minocycline and Dental-Pulp-Exposure

Revascularization treatment is rapidly becoming an accepted treatment alternative for the management of endodontic pathology in immature permanent teeth with necrotic dental pulps. However, the success and timing of clinical resolution of symptoms, and radiographic outcomes of interest, such as continued hard tissue deposition within the root, are largely unknown.. In this prospective cohort study, 20 teeth were treated with a standardized revascularization treatment protocol and monitored for clinical and radiographic changes for 1 year. Standardized radiographs were collected at regular intervals, and radiographic changes were quantified.. All 20 treated teeth survived during the 12-month follow-up period, and all 20 also met the clinical criteria for success at 12 months. As a group, the treated teeth showed a statistically significant increase in radiographic root width and length and a decrease in apical diameter, although the changes in many cases were quite small (such that the clinical significance is unclear). The within-case percent change in apical diameter after 3 months was 16% and had increased to 79% by 12 months, with 55% (11/20) showing complete apical closure. The within-case percent change in root length averaged less than 1% at 3 months and increased to 5% at 12 months. The within-case percent change in root thickness averaged 3% at 3 months and 21% at 12 months.. Although clinical success was highly predictable with this procedure, clinically meaningful radiographic root thickening and lengthening are less predictable after 1-year of follow-up. Apical closure is the most consistent radiographic finding.

Topics: Anti-Bacterial Agents; Apexification; Blood Coagulation; Child; Ciprofloxacin; Cohort Studies; Dental Pulp; Dental Pulp Exposure; Dental Pulp Necrosis; Dental Pulp Test; Dentin; Female; Follow-Up Studies; Humans; Male; Metronidazole; Minocycline; Periapical Tissue; Prospective Studies; Radiography; Root Canal Preparation; Tooth Apex; Tooth Root; Treatment Outcome

The aim of this study was to investigate the capacity of endodontic regenerative procedures combining an induced blood clot, platelet-rich plasma (PRP), and bone marrow aspirate (BMA) to regenerate dental pulp in canine closed-apex necrotic teeth.. Apical periodontitis was induced in 20 upper and lower premolars of 2 dogs. After biomechanical preparation, enlargement to a #60 file, and disinfection with a triantibiotic paste for 28 days, the roots were randomly assigned to 4 treatment groups: blood clot (BC), BC + PRP gel, BC + BMA gel, and BC + BMA/PRP gel. Negative controls were also included. After a 3-month follow-up period, the animals were killed.. Histologic analysis showed the presence of newly formed vital tissues (connective, cement-like, and bone-like tissue) in 23 of the 32 treated roots (71.87%). There was no statistically significant difference between the treatment groups.. New vital tissues were formed and characterized as connective, cementum-like, or bone-like, but not as pulp-like tissue; PRP and/or BMA did not improve the tissue ingrowth.

Topics: Animals; Anti-Bacterial Agents; Bicuspid; Blood Coagulation; Bone and Bones; Bone Marrow Cells; Ciprofloxacin; Connective Tissue; Dental Cementum; Dental Pulp Cavity; Dental Pulp Exposure; Dental Pulp Necrosis; Dogs; Drug Combinations; Fibroblasts; Male; Metronidazole; Minocycline; Neovascularization, Physiologic; Periapical Periodontitis; Platelet-Rich Plasma; Random Allocation; Regeneration; Root Canal Irrigants; Root Canal Preparation; Thrombin; Tissue Engineering

To evaluate the clinical and radiographic success rates of three mixed antibiotics in the non-instrumentation endodontic treatment of primary mandibular molars at 24-27 months postoperatively.. Eighty cariously involved lower primary molars from 58 children (ages 3-8 years) received a 3Mix medicament by non-instrumentation endodontic treatment and were then sealed with glass-ionomer cement and composite resin before permanent restoration with stainless steel crowns. The patients received a clinical and radiographic assessment every 6 months over a 2-year follow-up period with an intra-examiner reliability of 0.83-1.00 (κ value).. In 60 cases at 24- to 27-month follow-up, the success rates as determined by clinical and radiographic evaluation were 75% and 36.7%, respectively; however, the overall success rate of 3Mix non-instrumentation endodontic treatment was 36.7% with 15.8% of cases demonstrating a pulpal response of internal resorption.. Non-instrumentation endodontic treatment using 3Mix-MP showed good clinical success but had a low success rate based on radiographic evaluation at 2-year follow-up. Hence, 3Mix antibiotic treatment cannot replace a conventional root canal treatment agent as a long-term therapy.

Topics: Anti-Bacterial Agents; Anti-Infective Agents; Bisphenol A-Glycidyl Methacrylate; Child; Child, Preschool; Ciprofloxacin; Composite Resins; Crowns; Dental Alloys; Dental Caries; Dental Materials; Dental Pulp Exposure; Dental Pulp Necrosis; Drug Combinations; Follow-Up Studies; Glass Ionomer Cements; Humans; Mandible; Metronidazole; Minocycline; Molar; Organophosphates; Pulpotomy; Radiography, Bitewing; Resins, Synthetic; Root Canal Irrigants; Stainless Steel; Tooth, Deciduous; Treatment Outcome

The effects of antibacterial drugs on bacterially contaminated dental pulps were investigated in monkeys. Class V buccal cavities with pulpal exposures were prepared and then left open to the oral environment for 24 h. The exposed pulps were capped with alpha-tricalcium phosphate (alpha-TCP) containing a mixture of antibacterial drugs. Either alpha-TCP or Ca(OH)2 was used as a control. Pulpal responses were histologically evaluated after 4 wk. Those teeth capped with alpha-TCP alone showed total pulp necrosis and bacterial growth within the pulp chamber. By contrast, the pulps capped with alpha-TCP containing mixed antibacterial drugs remained almost normal without any necrotic layer, but showed persistent absorbing response to capping materials and no signs of hard tissue barrier formation. In teeth capped with Ca(OH)2, a hard tissue barrier was formed below the exposure site, with a wide loss of pulp tissue. No inflammation was seen under the barrier. These results indicate that mixed antibacterial drugs added to alpha-TCP effectively disinfected pulpal lesions, without destroying any of the sound pulp tissue. However, hard tissue barrier formation was delayed by this mixture as compared with Ca(OH)2.

Topics: Animals; Calcium Hydroxide; Calcium Phosphates; Cefaclor; Ciprofloxacin; Dental Pulp Capping; Dental Pulp Exposure; Dental Pulp Necrosis; Dentin, Secondary; Drug Therapy, Combination; Macaca; Metronidazole; Minocycline; Wound Healing