minocycline and Dentin--Secondary

This study analyzed the detailed biological events underlying pulpal dynamics evoked by 3Mix (the mixture of ciprofloxacin, metronidazole, and minocycline) solution after intentionally delayed tooth replantation because 3Mix improves pulpal healing after tooth injuries.. The maxillary first molars of 3-week-old mice were extracted and immersed in 3Mix solution for 30 minutes in comparison with phosphate buffered saline (PBS) alone. Cell proliferation, apoptosis, and differentiation were assessed in extracted/replanted teeth during days 0-14 using immunohistochemistry, apoptosis assay, and reverse-transcriptase polymerase chain reaction.. 3Mix solution accelerated odontoblast differentiation in the coronal pulp on day 7 and tertiary dentin formation on day 14, whereas the regenerative process was delayed in the PBS group. Cell proliferation and apoptosis occurred in the pulp of the 3Mix group during days 5-7 and subsequently decreased from days 7-14. On day 5, dentin sialophosphoprotein and nestin were first recovered in the 3Mix group, whereas expression levels for alkaline phosphatase, osteopontin, and osteocalcin increased in the PBS group. The expression levels for octamer-binding factor 3/4A and 3/4B reached the maximum level on day 1 and were sharply decreased on day 3 in both groups. High expression levels of Cd11c were first observed in the 3Mix group on day 1 and later at days 5 and 7.. The results suggest that the application of 3Mix may suppress osteoblast differentiation by the migration of dendritic cells to the injury site and via the activation of stem/progenitor cells, resulting in the acceleration of odontoblastlike cell differentiation.

Topics: Alkaline Phosphatase; Animals; Anti-Bacterial Agents; Apoptosis; Buffers; CD11 Antigens; Cell Differentiation; Cell Proliferation; Ciprofloxacin; Dental Pulp; Dentin, Secondary; Drug Combinations; Extracellular Matrix Proteins; Metronidazole; Mice; Minocycline; Nestin; Octamer Transcription Factor-3; Odontoblasts; Organ Preservation Solutions; Osteocalcin; Osteopontin; Phosphates; Phosphoproteins; Sialoglycoproteins; Sodium Chloride; Time Factors; Tooth Replantation

The aim of this study was to evaluate the enamel matrix derivative (EMD) biomaterial in nonvital immature teeth.. To arrest root development, pulpectomies were performed in the lower first molars of 36 4-week-old rats; the cavities were left exposed to the oral environment for 3 weeks. Then, chemical disinfection was performed, and triple antibiotic paste (TAP) or EMD was applied in the root canals. A control group did not receive any treatment. Radiographic and histological data were evaluated after 3 and 6 weeks.. At 3 weeks, TAP promoted a milder inflammatory response and increased root lengths compared with the control group. At 6 weeks, root development and reduced periapical lesions could be observed in both test groups, mainly because of the deposition of a cementum-like tissue. EMD promoted narrower canals compared with TAP (P < .05).. EMD deserves attention as a potential tool in the treatment of nonvital immature teeth. The ingrowth of cementum-like tissues into canal spaces favored dental wall thickness and may contribute to tooth resistance and support.

Topics: Animals; Anti-Bacterial Agents; Cementogenesis; Ciprofloxacin; Dental Cementum; Dental Enamel Proteins; Dental Pulp Cavity; Dental Pulp Necrosis; Dentin, Secondary; Drug Combinations; Image Processing, Computer-Assisted; Male; Metronidazole; Minocycline; Odontogenesis; Periapical Periodontitis; Periapical Tissue; Periodontal Ligament; Radiography, Dental, Digital; Rats; Rats, Wistar; Root Canal Irrigants; Time Factors; Tooth Apex; Tooth, Nonvital

This case series reports the outcomes of 8 patients (ages 9-4 years) who presented with 9 immature permanent teeth with pulpal necrosis and apical periodontitis. During treatment, 5 of the teeth were found to have at least some residual vital tissue remaining in the root canal systems. After NaOCI irrigation and medication with ciprofloxacin, metronidazole, and minocycline, these teeth were sealed with mineral trioxide aggregate and restored. The other group of 4 teeth had no evidence of any residual vital pulp tissue. This second group of teeth was treated with NaOCl irrigation and medicated with ciprofloxacin, metronidazole, and minocycline followed by a revascularization procedure adopted from the trauma literature (bleeding evoked to form an intracanal blood clot). In both groups of patients, there was evidence of satisfactory postoperative clinical outcomes (1-5 years); the patients were asymptomatic, no sinus tracts were evident, apical periodontitis was resolved, and there was radiographic evidence of continuing thickness of dentinal walls, apical closure, or increased root length.

Topics: Adolescent; Aluminum Compounds; Anti-Bacterial Agents; Apexification; Calcium Compounds; Calcium Hydroxide; Child; Ciprofloxacin; Dental Pulp; Dental Pulp Necrosis; Dentin, Secondary; Drug Combinations; Female; Follow-Up Studies; Humans; Male; Metronidazole; Minocycline; Odontogenesis; Oxides; Periapical Periodontitis; Regeneration; Root Canal Filling Materials; Root Canal Irrigants; Root Canal Preparation; Silicates; Sodium Hypochlorite; Tooth Apex; Tooth, Nonvital; Treatment Outcome

The objective of this study was to evaluate in vivo the revascularization and the apical and periapical repair after endodontic treatment using 2 techniques for root canal disinfection (apical negative pressure irrigation versus apical positive pressure irrigation plus triantibiotic intracanal dressing) in immature dogs' teeth with apical periodontitis.. Two test groups of canals with experimentally induced apical periodontitis were evaluated according to the disinfection technique: Group 1, apical negative pressure irrigation (EndoVac system), and Group 2, apical positive pressure irrigation (conventional irrigation) plus triantibiotic intracanal dressing. In Group 3 (positive control), periapical lesions were induced, but no endodontic treatment was done. Group 4 (negative control) was composed of sound teeth. The animals were killed after 90 days and the maxillas and mandibles were subjected to histological processing. The sections were stained with hematoxylin and eosin and Mallory Trichrome and examined under light microscopy. A description of the apical and periapical features was done and scores were attributed to the following histopathological parameters: newly formed mineralized apical tissue, periapical inflammatory infiltrate, apical periodontal ligament thickness, dentin resorption, and bone tissue resorption. Intergroup comparisons were done by the Kruskal-Wallis and Dunn's tests (alpha = 0.05).. Although statistically significant difference was found only for the inflammatory infiltrate (P < .05), Group 1 presented more exuberant mineralized formations, more structured apical and periapical connective tissue, and a more advanced repair process than Group 2.. From the histological observations, sodium hypochlorite irrigation with the EndoVac system can be considered as a promising disinfection protocol in immature teeth with apical periodontitis, suggesting that the use of intracanal antibiotics might not be necessary.

Topics: Alveolar Bone Loss; Alveolar Process; Animals; Anti-Bacterial Agents; Ciprofloxacin; Connective Tissue; Dental Pulp Cavity; Dentin; Dentin, Secondary; Dogs; Drug Combinations; Metronidazole; Minocycline; Neovascularization, Physiologic; Periapical Periodontitis; Periapical Tissue; Periodontal Ligament; Pressure; Root Canal Filling Materials; Root Canal Irrigants; Root Canal Preparation; Root Resorption; Sodium Hypochlorite; Therapeutic Irrigation; Tooth Apex; Wound Healing

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