Antimicrobial effect of intracanal substances

Fabrication of Ciprofloxacin-Immobilized Calcium Phosphate Particles for Dental Drug Delivery

Calcium phosphate (CaP) particles immobilizing antibacterial agents have the potential to be used as dental disinfectants. In this study, we fabricated CaP particles with immobilized ciprofloxacin (CF), a commonly prescribed antibacterial agent, via a coprecipitation process using a supersaturated CaP solution. As the aging time in the coprecipitation process increased from 2 to 24 h, the CaP phase in the resulting particles transformed from amorphous to low-crystalline hydroxyapatite, and their Ca/P elemental ratio, yield, and CF content increased. Despite the higher CF content, the particles aged for 24 h displayed a slower release of CF in a physiological salt solution, most likely owing to their crystallized matrix (less soluble hydroxyapatite), than those aged for 2 h, whose matrix was amorphous CaP. Both particles exhibited antibacterial and antibiofilm activities along with an acid-neutralizing effect against the major oral bacteria, Streptococcus mutans, Porphyromonas gingivalis, and Actinomyces naeslundii, in a dose-dependent manner, although their dose-response relationship was slightly different. The aging time in the coprecipitation process was identified as a governing factor affecting the physicochemical properties of the resulting CF-immobilized CaP particles and their functionality as a dental disinfectant.

Effect of polyethylene glycol on polysaccharides: From molecular modification, composite matrixes, synergetic properties to embeddable application in food fields

Polyethylene glycol (PEG) is a flexible, water-soluble, non-immunogenic, as well as biocompatible polymer, and it could synergize with polysaccharides for food applications. The molecular modification strategies, including covalent bond interactions (amino groups, carboxyl groups, aldehyde groups, tosylate groups, etc.), and non-covalent bond interactions (hydrogen bonding, electrostatic interactions, etc.) on PEG molecular chains are discussed. Its versatile structure, group modifiability, and amphiphilic block buildability could improve the functions of polysaccharides (e.g., chitosan, cellulose, starch, alginate, etc.) and adjust the properties of combined PEG/polysaccharides with outstanding chain tunability and matrix processability owing to plasticizing effects, compatibilizing effects, steric stabilizing effects and excluded volume effects by PEG, for achieving the diverse performance targets. The synergetic properties of PEG/polysaccharides with remarkable architecture were summarized, including mechanical properties, antibacterial activity, antioxidant performance, self-healing properties, carrier and delivery characteristics. The PEG/polysaccharides with excellent combined properties and embeddable merits illustrate potential applications including food packaging, food intelligent indication/detection, food 3D printing and nutraceutical food absorption. Additionally, prospects (like food innovation and preferable nutrient utilization) and key challenges (like structure-effectiveness-applicability relationship) for PEG/polysaccharides are proposed and addressed for food fields.

In vitro influence of PEG functionalized ZnO-CuO nanocomposites on bacterial growth

Polyethyleneglycol-coated biocompatible CuO-ZnO nanocomposites were fabricated hydrothermally varying Zn:Cu ratios as 1:1, 2:1, and 1:2, and their antibacterial activity was determined through the well diffusion method against the Gram-negative Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae, and the Gram-positive Staphylococcus aureus. The minimum inhibitory concentration and the minimum bactericidal concentration values of the synthesized samples were determined. Subsequently, the time synergy kill assay was performed to elucidate the nature of the overall inhibitory effect against the aforementioned bacterial species. The mean zone of inhibition values for all four samples are presented. The inhibitory effect increased with increasing concentration of the nanocomposite (20, 40 and 60 mg/ml) on all the bacterial species except for S. aureus. According to the MBC/MIC ratio, ZnO was found to be bacteriostatic for E. coli and P. aeruginosa, and bactericidal for S. aureus and K. pneumoniae. Zn:Cu 2:1 was bactericidal on all bacterial species. A bacteriostatic effect was observed on E. coli and P. aeruginosa in the presence of Zn:Cu 1:1 whereas, it showed a bactericidal effect on S. aureus and K. pneumoniae. Zn:Cu 1:2 exhibited a bacteriostatic effect on E. coli while a bactericidal effect was observed for E. coli, P. aeruginosa, and K. pneumoniae. The metal oxide nanocomposites were found to be more sensitive towards the Gram-positive strain than the Gram-negative strains. Further, all the nanocomposites possess anti-oxidant activity as shown by the DPPH assay.

