Antibiotic Paste Research Articles

Retracted: The Efficacy of Minocycline Hydrochloride Combined with Multiple Antibiotic Paste in Elderly Patients with Chronic Periodontitis and Concomitant Pulp Lesions.

[This retracts the article DOI: 10.1155/2022/7604741.].

Effects of an Nd:YAP laser used for root canal disinfection in pulp regenerative therapy: a pilot study.

This study aimed to compare the disinfection effects between a triple antibiotic paste and neodymium-doped yttrium aluminum perovskite (Nd:YAP) laser in pulp regenerative therapy and evaluate corresponding therapeutic effects based on apical radiographs and cone-beam computed tomography (CBCT). Sixty-six immature permanent teeth in 66 patients diagnosed with acute or chronic apical periodontitis were analyzed. All teeth were given pulp regenerative therapy. The patients were categorized into a control (triple antibiotic paste) and an experimental (Nd:YAP laser) group. Teeth in the experimental group were disinfected using an Nd:YAP laser, while those in the control group were disinfected using a triple antibiotic paste. Clinical and radiological examinations were performed every 3-6 months after treatment and followed up for 24 months. Statistical analysis was performed after clinical examination and showed that after one week of treatment, symptoms persisted in two teeth in the control group and two teeth in the experimental group. Two weeks later, the clinical symptoms disappeared in all teeth (p > 0.05). After 24 months of follow-up, the clinical symptoms recurred in two teeth in the control group and one tooth in the experimental group. On radiographic examination, 31 and 27 teeth showed continued root development, and three and two teeth showed no obvious root development in the control and experimental groups, respectively. The pulp sensibility test was positive in four teeth in both groups, with no significant difference between the two groups (p > 0.05). The results of this study suggest that endodontic irradiation with an Nd:YAP laser could be an effective alternative to triple antibiotic paste during disinfection of pulp regenerative therapy. Treatment outcomes were assessed using apical radiographs and CBCT, and no negative prognostic effects of the Nd:YAP laser on pulp regenerative therapy were found.

Comparative evaluation of antibacterial efficacy of nonsteroidal anti-inflammatory medications and proton-pump inhibitor against Enterococcus faecalis: An in vitro study.

The present in vitro experimental study was undertaken to evaluate and compare the antimicrobial activity of triple antibiotic paste (TAP), diclofenac, and proton-pump inhibitor (PPI) against the microorganism Enterococcus faecalis. Three medicaments were selected for the study, TAP, diclofenac, and PPI. The experimental groups for the test were as follows: Part 1 - Group 1: TAP, Group 2: diclofenac, and Group 3: PPI; Part 2 - Group 1: TAP + PPI and Group 2: diclofenac + PPI. An agar well diffusion test was used to determine the efficacy of the experimental medicaments against E. faecalis (ATCC 29212). The diameter of inhibition zones was measured in millimeters using an inhibition zone measuring scale and the results were recorded. The statistical analysis was done using an analysis of variance and an unpaired t-test. P value was set at < 0.05. There was a significant difference in the diameter of growth inhibition zones, with the greatest diameter noted for TAP + PPI followed by diclofenac sodium (DS) + PPI, TAP, DS, and PPI. The antimicrobial effectiveness of TAP + PPI was found to be superior to all other medicaments (DS + PPI, TAP, DS, and PPI).

Comparative evaluation of the antibacterial efficacy of herbal agents as intracanal medicaments individually or in combination with chitosan: An in vitro RTPCR study

