A Review on Triple Antibiotic Paste as a Suitable Material Used in Regenerative Endodontics

Zahed Mohammadi, Hamid Jafarzadeh, Sousan Shalavi, Shapour Yaripour, Farid Sharifi, Jun-Ichiro Kinoshita, Zahed Mohammadi, Hamid Jafarzadeh, Sousan Shalavi, Shapour Yaripour, Farid Sharifi, Jun-Ichiro Kinoshita

Abstract

As the root canal system shows different and complicated anatomies, mechanical instrumentation alone has not the ability to provide a bacteria-free environment in root canals. On the other aspect, necrotic tissue remaining can decrease the effects of root canal irrigants and medicaments and also interfere with the adaptation of root canal fillings to dentin. As a result, certain disinfection and irrigation procedures are required to remove the remaining tissues from the root canal area thoroughly and also be able to eliminate the microorganisms. Triple antibiotic paste (TAP) containing metronidazole, ciprofloxacin and minocycline has been proposed as a root canal medicament due to its antimicrobial effects in endodontic regenerative procedures. The purposes of this review were to determine the properties of TAP drugs and to evaluate the efficiency of TAP on the root canal disinfection, in primary and permanent teeth, along with its affection in regeneration/revascularization procedures. The biocompatibility and disadvantages of this medicament were also discussed.

Keywords: Intra-canal Medicament; Ndodontics; Regeneration; Triple Antibiotic Paste.

Conflict of interest statement

‘None declared’.

