Treatment Outcome with A Revascularization Protocol Using Double and Triple Antibiotic Pastes in Immature Necrotic Teeth – A Double Blinded Randomized Control Clinical Trial

Authors

  • Department of Conservative Dentistry and Endodontics, Sri Venkateswara Dental College and Hospital, Chennai, 603103
  • Department of Conservative Dentistry and Endodontics, Sri Venkateswara Dental College and Hospital, Chennai
  • Department of Conservative Dentistry and Endodontics, Sri Venkateswara Dental College and Hospital, Chennai
  • Sri Venkateswara Dental College and Hospital, Chennai
  • Department of Pharmacology, Sri Venkateswara Dental College and Hospital, Chennai

Keywords:

Double antibiotic paste Regenerative endodontics Revasculasrisation protocol Triple antibiotic paste

Abstract


Aim: The aim of this clinical trial is to evaluate the regenerative potential of two antibiotic pastes in permanent teeth with necrotic pulp and open apex and compare it with a standard treatment using mineral trioxide aggregate.
Materials and methods: This interventional study was conducted to assess the revascularization potential. It was designed with two test arms and one control arm. LA was administered, access was established under rubber dam, irrigation was done, and each tooth received an antibiotic paste depending on the test arm to which it belonged. The control arm received a standard MTA apexification. Primary and secondary outcomes were assessed at baseline, 6 months and 12 months. Data were tabulated and analyzed.
Results: Though there was an increase in root length in the test arms, the difference was not statistically significant among the various groups at the different time intervals of assessment. Overall, the mean pain scores decreased over the study period in all the three groups. Though no root closure was found at baseline among the test groups, a statistically significant improvement in the root closure scores was observed in Group A, when compared to Group B, at the end of 6th and 12th month of intervention.
Conclusion: The results to this study show that the revascularization potential of triple antibiotic paste is superior to that of the double antibiotic group. The increase in the root length is statistically superior over the study period in the triple antibiotic arm when compared to that of the double antibiotic arm.

References

Katebzadeh N, Dalton BC, Trope M. Strengthening immature teeth during and after apexification. J Endod. 1998;24:256– 259.

Abbot P. Apexification with calcium hydroxide: when should the dressing be changed? The case for regular dressing changes. Aust Endod J. 1998;24:27–32.

Sheehy EC, Roberts GJ. Use of calcium hydroxide for apical barrier formation and healing in non-vital immature permanent teeth: a review. Br Dent J. 1997;183:241–246.

Andreasen JO, Farik B, Munksgaard EC. Long-term calcium hydroxide as a root canal dressing may increase risk of root fracture. Dent Traumatol. 2002;18:134–137.

Cehreli ZC, Sara S, Uysal S, Turgut MD. MTA apical plugs in the treatment of traumatized immature teeth with large periapical lesions. Dent Traumatol. 2011;27:59–62.

Sarris S, Tahmassebi JF, Duggal MS, et al. A clinical evaluation of mineral trioxide aggregate for root-end closure of non-vital immature permanent incisors in children: a pilot study. Dent Traumatol. 2008;24:79–85.

Murray PE, Garcia-Godoy F, Hargreaves KM. Regenerative endodontics: a review of current status and a call for action. J Endod. 2007;33:377–390.

Jung IY, Lee SJ, Hargreaves KM. Biologically based treatment of immature permanent teeth with pulpal necrosis: a case series. J Endod. 2008;34:876–887.

Hoshino E, Kurihara-Ando N, Sato I, et al. In-vitro antibacterial susceptibility of bacteria taken from infected root dentine to a mixture of ciprofloxacin, metronidazole and minocycline. Int Endod J. 1996;29:125–130.

Sato I, Ando-Kurihara N, Kota K, Iwaku M, Hoshino E. Sterilization of infected root-canal dentine by topical application of a mixture of ciprofloxacin, metronidazole and minocycline in situ. Int Endod J. 1996;29:118–124.

Kim JH, Kim Y, Shin SJ, Park JW, Jung Y. Tooth discoloration of immature permanent incisor associated with triple antibiotic therapy: a case report. J Endod. 2010;36:1086–1091.

Kendall JM. Designing a research project: randomised controlled trials and their principles. Emerg Med J. 2003;20:164–168.

Nygaard-Ostby B. The role of the blood clot in endodontic therapy: an experimental histologic study. Acta Odont Scand. 1961;19:323–353.

Nygaard-Ostby B, Hjortdal O. Tissue formation in the root canal following pulp removal. Scand J Dent Res. 1971;79:333–349.

Iwaya SI, Ikawa M, Kubota M. Revascularization of an immature permanent tooth with apical periodontitis and sinus tract. Dent Traumatol. 2001;17:185–187.

Banchs F, Trope M. Revascularization of immature permanent teeth with apical periodontitis: new treatment Prot. J Endod. 2004;30:196–200.

Thomson A, Kahler B. Regenerative endodonticsbiologicallybased treatment for immature permanent teeth: a case report and review of the literature. Aust Dent J. 2010;55:446–452.

Kontakiotis EG, Filippatos CG, Tzanetakis GN, Agrafioti A. Regenerative endodontic therapy: a data analysis of clinical protocols. J Endod. 2015;41:146–154.

Chang YC, Huang FM, Tai KW, Chou MY. The effect of sodium hypochlorite and chlorhexidine on cultured human periodontal ligament cells. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001;92:446–450.

Martin DE, De Almeida JF, Henry MA, et al. Concentrationdependent effect of sodium hypochlorite on stem cells of apical papilla survival and differentiation. J Endod. 2014;40:51–55.

Nayar S, Bishop K, Alani A. A report on the clinical and radiographic outcomes of 38 cases of apexification with mineral trioxide aggregate. Eur J Prosthodont Restor Dent. 2009;17:150–156.

Al Ansary MA, Day PF, Duggal MS, Brunton PA. Interventions for treating traumatized necrotic immature permanent anterior teeth: inducing a calcific barrier & root strengthening. Dent Traumatol. 2009;25:367–379.

Sato T, Hoshino E, Uematsu H, Noda T. In vitro antimicrobial susceptibility to combinations of drugs on bacteria from carious and endodontic lesions of human deciduous teeth. Oral Microbiol Immunol. 1993;8:172–176.

Thibodeau B, Trope M. Pulp revascularization of a necrotic infected immature permanent tooth: case report and review of the literature. Pediatr Dent. 2007;29:47.

Trope M. Treatment of an immature tooth with a non vital pulp and apical periodontitis. Dent Clin N Am.

;54:313–324.

Kling M, Cvek M, Mejare I. Rate and predictability of pulp revascularization in therapeutically reimplanted permanent incisors. Endod Dent Traumatol. 1986;2:83–89.

Bose R, Nummikoski P, Hargreaves K. A retrospective evaluation of radiographic outcomes in immature teeth with necrotic root canal systems treated with regenerative endodontic procedures. J Endod. 2009;35:1343–1349.

Published

2018-05-02

How to Cite

Poorni, S., Srinivasan, M. R., Duraivel, D., Mahendra, L., & Premkumari, S. (2018). Treatment Outcome with A Revascularization Protocol Using Double and Triple Antibiotic Pastes in Immature Necrotic Teeth – A Double Blinded Randomized Control Clinical Trial. Journal of Pierre Fauchard Academy (India Section), 31(1), 1–8. Retrieved from https://informaticsjournals.com/index.php/jpfa/article/view/21029

Issue

Section

Original Articles