Browsing by Subject "triple antibiotic paste"

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    Effect of Antibiotic Pastes on Chemical Structure and Microhardness of Radicular Dentin
    (2014) Prather, Blake; Spolnik, Kenneth Jacob, 1950-; Legan, Joseph J.; Zunt, Susan L., 1951-; Ehrlich, Ygal; Platt, Jefrey A., 1958-
    Introduction: Regenerative endodontic therapy in immature teeth with necrotic pulps triggers continued root development, thereby improving the prognosis of these teeth. Disinfection of the canal is accomplished with an intracanal medicament, such as triple antibiotic paste (TAP) composed of metronidazole, ciprofloxacin, and minocycline. A modified triple antibiotic paste (MTAP) that replaces minocycline with clindamycin has recently been suggested to avoid the tooth discoloration and potential demineralization from minocycline. The effect these pastes have on radicular dentin is unknown. Objectives: The aim of this study was to investigate the effects of two intracanal medicaments used during endodontic regeneration, TAP and MTAP, at concentrations of 1 g/mL and 1 mg/mL, on the microhardness and chemical structure of radicular dentin. Materials and Methods: Roots from extracted, unrestored, non-carious human premolar teeth were sectioned. An antibiotic paste (MTAP or TAP) or sterile water (control) was applied to treatment groups and stored for four weeks in 80-percent humidity at 37 °C. The effect of each paste on the microhardness of radicular dentin was measured using a Vickers Microhardness Tester (n = 17) to take three pretreatment and post-treatment measurements at both 500 µm and 1000 µm from the pulp-dentin interface. The chemical structure was assessed from dentin specimens treated with the same medicaments or sterile water for four weeks. After treatment, three measurements were taken on each specimen using Attenuated Total Reflection Fourier Transform Infrared Spectroscopy to measure the phosphate/amide I ratios of dentin (n = 7). Results: The 1 g/mL of TAP or MTAP and the 1 mg/mL methylcellulose-based TAP caused significant reduction in microhardness of roots compared with untreated control roots at 500 µm and 1000 µm from the pulp-dentin interface. Furthermore, the methylcellulose-based 1 mg/mL TAP and MTAP caused significantly less reduction in microhardness compared with 1 g/mL TAP and MTAP. The 1 g/mL of TAP and DAP caused significantly lower phosphate/amide I ratios compared with other groups. Conclusion: The use of methylcellulose based 1 mg/mL of TAP and MTAP may minimize the reduction in microhardness of roots compared with the currently used 1 g/mL concentration of these antibiotics.
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    Effect of different endodontic regeneration protocols on wettability, roughness and chemical composition of surface dentin
    (Elsevier, 2015-06) Yassen, Ghaeth H.; Sabrah, Alaa H. A.; Eckert, George J.; Platt, Jeffrey A.; Department of Restorative Dentistry, IU School of Dentistry
    Introduction We investigated the changes in physiochemical properties of dentin surfaces after performing different endodontic regeneration protocols. Methods Human dentin slices were randomized into 4 treatment groups and 1 untreated control group (n = 10). One treatment group was irrigated with sodium hypochlorite (NaOCl) for 5 minutes followed by EDTA for 10 minutes. The other 3 treatment groups were irrigated with NaOCl; treated for 4 weeks with triple antibiotic paste (TAP), diluted triple antibiotic paste (DTAP), or calcium hydroxide (Ca[OH]2); and then irrigated with EDTA. After treatment, contact angles between a blood analog and dentin surfaces were evaluated. Surface roughness and chemical composition were characterized using optical profilometry and energy-dispersive X-ray spectroscopy, respectively. One-way analysis of variance followed by Fisher least significant difference tests were used for statistical analyses. Results All treatment groups showed a significant reduction in wettability and a significant increase in surface roughness when compared with untreated dentin. Dentin treated with Ca(OH)2 had significantly lower wettability compared with all other groups. No significant difference in wettability was found between dentin treated with DTAP and TAP protocols. Dentin treated with TAP had significantly higher surface roughness compared with all other groups. Untreated dentin and NaOCl + EDTA–treated dentin had significantly higher calcium and phosphorus as well as significantly lower carbon compared with dentin treated with Ca(OH)2, DTAP, and TAP. Conclusions Endodontic regeneration protocols had a significant effect on wettability, surface roughness, and chemical composition of surface dentin. The Ca(OH)2 protocol caused a significant reduction in dentin wettability compared with TAP or DTAP protocols.
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    The Effect of Diluted Triple and Double Antibiotic Pastes on Dental Pulp Stem Cells and Established Enterococcus faecalis Biofilm
    (Springer, 2015-11) Sabrah, Alaa H. A.; Yassen, Ghaeth H.; Liu, Wai-Ching; Goebel, W. Scott; Gregory, Richard L.; Platt, Jeffrey A.; Department of Restorative Dentistry, IU School of Dentistry
    Objectives To investigate the effect of various dilutions of antibiotic medicaments used in endodontic regeneration on the survival of human dental pulp stem cells (DPSCs) and to determine their antibacterial effect against established Enterococcus faecalis biofilm. Materials and methods The cytotoxic and antibacterial effects of different triple (TAP) and double antibiotic paste (DAP) dilutions (0.125, 0.25, 0.5, 1, and 10 mg/ml) were tested against Enterococcus faecalis established biofilm and DPSC. Established bacterial biofilm were exposed to antibiotic dilutions for 3 days. Then, biofilms were collected, spiral plated, and the numbers of bacterial colony forming units (CFU/ml) were determined. For the cytotoxic effect, lactate dehydrogenase activity assays (LDH) and cell viability assays (WST-1) were used to measure the percentage of DPSC cytotoxicity after 3-day treatment with the same antibiotic dilutions. A general linear mixed model was used for statistical analyses (α = 0.05). Results All antibiotic dilutions significantly decreased the bacterial CFU/ml. For WST-1 assays, all antibiotic dilutions except 0.125 mg/ml significantly reduced the viability of DPSC. For LDH assays, the three lowest tested concentrations of DAP (0.5, 0.25, 0.125 mg/ml) and the two lowest concentrations of TAP (0.25 and 0.125 mg/ml) were non-toxic to DPSC. Conclusions All tested dilutions had an antibacterial effect against E. faecalis. However, 0.125 mg/ml of DAP and TAP showed a significant antibacterial effect with no cytotoxic effects on DPSCs. Clinical relevance Using appropriate antibiotic concentrations of intracanal medicament during endodontic regeneration procedures is critical to disinfect root canal and decrease the adverse effects on stem cells.
