minocycline and Periapical-Periodontitis

Revascularization is a valuable treatment in immature necrotic teeth that allows the continuation of root development.. This article describes the successful revascularization treatment of an immature maxillary lateral incisor that was initially diagnosed with apical periodontitis. The tooth was asymptomatic and functional clinically and radiographically during the follow-up period of 5 years.. The follow-up showed evidence of progressive thickening of the dentinal walls, development of root length and apical closure. The article also discusses the currently available literature regarding revascularization of immature permanent teeth.

Topics: Anti-Bacterial Agents; Apexification; Calcium Hydroxide; Child; Ciprofloxacin; Dental Pulp Necrosis; Dental Restoration, Permanent; Dentin; Follow-Up Studies; Humans; Incisor; Male; Metronidazole; Minocycline; Neovascularization, Physiologic; Odontogenesis; Periapical Periodontitis; Root Canal Filling Materials; Root Canal Irrigants; Root Canal Preparation; Tooth Fractures; Tooth Root

Revascularization is a valuable treatment in immature necrotic teeth that allows the continuation of root development. In this article we describe successful revascularization treatment of 2 necrotic immature first mandibular molars.. The clinical and radiographic examinations showed extensive coronal caries, immature roots, and periapical radiolucencies in mandibular first molars of a 9-year-old boy and an 8-year-old girl. The exam findings suggested revascularization treatment in both cases, which was started with irrigation of the canals by using NaOCl 5.25% for 20 minutes, followed by 3 weeks of triple antibiotic (metronidazole, ciprofloxacin, and minocycline) paste dressing. Next, the antibiotic paste was removed, bleeding was induced in the canals, and calcium enriched mixture (CEM) cement was placed over blood clots.. In radiographic and clinical follow-ups both cases were asymptomatic and functional, periapical radiolucencies were healed, and roots continued to develop.. Revascularization is a realistic treatment in immature necrotic molars. In addition, placing CEM cement as a new endodontic biomaterial over the blood clot formed inside the canals provided good seal and favorable outcomes.

Topics: Anti-Bacterial Agents; Apexification; Biocompatible Materials; Calcium; Child; Ciprofloxacin; Dental Cements; Dental Pulp Necrosis; Female; Follow-Up Studies; Humans; Male; Mandible; Metronidazole; Minocycline; Molar; Neovascularization, Physiologic; Odontogenesis; Periapical Abscess; Periapical Periodontitis; Root Canal Irrigants; Root Canal Preparation; Sodium Hypochlorite; Time Factors; Tooth Root; Treatment Outcome

This randomized clinical study compared the antibacterial effectiveness of treatment protocols using either a triple antibiotic solution (1 mg/mL) or calcium hydroxide/chlorhexidine paste as interappointment medication in infected canals of teeth with primary apical periodontitis.. The root canals of single-rooted teeth with apical periodontitis were prepared by using a reciprocating single-instrument technique with 2.5% sodium hypochlorite irrigation and then medicated for 1 week with either a triple antibiotic solution (minocycline, metronidazole, and ciprofloxacin) at 1 mg/mL (n = 24) or a calcium hydroxide paste in 2% chlorhexidine gluconate (n = 23). Samples were taken from the canal at the baseline (S1), after chemomechanical preparation (S2), and after intracanal medication (S3). DNA extracts from clinical samples were evaluated for total bacterial reduction using a 16S ribosomal RNA gene-based quantitative polymerase chain reaction assay.. All S1 samples were positive for the presence of bacteria, and counts were substantially reduced after treatment procedures (P < .01). Bacterial levels in S2 and S3 samples did not significantly differ between groups (P > .05). S2 to S3 reduction was 97% in the antibiotic group and 39% in the calcium hydroxide/chlorhexidine group; only the former reached statistical significance (P < .01). There were significantly more quantitative polymerase chain reaction-negative S3 samples in the antibiotic group than in the calcium hydroxide group (P < .05).. Interappointment medication with a triple antibiotic solution at the concentration of 1 mg/mL significantly improved root canal disinfection, and its effects were at least comparable with the calcium hydroxide/chlorhexidine paste. Effectiveness and easy delivery of the antibiotic solution make it an appropriate medicament as part of a disinfecting protocol for conventional nonsurgical endodontic treatment and possibly regenerative endodontic procedures.

