Department of Conservative Dentistry and Endodontics, Saveetha University, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Chennai, India.
Department of Biomaterials, Saveetha University, Saveetha Dental College and Hospital, Saveetha Institute of Medical and Technical Sciences (SIMATS), Chennai, India.
Eur Endod J. 2024 Mar;9(2):154-160. doi: 10.14744/eej.2023.06977.
Triple antibiotic paste (TAP) is known to have an essential role in the success of endodontic treatment by eliminating pathogens from the root canal system. Unfortunately, it causes discolouration and cytotoxicity at high concentrations. The objective of this research was to assess and compare the antimicrobial effectiveness of various concentrations (1 mg, 5 mg, 10 mg) of TAP, TAP hydrogel (TAPH), M-TAP, and M-TAP hydrogel (MTAPH) against Enterococcus faecalis.
The agar well diffusion method was used to assess the antibiotic sensitivity of the following intracanal medicaments: TAP (ciprofloxacin, metronidazole, and minocycline) mixed in a ratio of 1: 1: 1; TAPH, M-TAP (ciprofloxacin, metronidazole, and amoxicillin), M-TAPH and plain hydrogel. Each tested medicament was individually evaluated for its antimicrobial activity against Enterococcus faecalis. Structural and topographical characterisation were analysed using a Scanning Electron Microscope (SEM) and interpreted using ImageJ software. A microdilution broth test was performed to examine the minimum inhibitory concentration and minimum bactericidal concentration (MBC) of M-TAP and TAP.
Except for the plain hydrogel, M-TAP and hydrogel and TAP and hydrogel showed significantly varied inhibitory zones at different concentrations. M-TAPH showed the highest mean zone of inhibition of 21.6, 33.33 and 38.0 mm at a concentration of 1, 5, and 10 mg/mL when compared to TAPH, which showed a mean zone of inhibition of 3.3 mm,12.3 mm, 21.3 mm at the respective concentrations. The MIC study shows that more than 75% of Enterococcus faecalis growth was inhibited by M-TAP at a concentration of 5 μg/mL, whereas TAP showed inhibition at a concentration of 35 μg/mL. MBC results indicate that almost 99.9% of the bacterial population was killed at a concentration of 100 μg/mL (10-1) for TAP and 10 μg/mL (10-2) for M-TAP.
The antibacterial efficacy of M-TAP was significantly higher than TAP. Application of M-TAP at lower doses is advised to overcome the disadvantages seen with TAP.
三抗生素糊剂（TAP）通过从根管系统中消除病原体，在根管治疗的成功中起着重要作用。然而，它在高浓度下会导致变色和细胞毒性。本研究的目的是评估和比较 TAP 的不同浓度（1mg、5mg、10mg）、TAP 水凝胶（TAPH）、M-TAP 和 M-TAP 水凝胶（MTAPH）对粪肠球菌的抗菌效果。
采用琼脂孔扩散法评估以下根管内药物的抗生素敏感性：TAP（环丙沙星、甲硝唑和米诺环素）以 1:1:1 的比例混合；TAPH、M-TAP（环丙沙星、甲硝唑和阿莫西林）、M-TAPH 和普通水凝胶。单独评估每种测试药物对粪肠球菌的抗菌活性。使用扫描电子显微镜（SEM）分析结构和形貌特征，并使用 ImageJ 软件进行解释。进行微量稀释肉汤试验以检查 M-TAP 和 TAP 的最小抑菌浓度（MIC）和最小杀菌浓度（MBC）。
除普通水凝胶外，M-TAP 和水凝胶以及 TAP 和水凝胶在不同浓度下显示出明显不同的抑制带。M-TAPH 在浓度为 1、5 和 10mg/ml 时显示出最高的平均抑制区，分别为 21.6、33.33 和 38.0mm，而 TAPH 分别为 3.3、12.3 和 21.3mm。MIC 研究表明，M-TAP 在浓度为 5μg/ml 时抑制了超过 75%的粪肠球菌生长，而 TAP 在浓度为 35μg/ml 时显示出抑制作用。MBC 结果表明，在浓度为 100μg/ml（10-1）时，TAP 几乎杀灭了 99.9%的细菌，而 M-TAP 在浓度为 10μg/ml（10-2）时杀灭了 99.9%的细菌。
M-TAP 的抗菌效果明显高于 TAP。建议以较低的剂量应用 M-TAP，以克服 TAP 存在的缺点。