Success of Lesion Sterilization and Tissue Repair Therapy and Pulpectomy in the Management of Infected Primary Molars with Poor Prognosis

Background and aim

To establish lesion sterilization and tissue repair (LSTR) therapy as an alternate treatment option in managing infected primary molars with poor prognosis that were indicated for extraction, thereby fulfilling the objective of retaining the primary tooth till its normal exfoliation in the dental arch.

Materials and methods

A total of 84 children who met the inclusion criteria requiring extraction in 142 teeth involving primary molars were included in the study. The selected patients were allocated to two groups, that is, group I-LSTR therapy with 3Mix-MP paste and group II-pulpectomy with metapex. All the treated teeth were then clinically and radiographically evaluated after 1, 3, 6, 9, and 12 months, respectively, to determine the success between groups I and II. Pearson's Chi-squared test along with the z-test was used to compare the clinical and radiographic success of the two groups (p < 0.05).

Results

Pain and tenderness were completely resolved within one month of follow-up in both groups. Abscesses were resolved completely at 1 month in the pulpectomy group and mobility was resolved at 6 months follow-up in both groups. Interradicular and periradicular radiolucency persisted even at 12 months of the follow-up period in both groups. The intergroup comparison revealed no statistical differences between LSTR and pulpectomy procedure and both were equally effective at all time intervals (p > 0.05).

Conclusion

Both LSTR therapy with 3Mix-MP and pulpectomy with metapex showed 100% clinical success rates. Radiographically no changes were observed even at the 12-month follow-up period in both groups. LSTR therapy can be an alternative treatment option for pulpally involved primary teeth with poor prognosis and in cases where mechanical instrumentation could not be achieved due to physiologic root resorption.

How to cite this article

Sefa I, Garg N, Pathivada L, et al. Success of Lesion Sterilization and Tissue Repair Therapy and Pulpectomy in the Management of Infected Primary Molars with Poor Prognosis. Int J Clin Pediatr Dent 2024;17(1):41-47.

In vitro bactericidal efficacy of a new triple antibiotic paste formulation against Enterococcus faecalis biofilm

The aim of this study was to evaluate the bactericidal efficacy on Enterococcus faecalis biofilm of a novel, low-concentration triple-antibiotic paste (TAP-L2) in propylene glycol/carboxymethylcellulose vehicle (VEH-2), a ready-to-use prototype, compared with two currently used products; a low-concentration (TAP-L1) and a high-concentration paste (TAP-H1) mixed in macrogol/propylene glycol vehicle (VEH-1). Sixty-two root canals were infected with E. faecalis biofilm, medicated with (a) TAP-L1, (b) TAP-L2, (c) TAP-H1, (d) VEH-1 or (e) VEH-2 (n = 10) and incubated for 21 days. Live/dead assays were performed using confocal laser scanning microscopy (CLSM), and dead bacteria (%) were calculated. The TAP-H1 group demonstrated the highest dead bacteria (67.54 ± 2.38%), which was significantly higher than the TAP-L2 and TAP-L1 groups (56.85 ± 7.11% and 54.23 ± 10.19%) (p < 0.05). The TAP groups demonstrated significantly higher dead bacteria than the VEH-1 and VEH-2 groups (47.51 ± 6.41% and 45.14 ± 8.28%) (p < 0.05). The ready-to-use TAP-L2 had antibacterial activity comparable to TAP-L1, both of which were lower than TAP-H1.

