Cytotoxicity Evaluation of Minimum Antibacterial Values of Different Medicaments Used in Endodontic Regenerative Procedures

Abstract

Objectives This study aimed to evaluate the cytotoxicity of minimum antibacterial values of medicaments used in endodontic regeneration on stem cells. Materials and Methods “Minimum inhibitory concentration,” “minimum bactericidal concentration,” and “minimum biofilm inhibitory concentration” of triple and double antibiotic paste, a modified triple antibiotic paste (minocycline replaced by clindamycin), Augmentin, and calcium hydroxide were determined using Enterococcus faecalis (ATCC 29212) by microtiter plate method. Direct cytotoxic effects of drugs were evaluated by lactate dehydrogenase and water-soluble tetrazolium salt-1 assays using stem cells of apical papilla obtained from immature third molars via enzymatic digestion. Statistical Analysis Data were analyzed using IBM SPSS Statistics 24, one-way analysis of variance and post hoc comparisons. The statistical power was set at p < 0.05. Results All medicaments caused similar cytotoxicity and cell proliferation at “minimum inhibitory concentration” (p > 0.05) except Augmentin which was significantly more toxic than others (p < 0.05). At “minimum bactericidal concentration,” calcium hydroxide was more toxic than other drugs (p < 0.001), but its adverse effect on cell proliferation was the same as Augmentin (p > 0.05). Triple and double antibiotic paste revealed similar favorable effects in terms of toxicity and proliferation rate at most of the tested concentrations (p > 0.05). At “minimum biofilm inhibitory concentration” both the modified paste and Augmentin caused less proliferation rate than triple and double antibiotic paste (p < 0.001and p < 0.05, respectively) and Augmentin induced more cytotoxicity (p < 0.05). Conclusions Considering the antimicrobial potency, triple antibiotic paste seems to be the safest drug for the stem cells of apical papilla, while Augmentin may have some adverse effects.

Effect of Different Intracanal Medicaments on the Viability and Survival of Dental Pulp Stem Cells

“…In our study, calcium hydroxide exposure up to 25 µg/mL did not significantly affect the viability of dental pulp stem cells after 48 h. In contrast, a previous study showed that calcium hydroxide is not toxic for stem cells of the apical papilla (SCAPs) and increases cell survival and proliferation [23]. However, an evaluation of calcium hydroxide's cytotoxicity towards SCAPs at its minimum bactericidal concentration showed higher toxicity than antimicrobial combinations [24]. Our study presents a similar result, additionally highlighting that both concentration and time of exposure contribute to its cytotoxic effect.…”

<strong>Effectiveness of ChKM solution compared to triple-antibiotic paste as an intracanal medicament for bacteria that cause a chronic periapical abscess</strong>

“…20 The results show that TAP has antibacterial effectiveness against E. faecalis. These results align with the research of Khoshkhounejad et al 21 stated that TAP with clindamycin modification can inhibit and kill E. faecalis.A study conducted by Sabrah et al 22 showed that at a concentration of 300 µg/mL, the TAP consisting of metronidazole, ciprofloxacin, and minocycline showed bactericidal activity against E. faecalis.…”

The Effects of Intracanal Irrigants and Medicaments on Dental-Derived Stem Cells Fate in Regenerative Endodontics: An update

“…Vice versa, high concentrations of TAP or DAP (1000 mg/mL) altered SCAPs viability [72]. According to a recent study, TAP induced less cytotoxic effect against SCAPs and it is the safest antibiotic, compared to DAP and Ca(OH) 2 [89]. Alghilan et al indicated that TAP enhanced the attachment of DPSCs to the dentin, while, TAP, DAP, and Ca(OH) 2 reduced DPSCs proliferation [76].…”