Antibiotic Mixtures in Noninstrumental Endodontic Treatment of Primary Teeth with Necrotic Pulps: A Systematic Review (original) (raw)
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Evaluation of antibiotic mix in Non-instrumentation Endodontic Treatment of necrotic primary molars
Aim To compare the clinical and radiographic success rates of an antibiotic mix consisting of metronidazole, minocycline and ciprofloxacin (3Mix-MP) and another mix where minocycline was replaced with clindamycin (3Mix-MP-R) in non-instrumentation endodontic treatment (NIET) of necrotic primary molars and to determine the effect of root resorption on the success of the treatment. Materials and methods Forty-two necrotic mandibular primary molars from 22 healthy children were randomly assigned to either mixture. Blinded clinical evaluation was conducted after 1, 3, 6 and 12 months by the operator, and blinded radiographic evaluation was conducted at 6 and 12 months followups by other two investigators with inter-examiner reproducibility of 0.95. Results Overall success rates of 3Mix-MP and 3Mix-MP-R were 80.96% and 76.20% respectively, with no statistically significant difference. Radiographically, resorption of more than one third of the root length had a lower failure rate with no statistically significant difference (p<0.5). Conclusion Primary teeth with necrotic pulp can be treated with 3Mix-MP or 3Mix-MP-R irrespective of the degree of root resorption.
International journal of immunopathology and pharmacology
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 objecti...
REVIEW ARTICLE Role of Triple Antibiotic Paste In Revascularization And Endodontics- A Review
Antibiotics are most important for the management of bacterial infections. During root canal treatment, antibiotics may be used systemically or locally. Because of the possibility of systemic side effects, Local use of antibiotics in root canal therapy in the form of intracanal medicaments and irrigants is more desirable. The aim of this article was to review the applications of antibiotic-containing medicaments in endodontics. The search was performed from 1990 to 2015 research papers. The keywords searched on Medline were 'Antibiotics in endodontics', 'Antibiotics and revuscularization, 'Antibiotics and TAP'. Suitable sources of information are studied after reviewing the reference section. After reviewing various articles, local administration of antibiotics seems more effective mode than systemic application. Antibiotics plays significant role in endodontic treatment, out of which a combination of three antibiotics (metronidazole, ciprofloxacin and minocycline) seems to be effective at reducing bacterial numbers in the root canal systems of infected teeth. Keywords: Triple antibiotic paste (TAP), ciprofloxacin, metronidazole, minocycline, root canal treatment, revascularization
Triple Antibiotic Paste and Alternative Medicaments in Endodontics: A Literature Review
IRJPMS, 2023
One of the major reasons for endodontic failure is inadequate disinfection of the root canals during canal preparation and cleaning. Despite the thorough instrumentation, chemo-mechanical preparation alone cannot eliminate residing bacteria, especially due to the complex anatomy of the root canal system. One effective intra-canal medicament is Triple Antibiotic Paste (TAP), which is a mixture of three antibiotics that has a combined effect to act as a potent antimicrobial agent against microbes. TAP has also been proposed as a root canal medicament in endodontic regenerative procedures, and the review assesses its efficiency in root canal disinfection in both primary and permanent teeth, along with its effects on regeneration/ revascularization procedures. Furthermore, the article discusses and compares other intra-canal medications used in contemporary endodontic practice, such as Calcium Hydroxide (CH) and Chlorhexidine Gluconate (CHX). The review emphasizes the importance of selecting the appropriate medicament and disinfectant to effectively treat odontogenic infections and maintain the vitality of diseased pulp when possible.
Antibacterial Efficacy and Discoloration Potential of Endodontic Topical Antibiotics
Journal of endodontics, 2018
The optimal concentration for the use of endodontic topical antibiotics is not known. The aims of this study were to determine the minimum bactericidal concentrations (MBCs) and minimum inhibitory concentrations (MICs) of metronidazole, ciprofloxacin, minocycline, Augmentin (GlaxoSmithKline, Research Triangle Park, NC), and tigecycline against common endodontic pathogens and to evaluate ex vivo the antibacterial efficacy and discoloration effect of triple antibiotic paste (TAP), Augmentin, and tigecycline at different concentrations using a slow-release hydrogel scaffold. Using the Epsilometer test method (Etest; bioMérieux USA, St Louis, MO), MICs and MBCs of selected antibiotics were determined against Fusobacterium nucleatum, Porphyromonas gingivalis, Streptococcus intermedius, and Enterococcus faecalis. Biofilms of these bacterial species were then grown in extracted single-rooted teeth anaerobically for 3 weeks. Root canals were filled with TAP, Augmentin, and tigecycline at co...