Comparative Evaluation of the Effect of Six Different Low-Surface-Tension Vehicles on the Penetration of Modified Triple Antibiotic Paste in Dentinal Tubules: An In Vitro Study

Background Modified triple antibiotic paste (MTAP) helps in the elimination of microorganisms which is imperative for the success of endodontic therapy. The intracanal medicament powders must be mixed with vehicles for better handling and penetration in the root canals. The purpose of this study is to compare the effect of six low-surface-tension vehicles on the penetration of MTAP in dentinal tubules. Methodology The root apices of 60 single-rooted human mandibular premolars were resected to obtain 12mm length. After biomechanical preparation, intracanal medicaments were prepared by mixing with the six vehicles (Group 1- Bupivacaine, Group 2- Sodium ether lauryl sulfate, Group 3- Neosporin H, Group 4- Chlorhexidine gluconate, Group 5- Chitosan, and Group 6- Polyethylene glycol) with MTAP and Rhodamine B dye. Middle and apical transverse sections were scanned under a confocal laser scanning microscope. The data were statistically analyzed using the one-way ANOVA test and the level of significance was p<0.05. Results The maximum depth of penetration was seen in Group 2 (MTAP with sodium ether lauryl sulfate) followed by Group 5 (MTAP with chitosan), Group 4 (MTAP with chlorhexidine gluconate), Group 1 (MTAP with bupivacaine), and Group 6 (MTAP with polyethylene glycol), and the least penetration by Group 3 (MTAP with Neosporin H). The depth of penetration in the middle level was in the order of Group 2 followed by Group 4, Group 5, Group 3, Group 6, and Group 1. The depth of penetration in the apical level was in the order of Group 2 followed by Group 5, Group 1, Group 4, Group 6, and Group 3. The overall depth of penetration was significantly higher at the middle level than at the apical level. Conclusion Group sodium ether lauryl sulfate showed the maximum depth of penetration in both the middle and apical areas. The least depth of penetration in the middle area was seen in group bupivacaine and the apical area by group Neosporin H.

Efficacy of Ciprofloxacin, Metronidazole and Minocycline in Ordered Mesoporous Silica against Enterococcus faecalis for Dental Pulp Revascularization: An In-Vitro Study

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.

The inhibitory effect of a novel neem paste against cariogenic bacteria

Background

Dental caries is a major oral health problem, which associates with cariogenic bacteria. Streptococcus mutans and Lactobacillus acidophilus are facultative anaerobic bacteria that are found in tooth decay. Accordingly, neem leaf extract was developed due to its great anti-microbial property against many bacteria. The aim of this study was to determine anti-cariogenic properties of neem leaf extract in a novel paste preparation.

Material and Methods

The neem extract was derived from maceration of dry neem leaves in ethanol for 48 h. The ethanolic extract was subjected to chemical identification using GC-MS. Neem pastes were prepared from ethanolic extract mixed with polyethylene glycol paste with or without zinc oxide. S. mutans and L. acidophilus test were initiated at bacterial concentration of 108 CFU/ml. The antibacterial activity was then performed by disc diffusion method following by minimum bactericidal concentration (MBC) technique.

Results

GC-MS result displayed 35 compounds. Compounds found in the extract were n-Hexadecanoic acid (31.18%), Hentriacontane (18%), Phytol (16.79%). Disc diffusion showed that ethanolic extract and neem pastes inhibited growth of both bacteria. For MBC, neem paste with zinc oxide at concentration of neem 0.4 mg/ml was the most effective concentration on inhibiting S. mutans growth. Neem pastes and ethanolic extract at concentration of neem 6.25 mg/ml inhibited L. acidophilus growth.

Conclusions

The ethanolic neem leaf extract and novel neem pastes had antimicrobial effect on both S. mutans and L. acidophilus. By this property, neem paste could be developed for the application in dental field, i.e. pulp capping.

Key words:Neem, Azadirachta indica, antimicrobial, cariogenic bacteria.

Antimicrobial and immunomodulatory in vitro profile of double antibiotic paste

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.

