Antibacterial Efficacy of Triple Antibiotic Medication With Macrogol (3Mix-MP), Traditional Triple Antibiotic Paste, Calcium Hydroxide, and Ethanol Extract of Propolis: An Intratubular Dentin Ex Vivo Confocal Laser Scanning Microscopic Study.

INTRODUCTION: This study aimed to assess the effectiveness of antibacterial activity of medications used in regenerative endodontic treatment. METHODS: Sixty-seven dentin cylinders of single-rooted teeth were contaminated with a culture of Enterococcus faecalis (ATCC 29212; American Type Culture Collection, Manassas, VA) for 5 days. Samples were divided into 1 control group and the following experimental groups according to the medication applied: traditional triple antibiotic paste (TAP), clindamycin-modified TAP (mTAP), triple antibiotic medication with macrogol (3Mix-MP), clindamycin-modified 3Mix-MP (m3Mix-MP), calcium hydroxide (CH), and ethanol extract of propolis (EEP). After 14 days, the medications were removed, and the samples were submitted to confocal laser scanning microscopic analysis to quantify the percentage of viable bacteria. The distribution of data was confirmed by the Shapiro-Wilk test. The Kruskal-Wallis and Dunn tests were used for intergroup comparisons, and the Wilcoxon test was used for comparison between superficial and deep antibacterial efficacy for the same medication. The level of significance was set at P < .05. RESULTS: 3Mix-MP and m3Mix-MP presented significantly higher antibacterial efficacy compared with the other tested medications (P < .05), except for mTAP. mTAP was more effective than TAP (P < .05). The antibacterial efficacy of EEP and CH did not differ significantly from TAP and mTAP (P > .05). All medications showed effective antibacterial action compared with the control group (P < .05). CONCLUSIONS: 3Mix-MP and m3Mix-MP, which present extremely high concentrations of antibiotics (1500 mg/mL), were not more effective than mTAP at the concentration recommended by the American Association of Endodontists (5 mg/mL). Moreover, CH and EEP were as effective as TAP and mTAP.

Evaluation of Success Rate of Lesion Sterilization and Tissue Repair Compared to Vitapex in Pulpally Involved Primary Teeth: A Systematic Review.

BACKGROUND: Vitapex has been a popular obturating material for several decades. In recent times, lesion sterilization and tissue repair (LSTR) has shown promising results. This technique uses a mixture of 3 antibiotics for sterilization of the root canals and healing of periradicular tissues. OBJECTIVE: The objective of this systematic review was to compile all the literature comparing Vitapex and LSTR for pulpally involved primary teeth and evaluate the success rate in terms of clinical and radiographic outcomes. MATERIALS AND METHODS: This review is based on PRISMA guidelines. The electronic search on MEDLINE via PubMed database and Google scholar, cross-referencing and hand search of journals was carried out for articles from January 1, 2000 to December 31, 2019. Articles only in the English language were selected. Out of the 17 articles, 3 unique articles were identified for the review, of which 2 were randomized controlled trials and 1 was a retrospective study. RESULTS: All the three articles were assessed for their quality and all had a low risk of bias. It was found that LSTR and Vitapex had a high clinical success after 12 months. The radiographic success after 6 months was high but decreased after 12 months in both the groups. CONCLUSION: There is no difference in the success rate of LSTR as compared to Vitapex for the treatment of pulpally involved primary teeth.

Lesion Sterilization and Tissue Repair-Current Concepts and Practices.

A deciduous tooth affected by dental caries involving the pulp tissue with subsequent periradicular pathosis at times makes the conventional endodontic procedures a dilemma for a variety of reasons. In this situation, lesion sterilization and tissue repair (LSTR) stands out as the only option by which dentists could increase the longevity of the deciduous teeth of a young child. This therapy aims to eliminate bacteria from the root canals by sterilizing the lesion and promoting tissue repair and regeneration by the host's natural tissue responses. This article reviews the rationale, indications, contraindications and the procedure in detail. How to cite this article: Sain S, Reshmi J, Anandaraj S, George S, Issac JS, John SA. Lesion Sterilization and Tissue Repair-Current Concepts and Practices, Int J Clin Pediatr Dent. 2018;11(5):446-450.

Tratamiento endodóntico no instrumentado en dientes deciduos: reporte de caso / Non instrumentation endodontic techniques in deciduous teeth. case report

Actualmente, se han publicado diversos casos cl¡nicos que describen la esterilizaci¢n de la lesi¢n pulpar en dientes deciduos como un tratamiento alternativo a la pulpectom¡a, evitando la exodoncia en dientes con necrosis pulpar y absceso. El procedimiento incluye: anestesia local, aislamiento absoluto, apertura cameral, remoci¢n de la pulpa cameral, ampliaci¢n de la entrada a los conductos, colocaci¢n de una pasta triantibi¢tica y la restauraci¢n. Se presenta el reporte de caso de una ni¤a de 4 a¤os de edad, la cual acude a la Cl¡nica Estomatol¢gica Central de la Facultad de Estomatolog¡a Roberto Beltr n de la Universidad Peruana Cayetano Heredia; con dolor, aumento de volumen en la regi¢n inferior izquierda y movilidad de la pieza 75. Radiogr ficamente se observa reabsorci¢n de la ra¡z distal de 1/3 y una lesi¢n osteol¡tica a nivel de la furcaci¢n. Por lo cual se decide realizar el tratamiento endod¢ntico no instrumentado de conductos, acompa¤ado de controles hasta los 12 meses, donde cl¡nicamente permanece asintom tico acompa¤ado con una regeneraci¢n de tejidos blandos, y radiogr ficamente una aposici¢n ¢sea en furca. Se concluye que el tratamiento endod¢ntico no instrumentado, muestra resultados prometedores y podr¡a ser una alternativa a la pulpectom¡a y/o exodoncia en dientes deciduos en algunos casos.

Now a days, clinical cases has been published in which describes the esterilization of pulpar lesi¢n on primary teeths as an alternative treatment to the pulpectomies avoiding the toot extractions on primary and necrotics or abscessed teeth. The procedure includes: local anesthesia, isolation with a rubber dam, remove the necrotic tissue from the coronal portionof the pulp chamber, enlarged of the canal orificie and a three mix paste placed over the pulpar floor. A case of 4 years old girl is presented in this work , that went to “Cl¡nica Estomatol¢gica Central de la Facultad de Estomatolog¡a Roberto Beltr n de la Universidad Cayetano Heredia”, with pain, mandibular left posterior swelling and mobility of her mandibular left second primary molar. X-ray shows 1/3 distal root resorption and furcation radiolucency. The clinical procedure ofnon- instrumented endodontic treatment was performed successfully and 12 months posterior controls was maded, in which soft tissue healing was showed, increased trabeculation in the furcation area, normal mobility and the patient was symptom-free. It concludes that this treatment shows promising results for the future pediatric dentistry and is an alterantive to pulpectomy and tooth extraction.