The Effects of Double Antibiotic Paste and Amoxicillin-Clavulanate Paste Used in Endodontic Regeneration on Microhardness of Radicular Dentine: An In vitro Study

Abstract

Objective: Double antibiotic paste is a root canal medicament used in regenerative endodontics and its long-term exposure to dental hard tissues was shown to reduce its mechanical properties. The amoxicillin-clavulanate paste is a medicament effective against endodontic pathogens and is effective in endodontic regeneration. Its effect on radicular dentine is yet to be investigated. The purpose of this study is to investigate and compare the effects of double antibiotic paste and amoxicillin-clavulanate paste on the microhardness of radicular dentine. Materials and Methods: The root canal of 45 premolars was mechanically prepared and divided into three groups for the placement of intracanal medicament: Group 1 ( n = 15) double antibiotic paste, Group 2 ( n = 15) amoxicillin-clavulanate paste, and Group 3 control group ( n = 15). All the specimens were subject to microhardness testing at 500 and 1000 microns depth for 1 week, 1 month, and 3 months and analyzed. Results: There is no significant reduction in microhardness of radicular dentin at 1 week on all the three groups. At 1 month and 3 month period, the amoxicillin-clavulanate paste is found to have no significant effect on dentin microhardness when compared to double antibiotic paste. Conclusion: The use of amoxicillin-clavulanate paste as an intracanal medicament does not cause significant weakening of dentin even after its long-term use.

The antimicrobial efficacy of graphene oxide, double antibiotic paste, and their combination against Enterococcus faecalis in the root canal treatment

“…This content is excluded in DAP (metronidazole and ciprofloxacin), which is still adequately efficient against E. faecalis and Porphyromonas gingivalis [ 9 , 10 ], and indicated in case of failure of commonly-used medicaments [ 1 ]. However, while even short-term application of antibiotic combinations (as in TAP and DAP) can increase the risk of antibacterial resistance, long-term exposure to DAP may cause demineralization and negatively affect the mechanical properties of dental hard tissues [ 11 ].…”

Effect of two graphene derivatives on <i>Enterococcus faecalis</i> biofilms and cytotoxicity

“…The ability of E. faecalis to form biofilms could also confer up to 1,000 times stronger resistance against antibiotic agents than in planktonic conditions 4,5) . Many researchers have performed experiments to eliminate E. faecalis from the root canal and prevent E. faecalis reinfection using various antibacterial materials, including nanoparticles [6][7][8][9] .…”

Healing of large endodontic lesions using a new combination of triple antibiotics: A case report

“…9 , 10 Some other studies have removed minocycline from the combination without any replacements for the drug; however, the double antibiotic paste comprising ciprofloxacin and metronidazole lack the antibacterial activity related to minocycline. 11 In a recent study, a novel combination of triple antibiotics was introduced (penicillin G, metronidazole, and ciprofloxacin; PMC), which exhibited a wide range of antibacterial activity with penicillin G as one of its components affecting Enterococcus faecalis , a dominant microorganism found in endodontic failure. Moreover, the combination revealed acceptable antibiotic activity against other prevailing intracanal microbiota.…”

“…As a result, modifications of TAP (mTAP), with cefaclor, amoxyclav, clindamycin, and amoxicillin as possible replacements for minocycline, have been studied; nevertheless, related research has reported degrees of tooth discoloration immediately or after a time period of using mTAP 9,10 . Some other studies have removed minocycline from the combination without any replacements for the drug; however, the double antibiotic paste comprising ciprofloxacin and metronidazole lack the antibacterial activity related to minocycline 11 . In a recent study, a novel combination of triple antibiotics was introduced (penicillin G, metronidazole, and ciprofloxacin; PMC), which exhibited a wide range of antibacterial activity with penicillin G as one of its components affecting Enterococcus faecalis , a dominant microorganism found in endodontic failure.…”