Reduction of viable bacteria in dentinal tubules treated with a novel medicament (Z-Mix)

Abstract

Background/purpose The 3Mix-MP formulation (a mixture of metronidazole, ciprofloxacin, and minocycline; macrogol and propylene glycol) has been used to kill residual bacteria in dentin caries. This study aimed to investigate the dentin disinfection and cytotoxicity of a novel zinc oxide (ZnO) based medicament, Z-Mix. Materials and methods Z - Mix was prepared as a prefilled syringe of materials containing mainly ZnO, incorporated with amoxicillin, ciprofloxacin, and metronidazole (1 g% of each antibiotic). Drug penetration was measured at 24 hours and 72 hours. Streptococcus mutans , Lactobacillus acidophilus , or Enterococcus faecalis were inoculated into dentinal tubules for 30 days and were then subjected to Z-Mix or 0.2% chlorhexidine (CHX) for 48 hours. Viable bacteria in the dentin were determined using fluorescence staining. Their cytotoxicity against human dental pulp cells was assessed using an MTT assay. Results Z - Mix obviously diffused into dentinal tubules and the root apex, compared to the 3Mix-MP (P < 0.05). Fluorescence staining demonstrated a reduction of viable bacteria at 100 μm and 500 μm below infected cavities after treatment with Z-mix or CHX for 48 hours. Live and dead bacteria ratios indicated that Z-Mix exhibited markedly antimicrobial effects on inoculated bacteria in dentin samples (P < 0.05). There was no significant difference in the antimicrobial property between Z-Mix and CHX (P > 0.05). An acceptable level of cytotoxicity was observed in Z-Mix and its ingredients. Conclusion Z-Mix, a soft shapeable paste containing a mixture of three antibiotics, is successfully. It can penetrate to the root apex and exhibits antimicrobial properties.

The viability of human dental pulp cells and apical papilla cells after treatment with conventional calcium hydroxide and nanoparticulate calcium hydroxide at various concentrations

“…Hence, conventional Ca(OH) 2 could not reach the deeper parts of dentin, and it was unable to kill Enterococcus faecalis ( E. faecalis ), which is the predominant resistant species, in the dentinal tubule ( Dianat et al, 2015a , Sirén et al, 2004 ). Bacteria can penetrate 300–1500 µm deep into the dentinal tubules ( Tasanarong et al, 2016 ), which are often inaccessible by medicaments ( Dianat et al, 2015b ). In addition to having antimicrobial efficacy, the ability to promote the viability of DPCs and apical papilla cells (APCs) is also critical for success in VPT and REPs. To improve the efficacy of Ca(OH) 2 , size reduction into a nanoparticulate form may be an alternative to enhance its properties ( Dianat et al, 2015a ).…”

Reabsorção radicular patológica em molar decíduo submetido a tratamento endodôntico com pasta à base de Cloranfenicol, Tetraciclina e Óxido de Zinco (CTZ): Relato de caso

“…Devido a essa problemática, o conceito de Lesion Sterilization and Tissue Repair (LSTR) tem sido pautado como alternativa para a terapia pulpar em dentes decíduos desvitalizados, técnica essa que dispensa o preparo mecânico e se embasa pela utilização de combinações de agentes antimicrobianos de largo espectro de atuação (Tasanarong et al, 2016). A pasta CTZ tem mostrado biocompatibilidade em tecido subcutâneo em modelo animal, no entanto, devido à morfologia complexa dos sistemas de canais, irregularidade do ápice radicular, processo de rizólise e proximidade com o germe do permanente ainda restam lacunas científicas a respeito dessa propriedade em humanos (Lima et al 2015;Moura Et al., 2018).…”