Aim: To evaluate and compare the antimicrobial efficacy of herbal agents as intracanal medicaments with or without a carrier against E. faecalis. Materials and Methods: In this in vitro study, 80 extracted human single-rooted anterior or premolar teeth were used. They were decoronated to obtain standardized 6 mm blocks of the mid root. The internal root diameter was standardized(GG drill #3). All samples underwent 21-day contamination with E. faecalis after which they were randomly divided into(n = 20) Group 1, Triple antibiotic paste (Control); Group 2, Curcumin; Group 3, Propolis and Group 4, Aloe Vera gel. The groups were further sub grouped(n = 10) based on presence / absence of carrier (chitosan). 14 days post medication, E. faecalis from samples was quantified using qPCR and the data was analysed using One-way ANOVA and Tukeys Post-Hoc test. Results: All medicaments exhibited antimicrobial properties. TAP performed the best, Individually, Propolis showed almost similar efficacy (P = 0.598). With chitosan combination, Curcumin was a close contender to TAP (P = 0.963). Aloe Vera gave the poorest result, but on addition of chitosan there was a significant increase (P = 0.000) in the antimicrobial efficacy. Conclusion: Based on the aim and the results obtained it can be concluded that all the test medicaments exhibited antimicrobial properties. TAP had superior antimicrobial properties compared to others. Individually, propolis and in combination with chitosan, curcumin showed similar antimicrobial efficacy. Aloe vera performed the poorest but when combined with chitosan, its antimicrobial properties significantly improved.

Antibacterial Efficacy of Polymer-Coated Ceramic Microparticles Loaded with a Modified Combination of Antibiotics on the Enterococcus faecalis Biofilm.

Nano-technology applied for the local delivery of different agents and/or drugs has made its path to endodontics. In the current study, the antibacterial efficacy of biopolymer-coated ceramic microparticles loaded with a modified combination of triple antibiotics, i.e. Penicillin G, Metronidazole and Ciprofloxacin (PMC), was evaluated against two strains of Enterococcus faecalis (E.faecalis); a standard clinical strain obtained from previously root-filled teeth with persistent periapical lesions, and compared to the most common antimicrobials used in endodontics. After synthesis of the polymer-coated microparticles loaded with antibiotics, the 21-day release of antibiotics were evaluated and a stock solution was produced using the maximum released amount of drugs and distilled water. The antibacterial activity of PMC, triple antibiotic paste (TAP), calcium hydroxide (CH), chlorhexidine (CHX) and sodium hypochlorite (NaOCl) against two bacterial strains was determined using "Minimum Inhibitory Concentration" and "Agar Diffusion Test". Additionally, "Microtiter Plate Assay" was performed to assess anti-biofilm properties. Minimum inhibitory concentration values reported for TAP and PMC were 1/256. PMC showed the maximum diameter of growth inhibition in both strains (33 mm and 35 mm), while CH had the minimum diameters (13 mm and13 mm). Based on microtiter plate assay, TAP showed higher biofilm formation than PMC. Biofilm formation was higher in the standard strain for PMC; however, NaOCl, CHX and CH completely inhibited biofilm formation. Based on the findings of the present study, it could be concluded that PMC and TAP were the most effective medicaments against E.faecalis in its planktonic form; however, none could inhibit its biofilm formation. Further studies using larger sample size and "Confocal Scanning Laser Microscopy" are recommended.

Lesion sterilization and tissue repair (LSTR) method in irreversible dental pulp changes of primary teeth

Background/Aim: Deep carious lesions on primary teeth usually have been causing infectious dental pulp changes. If indicated, traditional endodontic root canal treatment for these kinds of pulpal infections in primary teeth usually should involve the performing of pulpectomy methods, but often with questionable prognosis. The lesion sterilization and tissue repair (LSTR) approach is one of the good endodontic therapeutic alternatives for affected primary teeth with a poor prognosis, which could otherwise be condemned to premature extraction. Aim was to evaluate the medium-term clinical success in everyday practice of the LSTR method applied in affected primary teeth with irreversible pulpal tissue infections by observation of reduction/absence of their clinical symptoms. Material and methods: The study sample included child patients who had one or more of their affected primary molars with irreversible pulpal tissue changes of poor prognosis treated with the LSTR method. For each patient whose primary molar tooth was endodontically treated with the LSTR method a clinical evaluation of treated tooth was performed at intervals of 1 and 12 months afterwards. Results: Study sample was consisted of 40 child patients aged 4 to 9 years, with 45 primary molars included in total. It was obvious that the symptoms related to affected sample teeth have already been decreased almost immediately after initial action of triple antibiotic paste. Final outcome after 12-months follow-up period was success of applied LSTR method in 43 (95.6%) affected sample teeth in a way that initial clinical symptoms completely decreased and disappeared. Conclusions: LSTR method has been shown as successful pulpotomy technique for noninstrumental endodontic approach in non-vital pulp treatment of primary molar teeth in a 12-months follow-up period.