References

    1. Kakehashi S, Stanley HR, Fitzgerald RJ. The Effects of Surgical Exposures of Dental Pulps in Germ-Free and Conventional Laboratory Rats. Oral Surg Oral Med Oral Pathol. 1965;20:340–9.
    1. Moller AJ. Microbiological examination of root canals and periapical tissues of human teeth Methodological studies. Odontol Tidskr. 1966;74(5):1–380.
    1. Sundqvist G. Ecology of the root canal flora. J Endod. 1992;18(9):427–30.
    1. Mohammadi Z, Shalavi S, Giardino L, Asgary S. Endodontic Considerations in Three-canalled Premolars: A Practical Update. Iran Endod J. 2016;11(2):134–7.
    1. Mohammadi Z, Jafarzadeh H, Shalavi S, Palazzi F. Recent Advances in Root Canal Disinfection: A Review. Iran Endod J. 2017;12(4):402–6.
    1. Mohammadi Z, Shalavi S, Giardino L, Palazzi F, Asgary S. Impact of Ultrasonic Activation on the Effectiveness of Sodium Hypochlorite: A Review. Iran Endod J. 2015;10(4):216–20.
    1. Mohammadi Z, Giardino L, Palazzi F, Asgary S. Agonistic and Antagonistic Interactions between Chlorhexidine and Other Endodontic Agents: A Critical Review. Iran Endod J. 2015;10(1):1–5.
    1. Mohammadi Z, Z CC, Shalavi S, Giardino L, Palazzi F, Asgary S. Management of Root Resorption Using Chemical Agents: A Review. Iran Endod J. 2016;11(1):1–7.
    1. Hess W, Zürcher E, Dolamore WH. The anatomy of the root-canals of the teeth of the permanent dentition. J. Bale, sons & Danielsson, ltd; 1925.
    1. Peters OA, Laib A, Gohring TN, Barbakow F. Changes in root canal geometry after preparation assessed by high-resolution computed tomography. J Endod. 2001;27(1):1–6.
    1. Bystrom A, Sundqvist G. Bacteriologic evaluation of the efficacy of mechanical root canal instrumentation in endodontic therapy. Scand J Dent Res. 1981;89(4):321–8.
    1. Mohammadi Z, Abbott PV. The properties and applications of chlorhexidine in endodontics. Int Endod J. 2009;42(4):288–302.
    1. Gilad JZ, Teles R, Goodson M, White RR, Stashenko P. Development of a clindamycin-impregnated fiber as an intracanal medication in endodontic therapy. J Endod. 1999;25(11):722–7.
    1. Mohammadi Z, Abbott PV. On the local applications of antibiotics and antibiotic-based agents in endodontics and dental traumatology. Int Endod J. 2009;42(7):555–67.
    1. Abbott PV. Selective and intelligent use of antibiotics in endodontics. Aust Endod J. 2000;26(1):30–9.
    1. Mohammadi Z. Local applications of tetracyclines in endodontics and dental trauma: a review. Dent Today. 2009;28(1):95–6. 8, 100-1; quiz 1.
    1. Torabinejad M, Khademi AA, Babagoli J, Cho Y, Johnson WB, Bozhilov K, Kim J, Shabahang S. A new solution for the removal of the smear layer. J Endod. 2003;29(3):170–5.
    1. Greenstein G. The role of metronidazole in the treatment of periodontal diseases. J Periodontol. 1993;64(1):1–15.
    1. Roche Y, Yoshimori RN. In-vitro activity of spiramycin and metronidazole alone or in combination against clinical isolates from odontogenic abscesses. J Antimicrob Chemother. 1997;40(3):353–7.
    1. Siqueira JF Jr, de Uzeda M. Intracanal medicaments: evaluation of the antibacterial effects of chlorhexidine, metronidazole, and calcium hydroxide associated with three vehicles. J Endod. 1997;23(3):167–9.
    1. Lima KC, Fava LR, Siqueira JF Jr. Susceptibilities of Enterococcus faecalis biofilms to some antimicrobial medications. J Endod. 2001;27(10):616–9.
    1. Krithikadatta J, Indira R, Dorothykalyani AL. Disinfection of dentinal tubules with 2% chlorhexidine, 2% metronidazole, bioactive glass when compared with calcium hydroxide as intracanal medicaments. J Endod. 2007;33(12):1473–6.
    1. Wang ZP, Wang D, Zhang LJ, Kong L. [The observation of the effect of metronidazole-chlorhexidine solution on treatment of periapical periodontitis] Shanghai Kou Qiang Yi Xue. 2003;12(4):244–6.
    1. Gao J, Wang ZP, Li XG, Wang D, Zhang L. [The preparation and in vitro release test of sustained release delivery gutta-percha point containing metronidazole] Shanghai Kou Qiang Yi Xue. 2004;13(6):557–60.
    1. Drusano GL, Standiford HC, Plaisance K, Forrest A, Leslie J, Caldwell J. Absolute oral bioavailability of ciprofloxacin. Antimicrob Agents Chemother. 1986;30(3):444–6.
    1. Brunton LL, Lazo J, Parker K. Goodman & Gilman. As bases farmacológicas da terapêutica. 2006. p. 11.
    1. Grossman LI. Polyantibiotic treatment of pulpless teeth. J Am Dent Assoc. 1951;43(3):265–78.
    1. Mohammadi Z. Chemomechanical strategies to manage endodontic infections. Dent Today. 2010;29(2):91–2. 4, 6 passim; quiz 9.