Topics: Adolescent; Adult; Aged; Anti-Bacterial Agents; Bacterial Infections; Calcium Hydroxide; Chlorhexidine; Ciprofloxacin; Dental Disinfectants; Female; Humans; Male; Metronidazole; Middle Aged; Minocycline; Ointments; Periapical Periodontitis; Root Canal Irrigants; Root Canal Preparation; Solutions; Young Adult

A triple antibiotic mixture of ciprofloxacin, metronidazole, and minocycline was used as an intracanal medicament in an attempt to disinfect the root canal system for revascularization of a tooth with a necrotic pulp. However, discoloration developed after applying the triple antibiotic mixture.. Six weeks after a triple antibiotic paste had been applied to the root canal of tooth #8 of a 7-year-old girl, the tooth showed a dark discoloration. An in vitro experiment with human extracted teeth was performed to determine which of the 3 antibiotics caused the tooth discoloration. Another experiment was then carried out to examine whether a currently used dentin bonding agent would prevent or reduce such discoloration. The degree of discoloration was assessed by using a colorimeter.. Among the components of the triple antibiotic paste, only minocycline caused the tooth discoloration. Moreover, the dentin bonding agent reduced the intensity of the discoloration but did not prevent it.. The possible esthetic problems with the tooth color should be considered when using minocycline as a canal medication.

Topics: Acrylic Resins; Anti-Bacterial Agents; Anti-Infective Agents; Child; Ciprofloxacin; Colorimetry; Dental Disinfectants; Dental Pulp Necrosis; Dentin-Bonding Agents; Drug Combinations; Female; Follow-Up Studies; Humans; Incisor; Metronidazole; Minocycline; Periapical Periodontitis; Root Canal Irrigants; Tooth Bleaching; Tooth Crown; Tooth Discoloration

Pulp necrosis in immature teeth and the resulting periodontal apical inflammation negatively affect root formation. Resolvin E1 (RvE1) is a lipid-derived endogenous pro-resolution molecule that controls inflammation. The aim of this investigation was to evaluate the impact of RvE1 applied as an intracanal medication on root formation in nonvital immature teeth.. To arrest root development, pulpectomy was performed in the lower first molars of 4-week-old Wistar rats. After 3 weeks, irrigation with 2.5% sodium hypochlorite and 0.9% sterile saline was performed, and either a triple antibiotic paste (TAP) or RvE1 in saline was applied into the root canals. In the control group, access openings drilled into molars were left exposed to the oral environment. Root development and periapical repair were evaluated radiographically and histologically at 3 and 6 weeks after treatment.. RvE1 reduced periapical lesion size compared with the control at 3 weeks, which was similar to TAP. Inflammatory response in the RvE1-treated group was markedly reduced compared with both TAP and control specimens. At 6 weeks, root development was observed in both groups, but RvE1 treatment produced less cellularity with more regular calcified tissue deposition.. RvE1 and TAP had a positive impact on reducing inflammation and promoting root formation. RvE1 was more effective in reducing inflammation at earlier stages. RvE1 has potential to be used as root canal dressing to control inflammation in endodontically compromised teeth before complete root formation. Stability of RvE1 within the root canal and its delivery are issues to be addressed before its clinical use.

