Betancourt Pablo, Bucchi Cristina, Arroyo-Bote Sebastiana
Research Centre for Dental Sciences (CICO), Department of Integral Adult Dentistry, Universidad de La Frontera, Temuco, Chile.
Associate Professor at the Faculty of Medicine and Health Sciences. University of Barcelona. Spain. Coordinating Professor of ADEMA. University of the Balearic Islands. Spain. IDIBELL Researcher.
J Clin Exp Dent. 2021 Aug 1;13(8):e755-e761. doi: 10.4317/jced.58114. eCollection 2021 Aug.
Crown discoloration is an undesirable side effect of the use of triple antibiotic paste (TAP) in regenerative endodontic procedures (REPs). The aim of this ex vivo study was to assess the potential for tooth discoloration and induction of fluorescence associated with the use of TAP containing either doxycycline (DOX) or clindamycin (CLIN), and of calcium hydroxide (Ca(OH)2), by spectrophotometric analysis and confocal laser scanning microscopy (CLSM).
A total of forty single-rooted human teeth extracted by therapeutic indication were used. The root canals were enlarged using the step-back technique up to a K #80 file and were randomly divided into four experimental groups (10 specimens each): i)Ca(OH)2 group, ii)TAP with DOX group, iii) TAP with CLIN group, iv) Control group (no treatment). To quantify the change of color of the different groups of teeth included, the Vita Easyshade advance 4.0 spectrophotometer was used. CLSM was used to determine fluorescence.
After 28 days of action inside the root canal, no extreme discoloration was visible, to the naked eye, in any of the teeth included in the study. Under the conditions of this ex vivo study, TAP with DOX induced the highest crown discoloration among the medicaments tested. In contrast, Ca(OH)2 and TAP with CLIN did not induce crown discoloration after 28 days. The TAP with DOX group presented the highest fluorescence measurements.
Considering the discoloration potential and fluorescence changes in TAP with DOX or other tetracyclines, and the cytotoxic effect of TAPs, we recommend the use of Ca(OH)2 for REPs. Discoloration, doxycycline, clinadamycin, calcium hydroxide, endodontics.
在牙髓再生治疗（REP）中，使用三联抗生素糊剂（TAP）会导致牙冠变色，这是一种不良副作用。本体外研究的目的是通过分光光度分析和共聚焦激光扫描显微镜（CLSM）评估含有强力霉素（DOX）或克林霉素（CLIN）的TAP以及氢氧化钙（Ca(OH)₂）使用后牙齿变色和诱导荧光的可能性。
共使用40颗因治疗需要拔除的单根人牙。采用逐步后退技术将根管扩大至K #80锉，并随机分为四个实验组（每组10个样本）：i）Ca(OH)₂组，ii）含DOX的TAP组，iii）含CLIN的TAP组，iv）对照组（未治疗）。使用Vita Easyshade advance 4.0分光光度计对不同组牙齿的颜色变化进行量化。使用CLSM确定荧光。
在根管内作用28天后，肉眼观察，本研究中纳入的任何牙齿均未出现极度变色。在本体外研究条件下，含DOX的TAP在所测试药物中导致的牙冠变色最严重。相比之下，Ca(OH)₂和含CLIN的TAP在28天后未导致牙冠变色。含DOX的TAP组的荧光测量值最高。
考虑到含DOX或其他四环素的TAP的变色可能性和荧光变化，以及TAP的细胞毒性作用，我们建议在牙髓再生治疗中使用Ca(OH)₂。变色、强力霉素、克林霉素、氢氧化钙、牙髓病学。
