Abstract
Purpose:To measure the release of an antibiotic mixture of ciprofloxacin, cerfuroxim and metronidazole (TreVitaMix, TVM) through human dentine and to assess the growth inhibition of Fusobacterium nucleatum.Material and Methods:Twenty-four extracted human incisors were scaled and endodontically treated. Root canals were either filled with antibiotic tri-mixture (TVM) or with the carrier material alone (propylene glycol, PG) and were coronally and apically sealed with a flowable composite. Transradicular medicament release was spectrophotometrically measured at 277 nm in simulated body fluid for up to 21 days. In a second part, an agar diffusion assay (F. nucleatum) with representative TVM concentrations as determined in the first part was performed to study the growth inhibition. Samples were anaerobical incubated for 48 h and inhibition zones were measured.Results:TVM was spectrophotometrically detectable in the immersion solution and released in decreasing concentrations up to 21 days (222.5 ± 65.2 mg/ml at day 1 and 35.1 ± 15.6 mg/ml at day 21). In addition, inhibition zones were shown in the agar diffusion assay at representative TVM concentrations. The carrier material showed no antibacterial effect. Conlusion:TVM showed the potential to penetrate through dentine and to inhibit bacterial growth. Therefore, it might have the potential to disinfect the outer root surface in perio-endo lesions, but further research is needed to confirm these observations.
Highlights
Endodontic and periodontal diseases are primarily caused by bacterial infections [1,2,3,4,5] and studies suggest that infected root canal systems and periodontal pockets have analogical bacterial species [2, 4,5,6,7,8]
This investigation was divided in two parts: in the first part of the study, the concentrations of TVM release from medicated root canals were spectrophotometrically assessed in simulated bodyfluid (SBF) after a cumulative storage time of three weeks
The release rate of the antibiotic mix and the pure carrier material as a control up to 21 days is depicted in Fig. (1)
Summary
Endodontic and periodontal diseases are primarily caused by bacterial infections [1,2,3,4,5] and studies suggest that infected root canal systems and periodontal pockets have analogical bacterial species [2, 4,5,6,7,8]. Untreated infections in one of these compartments can lead to symptoms or signs of disease initiation and progression inside the other tissues [6, 7, 9, 10]. This can occur biderectionally, for example from the periodontium to the root canal and vice versa. In periodontal pockets more bacteria species can be found than in infected root canal systems but there is a more complex microflora in contaminated root canals of teeth that have a coexisting periodontal and endodontic disease in comparison with teeth that have a sole periapical pathosis [4]
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