Topics: Animals; Anti-Bacterial Agents; Anti-Inflammatory Agents; Ciprofloxacin; Dental Pulp Cavity; Dental Pulp Necrosis; Eicosapentaenoic Acid; Male; Metronidazole; Minocycline; Odontogenesis; Periapical Periodontitis; Pulpectomy; Rats; Rats, Wistar; Root Canal Irrigants; Sodium Hypochlorite; Tooth Calcification; Tooth Root; Tooth, Nonvital

In regenerative endodontic treatment (RET) for immature permanent tooth, better treatment results could be obtained by applying platelet-rich plasma (PRP) as the scaffold rather than the blood clot. The goal of this study was to compare the histologic differences between using PRP and blood clot in RET.. Three 6-month-old beagles each carrying 9 premolars with double root canals were randomly assigned to the PRP group, blood clot group, or negative control group. All experimental teeth suffered apical periodontitis, and RET was performed. In the blood clot group, bleeding was induced from the periapical tissues to fill the canal space. In the PRP group, autologous PRP was injected into each root canal. The animals were sacrificed 3 months later. Histologic sections were stained with hematoxylin-eosin. Statistical analysis was performed by the Fisher exact test, with the significance set at 0.05.. With the ingrowth of cellular cementumlike tissues, the canal wall was thickened, and the apical apex was closed in both the PRP and blood clot groups. Cementocytelike cells were present in the newly formed tissues. Meanwhile, no statistical difference was found in both experimental groups for the average percentage of apical closure, new tissue formation, and pulplike tissue formation. Noticeably, a large number of inflammatory cells were present in some root canals in both groups although the postoperative radiograph revealed the disappearance of periapical radiolucency.. PRP application could be an option for clinical cases in which little or no bleeding were found when irritating the apical tissue during RET.

Topics: Aluminum Compounds; Animals; Apexification; Blood Coagulation; Calcium Compounds; Cementogenesis; Ciprofloxacin; Dental Cementum; Dental Pulp; Dental Pulp Cavity; Dogs; Drug Combinations; Metronidazole; Minocycline; Oxides; Periapical Periodontitis; Platelet-Rich Plasma; Radiography, Bitewing; Random Allocation; Regeneration; Root Canal Filling Materials; Root Canal Irrigants; Root Canal Preparation; Silicates; Tooth Apex; Wound Healing

Regenerative endodontic therapy is currently used to treat immature permanent teeth with necrotic pulp and/or apical periodontitis. However, mature teeth with necrotic pulp and apical periodontitis have also been treated using regenerative endodontic therapy. The treatment resulted in resolution of apical periodontitis, regression of clinical signs and symptoms but no apparent thickening of the canal walls, and/or continued root development. A recent study in an animal model showed that the tissues formed in the canals of mature teeth with apical periodontitis after regenerative endodontic therapy were cementumlike, bonelike, and periodontal ligament-like tissue with numerous blood vessels. These tissues are similar to the tissues observed in immature permanent teeth with apical periodontitis after regenerative endodontic therapy.. A 23-year-old woman had a history of traumatic injury to her upper anterior teeth when she was 8 years old. Subsequently, #8 developed pulp necrosis and an acute apical abscess and #7 symptomatic apical periodontitis. The apex of #8 was slightly open, and the apex of #7 was completely formed. Instead of nonsurgical root canal therapy, regenerative endodontic therapy was attempted, including complete chemomechanical debridement on #8 and #7. This was based on the premise that filling of disinfected root canals with the host's biological vital tissue might be better than filling with foreign materials.. After regenerative endodontic therapy of #8 and #7, there was radiographic evidence of periapical osseous healing and regression of clinical signs and symptoms. The pulp cavity of #8 decreased in size, and the apex closed. The pulp cavity of #7 appeared to be obliterated by mineralized tissue. These indicated ingrowth of new vital tissue into the chemomechanically debrided canals.. Regenerative endodontic therapy of mature teeth with apical periodontitis and apical abscess can result in the regression of clinical signs and/or symptoms and healing of apical periodontitis but no apparent thickening of the canal walls or continued root development. Filling of the disinfected canals with the host's vital tissue may be better than with foreign materials because vital tissue has innate and adaptive immune defense mechanisms.