An in vitro comparative evaluation of the effect of three intracanal medicaments – chlorhexidine gel, triple antibiotic paste, and calcium hydroxide paste on the push-out bond strength of MTA Plus, Biodentine, and calcium-enriched mixture

ABSTRACT Aim: Caries or traumatic injuries affecting young permanent teeth during root development usually result in an open apex which is highly challenging to treat. The aim of this study was to evaluate the push-out bond strength of apical plugs of Mineral Trioxide Aggregate (MTA) Plus, Biodentine, and calcium-enriched mixture (CEM) after premedication with chlorhexidine, triple antibiotic paste (TAP), and calcium hydroxide. Methods: Fifty-four extracted intact anterior teeth were decoronated and 3 mm was sectioned from the apex. The canals were rendered parallel using #80 K-files and #3, #4 Peeso reamers to mimic an open apex situation. The samples were divided into 3 groups containing 18 samples each for the three intracanal medicaments. After premedication, the samples were stored for 2 weeks at 37°C, following which the canals were cleaned using #80 K-file along with ethylenediaminetetraacetic acid and sodium hypochlorite irrigation. The samples were further divided into three subgroups, each containing six samples for the three calcium silicate cement used in this study. They were later subjected to push-out bond strength testing. Results: Regardless of the type of intracanal medicament used, Biodentine had significantly higher bond strength than MTA Plus and CEM. The highest push-out bond strength results were obtained in samples premedicated with chlorhexidine. Compared to TAP and calcium hydroxide (Ca(OH) 2), this value was statistically significant (P &lt; 0.001). Conclusion: Within the limitations of this study, Biodentine showed the highest push-out bond strength as compared to MTA Plus and CEM. Chlorhexidine may be superior to calcium hydroxide and TAP medicaments when used for apexification procedures with calcium silicate cement.

Comparative evaluation of bromelain, double antibiotic paste, and calcium hydroxide as intracanal medicaments against Enterococcus faecalis

Aim: The aim of this in vitro study was to compare the antimicrobial effect of double antibiotic paste with that of bromelain and calcium hydroxide in eradication of E. faecalis. Hypothesis: we hypothesized that Bromelain may act as an intracanal medicament. Materials and methods: For this study, 40 extracted human teeth were used. After their decapitation, they were initially instrumented to reach 20 K-file, later they were separated into one control and three experimental groups (n=10) according to the medicament used; Group 1: Bromelain paste, Group 2: Control group, canals were left without any medicament, Group 3: Calcium hydroxide (CH)and Group 4: Double antibiotic paste (DAP). Preparation of all samples was done using Step- back technique to reach #50 file, irrigation using sodium hypochlorite solution of 2.6% concentration and EDTA, then intracanal medicaments were applied. First sample (S1) was collected after inoculation of bacteria into root canals. Second sample (S2) was collected after undergoing instrumentation and irrigation. Third sample (S3) was taken following application of medicament. Sterile cotton pellet and temporary restoration were then applied for seven days. Broth Heart Infusion (BHI) agar was used for culturing of samples then went under incubation to count Colony Forming Unit (CFU's). Results: Regarding S1 samples (after inoculation of bacteria) and S2 (after undergoing instrumentation and irrigation). In all groups, there was no statistically significant difference between them. While S 3 samples showed statistically significant difference in all groups. S3 Samples in Bromelain group showed the least statistically significant bacterial count followed by double antibiotic paste then calcium hydroxide group while S3 samples in negative control group showed the highest statistically significant bacterial count. Conclusion: Bromelain was found as an effective herbal intracanal medicament as it gives superior antimicrobial property compared to other intracanal medicaments. Clinical significance: Intracanal medicament from herbal sources like Bromelain is recommended for root canal disinfection as it has a promising effect with less side effect compared with other intracanal medicaments.

Retracted: Progress of Research on the Application of Triple Antibiotic Paste and Hydrogel Scaffold Materials in Endodontic Revascularization: A Systematic Review.

[This retracts the article DOI: 10.1155/2022/3610461.].

