Skip to main content

Advertisement

SpringerLink
Log in

In vitro evaluation of the antimicrobial effects of different intracanal medications in necrotic immature teeth

  • Original Scientific Article
  • Published:
European Archives of Paediatric Dentistry Aims and scope Submit manuscript

Abstract

Aim

This was to assess the antimicrobial effectiveness of pastes used as intracanal medicaments against Enterococcus faecalis in necrotic immature teeth.

Method

An agar-disc diffusion method over a period of 30 days was used. The following medications were analysed: triple antibiotic paste (TAP) I; double antibiotic paste (DAP) I; DAP I with calcium hydroxide; calcium hydroxide paste with saline solution 0.9 %; calcium hydroxide paste with chlorhexidine 2 % gel; DAP II; DAP II with zinc oxide; DAP II with calcium hydroxide; and saline solution 0.9 % as control. The diameters of the halos of inhibition (in mm) of tested medicaments were determined and analysed with one-way analysis of variance and Tukey’s post hoc tests.

Results

TAP I (G1) was significantly more effective against E. faecalis, and showed the largest halo of inhibition during all the experiments. DAP groups (G2 and G6) also showed inhibiting bacterial growth with said inhibition remaining stable throughout the 30-day period. In contrast, G4 and G5 groups, in which Ca(OH)2 was added to saline and chlorhexidine, had no antibacterial effect.

Conclusions

TAP and DAP showed better antibacterial efficacy and remained active for 30 days. Combination of Ca(OH)2 with antibiotics should be avoided, due to the possibility of antibiotic hydrolysis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Adl A, Hamedi S, Sedigh Shams M, Motamedifar M, Sobhnamayan F. The ability of triple antibiotic paste and calcium hydroxide in disinfection of dentinal tubules. Ir Endod J. 2014;9:123–6.

    Google Scholar 

  • Adl A, Shojaee NS, Motamedifar M. A comparison between the antimicrobial effects of triple antibiotic paste and calcium hydroxide against Enterococcus faecalis. Ir Endod J. 2012;7:149–55.

    Google Scholar 

  • Akçay M, Arslan H, Yasça B, Kıvrık F, Yasça E. Spectrophotometric analysis of crown discoloration induced by various antibiotic pastes used in revascularization. J Endod. 2014;40:845–8.

    Article  PubMed  Google Scholar 

  • Akgun OM, Altun C, Guven G. Use of triple antibiotic paste as a disinfectant for a traumatized immature tooth with a periapical lesion: a case report. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;108:62–5.

    Article  Google Scholar 

  • Asna Ashari M, Fayaz F, Moezzi Ghadim N, Alim Marvesti L, Mehrabi Y. Evaluation of the antimicrobial effects of MTAD, NaOCl against selected endodontic pathogens. Ir Endod J. 2009;4:63–8.

    Google Scholar 

  • Bezgin T, Sönmez H. Review of current concepts of revascularization/revitalization. Dent Traumatol. 2015;31:267–73.

    Article  PubMed  Google Scholar 

  • Brandle N, Zehnder M, Weiger R, Waltimo T. Impact of growth conditions on susceptibility of five microbial species to alkaline stress. J Endod. 2008;34:579–82.

    Article  PubMed  Google Scholar 

  • Cehreli ZC, Isbitiren B, Sara S, Erbas G. Regenerative endodontic treatment (revascularization) of immature necrotic molars medicated with calcium hydroxide: a case series. J Endod. 2011;37:1327–30.

    Article  PubMed  Google Scholar 

  • Dametto FR, Ferraz CC, Gomes BP, et al. In vitro assessment of the immediate and prolonged antimicrobial action of chlorhexidine gel as an endodontic irrigant against Enterococcus faecalis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005;99:768–72.

    Article  PubMed  Google Scholar 

  • Garcia-Godoy F, Murray PE. Recommendations for using regenerative endodontic procedures in permanent immature traumatized teeth. Dent Traumatol. 2012;28:33–41.

    Article  PubMed  Google Scholar 

  • Gomes BP, Souza SF, Ferraz CC, et al. Effectiveness of 2 % chlorhexidine gel and calcium hydroxide against Enterococcus faecalis in bovine root dentine in vitro. Int Endod J. 2003;36:267–75.

