Effect Of Triple Antibiotic Paste Research Articles

Bactericidal Effect of Triple Antibiotic Paste against Enterococcus faecalis in Dentinal Tubules: An Ex Vivo Study.

The aim of this study was to investigate the bactericidal effect of various concentrations of triple antibiotic paste (TAP) against Enterococcus faecalis (E. faecalis) in dentinal tubules using a bacterial culture assay and confocal laser scanning microscope (CLSM). Ninety human teeth were contaminated with E. faecalis (ATCC 29212) and randomly allocated into 5 groups; the negative control (without TAP), 1 mg/ml, 5 mg/ml, 7.5 mg/ml and 10 mg/ml TAP (n=18). After a 3-week TAP treatment, samples were collected from the root canal space, root dentin at 100-μm and 200-μm depth. The collected samples were subjected to a bacterial culture assay (n=10). Eight roots from each group underwent CLSM analysis to determine the live/dead bacterial cells. The bacterial culture assay results indicated that the negative control samples were all culturable. The number of culture-positive samples decreased after TAP treatment at 1, 5, 7.5 and 10 mg/ml, with 2, 2, 1 and 0 culturable samples, respectively. However, there was no significant difference among the TAP treatments. Surprisingly, the CLSM analysis demonstrated live bacteria in the dentinal tubules in all samples. The negative control had 52.36%+-3.24 live bacteria. TAP treatment at 10 mg/ml had the lowest percentage of live bacterial cells (40.58%+-5.40), followed by 7.5 mg/ml (44.14%+-6.03), 5 mg/ml (46.31%+-5.32) and 1 mg/ml (52.55%+-8.82). The percentage of live cells in the 10 mg/ml, 7.5 mg/ml and 5 mg/ml TAP groups were significantly lower than the 1 mg/ml TAP and negative control groups. TAP treatment significantly decreased the percentage of viable E. faecalis cells in the dentinal tubules and its bactericidal effect was dose-dependent.

Effect of three intracanal medicaments used in pulp regeneration on the push-out bond strength of mineral trioxide aggregate and calcium-enriched mixture: An in vitro study.

Background. The bond strength of the materials used as a cervical barrier in the pulp regeneration is essential for the success of treatment. This study aimed to evaluate the effects of triple antibiotic paste (TAP), double antibiotic paste (DAP), and simvastatin as intracanal medicaments on the dislodgement resistance of mineral trioxide aggregate (MTA) and calcium-enriched mixture (CEM). Methods. A total of 160 extracted human single-rooted teeth were selected, and root canal preparation was carried out. The teeth in each group were randomly divided into four subgroups: TAP, DAP, simvastatin, and the control group (without intracanal medicament). Four weeks after placing the medicaments, it was removed by sodium hypochlorite, and MTA and CEM were placed in the coronal third of the root canals. After a week, 2-mm-thick dentin disks were prepared from the coronal third of the roots, and the push-out test was performed using a universal testing machine. The data were analyzed using two-way ANOVA and independent t-test at a significance level of 0.05. Results. Regardless of the intracanal medicament, there was no significant difference between the overall bond strength of MTA (59.3±10 MPa) and CEM (55.8±11 MPa) (P=0.6). Furthermore, there were no significant differences in bond strength between the two intracanal medicament groups and the control group (P>0.05). Conclusion. Under the limitations of the current study, DAP, simvastatin, and TAP, as intracanal medicaments, did not adversely affect the push-out bond strength of CEM and MTA.

A Comparative Evaluation of Microhardness and Chemical Structure of Radicular Dentin with Two Combinations of TAP and MTAP: An In Vitro Study

