On the local applications of antibiotics and antibiotic‐based agents in endodontics and dental traumatology

Abstract

Antibiotics are a valuable adjunctive to the armamentarium available to health professionals for the management of bacterial infections. During endodontic treatment and when managing trauma to the teeth, antibiotics may be applied systemically (orally and/or parenterally) or locally (i.e. intra-dentally via irrigants and medicaments). Due to the potential risk of adverse effects following systemic application, and the ineffectiveness of systemic antibiotics in necrotic pulpless teeth and the periradicular tissues, the local application of antibiotics may be a more effective mode for delivery in endodontics. The aim of this article was to review the history, rationale and applications of antibiotic-containing irrigants and medicaments in endodontics and dental traumatology. The search was performed from 1981 to 2008 and was limited to English-language papers. The keywords searched on Medline were 'Antibiotics AND endodontics', 'Antibiotics AND root canal irrigation', 'Antibiotics AND intra-canal medicament', 'Antibiotics AND Dental trauma' and 'Antibiotics AND root resorption'. The reference section of each article was manually searched to find other suitable sources of information. It seems that local routes of antibiotic administration are a more effective mode than systemic applications. Various antibiotics have been tested in numerous studies and each has some advantages. Tetracyclines are a group of bacteriostatic antibiotics with antibacterial substantivity for up to 12 weeks. They are typically used in conjunction with corticosteroids and these combinations have anti-inflammatory, anti-bacterial and anti-resorptive properties, all of which help to reduce the periapical inflammatory reaction including clastic-cell mediated resorption. Tetracyclines have also been used as part of irrigating solutions but the substantivity is only for 4 weeks. Clindamycin and a combination of three antibiotics (metronidazole, ciprofloxacin and minocycline) have also been reported to be effective at reducing bacterial numbers in the root canal systems of infected teeth.

An endodontic practice profile amongst general dental practitioners in Kathmandu: A questionnaire survey

“…32 The common method of using bead sterilizer for sterilization time of few seconds is not effective and the sterilization time has to be at least 60 sec. 33 …”

Atividade Antimicrobiana Da Pasta Triantibiótica: Uma Revisão De Literatura

“…Essa combinação também ajuda a diminuir a probabilidade de estirpes resistentes 16 . A Pasta Triantibiotica é uma pasta composta por metronidazol, ciprofloxacina e minociclina.…”

Antimicrobial Effect of Different Root Canal Medicaments on Enterococcus Faecalis: in vitro Comparative Study

“…Owing to the potential risk of adverse effects and ineffectiveness of systemic antibiotics in necrotic pulpless teeth and the periradicular tissues, the local application of antibiotics may be a more effective mode for delivery in endodontics. [15,16] Due to their effectiveness, minimal toxicity and relatively low cost, penicillins, including amoxicillin constitute the first choice of antibiotics for odontogenic infections [17]. Furthermore, tetracyclines, including doxycycline have been used to remove the smear layer from instrumented root canal walls, for irrigation of apical root-end cavities during periapical surgical procedures, and as an intracanal medicament [18].…”