Abstract
Introduction
This study aimed to assess the effectiveness of antibacterial activity of medications
used in regenerative endodontic treatment.
Methods
Sixty-seven dentin cylinders of single-rooted teeth were contaminated with a culture
of Enterococcus faecalis (ATCC 29212; American Type Culture Collection, Manassas, VA) for 5 days. Samples
were divided into 1 control group and the following experimental groups according
to the medication applied: traditional triple antibiotic paste (TAP), clindamycin-modified
TAP (mTAP), triple antibiotic medication with macrogol (3Mix-MP), clindamycin-modified
3Mix-MP (m3Mix-MP), calcium hydroxide (CH), and ethanol extract of propolis (EEP).
After 14 days, the medications were removed, and the samples were submitted to confocal
laser scanning microscopic analysis to quantify the percentage of viable bacteria.
The distribution of data was confirmed by the Shapiro-Wilk test. The Kruskal-Wallis
and Dunn tests were used for intergroup comparisons, and the Wilcoxon test was used
for comparison between superficial and deep antibacterial efficacy for the same medication.
The level of significance was set at P < .05.
Results
3Mix-MP and m3Mix-MP presented significantly higher antibacterial efficacy compared
with the other tested medications (P < .05), except for mTAP. mTAP was more effective than TAP (P < .05). The antibacterial efficacy of EEP and CH did not differ significantly from
TAP and mTAP (P > .05). All medications showed effective antibacterial action compared with the control
group (P < .05).
Conclusions
3Mix-MP and m3Mix-MP, which present extremely high concentrations of antibiotics (1500 mg/mL),
were not more effective than mTAP at the concentration recommended by the American
Association of Endodontists (5 mg/mL). Moreover, CH and EEP were as effective as TAP
and mTAP.
Key Words:
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References
- Retrospective evaluation of radiographic outcomes in immature teeth with necrotic root canal systems treated with regenerative endodontic procedures.J Endod. 2014; 35: 1343-1349
- Revascularization of immature permanent teeth with apical periodontitis: new treatment protocol?.J Endod. 2004; 30: 196-200
- Clinical considerations for regenerative endodontic procedures revised 4/1/2018. IOP Publishing American Association of Endodontists (AAE). 2018.(Available at:) (Accessed March 12, 2021)
- European Society of Endodontology position statement: Revitalization procedures.Int Endod J. 2016; 49: 717-723
- Antibiofilm efficacy of photoactivated curcumin, triple and double antibiotic paste, 2% chlorhexidine and calcium hydroxide against Enterococcus faecalis in vitro.Sci Rep. 2016; 6: 24797
- Comparative evaluation of antimicrobial efficacy of triple antibiotic paste and modified double antibiotic paste using different vehicles against Candida albicans.Int J Adv Res. 2020; 8: 528-533
- Comparative evaluation of the cytotoxic and angiogenic effects of minocycline and clindamycin: an in vitro study.J Endod. 2019; 45: 882-889
- Clindamycin-modified triple antibiotic nanofibers: a stain-free antimicrobial intracanal drug delivery system.J Endod. 2018; 44: 155-162
- LSTR 3MIX-MP method-better and efficient clinical procedures of lesion sterilization and tissue repair (LSTR) therapy.Dent Rev. 1998; 666: 57-106
- Information on LSTR 3Mix-MP therapy: lesion sterilization and tissue repair (LSTR) therapy – LSTR 3Mix-MP therapy. 2007.(Available at:) (Accessed March 10, 2021)
- Effect of dentin conditioning with intracanal medicaments on survival of stem cells of apical papilla.J Endod. 2014; 40: 521-525
- Direct effect of intracanal medicaments on survival of stem cells of the apical papilla.J Endod. 2012; 38: 1372-1375
- Antimicrobial therapeutics in regenerative endodontics: a scoping review.J Endod. 2020; 46: S115-S127
- Antimicrobial and cytotoxic activity of Cinnamomum zeylanicum, calcium hydroxide, and triple antibiotic paste as root canal dressing materials.J Contemp Dent Pract. 2016; 17: 105-113
- The comparison of intracanal medicaments, diode laser and photodynamic therapy on removing the biofilm of Enterococcus faecalis and Candida albicans in the root canal system (ex-vivo study).Photodiagnosis Photodyn Ther. 2019; 26: 157-161