BackgroundThe success of regenerative endodontics depends on various factors and the most vital being the complete eradication of microorganisms in the dentinal tubules. This could lead to changes that leave the radicular dentin prone to fracture.AimThe purpose of the present study is to investigate the effects of triple antibiotic paste (TAP) and modified triple antibiotic paste (MTAP) of different concentrations on the microhardness and chemical structure of radicular dentin.Materials and methodsHuman root cylinders were instrumented and randomized into four treatment groups and an untreated control group. Two treatment groups received 1 g/mL TAP or MTAP, and the other two treatment groups received 1 mg/mL methylcellulose-based TAP or MTAP. Cylinders were stored at 100% relative humidity for 4 weeks. Each root cylinder was subjected to a microhardness test before and after treatment. Different sets of radicular dentin specimens were treated as mentioned previously, and were examined using attenuated total reflection Fourier transform infrared spectroscopy.ResultsSignificant reductions in microhardness of treated groups was noticed when compared to untreated control roots at 1,000 and/or 500 µm from the pulp-dentin interface.ConclusionThe use of 1 mg/mL methylcellulose-based TAP and MTAP may minimize the reduction in microhardness of roots compared with the currently used 1 g/mL concentration of these antibiotics.How to cite this articleDaneswari M, Reddy NV, Chris PA, et al. A Comparative Evaluation of Microhardness and Chemical Structure of Radicular Dentin with Two Combinations of TAP and MTAP: An In Vitro Study. Int J Clin Pediatr Dent 2022;15(S-2):S151-S157.

Effect of triple antibiotic paste on the bond strength of epoxy and methacrylate resin-based sealers to root canal dentin.

Purpose:This study aimed to evaluate the effect of triple antibiotic paste (TAP) as an endodontic intracanal medicament on the bond strength of epoxy and methacrylate resin-based sealers to root canal dentin.Materials and Methods:In this in vitro study, 80 single-rooted human mandibular premolars were prepared using ProTaper rotary system. The specimens were randomly divided into a control group (without intracanal dressing) and an experimental group receiving TAP (n = 40). The intracanal dressing was removed after 3 weeks. Then, samples of each group were randomly divided into four subgroups (n = 10) and obturated with gutta-percha and different resin-based sealers. G1: AH Plus, G2: Syntex, G3: EndoREZ, and G4: MetaSEAL. After 1 week, 16 slices of 1 ± 0.1 mm thickness were obtained from the midroots of teeth in each subgroup, and a push-out test was used to measure the bond strength. Slices were examined using a stereomicroscope at 30 × to determine the mode of failure. The data were analyzed using two-way analysis of variance, one-way analysis of variance, and Tukey post hoc tests (α = 0.05).Results:Compared to control group, TAP significantly increased the bond strength of MetaSEAL and EndoREZ (P < 0.05). In the control group, epoxy resin-based sealers showed higher bond strength compared to methacrylate ones (P = 0.00). In TAP group, Syntex and EndoREZ showed significantly the greatest and the lowest bond strengths, respectively, (P < 0.05). The analysis of failure modes revealed a predominance of mixed failures in all groups except for Syntex group in which most failures were cohesive.Conclusions:TAP significantly increased the bond strength of methacrylate resin-based sealers.

The effect of triple antibiotic paste as an intracanal medication with an anti-inflammatory drug on post-operative pain of asymptomatic uniradicular necrotic teeth: a double blind randomized clinical trial

Background:Flare-ups may occur after root canal treatment which consist of acute exacerbation of asymptomatic pulpal and/or periradicular pathologic condition. The causative factors of interappointment pain include mechanical, chemical or microbial irritation to the pulp or periradicular tissues. The potential role of microorganisms in interappointment pain is why the success of endodontic treatment depends on complete eradication of microorganisms capable of causing an intraradicular or extraradicular infection. This can be achieved by mechanical cleaning and shaping, in conjunction with irrigation and antibacterial agents. The aim of this study was to assess the ability of triple antibiotic paste with the anti-inflammatory drug diclofenac potassium versus calcium hydroxide used as an intra-canal medication in reducing post-operative pain.Methods:84 patients with asymptomatic uniradicular necrotic teeth were randomly assigned into two groups according to the intra-canal medication used: calcium hydroxide group (CH) and triple antibiotic paste with diclofenac potassium group (TAPC). In the first treatment session, intracoronal cavity preparation was performed after rubber dam isolation followed by chemo-mechanical preparation using rotary Protaper Universal files with saline irrigation followed by intra-canal medication placement then postoperative pain was assessed at 24, 48 and 72 hours postoperatively using Visual Analogue Scale (VAS). In the second treatment session, intracanal medications were removed by irrigation using saline followed by obturation.Results:Both intracanal medicaments resulted in a statistically significant decrease in mean pain value from 24 to 48 and 72 hours postoperatively. While when comparing both groups, TAPC intracanal medication showed less post-operative pain compared to that of the CH group at 24, 48 and 72 hours with a statistically significant difference at 48 hours only.Conclusion:Both intracanal medicaments were efficient in reducing post-operative pain in asymptomatic uniradicular necrotic teeth.Trial registration:Clinicaltrial.govNCT02907489, 20/09/2016.

