Division of Dental Biomaterials, Department of Biomedical and Applied Sciences, Indiana University School of Dentistry, Indianapolis, Indiana; Department of Clinical Dentistry, Endodontics, Federal University of Bahia, Salvador, Bahia, Brazil.
Dentistry Department, Endodontics, Federal University of Sergipe, Lagarto, Sergipe, Brazil.
J Endod. 2017 Sep;43(9S):S51-S56. doi: 10.1016/j.joen.2017.06.009. Epub 2017 Aug 1.
The elimination of microbial flora in cases of immature permanent teeth with necrotic pulp is both key and a challenging goal for the long-term success of regenerative therapy. Recent research has focused on the development of cell-friendly intracanal drug delivery systems. This in vitro study aimed to investigate the antimicrobial action of 3-dimensional (3D) tubular-shaped triple antibiotic-eluting nanofibrous constructs against a multispecies biofilm on human dentin. Polydioxanone polymer solutions, antibiotic-free or incorporated with metronidazole, ciprofloxacin, and minocycline, were electrospun into 3D tubular-shaped constructs. A multispecies biofilm consisting of Actinomyces naeslundii, Streptococcus sanguinis, and Enterococcus faecalis was forced inside the dentinal tubules via centrifugation in a dentin slice in vitro model. The infected specimens were exposed to 2 experimental groups (ie, 3D tubular-shaped triple antibiotic-eluting constructs and triple antibiotic paste [TAP]) and 2 control groups (7-day biofilm untreated and antibiotic-free 3D tubular-shaped constructs). Biofilm elimination was quantitatively analyzed with confocal laser scanning microscopy. Confocal laser scanning microscopic (CLSM) analysis showed a dense population of viable (green) bacteria adhered to dentin and penetrated into the dentinal tubules. Upon 3D tubular-shaped triple antibiotic-eluting nanofibrous construct exposure, nearly complete elimination of viable bacteria on the dentin surface and inside the dentinal tubules was shown in the CLSM images, which was similar (P < .05) to the bacterial death promoted by the TAP group but significantly greater when compared with both the antibiotic-free 3D tubular-shaped constructs and the control (saline). The proposed 3D tubular-shaped antibiotic-eluting construct showed pronounced antimicrobial effects against the multispecies biofilm tested and therefore holds significant clinical potential as a disinfection strategy before regenerative endodontics.
在牙髓坏死的未成熟恒牙中消除微生物菌群,对于再生治疗的长期成功至关重要,也是一个具有挑战性的目标。最近的研究集中在开发细胞友好的根管内药物输送系统上。本体外研究旨在研究 3 维(3D)管状三重抗生素洗脱纳米纤维结构对人牙本质上多菌种生物膜的抗菌作用。聚二恶烷酮聚合物溶液,无抗生素或掺入甲硝唑、环丙沙星和米诺环素,通过静电纺丝成 3D 管状结构。多菌种生物膜由奈瑟氏放线菌、血链球菌和粪肠球菌组成,通过在体外牙本质切片中离心,强制进入牙本质小管内。将感染标本暴露于 2 个实验组(即 3D 管状三重抗生素洗脱结构和三重抗生素糊剂[TAP])和 2 个对照组(7 天未处理生物膜和无抗生素 3D 管状结构)。用共聚焦激光扫描显微镜对生物膜清除进行定量分析。共聚焦激光扫描显微镜(CLSM)分析显示,大量存活的(绿色)细菌附着在牙本质上并渗透到牙本质小管中。在 3D 管状三重抗生素洗脱纳米纤维结构暴露后,CLSM 图像显示牙本质表面和牙本质小管内几乎完全消除了存活细菌,这与 TAP 组促进的细菌死亡相似(P<0.05),但与无抗生素 3D 管状结构相比,明显更大。与对照组(生理盐水)相比。所提出的 3D 管状抗生素洗脱结构对测试的多菌种生物膜表现出明显的抗菌作用,因此作为再生牙髓治疗前的消毒策略具有重要的临床潜力。