- Antimicrobial effects of four intracanal medicaments on Enterococcus faecalis: an in vitro study.Iran Endod J. 2014; 9: 195-198
- Deleterious effect of triple antibiotic paste on human periodontal ligament fibroblasts.Int Endod J. 2014; 47: 769-775
- Attachment ability of human apical papilla cells to root dentin surfaces treated with either 3Mix or calcium hydroxide.J Endod. 2016; 42: 89-94
- Evaluation of antibacterial activity of propolis on regenerative potential of necrotic immature permanent teeth in dogs.BMC Oral Health. 2019; 19: 174
- A scanning electron microscopic evaluation of in vitro dentinal tubules penetration by selected anaerobic bacteria.J Endod. 1996; 22: 308-310
- Antimicrobial activity and physicochemical properties of calcium hydroxide pastes used as intracanal medication.J Endod. 2016; 42: 1822-1828
- Antibacterial efficacy and discolouration potential of antibiotic pastes with macrogol for regenerative endodontic therapy.Aust Endod J. 2020; ([Epub ahead of print])https://doi.org/10.1111/aej.12438
- A new improved protocol for in vitro intratubular dentinal bacterial contamination for antimicrobial endodontic tests: standardization and validation by confocal laser scanning microscopy.J Appl Oral Sci. 2015; 23: 591-598
- Antimicrobial action of photodynamic therapy in root canals using LED curing light, curcumin and carbopol gel.Int Endod J. 2019; 52: 1010-1019
- In vitro infection and disinfection of dentinal tubules.J Dent Res. 1987; 66: 1375-1379
- A new noninvasive model to study the effectiveness of dentin disinfection by using confocal laser scanning microscopy.J Endod. 2011; 37: 1380-1385
- Antmicrobial effect of propolis and other substances against selected endodontic pathogens.Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007; 104: 709-716
- Intratubular decontamination ability and physicochemical properties of calcium hydroxide pastes.Clin Oral Investig. 2019; 23: 1253-1262
- HPLC and ESI-MS typification: new approaches for natural therapy with Brazilian propolis.in: Orsolic N. Basic I. Scientific Evidence of the Use of Propolis in Ethnomedicine. Transworld Research Network, Kerala, India2008: 33-54
- Chemical and mechanical influence of root canal irrigation on biofilm removal from lateral morphological features of simulated root canals, dentine discs and dentinal tubules.Int Endod J. 2021; 54: 112-129
- Disinfection efficacy of current regenerative endodontic protocols in simulated necrotic immature permanent teeth.J Endod. 2016; 42: 1218-1225
- Transcriptomics analysis reveals putative genes involved in biofilm formation and biofilm-associated drug resistance of Enterococcus faecalis.J Endod. 2017; 43: 949-955
- Translational science in disinfection for regenerative endodontics.J Endod. 2014; 40: 52-57
- Effectiveness and clinical implications of the use of topical antibiotics in regenerative endodontic procedures: a review.Int Endod J. 2018; 51: 981-988
- Regenerative endodontics versus apexification in immature permanent teeth with apical periodontitis: a prospective randomized controlled study.J Endod. 2017; 43: 1821-1827
- Reduction of viable bacteria in dentinal tubules treated with clindamycin or tetracycline.Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003; 96: 751-756
- Effect of calcium hydroxide on bacterial lipopolysaccharide.J Endod. 1993; 19: 76-78
- Intratubular disinfection with tri-antibiotic and calcium hydroxide pastes.Acta Odontol Scand. 2017; 75: 87-93
- Antibacterial activity of propolis versus conventional endodontic disinfectants against Enterococcus faecalis in infected dentinal tubules.J Endod. 2011; 37: 376-381
- Comparative evaluation of propolis and triantibiotic mixture as an intracanal medicament against Enterococcus faecalis.J Endod. 2011; 37: 1287-1289
- Effect of propolis on dentin regeneration and the potential role of dental pulp stem cell in guinea pigs.Cell J. 2012; 13: 223-228
Article info
Publication history
Published online: July 22, 2021
Identification
Copyright
© 2021 American Association of Endodontists.