The Chinese journal of dental research : the official journal of the Scientific Section of the Chinese Stomatological Association, 2019
OBJECTIVE To evaluate and compare the efficacy of gentamicin, amoxicillin and metronidazole (GAM) antibiotic paste in noninstrumentation and instrumentation techniques in infected primary molars. METHODS Sixty primary molars in children of 4 to 8 years were selected and divided into four groups: teeth without any periapical or furcation involvement undergoing pulpectomy by noninstrumentation (Group N1) and instrumentation (Group N2) technique using GAM antibiotic paste; teeth with periapical or furcation involvement undergoing pulpectomy by noninstrumentation (Group R1) and instrumentation (Group R2) technique using GAM antibiotic paste. Regular follow-up at 3, 6 and 12 months was carried out for each group and all the clinical and radiographic changes were evaluated statistically using SPSS software. The level of significance was set to P < 0.05. RESULTS Overall, 73.3% of success was observed in Group N1, 71.4% in Group N2, 86.7% in both Group R1 and Group R2 (P = 0.003). CONCLU...
Triple antibiotic paste: momentous roles and applications in endodontics: a review
Restorative Dentistry & Endodontics, 2018
This study investigated the latest findings and notions regarding 'triple antibiotic paste' (TAP) and its applications in dentistry, particularly endodontics. TAP is a combination of 3 antibiotics, ciprofloxacin, metronidazole, and minocycline. Despite the problems and pitfalls research pertaining to this paste has unveiled, it has been vastly used in endodontic treatments. The paste's applications vary, from vital pulp therapy to the recently introduced regeneration and revascularisation protocol. Studies have shown that the paste can eliminate the root canal microorganisms and prepare an appropriate matrix for further treatments. This combination is able to remove diverse groups of obligate and facultative gram-positive and gram-negative bacteria, providing an environment for healing. In regeneration protocol cases, this allows the development, disinfection, and possible sterilization of the root canal system, so that new tissue can infiltrate and grow into the radicular area. Moreover, TAP is capable of creating a discipline in which other wanted and needed treatments can be successfully performed. In conclusion, TAP, as an antibacterial intracanal medication, has diverse uses. Nevertheless, despite its positive effects, the paste has shown drawbacks. Further research concerning the combined paste and other intracanal medications to control microbiota is a must.
Role of Triple Antibiotic Paste in Treatment of Immature Necrotic Teeth
IOSR Journals , 2019
The development and progression of periapical lesions are associated with the presence of both aerobic and anaerobic bacteria. Immature teeth with apical periodontitis complicate this problem. A combination of antibiotic drugs (metronidazole, ciprofloxacin, and minocycline) is used to eliminate target bacteria, which are the possible sources of endodontic lesions. These case reports describe the treatment of immature teeth with large periradicular lesions using triple antibiotic paste. The follow-up radiograph of both cases showed progressive healing of periradicular lesions and root formation which confirmed the effectiveness of triple antibiotic paste in treatment of immature apical periodontitis.
The use of systemic antibiotics in endodontics: a cross-sectional study
Revista Portuguesa de Estomatologia, Medicina Dentária e Cirurgia Maxilofacial, 2017
Portugal is one of the European countries with the highest antibiotic consumption rate and, consequently, the highest rates of bacterial resistance. Dentistry's contribution to that problem can be substantial because dentists prescribe approximately 10% of all common antibiotics. The purpose of this study was to characterize the prescription of systemic antibiotics for pulpal and periapical pathology in a sample of Portuguese dentists. Methods: A cross-sectional study was conducted in dentists working in the city of Viseu. A total of 135 questionnaires were distributed among all dental clinics and dental offices of Viseu. Results: The overall response rate was 70% (n = 95). The vast majority of dentists prescribed antibiotics for 8 days (78.9%). The most commonly prescribed antibiotic therapy was the association 875-mg amoxicillin with 125-mg clavulanic acid (82.1%). In cases of sensitivity to penicillin, the most prescribed antibiotics were 500-mg clarithromycin (34.7%) and 500-mg azithromycin (33.7%). A considerable percentage of dentists prescribed antibiotics for situations of irreversible pulpitis, pulp necrosis without systemic involvement, fistula and endodontic retreatment. Conclusions: A considerable part of the inquired dentists prescribed antibiotics inappropriately for endodontic inflammatory conditions such as pulpitis. This kind of behavior could contribute to the world problem of antimicrobial resistance. It is important that dentists understand the importance of restricting the use of antibiotics for cases of severe infection, when they are truly needed.