistics, Hamadan University of Medical Sciences, Hamadan, Iran
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Effect of Different Intracanal Medicaments on the Viability and Survival of Dental Pulp Stem Cells. J Pers Med 2022; 12:jpm12040575. [PMID: 35455691 PMCID: PMC9032254 DOI: 10.3390/jpm12040575] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 03/29/2022] [Accepted: 04/02/2022] [Indexed: 02/07/2023] Open
Abstract
Background: Stem cells play an important role in the success of regenerative endodontic procedures. They are affected by the presence of medicaments that are used before the induction of bleeding or the creation of a scaffold for endodontic regeneration. This study examines the effects of different intracanal medicaments on the viability and survival of dental pulp stem cells at different doses and over different exposure times. Methods: Dental pulp stem cells were cultured from healthy third molar teeth using the long-term explant culture method and characterized using flow cytometry and exposed to different concentrations of calcium hydroxide, doxycycline, potassium iodide, triamcinolone, and glutaraldehyde, each ranging from 0 (control) to 1000 µg/mL. Exposure times were 6, 24, and 48 h. Cell viability was measured using the MTT assay, and apoptosis was measured using the Annexin V-binding assay. Results: All medicaments significantly reduced cell viability at different concentrations over different exposure times. Calcium hydroxide and triamcinolone favored cell viability at higher concentrations during all exposure times compared to other medicaments. The apoptosis assay showed a significant increase in cell death on exposure to doxycycline, potassium iodide, and glutaraldehyde. Conclusion: The intracanal medicaments examined in our study affected the viability of dental pulp stem cells in a time and dose-dependent manner. They also adversely affected the survival of dental pulp stem cells. Further studies are needed to better understand the effect of prolonged exposure to medicaments according to clinical protocols and their effect on the stemness of dental pulp stem cells.
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Efficacy of Ciprofloxacin, Metronidazole and Minocycline in Ordered Mesoporous Silica against Enterococcus faecalis for Dental Pulp Revascularization: An In-Vitro Study. MATERIALS 2022; 15:ma15062266. [PMID: 35329718 PMCID: PMC8953332 DOI: 10.3390/ma15062266] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 03/13/2022] [Accepted: 03/14/2022] [Indexed: 11/16/2022]
Abstract
Pulp revascularization of teeth with necrotic pulp has become an alternative treatment in cases with immature apex. Microbial control is essential to achieve a successful outcome and continued root development. Enterococcus faecalis (E. faecalis) is the most frequently isolated bacterial species in root canals of endodontically failed teeth. Our main goal was to compare the in-vitro antimicrobial efficacy of different antibiotic formulations delivered by ordered mesoporous silica (OMS) against E. faecalis. To determine antibiotic susceptibility, we tested OMS and triple antibiotic paste (TAP; ciprofloxacin:metronidazole:minocycline) with different reagents in different concentrations, using the Kirby−Bauer disk diffusion method. OMS and metronidazole showed no antibacterial activity against E. faecalis. Mixtures of OMS and antibiotics in proportions of 2:2:14 and 4:1:7 (mg/L of ciprofloxacin:metronidazole:minocycline, respectively) showed the lowest antibacterial activity. The antibacterial activity of the combined solutions of ciprofloxacin and metronidazole was significantly higher (p < 0.005). Combinations in different concentrations of minocycline, ciprofloxacin, and metronidazole in OMS have shown activity against E. faecalis, although the combined use of ciprofloxacin and metronidazole has shown the most effective results. This study demonstrates the efficacy of intracanal antibiotic combination paste activity against E. faecalis, avoiding the use of minocycline, whose undesirable effect of teeth staining is a common problem for patients and professionals in dental clinic.
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Alencar MN, Kowaltschuk TC, Kowalczuck A, Carneiro E, da Silva Neto UX, Ditzel Westphalen VP. Regenerative Endodontic Treatment of a Traumatized Immature Necrotic Permanent Incisor: A Case Report. IRANIAN ENDODONTIC JOURNAL 2022; 17:146-150. [PMID: 36704083 PMCID: PMC9869012 DOI: 10.22037/iej.v17i3.36970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 07/14/2022] [Accepted: 07/23/2022] [Indexed: 01/28/2023]
Abstract
The current case report documents the clinical approach adopted for a traumatized immature necrotic permanent upper left central incisor after a bike accident. The treatment involved regenerative endodontic procedures (REPs) using "High Plasticity Mineral Trioxide Aggregate" (MTA Repair HP) as a cervical barrier over blood clot. The preservation included three years of follow-up appointments of clinical evaluations and periapical digital radiographs. Cone beam computer tomography (CBCT) was taken at six and thirty-six months for the evaluation of root development.