Effect of triple antibiotic paste and calcium hydroxide on the rate of healing of periapical lesions: A systematic review.

Aim:The rate of healing of periapical lesion after the antibacterial dressing with triple antibiotic paste and calcium hydroxide was assessed.Materials and Methods:Case reports which used triple antibiotic paste and calcium hydroxide as the intracanal dressing was searched in PubMed, Google Scholar and Cochrane Oral Health's Trials Register up to August 2020, without language and period restriction. Two authors independently reviewed all identified titles and abstracts for eligibility. Tables were generated to summarize the included studies.Results:Sixteen (n = 16) articles met the eligibility criteria. Nonsurgical endodontic treatment was carried out in eleven cases with triple antibiotic paste and in nineteen cases calcium hydroxide was used. Results of the study after analyzing the case reports indicate that both triple antibiotic paste and calcium hydroxide are equally effective as intracanal medicament. In cases where calcium hydroxide failed to eliminate symptoms, triple antibiotic paste was found to be effective.Conclusion:As far as the effect on the healing of the periapical lesions is concerned, all the studies showed a high success rate. Available scientific data indicates nonsurgical treatment can be adopted as a routine measure to conservatively treat large periapical lesions of endodontic origin.

The effect of triple antibiotic paste as an intracanal medication with an anti-inflammatory drug on post-operative pain of asymptomatic uniradicular necrotic teeth: a double blind randomized clinical trial

Background:Flare-ups may occur after root canal treatment which consist of acute exacerbation of asymptomatic pulpal and/or periradicular pathologic condition. The causative factors of interappointment pain include mechanical, chemical or microbial irritation to the pulp or periradicular tissues. The potential role of microorganisms in interappointment pain is why the success of endodontic treatment depends on complete eradication of microorganisms capable of causing an intraradicular or extraradicular infection. This can be achieved by mechanical cleaning and shaping, in conjunction with irrigation and antibacterial agents. The aim of this study was to assess the ability of triple antibiotic paste with the anti-inflammatory drug diclofenac potassium versus calcium hydroxide used as an intra-canal medication in reducing post-operative pain.Methods:84 patients with asymptomatic uniradicular necrotic teeth were randomly assigned into two groups according to the intra-canal medication used: calcium hydroxide group (CH) and triple antibiotic paste with diclofenac potassium group (TAPC). In the first treatment session, intracoronal cavity preparation was performed after rubber dam isolation followed by chemo-mechanical preparation using rotary Protaper Universal files with saline irrigation followed by intra-canal medication placement then postoperative pain was assessed at 24, 48 and 72 hours postoperatively using Visual Analogue Scale (VAS). In the second treatment session, intracanal medications were removed by irrigation using saline followed by obturation.Results:Both intracanal medicaments resulted in a statistically significant decrease in mean pain value from 24 to 48 and 72 hours postoperatively. While when comparing both groups, TAPC intracanal medication showed less post-operative pain compared to that of the CH group at 24, 48 and 72 hours with a statistically significant difference at 48 hours only.Conclusion:Both intracanal medicaments were efficient in reducing post-operative pain in asymptomatic uniradicular necrotic teeth.Trial registration:Clinicaltrial.govNCT02907489, 20/09/2016.

