Abstract

Background and Aims This study was aimed at evaluating the antibacterial property of an injectable platelet-rich fibrin (I-PRF) scaffold containing triple antibiotic mixture against an Actinomyces naeslundii (A. naeslundii) and Enterococcus faecalis (E. faecalis) biofilm in an infected immature root canal model. Methods A dual-species biofilm was inoculated inside the root canals via a series of centrifugal cycles. The samples were allocated to three experimental groups (i.e., G1: triple antibiotic mixture, G2: I-PRF containing triple antibiotic mixture, and G3: antibiotic-free I-PRF scaffold) and two control groups (G4: seven-day biofilm untreated and G5: bacteria-free untreated). Results Bacterial gene quantification change and the overall reduction of live bacteria were evaluated. The highest antibacterial activity against A. naeslundii belonged to G2. However, G1 and G2 had similar antibacterial property against E. faecalis (p value = 0.814). In general, experimental groups revealed higher levels of antibacterial activity against E. faecalis than against A. naeslundii (p value < 0.001). Notably, G2 could dramatically decrease the number of live bacteria up to near 92%. Conclusions The current study provides insight into the antibacterial property of an antibiotic-eluting I-PRF scaffold against a dual-species biofilm colonized inside the root canal. The fabricated scaffold contains not only the antibiotics but also the growth factors, which favor the regeneration.

Highlights

  • The symbiosis of various bacterial species, mostly facultative and strict anaerobic bacteria, inside the root canal system plays an essential role in endodontic infection [1]

  • Copious chemical canal irrigation with minimal or no mechanical instrumentation, placement of an antibacterial medicament, removal of the medicament after nearly 14 weeks, and bleeding stimulation are the main steps in regenerative endodontics [7]

  • Complete elimination of the BioMed Research International microbial population is one of the most crucial yet challenging steps in regenerative-based treatments [8]. This is achieved by the intracanal placement of calcium hydroxide, triple antibiotic paste (TAP) containing ciprofloxacin (CIP), metronidazole (MET), and minocycline (MINO), or double antibiotic paste (DAP), containing CIP and MET (Kamocki et al, 2015)

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Summary

Introduction

The symbiosis of various bacterial species, mostly facultative and strict anaerobic bacteria, inside the root canal system plays an essential role in endodontic infection [1]. The use of either calcium hydroxide or antibiotic paste can cause unfavorable side effects The former is responsible for root weakening even after a short period [9]. This study was aimed at evaluating the antibacterial property of an injectable platelet-rich fibrin (I-PRF) scaffold containing triple antibiotic mixture against an Actinomyces naeslundii (A. naeslundii) and Enterococcus faecalis (E. faecalis) biofilm in an infected immature root canal model. The current study provides insight into the antibacterial property of an antibiotic-eluting I-PRF scaffold against a dual-species biofilm colonized inside the root canal. The fabricated scaffold contains the antibiotics and the growth factors, which favor the regeneration

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