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Affiliation(s)
- Marisa Nogueira Alencar
- Division of Endodontics, School of Life Sciences, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil
| | - Tatiana Carvalho Kowaltschuk
- Division of Endodontics, School of Life Sciences, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil
| | - Alexandre Kowalczuck
- Division of Endodontics, School of Life Sciences, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil
| | - Everdan Carneiro
- Division of Endodontics, School of Life Sciences, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil
| | - Ulisses Xavier da Silva Neto
- Division of Endodontics, School of Life Sciences, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil
| | - Vânia Portela Ditzel Westphalen
- Division of Endodontics, School of Life Sciences, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil,Corresponding author: Vânia Portela Ditzel Westphalen-Rua Pasteur, 486/401 Curitiba, Paraná, Brazil, Zip code: 80250-080. Tel: +5541-99962 5110, E-mail:
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Sousa MGDC, Xavier PD, Cantuária APDC, Amorim IA, Almeida JA, Franco OL, Rezende TMB. Antimicrobial and immunomodulatory in vitro profile of double antibiotic paste. Int Endod J 2021; 54:1850-1860. [PMID: 34033685 DOI: 10.1111/iej.13576] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 05/19/2021] [Accepted: 05/21/2021] [Indexed: 12/20/2022]
Abstract
AIM To evaluate the antimicrobial and immunomodulatory activity of double antibiotic paste (DAP) in an in vitro infection model. METHODOLOGY The minimum inhibitory and bactericidal concentrations (MIC and MBC) and the antibiofilm activities (TTC assay) of DAP and its components (ciprofloxacin and metronidazole) were evaluated against Staphylococcus aureus and Enterococcus faecalis compared with triple antibiotic paste (TAP). The cellular viability of RAW 264.7 macrophages (24 and 72 h) and L929 fibroblasts (48 and 72 h) was evaluated by MTT. Furthermore, the production of TNF-α, IL-12, IL-6, IL-1α, IL-10 and NO (on RAW 264.7), besides IL-6, TGF-β and NO (on L929), stimulated with DAP in baseline and associated with heat-killed microbial-antigen conditions was measured by ELISA and Griess reaction. Data were analysed using the one-way ANOVA test with Bonferroni's corrections. RESULTS The MBC of pharmacopoeia DAP was similar to TAP for E. faecalis (0.25 μg. mL-1 ) and lower for S. aureus (DAP 1 μg. mL-1 and TAP 2 μg. mL-1 ; p < .001). Ciprofloxacin was the most effective antibiofilm drug from the pastes (35% of reduction for E. faecalis and S. aureus; p < .0001), and both pastes had a similar antibiofilm eradication against both biofilm species (29% and 35% for S. aureus and 76% and 85% for E. faecalis; p < .0001). DAP was cytotoxic against the tested cells. DAP significantly upregulated IL-1α (p < .001), IL-6 (p < .0001), TNF-α (p < .01) and IL-12 (p < .05; in the absence of antigens) and significantly reduced IL-6 (p < .0001; in the presence of HK-S. aureus) and IL-10 (p < .05; in the presence of both antigens) on macrophages. Furthermore, DAP upregulated IL-6 (p < .001) and NO (p < .05; in the absence of antigens), IL-6 (p < .001; in the presence of HK-S. aureus) and reduced NO (p < .001; in the presence of HK-S. aureus). CONCLUSIONS Double antibiotic paste and TAP had similar antimicrobial activity against S. aureus and E. faecalis. DAP upregulated pro-inflammatory cytokines mainly in the absence of antigens and had pro- and anti-inflammatory activity in RAW 264.7 macrophages and L929 fibroblasts in the presence of antigens involved in pulp infections.
