Department of Endodontics, University of Texas Health Science Center at San Antonio, San Antonio, Texas 78229, USA.
J Endod. 2012 Oct;38(10):1372-5. doi: 10.1016/j.joen.2012.06.018. Epub 2012 Aug 16.
Regenerative endodontic procedures are an alternative treatment for immature teeth with necrotic pulps. Typically, intracanal medicaments such as triple antibiotic paste (TAP) or double antibiotic paste (DAP) and calcium hydroxide (CaOH) are used for disinfection. However, their effect on human stem cells of the apical papilla (SCAPs) is unknown. We hypothesized that intracanal medicaments at high concentrations are toxic to SCAPs. To test this hypothesis, a cell culture assay was used.
Briefly, SCAPs were cultured and subjected to either no drug treatment or various concentrations including TAP, DAP, modified TAP (ciprofloxacin, metronidazole and cefaclor), Augmentin (Champs Pharmacy, San Antonio, TX), or Ca(OH)(2). Viable stem cells counts were obtained using an automated method of detecting trypan blue dye at 3 days after treatment.
All 4 antibiotics significantly reduced SCAP survival in a concentration-dependent fashion. Interestingly, Ca(OH)(2) was conducive with SCAP survival at all concentrations.
Collectively, our data show that high concentrations of antibiotics have a detrimental effect on SCAP survival, whereas lower concentrations as well as Ca(OH)(2) at all tested concentrations are conducive with SCAP survival and proliferation. These studies highlight the clinically important point that intracanal medicaments must be used at concentrations that are bactericidal while having minimal effects on stem cell viability.
再生性牙髓治疗是牙髓坏死未成熟恒牙的一种替代疗法。通常，三抗（TAP）或双抗（DAP）糊剂和氢氧化钙（CaOH）等根管内药物用于消毒。然而，它们对根尖乳头干细胞（SCAPs）的影响尚不清楚。我们假设高浓度的根管内药物对 SCAPs 有毒性。为了验证这一假设，我们进行了细胞培养实验。
简要地说，SCAPs 经培养后，分别给予无药物处理或不同浓度的 TAP、DAP、改良 TAP（环丙沙星、甲硝唑和头孢克洛）、奥格门汀（Champs Pharmacy，圣安东尼奥，TX）或 Ca(OH)(2)处理。在治疗后 3 天，使用自动检测台盼蓝染料的方法获得活干细胞计数。
所有 4 种抗生素均以浓度依赖性方式显著降低 SCAP 存活率。有趣的是，Ca(OH)(2)在所有浓度下均有利于 SCAP 存活。
总之，我们的数据表明，高浓度的抗生素对 SCAP 存活有不利影响，而较低浓度以及 Ca(OH)(2)在所有测试浓度下均有利于 SCAP 的存活和增殖。这些研究强调了一个重要的临床观点，即根管内药物必须以既能杀菌又能将对干细胞活力的影响降到最低的浓度使用。