Topics: Anti-Bacterial Agents; Apexification; Blood Coagulation; Ciprofloxacin; Dental Pulp Necrosis; Female; Follow-Up Studies; Humans; Methylmethacrylates; Metronidazole; Minocycline; Patient Care Planning; Periapical Abscess; Periapical Periodontitis; Regeneration; Root Canal Preparation; Root Canal Therapy; Young Adult; Zinc Oxide-Eugenol Cement

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

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 present study aimed at developing an experimental model in rat molars for evaluating treatment strategies in necrotic immature teeth.. To define the periods to be adopted in the experimental procedures and to confirm induction of periapical lesions and interruption of root embryogenesis, the left lower first molars of 4-weeks-old Wistar rats underwent pulpectomy and were left open to the oral environment. Comparisons with the right lower first molars (vital teeth) were performed in animals with ages of 7, 10, 13, and 16 weeks. In another group of animals the teeth were left open for 3 weeks, and then interventions for disinfection including the use of an antibiotic paste were carried out. Root formation was then assessed after 3 and 6 weeks on the basis of radiographic and histologic evaluation.. Vital teeth showed increase of root length and hard tissue thickness throughout the experimental periods. On the other hand, induction of necrosis arrested root formation. Teeth subjected to disinfection with sodium hypochlorite associated with the triple antibiotic paste showed significant reduction of periapical lesions, gain in root length, and increased wall thickness compared with the control (P < .05).. The root canal disinfection protocol used was able to reduce periapical lesion size and improve root development. The experimental model presented should contribute to studies that aim at improving therapeutic strategies for necrotic immature teeth by using a rat model.

Topics: Animals; Anti-Bacterial Agents; Apexification; Cementogenesis; Ciprofloxacin; Dental Pulp Necrosis; Disease Models, Animal; Drug Combinations; Metronidazole; Minocycline; Odontogenesis; Periapical Periodontitis; Radiography; Rats; Rats, Wistar; Root Canal Irrigants; Sodium Hypochlorite; Tooth Apex; Tooth, Nonvital

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

To present a case report in which the pulp of two bilateral mandibular premolars with dens evaginatus were revascularized using a modified novel technique to avoid undesired crown discolouration.. Recently, regeneration of necrotic pulps has become an alternative conservative treatment option for young permanent teeth with immature roots and is a subject of great interest in the field of endodontics. This novel procedure exploits the full potential of the pulp for dentine deposition and produces a stronger mature root that is better able to withstand the forces than can result in fracture. However, the current protocol has potential clinical and biological complications. Amongst them, crown discolouration, development of resistant bacterial strains and allergic reaction to the intracanal medication. In the case presented, a modified technique to avoid undesired crown discolouration was applied sealing the dentinal tubules of the chamber, thus avoiding any contact between the tri-antibiotic paste and the dentinal walls.. * Sealing the dentinal tubules of the chamber prevents the undesirable crown discolouration produced by tri-antibiotic medication whilst maintaining the revascularization potential of the pulp. * Further research is warranted to seek an alternative infection control protocol capable of preventing possible allergic reactions and development of resistant strains of bacteria, as well as a biological material capable of inducing angiogenesis and allow a more predictable scaffold and tissue regeneration.

Topics: Anti-Bacterial Agents; Anti-Infective Agents; Bicuspid; Child; Ciprofloxacin; Dental Fistula; Dental Pulp; Dental Pulp Necrosis; Drug Combinations; Female; Follow-Up Studies; Humans; Metronidazole; Minocycline; Neovascularization, Physiologic; Periapical Periodontitis; Root Canal Irrigants; Root Canal Preparation; Root Canal Therapy; Tooth Discoloration

The purpose of this study was to examine the effect of a pulpal revascularization procedure for immature necrotic teeth with apical periodontitis.. Twelve patients, each with an immature permanent tooth with chronic or acute apical periodontitis, were recruited. A triantibiotic mix (ciprofloxacin, metronidazole, and minocycline) was used to disinfect the pulp for 1 week. Then a blood clot was created in the canal, over which grey mineral trioxide aggregate was placed. Patients were recalled periodically.. Six patients dropped from the study (as a result of pain or failure to induce bleeding after canal disinfection) and instead received a standard apexification procedure. Another 3 patients did not attend any recall appointments. The remaining teeth (n = 3) were found to exhibit complete root development, with a positive response to pulp testing.. Revascularization could be effective for managing immature permanent teeth with apical periodontitis with appropriate case selection.