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Affiliation(s)
- Maurício Gonçalves da Costa Sousa
- Pós-Graduação em Ciências Genômicas e Biotecnologia, Centro de Análises Proteômicas e Bioquímicas, Universidade Católica de Brasília, Brasília, Brazil
| | | | | | - Ingrid Aquino Amorim
- Pós-Graduação em Ciências Genômicas e Biotecnologia, Centro de Análises Proteômicas e Bioquímicas, Universidade Católica de Brasília, Brasília, Brazil.,Curso de Odontologia, Centro Universitário Unieuro, Brasília, Brazil
| | - Jeeser Alves Almeida
- Pós-Graduação em Saúde e Desenvolvimento na Região Centro Oeste, Faculdade de Medicina, Universidade Federal de Mato Grosso do Sul, Campo Grande, Brazil
| | - Octavio Luiz Franco
- Pós-Graduação em Ciências Genômicas e Biotecnologia, Centro de Análises Proteômicas e Bioquímicas, Universidade Católica de Brasília, Brasília, Brazil.,Pós-Graduação em Patologia Molecular, Universidade de Brasília, Brasília, Brazil.,S-Inova Biotech, Pós-Graduação em Biotecnologia, Universidade Católica Dom Bosco, Campo Grande, Brazil
| | - Taia Maria Berto Rezende
- Pós-Graduação em Ciências Genômicas e Biotecnologia, Centro de Análises Proteômicas e Bioquímicas, Universidade Católica de Brasília, Brasília, Brazil.,Pós-Graduação em Ciências da Saúde, Faculdade de Ciências da Saúde, Universidade de Brasília, Brasília, Brazil.,Curso de Odontologia, Universidade Católica de Brasília, Brasília, Brazil
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Khoshkhounejad M, Sharifian M, Assadian H, Afshar MS. Antibacterial effectiveness of diluted preparations of intracanal medicaments used in regenerative endodontic treatment on dentin infected by bacterial biofilm: An ex vivo investigation. Dent Res J (Isfahan) 2021; 18:37. [PMID: 34322213 PMCID: PMC8314970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 03/03/2020] [Accepted: 05/03/2020] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Conventional drug mixtures used in regenerative endodontic procedures have a toxic effect and no consensus has been reached about their best composition and concentration. Therefore, the aim of this study was to determine minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC), and minimum biofilm inhibitory concentration (MBIC) of the antimicrobial preparations and to compare their antimicrobial efficacy on bovine dentin infected by Enterococcus faecalis. MATERIALS AND METHODS For this original ex vivo investigation, prepared concentrations (MIC, MBC, and MBIC) of triple antibiotic paste (TAP), double antibiotic paste (DAP), modified triple antibiotic paste (MTAP)-1, MTAP2, co-amoxiclav, and calcium hydroxide (CH) were added to the prepared bovine dentin blocks (which incubated in E. faecalis suspension previously) and incubated for 3 days. The samples were subsequently prepared for culture and CFU counts. Statistical analysis of data was carried out using one-way analysis of variance and post hoc tests. The statistical power was set at P < 0.05. RESULTS All medicament groups significantly showed an antimicrobial efficacy compared with negative control (without antibiotic) (P < 0.001). TAP, DAP, co-amoxiclav, and CH (at its MBC value) were significantly capable of eliminating E. faecalis biofilm and showed no significant difference in comparison with positive control (complete biofilm removal) (P < 0.05). CONCLUSION TAP, DAP, co-amoxiclav, and CH (at its MBC value) could effectively eliminate biofilm bacteria on the dentin surface. Antimicrobial efficacy of other medicaments containing cefaclor or clindamycin was limited.
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Affiliation(s)
- Mehrfam Khoshkhounejad
- Department of Endodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Sharifian
- Department of Endodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Hadi Assadian
- Department of Endodontics, School of Dentistry, Shahed University, Tehran, Iran
| | - Mahsa Sobhi Afshar
- Department of Endodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran,Address for correspondence: Dr. Mahsa Sobhi Afshar, Department of Endodontics, School of Dentistry, Tehran University of Medical Sciences, North Karegar, Tehran, Iran. E-mail:
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Dahake PT, Baliga SM, Kumbar VM, Bhat KG. Cytotoxicity of Novel Polymeric Gel Matrix Triple Antibiotic Paste—an In Vitro Study. REGENERATIVE ENGINEERING AND TRANSLATIONAL MEDICINE 2020. [DOI: 10.1007/s40883-020-00191-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Ribeiro JS, Münchow EA, Ferreira Bordini EA, de Oliveira da Rosa WL, Bottino MC. Antimicrobial Therapeutics in Regenerative Endodontics: A Scoping Review. J Endod 2020; 46:S115-S127. [PMID: 32950183 DOI: 10.1016/j.joen.2020.06.032] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
