The ability of triple antibiotic paste and calcium hydroxide in disinfection of dentinal tubules

Alireza Adl, Sabie Hamedi, Mahdi Sedigh Shams, Mohamad Motamedifar, Fereshte Sobhnamayan, Alireza Adl, Sabie Hamedi, Mahdi Sedigh Shams, Mohamad Motamedifar, Fereshte Sobhnamayan

Abstract

Introduction: The purpose of this in vitro study was to compare the ability of triple antibiotic paste (TAP) to calcium hydroxide (CH) in disinfecting dentinal tubules.

Material and methods: Sixty root blocks were obtained from extracted single-rooted human teeth. The root canals were enlarged with Gates-Glidden drills up to size 3 and were contaminated with Enterococcus. faecalis (E. faecalis), and then left for 21 days. The contaminated blocks were treated with saline (as negative control), CH or TAP. Dentin debris was obtained at the end of first and 7th days, using Gates-Glidden drills sizes 4 and 5 from two different depths of 100 and 200 µm. The vital bacterial load was assessed by counting the number of colony forming units (CFUs). The data was analyzed with the Kruskal-Wallis H and Dunn Post-Hoc tests. The Wilcoxon Signed Ranks test was used to check for differences in bacterial growth at both depths (P<0.05).

Results: In comparison with CH, the TAP significantly decreased the number of CFUs in both depths and time intervals (P<0.001), while the CH group showed a moderate antibacterial effect.

Conclusion: TAP is more effective in disinfecting the canal against E. faecalis compared to CH.

Keywords: Antibiotic; Bacterial Infection; Calcium Hydroxide; Enterococcus faecalis; Root Canal Medicaments; Triple Antibiotic Paste.

