Dahake Prasanna T, Kothari Sonal
Department of Pediatric and Preventive Dentistry, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education & Research (DMIHER) (Deemed to be University), Wardha, Maharashtra, India.
Department of Pediatric Dentistry, Pacific Dental College & Research Center, Udaipur, Rajasthan, India.
Int J Clin Pediatr Dent. 2023 Mar-Apr;16(2):312-320. doi: 10.5005/jp-journals-10005-2521.
The ineffective disinfection potential of conventional intracanal medicaments to eliminate enteropathogens from root canal systems leads to their persistence contributing to endodontic treatment failures. Hence, the use of appropriate intracanal medicament becomes the essential phase to accomplishing comprehensive decontamination of the root canal system. When applied topically as an intracanal medicament, antibiotics eradicate residual microorganisms from tortuous endodontic spaces, minimizing the risk of systemic toxicity.
To evaluate the prevalence of various bacterial species associated with signs of irreversible pulpitis and pulp necrosis with/without abscess in primary teeth root canals and their susceptibility against three antimicrobial agents.
The pulp tissue and organic debris were retrieved from deciduous teeth ( = 50) from children between the age of 3-10 years and cultured. The bacterial identification and antibacterial profiling of isolated bacteria were done against clindamycin, metronidazole, and doxycycline through minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) assay. The MIC and MBC of each antibiotic were expressed as mean ± standard deviation (SD), range, and standard error (SE of the mean). The intergroup comparisons were done by the Kruskal-Wallis test, while intragroup pair-wise comparisons were done using the Wilcoxon signed-rank test. The confidence level will be set at 95%.
Aerobic bacteria were found in 54%, microaerophilic bacteria in 76%, facultative anaerobes in 26%, and obligatory anaerobes were isolated from 30% of teeth. The intragroup and intergroup comparisons of test agent MIC revealed a nonsignificant difference ( > 0.05). The intragroup MBC comparisons of all the test agents revealed statistically nonsignificant ( > 0.05), while intergroup comparisons demonstrated nonsignificant ( > 0.05) to highly significant difference ( < 0.001).
Clindamycin demonstrated promising antibacterial activity against most of the isolated bacteria, while against metronidazole and doxycycline, most of the bacteria were moderate to highly resistant.
Determining the antibacterial agents' efficacy along with modifications can help to target maximum pathogenic microbes and reduce catastrophic endodontic therapy failures.
Dahake PT, Kothari S. Microbiological Profile of Primary Teeth with Irreversible Pulpitis and Pulp Necrosis with/without Abscess and their Susceptibility to Three Antibiotics as Intracanal Medication. Int J Clin Pediatr Dent 2023;16(2):312-320.
传统根管内药物消除根管系统中肠道病原体的消毒效果不佳，导致这些病原体持续存在，从而导致牙髓治疗失败。因此，使用合适的根管内药物成为实现根管系统全面消毒的关键阶段。当作为根管内药物局部应用时，抗生素可根除弯曲根管空间内的残留微生物，将全身毒性风险降至最低。
评估与乳牙根管中不可逆性牙髓炎和牙髓坏死伴/不伴脓肿体征相关的各种细菌种类的流行情况，以及它们对三种抗菌药物的敏感性。
从3至10岁儿童的乳牙（n = 50）中获取牙髓组织和有机碎屑并进行培养。通过最低抑菌浓度（MIC）和最低杀菌浓度（MBC）测定，对分离出的细菌进行针对克林霉素、甲硝唑和强力霉素的细菌鉴定和抗菌谱分析。每种抗生素的MIC和MBC以平均值±标准差（SD）、范围和标准误（平均值的SE）表示。组间比较采用Kruskal-Wallis检验，组内成对比较采用Wilcoxon符号秩检验。置信水平设定为95%。
54%的牙齿中发现需氧菌，76%的牙齿中发现微需氧菌，26%的牙齿中发现兼性厌氧菌，30%的牙齿中分离出 obligatory anaerobes（此处原文有误，可能是obligate anaerobes，即专性厌氧菌）。测试药物MIC的组内和组间比较显示无显著差异（P > 0.05）。所有测试药物的组内MBC比较显示无统计学意义（P > 0.05），而组间比较显示无显著差异（P > 0.05）至高显著差异（P < 0.001）。
克林霉素对大多数分离出的细菌显示出有前景的抗菌活性，而大多数细菌对甲硝唑和强力霉素具有中度至高耐药性。
确定抗菌药物的疗效并进行调整有助于针对最大数量的致病微生物，减少灾难性的牙髓治疗失败。
Dahake PT, Kothari S. 乳牙不可逆性牙髓炎和牙髓坏死伴/不伴脓肿的微生物学特征及其对三种抗生素作为根管内用药的敏感性。《国际临床儿科牙科学杂志》2023；16(2):312 - 320。
