Barve Archita, Lakade Laxmi, Shah Preetam, Chaudhary Shweta, Jajoo Shweta, Joshi Gandhali
Pediatric Dentistry, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Pune, IND.
Cureus. 2025 Apr 23;17(4):e82876. doi: 10.7759/cureus.82876. eCollection 2025 Apr.
Intracanal medicaments, such as antibiotic pastes, in infected primary teeth have been evaluated to treat persistent polymicrobial infections, especially with resistant species like and . Advanced formulations such as triple antibiotic paste (TAP), calcium hydroxide (Ca(OH)₂), clindamycin-modified TAP, and nanoparticle-based medicaments have been studied for microbial reduction and clinical outcomes. This systematic review included studies that had evaluated antibiotic pastes for intracanal use in primary teeth. A comprehensive electronic database search was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and studies were evaluated for eligibility on a population, exposure, comparator, outcome, and study design (PECOS) framework. A comprehensive search was conducted across seven electronic databases that included PubMed, Scopus, Web of Science, ScienceDirect, Cochrane Library, Embase, and Google Scholar. Risk of bias was evaluated using RoB 2.0 and QUIN tools. Out of 381 studies, 11 studies met the inclusion criteria, which evaluated medicaments such as TAP, Ca(OH)₂, clindamycin-modified TAP, 3C paste, chitosan chlorhexidine (CS-CHX) nanoparticles, and herbal alternatives. Results showed that TAP and its modified forms showed better antimicrobial efficacy, with reductions of up to 99.95% for aerobes and 99.78% for anaerobes. New formulations like nanoparticle-based drugs and 3C paste are promising but need clinical validation. This study suggests the potential of tailored intracanal medicaments in pediatric endodontics.
已对感染乳牙中的根管内药物，如抗生素糊剂，进行评估以治疗持续性混合微生物感染，尤其是针对如[具体菌种1]和[具体菌种2]等耐药菌。已对诸如三联抗生素糊剂（TAP）、氢氧化钙（Ca(OH)₂）、克林霉素改性TAP以及基于纳米颗粒的药物等先进制剂进行了微生物减少和临床疗效方面的研究。本系统评价纳入了评估乳牙根管内使用抗生素糊剂的研究。按照系统评价和Meta分析的首选报告项目（PRISMA）指南进行了全面的电子数据库检索，并在人群、暴露、对照、结局和研究设计（PECOS）框架下对研究的纳入资格进行了评估。在包括PubMed、Scopus、科学网、ScienceDirect、Cochrane图书馆、Embase和谷歌学术在内的七个电子数据库中进行了全面检索。使用RoB 2.0和QUIN工具评估偏倚风险。在381项研究中，有11项研究符合纳入标准，这些研究评估了诸如TAP、Ca(OH)₂、克林霉素改性TAP、3C糊剂、壳聚糖氯己定（CS-CHX）纳米颗粒以及草药替代品等药物。结果表明，TAP及其改性形式显示出更好的抗菌效果，需氧菌减少高达99.95%，厌氧菌减少高达99.78%。基于纳米颗粒的药物和3C糊剂等新制剂很有前景，但需要临床验证。本研究表明了定制化根管内药物在儿童牙髓病学中的潜力。
