Awghad Srushti, Mahapatra Joyeeta, Reche Amit, Burse Ankita, Kibe Aradhana
Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND.
Public Health Dentistry, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND.
Cureus. 2024 Jun 14;16(6):e62349. doi: 10.7759/cureus.62349. eCollection 2024 Jun.
Infection of the dental pulp involves mainly Gram-negative, anaerobic bacterial flora and due to this infection, the periapical area experiences an immunological response, which is termed a periapical lesion. This lesion may appear as a radiolucent (dark) area on X-rays, which indicates periapical inflammation and infection. Its prevalence depends on factors such as age, oral health maintenance, and dental care. Men are more likely to be affected by this infection than women. There are two modalities for the treatment of periapical lesions: surgical or non-surgical endodontic therapy. The modified triple antibiotic paste (TAP) comprising ciprofloxacin, metronidazole, and clindamycin in the ratio of 1:1:1 was first prepared expressly to treat the teeth with necrotic pulp and to support the protocol for revitalization and regrowth. The treatment was very successful in eliminating germs from the root canal system. It provides broad-spectrum antimicrobial activity against a wide range of bacteria commonly associated with endodontic infections. The modified TAP is usually inserted into the canal for a predetermined amount of time and then removed followed by the irrigation of root canal, which helps to eliminate the microorganisms from the root canal. The non-surgical treatment should always be the first choice over the surgical approach so as to avoid a more invasive procedure.
牙髓感染主要涉及革兰氏阴性厌氧菌菌群，由于这种感染，根尖周区域会发生免疫反应，这被称为根尖周病变。这种病变在X射线上可能表现为透射（暗）区，表明根尖周炎症和感染。其患病率取决于年龄、口腔卫生维护和牙科护理等因素。男性比女性更容易受到这种感染的影响。根尖周病变有两种治疗方式：手术或非手术牙髓治疗。改良三联抗生素糊剂（TAP）由环丙沙星、甲硝唑和克林霉素按1:1:1的比例配制而成，最初是专门为治疗牙髓坏死的牙齿而制备的，并支持牙齿复活和再生方案。该治疗在消除根管系统中的细菌方面非常成功。它对多种通常与牙髓感染相关的细菌具有广谱抗菌活性。改良TAP通常在根管内放置预定时间，然后取出，接着进行根管冲洗，这有助于从根管中清除微生物。非手术治疗应始终优先于手术方法，以避免更具侵入性的操作。
