Advertisement

European Archives of Paediatric Dentistry

, Volume 17, Issue 4, pp 251–255 | Cite as

In vitro evaluation of the antimicrobial effects of different intracanal medications in necrotic immature teeth

  • C. Maniglia-FerreiraEmail author
  • F. de Almeida-Gomes
  • M. M. N. Pinto
  • F. T. de Sousa Barbosa
  • D. M. de Farias Filho
  • N. L. G. Albuquerque
Original Scientific Article

Abstract

Aim

This was to assess the antimicrobial effectiveness of pastes used as intracanal medicaments against Enterococcus faecalis in necrotic immature teeth.

Method

An agar-disc diffusion method over a period of 30 days was used. The following medications were analysed: triple antibiotic paste (TAP) I; double antibiotic paste (DAP) I; DAP I with calcium hydroxide; calcium hydroxide paste with saline solution 0.9 %; calcium hydroxide paste with chlorhexidine 2 % gel; DAP II; DAP II with zinc oxide; DAP II with calcium hydroxide; and saline solution 0.9 % as control. The diameters of the halos of inhibition (in mm) of tested medicaments were determined and analysed with one-way analysis of variance and Tukey’s post hoc tests.

Results

TAP I (G1) was significantly more effective against E. faecalis, and showed the largest halo of inhibition during all the experiments. DAP groups (G2 and G6) also showed inhibiting bacterial growth with said inhibition remaining stable throughout the 30-day period. In contrast, G4 and G5 groups, in which Ca(OH)2 was added to saline and chlorhexidine, had no antibacterial effect.

Conclusions

TAP and DAP showed better antibacterial efficacy and remained active for 30 days. Combination of Ca(OH)2 with antibiotics should be avoided, due to the possibility of antibiotic hydrolysis.

Keywords

Dental pulp necrosis Enterococcus faecalis Root canal medicaments 

Notes

Acknowledgments

This study supported by Department of Endodontics, Universidade de Fortaleza, Ceará, Brazil.

Compliance with ethical standards

Ethical approval

This study does not contain any studies with human participants or animals performed by any of the authors.

Conflict of interest

The authors certify that they have no commercial or associative interest that represents a conflict of interest in connection with the manuscript.