Host defense peptide IDR-1002 associated with ciprofloxacin as a new antimicrobial and immunomodulatory strategy for dental pulp revascularization therapy

Regenerative therapies such as dental pulpal revascularization appear as an option for traumatized immature permanent teeth. However, the triple antibiotic paste - TAP (metronidazole, minocycline, and ciprofloxacin), used for these therapies, can generate cytotoxicity and dentin discoloration. In contrast, host defense peptides (HDPs) are promising antimicrobial and immunomodulatory biomolecules for dentistry. This study aimed to evaluate in vitro the antimicrobial activity (against Staphylococcus aureus and Enterococcus faecalis) and the immunomodulatory potential (by the evaluation of IL-1α, IL-6, IL-12, IL-10, TNF-α and NO, in RAW 264.7 macrophages and IL-6, TGF-β and NO, in L929 fibroblast) of synthetic peptides (DJK-6, IDR-1018, and IDR-1002), compared to TAP in an in vitro infection model containing heat-killed antigens from E. faecalis and S. aureus. Furthermore, the synergistic potential of ciprofloxacin and IDR-1002 was evaluated by checkerboard. Ciprofloxacin was the best antimicrobial of TAP, besides acting in synergism with IDR-1002. TAP was pro-inflammatory (p < 0.05), while the association of ciprofloxacin and IDR-1002 presented an anti-inflammatory profile mainly in the presence of both heat-killed antigens (p < 0.05). Based on these results, ciprofloxacin associated with IDR-1002 may demonstrate an efficient antimicrobial and immunomodulatory action in this in vitro model. Further in vivo studies may determine the real potential of this combination.

Optimal antimicrobial concentration of mixed antibiotic pastes in eliminating Enterococcus faecalis from root dentin

This study aims to identify the optimal concentrations of triple antibiotic paste (TAP), modified triple antibiotic paste (mTAP) and double antibiotic paste (DAP) that could completely eradicate Enterococcus faecalis in dentinal tubules. One hundred and ninety extracted human premolars inoculated with E. faecalis were medicated with calcium hydroxide and mixed antibiotic pastes (TAP, mTAP and DAP at 0.1, 1.25, 5, 10 and 20 mg mL^-1 of each drug) for seven days before being frozen, pulverised and cultured. Specimens treated with the lowest concentration of the mixed antibiotics capable of eradicating E. faecalis were examined using scanning electron and confocal laser scanning microscopy to confirm the eradication of the microbial. TAP at 10 mg mL^-1 of each drug was able to completely eliminate bacteria inside dentinal tubules, whereas mTAP and DAP required 20 mg mL^-1 of each drug. Calcium hydroxide was not effective in eradicating E. faecalis inside dentinal tubules.

Comparative assessment of efficacy of two different pretreatment single oral doses of betamethasone on inter-appointment and postoperative discomfort: An in vivo clinical evaluation

Aim:

Study aimed to evaluate the efficacy of two different pretreatment single oral doses of betamethasone on the incidence of inter-appointment flare up and postoperative discomfort.

Materials and Methods:

Fifty-four patients aged 18–59 years requiring endodontic treatment were selected and randomly assigned to three groups; single pretreatment oral dose of placebo or betamethasone in two different oral doses of 0.5 mg and 1 mg, respectively. Endodontic therapy was completed in two visits using triple antibiotic paste as intracanal medicament. Patients were given a questionnaire to record their pain at 1, 2, 3, and 7 days after treatment. In the second visit, obturation was done, and the patients were again instructed to record their pain scores after treatment and discharged. The verbal rating scale was used for recording the pain scores. Statistical analysis was done using ANOVA and the Friedman test.

Results:

0.5 mg betamethasone group showed least mean pain scores among all experimental groups; however, there was no statistically significant difference between any of the groups (P > 0.05).

Conclusion:

Pretreatment single oral dose of betamethasone is an effective in managing endodontic flare-ups; however, the results were statistically insignificant.

