Premium
Effectiveness and clinical implications of the use of topical antibiotics in regenerative endodontic procedures: a review
Author(s) -
MonteroMiralles P.,
MartínGonzález J.,
AlonsoEzpeleta O.,
JiménezSánchez M. C.,
VelascoOrtega E.,
SeguraEgea J. J.
Publication year - 2018
Publication title -
international endodontic journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.988
H-Index - 119
eISSN - 1365-2591
pISSN - 0143-2885
DOI - 10.1111/iej.12913
Subject(s) - antibiotics , clindamycin , metronidazole , antimicrobial , ciprofloxacin , dentistry , root canal , medicine , microbiology and biotechnology , biology
Regenerative endodontic procedures ( REP s) are biologically based procedures planned to replace damaged tissues, including dentinee and root structures, as well as cells of the pulp–dentine complex. Effective sterilization of the root canal is essential in REP s, and antibiotics have been widely used to disinfect root canals. The aim of this paper was to review the scientific literature on (i) Effectiveness of antibiotics used in REP s against bacteria implicated in endodontic disease; (ii) Scientific evidence supporting the use of topical antibiotics in REP s; (iii) Clinical implications of the use of antibiotics in REP s and the possible side effects; (iv) Effect of antibiotics on dental pulp stem cells; and (v) Ongoing research on the use of antibiotics in REP s. Antibiotics used in REP s are effective against bacteria implicated in endodontic infections. Triple antibiotic pastes with minocycline attain complete disinfection of immature teeth with necrotic pulps, without affecting SCAP . Experimental studies carried out in dogs support the use of antibiotics in REP s. Clinical studies report high success rates of RET using antibiotics as intracanal dressings. However, tooth discolouration is an important side effect of the use of TAP . An antibiotic paste containing only metronidazole and ciprofloxacin could be a good alternative to the use of TAP . The use of antibiotic‐containing scaffolds or clindamycin‐modified triple antibiotic (metronidazole, ciprofloxacin and clindamycin) polymer could be a biologically safe antimicrobial drug delivery system in REP s.