    Article  PubMed  Google Scholar 

  • Gomes-Filho JE, Duarte PC, de Oliveira CB, et al. Tissue reaction to a triantibiotic paste used for endodontic tissue self-regeneration of nonvital immature permanent teeth. J Endod. 2012;38:91–4.

    Article  PubMed  Google Scholar 

  • Hargreaves KM, Diogenes A, Teixeira FB. Treatment options: biological basis of regenerative endodontic procedures. J Endod. 2013;39:30–43.

    Article  Google Scholar 

  • Huang GTJ. Apexification the beginning of its end. Int Endod J. 2009;42:855–66.

    Article  PubMed  Google Scholar 

  • Iwaya SI, Ikawa M, Kubota M. Revascularization of an immature permanent tooth with apical periodontitis and sinus tract. Dent Traumatol. 2001;17:185–7.

    Article  PubMed  Google Scholar 

  • Jung IY, Lee SJ, Hargreaves KM. Biologically based treatment of immature permanent teeth with pulpal necrosis: a case series. J Endod. 2008;34:876–87.

    Article  PubMed  Google Scholar 

  • Kahler B, Mistry S, Moule A, et al. Revascularization outcomes: a prospective analysis of 16 consecutive cases. J Endod. 2014;40:333–8.

    Article  PubMed  Google Scholar 

  • Kim JH, Kim Y, Shin SJ, Park JW, Jung IY. Tooth discoloration of immature permanent incisor associated with triple antibiotic therapy: a case report. J Endod. 2010;36:1086–91.

    Article  PubMed  Google Scholar 

  • Martin G, Ricucci D, Gibbs JL, Lin LM. Histological findings of revascularized/revitalized immature permanent molar with apical periodontitis using platelet-rich plasma. J Endod. 2013;39:138–44.

    Article  PubMed  Google Scholar 

  • Mohammadi Z, Dummer PM. Properties and applications of calcium hydroxide in endodontics and dental traumatology. Int Endod J. 2011;44:697–730.

    Article  PubMed  Google Scholar 

  • Mozayeni MA, Haeri A, Dianat O, Jafari AR. Antimicrobial effects of four intracanal medicaments on enterococcus faecalis: an in vitro study. Ir Endod J. 2014;9:195–8.

    Google Scholar 

  • Nagata JY, Gomes BP, Rocha Lima TF, et al. Traumatized immature teeth treated with 2 protocols of pulp revascularization. J Endod. 2014a;40:606–12.

    Article  PubMed  Google Scholar 

  • Nagata JY, Soares AJ, Souza-Filho FJ, et al. Microbial evaluation of traumatized teeth treated with triple antibiotic paste or calcium hydroxide with 2 % chlorhexidine gel in pulp revascularization. J Endod. 2014b;40:778–83.

    Article  PubMed  Google Scholar 

  • Nosrat A, Li KL, Vir K, Hicks ML, Fouad AF. Is pulp regeneration necessary for root maturation? J Endod. 2013;39:1291–5.

    Article  PubMed  Google Scholar 

  • Nosrat A, Seifi A, Asgary S. Regenerative endodontic treatment (revascularization) for necrotic immature permanent molars: a review and report of two cases with a new biomaterial. J Endod. 2011;37:562–7.

    Article  PubMed  Google Scholar 

  • Ordinola-Zapata R, Bramante CM, Cavenago B, et al. Antimicrobial effect of endodontic solutions used as final irrigants on a dentine biofilm model. Int Endod J. 2012;45:162–8.

    Article  PubMed  Google Scholar 

  • Peters LB, van Winkelhoff AJ, Buijs JF, Wesselink PR. Effects of instrumentation, irrigation and dressing with calcium hydroxide on infection in pulpless teeth with periapical bone lesions. Int Endod J. 2002;35:13–21.

    Article  PubMed  Google Scholar 

  • Pinheiro ET, Gomes BP, Ferraz CC, et al. Microorganisms from canals of root-filled teeth with periapical lesions. Int Endod J. 2003;36:1–11.