Antimicrobial Activity of Endodontic Medicaments and Vehicles using Agar Well Diffusion Method on Facultative and Obligate Anaerobes

Aims

The aim of this study was to determine the relative antimicrobial effectiveness of these endodontic medicaments and various vehicles using an agar well diffusion assay.

Materials and methods

Double Antibiotic Paste(DAP), modified DAP, 2% Chlorhexidine gluconate and their combination with four vehicles namely Polyethylene glycol 400 (PEG), Propylene glycol (PG), combinations of PG with PEG and lastly Glycerine were tested using agar well diffusion assay. The minimum bactericidal concentration was noted against four standard strains of organisms ie Streptococcus mutans ATCC( American Type Culture Collection) 25175, Staphylococcus aureus ATCC 12598, Enterococcus faecalis ATCC 35550 and Eschericia coli ATCC 25922. Successful endodontic therapy depends upon thorough disinfection of root canals. In some refractory cases, routine endodontic therapy is not sufficient, so intracanal medicaments are used for proper disinfection of canals. Issues of resistance, limited spectrum of activity and lack of antifungal properties, the hunt for the ideal intracanal medicament continues. In this regard, the vehicles used to form the pastes play a supportive role by forming the appropriate consistency for placement and may dramatically influence their chemical characteristics like their solubility and diffusion. Thus, inorder to use safer and equally effective intracanal medicaments, Chlorhexidine gluconate is being unveiled in this study.

Results

The difference between the four vehicles when combined with the same endodontic medicament studied above is nonsignificant (NS) except against Porphyromonas gingivalis. Propylene glycol is significantly effective than Glycerine when used with DAP ie C+M medicament combination. (p = 0.029)

Conclusion

2% chlorhexidine gluconate and modified DAP can definitely replace DAP and triple antibiotic paste as end-odontic medicaments with chlorhexidine having an added advantage of bactericidal action, substantivity, biocompatibility, low toxicity, and lesser chances of developing resistance.

How to cite this article

Nalawade TM, Bhat KG, Sogi S. Antimicrobial Activity of Endodontic Medicaments and Vehicles using Agar Well Diffusion Method on Facultative and Obligate Anaerobes. Int J Clin Pediatr Dent 2016;9(4):335-341.

Reduction of viable bacteria in dentinal tubules treated with a novel medicament (Z-Mix)

Background/purpose

The 3Mix-MP formulation (a mixture of metronidazole, ciprofloxacin, and minocycline; macrogol and propylene glycol) has been used to kill residual bacteria in dentin caries. This study aimed to investigate the dentin disinfection and cytotoxicity of a novel zinc oxide (ZnO) based medicament, Z-Mix.

Materials and methods

Z-Mix was prepared as a prefilled syringe of materials containing mainly ZnO, incorporated with amoxicillin, ciprofloxacin, and metronidazole (1 g% of each antibiotic). Drug penetration was measured at 24 hours and 72 hours. Streptococcus mutans, Lactobacillus acidophilus, or Enterococcus faecalis were inoculated into dentinal tubules for 30 days and were then subjected to Z-Mix or 0.2% chlorhexidine (CHX) for 48 hours. Viable bacteria in the dentin were determined using fluorescence staining. Their cytotoxicity against human dental pulp cells was assessed using an MTT assay.

Results

Z-Mix obviously diffused into dentinal tubules and the root apex, compared to the 3Mix-MP (P < 0.05). Fluorescence staining demonstrated a reduction of viable bacteria at 100 μm and 500 μm below infected cavities after treatment with Z-mix or CHX for 48 hours. Live and dead bacteria ratios indicated that Z-Mix exhibited markedly antimicrobial effects on inoculated bacteria in dentin samples (P < 0.05). There was no significant difference in the antimicrobial property between Z-Mix and CHX (P > 0.05). An acceptable level of cytotoxicity was observed in Z-Mix and its ingredients.