Non-surgical Management of a Large Periapical Lesion: A Case Report

Periapical lesions develop as a sequela to pulpal diseases. The majority of inflammatory periapical lesions are initially treated with conservative non-surgical procedures. The success of root canal treatment is based on thorough cleaning, shaping and obturation of the root canal system. Calcium hydroxide and triple antibiotic paste (TAP) are recommended as intracanal medicaments due to its antibacterial properties. This case report describes the non-surgical management of a large cyst-like periapical lesion in relation to the maxillary lateral incisor of a 19-year-old male with the chief complaint of periodic swelling and pus drainage from the palatine region with a history of a traumatic accident in the same area. The present case highlights the use of calcium hydroxide and TAP as an interappointment endodontic dressing for non-surgical management of large periapical radiolucency, which resulted in favourable clinical and radiographic outcomes.

Concentration of sodium hypochlorite disinfection in regenerative endodontic procedure: A systematic review

Objectives: To evaluate whether low concentration sodium hypochlorite (NaOCl) disinfectant protocol can achieve a sufficient amount of disinfection to provide a conducive environment for clinical and radiographic success of regenerative endodontic procedure. Materials and methods: This systematic review includes necrotic immature permanent anterior teeth below 20 years of age using triple antibiotic paste as an intra-canal medicament and autologous platelet concentrates as scaffold. The interventional group was low concentration (≤2%) NaOCl and comparator group included high concentration (&gt;2%) NaOCl as disinfectant. Cochrane risk of bias assessment 2 (RoB 2) tool was used for assessment of risk of bias. Included studies were evaluated for the absence of clinical signs and symptoms, increase in root length and apical closure on radiograph, and positive response to vitality testing. Results: After evaluation, seven studies were included. Clinical success rate was seen in 98.33% cases in low concentration (≤2%) and 95% cases in high concentration (&gt;2%) NaOCl. The radiographic success rate was 86.66% in low concentration (≤2%) and 80% in high concentration (&gt;2%) NaOCl disinfection. Positive response for vitality testing was seen in 46.66% cases in low concentration (≤2%) and 38.70% in high concentration NaOCl (&gt;2%). Conclusion: Low concentration (≤2%) NaOCl is as effective as high concentration (&gt;2%) to achieve disinfection of the root canal. However, an increased success rate is associated with the use of low concentration (≤2%) NaOCl. Response to pulp vitality is observed to be superior with low concentration (≤ 2%) NaOCl although it might be attributed to a longer follow-up period.

Is clindamycin-modified triple antibiotic paste better than iodoform-based medicament for the treatment of non-vital primary molars using LSTR technique – A randomised clinical trial

Objectives: The objectives of this study were to evaluate and compare the success rate of local application of iodoform-based obturating material (Pulpotec – [Produits Dentaires S.A., Switzerland]) and clindamycin-modified triple antibiotic paste (ClinM-TAP) in pulp chamber using minimally invasive endodontic treatment of carious primary molars indicated for pulpectomy, for 12 months, using clinical and radiographic parameters. Materials and Methods: A randomised clinical trial was conducted in 60 children in the age group of 3–8 years reporting carious primary molars with symptoms of irreversible pulpitis and pulpal involvement clinically, allocated into Group 1 (30) and Group 2 (30). In Group 1, Lesion sterilisation and tissue repair (LSTR) was done using Pulpotec (Produits Dentaires S.A., Switzerland) as medicament and in Group 2, ClinM-TAP (Clindamycin-modified triple antibiotic paste) was used as medicament. Clinical follow-up was done at 3, 6 and 12 months; radiographic follow-up was done at 6 and 12 months. Clinical parameters compared were tenderness on percussion, spontaneous pain, intraoral swelling and sinus/fistula. Radiographic comparison was done based on furcation radiolucency, root resorption and bone regeneration. Both intergroup and intragroup statistical analysis was done using Chi-square test or Fisher exact test, Cochran’s Q Test and Mann–Whitney U-Test for the test of significance. All the statistical tests were performed at 5% significance level. Results: The mean age of patients in the study was 5.25 ± 1.3years with 45% males and 55% females. Both groups showed significant improvement in terms of clinical symptoms from baseline to 12 months. On intergroup comparison clinical parameters, TOP was present in 11.2% and 44% of cases at the end of 12 months in Groups 1 and 2, respectively (P &lt; 0 0.05). On intergroup comparison of radiographic parameters, at the end of 12 months, furcation radiolucency was seen in 32% and 73% (P &lt; 0.05) and root resorption was seen in 16% and 30% cases in Group 1 and 2, respectively (P &gt; 0.05). Overall clinical success rate of Group 1 and Group 2 was 88% and 50%, respectively (P &lt; 0.05) and radiographic success rate was 60% and 27%, respectively (P &lt; 0.05). Conclusion: LSTR using Pulpotec as a medicament has shown promising results in the present study. It could be a better alternative to conventional endodontic treatment in primary teeth. In the present study, ClinM-TAP has shown poor radiographic success; hence, it should be used with caution.