Effectiveness of triple antibiotic paste as an intra-canal medication for the root canal treatment of non-vital teeth with apical periodontitis: A systematic review

Background: This is a systematic review to assess and provide a pooled effect estimate, if possible, for the effects of triple antibiotic paste as an intra-canal medication for root canal treatment of mature permanent non-vital teeth with apical periodontitis. This review will assess post-operative pain, flare-up incidence, and clinical and radiographic healing. Methods: Nine electronic databases (Pubmed, CENTRAL, VHL, Scopus, EBSCOhost, Web of Science, Trip, OpenGrey, Proquest) were searched along with two major clinical trial registries. Conference proceedings, reference lists and citations of the included studies were also searched. A total of 537 records were identified and 392 were obtained after duplicate removal. Six records were identified after screening and three studies were included after full text eligibility assessment. Results: Three comparators were reported in the included studies: calcium hydroxide paste, 2% chlorhexidine gel and ledermix paste. There was no statistically significant difference between triple antibiotic paste and calcium hydroxide regarding postoperative pain, and clinical and radiographic healing of periapical lesions. There was no difference between triple antibiotic paste and chlorhexidine regarding flare-up incidence. However, triple antibiotic paste reduced the level of post-operative pain more than ledermix, which was statistically significant. Conclusions: The evidence is still insufficient surrounding the use of triple antibiotic paste; therefore more clinical investigations with high levels of evidence and rigorous methodologies are needed.

The Effect of Triple Antibiotic Paste on Pulp Capping of Primary Teeth. (Clinical and Radiographic Study)

The use of 3Mix can play a significant role in the dental management of pulp therapy for primary teeth. Where caries has penetrated into the deeper dentinal tissue, triple antibiotic paste may have a role depending on its antimicrobial effect. This study compared between the clinical, radiographic and microbiological effects of two medicaments; (3Mix and formocresol) on the remaining pulp tissue of the pulpotomized teeth, comprised 4main groups. In the first and second groups, vital pulpotomy procedure was performed while the third and fourth groups, non-vital pulpotomy were done. The teeth were evaluated clinically and radiographically at different intervals (immediately post-operative, 6 weeks, and 3 months), the result show that antibiotic paste having promising clinical effect on primary teeth.

Antibacterial Efficacy and Discoloration Potential of Endodontic Topical Antibiotics

IntroductionThe optimal concentration for the use of endodontic topical antibiotics is not known. The aims of this study were to determine the minimum bactericidal concentrations (MBCs) and minimum inhibitory concentrations (MICs) of metronidazole, ciprofloxacin, minocycline, Augmentin (GlaxoSmithKline, Research Triangle Park, NC), and tigecycline against common endodontic pathogens and to evaluate ex vivo the antibacterial efficacy and discoloration effect of triple antibiotic paste (TAP), Augmentin, and tigecycline at different concentrations using a slow-release hydrogel scaffold. MethodsUsing the Epsilometer test method (Etest; bioMérieux USA, St Louis, MO), MICs and MBCs of selected antibiotics were determined against Fusobacterium nucleatum, Porphyromonas gingivalis, Streptococcus intermedius, and Enterococcus faecalis. Biofilms of these bacterial species were then grown in extracted single-rooted teeth anaerobically for 3 weeks. Root canals were filled with TAP, Augmentin, and tigecycline at concentrations of 1 or 0.1 mg/mL in a degradable hydrogel scaffold or pure TAP at 1 g/mL for 7 days. Coronal discoloration was evaluated spectrophotometrically at 1, 2, and 3 weeks after dressing. ResultsMIC/MBC data showed significant efficacy of tigecycline, Augmentin, and minocycline compared with the other antibiotics (P < .05). Significant differences were found when comparing the log10 colony-forming units of all experimental groups (P < .05). TAP at 1 g/mL had no bacterial growth but caused the greatest discoloration. Hydrogel mixtures with TAP, Augmentin, or tigecycline at 1 mg/mL significantly reduced bacterial growth and the number of positive samples compared with those at 0.1 mg/mL (P < .05) with minimal discoloration. ConclusionsTAP, Augmentin, and tigecycline in a hydrogel at 1 mg/mL reduced bacterial growth significantly with minimal color change.