Conclusion

Z-Mix, a soft shapeable paste containing a mixture of three antibiotics, is successfully. It can penetrate to the root apex and exhibits antimicrobial properties.

Bactericidal activity of propylene glycol, glycerine, polyethylene glycol 400, and polyethylene glycol 1000 against selected microorganisms

Aim:

The aim of the present study was to evaluate the bactericidal activity of propylene glycol, glycerine, polyethylene glycol 400 (PEG 400), and polyethylene glycol 1000 (PEG 1000) against selected microorganisms in vitro.

Materials and Methods:

Five vehicles, namely propylene glycol, glycerine, PEG 400, PEG 1000, and combination of propylene glycol with PEG 400, were tested for their bactericidal activity. The minimum bactericidal concentration was noted against four standard strains of organisms, i.e. Streptococcus mutans American Type Culture Collection (ATCC) 25175, Streptococcus mutans ATCC 12598, Enterococcus faecalis ATCC 35550, and Escherichia coli ATCC 25922, using broth dilution assay. Successful endodontic therapy depends upon thorough disinfection of root canals. In some refractory cases, routine endodontic therapy is not sufficient, so intracanal medicaments are used for proper disinfection of canals. Intracanal medicaments are dispensed with vehicles which aid in increased diffusion through the dentinal tubules and improve their efficacy. Among the various vehicles used, glycerine is easily available, whereas others like propylene glycol and polyethylene glycol have to be procured from appropriate sources. Also, these vehicles, being viscous, aid in sustained release of the medicaments and improve their handling properties. The most commonly used intracanal medicaments like calcium hydroxide are ineffective on many microorganisms, while most of the other medicaments like MTAD (Mixture of Tetracycline, an Acid, and a Detergent) and Triple Antibiotic Paste (TAP) consist of antibiotics which can lead to development of antibiotic resistance among microorganisms. Thus, in order to use safer and equally effective intracanal medicaments, newer alternatives like chlorhexidine gluconate, ozonized water, etc., are being explored. Similarly, the five vehicles mentioned above are being tested for their antimicrobial activity in this study.

Results:

All vehicles exhibited bactericidal activity at 100% concentration.

Conclusion:

Propylene glycol was effective against three organisms namely S. mutans E. faecalis and E. coli and its bactericidal activity was at 50%, 25% and 50% respectively. PEG 1000 was effective against S. mutans and E. coli at 25%. Hence propylene glycol was effective on more number of organisms of which E. faecalis is a known resistant species. PEG 1000 was bactericidal at a lower concentration but was effective on two organisms only.

Time- and concentration-dependent cytotoxicity of antibiotics used in endodontic therapy

OBJECTIVE

New drugs have to be assessed in endodontic therapy due to the presence of microorganisms resistant to therapeutic procedures. Thus, this study evaluated the time- and concentration-dependent cytotoxicity of different antibiotics used in endodontic therapy.

MATERIAL AND METHODS

Human gingival fibroblasts were treated and divided into the following experimental groups: Group I - control; Group II - ciprofloxacin hydrochloride; Group III - clyndamicin hydrochloride; and Group IV - metronidazole. Each drug was used at concentrations of 5, 50, 150, and 300 mg/L for 24, 48, 72, and 96 h. Cytotoxicity was evaluated by the MTT assay [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide] and spectrophotometric reading of ELISA plates. The results were analyzed by BioEstat 4.0 software using Kruskal-Wallis and Dunn's tests at a significance level of 5%. Cell viability was assessed for the different concentrations and times.

RESULTS

All drugs presented dose-dependent cytotoxicity. Concentrations of 5 and 50 mg/L produced viable fibroblasts at all experimental times in all groups.

CONCLUSIONS

Cell viability at 24 h was greater than in the other experimental times. Comparison between the same concentrations of antibiotics at different times showed that metronidazole presented the highest cell viability at 72 and 96 h compared to the other antibiotics, whereas clyndamicin hydrochloride showed higher cell viability at 72 h than ciprofloxacin hydrochloride.