Causes of Discoloration of Dental Fillings in Adults: A Systematic Review

The purpose of this investigation was to carry out an exhaustive review of the relevant previous research in order to ascertain the underlying causes of the observed discoloration and determine which component, if any, was to blame. A number of phrases taken from previously conducted systematic reviews were used in the search conducted in PubMed. There were a total of 389 teeth treated across eleven different trials that were discovered. Although it was seen more often with the use of the triple antibiotic paste that included minocycline, discoloration was shown to be substantially associated with the utilisation of other components as well. It is strongly suggested that you reevaluate your decision to use minocycline as the intracanal drug in conjunction with the other two antibiotics in the paste. The use of calcium hydroxide or an antibiotic paste containing both metronidazole and ciprofloxacin could be necessary in order to achieve the desired level of discoloration control. The presence of mineral trioxide aggregate was also associated with the discoloration. On the other hand, there is little evidence to suggest that any other material could possibly function as an acceptable coronal barrier. Because discoloration is a result that has a direct impact on patients, further research is required to determine the underlying causes of discoloration.

EFFECTIVENESS OF THREE INTRACANAL MEDICAMENTS AGAINST STAPHYLOCOCCUS AUREUS

Background: Medikamen intrakanal used to remove remaining bacteria in the root canal after the instrumentation process, especially with some of the material between the infected root canal. The purpose of the medikamen intrakanal, among others, is reducing the number of bacteria, by preventing the growth of bacteria, eliminates exudate periapikal, prevent or restrain resorpsi root and prevent infected root canal system. The most influential of these bacteria i.e. Staphylococcus aureus. The purpose of this study was to determine the effectiveness of three intracanal medicament ingredients as anti-bacterial in Staphylococcus aureus. Method: The research, an experimental laboratory method carried out with a post test only control group design, was performed on Staphylococcus aureus bacteria that had been cultured and divided into 4 groups each given 1 mg zinc oxide paste, 1 mg antibiotic paste, 1 mg calcium hydroxide, and aquadest as negative control. Subsequently the results are seen from the zone of inhibition and kill zone which are measured by calliper and analyzed by One-way Annova followed by the Post-hoc LSD. Result: The result of On-way Anova test (p=0.000), showed there was a difference for using medicaments zinc oxyde, antibiotic paste, and calcium hydroxide towards Staphylococcus aureus. The post hoc LSD test showed there was a significant mean’sdefference of inhibition zone and kill zone (p-0.05) intergrups. Conclusion: there was an effect after using zinc oxyde, antibiotic paste, and calcium hydrxide as antibacterial on Staphylococcus aureus bacteria seen from inhibition zone and kill zone.

Effect of Nano Forms of Propolis and Antibiotic Pastes as canal Medicaments on Radicular Dentin Microhardness. (In-Vitro Study)

Effect of Nano Forms of Propolis and Antibiotic Pastes as canal Medicaments on Radicular Dentin Microhardness. (In-Vitro Study)

Effectiveness of Teeth Whitening after Regenerative Endodontics Procedures: An In Vitro Study.