References

  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. Ir Endod J. 2014;9:123–6.Google Scholar
  2. Adl A, Shojaee NS, Motamedifar M. A comparison between the antimicrobial effects of triple antibiotic paste and calcium hydroxide against Enterococcus faecalis. Ir Endod J. 2012;7:149–55.Google Scholar
  3. Akçay M, Arslan H, Yasça B, Kıvrık F, Yasça E. Spectrophotometric analysis of crown discoloration induced by various antibiotic pastes used in revascularization. J Endod. 2014;40:845–8.CrossRefPubMedGoogle Scholar
  4. Akgun OM, Altun C, Guven G. Use of triple antibiotic paste as a disinfectant for a traumatized immature tooth with a periapical lesion: a case report. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;108:62–5.CrossRefGoogle Scholar
  5. Asna Ashari M, Fayaz F, Moezzi Ghadim N, Alim Marvesti L, Mehrabi Y. Evaluation of the antimicrobial effects of MTAD, NaOCl against selected endodontic pathogens. Ir Endod J. 2009;4:63–8.Google Scholar
  6. Bezgin T, Sönmez H. Review of current concepts of revascularization/revitalization. Dent Traumatol. 2015;31:267–73.CrossRefPubMedGoogle Scholar
  7. Brandle N, Zehnder M, Weiger R, Waltimo T. Impact of growth conditions on susceptibility of five microbial species to alkaline stress. J Endod. 2008;34:579–82.CrossRefPubMedGoogle Scholar
  8. Cehreli ZC, Isbitiren B, Sara S, Erbas G. Regenerative endodontic treatment (revascularization) of immature necrotic molars medicated with calcium hydroxide: a case series. J Endod. 2011;37:1327–30.CrossRefPubMedGoogle Scholar
  9. Dametto FR, Ferraz CC, Gomes BP, et al. In vitro assessment of the immediate and prolonged antimicrobial action of chlorhexidine gel as an endodontic irrigant against Enterococcus faecalis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005;99:768–72.CrossRefPubMedGoogle Scholar
  10. Garcia-Godoy F, Murray PE. Recommendations for using regenerative endodontic procedures in permanent immature traumatized teeth. Dent Traumatol. 2012;28:33–41.CrossRefPubMedGoogle Scholar
  11. Gomes BP, Souza SF, Ferraz CC, et al. Effectiveness of 2 % chlorhexidine gel and calcium hydroxide against Enterococcus faecalis in bovine root dentine in vitro. Int Endod J. 2003;36:267–75.CrossRefPubMedGoogle Scholar
  12. Gomes-Filho JE, Duarte PC, de Oliveira CB, et al. Tissue reaction to a triantibiotic paste used for endodontic tissue self-regeneration of nonvital immature permanent teeth. J Endod. 2012;38:91–4.CrossRefPubMedGoogle Scholar
  13. Hargreaves KM, Diogenes A, Teixeira FB. Treatment options: biological basis of regenerative endodontic procedures. J Endod. 2013;39:30–43.CrossRefGoogle Scholar
  14. Huang GTJ. Apexification the beginning of its end. Int Endod J. 2009;42:855–66.CrossRefPubMedGoogle Scholar
  15. Iwaya SI, Ikawa M, Kubota M. Revascularization of an immature permanent tooth with apical periodontitis and sinus tract. Dent Traumatol. 2001;17:185–7.CrossRefPubMedGoogle Scholar
  16. Jung IY, Lee SJ, Hargreaves KM. Biologically based treatment of immature permanent teeth with pulpal necrosis: a case series. J Endod. 2008;34:876–87.CrossRefPubMedGoogle Scholar
  17. Kahler B, Mistry S, Moule A, et al. Revascularization outcomes: a prospective analysis of 16 consecutive cases. J Endod. 2014;40:333–8.CrossRefPubMedGoogle Scholar
  18. Kim JH, Kim Y, Shin SJ, Park JW, Jung IY. Tooth discoloration of immature permanent incisor associated with triple antibiotic therapy: a case report. J Endod. 2010;36:1086–91.CrossRefPubMedGoogle Scholar
  19. Martin G, Ricucci D, Gibbs JL, Lin LM. Histological findings of revascularized/revitalized immature permanent molar with apical periodontitis using platelet-rich plasma. J Endod. 2013;39:138–44.CrossRefPubMedGoogle Scholar
  20. Mohammadi Z, Dummer PM. Properties and applications of calcium hydroxide in endodontics and dental traumatology. Int Endod J. 2011;44:697–730.CrossRefPubMedGoogle Scholar
  21. Mozayeni MA, Haeri A, Dianat O, Jafari AR. Antimicrobial effects of four intracanal medicaments on enterococcus faecalis: an in vitro study. Ir Endod J. 2014;9:195–8.Google Scholar