INTRODUCTION This review aimed to provide a critical appraisal of alternative antimicrobial strategies in lieu of traditional triple antibiotic paste (TAP). METHODS This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The literature search was performed in 8 databases (PubMed/Medline, Embase, LILACS, Web of Science, Scopus, BVS, SciELO, and the Cochrane Library), selecting clinical, in vitro, in vivo, and in situ studies that evaluated antimicrobial alternatives to TAP in regenerative endodontics. Studies lacking an experimental TAP group were excluded. RESULTS A total of 1705 potentially relevant records were initially identified. From the 38 studies retrieved for full-text reading, 16 fulfilled all selection criteria and were included in the qualitative analysis. According to the study design, 11 studies were solely in vitro, 1 study was both in vitro and in vivo (animal model), 2 studies were solely animal experiments, and 2 studies were clinical trials. The alternative antimicrobial agents to TAP consisted of modified TAP formulations (eg, a combination of TAP with chitosan); TAP-eluting nanofibers; propolis; chlorhexidine (CHX) gels/solutions; double antibiotic pastes composed of distinct combinations of antibiotics; Ca(OH)2-based formulations; and sodium hypochlorite. Overall, most of the alternative agents performed similarly to TAP, although some strategies (eg, Ca(OH)2- and CHX-based formulations) seemed to present dubious importance in the control of infection. CONCLUSIONS TAP still remains an excellent option in terms of the complete elimination of microorganisms. This review points to the use of electrospun fibers as a drug delivery system to offer a controlled release of the antimicrobial agent, as well as the use of natural compounds, deserving future investigation.
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Affiliation(s)
- Juliana S Ribeiro
- Department of Cariology, Restorative Sciences, and Endodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan; Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Eliseu A Münchow
- Department of Conservative Dentistry, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Ester A Ferreira Bordini
- Department of Cariology, Restorative Sciences, and Endodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan; Department of Dental Materials and Prosthodontics, Araraquara School of Dentistry, São Paulo State University, Araraquara, São Paulo, Brazil
| | | | - Marco C Bottino
- Department of Cariology, Restorative Sciences, and Endodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan.
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Ayoub S, Cheayto A, Bassam S, Najar M, Berbéri A, Fayyad-Kazan M. The Effects of Intracanal Irrigants and Medicaments on Dental-Derived Stem Cells Fate in Regenerative Endodontics: An update. Stem Cell Rev Rep 2020; 16:650-660. [PMID: 32394343 DOI: 10.1007/s12015-020-09982-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Regenerative endodontics is a biologically based treatment designed for immature permanent teeth with necrotic pulp to replace dentin and root structures, as well as dental pulp cells. This procedure has become a part of novel modality in endodontics therapeutic manner, and it is considered as an alternative to apexification. In the last decade, numerous case reports, which describe this procedure, have been published. This therapeutic approach succeeded due to its lower financial cost and ease of performance. Although the clinical protocol of this procedure is not standardized and the effects of irrigants and medicaments on dental stem cells fate remain somewhat ambiguous, however when successful, it is an improvement of endodontics treatment protocols which leads to continued root development, increased dentinal wall thickness, and apical closure of immature teeth. To ensure a successful regenerative procedure, it is essential to investigate the appropriate disinfection protocols and the use of biocompatible molecules in order to control the release of growth factors and the differentiation of stem cells. This is the first review in the literature to summarize the present knowledge regarding the effect of intracanal irrigants and medicaments on the dental derived stem cells fate in regenerative endodontic procedures.
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Affiliation(s)
- Sara Ayoub
- Department of Prosthodontics, Faculty of Dental Medicine, Lebanese University, Hadath, Beirut, Lebanon
| | - Ali Cheayto
- Department of Restorative Dentistry and Endodontics, Faculty of Dental Medicine, Lebanese University, Hadath, Beirut, Lebanon
| | - Sanaa Bassam
- Department of Restorative Dentistry and Endodontics, Faculty of Dental Medicine, Lebanese University, Hadath, Beirut, Lebanon
| | - Mehdi Najar
- Genetics and Immune Cell Therapy Unit, Faculty of Sciences, University Mohammed Premier, Oujda, Morocco.,Osteoarthritis Research Unit, Department of Medicine, Research Center (CRCHUM), University of Montreal Hospital, University of Montreal, Montreal, QC, Canada
| | - Antoine Berbéri
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Lebanese University, Hadath, Beirut, Lebanon
| | - Mohammad Fayyad-Kazan
- Laboratory of Cancer biology and Molecular Immunology, Faculty of Sciences-I, Lebanese University, Hadath, Beirut, Lebanon. .,Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, Beirut, Lebanon.
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