Comparative Evaluation of Stability and Anti Bacterial Activity of various concentrations of triple antibiotic paste against Streptococcus salivarius-An in-vitro study

Triple antibiotic paste is used as intracanal medicament to completely eliminate the microrganisms from the root canals. The Aim of this study is to evaluate the antimicrobial effect of various concentrations of triple antibiotic paste against Streptococcus salivarius by antimicrobial susceptibility testing. The stability and antimicrobial effect of triple antibiotic paste were tested by antibiotic susceptibility testing against Streptococcus salivarius by using Agar disc diffusion method over the period of one day, 3 days and 7 days. The samples were divided into three groups: Group 1, 1% TAP; Group 2, 2% TAP; Group 3, 3%; Group 4, Chlorhexidine (control). The zone of inhibition was measured after 24 hours and recorded in millimeters and the same procedure was repeated after 3 days and 7 days. Higher concentration of triple antibiotic paste (3%) showed superior antibacterial effect compared to 1%, 2% TAP and chlorhexidine. The antibacterial efficacy increased more rapidly after 7 days compared to 24 hours and 3 days. Under the impediment of this in vitro study, higher concentrations of triple antibiotic paste when used for a period of time showed an effective antibacterial effect.

Comparative Evaluation of Anti Microbial effects of Triple Antibiotic Paste and Amox and its derivatives against E. Faecalis: An in vitro study.

BackgroundEnterococcus faecalis is a microorganism commonly detected in asymptomatic, persistent endodontic infections. Triple antibiotic paste has stood the test of time as a proven antibiotic combination against E. Faecalis. However, problems with this include staining of teeth and standardization of the preparation. Thus, the search for better alternatives and better preparation techniques is still on.AimTo observe the potential of combinations [(Amoxicillin+ Metronidazole, Amoxicillin Clavulanic Acid + Metronidazole; Amoxicillin and Cloxacillin + Metronidazole)] over Triple Antibiotic Paste.Material and MethodsFifty single rooted teeth free from dental caries were selected for the study. Teeth were cut at equal distance from root apex (13mm from apex) with sterile diamond disk and straight hand piece for standardization of root length. The opening of root canal was enlarged with engine driven pro-taper files. To remove the organic and inorganic debris, canal was cleaned with 17% EDTA followed by 2.5% NaOCl for 5min. Distilled water irrigation was done for 5 min to remove any traces of used chemical and then sterilized in autoclave at 1200c for 15 min. at 15 lbs pressure. Bacteria cultured on blood agar plate and at the same time fresh antibiotic combinations were made and placed in the root canals, then incubated in the incubator, under sterile conditions and observed at 24hrs, 48hr and 72hrs.ResultsThe largest inhibition zones were observed for the Triple Antibiotic Paste, followed by Amoxicillin and Clavulanic acid + Metronidazole group however, the clearest zones were achieved with Amoxicillin and Clavlunic acid + Metronidazole group and the smallest for Amoxicillin and Metronidazole group.ConclusionsThe results suggest that though Triple antibiotic showed the maximum inhibition, Amoxicillin and Clavulanic acid combination along with Metronidazole gave the most reliable results. Further studies using the different combinations and different concentrations along with different methods of increasing the shelf life of such medications can be undertaken. Key words:Enterococcus faecalis, Triple Antibiotic Paste, Amoxcillin, Clavulanic acid.

Effect of triple antibiotic paste and calcium hydroxide as intracanal medicaments on bond strength of composite to dentin

Objective: Considering the use of triple antibiotic paste (TAP) for root canal treatment of open apex teeth, this study aimed to assess the effect of TAP and calcium hydroxide (CH) on bond strength of composite to dentin. Methods: This in-vitro study was conducted on 32 extracted human premolar teeth. After disinfection with 2% thymol solution, the enamel on the buccal surface of specimens was removed to expose a smooth dentin surface parallel to the long axis of the teeth with approximately 19mm2 surface areas. Specimens were divided into three groups of 11, 10 and 11 specimens. In group one, TAP, in group two CH and in group three, saline solution were applied to dentin surfaces for 14 days. After removal of medicaments, composite cylinders were bonded to the dentin surfaces using a bonding agent. Shear bond strength was measured in an Instron machine at a crosshead speed of 1mm/min. Data were analyzed using one-way ANOVA. Results: The highest mean bond strength belonged to the control group (14.4760 MPa) and the lowest belonged to the TAP group (11.5808 MPa). The mean bond strength in CH group was less than that of the control and higher than that of the TAP group (11.7834 MPa). However, the difference among the three groups was not statistically significant (p=0.327). Conclusion: Use of medicaments such as CH and TAP has no effect on bond strength of composite to dentin.

