Lesion Sterilization and Tissue Repair–Current Concepts and Practices

Sain, Shaniya; J, Reshmi; Anandaraj, S; George, Sageena; Issac, Jyoti Sumi; John, Sheen Ann

doi:10.5005/jp-journals-10005-1555

Cited by 27 publications

(34 citation statements)

References 19 publications

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“…Calcium hydroxide-based obturating materials, despite acceptable biological properties [45], show high solubility in tissue fluids and within the root canals [46]. To overcome such flaws, the use of antimicrobial agents individually, or in combination with other nonantibiotic agents, like double antibiotic paste (DAP: metronidazole and ciprofloxacin), modified triple antibiotic paste (MTAP: minocycline component replaced), gained popularity to use in form of obturating materials to preserve primary and young permanent teeth in uncooperative children [47]. Besides reduction in the systemic toxicity, application of multi-antimicrobial preparations has shown to achieve nearly complete microbial elimination at very low concentrations [48].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of a Triple Antibiotic Paste as a Root Canal Obturating Material for Deciduous Teeth: A Study Protocol

Prasanna

Nilima

2021

JPRI

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Background: Teeth with infected root canals, secondary to endodontic infections are a common problem in primary as well as permanent dentition. The key to successful endodontic treatment is seen only after the complete removal of infection from root canals. Systemic antibiotics have limited reach to endodontic spaces. In pediatric dentistry, difficulties in antimicrobial control require the development of a new root canal obturating paste with broad antimicrobial activity, minimal tissue toxicity, and high safety index. In this experimental study, a new Triple Antibiotic Obturating Paste (TAOP) will be developed and its efficacy will be evaluated. Methods and Design: This is a pre-clinical in-vitro microbiological and in-vivo animal study, utilizing laboratory-grown white Wistar rats aged 2-3 months and weighing 200-300 grams. The antibiotic sensitivity test (AST) will be conducted using 21 standard aerobic and anaerobic microbial strains for determining potency through serial dilution and agar diffusion assay. The systemic and local tissue toxicity will be assessed by inserting the test and control materials into the dorsal connective tissues of the experimental rats. The antimicrobial efficacy of triple antibiotic obturating paste [thermo-modulated in-situ polymeric hydrogel matrix of TAOP, containing chitosan-carbopol and poloxamer blended with clindamycin (5%), metronidazole (5%), and doxycycline (1%)] will be evaluated against Metapex [Ca(OH)2-Iodoform paste] on endodontic microflora. The microbiological study data will be evaluated through One-way ANOVA trailed by ‘Tuckey’s post hoc test’ for intergroup as well as, t-test for intragroup comparison. The animal study data will be evaluated through One-way ANOVA for intergroup and ‘paired t-test’ for intragroup comparison. Results: The newly developed bio-degradable obturating material will be more suitable than the conventionally used one, to eliminate resistant endodontic pathogens from root canal systems, along with good pharmacokinetic and pharmacodynamic responses as well as minimal local and systematic tissue toxicity when used in primary teeth. Conclusion: The application of such novel multi-antibiotic formulation as an obturating material not only will achieve efficient disinfection of the endodontic spaces but also increase chances of therapeutic success due to the elimination of side effects associated with cytotoxicity and material properties as it contains most of the bioresorbable organic ingredients.

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Section: Discussionmentioning

confidence: 99%

Evaluation of a Triple Antibiotic Paste as a Root Canal Obturating Material for Deciduous Teeth: A Study Protocol

Prasanna

Nilima

2021

JPRI

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“…A phase III study is currently underway in the literature to test the efficacy of the new chitosan containing lesion sterilization therapy and tissue repair (LSTR) material in a dual antibiotic paste. This study has been published, but the registry is not yet open [ 231 ]. The incorporation of different nanomaterials has been proposed to improve the antimicrobial properties of bioceramic seals.…”

Section: New Therapeutic Strategies: Combinatorial Treatmentsmentioning

confidence: 99%

Nanomaterials-Based Combinatorial Therapy as a Strategy to Combat Antibiotic Resistance

et al. 2022

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Since the discovery of antibiotics, humanity has been able to cope with the battle against bacterial infections. However, the inappropriate use of antibiotics, the lack of innovation in therapeutic agents, and other factors have allowed the emergence of new bacterial strains resistant to multiple antibiotic treatments, causing a crisis in the health sector. Furthermore, the World Health Organization has listed a series of pathogens (ESKAPE group) that have acquired new and varied resistance to different antibiotics families. Therefore, the scientific community has prioritized designing and developing novel treatments to combat these ESKAPE pathogens and other emergent multidrug-resistant bacteria. One of the solutions is the use of combinatorial therapies. Combinatorial therapies seek to enhance the effects of individual treatments at lower doses, bringing the advantage of being, in most cases, much less harmful to patients. Among the new developments in combinatorial therapies, nanomaterials have gained significant interest. Some of the most promising nanotherapeutics include polymers, inorganic nanoparticles, and antimicrobial peptides due to their bactericidal and nanocarrier properties. Therefore, this review focuses on discussing the state-of-the-art of the most significant advances and concludes with a perspective on the future developments of nanotherapeutic combinatorial treatments that target bacterial infections.

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“…In the modern age of endodontics, conservative/non-surgical management of endodontic pathosis is considered a priority when compared with aggressive surgical procedures [ 4 ]. To achieve successful outcomes in non-surgical approaches, regional disinfection and tissue repair are proposed [ 5 ]. Non-surgical management of periapical lesions has been reported in several investigations, where mechanical instrumentation of root canals and employment of an intracanal medicament have been suggested [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Healing of Large Endodontic Lesions Using Long-Term Application of a New Combination of Triple Antibiotics: A Series of Cases

Asgary

Parhizkar

2023

Case Reports in Dentistry

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Apical periodontitis (AP) is defined as an inflammatory and destructive reaction of periapical tissues and a consequence of bacterial invasion to the dental pulp and root canal system. To avoid possible complications and undesirable repercussions of the surgical treatment of large AP, more conservative non-surgical approaches are endorsed. In the presented hopeless cases, a newly introduced modified combination of triple antibiotics, that is Penicillin G, metronidazole, and ciprofloxacin (PMC), was used as a long-term intracanal medication in the non-surgical endodontic retreatments of large AP. In the course of 10-month to 3-year follow-up, the large periapical lesions completely disappeared, and thorough bone healing was evident. Additionally, complete functionality of the involved teeth as well as other favourable treatment outcomes of the addressed cases showed that the long-term use of PMC, as a modified combination of antibiotics, in non-surgical endodontic retreatments may successfully resolve large AP. However, further investigations and well-designed controlled clinical trials are recommended.

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Lesion Sterilization and Tissue Repair–Current Concepts and Practices

Cited by 27 publications

References 19 publications

Evaluation of a Triple Antibiotic Paste as a Root Canal Obturating Material for Deciduous Teeth: A Study Protocol

Evaluation of a Triple Antibiotic Paste as a Root Canal Obturating Material for Deciduous Teeth: A Study Protocol

Nanomaterials-Based Combinatorial Therapy as a Strategy to Combat Antibiotic Resistance

Healing of Large Endodontic Lesions Using Long-Term Application of a New Combination of Triple Antibiotics: A Series of Cases

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