Low conc. double antibiotic paste best for bond strength between root cements and radicular dentin

Medically Reviewed By : Dr. Kamal Kant Kohli

Published On 2021-01-05 04:45 GMT | Update On 2021-01-05 10:21 GMT

According to recent research, it has been found out that the use of 1 mg/mL DAP resulted in significantly higher push-out bond strength compared with the typical clinical concentration of TAP and DAP regardless of the type of the root cement used.

The study is published in the European Journal of Dentistry.

The most contemporary treatment option to manage immature teeth with pulpal necrosis is endodontic regeneration (ER), which depends on the efficient disinfection of the root canal. Numerous intracanal medicaments have been proposed for ER treatment, such as Ca(OH)2, triple antibiotic paste (TAP) (equal amounts of metronidazole, ciprofloxacin, and minocycline), and double antibiotic paste (DAP) (equal parts of metronidazole and ciprofloxacin). Furthermore, lower concentrations of DAP and TAP ranging from 1 to 5 mg/mL have been recommended by the American Association of Endodontists (AAE) to minimize the harmful biological effects of these medicaments on stem cells from apical papillae.

Therefore, Rayan B. Yaghmoor and colleagues from the Department of Restorative Dentistry, College of Dental Medicine, Umm Al-Qura University, Makkah, Saudi Arabia aimed to evaluate the effects of typical clinical concentration (1,000 mg/mL), low concentration (1 mg/mL) triple antibiotic pastes (TAP), and double antibiotic pastes (DAP) on the bond strength between various root cement and radicular dentin.

The authors studied a total sample of 144 intact single-rooted human teeth. Each tooth was horizontally decoronated and canals instrumented. The roots were treated for 4 weeks with Ca(OH)2, 1,000 mg/mL of TAP or DAP, and 1 mg/mL of TAP or DAP. Untreated roots served as a control. After treatment, the medicaments were irrigated and each group was divided into three subgroups receiving MTA, Biodentine, or Endosequence putty cement. After 2 weeks, coronal and middle root cylinders were obtained from each root. Push-out bond strength test and failure analysis were performed for all root cylinders.

The results showed that 1 mg/mL DAP and TAP and Ca(OH)2 demonstrated significantly higher bond strength compared with the typical clinical concentration and the control groups. For Biodentine applied coronally in the roots, 1 mg/mL of DAP resulted in significantly higher bond strength than all other groups. For Endosequence putty cement applied coronally in the roots, 1 mg/mL of DAP offered significantly higher bond strength than all groups except for Ca(OH)2.

Hence, they concluded that "1 mg/mL of DAP loaded into a hydrogel methylcellulose system and Ca(OH)2 did not have a significant negative effect on the bond strength of calcium silicate-based cement to radicular dentin."

Article Source : European Journal of Dentistry

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Dr. Nandita Mohan

Dr. Nandita Mohan is a practicing pediatric dentist with more than 5 years of clinical work experience. Along with this, she is equally interested in keeping herself up to date about the latest developments in the field of medicine and dentistry which is the driving force for her to be in association with Medical Dialogues. She also has her name attached with many publications; both national and international. She has pursued her BDS from Rajiv Gandhi University of Health Sciences, Bangalore and later went to enter her dream specialty (MDS) in the Department of Pedodontics and Preventive Dentistry from Pt. B.D. Sharma University of Health Sciences. Through all the years of experience, her core interest in learning something new has never stopped. She can be contacted at editorial@medicaldialogues.in. Contact no. 011-43720751

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Low conc. double antibiotic paste best for bond strength between root cements and radicular dentin

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