Effect of triple antibiotic paste with or without ethylenediaminetetraacetic acid on surface loss and surface roughness of radicular dentine.

This study aimed to compare the effect of two concentrations of triple antibiotic paste (TAP) with or without ethylenediaminetetraacetic acid (EDTA) on surface loss and surface roughness of radicular dentine. Human radicular dentine specimens were randomized into six experimental groups (n = 16 per group). The first and second groups were treated with 1,000 mg/mL or 1 mg/mL of TAP for 4 weeks. The third and fourth groups were treated with 1,000 mg/mL or 1 mg/mL of TAP for 4 weeks followed by 17 % EDTA for 5 min. The fifth group was treated with 17 % EDTA for 5 min and the sixth group received no treatment (control). Dentine surface loss and surface roughness were quantified after various treatments using optical and contact profilometry, respectively. One-way ANOVA followed by Fisher's protected least significant differences was used for statistical analyses. All treatment groups showed significantly higher surface loss compared to the untreated dentine. Dentine treated with 1,000 mg/mL had significant increase in surface loss and surface roughness compared to dentine treated with 1 mg/mL of TAP. The use of EDTA after both concentrations of TAP did not have significant additive effect on surface loss and surface roughness of dentine. The clinically used concentration of TAP (1,000 mg/mL) caused significantly higher surface loss and surface roughness of radicular dentine compared to the use of 1 mg/mL of TAP. Furthermore, the substantial amount of dentine surface loss and surface roughness detected in the current study may be attributed to TAP rather than EDTA.

Effect of various intracanal medicaments on the bond strength of self-adhesive resin cement to root canal dentin

Objective: It has been shown that the irrigating solutions and medicament used during root canal treatment may affect the bonding strength. The aim of this study was to evaluate the effect of triple antibiotic paste (TAP), double antibiotic paste (DAP) and calcium hydroxide (CH) on the bond strength to root dentin of self-adhesive resin cement.Materials and methods: Forty-eight single-rooted human teeth were prepared and randomly divided into one control and three experimental groups (dressing with TAP, DAP or CH). After removal of intracanal dressing, post-spaces were created and fiber posts cemented to the root canal using a self-adhesive resin cement. A push-out test was performed. The data obtained from the push-out test were analyzed using analysis of variance and Bonferroni post hoc tests (p = 0.05).Results: TAP decreased the bond strength of self-adhesive resin cement bond strength to root dentin compared to the control group (p = 0.012), while CH and DAP did not influence this (p > 0.05). The majority of specimens exhibited adhesive failures.Conclusions: TAP decreased the bond strength of self-adhesive to the root dentin compared to the control group.

Deleterious effect of triple antibiotic paste on human periodontal ligament fibroblasts