Discolouration resulting from regenerative endodontic procedures may have a negative impact on the quality of life of treated patients; therefore, it is recommended to minimize this risk by selecting appropriate scaffolds and barrier materials, and if discolouration occurs, the use of a simple, cost-effective and minimally invasive technique, such as whitening, should be considered. This in vitro study aimed to evaluate tooth discolouration after two- and single-visit regenerative endodontic procedures and the effectiveness of subsequent whitening procedures with carbamide peroxide. Two hundred bovine incisors were included in this study and divided into twenty groups based on the tested material combinations. Two groups were control groups, one with saline and the other group with blood. In the 12 groups, the experiment was designed to be consistent with the two-visit regenerative endodontic procedures. Triple antibiotic paste or calcium hydroxide were placed in the root canal, and then scaffolds (e.g., blood or platelet-rich fibrin) and barrier materials (Biodentine, OrthoMTA or MTA Repair HP) were applied after rinsing the disinfectant pastes. In the six groups that corresponded to the single-visit regenerative endodontic procedure, the use of a disinfectant paste was omitted. Subsequently, the specimens were bleached twice with carbamide peroxide at a 7-day interval. Colour change measurements were performed using a spectrophotometer (VITA Easyshade Compact 5.0, VITA Zahnfabrik, Bad Säckingen, Germany). Statistical analysis was performed with the Kruskal−Wallis H test, the independent t-test and t-test for related samples. Tooth discolouration was noticed after two- and single-visit regenerative endodontic procedures, except for the platelet-rich fibrin+MTA Repair HP group. After the first and second whitening procedures, all of the tested two- and single-visit regenerative endodontic procedures groups showed a change in the colour of the crown, which was noticeable to the naked eye (∆E > 3.3). When analysing the ∆E value between the first and second bleaching procedures, no changes in the colour of teeth were visually noticed in the calcium hydroxide and platelet-rich fibrin +MTA Repair HP groups (∆E < 3.3). Single-visit regenerative endodontic procedures are suggested if possible; however, if two-visit regenerative endodontic procedures are performed, it is recommended to use calcium hydroxide as the disinfectant paste because of the lower staining potential. In the context of discolouration, platelet-rich fibrin is advisable for use as a scaffold. The whitening procedure is worth considering, but does not guarantee a return to the original tooth colour, especially when triple antibiotic paste is used.

Evaluation of Antibacterial Effects of Cold Atmospheric Plasma, Calcium Hydroxide, and Triple Antibiotic Paste on Enterococcus faecalis Biofilm in the Root Canal System: An In Vitro Study.

Introduction: One of the essential factors in successful endodontic therapy is the effective cleaning and disinfection of the root canal. This study aimed to determine the effect of cold plasma on infected root canals with Enterococcus faecalis and compare its antibacterial effect with the conventional medicaments in vitro. Methods: Sixty-tree single-root teeth were extracted. Canals were cleaned and shaped. Ten teeth were selected as the negative control randomly. The rest of the teeth were incubated at 37°C for 21 days to form E. faecalis biofilm. The specimens were divided into six groups; each group had 10 teeth. In group 1 (the positive control group of calcium hydroxide and triple antibiotic paste [TAP]), methylcellulose was placed in the root canal; in group 2, calcium hydroxide was placed in the root canal for 12 days; in group 3, 10 mg/mL of TAP was placed in the root canal for 12 days; in group 4, helium/oxygen plasma jet was used for 10 minutes. Group 5 was considered as a positive control of plasma, and group 6 was the negative control. After treatment, F4 Pro-Taper rotary file was used to collect root canal microbial biofilms. Bacterial suspensions were serially diluted, and the percentage of growth reduction for each group was obtained by dividing the logarithm of CFU/mL of each group by CFU/mL of the control of the same group. Results: The CFU/mL of TAP and plasma-treated samples was significantly lower than that of the control groups; however, there were no significant differences between the control group and the samples treated by calcium hydroxide. The most percentage of CFU reduction was in the TAP-treated group compared with plasma and calcium hydroxide-treated groups. Conclusion: The application of cold plasma effectively inhibited the growth of E. faecalis and reduced bacterial biofilm. Also, in the present study, 10 mg/mL of TAP caused the complete elimination of E. faecalis. Calcium hydroxide had the most negligible effect on E. faecalis biofilm elimination.