    1. Windley W, 3rd , 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. 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. 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. Adl A, Hamedi S, Sedigh Shams M, Motamedifar M, Sobhnamayan F. The ability of triple antibiotic paste and calcium hydroxide in disinfection of dentinal tubules. Iran Endod J. 2014;9(2):123–6.
    1. Nabavizadeh M, Moazzami F, Bahmani M, Mirhadi H. The Effect of Intracanal Medicaments on Microleakage of Mineral Trioxide Aggregate Apical Plugs. Iran Endod J. 2017;12(3):329–33.
    1. Iwaya SI, Ikawa M, Kubota M. Revascularization of an immature permanent tooth with apical periodontitis and sinus tract. Dent Traumatol. 2001;17(4):185–7.
    1. Scarparo RK, Dondoni L, Bottcher DE, Grecca FS, Rockenbach MI, Batista EL Jr. Response to intracanal medication in immature teeth with pulp necrosis: an experimental model in rat molars. J Endod. 2011;37(8):1069–73.
    1. Albuquerque MT, Ryan SJ, Munchow EA, Kamocka MM, Gregory RL, Valera MC, Bottino MC. Antimicrobial Effects of Novel Triple Antibiotic Paste-Mimic Scaffolds on Actinomyces naeslundii Biofilm. J Endod. 2015;41(8):1337–43.
    1. Johns DA, Varughese JM, Thomas K, Abraham A, James EP, Maroli RK. Clinical and radiographical evaluation of the healing of large periapical lesions using triple antibiotic paste, photo activated disinfection and calcium hydroxide when used as root canal disinfectant. J Clin Exp Dent. 2014;6(3):e230–6.
    1. Frough Reyhani M, Rahimi S, Fathi Z, Shakouie S, Salem Milani A, Soroush Barhaghi MH, Shokri J. Evaluation of Antimicrobial Effects of Different Concentrations of Triple Antibiotic Paste on Mature Biofilm of Enterococcus faecalis. J Dent Res Dent Clin Dent Prospects. 2015;9(3):138–43.
    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. Lovelace TW, Henry MA, Hargreaves KM, Diogenes A. Evaluation of the delivery of mesenchymal stem cells into the root canal space of necrotic immature teeth after clinical regenerative endodontic procedure. J Endod. 2011;37(2):133–8.
    1. Nakornchai S, Banditsing P, Visetratana N. Clinical evaluation of 3Mix and Vitapex as treatment options for pulpally involved primary molars. Int J Paediatr Dent. 2010;20(3):214–21.
    1. Pinky C, Shashibhushan KK, Subbareddy VV. Endodontic treatment of necrosed primary teeth using two different combinations of antibacterial drugs: an in vivo study. J Indian Soc Pedod Prev Dent. 2011;29(2):121–7.
    1. Trairatvorakul C, Detsomboonrat P. Success rates of a mixture of ciprofloxacin, metronidazole, and minocycline antibiotics used in the non-instrumentation endodontic treatment of mandibular primary molars with carious pulpal involvement. Int J Paediatr Dent. 2012;22(3):217–27.
    1. Takushige T, Cruz EV, Asgor Moral A, Hoshino E. Endodontic treatment of primary teeth using a combination of antibacterial drugs. Int Endod J. 2004;37(2):132–8.
    1. Er K, Celik D, Tasdemir T, Yildirim T. Treatment of horizontal root fractures using a triple antibiotic paste and mineral trioxide aggregate: a case report. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;108(1):e63–6.
    1. Ruparel NB, Teixeira FB, Ferraz CC, Diogenes A. Direct effect of intracanal medicaments on survival of stem cells of the apical papilla. J Endod. 2012;38(10):1372–5.
    1. Pereira MS, Rossi MA, Cardoso CR, da Silva JS, Bezerra da Silva LA, Kuga MC, Faria G. Cellular and molecular tissue response to triple antibiotic intracanal dressing. J Endod. 2014;40(4):499–504.
    1. Kim ST, Abbott PV, McGinley P. The effects of Ledermix paste on discolouration of mature teeth. Int Endod J. 2000;33(3):227–32.
    1. Kim ST, Abbott PV, McGinley P. The effects of Ledermix paste on discolouration of immature teeth. Int Endod J. 2000;33(3):233–7.
    1. Lenherr P, Allgayer N, Weiger R, Filippi A, Attin T, Krastl G. Tooth discoloration induced by endodontic materials: a laboratory study. Int Endod J. 2012;45(10):942–9.
    1. Akcay M, Arslan H, Yasa B, Kavrik F, Yasa E. Spectrophotometric analysis of crown discoloration induced by various antibiotic pastes used in revascularization. J Endod. 2014;40(6):845–8.
    1. Yilmaz S, Dumani A, Yoldas O. The effect of antibiotic pastes on microhardness of dentin. Dent Traumatol. 2016;32(1):27–31.
    1. Yassen GH, Eckert GJ, Platt JA. Effect of intracanal medicaments used in endodontic regeneration procedures on microhardness and chemical structure of dentin. Restor Dent Endod. 2015;40(2):104–12.

Source: PubMed

3
Subskrybuj