To evaluate the cytotoxic effects of triple antibiotic paste (TAP), double antibiotic paste (DAP), minocycline and calcium hydroxide and their influence on cytokine mRNA expression levels on human periodontal ligament (HPDL) fibroblasts. Triple antibiotic paste, DAP and Ca(OH)2 test samples were immersed in culture medium and incubated at 37°C for 24 and 48h. HPDL cells were seeded at a density of 2×10(4) cells and exposed to either culture media (negative control), 0.1% SDS (positive control), 24- or 48-h elutes of each test material and incubated for 24h. A multiparametric cytotoxicity assay kit (XTT, NR and CVDE) was used to evaluate the cytotoxic effects of each test material. Results were analysed using an ELISA plate reader and light absorbances of 450 and 530nm as references. Cytokine mRNA expression levels in HPDL cells treated with the materials were also investigated using real-time PCR. Expression levels were calculated using the comparative 2(-ΔΔCt) method. Statistical analyses included anova followed by Bonferroni correction. Triple antibiotic paste and minocycline were the most cytotoxic materials when compared with DAP and Ca(OH)2 in all three (XTT, NR and CVDE) assays (P<0.0001). No significant differences (P>0.05) were found for cytokine gene expression levels after exposure to 24- or 48-h elutes of any of the materials except for IL6, which had significantly higher mRNA levels with the 24-h TAP elute (P<0.01). Ca(OH)2 had a minimal effect on cell viability and cytokine production. The TAP showed deleterious effects on HPDL viability and increased expression of the pro-inflammatory cytokine IL6.

Effectiveness of Antibiotic Medicaments against Biofilm Formation of Enterococcus faecalis and Porphyromonas gingivalis

IntroductionIn this study we compared the antibacterial effect of triple antibiotic paste (TAP), double antibiotic paste (DAP), and calcium hydroxide [Ca(OH)2] against Enterococcus faecalis and Porphyromonas gingivalis biofilm. MethodsThe minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC), minimum biofilm inhibitory concentration (MBIC), and biofilm formation were measured by using microtiter plate methods. The 2 bacteria were treated with different dilutions of TAP, DAP, and Ca(OH)2 solutions. The turbidities of the bacterial cultures in the microtiter plate were measured by optical density at 490 nm by using a spectrophotometer. Data were analyzed by 2-way analysis of variance (α = 0.05). ResultsFor TAP, the MIC and MBIC values were 0.003 mg/mL for E. faecalis and 0.006 mg/mL for P. gingivalis. The MBC values for TAP were 0.3 mg/mL for both bacteria. The MIC and MBIC values for DAP were 0.001 mg/mL for E. faecalis and P. gingivalis. The MBC values for DAP were 0.14 mg/mL for both bacteria. Biofilm formation of the 2 bacteria was significantly decreased with TAP and DAP at all tested dilutions (P < .0001) compared with control groups; however, TAP and DAP biofilm formations were not significantly different from each other. Ca(OH)2 significantly decreased bacterial biofilm formation compared with the control, but it was significantly less than TAP and DAP (P < .05). ConclusionsBoth TAP and DAP were more effective than Ca(OH)2 against E. faecalis and P. gingivalis. DAP can be considered an effective and comparable antibacterial substitute for TAP.

A Comparison between the Antimicrobial Effects of Triple Antibiotic Paste and Calcium Hydroxide Against Entrococcus Faecalis.

The purpose of this study was to determine the in vitro antimicrobial ability against Entrococcus (E.) faecalis of triple antibiotic paste and its components compared with calcium hydroxide mixtures. An agar well diffusion assay and MIC method were used to determine the efficacy of the experimental medicaments in removing E. faecalis. Medicaments were divided into 9 groups; triple antibiotic powder with saline or chlorhexidine, metronidazole, ciprofloxacin, minocycline antibiotics were also separately tested (with normal saline), and Ca(OH)2 (plus normal saline or 2% chlorhexidine). These medicaments were evaluated at four concentrations of 25, 50, 100 and 200 μgram per mL in an agar well diffusion test. The diameters of the growth inhibition zones for each group were recorded and compared. The minimum inhibitory concentrations (MIC) of tested medicaments that are required to kill E. faecalis were also determined. The differences between groups were analyzed by Kruskal-Wallis and Mann-Whitney U tests. The largest inhibition zones were observed for the triple antibiotic mixture/saline, triple antibiotic mixture/2% chlorhexidine and minocycline/saline, and the smallest for Ca(OH)(2)/saline, Ca(OH)(2)/2% chlorhexidine. Concentration increases produced greater antibacterial effects in all groups. The MIC determination method showed similar results. The results suggest that the triple antibiotic paste with either 2% chlorhexidine or normal saline would be the preferred medicament against E. faecalis and, among its three components, minocycline has the greatest antibacterial effect.