  22. Nagata JY, Gomes BP, Rocha Lima TF, et al. Traumatized immature teeth treated with 2 protocols of pulp revascularization. J Endod. 2014a;40:606–12.CrossRefPubMedGoogle Scholar
  23. Nagata JY, Soares AJ, Souza-Filho FJ, et al. Microbial evaluation of traumatized teeth treated with triple antibiotic paste or calcium hydroxide with 2 % chlorhexidine gel in pulp revascularization. J Endod. 2014b;40:778–83.CrossRefPubMedGoogle Scholar
  24. Nosrat A, Li KL, Vir K, Hicks ML, Fouad AF. Is pulp regeneration necessary for root maturation? J Endod. 2013;39:1291–5.CrossRefPubMedGoogle Scholar
  25. Nosrat A, Seifi A, Asgary S. Regenerative endodontic treatment (revascularization) for necrotic immature permanent molars: a review and report of two cases with a new biomaterial. J Endod. 2011;37:562–7.CrossRefPubMedGoogle Scholar
  26. Ordinola-Zapata R, Bramante CM, Cavenago B, et al. Antimicrobial effect of endodontic solutions used as final irrigants on a dentine biofilm model. Int Endod J. 2012;45:162–8.CrossRefPubMedGoogle Scholar
  27. 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;35:13–21.CrossRefPubMedGoogle Scholar
  28. Pinheiro ET, Gomes BP, Ferraz CC, et al. Microorganisms from canals of root-filled teeth with periapical lesions. Int Endod J. 2003;36:1–11.CrossRefPubMedGoogle Scholar
  29. Portenier I, Haapasalo H, Orstavik D, Yamauchi M, Haapasalo M. Inactivation of the antibacterial activity of iodine potassium iodide and chlorhexidine digluconate against Enterococcus faecalis by dentin, dentin matrix, type-I collagen, and heat-killed microbial whole cells. J Endod. 2002;28:634–7.CrossRefPubMedGoogle Scholar
  30. Rafter M. Apexification: a review. Dent Traumatol. 2005;21:1–8.CrossRefPubMedGoogle Scholar
  31. Ritter ALS, Ritter AV, Murrah V, Sigurdsson A, Trope M. Pulp revascularization of replanted immature dog teeth after treatment with minocycline and doxycycline assessed by laser Doppler flowmetry, radiography, and histology. Dent Traumatol. 2004;20:75–84.CrossRefPubMedGoogle Scholar
  32. Sabrah AH, Yassen GH, Gregory RL. Effectiveness of antibiotic medicaments against biofilm formation of Enterococcus faecalis and Porphyromonas gingivalis. J Endod. 2013;39:1385–9.CrossRefPubMedGoogle Scholar
  33. Siqueira JF Jr, Lopes HP. Mechanisms of antimicrobial activity of calcium hydroxide: a critical review. Int Endod J. 1999;32:361–9.CrossRefPubMedGoogle Scholar
  34. Siqueira JF Jr. Aetiology of root canal treatment failure: why well-treated teeth can fail. Int Endod J. 2001;34:1–10.CrossRefPubMedGoogle Scholar
  35. Soares Ade J, Lins FF, Nagata JY, et al. Pulp revascularization after root canal decontamination with calcium hydroxide and 2 % chlorhexidine gel. J Endod. 2013;39:417–20.CrossRefPubMedGoogle Scholar
  36. Wang CS, Arnold RR, Trope M, Teixeira FB. Clinical efficiency of 2 % chlorhexidine gel in reducing intracanal bacteria. J Endod. 2007;33:1283–9.CrossRefPubMedGoogle Scholar
  37. Wigler R, Kaufman AY, Steinbock N, Hazan-Molina H, Torneck CD. Revascularization: a treatment for permanent teeth with necrotic pulp and incomplete root development. J Endod. 2013;39:319–26.CrossRefPubMedGoogle Scholar
  38. Windley W, Teixeira F, Levin L, Sigurdsson A, Trope M. Disinfection of immature teeth with a triple antibiotic paste. J Endod. 2005;31:439–43.CrossRefPubMedGoogle Scholar

Copyright information

© European Academy of Paediatric Dentistry 2016

Authors and Affiliations

  • C. Maniglia-Ferreira
    • 1
    • 4
    Email author
  • F. de Almeida-Gomes
    • 1
  • M. M. N. Pinto
    • 2
  • F. T. de Sousa Barbosa
    • 1
  • D. M. de Farias Filho
    • 1
  • N. L. G. Albuquerque
    • 3
  1. 1.Departamento de EndodontiaUniversidade de Fortaleza (UNIFOR)FortalezaBrazil
  2. 2.Departamento de MicrobiologiaUniversidade de Fortaleza (UNIFOR)FortalezaBrazil
  3. 3.Doutoranda do programa de pós-graduação da Universidade Federal do Ceará (UFC)FortalezaBrazil
  4. 4.FortalezaBrazil

Personalised recommendations