Topics: Aluminum Compounds; Anti-Bacterial Agents; Anti-Infective Agents; Bicuspid; Blood Coagulation; Calcium Compounds; Child; Ciprofloxacin; Dental Pulp; Dental Pulp Cavity; Dental Pulp Necrosis; Drug Combinations; Female; Follow-Up Studies; Guided Tissue Regeneration; Humans; Incisor; Male; Metronidazole; Minocycline; Neovascularization, Physiologic; Odontogenesis; Oxides; Periapical Periodontitis; Root Canal Filling Materials; Root Canal Preparation; Root Canal Therapy; Silicates; Tooth Apex; Treatment Outcome

Elimination of microbial contamination from the root canal system is a precondition for successful root canal treatment. In this regard, mechanical instrumentation, irrigation, and intracanal medication are all important. This case report assesses the efficacy of a triple antibiotic paste consisting of metronidazole, ciprofloxacin, and minocycline in the disinfection of immature teeth with apical periodontitis. An 8-year-old girl presented at the Department of Pediatric Dentistry for the evaluation of right and left maxillary central incisors with crown fractures and luxation. The right central incisor had a large periapical lesion, which was treated by filling the canal with a ciprofloxacin/metronidazole/minocycline paste. After 4 months, the patient had no symptoms, and a radiograph showed the radiolucency had completely resolved. At the 1-year follow-up, a periapical radiograph showed complete root development and apical closure. These results indicate that triple antibiotic paste is effective in disinfecting immature teeth with periapical lesions.

Topics: Anti-Infective Agents, Local; Child; Ciprofloxacin; Drug Combinations; Female; Humans; Incisor; Metronidazole; Minocycline; Periapical Periodontitis; Root Canal Irrigants; Tooth Crown; Tooth Fractures; Tooth Root; Treatment Outcome

This case series reports the outcomes of 8 patients (ages 9-14 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 NaOCl 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; Anti-Infective Agents, Local; Child; Ciprofloxacin; Dens in Dente; Dental Pulp; Dental Pulp Necrosis; Dentition, Permanent; Female; Humans; Male; Metronidazole; Minocycline; Neovascularization, Physiologic; Periapical Periodontitis; Regeneration; Root Canal Irrigants; Sodium Hypochlorite; Tooth Apex

This study assessed the efficacy of a triple antibiotic paste in the disinfection of immature dog teeth with apical periodontitis. The canals were sampled before (S1) and after (S2) irrigation with 1.25% NaOCL and after dressing with a triple antibiotic paste (S3), consisting of metronidazole, ciprofloxacin, and minocycline. At S1, 100% of the samples cultured positive for bacteria with a mean CFU count of 1.7 x 10. At S2, 10% of the samples cultured bacteria-free with a mean CFU count of 1.4 x 10. At S3, 70% of the samples cultured bacteria-free with a mean CFU count of only 26. Reductions in mean CFU counts between S1 and S2 (p < 0.0001) as well as between S2 and S3 (p < 0.0001) were statistically significant. These results indicate the effectiveness of a triple antibiotic paste in the disinfection of immature teeth with apical periodontitis.

Topics: Animals; Bacteria, Anaerobic; Ciprofloxacin; Colony Count, Microbial; Dental Pulp; Dogs; Drug Therapy, Combination; Metronidazole; Minocycline; Neovascularization, Physiologic; Periapical Periodontitis; Root Canal Irrigants; Sodium Hypochlorite; Tooth Apex