Antimicrobial effects of different concentrations of simvastatin versus triple antibiotic paste on Enterococcus faecalis biofilms at different stages of development.

Background. This study assessed the antimicrobial effects of different concentrations of simvastatin versus triple antibiotic paste (TAP) on Enterococcus faecalis biofilms at different stages of development. Methods. In this in vitro study, 70 human single-rooted mature premolars were decoronated, instrumented, and autoclave-sterilized. Next, an E. faecalis suspension was prepared and inoculated into the canals to obtain 4- and 6-week biofilms. After ensuring biofilm formation, the samples in each group were randomly assigned to 5 subgroups (n=12): 1 mg/mL TAP, 10 mg/ mL TAP, 1 mg/mL simvastatin, 10 mg/mL simvastatin, and positive control (phosphate-buffered saline solution). The medicaments were applied in the canals, and the teeth were incubated for one week. Dentin samples were collected by a rotary file, cultured, and the number of E. faecalis colonies was counted. The Kruskal-Wallis, Mann-Whitney U, and Wilcoxon tests were used for data analysis (α=0.05). Results. There were significant differences in colony counts between the two concentrations of TAP and the control group against both 4- and 6-week biofilms (P<0.05). The antibacterial effect of 10 mg/mL TAP and simvastatin was stronger than that of 1 mg/mL concentration against the 4- and 6-week E. faecalis biofilms (P<0.05). Furthermore, 10 mg/mL TAP and simvastatin were more effective against the 4-week biofilms than the 6-week biofilms (P<0.05). Conclusion. According to the present results and since biofilms may remain viable in the root canal system for weeks to months, applying 10 mg/mL TAP and simvastatin might be more effective.

Comparing Antibiotic Pastes with Electrospun Nanofibers as Modern Drug Delivery Systems for Regenerative Endodontics.

Nanomaterials can be applied in different biomedical applications like diagnosis, treatment, and drug delivery due to their unique features. Using such materials in the endodontic treatment processes may prove challenging as these materials must exhibit antibacterial effects without posing any harm to the host cells. The approach involving nanofibers loaded with various antibacterial drugs offers a potential treatment method to enhance the elimination procedure of intracanal biofilms. Clinically, many models of bacterial biofilms were prepared under in vitro conditions for different aims. The process of drug delivery from polymeric nanofibers is based on the principle that the releasing ratio of drug molecules increases due to the increase in the surface area of the hosted structure. Our review discusses diverse approaches to loading/releasing drugs on/from nanofibers; we summarized many studies on electrospun nanofibers loaded with various drugs applied in the endodontic field. Moreover, we discussed both the advantages and the limitations of these modern endodontic treatment materials, comparing them with the traditional ones.

Antibiofilm Activity of LL-37 Peptide and D-Amino Acids Associated with Antibiotics Used in Regenerative Endodontics on an Ex Vivo Multispecies Biofilm Model.

The antimicrobial peptide LL-37 and D-amino acids (D-AAs) have been proposed as antibiofilm agents. Therefore, this study aimed to test the antimicrobial effect of antibiofilm agents associated with antibiotics used in regenerative endodontic procedures (the triple antibiotic paste-TAP: ciprofloxacin + metronidazole + minocycline). An endodontic-like biofilm model grown on bovine dentin discs was used in this study. After 21-day growth, the biofilms were treated with 1 mg/mL TAP, 10 μM LL-37, an association of LL-37 + TAP, 40 mM D-AAs solution, an association of D-AAs + TAP, and phosphate-buffered saline (negative control). Colony forming unit (CFU) data were analyzed by two-way ANOVA and Tukey's multiple comparison test (p &lt; 0.05). LL-37 + TAP showed the best antibacterial activity (7-log10 CFU/mL ± 0.5), reaching a 1 log reduction of cells in relation to the negative control (8-log10 CFU/mL ± 0.7) (p &lt; 0.05). In turn, no significant reduction in bacterial cells was observed with TAP, LL-37, D-AAs, and D-AAs + TAP compared to the negative control. In conclusion, the combination of antibiotics and LL-37 peptide showed mild antibacterial activity, while the combination of antibiotics and D-AAs showed no activity against complex biofilms.