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    The effect of triple antibiotic paste and EDTA on the surface loss and surface roughness of radicular dentin
    (2014) Nerness, Andrew; Spolnik, Kenneth Jacob, 1950-; Zunt, Susan L., 1951-; Platt, Jeffrey A., 1958-; Ehrlich, Ygal
    Introduction: Regenerative endodontic therapy in immature teeth with necrotic pulps triggers continued root development thereby improving the prognosis of these teeth. Several agents are under consideration for the disinfection and conditioning phases of this therapy. Triple antibiotic paste (TAP, i.e. equal parts of ciprofloxacin, metronidazole, minocycline) is used for canal disinfection and 17% EDTA solution is used for dentin conditioning. However, TAP and EDTA cause demineralization and their effect on surface loss and surface roughness of radicular dentin during regenerative procedures has not been quantified. Surface loss may be correlated with reduced tooth strength and surface roughness may be correlated with stem cell attachment. Objectives: The aim of this in vitro study was to quantitatively investigate the surface loss and surface roughness on human radicular dentin after treatment with two concentrations of TAP followed by EDTA. Materials and Methods: Human radicular dentin specimens were prepared from extracted human anterior teeth and randomized into six experimental groups. Group 1: saline control; Group 2: 17% EDTA; Group 3: TAP 1 mg/mL; Group 4: TAP 1 mg/mL and 17% EDTA; Group 5: TAP 1,000 mg/mL; Group 6: TAP 1,000 mg/mL and 17% EDTA for 5 minutes. After TAP is applied to Groups 3-6, all groups were incubated for 4 weeks. Then, groups 2, 4, and 6 were treated with EDTA for 5 minutes. Dentin surface loss (μm) and surface roughness (Ra, μm) were quantified after various treatments using non-contact and contact profilometry, respectively. Data were analyzed by one-way analysis of variance (α = 0.05) Hypothesis: It was hypothesized that there would be a significant difference in surface loss or surface roughness between at least two treatment groups. Results: All treatment groups showed significantly higher surface loss compared to untreated control. Dentin treated with 1g/mL TAP caused significant increase in surface loss and surface roughness compared to dentin treated with 1 mg/mL TAP. However, only 1g/mL TAP treated dentin showed significantly higher surface roughness compared to untreated control. The use of EDTA after both concentrations of TAP did not have significant additive effect on surface loss and surface roughness of dentin. Conclusion: The use of 1 mg/mL TAP can minimize surface loss and surface roughness of radicular dentin compared to higher concentrations. The use of EDTA after TAP may not cause additional surface loss and surface roughness of dentin.
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    A novel approach to evaluate the effect of medicaments used in endodontic regeneration on root canal surface indentation
    (The final publication is available at: http://link.springer.com/article/10.1007%2Fs00784-013-1125-x doi: 10.1007/s00784-013-1125-x, 2013-10) Yassen, Ghaeth H.; Chu, Tien-Min G.; Gallant, Maxime A.; Allen, Matthew R.; Vail, Mychel M.; Murray, Peter E.; Platt, Jeffrey A.
    Objectives: To investigate the capability of a novel reference point indentation apparatus to test the indentation properties of root canal surface dentine treated with three intracanal medicaments used in endodontic regeneration. Materials and Methods: Immature human premolars were selected (n=22). Four specimens were obtained from each root and randomly assigned to three treatment groups and a control group. Each specimen was exposed to one of three treatment pastes (triple antibiotic (TAP), double antibiotic (DAP), or calcium hydroxide [Ca(OH)2] or neutral de-ionized water (control) for one or four weeks. After each time-interval, the indentation properties of the root canal dentine surfaces were measured using a BioDent reference point indenter. Two-way ANOVA and Fisher’s Protected Least Significant Differences were used for statistical analyses. Results: Significant differences in indentation parameters and estimated hardness between all groups at both time points were found. TAP treated dentine had the highest significant indentation parameters, followed by DAP treated dentine, untreated control dentine and Ca(OH)2 treated dentine, respectively. Furthermore, TAP treated dentine had the lowest significant estimated hardness, followed by DAP treated dentine, untreated control dentine and Ca(OH)2 treated dentine, respectively. Conclusion: BioDent reference point indenter was able to detect significant differences in indentation properties of root canal dentine treated with various medicaments. Clinical Relevance: The use of a reference point indenter is a promising approach to characterize the indentation properties of root canal surfaces without any surface modification. This might provide an in vitro mechanical measurement that is more representative of the actual clinical situation.