References

    1. Kakehashi S, Stanley HR, Fitzgerald RJ. The Effects of Surgical Exposures of Dental Pulps on Germ-Free ond Conventional Laboratory Rats. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1965;20:340–9.
    1. Byström A, Sundqvist G. Bacteriologic evaluation of the efficacy of mechanical root canal instrumentation in endodontic therapy. Eur J Oral Sci. 1981;89(4):321–8.
    1. Ørstavik D, Kerekes K, Molven O. Effects of extensive apical reaming and calcium hydroxide dressing on bacterial infection during treatment of apical periodontitis: a pilot study. Int Endod J. 1991;24(1):1–7.
    1. Williams JM, Trope M, Caplan DJ, Shugars DC. Detection and Quantitation of E. faecalis by Real-time PCR (qPCR), Reverse Transcription-PCR (RT-PCR), and Cultivation During Endodontic Treatment. J Endod. 2006;32(8):715–21.
    1. Donlan RM, Costerton JW. Biofilms: survival mechanisms of clinically relevant microorganisms. Clin Microbiol Rev. 2002;15(2):167–93.
    1. Chong B, Ford TP. The role of intracanal medication in root canal treatment. Int Endod J. 1992;25(2):97–106.
    1. Siqueira J, Lopes H. Mechanisms of antimicrobial activity of calcium hydroxide: a critical review. Int Endod J. 1999;32(5):361–9.
    1. George S, Kishen A, Song P. The Role of Environmental Changes on Monospecies Biofilm Formation on Root Canal Wall by Enterococcus faecalis. J Endod. 2005;31(12):867–72.
    1. Haapasalo H, Sirén E, Waltimo T, Orstavik D, Haapasalo M. Inactivation of local root canal medicaments by dentine: an in vitro study. Int Endod J. 2000;33(2):126–31.
    1. Peters LB, van Winkelhoff AJ, Buijs JF, Wesselink PR. Effects of instrumentation, irrigation and dressing with calcium hydroxide on infection in pulpless teeth with periapical bone lesions. Int Endod J. 2002;35(1):13–21.
    1. Bose R, Nummikoski P, Hargreaves K. A retrospective evaluation of radiographic outcomes in immature teeth with necrotic root canal systems treated with regenerative endodontic procedures. J Endod. 2009;35(10):1343–9.
    1. Windley III W, Teixeira F, Levin L, Sigurdsson A, Trope M. Disinfection of immature teeth with a triple antibiotic paste. J Endod. 2005;31(6):439–43.
    1. Hoshino E, Kurihara‐Ando N, Sato I, Uematsu H, Sato M, Kota K, Iwaku M. In‐vitro antibacterial susceptibility of bacteria taken from infected root dentine to a mixture of ciprofloxacin, metronidazole and minocycline. Int Endod J. 1996;29(2):125–30.
    1. Sato I, Ando‐Kurihara N, Kota K, Iwaku M, Hoshino E. Sterilization of infected root-canal dentine by topical application of a mixture of ciprofloxacin, metronidazole and minocycline in situ. Int Endod J. 1996;29(2):118–24.
    1. Adl A, Shojaee NS, Motamedifar M. A Comparison between the Antimicrobial Effects of Triple Antibiotic Paste and Calcium Hydroxide against Entrococcus Faecalis. Iran Endod J. 2012;7(3):149.
    1. Madhubala MM, Srinivasan N, Ahamed S. Comparative Evaluation of Propolis and Triantibiotic Mixture as an Intracanal Medicament against Enterococcus faecalis. J Endod. 2011;37(9):1287–9.
    1. Haapasalo M, Ørstavik D. In vitro infection and of dentinal tubules. J Dent Res. 1987;66(8):1375–9.
    1. Ercan E, Dalli M, Duulgergil CT, Yaman F. Effect of intracanal medication with calcium hydroxide and 1% chlorhexidine in endodontic retreatment cases with periapical lesions: an in vivo study. J Formos Med Assoc. 2007;106(3):217–24.
    1. Kayaoglu G, Erten H, Bodrumlu E, Ørstavik D. The Resistance of Collagen-associated, Planktonic Cells of Enterococcus faecalis to Calcium Hydroxide. J Endod. 2009;35(1):46–9.
    1. Ercan E, Dalli M, Türksel Dülgergil Ç, Yaman F. Effect of Intracanal Medication with Calcium Hydroxide and 1% Chlorhexidine in Endodontic Retreatment Cases with Periapical Lesions: An In Vivo Study. J Formos Med Assoc. 2007;106(3):217–24.
    1. Peciuliene V, Reynaud A, Balciuniene I, Haapasalo M. Isolation of yeasts and enteric bacteria in root‐filled teeth with chronic apical periodontitis. Int Endod J. 2001;34(6):429–34.
    1. Sundqvist G, Figdor D, Persson S, Sjögren U. Microbiologic analysis of teeth with failed endodontic treatment and the outcome of conservative re-treatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998;85(1):86–93.
    1. Chávez de Paz L, Dahlén G, Molander A, Möller Å, Bergenholtz G. Bacteria recovered from teeth with apical periodontitis after antimicrobial endodontic treatment. Int Endod J. 2003;36(7):500–8.
    1. Byström A, Claesson R, Sundqvist G. The antibacterial effect of camphorated paramonochlorophenol, camphorated phenol and calcium hydroxide in the treatment of infected root canals. Dent Traumatol. 1985;1(5):170–5.
    1. Ørstavik D, Haapasalo M. Disinfection by endodontic irrigants and dressings of experimentally infected dentinal tubules. Dent Traumatol. 1990;6(4):142–9.
    1. Kaufman B, Spångberg L, Barry J, Fouad AF. Enterococcus Spp. in Endodontically Treated Teeth with and without Periradicular Lesions. J Endod. 2005;31(12):851–6.
    1. Case PD, Bird PS, Kahler WA, George R, Walsh LJ. Treatment of Root Canal Biofilms of Enterococcus faecalis with Ozone Gas and Passive Ultrasound Activation. J Endod. 2012;38(4):523–6.
    1. Licata M, Albanese A, Campisi G, Geraci D, Russo R, Gallina G. Effectiveness of a new method of disinfecting the root canal, using Er, Cr: YSGG laser to kill Enterococcus faecalis in an infected tooth model. Lasers Med Sci. 2013:1–6.
    1. Basmaci F, Öztan M, Kiyan M. Ex vivo evaluation of various instrumentation techniques and irrigants in reducing E. faecalis within root canals. Int Endod J. 2013
    1. Siren E, Haapasalo M, Ranta K, Salmi P, Kerosuo E. Microbiological findings and clinical treatment procedures in endodontic cases selected for microbiological investigation. Int Endod J. 1997;30(2):91–5.
    1. Schäfer E, Bössmann K. Antimicrobial effect of camphorated chloroxylenol (ED 84) in the treatment of infected root canals. J Endod. 1999;25(8):547–51.
    1. Basrani B, Tjäderhane L, Santos JM, Pascon E, Grad H, Lawrence HP, Friedman S. Efficacy of chlorhexidine-and calcium hydroxide-containing medicaments against Enterococcus faecalis in vitro. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003;96(5):618–24.
    1. Mohammadi Z, Abbott P. On the local applications of antibiotics and antibiotic‐based agents in endodontics and dental traumatology. Int Endod J. 2009;42(7):555–67.
    1. Peters L, Van Winkelhoff AJ, Buijs J, Wesselink P. Effects of instrumentation, irrigation and dressing with calcium hydroxide on infection in pulpless teeth with periapical bone lesions. Int Endod J. 2002;35(1):13–21.
    1. Sukawat C, Srisuwan T. A Comparison of the Antimicrobial Efficacy of Three Calcium Hydroxide Formulations on Human Dentin Infected with Enterococcus faecalis. J Endod. 2002;28(2):102–4.
    1. Gomes B, Souza S, Ferraz C, Teixeira F, Zaia A, Valdrighi L, Souza-Filho F. Effectiveness of 2% chlorhexidine gel and calcium hydroxide against Enterococcus faecalis in bovine root dentine in vitro. Int Endod J. 2003;36(4):267–75.
    1. Estrela C, Bammann L, Pimenta F, Pécora J. Control of microorganisms in vitro by calcium hydroxide pastes. Int Endod J. 2001;34(5):341–5.
    1. Lynne RE, Liewehr FR, West LA, Patton WR, Buxton TB, McPherson III JC. In Vitro Antimicrobial Activity of Various Medication Preparations on. E. faecalis. in Root Canal Dentin. J Endod. 2003;29(3):187–90.

Source: PubMed

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