Asgary Saeed, Parhizkar Ardavan
Iranian Centre for Endodontic Research, Research Institute for Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran 198396-3113, Iran.
Case Rep Dent. 2023 Apr 5;2023:6889019. doi: 10.1155/2023/6889019. eCollection 2023.
Apical periodontitis (AP) is defined as an inflammatory and destructive reaction of periapical tissues and a consequence of bacterial invasion to the dental pulp and root canal system. To avoid possible complications and undesirable repercussions of the surgical treatment of large AP, more conservative non-surgical approaches are endorsed. In the presented hopeless cases, a newly introduced modified combination of triple antibiotics, that is Penicillin G, metronidazole, and ciprofloxacin (PMC), was used as a long-term intracanal medication in the non-surgical endodontic retreatments of large AP. In the course of 10-month to 3-year follow-up, the large periapical lesions completely disappeared, and thorough bone healing was evident. Additionally, complete functionality of the involved teeth as well as other favourable treatment outcomes of the addressed cases showed that the long-term use of PMC, as a modified combination of antibiotics, in non-surgical endodontic retreatments may successfully resolve large AP. However, further investigations and well-designed controlled clinical trials are recommended.
根尖周炎（AP）被定义为根尖周组织的炎症性和破坏性反应，是细菌侵入牙髓和根管系统的结果。为避免大型AP手术治疗可能出现的并发症和不良后果，更保守的非手术方法得到认可。在本研究的无望病例中，一种新引入的三联抗生素改良组合，即青霉素G、甲硝唑和环丙沙星（PMC），被用作大型AP非手术牙髓再治疗中的长期根管内用药。在10个月至3年的随访过程中，大型根尖周病变完全消失，骨组织明显完全愈合。此外，患牙的完全功能以及所治疗病例的其他良好治疗结果表明，在非手术牙髓再治疗中长期使用PMC这种改良抗生素组合可能成功解决大型AP。然而，建议进一步开展研究和精心设计的对照临床试验。