    Article  PubMed  Google Scholar 

  • Portenier I, Haapasalo H, Orstavik D, Yamauchi M, Haapasalo M. Inactivation of the antibacterial activity of iodine potassium iodide and chlorhexidine digluconate against Enterococcus faecalis by dentin, dentin matrix, type-I collagen, and heat-killed microbial whole cells. J Endod. 2002;28:634–7.

    Article  PubMed  Google Scholar 

  • Rafter M. Apexification: a review. Dent Traumatol. 2005;21:1–8.

    Article  PubMed  Google Scholar 

  • Ritter ALS, Ritter AV, Murrah V, Sigurdsson A, Trope M. Pulp revascularization of replanted immature dog teeth after treatment with minocycline and doxycycline assessed by laser Doppler flowmetry, radiography, and histology. Dent Traumatol. 2004;20:75–84.

    Article  PubMed  Google Scholar 

  • Sabrah AH, Yassen GH, Gregory RL. Effectiveness of antibiotic medicaments against biofilm formation of Enterococcus faecalis and Porphyromonas gingivalis. J Endod. 2013;39:1385–9.

    Article  PubMed  Google Scholar 

  • Siqueira JF Jr, Lopes HP. Mechanisms of antimicrobial activity of calcium hydroxide: a critical review. Int Endod J. 1999;32:361–9.

    Article  PubMed  Google Scholar 

  • Siqueira JF Jr. Aetiology of root canal treatment failure: why well-treated teeth can fail. Int Endod J. 2001;34:1–10.

    Article  PubMed  Google Scholar 

  • Soares Ade J, Lins FF, Nagata JY, et al. Pulp revascularization after root canal decontamination with calcium hydroxide and 2 % chlorhexidine gel. J Endod. 2013;39:417–20.

    Article  PubMed  Google Scholar 

  • Wang CS, Arnold RR, Trope M, Teixeira FB. Clinical efficiency of 2 % chlorhexidine gel in reducing intracanal bacteria. J Endod. 2007;33:1283–9.

    Article  PubMed  Google Scholar 

  • Wigler R, Kaufman AY, Steinbock N, Hazan-Molina H, Torneck CD. Revascularization: a treatment for permanent teeth with necrotic pulp and incomplete root development. J Endod. 2013;39:319–26.

    Article  PubMed  Google Scholar 

  • Windley W, Teixeira F, Levin L, Sigurdsson A, Trope M. Disinfection of immature teeth with a triple antibiotic paste. J Endod. 2005;31:439–43.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This study supported by Department of Endodontics, Universidade de Fortaleza, Ceará, Brazil.

Author information

Authors and Affiliations

  1. Departamento de Endodontia, Universidade de Fortaleza (UNIFOR), Av. Washington Soares 1321, Fortaleza, CE, 60811341, Brazil

    C. Maniglia-Ferreira, F. de Almeida-Gomes, F. T. de Sousa Barbosa & D. M. de Farias Filho

  2. Departamento de Microbiologia, Universidade de Fortaleza (UNIFOR), Av. Washington Soares 1321, Fortaleza, CE, 60811341, Brazil

    M. M. N. Pinto

  3. Doutoranda do programa de pós-graduação da Universidade Federal do Ceará (UFC), Rua Monsenhor Furtado s/n, Fortaleza, CE, 60430-350, Brazil

    N. L. G. Albuquerque

  4. Rua Bento Albuquerque, 685, ap. 1102, Fortaleza, CE, CEP 60192-060, Brazil

    C. Maniglia-Ferreira

Authors
  1. C. Maniglia-Ferreira
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. F. de Almeida-Gomes
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M. M. N. Pinto
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. F. T. de Sousa Barbosa
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. D. M. de Farias Filho
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. N. L. G. Albuquerque
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to C. Maniglia-Ferreira.

Ethics declarations

Ethical approval

This study does not contain any studies with human participants or animals performed by any of the authors.

Conflict of interest

The authors certify that they have no commercial or associative interest that represents a conflict of interest in connection with the manuscript.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Maniglia-Ferreira, C., de Almeida-Gomes, F., Pinto, M.M.N. et al. In vitro evaluation of the antimicrobial effects of different intracanal medications in necrotic immature teeth. Eur Arch Paediatr Dent 17, 251–255 (2016). https://doi.org/10.1007/s40368-016-0236-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40368-016-0236-x

Keywords

Search

Navigation