Abstract
Background and aims. Triple antibiotic paste (TAP) is widely used in endodontics for root canal disinfection, particularly in regenerative procedures. The aim of this in vitro study was to evaluate the antimicrobial effects of different concentrations of TAP at 1-, 2-, 3-, and 4-week intervals on mature Enterococcus faecalis biofilm.Materials and methods. A total of 287 extracted one-rooted human central incisors were infected with E. faecalis ATCC 29212 after removing the crown and preparation. The root canal space was filled with one of the 0.01-, 0.1-, 1-, 10-, 100-, and 1000-mg/mL concentrations of TAP or normal saline (control). The root canal dentin was sampled after 1, 2, 3, and 4 weeks. The dentinal shavings were cultured on Mueller-Hinton agar plates after serial dilutions. The classic colony-forming unit (CFU) counting technique was used to determine remaining bacterial counts. Data were analyzed by using the two-way ANOVA, post hoc Tukey tests and one-way ANOVA (P<0.05).Results. TAP completely eliminated E. faecalis biofilms at all the intervals at concentrations of 1000, 100, and 10 mg/mL, whereas 1-, 0.1-, and 0.01-mg/mL TAP resulted in significant reduction of CFU means compared with the control group. There were no statistically significant differences between the four time intervals.Conclusion. Use of lower concentrations of TAP at short term could eradicate E. faecalis biofilm and decrease high-concentration side effects.
Highlights
Enterococcus faecalis is the chief colonizing microorganism in endodontic infections and the most important bacterial species in refractory infections of the root canal system.[1]
The results of statistical analysis showed that Triple antibiotic paste (TAP) at concentrations of 1000, 100, and 10 mg/mL completely eliminated mature E. faecalis biofilms at 1, 2, 3- and 4-week intervals
Treatment of immature necrotic teeth is a challenge in endodontics and requires special disinfection procedures to achieve regenerative aims
Summary
Enterococcus faecalis is the chief colonizing microorganism in endodontic infections and the most important bacterial species in refractory infections of the root canal system.[1]. Endodontic regenerative processes are feasible with the use of tissue engineering principles which require spatial orientation of stem cells, signaling molecules and scaffolds as prerequisites.[7] It has been reported that the remnants of Hertwig epithelial sheath or the remnants of Malassez rest cells are resistant to periapical infections; signaling networks from these residual cells in immature and non-infected non-vital teeth stimulate different stem cells, including apical papilla stem cells, bone marrow and pluripotent stem cells of the pulp to form dentin and help the normal root maturation.[7] Prerequisites for regenerative treatments include the presence of a sterilized environment, a matrix for cellular growth and a hermetic coronal seal to prevent re-contamination.[8,9] In this context, the most commonly used and studied agent for disinfection of the root canal is triple antibiotic paste (TAP), which is a mixture of metronidazole, ciprofloxacin and minocycline. Triple antibiotic paste (TAP) is widely used in endodontics for root canal disinfection, in regenerative procedures The aim of this in vitro study was to evaluate the antimicrobial effects of different concentrations of TAP at 1-, 2-, 3-, and 4-week intervals on mature Enterococcus faecalis biofilm.
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